Too often suicide is met with judgment, criticism, shame, and taboo. Suicide is the result of a confluence of stressors, circumstances, and experiences. It is an individual response to pain of every shape, size, and dimension. Suicide leaves a rippling wake of shock, horror, and grief. Isn’t it time we pull suicide out of the shadows and meet it with compassion?
If we want to address suicide, then we must sink down into the essentials and deal with the factors that contribute to suicide. And those factors are how we treat one another and ourselves. It is that basic.
Why not embrace differences, understand commonality, and reinforce the idea of oneness? We are all connected. Let’s go for bridge-building. Let’s develop our C.Q., our cultural quotient, so that we understand one another better. Let’s make room at the table for everyone. We can agree to disagree, and we can find the common thread in our shared human experience.
Why not expand our perspective and provide tools? Let’s raise our E.Q., our emotional quotient, and gain mastery. Let’s become fluent in emotional intelligence so that we can talk to one another, express our anger, and deal with conflict in an effective way. We can have healthier relationships. Let’s teach energy techniques and self-healing modalities, like HeartMath®, Reiki, Therapeutic Touch, and shamanism, for self-empowerment, resilience building, and an increased understanding of the power of personal energies.
Why not change our focus? We can increase cognitive dissonance around bullying, unethical behavior, and violence. We can work toward eradicating the learned responses of shame and fear. We can promote cooperation vs. competition; and we can make life-work-balance a priority. These are possibilities and options to create a healthier and happier society.
Speaking of priorities, how we treat our children says volumes about our societies. Let’s feed, house, clothe, and educate our children. Why are any children on this globe going to bed hungry? Let’s address childhood sexual abuse, sex trafficking, and domestic violence. Children are in crisis—and they are our future.
Let’s share our burdens by practicing empathy and cultivating compassion. We need to walk in one another’s shoes. Let’s give our wounded the help they need. Mental health services, VA services, and the like are in dire need of public support and funding. Substance abuse requires more long-term treatment strategies. Why is this problematic?
And if we are to address the pervasive soul loss, then we need to honor the soul. We can move toward that by rebalancing priorities, respecting Mother Nature, healing Mother Earth, celebrating the arts, course-correcting the pace, being open to creative expression, and developing more meaningful ways of connecting with one another.
And, lastly, we need to live peace, with ourselves and with others. If we cannot accept ourselves, if we feel we are forever unworthy, we will act in ways that can have enormous ripple effects. Peace is a five-letter word that offers relief and healing. And it starts with each of us.
Every three seconds, on average, someone is attempting suicide, according to research out of India. The numbers of suicide attempts are exponentially higher than the number of completed suicides, which average every 13 seconds across the globe per the World Health Organization (WHO). Tragically, every minute of every day is influenced by some aspect of suicide.
Suicidality shows itself in a range of behaviors and thoughts that can become more fixed and concretized. There is a progression of pain and disconnection. Emotions are not linear. Thoughts can be disordered and scattered. There is no straight line or exact trajectory. That said, there is a continuum of suicide, where aspects of suicidality are portrayed by each individual in their own idiosyncratic manner.
Over my 30+ years of clinical work, these are the aspects of suicide I have seen in the consultation room and through crisis intervention lines. There are seven points on this spectrum, each with its own degree of severity. Clearly, some points are more intense and critical than others, but each is to be taken seriously and warrants professional help.
Quite simply, you are thinking about suicide. You are rolling the idea around in your brain. Does this make sense for me? Would it be my answer?
Many people consider suicide in the abstract. What if? Thinking does not necessarily mean doing. Ideation is considering the option — usually, when there seem to be few options, and distress and overwhelm are at the fore.
This is a seeming attempt at suicide by self-injury without serious or fatal consequences. Taking an overdose of aspirin or cutting one’s wrists are good examples.
(Please note, there is a distinction between self-harm and suicidal gestures. Cutting as self-harm is intended to relieve crushing emotions or to be able to feel something and no longer be numb; whereas, the intention of suicide is to cease the painful feelings and end one’s life. That said, be it self-harm — very common with trauma survivors who are at risk for suicide — or a suicidal gesture, both indicate a need for professional help.)
Suicidal gestures are a cry for help and, sometimes, attention. They are an alarm bell for action to be taken. These gestures are often labeled with the unfortunate term “para-suicide,” which minimizes the gravity of the situation. Repeated gestures are frequently a precursor to a completed suicide.
