Working with adults during periods of suicidal crisis is a high-risk venture. Unlike other medical crises, there are no accurate biologic tests to determine the level of suicide risk,nor metrics for determining when a suicidal crisis may occur. It is no surprise that when adults speak of suicide, we are at a considerable disadvantage in discerning if the thought is a fleeting fantasy, a declarative statement of imminent purpose, or something in between. Fear of the unknown, failing to save them, imagined reprisal, and fear of judgment by their family and our peers can lead most of us to move too quickly into unilateral crisis management and thus subvert their voice and dignity to make choices. Repeated (often traumatizing) experiences with others have trained the suicidal individual to expect being controlled, hospitalized, shunned when they speak of their wish to die. John’s words ring in my ears: “Don’t push the red button, DF! I’m feeling likeI want to die, but I swear if you push that red button I will kill you!” The red button was John’s iconic representation of his past therapists’ reactionary crisis management that forced him into locked hospital wards and fueled distrust of not only his therapists but the entire field of psychiatry. There was no room for John to speak of his desire to die without the risk of losing his sneakers, his belt, freedom and dignity. So how do we restore trust, dignity, and respect for those who are episodically suicidal while providing ethical and effective care during and between suicidal states? Weaving together decades of clinical research, and direct care for many suicidal adults, I propose the pathway forward starts with taking their fantasies, fears, and emotional reactions seriously, avoiding (if at all possible) moving into crisis management, and creatively coaxing them into a state of curiosity and interest in the validity of their feeling states without endorsing suicide as the option of choice. At its base, we must trust and respect the suicidal person before we can expect them to trust and respect us to help them escape the allure of suicide.