Suicide revisited (Trigger: this post deals with suicide issues)

As a therapist, it can always be the case that I can be confronted with a situation where a patient is suicidal.  While some are obvious cases, I always need to be aware of the more subtle clues that might lead me to believe that it could happen.  It is a difficult one. Given the legal obligations that therapists work under in that these cases must be reported if a feeling is there that an attempt is imminent, some patients who would plan such a step would go to great lengths in order to avoid the therapist getting any kind of clue of intention.  I have been through this a number of times and it doesn’t get easier.

The whole idea of someone taking their own life is a mystery to most. Often loved ones left behind are racked with guilt and pain,  torturing themselves about what they could have done to stop it. In the end, the answer might be not much but that doesn’t stop the living hell that goes with the pain of loss. While suicide is a mystery to most,  there are some myths that never seem to disappear from the subject.  I thought it might be good to revisit an old post of mine to dispel some of these.

Statistics from the WHO say that over one million people commit suicide every year and this figure is rising every year. That is one death every forty seconds and a sixty per cent rise since 1945. One factor in this is clearly our modern, hectic lifestyle which cares little for emotional well-being. It is also strongly believed that other factors including living conditions, cultural and family restrictions as well as religion play a major role. Alarmingly, suicide amongst young people aged between 15 and 25 is on an all time global high. Interestingly, there are approximately twenty million attempted suicides per year, according to the WHO meaning that 1 in 20 actually achieve their aim.

One of the main features of some of the more recent stories of suicide in the media has been that suicide was committed by people who seemingly had everything to live for and showed no signs of depression, worry or any kind of problem beforehand. One must then ask, was it planned or was it just an explosion of feelings that lead to the ultimate in spontaneous death? Many times, these questions can never be answered and loved ones and friends left behind torture themselves with thoughts of uncertainty, guilt and anguish.  Is it however possible that someone ends their life so brutally without a long catalogue of problems? We can only speculate about this but an analysis of suicide notes (WHO) suggests that  many times  one single event pushed an otherwise depressed person over the edge. However as  much as we speculate, suicide is one of the most perplexing aspects of human behavior. However there are also many myths surrounding the subject :

Myth:    People who talk about suicide don’t do it.
Fact:   Talking about suicide can be an appeal for help. Most people usually communicate their intentions to suicide to another person, either directly or indirectly. This could include dropping hints about suicide, talking about death or dying, or writing a poem. If not responded to, the person’s thoughts could progress to action – a suicide attempt. All talk of suicide should therefore be taken seriously and acknowledged as such to the suicidal person. People who talk about suicide should be encouraged to talk further and seek professional support.

Myth:    Once a person decides to complete suicide, there is nothing anyone can do to stop them.
Fact:   The suicidal crisis represents a cry for help rather than a wish to die. A part of the person wants to live and a part wants to die. With help the person can be encouraged towards life. If the person receives the help he or she is seeking, an attempt is less likely. Suicidal crises can be relatively short-lived. To protect the person during this time: stay with the person, listen to their struggle and encourage them to keep safe. Help the person to access professional support, as many people do move beyond seeing death as an option with professional assistance.

Myth:    All deaths are preventable. 
Fact:   Despite our best efforts to help a person at risk of suicide, some people who attempt suicide will die as a result of their actions.

Myth:    Suicides happen without any warning/ are spontaneous acts/ people keep their plans to themselves.
Fact:   Studies have indicated that as many as eight out of ten people give warning of their intention to suicide. More often, this intention is not recognised rather than hidden.

Myth:    Talking openly about suicide increases the risk.
Fact:   It is important not to treat suicide as a taboo subject. Raising the issue sensitively and asking directly about suicide gives the person at risk permission to speak about his or her distress, and demonstrates to the person that you care. Rather than feeling worse, the person at risk could feel relieved if the issue of suicide is raised in a caring and non-judgmental manner. This could prevent action and increase the chances of the person at risk seeking further help.

Myth:    People who talk about suicide/ make a nonfatal suicide attempt are just seeking attention.
Fact:   All suicidal thoughts and behaviours are a cry for help that need to be listened to and responded to. We cannot make assumptions about the person’s intentions and need to take this seriously. Anyone distressed enough to talk about or attempt suicide needs professional support. Addressing the underlying problems through talking with a professional helper could reduce the likelihood of future attempts.

Myth:    Suicidal people always want to die.
Fact:   The majority of people who attempt suicide are confused about whether they want to live or die. Most people want to live better and happier lives but need relief from the intense emotional pain they are experiencing. If people in the midst of a suicidal crisis were certain that they wanted to die, they would not be communicating their distress to others. In communicating their distress to others in this way, suicidal people are actually reaching out for help to ease their emotional pain.

