Category Archives: Suicidality

On Terminal Uniqueness

“Terminal Uniqueness/Personal Exceptionalism is the false belief that the situation a person is facing is unlike anything anyone has ever faced before. …. It is called terminal because this delusional thinking that leads to a refusal to get help and the denial that consequences … apply to them, is ultimately self destructive and relationship destroying.”

Bloomie, Out of the Fog

This is a concept often used in the context of substance use disorders, but I have observed well beyond addiction. I’ve seen this impact victims of sexual abuse, rape, domestic violence, other forms of violence, child abuse, mental health issues, suicidality, grief, health issues, and much more. It is common in people from all walks of life and in all situations.

Terminal uniqueness is a belief or feeling that your experiences are so unique that no one else can possibly understand what they were like or how you reacted. It’s a dangerous mentality. People who suffer from terminal uniqueness not only believe that they are alone in their experiences but also that no one else can understand or help them process the things that they have been through. They invalidate all suggestions and insights with, “You can’t speak to this if you haven’t been through it yourself.” While it is true that a person cannot 100% understand something that they haven’t lived, that’s not why people think this way. They think this way because their ego has come to rely on the belief that they are unique in their struggle. Their sense of terminal uniqueness often becomes a part of the way they identify and understand themselves. Letting it go means learning to view themselves differently.

This thought process leaves people feeling isolated and alone. It has also created a belief that mental health providers who haven’t experienced something (although this is an unfair assumption) can’t help. When no one can help, and no one understands, what is left in life?

This thought process can kill.

Think of it this way. The greatest cardiologist in the world cannot know what it feels like to have a heart attack if he hasn’t had one. He may understand the symptoms, but he doesn’t know how it feels. With that said, he doesn’t need to know exactly what it felt like; he is extensively trained to provide complete, competent care.  

Likewise, a heart attack survivor knows what it felt like to have a heart attack. But they “know” what their heart attack felt like. It doesn’t mean they know what anyone else’s was like.

Which person would you trust with your care? The cardiologist or the heart attack survivor?

The answer is both because both are important.

Peer Support and mental health treatment are not inherently at odds with each other. Getting good care will save your life. Being able to talk with people who have been through it will help you feel less alone. You can learn how others recovered and healed.

Let’s go back to this idea of terminal uniqueness. It becomes a part of a person’s self-perception. They invalidate all supports and push themselves to feel more and more alone. They sometimes engage in competitive trauma or hardship as well, which fuels these feelings more.

I speak about this mentality not only as a clinician that has worked with it for many years in many environments but also as someone who has overcome a sense of terminal uniqueness.

You could say I am both the cardiologist and the heart attack survivor.

With that said, I would like to point out that most cardiologists don’t tell their patients if they have had a heart attack or not, so it is dangerous to assume that they haven’t. In fact, most people in general don’t walk around announcing their life experiences so I think it’s unfair to assume anything at all.

I share this with you in the hope that my lived experience will assist you in breaking free from terminal uniqueness.

The first step is recognizing you have a problem.

Ask yourself:

  1. Do I compare my hardships to other people?
  2. Do I minimize their experiences?
  3. Do I feel like I have had it harder than most other people?

The next step is figuring out how to address it (I’m making that sound way easier than it is).

  1. Can I make a conscious effort to catch myself when I do this?
  2. Who in my life can I talk to about this?
  3. Will it help to talk to a therapist about it? (Hint: the answer is often Yes)

The last step is following through on whatever plan you have created. It may seem difficult but I know you can do it!

Be well. Be Brave.


It’s finally here!

I am delighted to announce that my first novel, The Price, is now available on Amazon!

The Price uses storytelling to demonstrate the intersectionality of several issues such as trauma, domestic violence, substance use, sexual violence, suicide, and grief while also providing paths of hope and healing. It was designed specifically to bring to life the lessons of psychology courses that can help clinicians, peer supporters, family, and friends understand how suicide comes to be an option: the risk factors, warning signs, and protective factors. It also demonstrates the complexity of grief from multiple perspectives and experiences. This book combines a Master’s program, 10 years experience in the mental health and suicide prevention field, and the experiences of a suicide loss survivor wrapped into one gripping novel.

I have tried to put all that I have learned about life and death into a work that will help people understand how one of the greatest tragedies – suicide – comes to happen and the incredible complexity and impact that it has.

My goal is to leave the reader not with despair and sadness, but with hope and inspiration.

Here are some quotes from forewords and Testimonials:

“In this exquisite and poignantly written story, we walk beside those left behind in the wake of suicide. Day by day, minute by minute we experience many points of view – and varying slices of truth – from the survivors. Their truths are not easy, and this book may be difficult to read for many, but the different perspectives validate the complexity of our suicide grief experiences and why healing from suicide is often so tangled and formidable.”

Sally Spencer-Thomas, United Survivors

“After reading “The Price” I could not stop thinking about. I thought about it for days and wondered why was I so invested in the story. I know the subject matter is near and dear to my heart but there was something more happening. After several days it became clear to me that the characters and what they were dealing with was the answer. Each character touched me in a different way and it was them that I continued to think about. It felt like I knew them all. To bring these characters to life the way Sarah did and have the reader truly care about them is a gift.”

Deborah Louis Ortiz, Code9Project

“There is no greater reading delight than a wonderful debut novel. It’s often an amazing work of fiction, that has been trapped in the mind of the author demanding to be released to the page, and “The Price” by Sarah W. Gaer is no exception. It grabs the reader by the lapels and refuses to let them go until the final period. It had best seller written all over (and through) it. Enjoy.”

Frank King, Suicide Prevention Speaker & Trainer

I am a brand new author and have worked very hard to make sure I provide you with an excellent product, but I am human. If you have questions or find mistakes, please feel free to reach out to me so that I can answer your concerns and correct any errors.

Sincerely and with gratitude,

Sarah W. Gaer