Suicide and cumulative stressors

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 and suicide

Pain does not discriminate. It moves among us equally, wearing many faces, including that of physical, emotional, mental, and spiritual pain.

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.

A very brief history of suicide

Suicide has been part of the human experience, across the globe, as long as we have been recording our history. Over the centuries, suicide has been perceived as a personal choice, a mortal sin, a social issue, a mental illness, as well as an act of honor, piety, or shame.

In ancient Egypt, it is said, “There is no direct archaeological evidence for suicide . . . nor for any discriminatory treatment of people who died at their own hand.” In other words, suicide did not break any laws or codes. There was no taboo against it.

Romans and Greeks (with the exception of Pythagoras for mathematical reasons, and Aristotle due to his belief in a finite number of souls and the consequences of same) were not troubled about suicide. Roman and Japanese soldiers were known to take their own lives if defeated in battle. It was considered a point of honor or a ‘patriotic suicide’ and may have also served as a way to avoid capture and possible torture.

Early Christians, often en masse, chose voluntary death and martyrdom in lieu of persecution. These suicides were considered a great act of piety. In the fourth century, St. Augustine was the first Christian to publicly declare suicide a sin.

During the Middle Ages, a time that was deeply influenced by the venal actions of the Roman Catholic Church, suicide was shrouded in great shame and fear of eternal repercussions. If you took your own life, your body became an object of public ridicule and torture. You were excommunicated from the Church, your property was seized, and you were prohibited from burial in consecrated or sacred ground.

Suicide moved out the Dark Ages and became a topic of social interest during the Renaissance and Reformation. Shakespeare, as we know, wrote of suicide in a number of his plays, as did the poet John Donne. The philosophers Voltaire and Montesquieu also defended an individual’s right to choose death.

French sociologist, social psychologist, and philosopher Émile Durkheim wrote Le Suicide (1897). This book was the first social analysis of suicide, and it helped increase awareness of suicide as well as decrease the shame surrounding suicide.

Sigmund Freud stepped onto the world stage in the early twentieth century, and with his arrival, mental illness was first viewed as a medical condition. Studies in psychiatry and psychology blossomed; suicide awareness, education, and treatment strategies were created. In 1983, the Roman Catholic Church reversed its canon, and those who died by suicide could have a Catholic funeral and burial.

Today, suicide is a worldwide epidemic that is indifferent to the boundaries between cultures, age, religion, gender, and socioeconomic classes. Suicide has many faces, and each one is part of humanity regardless of our differences. Suicide may be a response to despair, pain, illness, and the pull of inner demons. It can be an act of war, a reaction to violence, or a final surrender.

How do we help a loved one who has lost someone to suicide?

Suicide is often a sudden, unexpected death. It leaves loved ones reeling with shock, confusion, heartbreak, anger and whole panoply of emotions.

When word gets out about a death by suicide, there is a ripple effect. The loss moves out in ever-widening circles and whoever hears or knows anyone impacted by the loss wants to do something. Bake lasagna, make the calls, organize logistics, walk the dog, help with the service, be a shoulder, lend an ear. They want to feed you, nourish you and hold you. They want to help you stay afloat when you are drowning in heartbreak. They feel your loss, and your loss becomes their loss.

Loss is primal; we all feel it. And this is especially true when we hear of a suicide, and especially, the suicide of a young person with their unfurled life before them.

It is hard to see our loved ones doubled over in grief and pain. We want to do something — anything — to help ease their misery.

What can we do when someone we care about loses a loved one to suicide?

Read more here.


N.B. The HuffingtonPost Canada retitled this article to “Don’t be Afraid to Talk about People Who’ve Died by Suicide.”

Thinking of you, survivors of suicide loss

November 23, is International Survivors of Suicide Loss Day. According to the World Health Organization, around the globe, on average there is one suicide every 40 seconds.

If you are a survivor yourself or you know someone or know someone who knows someone who lost someone to suicide. Suicide stops us in our tracks. It can be hard to wrap our heads around that much pain and anguish.

Suicide research originally indicated that each suicide left, on average, six people in its wake. However, there are new indications that each suicide could leave 22-26 people in its wake. The higher number is not surprising when you think of coworkers, classmates, neighbors and the like.

We humans are social beings. Our lives are filled with connections and relationships. It is hard to see our loved ones, friends or coworkers doubled over in grief and pain. We want to do something – anything — to help ease their misery.

And if you are a survivor yourself, you know all too well how treacherous the path is out of the well of complicated and traumatic grief from a death by suicide.

To help you as well as to help others, here are eight articles that hopefully will expand your understanding  and assist you in caring for those you love who are heartbroken:

When You Are the Survivor of Suicide

 This is What Grief Feels Like 

Understanding Teen Suicide Helps Make Sense of the Heartbreak

7 Things You Need to Know after a Loss from Suicide

When You Are Ready, This Can Help You Heal from a Loss by Suicide

Dealing with the Death of a Young Person

How to Help your Grieving Child

Shattered Hearts: Explaining Suicide to Children

Thinking of all of you who have walked this path, directly and indirectly. May your heart find peace.