3. Passively Suicidal
This is a form of suicidal ideation. You are thinking about it, but know at this moment you would never do it. It sounds like a plausible idea because you are in so much emotional pain. There is a level of resignation in this thinking.
If someone magically took you out of your misery, you feel certain you would not fight back. You don’t want to feel so much pain any more. You are thoroughly depleted and paralyzed. You are exhausted on every level; you feel powerless and unable to change your current situation.
4. Active Thinking
This form of suicidal ideation is farther along the spectrum. You are developing a plan. You are working out the details. You know exactly what, when, and how you will do it. For some, there is relief in having a plan. For others, there is a grim satisfaction in imagining the impact their death will have on others. Maybe now they will understand how much I hurt.
5. Thinking and Doing
There are two forms of thinking-and-doing; one is planned and the other is impulsive.
You are now making a concrete plan. You are making preparations, securing the necessary accoutrements, and orchestrating how you will make your suicide happen.
Frequently, when individuals have reached this step, they may present themselves as happy to their loved ones and therapists. They have a plan of action. They are resolved, and there is no more equivocation.
Sometimes, the plan is enough in and of itself and serves as a fallback position if everything goes horribly wrong. When there are self-doubts about the viability and impact of the plan, the individual may be open to outside intervention and assistance, and the plan may crumble.
Impulsive thinking-and-doing is, as the name states, impulsive. It’s a flash of a thought and a rush of feeling that makes sense at the time. It’s an immediate way to end the internal anguish. Frequently, this occurs with teens and young adults.
This impulsivity can be accelerated by substance abuse that lowers the inhibitions, a history of risky behavior, unfettered anger, and unrelenting anxiety.
Impulsivity can also be triggered by a psychotic incident where there may be delusions and hallucinations. For example, voices in a young man’s head told him to kill himself immediately because all of his family were now living on another planet.
6. Chronically Suicidal
The chronically suicidal are individuals who, by virtue of mental illness, are always in and out of suicidality. Usually, they have been on psychiatric meds for years, and they have been hospitalized frequently.
Suicide is their default wiring. It’s where they land when their pain escalates; their thinking contracts, expands, or becomes chaotic; and they want to escape from the effects of their medications. The chronically suicidal want out; they want their internal struggle and torment to be over.
7. Slow Suicide
Slow suicide speaks to a long-term history of intractable, unrelenting addiction and substance abuse, such as full-blown anorexia nervosa, chronic heroin abuse and alcoholism.
Slow suicide is evidenced by a lifetime of self-harm that chronically erodes a person’s health, well-being, mental stability, emotional resilience, and vital energy. There is inordinate pain, grief, and anger. Unresolved trauma is likely.
Slow suicidal people choose to stay stuck in their toxic and self-defeating spin and steadfastly refuse any offers of help and assistance.
Suicide is never easy. We know it’s not painless. This spectrum of suicidality delineates the range of behaviors and thinking in order to increase understanding and compassion and, perhaps, circumvent tragedy.
This column was also featured on The Huffington Post Canada.
Circling the international news is the story of the assisted suicide of a young Dutch woman due to long-term childhood sexual abuse. This woman in her 20’s asked for — and was granted — euthanasia by lethal injection.
She requested an end to her life due to intractable trauma (i.e., severe Post-Traumatic Stress Disorder) and concomitant medical issues (i.e., advanced anorexia, chronic depression and hallucinations) that left her primarily bedridden.
Her story has raised questions and concerns.
As a mental health professional who has worked first-hand with childhood sexual abuse survivors, I have witnessed the repercussions of the compounded and complicated trauma of childhood sexual abuse.
Read more here.
Suicide is heartbreaking. And suicide is especially crushing when a teenager has made the lethal choice to end their life. What happened? As the adults in their lives, we cannot fathom how things went so bad so fast. We feel so certain there could have been another way, a different choice. Yes, we might have been mad, but love comes first, above all, and we would have helped you.
And so begins the hell for parents and loved ones of a teen suicide. You are full of questions and “what ifs,” reeling in shock and disbelief. You rethink everything. What did you miss? Were there signs? You thought it was normal teenage angst and withdrawal. You had no idea it was this bad.
Or maybe you did. Maybe your teen’s life was a maelstrom of chaos and upheaval. He or she kept unraveling, becoming riskier, angrier, withdrawn or hell-bent on self-destruction. You were considered the enemy. Communication had shut down. You felt powerless. It was hard to recognize this snarky stranger who avoided eye contact with you at all possible costs as your child.
