Groups

Here, you’ll find guidelines for creating a support group for attempt survivors or those with suicidal thinking, based on information from several groups in the U.S. and Canada. A list of all known support groups in both countries, plus Ireland and the UK, is at the end of this page. If you have a group and don’t see it listed, let us know.

Interested in creating a group? Watch the webinar at the end of this page. Or this webinar from Canada.

If you’d like to see one of these groups at work, watch this.

You’ll find few support groups. That hasn’t changed since the 1960s and 1970s, when the first groups were tried. “Group therapy as a therapeutic procedure for self-destructive persons has been singularly neglected,” suicidologist Norman Farberow wrote back then.

Why? Farberow and Calvin Frederick were frank: Therapists were scared of us. “In general, psychotherapists recommend exclusion of suicidal persons from groups and are disinclined to work with such patients even on an individual basis,” they wrote. In an age before political correctness, perhaps, the researchers called attempt survivors a “special problem group” along with, among others, stutterers and paraplegics.

And yet, Farberow encouraged such groups, and he took aim at another fear that exists today: The fear of legal liability if someone dies. “lt is not nearly as easy for the patient to blame several persons who share responsibility for treatment as it is to blame one particular therapist,” he wrote. In other words, it’s easier to protect yourself from a lawsuit with more people in the room. And many organizations in mental health already have liability insurance.

The groups mentioned here are in Los Angeles, Virginia, Illinois, Arizona, Toronto, New Jersey and Massachusetts. Most are affiliated with mental health centers, crisis centers, hospitals or community centers.

If you’d like to have a group in your community, approach organizations like that and ask. Organizations that already host support groups for those bereaved by suicide might be sympathetic and equipped to help.

Where are groups based?

They’re often on site at a crisis or mental health-related center, because of the clinicians at hand. The Virginia group shares the group location with new members once they are screened. In the case of a Suicide Anonymous group in New Jersey, some meetings are open to people on Skype as well. The Massachusetts groups are 100 percent peer-run.

How to know if there’s interest in forming a group?

The crisis or mental health center can ask employees and volunteers for their thoughts. Ask local suicide survivor groups. Find a way to float the idea in the local media. “We would receive calls on the hotline looking for a group for attempt survivors.” _ Shari Sinwelski, Los Angeles

Should the group be open or closed?

Some are closed. “That helps with group bonding and helping people to really get to know each other.” _ Los Angeles. Some are open. “There ends up being sort of a core group that acts as a nest, so when someone new joins, there’s already a climate created. We experimented with having a closed group but realized that people don’t always ‘plan’ to be suicidal, so we want folks to be able to act with spontaneity in coming to our groups.” _ Janice Sorensen, Massachusetts

What kind of atmosphere helps?

“At the beginning, I found it pretty cold and sterile, so I always make sure we have refreshments, drinks and food, a more welcoming environment. At times we’ve done other things for fun. For example … we made one of our groups a Thanksgiving potluck.” _ Los Angeles

Who can join the group? And how to publicize the group?

Going by referral means a person’s therapist knows their suicidal background, and some don’t want that. But cooperation with therapists means having an established network. Being open to both referrals and walk-ins is an option. “We’ve been surprised that most of the referrals have been self-referrals.” _ Katie Ayotte, Arizona. ” We get a lot of doctor referrals. We put up posters in hospital emergency rooms, psych units of area hospitals.” _ Lisa Liedberg, Illinois. “Most people come from word of mouth. … I think it will take someone higher up in hospitals or the police department to say, ‘Tell them about this.’” _
Cory Cobern, Virginia. “We started calling churches and libraries, handing out fliers.” _ Massachusetts

Should new members be screened, and how?

“The individual goes through a telephone intake with me so I can learn a little more about their experience, to make sure that we both feel a group environment is something they’re ready for.” _ Los Angeles. “Anyone who wants to come to the group, they call the helpline and leave their information. I call back and do a phone interview to make sure they are actual attempters, make sure they are OK for the group. I don’t turn anyone away, but I don’t want anyone else there.” _ Virginia. “We rarely turn away. Maybe because of a psychotic disorder.” _ Yvonne Bergmans, Toronto. “You can’t come to the meeting drunk or under the influence of medication that is not prescribed.” _ Illinois. “We don’t screen, as we know how easily a person can be discouraged from attending.” _ Massachusetts

What about confidentiality? And should records be kept?