Understanding Intolerance, Bullying And Suicide

Intolerance is a battering ram directed at anyone who is perceived as different and who has therefore become a focus of enmity. You want them to be like you. If they are not like you, you have things to say and you might become enraged, disgusted and afraid — all of this in the name of like-mindedness.

They, those other ones, become your enemy and the focus of your attention as you rain down your vitriol on their different-from-you selves. They, those other ones, become fair game for your averted eyes, comments, slurs, stares, grimaces, cold shoulders, bullying, graffiti, hate crimes, attacks, thefts and warheads.

Intolerance is predicated on fear. “Otherness” has scared people for centuries. Wars and conversion missions have been started in the name of homogeneity: Be like me and then we can understand each other. Intolerance smacks of fundamentalism: I’m right, and you’re wrong. It seems there can be no middle ground, and no acceptance of the other.

Many a suicide happens because of this rampage of intolerance. The horror of bullying is a prime example, a universal phenomenon, and it is just beginning to get the attention it deserves.

There are three kinds of bullying: verbal, physical and social, with verbal abuse being the most common. Bullying includes physical bullying, emotional bullying, and cyber-bullying (i.e., bullying on the Internet, and circulating suggestive or nude photos or messages about someone).

According to studies by Yale University, bullying victims are two to nine times more likely to consider suicide than their non-bullied classmates. A study in the U.K. found that at least half of the suicides among young people are related to bullying. Further, ABC News (U.S.) reported statistics that showed nearly 30 per cent of students are either bullies or victims of bullying. Some 160,000 students stay home from school every day because of fear of bullying.

Kids are bullied because they are different, and they can be different in any possible way. If you are different you can be picked on, and you become a potential target. Parents of bullied kids will sometimes go to extreme measures to help their children avoid bullying: one first grader was given plastic surgery to have her ears pinned back.

Kids are bullied for any number of reasons. Common “differences” that can draw unwanted negative attention include:

• Having an unusual appearance or body size
• Showing behaviors of attention-deficit/hyperactive disorder (ADHD)
• Being diabetic
• Being gay
• Being a gifted student
• Having food allergies
• Displaying a noticeably high level of anxiety
• Having learning disabilities
• Having medical conditions that affect appearance
• Being obese
• Stuttering

It’s easy to understand that bullying leads to shattered self-esteem, poor self-worth, depression and suicidal thoughts or actions. Bullying can have long-term emotional ramifications for the victim. Further, a number of school shootings — for example, Columbine — have been caused by bullied kids seeking revenge. Bullying is a symptom of intolerance that escalates and becomes a vicious cycle.

So much suicide is a result of intolerance. Think of all the heartache that is caused by simply not accepting people for who they are and where there are. Intolerance is a mighty powerful belief system. It prevents peace, contributes to suicidality, and causes pain across the globe.

Let’s make bullying an intolerable. Let’s teach our children. Let’s model tolerant and compassionate behavior and tip the societal balance in favor of understanding and acceptance.


This post was also featured on The Huffington Post Canada.

The three common elements of suicide

From my perspective, all suicidal gestures and actions, no matter how large or small, injurious or lethal, share these three elements:

  • Pain
  • Disconnection
  • Disenfranchisement

Pain means any and all pain in all its permutations—be it physical, emotional, mental, spiritual, or any combination thereof. Pain hurts. When we are in pain, we have one goal: to stop hurting. We do everything we can to get out of pain. Often, we don’t care what it takes to be pain-free; we just want the howling, can’t-take-a-deep-breath or think-clearly pain to be over as soon as possible.

Constant, chronic pain—of any variety—changes people. Pain is exhausting and debilitating. Pain makes us cranky and intolerant. Pain wreaks havoc with our sleep cycle. It rearranges our thinking as well as diminishes our ability to cope and withstand the vagaries of everyday life.

When we are in pain, we contract into ourselves. Our world becomes smaller, darker, and enclosed. We shut out the world. There is only so much bandwidth, and we use it to manage the pain. The only thing that matters is to be pain-free, now. And, unfortunately, that can sometimes result in a suicidal action.

Disconnection speaks to the separation between the self and others. Separation is the operative word. We feel unwanted and unloved, alone and isolated, misunderstood and alien. There may be no one in our corner or no sense of connection with another person, a group of people, or a higher power. We can even feel profoundly disconnected among family and friends, who do not understand us and, more pointedly, do not comprehend what we have experienced and what has happened to us. This can be the height of loneliness.

