Q: The language in the app sounds pretty negative. Shouldn't things be phrased more positively in order to help people feel better?
A: It does seem very counterintuitive. We would expect that postitive language would boost mood. However, the foundation of chronic suicidal ideation is from a time in development that is pre-verbal, and before the capacity for meaning-making. It's best described in this excerpt from the paper Chronic suicidal thoughts and implicit memory: hypothesis and practical implications by Dr. Nick Bendit, who is an advisor on this project.
In most situations as an adult, emotional pain can be satisfactorily diminished, or escaped from, or will reduce with time. Either on our own, or with the help of others, most emotional pain can be managed, such that death is not the only solution. However, there is a phase in life when we have little control over our actions, mind or feelings, and time is endless. In the first 8 months of life, babies have little control over anything unless a caregiver helps. Furthermore, in the first 7–8 months, babies do not have the mental capacity to bring up the past or speculate about the future. The capacity to contextualize time as past or future occurs usually around age 8 months, and may be part of the mechanism of stranger danger. Babies are ‘in the moment’, and therefore suffering is endless (as is pleasure!).
In the situation of chronic parental non-responsiveness, the baby is stuck in an endless suffering that is recorded in implicit memory, as the events of non-responsiveness are repeated many times. Any future experience of intense emotional pain will trigger encoded feeling/action experiences that say this pain is unbearable, endless, and there is no one there to help. As the feelings are experienced as an adult, but there is no recall of where it comes from in implicit memory, it is experienced as current and real to the present situation.
When others try to understand why the patient feels that suicide is the only way to relieve the pain, they fail, as it makes no sense to them. They know that as an adult, the patient can act to reduce pain, or use mental strategies to diminish or contextualize suffering, or get help from other people, or know that time is likely to heal their hurt. Anyone trying to help does not realize that the patient is in the grip of an implicit memory system that says that there is nothing they or anyone else can do.
If the helper tries to argue that there are things that can be done, it will seem like they are not in touch with what the patient is facing, and that they do not understand the patient’s plight. Furthermore, if the helper tries to undermine suicidal plans, the patient is likely to feel that their one way of escaping unbearable and eternal pain is being stripped away. The patient then feels increasingly alienated, which reinforces the original implicit memory, that there is no one that can help. Suicidal urges are likely to be strengthened.
So, that is why we avoid phrasings like "things to live for" or "things will get better" in NotToday. Arguing against this unfortunate uncoding of "reality" is not something that the app could do to help. Only by respecting and validating their painful reality can it help the person achieve the goal of not acting on those thoughts.