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I think I can speak to this issue with some credibility.
    I think most people who want to kill themselves feel that way for one basic reason: they’re faced with a problem that they don’t know how to solve, and that they literally don’t feel they can live with. They and the problem can’t live together, and they can’t see any way to eliminate the problem, so they feel they must eliminate themselves. You aid the suicidal person by helping them find an alternative solution. In many ways, the motto of suicide prevention is, “Can you see any other way?”
    I doubt that people who want to die know what they’re getting into. For one thing, nobody actually knows what happens when we die. For another, the dying process is irreversible if it proceeds beyond a certain point. If it’s not what you wanted, you’re stuck anyway. Death is final.
    Few people truly want to die. On the other hand, many people want to escape terrible suffering, and they believe — sometimes validly — that dying may offer relief.
    I have learned through experience, both personal and professional, that it is almost always possible to find a less traumatic solution to a problem than suicide (or killing someone else, or having someone kill you). I have found alternate solutions for myself — sometimes with help, sometimes alone — and I have helped others find solutions for themselves. And I’ll tell you, I’m now delighted that I didn’t kill myself. Please try to find another way. Talk to friends, see a shrink, write a journal. Do something.
    It may help to write down the following questions, one per page.
1. What, exactly, is the greatest problem right now? There may be several, but one is probably greatest.
2. What caused it?
3. What, specifically, can be done about it?
     
In SM, things are often happening on several different levels at once. At one level, the dominant is selfish and cruel; at another, the dominant is giving and nurturing.
     
    Call a suicide-prevention hotline. The people who work on these lines can often help a great deal. They’re mostly trained volunteers. (Quality may vary; if you have a poor experience with one counselor, call back another time and talk to someone else.) They can do much to ease your pain, help you regain your emotional balance, and assist you in finding valid reasons to hope again.
    (By the way, if your life is in good shape, consider volunteering yourself. The knowledge and skills I learned there greatly eased things for me and many other people I have since talked to over the years.)
    Understand that the pain of the situation has probably caused you to lose your perspective. Further understand that the pain you’re feeling is likely to pass after a while. (It’s often, and quite validly, said that suicide is a permanent solution to a temporary problem.) If you can regain a realistic perspective, you are well started toward finding a workable solution.

A Tough Decision
     
    I wanted to write this book for over a dozen years. Indeed, back in 1980, when I was trying to find a way to raise the money to go to medical school, I wrote an entire book-length manuscript on this subject and was working on finding a publisher. Another method of paying my way emerged, so I dropped the idea (for then, anyhow) and went on my way.
    Later, I tackled it again. I worked on the first edition of this book from 1988 till 1992, and yet somehow hadn’t finished it. In fact, I “detoured” enough to write and publish three other books. I would work on it and work on it, and yet somehow it wouldn’t get finished.
    And I knew why: I was scared to publish it. With the publication of this book, I would reveal myself to the world as a practicing sadomasochist. I dreaded the reaction.
    The subject of sex makes a lot of people nervous. Many folks out there have strongly negative attitudes toward it. I learned that lesson very clearly with the publication of my first two books. A fair number of retailers and others