We know from research that people who feel socially isolated (i.e., divorced, widowed, etc.) are at increased risk for suicide as compared with those who have responsibility for family members and are part of some kind of social grouping, network, or organization.

With disconnection, it feels as if there is no tether to stay anchored and grounded on the earth plane. We are alone. No one gets us. This is particularly true of survivors of a suicide loss, the military and veterans, and survivors of childhood sexual abuse.

Disenfranchisement, in the psychological sense, is disconnection to the nth degree. It is the ultimate sense of disconnection; it’s as if we are looking at the world with our nose pressed to the glass. We do not feel that we belong, nor are we connected in any larger sense. We are no longer a part of the whole. We are a free-floating entity adrift in the world, alone, without value, purpose, or plan. There is no meaning in our life. We feel invisible and worth nothing. This is the utmost of pain.

All three elements — pain, disconnection, and disenfranchisement — take us to shut-down, closed-off places. This leads to inactivity, inertia, passivity, and powerlessness. We feel stuck. We have lost our abilities to be creative and expansive. There is precious little energy or flow. And, from that position, it is easy to become dispirited and hopeless, which is another kind of pain. And pain of all kinds can lead to suicidal thinking and action.

Suicide is a complicated and multi-factored issue, and yet there are three common elements that serve as the foundation to suicidality. These elements address the full spectrum of suicide. They can help us understand the ineffable “why” of suicide and, also, serve as warning flags for the future.

These three elements also underscore our need to find better ways to reach out and provide safety nets, support, and aid for our most vulnerable and traumatized.

Suicide and brain damage

The brain is doubly impacted by trauma and addiction. We also know that organic brain disease may increase suicidality, and there are worrisome side effects that come with certain psych meds. Soldiers, football players, boxers, other high-impact sports athletes, car accident victims, and others who have had a traumatic brain injury (TBI) or its milder form, post-concussion syndrome (PCS), are at risk.

Traumatic Brain Injury has two causes:

1. Penetration of the head by a foreign object, such as a gunshot or sharp object.
2. Strong jostling within the cranium from a fall, a blow to the head, a car or motorcycle accident, etc.

The hallmarks of TBI, depending upon the severity of the blow to the head, can be:

• Cognitive impairment, evidenced in poor memory and lack of focus
• Emotional problems, such as depression, anxiety, personality change, aggression, and impulse control
• Impaired motor function, poor balance and coordination, and weakness in the extremities
• Problems with vision, hearing, and touch as well as impaired perception

NFL player Dave Duerson, former star of the Chicago Bears, shot himself in the chest at age 50. Before taking his life with a self-inflicted gunshot wound to the chest, he texted his family, asking that his brain be given to Boston University School of Medicine to be used for research—which is why he shot himself in the chest rather than in the head.

Researchers in neurology discovered that Duerson suffered from a neurodegenerative disease called CTE (chronic traumatic encephalopathy), which is linked to repeated head trauma and promotes the growth of a protein that is prevalent in degenerating brains like those with Alzheimer’s disease. The symptoms of CTE include suicidality, depression, aggression, and impaired judgment.

In 2006, another NFL player, Andre Waters of the Philadelphia Eagles, ended his life at the age of 44. The forensic pathologist who studied Waters’s brain said that it resembled the brain of an 85-year-old man in the first stages of Alzheimer’s.

The current research indicates that CTE is also found among military veterans and young school athletes, including those who play hockey and football, who take repeated blows to head. The soft-tissue damage to the brain is cumulative and dangerous.

Most significantly, the brain damage caused by CTE and TBI can lead to suicide.

A word about substance abuse, addiction and suicide

Research tells us the following:
• Drugs and alcohol increase the risk of death by suicide more than six times.
• The largest risk factors for suicidal thoughts are depression and other mental disorders, and substance abuse.
• More than one in three people who die from suicide are intoxicated, most commonly with alcohol or opiates (i.e., heroin, oxycodone).

Addiction is a brain disorder, not merely a matter of willpower. The brain is held hostage by drugs and alcohol. It is a real disease that is both cunning and baffling. And, it is treatable.

The abuse of substances, drugs and/or alcohol, leads to ignoring your responsibilities, taking risks, relationship problems, and potential legal issues. You are using substances without concern for their impact. It’s a bit like you have begun an unhealthy love affair. You are not quite yourself; you don’t care what others say, and you become more and more entranced with your new “love.” Slowly, and most certainly, you hand your power over to the substances of your choice.

Full-blown addiction harms the body, makes changes in the brain, results in poor life choices, and batters relationships. Addiction also increases feelings of self-hate, shame, isolation, and scheming behaviors. It erodes the spirit. Your life totally revolves around making connections, getting the substance of your choice, using that substance, and recovering from its use. Yet, you continue to use the drugs and/or alcohol even though you know it is bad for you. You are powerless, and the substances now own you.

Why do suicide, substance abuse, and addiction frequently go hand-in-hand?