Basic personal information is usually taken but used only to contact the person. That and attendance records are helpful to track program statistics. “We have called a therapist without the patient’s consent, but only in emergencies.” _ Norman Farberow, earlier Los Angeles support groups.

Are there any taboo topics?

“This being an attempters’ group, there is no taboo subject, because anything can lead someone to another attempt. … I don’t want anyone to go home and say, ‘This was on my mind.’” _ Virginia. “One of the things we discourage in the Suicide Anonymous rooms is the methods.” _ Phillip Garber, New Jersey. “We want people to be able to say what’s happening to them, but we ask that they not paint a picture. So that means someone can say they’ve really been thinking about killing themselves, but we don’t really want to hear that someone purchased rope. We don’t want to hear someone’s story about the blood.” _ Massachusetts. “We haven’t really come up with any topics so far that would be
prohibited. On the other hand, it is a group, so we are always checking in with the group to make sure that topics are comfortable for everyone. ” _ Los Angeles

What’s the plan in case of crisis?

“I can’t commit anybody. I don’t have that capacity. … I’ve been known to walk with people down to the emergency department. Or to my office, figure out a strategy, talk every few hours with them, ask them to let me know how they’re doing. Sometimes going to the ER can be more traumatizing than their actual feelings.” _ Toronto. “If they want us to take them to the hospital, we can. I leave it to them. I just do my absolute best not to leave them alone.” _ New Jersey. “The most important thing is to try and assess if people have enough immediate support in their lives that they will be able to stay safe until the
next group starts.” _ Los Angeles. “We take them, there’s a hospital a 10-minute drive (away). _ Illinois

What’s the plan in case of the death of a member?

“We learned as we went. We felt that because everybody knew (the member who killed himself), we should talk about it. I announced he had done that, and we spent the evening talking about that and the things he had said. … And then when (the crisis center founder) asked his sister to come and tell us, that was a big help too because we weren’t left wondering.” _ Illinois

How large should a group be?

“If I ever get 12 people regularly, I’ll close the group and start another.” _ Virginia. “We have had as few as three, and I think our biggest group was seven.” _ Los Angeles. The Illinois group has had up to 15.

What is the age requirement, if any?

“No one under 18.” _ Illinois. “A broad span in age enables the suicidal individual to see that his problem is not unique to his own age group. Moreover, if a suicidal youngster is particularly dependent and in need a parental surrogate, the presence of older persons may be of value.” _ Farberow

Who should lead the group?

Usually a clinician, along with a peer facilitator or facilitators. “We’ve had some grads to come back and become peer facilitators. … When we do groups, I have many colleagues from various professions working with me, co-facilitating, so they develop a skill set. So they come to realize that when our clients are in good shape, they’re just a hoot and half, a human being you could meet anywhere.” _ Toronto. “We would take a peer who’s really at a good strong point in life to handle the intensity. When we started, we had an attempt survivor as my co-facilitator. After a while, it became overwhelming.” _ Los Angeles. “One of the main things of the group is, I’m the facilitator, but I’m not in charge. I could
not possibly be in charge of everyone being alive. … We’ve had people walk in and not know who the facilitator was. This is a good thing. Everyone takes ownership.” _ Massachusetts. “Therapists should be emotionally stable, have basic knowledge in behavioral science and special familiarity and training in the area of suicide prevention. Beyond this there is no evidence that any particular type of therapist, psychologist, physician, clergyman or social worker, is more effective than any other.” _ Farberow

How does a typical meeting go?