The teen years are an emotional roller coaster
Teenage years, by definition, are tumultuous. The brain is not fully developed. Hormones reconfigure bodies and play havoc with emotions. Psychologically, teens need to individuate — pull away from their parents to become their own person. These years are physically, emotionally, mentally and socially difficult. They can be hard to negotiate. Teens can be extreme and dramatic — and their parents, too, who wonder who they have become in trying to manage and protect their teenager. It’s a highly sensitive and volatile stage of life.
Please click this link to read the remainder of this article which is a part of “Frame of Mind,” a new month-long series focused on teens and mental health by the Huffington Post Canada:
Not all suicides are defined by mental illness, substance abuse, and unrelenting pain. There are many ways in which we see and interpret the world. From time immemorial, the soul, our spark of being, has been viewed as our primary force of life. It is what animates us.
If we have been abused, humiliated, oppressed, terrorized, tortured, traumatized, or hurt physically or emotionally in any powerful way, our soul can be crushed. Our life force leaks out. We are no longer our whole selves. We have lost some of our light and we are hunkered down in a protective, survival mode. If the soul loss is profound, we become numb, hollow, and begin to move through life in a disconnected, zombie-like way. We see profound soul loss in the eyes of our military, childhood sexual abuse survivors, and the severely bullied, to name a few.
Soul loss should also be considered a primary cause for suicide. Soul loss does not necessarily preclude the diagnostic criteria, but, instead, often views the diagnostic criteria as further evidence of soul loss.
The Indigenous world has long honored the soul. Illness, depression, trauma, and other Western-labeled maladies are explained as soul loss.
If the soul is tended, then the body, mind, and heart can heal.
To explain further, here is an example:
In South America, a young girl is no longer speaking. She has become totally silent. Her parents take her to doctors and specialists, but to no avail. As a last resort, they drive to a village in the country and take their daughter to a local shaman. He tells them to leave their daughter with his tribe for the week. The shaman then instructs the women to bathe the girl daily and, while bathing her, they are to sing her healing songs. At the end of the week, the girl begins to speak and tells of the rape she had recently endured. She had refound her voice and was healed.
I suggest that soul loss runs parallel to psychoneuroimmunology (PNI), which looks at the mind-body (and often, spirit) interaction. Science does recognize that our thoughts and feelings influence our well-being. As a result, we now see more holistic treatments, an awareness of the role of the soul, as well as an acceptance of assorted energy modalities to help bring the individual back to wholeness.
Understanding the ramifications of soul loss is an important factor in looking at suicide and suicide prevention. If we don’t feed our souls, we lose our animation and our energies dissipate. We would be well served to consider soul loss when assessing suicidality.
After you have lost a loved one to suicide, you feel anything but powerful or strong. Most likely, you are at your most vulnerable, full of heartbreak and deep grief.
Suicide leaves a trail of uncertainties and questions. Knowledge can help make some sense of the unimaginable. When we learn more, we have a basis for comparison. We realize, perhaps, that our situation is not so unusual. Plus, we can accept more fully the biochemical or psychosocial elements that have led to a suicidal action. When we understand more, we are no longer so confused, confounded, or upset. We find steadier footing, and we find ourselves more emotionally and mentally stable. Indeed, knowledge can serve as a powerful healing ally.
Peace can never be achieved by force.
It can only be achieved by understanding.
And, sometimes, they are. There are people who cannot function on a day-to-day basis, do not bathe for a year, receive messages to kill themselves or others, or believe their fillings are wired to Martian intelligence. There are very real neurological and biochemical influences that place these patients at high risk.
Untreated depression is considered the number one cause of suicide. If you, or someone you love, has experienced the reality of major depression, you know what a devastating, debilitating, and a biochemical illness it is. The depressed person does not see or think clearly. She is locked inside a black, airless box that offers no light or perspective.
Hospitalization and medication have saved many lives. William Styron, in his memoir, Darkness Visible: A Memoir of Madness (1992), eloquently detailed his descent into, and recovery from, depression, which he called, “a howling tempest in the brain . . . dreadful, pouncing seizures of anxiety.” Styron understood the stranglehold of depression: “The pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne.”
Along with major depressive disorder, the psychiatric illnesses that can lead to suicidal actions are bipolar disorder (formerly known as manic depression), borderline personality disorder, post-traumatic stress disorder (PTSD), schizophrenia, and other psychotic disorders.
Did you know that the single greatest risk factor for suicide is a history of suicidal behaviors and attempts? Of course, this makes perfect sense, and if someone you love has these behavior patterns, take them seriously.
