Compassion Matters

How to save a life

Why We Lost a Lovable Genius: The Hidden Enemy in Suicide

Understanding the suicidal mind

I’ve spent 30 years working in the field of suicide prevention. Still, it never gets easier or less shocking to process a tragedy like that of Robin Williams’ death. I didn’t know him, but Williams possessed the sort of warmth, humor, presence and vulnerability that made most of us feel like he was a friend. He was lovable and loved by many. Losing him rekindles memories of how he touched our own lives, moments of laughter, sadness or inspiration but always moments of feeling. Robin Williams had the ability to communicate feeling and make us feel for his characters. He showed compassion and a desire to touch others, which is perhaps why the circumstances of his loss seem even more tragic. The biggest message we need to send in the wake of this tragedy is that help is available for those in pain.

Suicide is not a solution and does not create peace or freedom, as some would like to believe. The suicide of Robin Williams left us stunned, pained and saddened.  For those closest to him, the pain is even more intense; suicide always hurts other people, particularly those closest to the person. Nor is suicide an easy way out, a sign of weakness or a cowardly path, as still others would claim. Suicide is caused by what suicidologist Edwin Shneidman called "unbearable psychological pain," the work of a vicious “anti-self” that goes against a person's basic instinct to stay alive.

From the overwhelming response to his death from people all over the world, one thing is clear: the way Robin Williams saw himself, his life and his significance bore little resemblance to how the world saw Robin Williams. The filter he perceived himself through was a distorted reality. This is true of every person who attempts suicide. They are NOT on their own side or in their own point of view in the moment they attempt to take their own life. In several interviews, Williams spoke about his inner voice. In one interview with Diane Sawyer in which he described his struggle with addiction, he said “You're standing at a precipice, and you look down. There's a voice, and it's a little quiet voice that goes "jump." It's the same voice; the same voice goes ‘just one.’ There's a voice that goes ‘jump,’ and the idea of ‘just one’ for someone who has no tolerance for it; that's not a possibility.”

These are the types of “voices” that drive suicidal behavior. In our research, we have found that we can identify the thought process that precipitates suicidal behavior. Individuals who attempt or die by suicide are listening to what my father psychologist Robert Firestone refers to as the “critical inner voice” or "anti-self," which berates them and lures them into their ultimate destruction. This internal enemy exists within all of us. Yet to some, particularly those who struggle with depression, addiction or other mental health disorders, this enemy can be life-threatening. In truth, it can be life threatening to any of us who succumb to its self-destructive directives.

Sadly, for Williams, the same genius that allowed him to transform from a hilarious genie to a heartwarming psychologist was at the disposal of this inner enemy.  What happens when a brilliant and creative mind turns on itself can be a frightening thing. And while no one knows the exact thoughts that went through his head before his death, we do know the types of thoughts people commonly experience before they attempt suicide.

Years ago, my father and I created a scale to assess the risk for suicide by measuring people’s self-destructive thoughts on a continuum. Results from the Firestone Assessment of  Self-Destructive Thoughts (FAST) showed that people at high risk for suicide or who have prior attempts are experiencing critical inner voices further down a continuum of self-destructive thoughts, and they are experiencing these thoughts with greater intensity than non-suicidal people with the same mental health disorders. The voices at this extreme end of the continuum tell them “you are a burden to your family and friends” and “people would be better off without you.”

The thoughts make them feel alienated from others, as if they don’t fit in anywhere and don’t matter to anyone.  This is never true. No one is an island onto themselves to the degree that their suicide does not impact other people. Families and friends are always devastated by the loss of someone they love to suicide. These negative thought processes encourage the person to isolate themselves, the opposite of where someone at-risk for suicide should be. The voices feed feelings of hopelessness, telling them things like “nothing matters anymore.”

The person is essentially disconnected from themselves, their real self, and their own self-interest. Ultimately, their critical inner voices can escalate, instructing them to engage in extreme risk taking, self-harm and actual suicide. Interviews by researchers all over the world with individuals who survived very lethal suicide attempts reveal evidence of these thoughts or voices, leading up to the suicide attempt. Often these voices culminate in thoughts baiting or commanding the person toward suicide. 

