Your presence can save lives: A practical, evidence-based guide to creating spaces of safety and connection
Disclaimer: This article discusses themes related to suicide and may be emotionally challenging. If you are feeling vulnerable, consider waiting until you are in a more grounded space, or read with the support of someone you trust. This article is for informational purposes only. The PRESENCE framework is designed to support listening and connection, not to replace professional care. It is not a substitute for medical advice, diagnosis, or treatment from a licensed mental health provider. If you are in crisis or having an emergency, please call 911 or go to your nearest emergency room immediately. In the U.S., you can dial or text 988 to connect with the Suicide & Crisis Lifeline for immediate support. If you are outside the U.S., please look up the crisis hotline available in your country.
September is Suicide Awareness Month—a time to remember the importance of hope and the power of open conversation. I wrote the article below to help break stigma, offer support to anyone struggling with suicidal thoughts, and provide guidance for loved ones who want to help. Talking about suicide with honesty and compassion can save lives. My hope is that this piece helps anyone who feels lost feel less alone.
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Suicide prevention begins with presence—the simple, powerful act of sitting with someone in their pain. At its heart, prevention is not just about stopping pain, but about creating spaces where people feel seen, understood, and less alone.
As a clinical psychologist, I've spent thousands of hours with people—many of them children and teens—sitting in the midst of hopelessness and listening to their questions about whether life is worth living. These moments have taught me again and again how much courage it takes to keep going when life feels unbearable.
What's the point? they ask me.
What's the purpose of my life?
It's obvious from social media that there's no place for me in the world.
I've already failed—I'm behind, my grades are terrible, and there's no going back now.
My parents criticize everything about me. I just can't do anything right.
Below is an example of what I might say to someone feeling suicidal. These words were first spoken to me years ago, when I was a young person in the same place—lost, hopeless, and certain there was no way forward. They came from the clinical psychologist who saved my life. He looked at me and said:
"Victoria, I've struggled with suicidal thoughts too.
That's why I know—you don't really want to die. You just want an escape hatch. Suicide is the door your mind has created to escape the pain.
But if you're imagining a way out, it means you're trying to cope. And if you're trying to cope, then that means somewhere inside you, you want to live. So you see, you don't want to die.
Actually, you want to live."
I have since said similar words to many others. And when I look into their eyes, what I see—again and again—is hope.
Notice how he validated my pain without validating the method. That distinction is powerful. Emotional validation is critical when speaking to someone who is suicidal because it communicates, “Your suffering is real and it makes sense.” It opens the door for connection and trust. But he did not validate suicide itself—that would have reinforced despair. Instead, he honored my pain while keeping the focus on life.
This balance is at the heart of suicide prevention: acknowledging suffering without endorsing self-destruction. In Dialectical Behavior Therapy (DBT), an evidence based treatment for depression and suicidality, this is known as dialectical thinking where two opposing truths can exist at once.
Presence is enormously powerful, and yet when someone speaks of wanting to die, fear often drives us to offer reassurances or hopeful phrases like, “But look at all the good things in your life,” or “don't think so much about it,” Although meant kindly, such words can leave a person feeling emotionally unseen and alone.
What people in pain most need is not to be fixed, but to be met with presence. This may feel counterintuitive, yet when someone feels truly seen and understood, space opens—for coping, for safety, for imagining what a life worth living might look like.
Below, I share practical, evidence-based ways to listen and create space for someone in suicidal distress. I call it the PRESENCE framework.
About the PRESENCE Framework
I created the PRESENCE framework to translate evidence-based skills into a relational guide for listening to people in suicidal pain. It reflects the same principles I use in conversations: honoring and validating suffering, without validating the suicidal urge itself.
This framework is not meant to replace professional treatment. Loved ones and supporters are not responsible for treating suicide. PRESENCE is simply a way to listen and offer support—an approach anyone can use to help someone feel less alone until professional help is in place.
PRESENCE is an acronym that teaches us how to support someone in distress. Each letter stands for a simple step in how to listen and make space. But more than steps, PRESENCE is really a way of being—with it, people feel seen, understood, and less alone. Whether you're a parent, teacher, counselor, friend, or even a stranger, you can use the PRESENCE framework to support someone in suicidal distress. It's a powerful tool that can bring comfort, spark hope, and sometimes even save a life.
P – Presence
Be fully there.
Don't fix—just be.
Sit with their pain and stay focused.
Your calm, compassionate presence is powerful.
Suicidal thoughts often live in isolation; presence interrupts loneliness and shame—the primary drivers of suicide.
Be willing to hold their pain with understanding, and to stay with it deeply.
Helpful Example: “I'm here with you.”
Unhelpful Example: “Don't think about it—you'll be fine.”
R – Reflective Listening
Focus on listening to understand, not to fix.
Resist the urge to redirect, reassure, minimize, fix, or convince.
Reflect back what you hear so the person feels understood.
Listen without judgment.
Pay attention not only to words, but also to tone, expression, and body language.
Helpful Examples: “Tell me what you've been feeling.” “It sounds like you are in a lot of pain.”
Unhelpful Example: “You'll get over it—it's not that bad.”
E – Emotion Validation
Let the person know their feelings make sense in light of their experiences.
