Promoting Hope, Preventing Suicide

Research and advice on preventing teen and adult suicide

Simmer to Boil: How Accumulation of Stressful Life Events Influences Suicide Risk

It wasn't a single event that influenced Terry's suicide attempt.

A few years ago, I had a bagel in Newton, Massachusetts with a woman named Terry Wise. Working in a community-based domestic violence program, I met with Terry because she had grown up in a home in which domestic violence occurred and my program wanted to see if she, a local resident, might want to be involved in our efforts to help families experiencing domestic violence.

As I talked with Terry, I found out that in addition to her early experiences of domestic violence and child abuse, she lost her husband to Lou Gehrig's Disease (ALS) after four years of marriage, when she was 35 years old. I also found out that Terry Wise is pretty famous. Terry has written a book about her life's experiences called, "Waking Up: Climbing Through the Darkness," and speaks widely about what she seems best known for, her suicide attempt.

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Sitting next to Terry in Bruegger's back in the day, I felt so happy that she had survived her attempt. Her life is her message and I am glad that she is here to share it.

Yesterday, four years after I first met her, I had the opportunity to hear Terry speak at the annual Massachusetts Suicide Prevention Conference. Her keynote, "When I Decided to Die, How I Decided to Live," was funny, charming, and strikingly honest - all qualities I had noticed when I met her that first time.

Terry said that one of the most common questions she is asked about her suicide attempt is "Why?"

Answering this question, she re-frames the often overwhelming work of "suicide prevention" as perhaps the more accessible work of "decreasing the likelihood of a suicide attempt," and listed ways that the likelihood of her attempt could have been decreased:

-Child abuse prevention
-Earlier access to mental health services to deal with the aftermath of child abuse
-Education for teachers about child abuse
-Education for parents and other adults in communities about child abuse
-Stopping consumption of alcohol and pain-killers
-Decreasing stigma about depression and mental illness
-Help for caregivers of chronically ill individuals
-Developing better coping skills for bereavement
-Decreasing access to suicide means

The above list includes all the "reasons" she attempted suicide:

-Child abuse
-Lack of mental health supports
-Lack of understanding of teachers
-Lack of understanding of adults
-Self-medication through alcohol and prescription drug abuse
-Fear and shame of seeking help
-Burden of caring for a dying spouse
-Grief after losing a spouse
-Access to lethal means

Without going into too much detail about her attempt, I will say that Terry, because of her husband's long illness, had a virtual arsenal of prescription drugs at her fingertips.

I think a lot about the links between trauma and suicide, so Terry's story wasn't shocking to me. I know that people who experience trauma in childhood and have additional losses in adulthood are at risk for suicide. But, when Terry said that her experience, and that of others who experience stressful life events over a long period of time, is like when you have a pot on simmer and all of a sudden it gets turned up to a full boil, I got it. It wasn't a single event that influenced Terry's suicide attempt, the most proximal being her husband's death. It was the accumulation of a lifetime of factors, as she said, "the totality of the situation."

Copyright 2009 Elana Premack Sandler, All Rights Reserved

Elana Premack Sandler, L.C.S.W., M.P.H., is a public health social worker specializing in violence and injury prevention and adolescent health promotion.

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