We know that substance abuse changes us physically, emotionally, and mentally in these ways:

• Decreases inhibitions and lowers defenses
• Increases aggressiveness and violent behavior
• Impairs judgment
• Increases impulsivity. (Adolescents and young adults, especially, feel “bullet-proof,” and that nothing bad could ever happen to them.)
• Amplifies emotional responses such as hopelessness, despair, shame, and abandonment
• Increases and exacerbates emotional fragility already present within certain populations, i.e., those who are dual diagnosed (mental illness + substance abuse) and those suffering with PTSD and traumatic brain injury (TBI)

We know that substance abuse changes the brain. It impacts thoughts, feelings, and actions. Frequently, substance abuse is an anesthetic, a maladaptive habit-pattern, a coping response for stress, pain, and unhappiness. For the emotionally vulnerable person, substance abuse is akin to a match near a can of gasoline. There is a much greater potential for disaster.

Suicide and the Power of Shame

Shame is a feeling state. It is a deep-down, red-faced humiliation and mortification with oneself.

Through the lens of shame, we look at ourselves with complete disgust, revulsion, and contemptibility. We judge ourselves harshly, and show no mercy. We see ourselves as the epitome of gross imperfection, enormous stupidity, complete failure, and abject incompetence. Shame is a powerful force, and it can be a driving factor in suicidal thinking.

Shame is associated with intense feelings of disgrace, dishonor, and condemnation. It is also a major component of ostracism, shunning (think Hester Prynne and her Scarlet “A”), and punishment.

Shame is not the same thing as embarrassment. When we are embarrassed we feel, in varying degrees, uncomfortable with ourselves for something we have done or experienced. We are discomfited by our behavior. For example, we look in a mirror and realize that we had a piece of spinach stuck to our front tooth during our dinner date as we laughed and acted charming.

Nor is shame the same as guilt. We feel guilty when we have violated our personal standard. For example, we forgot to send our favorite Aunt Minnie a birthday card or we didn’t check up on a sick friend.

The etymology of the word “shame” is rooted in the words “to cover up, hide.” And, that’s exactly what we do when we feel ashamed; we want to hide and cover up. We avert our eyes, lower our head, and our shoulders slump. We want to disappear. And when there is intense shame, there is vasodilation (blushing) along with increased body heat and warmth.

Like fear, shame is a learned response. No one is born with shame. Shame is passed along by super-critical parents, relatives, employers, teachers, and the like. They regularly make denigrating comments that make you feel horrible about yourself. You might hear that you are stupid, worthless, unlovable, ugly, fat, a failure, incompetent, and any number of put-downs that attack your very essence. These critical folks (from their own wounded and unhealed hearts) tell you these terrible things about yourself, and you believe them. You unconsciously absorb their personal poison and drink it in as truth. You forever feel not good enough, not lovable enough, not enough enough.

You can feel ashamed when you are stopped for a DUI (i.e., driving while intoxicated); are verbally abused in front of your co-workers; or tell your friends your father died of a heart attack when he actually died by suicide. You can feel shame when you learn you are infertile or you need to file for bankruptcy. You can be filled with shame and the attendant self-loathing after you rage at your children or realize you have sent a scathing email to the wrong person.

Perfectionists, understandably, carry a tremendous load of shame. Members of dysfunctional families where there is addiction, violence, anger, and control issues also live with shame every day of their lives. Shame is all too common in cases of child abuse and child neglect. And, we all carry the secret shame of being ashamed. Shame says, I am a bad person, a horrible person, a no-good person.

Brené Brown, PhD, LMSW, is a researcher and storyteller who studies vulnerability, courage, worthiness, and shame. (Check out her fab TED talks on shame and vulnerability.) Brown has discerned what she calls her 1-2-3’s of shame:

1. “Shame is universal. It is one of the most primitive of human emotions. The only people who don’t have shame are those who have no empathy and lack the capacity for human connection. Here’s your choice: Fess up to experiencing shame or admit that you’re a sociopath.”
2. “We are all afraid to talk about shame.”
3. “The less we talk about shame, the more control shame has over our lives.”

Further, Brown has identified 12 categories of shame:

• Addiction
• Aging
• Appearance and body image
• Being stereotyped or labeled
• Family
• Mental and physical health
• Money and work
• Motherhood/fatherhood
• Parenting
• Religion
• Sex
• Surviving trauma

Within each of these shame categories, we can see a link to suicidal thinking and behavior. Brown reminds us, “Shame is such a powerful emotion that it can literally overcome us.” It can. It does, and, alas, too frequently results in suicide.

Let us watch for and notice the pernicious and dangerous hold of shame. We can circumvent the slippery slope of shame with compassion, discussion and reality-testing. Shame is a powerful, soul-eroding emotion that distorts good minds and twists hearts.