Take a chance

By Amy Bloom

Telling people to take a chance on love is like telling them to get wet when they shower: There is no other way.

There's no love without risk, and, worse, there's no love without loss. It's true, one can live without romantic love and avoid the messiness of breakups, the weirdness of in-laws, and the tedium of another person's annoying habits. Without romantic love you can skip those terrible hours when you lie in bed, not alone, which wouldn't be so bad accompanied by chocolate ice cream and the 3 A.M. rerun of Law & Order—but instead you're next to the man or woman you share your life with, a person who, while claiming to love you, has let you down, disappointed you deeply, abandoned you when you were in great need. And, just as bad, you know you've done the same, and will again. If only perfect people loved, the species would have died before we got upright. And for all the pain and discomfort, and occasional boredom and unkindness, it's still a chance worth taking, which is why happily married people talk about the bad times with the perspective and humor of successful gamblers, and unhappily married people curse the cards, the dealers, and the stars.

Even if you duck out on romance, love, in all of its other forms, can still grab you and make you roll the dice. If we're lucky, we love our children passionately (sometimes so much that there's hardly room for adult passion). We plunge into that great love—some of us frightened and reluctant, some of us realistic and cheerful, some of us in a match-the-diaper-bag-to-the-crib-bumper frenzy—and spend 18 years doing a lot of giving, thinking, sacrificing, planning, and getting back much more:

She's so good at holding the bottle...I better buy a sippy cup. She needs braces...how can I help her not mind the braces? I hope she gets asked to the prom...how can I help her not care about the prom? I want her to be seen in the world as she truly is...how can I help her not care about superficial things, because she's a fine human being, but make sure she gets asked to every dance, because that would be so nice? 

And after all that, they go. If you've done your job well, they grow up and go on, and as close as they remain to you and as much joy as they bring you as the intelligent, interesting adults they've become, those scampering children, those little bottomless pits who took so much of your energy and drive and commitment, are gone. It is, in its way, like a great love affair that must end; that it only lasts a few decades doesn't tarnish its glory. That preoccupying, even blinding, passion does change. And if it doesn't, it probably should. 

Responding to Crisis

Depression is a common psychiatric disorder found in children, adolescents, adults and the elderly (Sharp & Lipsky, 2002). Symptoms of depression include feelings of stress, sadness, hopelessness and agitation (Monroe, et al., 2007). Identifying and assessing clients with severe depression who may be suicidal is important in order to provide the best care and course of treatment.

In my practice, if a client presents with suicidal ideation, the following information is discovered: (1) thoughts of suicide, (2) plan for committing suicide, and (3) accessibility for implementing suicide plan.

If an individual is identified as “low risk” then it is understood by the counselor that the client does not mean to harm self, has no history of suicide attempts, is not a substance abuser and is not physically abused.

An individual identified as a “moderate risk” may have a vague plan of self harm, accessible means of committing suicide, has reported suicidal ideation, and is in a violent or abuse environment.

In order to be identified as “high risk” of committing suicide, an individual would report, describe or detail a specific plan of suicide, possess the mean of committing a suicidal act, have attempted suicide I the past, is substance dependent, and is in a physically violent environment.

Following the above referenced suicide risk assessment, an individual identified as “moderate” risk would complete a suicide contract, identify and develop a support group of friends or family members, and receive treatment for depression with a referral to a physician to determine the need for anti-depressants.

With a high risk client safety is the top priority. The procedures involved with a high risk client include (1) complete a suicide contract, (2) contact individual, identified by client, who will act as client/counselor liaison, (3) encourage client to report to a local in-patient treatment facility.