Tragically for those who die, we know from those who survive a suicide attempt that once they take the suicidal action, they often experience a complete shift; their real self becomes ascendant, and they don’t want to die.  For example, one woman I interviewed, who made a life-threatening suicide attempt, realized the moment she did it that she wanted to live. The voices telling her to end her life were gone, and even though she was severely injured, she struggled to take actions to save her life

The critical inner voices that suicidal people are experiencing are not based on reality. No one could imagine someone as well-loved as Robin Williams believing that he was alone or insignificant. Yet, this is typical dialogue of a vicious “anti-self” at work. Even the most beloved celebrity can find themselves listening to this inner enemy, despite its irrational and dangerous point of view. It is this anti-self that drives a suicidal state.

The important thing to remember about a suicidal state is that it is almost always transient, temporary and treatable. Your critical inner voice is NOT you. You can learn strategies to fight it, and you can diminish the influence of this inner enemy over your life. You can strengthen your real sense of self and create a meaningful, fulfilling life for yourself. People who feel hopeless must be reminded that they can and will feel better. Survivors who’ve attempted suicide have said they regretted it the very second they were out of that trance of this anti-self. Every person who’s jumped off The Golden Gate Bridge and survived said this awakening and instant regret came the moment they jumped. For people to survive and feel better, they must be kept alive through these moments of extreme psychological pain and intense draw toward self-destruction. If you are concerned about a loved one or yourself, you can take actions to help save a life. It is important to learn the warning signs and to know how to reach out to a person you are worried about and how to get that person or yourself to help.

Warning Signs for Suicide

  1. Disrupted sleep. Often people who commit suicide have not slept for a long time. Sometimes, however, they are sleeping a lot more than normal, a sign of depression.
  2. Isolation. The person may start wanting to be alone. Their pulling away shouldn’t be taken as a rejection. Have they been pulling away from other friends or isolating themselves in general?
  3. Loss of interest. A suicidal person may stop showing interest in activities that once lit them up. They are having a hard time getting pleasure out of anything.
  4. Extreme self-hatred. When listening to their inner critic, people at risk can become extremely self-hating and turn completely against themselves.
  5. Not belonging. The person may feel like no one cares or like they don’t fit in anywhere. These thoughts often skew reality dramatically.
  6. A burden to others. The person may have the extreme irrational thought that the world is better off without them or that they are a burden to loved ones.  They may feel their depressed state would weigh on others and don’t realize that their suicide would bring about way more pain and sadness.
  7. Positive mood change. Sometimes, before a suicide attempt, a person may unexpectedly appear to be in a better mood, because they have made a plan that they perceive as a solution.
  8. Suicidal talk. If a person makes any statements or alludes to suicide, DO NOT IGNORE IT. It is much better to overreact and get help than to underreact.

What You Can Do

If you are feeling bad or are worried about someone who could be in trouble, do not hesitate to call the National Suicide Prevention Lifeline, which is free and available 24/7 at 1-800-273-TALK(8255). The website also has on online messaging service.

If you want to reach out to someone you may feel is in a suicidal state, these are four steps you can follow:

  1. Engage the person in a personal way. Look them in the eyes. Pay close attention to what they say. Let them feel accepted by you.
  2. Convey your feelings of empathy. Make an effort to see things from their perspective.
  3. Ask if the person is thinking about suicide. Don’t be afraid to be direct. Talking about suicide won’t put the idea in their head. Make sure to be sensitive. The way you treat them will give them permission to talk about if they have suicidal thoughts or plans.
  4. Ask if the person has a plan. Is there a time frame or a means that they are thinking about?
  5. Develop an action plan with the person to get him or her to professional help. Arrange a meeting with a counselor or psychotherapist, and accompany the person there. Have them call the National Suicide Prevention Lifeline. Call 911 or take them to the emergency room if they’re in immediate danger.

Robin Williams’ life was important. He mattered to many people. But some twisted and internal monster convinced him otherwise. We should all feel permission to be furious at this monster. It is a being that resides in all of us. We must strive to understand it, to separate from it and challenge it at every turn. It is in us, but it is NOT who we really are. No matter what your critical inner voice may be telling you, it is not you.  YOU matter. You’re important. Get help today. 

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

Dr. Lisa Firestone will be hosting the free one-hour online presentation "Learn the CPR of Suicide Prevention" on Sep. 11 - Learn More or Register Now

Read more from Dr. Lisa Firestone at PsychAlive.org

Lisa Firestone, Ph.D., is a clinical psychologist, author, and the Director of Research and Education for the Glendon Association.

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