Suicidal ideation is often thought of as a desire to end one's life. However, Firestone (2018) contended that people have two selves. The first is the 'real self,' which re-affirms that life is worth living. The 'anti-self' functions as the alien part of their personality and includes critical and self-destructive voices. The anti-self develops in childhood where children incorporate angry and hostile aspects of their parents' reactions into themselves because it is too painful or threatening to view the danger as coming from the very person they rely on for survival (Firestone, 2018, p. 18). This is why we all tend to have negative concepts about ourselves, regardless of how unrealistic they are. The only thing that makes them real are the actions that we take to validate them.

 

Many people struggling with suicidal ideation report their anti-self telling them things like "you mind as well do it - nobody will care" or "you're better off dying because you don't deserve to live." The anti-self can be harsh, extreme and intense for people who struggle with persistent thoughts of suicide. There is often an event that triggers the anti-self, such as a loss of an important relationship (Firestone, 2018). The good news is that the 'real self' often offers up reasons for living, which makes people ambivalent to dying. This ambivalence is important to amplify in counselling because it gives people the opportunity to challenge the sentiments of the anti-self that have been internalized without being filtered. Although the anti-self can be useful in helping people communicate pain, its hostility towards the self needs to be exposed and re-voiced in order for people to have greater control over what is said between their ears. In addition, people struggling with suicidal ideation also often need strategies to deal with intense emotions, which can exhaust and overwhelm them. Finally, it is important for people feeling suicidal to develop a safety plan, including working with their therapist to connect them to loving and supportive people in their lives and communities. 

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Firestone, R. W. (2018). The enemy within: Separation theory and voice therapy. Pheonix, AZ: Zieg, Tucker, & Theisen.