Validation does not mean you agree with everything they say or do—it means you acknowledge their emotional reality as it is.
Look for the kernel of truth in what they're expressing.
Check the facts: emotions and behaviors don't come out of nowhere—they have causes, and for that reason they're understandable.
Remember: you don't have to agree; you only need to understand where they are coming from.
When emotions are ignored, minimized, or argued against, suffering intensifies and suicidal urges can increase.
When someone feels deeply understood, their suffering and suicidal urges decrease.
Validate the emotion or suffering, not the suicidal urge or action.
Validate only what is valid—stick to the facts.
Avoid a judgmental tone.
Helpful Example: “Given everything you've been going through, it makes sense that you aren't feeling well.”
Unhelpful Example: “You shouldn't feel that way.”
S – Speak Genuinely
Be real. Show up as a human being, not just as a role.
In DBT, this is called radical genuineness—treating the other person as an equal and allowing your own humanity into the space.
Be willing to admit mistakes.
Let go of the pressure to “know it all.”
Honesty and genuineness build trust and connection.
Helpful Example: “You matter to me. I don't have all the answers, but I'm here with you through this.”
Unhelpful Example: “Just try to be positive. Cheer up.”
E – Engage Dialectically
Dialectical thinking means holding multiple truths at once.
You can accept your emotions while also working on changing them.
In suicidal pain, this might sound like: “This feels unbearable—and a part of you still wants to live.”
Two seemingly opposite things can both be true: your pain makes sense given what you've lived through, and there are skills and strategies that can help you move toward a life worth living.
Naming both truths creates space for complexity instead of forcing one to cancel the other.
Examples of dialectics: You can want to die and want to live in the same breath. You can make a mistake and still be a good person. You can feel hopeless and hopeful at the same time.
This openness is a critical quality of the space we must create when listening or speaking with someone in suicidal distress.
Helpful Example: “It sounds like there is a part of you that feels hopeless while another part feels hopeful.”
Unhelpful Example: “You shouldn't feel hopeless—you just need to be positive.”
N – Name the Suicidality Directly
Ask about suicide openly, clearly, and without fear.
Avoid vague language or euphemisms.
Direct questions show respect and reduce shame.
Naming it out loud does not increase risk—it creates safety by giving the person permission to speak the truth.
Silence increases risk; directness increases safety.
Helpful Examples: “Are you thinking about killing yourself?” “Do you have a plan?”
Unhelpful Example: “You're not thinking about suicide, are you?”
C – Curiosity Over Control
Ask questions with openness.
Be curious, not controlling.
Control often comes from fear—the urgency to stop the pain or make it go away.
Attempts to manage or push an agenda can leave someone feeling shut down or unseen.
Curiosity communicates interest and respect. Control communicates fear and avoidance.
When someone feels your curiosity instead of your fear, their pain becomes easier to share—and easier to bear.
Curiosity builds connection; control builds walls.
Helpful Examples: “What does it feel like when the thoughts get strongest?” “What helps, even a little, if anything?”
Unhelpful Examples: “Don't talk like that.” “You have so much to live for.”
E – Embody Hope Without Forcing It
Hold hope, even if the person cannot.
Embodying hope does not mean pushing optimism or offering false reassurances like, “It will all be fine.”
Instead, it means persisting in the belief that change is possible and that their life has value—even when they feel none.
Marsha Linehan, the founder of DBT, described it this way: “Responding to a suicide attempt by insisting that it must stop, and devoting the full resources of therapy to preventing it, is a communication with compassion and care at its very core.”
Her words highlight the dialectic at the heart of this step: recognition of suffering and commitment to life.
Validation says, “Your pain is real.” Commitment says, “Even so, I will stand with you to protect your life.”
Helpful Example: “You don't have to believe in hope right now. I'll hold it for you.”
Unhelpful Example: “Don't worry, you'll be fine.”
Summary (PRESENCE):
P – Presence
R – Reflective Listening
E – Emotion Validation
S – Speak Genuinely
E – Engage Dialectically
N – Name the Suicidality
C – Curiosity Over Control
E – Embody Hope Without Forcing It
By using the PRESENCE framework, you can create not only supportive conversations and spaces for people, but also a greater culture that helps prevent suicide. When you approach someone from this perspective, you aren't dismissing their suffering or demanding instant change. Instead, you are validating their experience while leaving room for hope. Presence—grounded in acceptance, compassion, and the belief that hope is possible—becomes one of the most powerful forms of suicide prevention we have.
Please note that this framework is about listening, not crisis management. Professional help is always essential, but each of us in the community play an important role in cultivating spaces where people in pain feel seen, heard, and less alone.
In conclusion…
Thank you for helping to create spaces of safety and connection. Your willingness to show up with presence makes an immense difference. Presence itself is a form of prevention—when we learn to sit with pain, we help others discover the strength to sit with theirs.
And remember that your presence is not only powerful, it's critically needed. Your story matters. Your humanness is what connects you to others who may be feeling alone, and it is through that shared humanness that healing and hope can grow.
If you found this article helpful, please consider forwarding it along to someone who might benefit. Together, we can remind others that none of us are alone. Thank you so much!!!