“I actually told my story, which kind of loosened everyone else up. … For the most part, I start with, ‘How’s everyone?’ _ a quick wellness check. I can rely on (veteran members) to get others talking. If not, I know most of my group members now that I can say, ‘OK, what’s going on with you?’” _ Virginia. “A normal group starts with the check-in: How’s your day, what’s worked and what’s not worked for you the past couple of weeks. Myself or the other facilitator brings a discussion topic, unless a topic has already started during the check-in.” _ Arizona. “A lot of times we didn’t do anything that I had planned. In the first few weeks, we really just take some time for members to get to know each other. On the first night, we’d go over guidelines, things they can get from the group, the chance to
introduce themselves. … Sometimes if they need more of a conversation starter, we show a National Suicide Prevention Lifeline video that shows stories of others who have survived a suicide attempt and they can relate, talk about stigma and other concerns. … If it was difficult, we encourage them to stick with it and follow up with every new member afterward to make sure they are comfortable.” _ Los Angeles. “We see if a common theme has emerged from our two-minute ‘check-in,’ and we will start with that. Sometimes we just talk about funny stupid stuff. We also share resources. There’s no directive we must talk about despair or of feeling suicidal, but we really try to hold the space open for that.” _ Massachusetts. “We introduce ourselves and how many times we’ve attempted suicide … And then if someone is really having problems, they speak first. We try to help them, give them coping mechanisms that they might not have thought of.” _ Illinois. “There’s a lot of work about developing a language of safety. Knowing early warning signs, knowing the tools to use. And being a teacher to the care providers you work with. We work from the perspective that everyone is a learner and teacher.” _ Toronto

How long are meetings, how often do groups meet, and how long does the same group meet?

It varies. “The eight weeks are kind of arbitrary. … It’s a way to allow people to join or come back again. … We meet once a week. Initially it was an hour and a half, but recently it went up to two hours because there were bigger groups and not enough time to get everything done.” _ Los Angeles. “The group therapy program … now includes two long-term insight-oriented groups (once a week, people joining at varying intervals, focus on social and interpersonal relationships), a postcrisis-oriented, time-limited group (twice a week for a specified period of eight weeks, maximum eight people), a drop-in group (five days a week, no waiting period, limit 10 people, focus on temporary stresses).” _ Farberow

Are there any issues about completing and leaving the group?

“Their separation anxieties are buffered by the fact that all of the patients have the option of continued participation in drop-in groups and/or of availing themselves of our 24-hour answering service. Thus, the patients find there is always someone available if an emergency arises.” _ Farberow

What about any concerns about liability?

“lt is not nearly as easy for the patient to blame several persons who share responsibility for treatment as it is to blame one particular therapist.” _ Farberow

How do the group leaders take care of themselves?

“We always make sure to have weekly supervision with all facilitators so we can stay honest about our emotions.” _ Toronto. “Although many patients who attend were extremely depressed and difficult to manage, the therapists have not felt overburdened because the responsibility and transference are shared by all.” _ Farberow

Some parting thoughts:

“It is important for people to feel safe in sharing their thoughts of suicidality. Many of us know that if we share these feelings in a clinical setting, and that agency has a policy requiring that anyone who shares such thoughts needs to be hospitalized, that person may end up with a section 12 and return home to find the police waiting to take them to the hospital. Such a thing would keep me from sharing those thoughts. It is counterproductive.” _ Massachusetts

“Members can feel comfortable being completely open and honest with each other, knowing that they won’t be judged. They can also learn things from people who have walked in their shoes.” _ Los Angeles

“If we’re available to people, it lessens other people’s and agencies’ burdens. And I think before too long, the numbers, in terms of budgetary benefits, are going to show themselves. I don’t know how people can track it well, but I know we are keeping people out of the hospital, and that’s where the huge expenses lie.” _ Massachusetts

“The fact that other group members speak directly about their own suicidal feelings, breaking the taboo of silence around the subject of suicide, is helpful. … Participants often strike up quick, sympathetic friendships with each other, and there are endless examples of self-help and assistance to each other among members of the groups. We had not anticipated that so many patients would continue to return after the crisis had passed, or that they would drop out after a few visits, only to return, sometimes months later when another crisis developed or simply because they felt lonely and remembered the
drop-in group as a comfortable, friendly place.” _ Farberow

The groups:

Los Angeles: Didi Hirsch Mental Health Services. didihirsh.org

Virginia: ACTS Helpline. actspwc.org

Illinois: Suicide Prevention Services of America. spsamerica.org

Arizona: Magellan of Arizona. magellanofaz.com

Toronto: St. Michael’s Hospital. stmichaelshospital.com

New Jersey: Suicide Anonymous. suicideanonymous.net

Massachusetts: Western Massachusetts Recovery Learning Community. westernmassrlc.org

Other groups we know of:

