Posts Tagged Suicide
No single explanation can account for all self-destructive behavior. Edwin Shneidman, a clinical psychologist who is a leading authority on suicide, described ten characteristics that are commonly associated with completed suicide. Schneidman’s list includes features that occur most frequently and may help us understand many cases of suicide.
1. The common purpose of suicide is to seek a solution.
Suicide is not a pointless or random act. To people who think about ending their own lives, suicide represents an answer to an otherwise insoluble problem or a way out of some unbearable dilemma. It is a choice that is somehow preferable to another set of dreaded circumstances, emotional distress, or disability, which the person fears more than death.
Attraction to suicide as a potential solution may be increased by a family history of similar behavior. If someone else whom the person admired or cared for has committed suicide, then the person is more likely to do so.
2. The common goal of suicide is cessation of consciousness.
People who commit suicide seek the end of the conscious experience, which to them has become an endless stream of distressing thoughts with which they are preoccupied. Suicide offers oblivion.
3. The common stimulus (or information input) in suicide is intolerable psychological pain.
Excruciating negative emotions – including shame, guilt, anger, fear, and sadness – frequently serve as the foundation for self-destructive behavior. These emotions may arise from any number of sources.
4. The common stressor in suicide is frustrated psychological needs.
People with high standards and expectations are especially vulnerable to ideas of suicide when progress toward these goals is suddenly frustrated. People who attribute failure or disappointment to their own shortcomings may come to view themselves as worthless, incompetent or unlovable. Family turmoil is an especially important source of frustration to adolescents. Occupational and interpersonal difficulties frequently precipitate suicide among adults. For example, rates of suicide increase during periods of high unemployment (Yang et al.,1992).
5. The common emotion in suicide is hopelessness-helplessness.
A pervasive sense of hopelessness, defined in terms of pessimistic expectations about the future, is even more important than other forms of negative emotion, such as anger and depression, in predicting suicidal behavior (Weishaar & Beck, 1992). The suicidal person is convinced that absolutely nothing can be done to improve his or her situation; no one else can help.
6. The common internal attitude in suicide is ambivalence.
Most people who contemplate suicide, including those who eventually kill themselves, have ambivalent feelings about this decision. They are sincere in their desire to die, but they simultaneously wish that they could find another way out of their dilemma.
7. The common cognitive state in suicide is constriction.
Suicidal thoughts and plans are frequently associated with a rigid and narrow pattern of cognitive activity that is comparable to tunnel vision. The suicidal person is temporarily unable or unwilling to engage in effective problem-solving behaviors and may see his or her options in extreme, all or nothing terms. As Shneidman points out, slogans such as “death before dishonor” may have a certain emotional appeal, but they do not provide a sensible basis for making decisions about how to lead your life.
8. The common action in suicide is escape.
Suicide provides a definitive way to escape from intolerable circumstances, which include painful self-awareness (Baumeister, 1990).
9. The common interpersonal act in suicide is communication of intention.
One of the most harmful myths about suicide is the notion that people who really want to kill themselves don’t talk about it. Most people who commit suicide have told other people about their plans. Many have made previous suicidal gestures. Schneidman estimates that in at least 80 percent of completed suicides, the people provide verbal or behavioral clues that indicate clearly their lethal intentions.
10. The common consistency in suicide is with life-long coping patterns. During crisis that precipitate suicidal thoughts, people generally employ the same response patterns that they have used throughout their lives. For example, people who have refused to ask for help in the past are likely to persist in that pattern, increasing their sense of isolation.
SOURCE: Thomas F. Oltmanns, Robert E. Emery
University of Virginia
http://www.depression.com.au 05 September 2009
Some warning signs of suicide
If you have strong suicidal thoughts at this time, you may wish to exit this site and get more specific advice on the free site www.suicideprevention.com.au.
Even psychiatrists find it extremely difficult to predict suicide in patients they know to be ill. I believe I was the first doctor to publish the idea that predicting suicide is equivalent to predicting the weather; whatever accuracy one may have for the next 24 hours, it gets progressively less the longer the gap is since the patient last saw the psychiatrist. The weather forecast model of suicide prevention has now been widely publicised by other psychiatrists.
Of people who commit suicide, over seventy per cent have depressive illness, with schizophrenia and alcoholism making up the majority of other cases of suicide.
In depressive illness cases, the only factor that has repeatedly been shown in research to be associated with suicide is a patient’s sense of hopelessness, ie a belief that they will never recover. Accordingly, reassuring a depressed person that they will in fact recover is a vital part of reducing the suicide risk.
Other factors in depressive illness that seem to be associated with an extreme risk of suicide are severe problems sleeping (there is perhaps nothing worse than lying awake in a state of great distress while everyone else sleeps), being very anxious and agitated, and being too unmotivated as a result of depression to care for one’s self properly. People who experience panic attacks, in which they become terrified they are going to die or some catastrophe is going to happen, have an increased risk of suicide.
For those having treatment for depressive illness, the early stages of recovery are in many ways the most dangerous! At this stage, the patient is still suffering considerably, but is now mentally more focussed, and therefore more able to organise his or her suicide. Although everyone is relieved when a depressed patient starts to show signs of recovery, great care is needed for the next few weeks, until the recovery is well established, and the emotional pain has subsided. Similarly, the first few weeks after discharge from hospital for treatment of depression is a period of increased risk of suicide, as the person is again confronted with the remaining symptoms of their illness and the pressures of their normal lives.
Drinking heavily or smoking a lot of marijuana while depressed increases the risk of an impulsive self- destructive act.
A previous suicide attempt is an extremely serious warning sign in people with depressive illness. While one in a thousand people will die from suicide, this risk is multiplied by ten in the first 12 months after an individual has carried out a self destructive act which did not end in death.
Emotional aloneness markedly increases the risk of suicide. Therefore, if you lose patience with a person who is very depressed, they may well feel the loss of your support is the final straw, which pushes them to attempt suicide.
Depressed people giving presents to others at an unexpected time, and especially young people parting with personally important possessions, are considered warning signs of impending suicide.
Finally, it must be kept in mind that depressive illness can be fatal if untreated, and a relatively minor problem if treated, but predicting who will attempt suicide, or who will be successful in committing suicide, is extremely difficult, even for professionals.
Important Disclaimer: This site is medical information only, and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.