Quote of the Week

"Abuse victims are always the best actors.  They have to be, to live
their whole lives with the pain and shame, pretending there is nothing
wrong.  It’s the greatest performance of all." — Richard Dreyfuss in
"Silent Fall"

Advertisements

The Purple Elephant in the Room

“Every minute, a suicide is attempted.” — everyminute.org

“With over 30,000 people dying by suicide each year in the United States, averaging 82 per day, there are almost twice as many suicides as homicides each year.” — stopasuicide.org

gun82 per day. Despite the fond memories the “Thompson” family will always have of Bob’s grandfather — whom we’ll call Grandpa — he is now logged as a suicide statistic:

  • Suicide per minute
  • Suicide per hour
  • Suicide per day
  • Suicide per year
  • Suicide in the town
  • Suicide in the state
  • Suicide in the nation
  • Suicide in the world
  • Suicide by age (elderly)
  • Suicide by gender
  • Suicide by firearm

The list likely goes on.

Suicide is the purple elephant in the room that no one likes to talk about. It’s never a pleasant subject, especially when it’s by someone you know. The pain of losing someone by suicide seems to surpass the pain of all other kinds of death. There’s something about suicide in which we feel that the deceased had control.

  • “It didn’t have to be that way.”
  • “If he’d just gotten help.”

Read the rest of this entry »

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 III

A “situational crisis” may lead a person to have “intense psychological pain.” As a result of this psychological pain, a person can begin to experience “distorted thinking” and/or may “abuse medication.”

1. Situational crises

These include financial problems, illness, bereavement, relational conflict, or public humiliation. Black notes that situational crises tend to act as a “catalyst to suicide,” driving the person to believe he or she has no other solutions to solve his or her problem(s).

2. Severe psychological pain
Black gets to the heart of suicide attempts:

“The goal of suicide is often simply to end that pain: ‘I just want the pain to go away.’ … ‘I just want to die’ most often means, ‘I want to stop feeling bad.’”

This, above all things, is the biggest reason behind a suicide attempt. If people felt like they had other options to their problems apart from suicide, most would take the alternate routes. In a suicidal moment – whether planned or not – the suicidal person is thinking about ending the “pain.” Death itself is not the goal; it’s an end to emotional pain. Death seems to serve as a means to that end.

3. Distorted Thoughts
Distorted thinking is a characteristic of suicides. Black writes:

“Problems may seems catastrophic when they are not. Predictions about the future can become arbitrary and unrealistic.

While problems get unbearable and circumstances may seems bleak, instead of looking for assistance, those who are suicidal convince themselves that only death or loss of consciousness can release them from emotional pain.

4. Abuse of medication
A person who attempts to overdose on medication seeks one of two things: death or loss of consciousness. Abuse of medication that requires hospitalization provides a legitimate reason to “escape” the problems of life. Abusing medication is a person’s way of saying that he needs, as Black puts it, “an emotional vacation.” The person feels overwhelmed by the stressors of life and temporarily need to block out all distractions. At this point, it is safe to say a person is mentally ill. The need for escape from problems is the mind’s way of saying that it needs time to recover and become mentally healthy again. Abusing medication is the desperate way of doing this.

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.

Tyra Banks Fights Back

I liked Tyra Banks before because she seemed really down-to-earth, but I absolutely love her now.

Tyra BanksPeople magazine has run a cover of Banks at an awful weight of 162 lb at 5’10”. (sarcasm) She received tabloid names like “America’s Next Top Waddle” and “Tyra Porkchop.” I’m not even Tyra and that hurt me. I’m barely 5’4″ and used to weigh 162. I was on the verge of being “obese” (as opposed to “morbidly obese.”) Yeah. Even my family told me I was fat and needed to lose weight. There was only one issue that drove me nuts:

“It’s when I put on the jeans that used to fit a year ago and don’t fit now and give me the muffin top, that’s when I say, ‘Damn!’ “

The bar is raised because she’s Tyra and a former model. But she’s absolutely cool about it and not in the business of running to change her new weight:

“Still, she isn’t freaking out about wearing size 32-waist jeans or about “the fat roll” she claims to have on her back. (Her biggest source of figure angst is her size-DD breasts, which she says make it hard to find clothes that fit: “I would love for them to be a size and a half smaller.”)

But, she adds, “I’ve made millions of dollars with the body I have, so where’s the pain in that? If I was in pain, I would have dieted. The pain is not there – the pain is someone printing a picture of me and saying those (horrible) things.”

She’s also aware that the tabloids not only hurt her, but also paint a false reality for young girls and teens:

“I get so much mail from young girls who say, ‘I look up to you, you’re not as skinny as everyone else, I think you’re beautiful,’ ” she says. “So when they say that my body is ‘ugly’ and ‘disgusting,’ what does that make those girls feel like?”

My brief struggle with weight — it was only from the beginning of 2004 to the end of 2006 — has taught me a lot about myself and others. I attribute much of my weight gain to Paxil and Lexapro.

Read the rest of this entry »