The Act and Follow-through of Suicide: Part IV

Compilation of Statistics Regarding Suicide

Scott Anderson in his NYT article weaves the grim statistics of suicide in and out of his story. Here’s the morbid list:

General

  • mental illnessThe nation’s suicide rate (11 victims per 100,000 inhabitants) is almost precisely what it was in 1965.
  • In 2005, approximately 32,000 Americans committed suicide, or nearly twice the number of those killed by homicide.
  • The National Institute of Mental Health says that 90 percent of all suicide “completers” display some form of diagnosable mental disorder.

Demographics

  • Both elderly men living in Western states and white male adolescents from divorced families are at elevated risk.

Premeditation vs. Passion

  • [T]he person who best fits the classic definition of “being suicidal” might actually be safer than one acting in the heat of the moment — at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself.
  • In a 2001 University of Houston study of 153 survivors of nearly lethal attempts between the ages of 13 and 34, only 13 percent reported having contemplated their act for eight hours or longer. To the contrary, 70 percent set the interval between deciding to kill themselves and acting at less than an hour, including an astonishing 24 percent who pegged the interval at less than five minutes.
  • “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total. By the early 1970s, the amount of carbon monoxide
    running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

Read the rest of this entry »

The Act and Follow-through of Suicide: Part III

Premeditation vs. Passion

Author Scott Anderson in his NYT magazine article, "The Urge to End It All," notes:

Just as with homicide, researchers have long recognized a premeditation-versus-passion dichotomy in suicide.

Read the rest of this entry »

Suicide: Understanding and Intervening – Part VI, Hopelessness

“If a Christian is without hope and sees himself as helpless, it underscores that his thinking is out of alignment with God’s.” – Jeffrey S. Black

A hopeless Christian is a paradox considering that Christians should have reason to hope. But when faced with trials of life, “keeping hope alive” proves difficult.

Black defines hopelessness in three ways:

  1. A failure to recognize God’s wisdom.
  2. A failure to desire what God desires.
  3. An unwillingness to view time the way God does.

Important questions for a hopeless Christian to ask himself:

  • Are my hopes in the situation getting better or in Christ?
  • Are my hopes in me or in Christ?
  • Are my hopes in other people or Christ?

A quote from Psalm 73:21-22:

“When my heart was embittered and I was pierced within, then I was senseless and ignorant.”

When a Christian’s focus isn’t on Christ, everything is hopeless. I struggle with answers how to get a Christian from a point of hopelessness to hopeful ness.

Suicide: Understanding and Intervening – Part V, Felt Need

According to Black, those drawn to suicide are being denied a “felt need.”

“Depressed people who report feeling suicidal normally associate their pain with some thwarted felt need. Second, they have come to believe that they cannot endure the pain associated with that ‘unmet need.’”

He continues:

“Where does all this anguish come from? It is created and sustained by thwarted desires that a person experiences as felt needs: ‘I need what I have lost and have no hope of getting.’”

I like the principle of felt need. It can be used in any suicidal situation. The principle of “felt need” correctly identifies why a person considers suicide. The main statement follows Black’s model:

“I need ___[fill in the blank]___ and feel hopeless about ___[fill in the blank]___.”

In my case, sometimes I don’t have specific reasons for being suicidal – I just am. Therefore, the previous statement for me is as follows, “I need TO BE FREE FROM EMOTIONAL PAIN and feel hopeless about FREEDOM FROM EMOTIONAL PAIN.”

This lack of hopelessness is what drives me directly to suicide.

Suicide: Understanding and Intervening – Part IV, Helping A Suicidal Person

Helping a suicidal person is a touchy subject.  Black’s booklet is addressed to people who want to help a person who is suicidal.  Black’s provides some tips to help a suicidal person:

  1. “Acknowledge the reality of [the person’s] pain.”
  2. “Help him see the connection between his pain and his felt need.” Get them to say, “Life without ___ [fill in the blank]___ will be unbearable because ___[fill in the blank]___.
  3. “Challenge constricted options and irrational thoughts.”
  4. “Explore [the person’s] perceptions of hopelessness.” How hopeless is the person feeling? Can the situation be rectified or is it hopeless?
  5. “Help the person to separate pain and need.”

