Suicide awareness campaigns highlight one of the most uncomfortable and perplexing questions about human behavior: why do people commit suicide?
From the standpoint of someone who is not currently suicidal - which is most of us, most of the time - it's difficult to understand how a person could ignore survival instinct, disregard the good things in life, and foreclose every possibility of future happiness. Why can't they see that they're good people? Why don't they understand that things will improve?
And if we have considered suicide ourselves in the past – which is most of us – it can be even harder to understand why they can’t shake it off. We want desperately for them to feel better.
Perhaps it is the perplexing nature of suicide that leads us to one of humanity's old explanatory standbys: diagnosis and categorization. People who are suicidal are usually placed into categories such as "depressed," "psychotic," or "manipulative."
That kind of diagnosing is done with the best intentions, I think, and with some reasonable hope of prevention. It works in some cases. For example, biological abnormalities like organic brain disease, medication reactions, or severe thyroid problems can make someone feel inexplicably suicidal. Problems like these have straightforward answers, and so proper diagnosis is vitally important.
But in the absence of an unequivocal medical diagnosis, categorizing suicidal behavior as something like "depressed" or "manipulative" doesn't explain the problem and generally skirts the real source of suicidal ideation. There is a certain kind of thinking that fuels suicide, and for most of us it is a terribly difficult idea to sit with: suicide is problem-solving behavior. In the mind of someone considering suicide, the act may seem like an expeditious and effective way to eliminate pain.
Acknowledging suicide as problem-solving behavior is uncomfortable, I think, because it appears to edge dangerously close to endorsing the act. Nothing could be further from the truth. We don't have to agree with the desire to die in order to empathize with the pain lurking behind that desire. The thought of suicide most often occurs when a person feels they have run out of solutions to problems that seem inescapable, intolerably painful, and never-ending (Chiles & Strosahl, 2005).
There is a powerful and natural temptation to argue with someone who is suicidal. We want to convince them that suicide won't solve their problems. I'm sure we're all familiar with the old bromide, "suicide doesn't fix anything."
From our perspective that may be true, but the person considering suicide may mistakenly perceive suicide as the only thing that will end their pain. Ironically, arguing this point can increase a person's resolve to end their life. Luckily, it's an argument in which we need not engage.
An alternative approach to suicidal ideation is to:
- Understand that to the mind of the person contemplating suicide, it appears to be an effective way to end their pain. We need not endorse suicide in order to understand that their pain seems to be intolerable, inescapable, and interminable. Most importantly, we can acknowledge that thoughts of suicide represents a desire to solve problems.
- Identify and discuss the sources of pain that exist behind suicidal ideation. When we shift the focus to the sources of pain, then we can discuss solutions other than ending a life. Often, the very act of putting words to vague and overwhelming feelings shines a light of rationality on our problems and expands our willingness to explore a broader range of solutions.
Negotiating the tricky waters of suicidal ideation is complicated business and should always be referred to trained and competent professional. If you are contemplating suicide, please contact one of these hotlines before you do anything else.
Chiles, J.A. & Strosahl, K.D. (2005). Clinical Manual for Assessment and Treatment of Suicidal Patients. Washington, DC: American Psychiatric Publishing, Inc.
For an expanded discussion, please visit my related posting at ironshrink.com.
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Dr. Smith is a psychologist in Denver, Colorado and the author of The User's Guide to the Human Mind: Why Our Brains Make Us Unhappy, Anxious, and Neurotic and What We Can Do about It. You can read the introduction and find other goodies at guidetothemind.com.