San Francisco: Mental Health Association of San Francisco: mentalhealthsf.org

Outer Toronto: Self Help Alliance: self-help-alliance.ca

Milwaukee, Wisc.: Mental Health America of Wisconsin: mhawisconsin.org

Ireland: Suicide or Survive: suicideorsurvive.ie

UK: Leeds Survivor-Led Crisis Service: lslcs.org.uk

Oakland: Crisis Support Services: crisissupport.org

Pikes Peak, Colo.: Suicide Prevention Partnership: pikespeaksuicideprevention.org

Dayton, Ohio: Network of Care: clark.oh.networkofcare.org

Bakersfield, Calif.: Kern County Mental Health: co.kern.ca.us

Kalispell, Montana: Pathways: kalispellregional.org

Riverton, Wyoming: Fremont Counseling: fremontcounseling.com

Charlotte, North Carolina: SOSA Charlotte: cltsasurvivors (at) gmail (dot) com

Toms River, N.J.: The Support Place: thesupportplace.com

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18 Comments Join the Conversation

  1. It’s a shame you don’t have a donate button! I’d without a doubt donate to this superb blog! I suppose for now i’ll settle for book-marking
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    to new updates and will talk about this site with my Facebook group.
    Chat soon!

    Reply

  2. I survived, unconscious for 4 days. Still don’t know why I survived, I believe that is my biggest question? I don’t believe I am still suicidal, most days, but still can’t believe I’m alive.

    Reply

  3. I totally get that. I often felt/feel the same way, and it’s been over a year since my attempt. I think there is a certain amount of shock that you go through, mentally and physically, after you have committed yourself to such a huge decision (to end your life) and it doesn’t turn out as expected. My advice is not original: just keep taking life one day at a time and hope for a glimpse of an answer at some point. There are times, now, that I do experience moments of gratitude that I lived.

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  4. I am grateful but I took enough pills to kill an elephant. No residual side effects, kidney & liver functions all returned to normal after 10 days. I feel I must a something special that still needs to be done. No one, except my husband knows what happened. It was 6 mos. ago. Thanks for responding,

    Reply

  5. I thought I took enough pills to kill a rhinoceros, too, and also suffered no permanent liver/kidney damage. However, I was air-lifted to the hospital, went to an acute care psych center and from there to a really great psych hospital in Houston for 9 weeks (in some ways the best 9 weeks of my life…really!). We probably did survive for some greater purpose, but that will take time to figure out.
    The fact that no one knows about your attempt worries me. One of the keys to my continuing recovery has been to share my story, selectively, in order to help myself and others, and I am working to grow a depression support group in my community. I also continue to see an excellent therapist and, as I said, it took nine weeks in a psych hospital to help me gain enough strength to return home again. How are you coping with the feelings that led you to attempt suicide in the first place?

    Reply

  6. Much better. I was housebound for 3+ years with severe asthma & I was allergic to the world. I also fell in Feb & broke my collarbone in half & cracked it across. Another story. I couldn’t take the pain & loneliness any longer. I had surgery in Aug. which turned into a major operation w/ a plate, 7 screws & bone marrow implant. The collarbone just kept separating. I had started a new immune shot in May & it started to work in Nov. so my physical pain is almost gone & I can actually leave my house. So my circumstances have changed & I feel so much more positive. But the nagging why still keeps me awake at night. Thanks again for your time & compassion, you are making a difference.

    Reply

  7. Being environmentally/chemically sensitive is a huge challenge, let alone trying to cope with major surgeries and complications. WIth those ongoing major stresses, I can see why you lost sight of the value of life! Chronic pain is another big stressor, and the fact that you are close to being physically pain-free is a big accomplisment.
    So what exactly is keeping you awake at night? The search for an answer to why you survived? If that’s the case, try letting those thoughts fade more into the background and understand that if there is an answer, it will become clear when it the time is right. It can be helpful to accept that we are powerless over many things, and one of those things is the ability to see the value of each and every action or reaction we encounter as it happens, or even in the near future. Sometimes you have to really do your best to let those types of things go….maybe you’ll get an answer some day, and maybe you won’t, but in the meantime it’s better to focus on what you DO have control over, which is what you seem to be doing with your allergies and pain, so good for you! Although we often cannot control what happens to us, we CAN control how we choose to see/interpret it, i.e. our thoughts.
    When my mind is too busy when I am trying to get to sleep or get back to sleep, I have found two things that help: 1. Getting up and writing down whatever issues I am afraid I might forget before morning; and then, 2. Reminding myself over and over, “This is the time for sleeping, not the time for thinking.” Sleep is so important in so many ways, and it is just as important to the overall healing process as good nutrition, exercise, and mental self-care.