If you have lived with a loved one who has suffered from any of these mental illnesses, your life has not been an easy one. Nor has theirs. No one chooses to live with a debilitating psychiatric or psychological disorder that frequently moves in and out of crisis. It is painful, chaotic, exhausting, and terrifying for both the patient and loved ones. Ongoing treatment and meds are usually necessary to help make life more manageable.
A psychiatrist colleague of mine, once shared this with me: The majority of her patients who ended up in the hospital emergency room had stopped taking their medications, which then precipitated the subsequent disintegration.
Whereas, Nancy Kehoe, PhD, RSCJ, a Harvard Medical School professor, clinical psychologist, and nun, offered a new take on psychiatric hospitalizations during a lecture I attended decades ago in Boston. She allowed that for many of her patients, a psychiatric hospital gave them a much-needed sense of community and connection. And, with that sense of community and connection, they were able to heal. And by heal, I mean to find some stability so that they could return to the world as a functioning participant.
This made me think of the African tribes as well as many of the Indigenous people who work as a community and address the soul to help those in pain (of any kind) to find relief. There are many paths to wellness and wholeness.
As we continue to look at some of the whys suicide has been chosen, let’s consider the impact of cumulative stressors and trauma:
A darling Celtic client of mine had a great saying, “Life does life.” She was right. It does.
There are times when life throws us a major curveball and we are seriously rattled. We lose our footing, and our wherewithal is seriously diminished. If there are continuous stressors such as disasters, losses, medical conditions, and financial issues, a person who has been functioning well may begin to feel the onslaught, for it is akin to non-stop blows to the body.
Stress is cumulative, and non-stop stress allows no room to take a breath, to process, or assess. You are going from one thing to another. Before you know it, you are holding on by a thread. Life has become overwhelming. There seems to be no meaning and no point to it all. You are psychologically shattered. Then one more stressor knocks at your door, and you can’t imagine how you are going to keep going on like this. You have tried your best, but you are tired. You are worn out.
Think of the rash of “suicides by economic crises” in several European countries. Imagine the suddenly homeless, the ostracized and shunned, the failed crops, the medical emergencies, the bereft husband, and the bankrupt. They have endured much, and this accumulation of stress and being powerless can prompt suicidal feelings.
Be it an injury to the body, mind, soul, or an emotional shock that upends a life, trauma is pervasive in our world. Trauma can be a sudden death, combat service, childhood sexual abuse, a natural disaster, terrorism, catastrophic illness, and violence such as unrelenting bullying.
For some, that acute stress and shock of the experience(s) does not fade away or diminish; it becomes entrenched in an insidious way. The body-whacking, heart-thumping, mind-numbing, horrifying, excruciating, and unfathomable traumatic experience holds a person hostage in a complete mind-body-heart hell.
This chronic pattern of neurological and physical responses is called post-traumatic stress disorder (PTSD). This is particularly prevalent, and most understandable, among survivors of childhood sexual abuse, victims of bullying, and combat soldiers. They are at high risk for suicide given the horrors they have lived through, have been tormented by, and have survived.
Imagine the VA Hospital and a group of vets waiting to attend a PTSD treatment group. Their hands are shoved into their pockets. Very few are holding cups of coffee because their hands shake from the increased cortisol in their systems.
Imagine the student who has been bullied to such an extreme that he cannot focus on his classes. He sits in terror waiting for the next attack and wondering how he can protect himself.
Imagine a sexual abuse support group. The women share their difficulties sleeping due to nightmares replaying nightly. The terror and the body memories flood their systems frequently; sleep is anathema. Pain is a constant companion.
For those in the hell of PTSD, suicide can be seen as an option to end the recurring cycles of pain and horror. Sometimes, too much is just too much.
Pain can look like a physical wound, broken parts, a speeding mind cycling through multi-dimensional layers, heartbreak, trauma, abandonment, shattered dreams, a wailing debate with God, homelessness, hunger, failed attempts, low-slung despair, high-pitched anxiety, self-hate, the endless push and pull of addiction, torture, and the intractable agony of chronic pain, among other conditions. Both cluster headaches and trigeminal neuralgia are called the “suicide diseases.” The excruciating levels of pain associated with each disorder make the individuals want to die to be free of the inordinate pain.
Unrelenting pain can wear a person down. It feels as if it will never end. It feels like there is no solution. It hurts so, so much. That sort of pain can leave you breathless. And, that kind of fetal-positioned, tear-producing pain can prompt thoughts of suicide.