Assessing risk
Black’s following guideline is a good way to assess whether a person is considering suicide:

1. Presenting problem – Assessment begins by evaluating the problem that triggered the downward spiral.  This is difficult to do if the person can’t identify any triggers.

2. Background information – Analyze the person’s life and personality to gain a better understanding of how and why he is driven to a point where he considers taking his own life.  A good warning sign: If someone says, "I can’t deal" repeatedly. "I can’t deal" really means, "I don’t have the appropriate coping skills to handle my situation."

3. Substance abuse – While a person who abuses drugs or alcohol may not be suicidal, the likelihood that a depressed person who abuses drugs or alcohol is.

4. Resources – Encourage the (potentially) suicidal individual to seek out a support network: family, friends, church, therapists, or social groups.  If a person feels needed, he is more likely to realize that his death will have a significant impact.  Perhaps he’ll think twice before making an attempt.

5. Suicidal thinking and intent

A.     "Evaluate the person’s felt experience." Use a mood scale from 1-10 to gauge how good or bad a person is feeling. (Feel free to use mine on the right.)
B.     "Determine how often the person has suicidal thoughts and how intense or compelling they are."  Frequent "passing" thoughts are no longer passing thoughts.
C.     Dry run. A person contemplating suicide might have “tried out” the way he plans on killing himself.

“Has she ever taken a few pills to see what it feels like, tied things around her neck, driven at high speed, or practiced with an unloaded gun? Dry runs help the person to resolve any ambivalence she might feel about suicide.”

If a person admits to attempting a “dry run,” the person likely is in extreme danger of following through.

6. Noble End – A person who is at the point of beautifying suicide as a glorious end to his life is completely disillusioned and should be seen as a high risk.  Watch out for talk of "No one needs me anymore" or "Everyone would be better off without me."

An addendum: A person who says "I hate myself" may be a suicidal risk, but not always.  An admission of self-hatred provides evidence that he may want to eliminate the hatred in some way.

Suicide: Understanding and Intervening – Part II

In 10 years of struggling with suicidal thoughts, I’m practically a “suicidal” expert. (I said "practically," not actually.) I know quite a bit about suicidal ideations and many of the thought processes behind them. Jeffrey Black lists more common features in suicidal thinking:

  • Extreme psychological pain related to unmet psychological needs.
  • A view of self that says she cannot tolerate such intense pain.
  • An overwhelming feeling of hopelessness, and the belief that she is helpless to solve problems.
  • A sense of isolation or desertion accompanied by the belief that others cannot, should not, or do not want to offer support, nurture, or care.

Not all suicides are planned. I, for one, can attest to the fact that they can be impulsive. The combination of elements that Black identifies can seem to lead someone to a suicide attempt. Black’s pattern of identifying someone who possibly could have suicidal tendencies is as follows:

  • Sense of hopelessness
  • Pattern of poor coping skills
  • Limited tolerance for pain
  • Need to flee from help

All four are likely to be present to classify someone as suicidal. Two out of four does not a suicidal person make. Desperate, yes, but not undeniably suicidal.

“Hopelessness can be both a source of psychological pain and a result. A person’s belief in her inability to change things is probably bound up with her experience that the pain is intolerable.

Here’s the equation for a suicidal mind, here is the equation:

problems + inability to change problems = intolerable pain.

If the equation becomes problem + inability to change problems + intolerable pain, then the only solution – as perceived – is suicide. Black breaks down the facets of suicide:

  • The result of a continuous transaction between a person’s heart
  • The symptoms of depression
  • The kinds of stressors in the person’s environment
  • The strategies a person uses to cope with depression and other life events

A person turns to suicide if he is suffering from severe depression; has poor coping strategies; feels that his stressors are too much to handle; and in his heart, has decided that as a result of these circumstances and feelings, he must end his life.