    I am glad our conversation is valuable to you. It’s good for me, too!

    Reply

  8. I think I have found a confidant; can’t thank you enough. 2012 was the worst year of my life. I lost my dad in 2011, had a 3 month blip (separation) from my husband at the end of 2011 & then I challenged worse in 2012 by being prescribed cymbalta, steroids to keep me breathing, breaking my collarbone, prescribed Percocet 10 along with every medication known for asthma including a nebulizer treatment 4x’s a day & too much alcohol. I agree with you 100%; sleep is a major influence and factor on your mental health. Half the time I was climbing the walls & turned into a person I didn’t know. I had a very unusual upbringing, another story. Put it all together & I was a bomb ready to go off. I had to end the pain & throbbing in my head. My daughter also separated from her husband and was broke. I have life insurance, I thought she could use the money more than me. My attempt caused the worst pneumonia I had to date; 3 times a year is usual. That was the reason I used for being in the ICU being in the ICU for 10 days plus another 2 on the floor. After that I just wanted to go home. I stopped all drugs except for my asthma, but still drink way too much. It is my escape.
    Your “not sleeping advice” was excellent. I believe I am still alive for my mom & daughter. My marriage is a sham, we do love each other but also play make believe. I/we could benefit from counseling but can’t bring myself to get the help or open myself up. You, a total stranger, are the one person I have actually opened up to. I am the strong one, always in charge and the person everyone leans on & depends on. I can’t admit my own weaknesses to the world. I am the rock that has so many cracks.
    How can I thank you for being a sounding board. I’m realizing I so need to open up & should probably find a professional. I am so embarrassed to not be the rock everyone depends on.
    Too much responsibility since I was young. Thank you again, you are making a good difference & I hope you continue to email me. Make it a great night!

    Reply

    • Lady, if in your own words you “drink way too much,” I strongly suggest you consider becoming involved in Alcoholics Anonymous. It saved my life, set me free of the bondage of alcohol (a major central nervous system depressant) and has enabled me to heal emotionally, given me a whole new perspective on my life, and greatest of all gifted me with a God of my new understanding and a real spiritual life. In the AA ‘family’ you will find many others who have survived suicide attempts or had known deep depression and despaired of life itself at one time, but together we have climbed out of the abyss of darkness. I am a survivor myself, of two attempts, one fully flat-lining, and it was not until I got the alcohol dependency out of my life that I could begin to really live and recover. Its a tough road, but I didn’t, couldn’t, still can’t, walk it alone. I’ve been blessed to live long enough to become a grandmother, to live life in hope, a lot of humor (I’d forgotten how to laugh) and love, very much love. Dear God, I would have missed all of this, all of the last 16 years! I still go through rough times occasionally but now I am not alone, and I have tools to deal with my thinking and emotions and a support base of people who care, people who have been there themselves, right in my own neighborhood. Please be honest with your doctors and therapists and yourself about how much you drink. The majority of suicide attempts do involve alcohol or drugs, and the most successful attempts are those who have tried before. There is help available, my dear, and there is a way out…. …and up!! The journey begins with doing the next right thing for yourself and those you love one baby step at a time. Ask whatever, whoever you consider The Almighty to be for the strength to do it. Then, keep on asking!

      Reply

  9. I just wanted to let you know how much you have helped me. I actually sat down with my husband and told him I was going to seek professional couciling & I have too many unresolved issues I need to discuss. I also asked him if he would attend some sessions if the doctor thought it would be beneficial & he agreed. I also told him I was talking to a fellow survivor, another secret. So at least it is out in the open between us, if it goes any further I will seek advice from the pro. Thank you again & I hope we can become “pen pals”. Now I’m showing my age. I actually am smiling, I have a new, improved plan. Maybe this is why you survived, to become my guiding light!

