Saturday, June 27, 2009

Suicide Prevention for All of Us

I end this month's focus on suicide with what we can do. Remember, "Suicide is not chosen; it happens when pain exceeds resources for coping with pain." (David L. Conroy, Out of the Nightmare: Recovery from Depression and Suicidal Pain)

So the way out of the nightmare is laid before us: reduce pain and increase resources.   Somewhere below is something you can do for yourself, for those you love and for those whom you have been commanded to love, if you believe in that sort of thing.   These lists are from Conroy, pp. 300-302.  My remarks are in brackets.

MAJOR COMPONENTS OF SUICIDAL PAIN

physical and/or psychological pain

death or terminal illness in family
mental illness
alcohol and/or drug abuse
sexual assault or abuse
crime victimization
stress, confusion, anxiety
vicious circle problems
 
eating or sleeping disorders
loss of esteem, security, health, talent, status, job, money, relationship, home, social isolation and loneliness

physical or mental capacity
physical and/or emotional abuse
disruption or dysfunction in family
feelings of hopelessness
prejudice and stigma for suicidal pain
other forms of prejudice and stigma
loss of any resource for coping with pain

BARRIERS IN BETWEEN
[preventing access to resources]

fear, ignorance, silence
stigma and prejudice, denial, minimalization, belittlement
negative moral attitudes

blame the victim
hostility
the non-suicidal's uses of the suicidal for their own purposes [e.g., focus on teen suicide to exercise denial of adult concerns about suicide]

myths: just wants attention
motives of revenge or escape
suicide is rational, a solution
blame the family
suicide prevention is a last minute activity
suicide is romantic and dramatic
being suicidal is good for you
attempts to get it out of your system
it must have been something more [some deeper, hidden motive]
suicide is voluntary
they can't be stopped
the suicidal need an inner light
suicidal pain is psychological pain [ignoring physical manifestations and causes]

service providers who will not provide or continue with services [when suicidal condition is made known]
inadequate referral systems, quick referrals
too little
confidentiality: breaches that cause more pain
too much confidentiality: secrecy, limitations on access to resources
being trusted with possession of the means [get rid of the goddamn gun! and the pills, and...]
pressure to hurry up and get better
interruptions
inappropriate language: "threat, confrontation, success, failure" [more on these in later OMG! awards]
ignorance and false beliefs about the effect of suicide on survivors
false conceptions of themselves and each other that are had by both the suicidal and their counselors
lack of information and education for both the general public and professionals
lack of public and private support for education and research
theories of suicide that ignore much of the pain
esoteric theories of suicide, single cause theories
caregivers' perfectionism and fear of blame [that cause them to withdraw, so they don't "do something wrong"]
false conceptions of self-reliance, ride it out strategies
no words for one's pain
no role models for recovery
denial on the existence of recovery



COPING RESOURCES [finally!]

patience, acceptance, understanding, compassion, tolerance
no-fault theory of suicide
comprehensive examinations for physiological causes of suicidal pain
improved models of what suicide is
improved theories and treatments for depression
ordinary language theories [e.g., "when pain exceeds resources"]
decomposition of suicidal pain
new conceptions of the rights and worth of suicidal people [e.g., the right to treatment]
studies on suicide self-prevention
role models for recovery
hope appropriate for a condition with a high recovery rate
recognition for recovery [where's my cake?! my six month pin?]
efforts to help others with their pain
willingness to give and get help sooner rather than later
support groups
professional treatment
improved support for survivors
improved policies, support, and referral systems for caregivers
legislation on discrimination against the suicidal

legislation on access to means
education for the public and caregivers about suicide
increased support for research


I will add your contributions by comments, if you permit. 

God bless you, Willa

book cover by amazon.com
photo by RN Marshman, licensed under the Creative Commons Attribution ShareAlike 2.5
photo of man in shadow by Cornava, permission is granted to useunder the terms of the GNU Free  Documentation License
Tiffany window Tree of Life in public domain

reformatted 6/4/2011

1 comment:

  1. Dear Willa:

    Thanks for all that you are doing with your blog--this is a real gift to the rest of us. You convey so much of your own story alongside excellent research and present it in a way that we can understand. I'm truly grateful.

    My mother committed suicide by jumping out of a 16th-story window in March of 2007. She was 72+ (probably around 75) and lived with depression borne of her long-term struggle with diabetes and kidney failure. What you share helps me so much in understanding more of what must have been going on behind the mask of what seemed to be coping with physical illness.

    I'm sorry that there wasn't more time in Anaheim to visit in person--I'm grateful for our connection through the ether. I send you richest blessings in your ministry among us.

    Thom Chu

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