Let me leave you with a few choice quotes on the subject:

“Suicide is a whispered word, inappropriate for polite company. Family and friends often pretend they do not hear the word’s dread sound even when it is uttered. For suicide is a taboo subject that stigmatize not only the victim but the survivors as well “. EARL A. GROLLMAN, Suicide

“The reality of suicide is far different from the fantasy. Most suicidal thinkers romanticize their death by suicide, failing to realize that any suicide gesture or attempt can result in permanent brain, kidney, or liver damage, loss of limbs, blindness, or even death”. SUSAN ROSE BLAUNER, How I Stayed Alive When My Brain Was Trying to Kill Me

  16 comments for “Suicide revisited (Trigger: this post deals with suicide issues)

  1. June 29, 2013 at 1:49 am

    Appreciate the detail.

    Like

  2. June 29, 2013 at 3:37 am

    Thanks for a thoughtful article. Having occupied both chairs in the counseling room, I can say that it is never an easy subject, but people need to able to talk about the thoughts. As a dual diagnosis person I have had some very dark times and I have benefited from structure and support that let me get past the worst of it. I deeply regret that it is so hard today to find supportive treatment for the non-wealthy, because I do have to be pretty desperate these days to seek help.

    Like

  3. June 29, 2013 at 6:57 am

    This was a great article, naturally. 🙂 Having been suicidal myself (I’m better now), I appreciated the way you handled the topic with such compassion.

    Would it be presumptuous of me to add one more myth? A myth that bothers me is: Suicide is selfish.

    When I was suicidal, I don’t believe I was being selfish. The trouble was that I was in so much emotional pain I was not thinking clearly. I was convinced that I was a problem for my family and they would be better off without me. I knew that what I was feeling was very serious, and perhaps I should go to the hospital, but I worried that would be to stressful for my kids–as if my suicide would not be? As I said I was not thinking clearly at the time.

    I was in therapy, and I told my therapist what I was feeling. Because as you said, I was absolutely serious. I wanted the pain to end, and I felt that death was the only way, but telling my therapist was my way of trying–one more time–to find another solution. He was able to convince me that my death would be very hard on my family, so for them, I held on.

    It was my pain and muddled thinking, not selfishness, that drove me.

    Thanks for the helpful article!

    Like

  4. June 29, 2013 at 11:32 am

    Thanks for this very informative article. I’ve heard another myth that says,”If a person attempts suicide and doesn’t succede then they didn’t really want to kill themselves, because there are too many sure ways to kill yourself that you are not going to mess it up if you truly want to die.”

    Like

    • June 29, 2013 at 1:33 pm

      Hi .I have heard this one too. This really does prove that there are some strange thoughts around this subject.

      Like

  5. June 29, 2013 at 2:32 pm

    Reblogged this on Ginger Musings and commented:
    Worth reading.

    Like

  6. June 30, 2013 at 12:20 am

    Good article. Tweeted via @HelpToHope. Always good to promote conversation about this subject. Thanks.

    Monica

    Like

  7. June 30, 2013 at 7:44 am

    Nice article. Suicidal intentions is something that has interested me recently. The question of suicidal intentions is features on the depression assessment questionnaires and it’s something I’ve always answered as no.

    Could you comment/diversify your article with respect to how suicide fits in the spectrum of depression. Is the absolute extreme of all depressive cases or are some people primed for suicidal thinking whilst others would never reach those thoughts, no matter how deep their depression is? The same applies to self harm, I guess, is it something everyone suffering from depression is susceptible to? I know depressive symptoms are unique to an individual, but there are clearly shared symptoms.

    Like

    • June 30, 2013 at 9:52 am

      Thanks for the comment and as you have already identified, it is not a given that depression sufferers will ultimately take their own life though some will. I can really only talk of my own experience as a therapist. I have some deeply depressed patients who have stated that they have never had a thought of suicide ( though one has to take this with caution) but cut themselves frequently to relieve stress and negative thinking. One lady told me that she self harms to avoid the suicidal thoughts. I had one or two cases over the years when patients who seemed to be on the verge of recovery, suddenly attempted suicide when there were absolutely no signs whatsoever. One stated afterwards that the thought of running her own life and the responsibility that went with it was scary enough for her to think about dying and to seriously attempt to kill herself. As I stated in the article, therapists must be aware at all times of those subtle signs and it is hard to fit anyone into a general framework of how they might think or behave at any one time.

      Like

  8. July 17, 2013 at 8:44 pm

    Reblogged this on Our Monsters and commented:
    I’m three suicide attempts in now, the last serious one ended me up in the hospital in March, the first serious one no one ever knew about. I’ve come up with a way to describe my problems though. Seeing as I don’t want to die, but yet I still feel suicidal, I tell professionals that I struggle with “suicidal ideation,” which I think means that you are plagued by the thought of suicide even if you don’t actually have a plan. I don’t like my suicidal thoughts, and the last thing I want to do is act on them, but it’s very hard to fight them when something triggers despair. In a crisis situation, my mind looks at it as an end to pain. When I was alone in New York for a minute, I remember being on the phone with Brian crying and him desperately trying to convince me not to jump off a subway platform, it was a horrible blackout attack. He came and got me after that, and has basically done everything for me since even to getting me a glass of water. It’s very hard, I want to live, but I struggle against the equally strong desire to not live in pain.

    Like

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