    Reply

  10. So not to make light of my attempt but considering the drugs I tried to overdose on, one would think that they’d balance themselves out! I can still feel the way it felt to be laying in bed, every time I had a seizure, I could feel my arms and legs stiffening while my hands and teeth clenched. At that point I really did want to die, not for the reasons I had tried to overdose but just to be released of that horrible pain. I was lucky though… By the time these effects took over my mind and body, I had managed to drive myself to the hospital, where I checked myself in and eventually given liquid charcoal to help flush my system.
    I really wish I could say I had had a saving grace moment of clarity or someone to help bring me back from the brink but I didn’t. What stress and self depreciation did to me, guilt managed to save me. I had been talking to a friend before I took the pills but rather than talk me down, they merely said that they couldn’t and wouldn’t go on living themselves; instead they’d abandon their barely born goddaughter, her sister who was about to get married but they had recently lost their step father to old age and put down their dogs before killing themselves. I couldn’t allow myself to die carrying that guilt on me, which was the reason why I rushed myself to the hospital to be treated.
    Not sure why but I was oddly proud at the fact that I managed to chug down the whole bottle of charcoal without throwing up once, odd because that stuff is meant for you to throw up. I had a good nurse come by and tell me I was one tough bastard, pardon the language please. I was reviewed by a psychologist and eventually found to be mentally stable and competent and without reason to be held for observation. I have since been required to attend mandatory therapy sessions with the availability of medication to help with my depression but unlike that one night, I’ve always attempted to work through my problems without the use of medications, not sure why I feel like they’d leave me worse than the way I started.
    Once I was released from the hospital, first thing I made sure of was that my friend was still okay, thankfully they themselves hadn’t done anything rash but they scolded me like no tomorrow for scaring them and for hurting them so badly. They’ve since stopped talking to me because of that incident. I couldn’t bring myself to tell them that they were one of the biggest reasons why I had come to the decision to end my life, instead I apologized for my actions towards them, towards myself and I wished them all the best in life. There was no point in hurting them anymore.
    Before anyone reading this, assuming people actually make it this far into this post, think that my decision to end my life was done on the premise of a failed relationship, it wasn’t, I had been feeling like I was a burden to everyone in my life, feeling worthless, useless and just utterly defeated by everything. After I was discharged from the Army, I was completely lost, the Army was my life, the only thing I was ever good at and now, I had nothing. I’ve struggled for the past three years since to readjust to civilian life, find work, find friends, do activities. I let myself go in every aspect of my life. Suppose I still feel the same as I did before but only difference now is that I’m trying harder to keep myself together and now I have a group of people watching over me, not in a good way but just making sure I don’t fall too far. Oh also another reason why I’m no longer thinking of ending my life is because after having been deemed not really a threat to myself or others, I am still trying to find work but having a 5150 code on your record can and will very undoubtedly destroy your entire life in regards to work.
    *For those that don’t know, a 5150 in the state of CA, is a psychiatric hold where authorities can hold you for up to 72 hours for observation to make sure you are not a danger to yourself or others.
    I do apologize for the lengthy post but do appreciate anyone and everyone who took the time to read it… Since my attempt, I’ve needed someone or someplace to just let this all out. Thank you again to everyone and for those still struggling worse than I am, hold onto hope, think about how you’ll be cheating others of your life and worst, cheating yourself out of so many opportunities. I like to fancy the idea that I can still give this world something amazing, something it’ll remember me forever for, something positive. Remember to always smile, even if you’re having a bad day, smile because that may be enough to help make someone else’s day better and you should take joy in that.

    Reply

  11. So much good information in blog and comments…….the one thing I can relate to the most when I had serious attempt in 2002 is that I thought my very existence was causing my children pain…I wanted to end their pain….mine was not a selfish act!….Of course my thinking was not “right” at the time….I like to say that my brain was lying to me….I am very glad I did not succeed now and have watched my children grow into extraordinary young adults and have greeted a grandson into this world who is now 6 years old and calls me Nana.

    Reply

  12. I am still very much in love with Jesus but find God has left me is there any means of salvation after our mistakes

    Reply

    • Jack–
      Salvation comes by grace…not by works. God always forgives. And He never leaves us — we only turn our back on Him sometimes. Even in our darkest time He is there, in the song of a bird, in the rain as it falls, and in our heart…even if we cannot feel or see.

      Reply

  13. Salvation comes by grace…not by works. God always forgives. And He never leaves us — we only turn our back on Him sometimes. Even in our darkest time He is there, in the song of a bird, in the rain as it falls, and in our heart…even if we cannot feel or see.

    Reply

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