Is suicide selfish? It’s a question I am asked frequently in my work as a trusted advisor within the military and veteran community. This question was posed to me during media interviews following the news of the tragic deaths of Kate Spade and Anthony Bourdain.
Suicide certainly leaves a wake of devastation for those who are impacted. Survivors of suicide loss are at increased risk for depression, addiction, and the emergence of suicidal ideation themselves. In my work with veterans, the times when I was most worried about my patients was after the suicide loss of a military brother or sister. They experienced a range of overwhelming emotions—such as helplessness, fear, and rage that had no clear target. Some felt personally abandoned after losing a battle buddy to suicide.
Yet, even though suicide causes massive collateral damage, can it really be considered selfish? I have worked with many patients now—both civilians and veterans alike—who have at times been in suicidal crisis. I would argue that it’s not a matter of selfishness, based on the following observations.
The suicidal mode is an altered state of consciousness. When a person is battling with their demons and feeling hopeless, their thinking is often significantly distorted. They do not see reality the way they would if they were not in suicidal crisis. Their thoughts loop on the theme of how they are a burden to those they love. Their brains actively make a case for how others will not really miss them or that in the long run, those they love would be better off without them somehow. (Of course, loved ones often vehemently disagree with this). An analogy may be helpful to illustrate this point. Take the case of a person who is in the grips of a late-stage eating disorder. Such an individual may be dangerously underweight (and will appear so to others). However, when they look in the mirror, they see themselves as fat. In a similar way, those towards the end of a tunnel of despair often have distorted perceptions of reality—they see themselves as a burden the same way that an individual struggling with anorexia sees him or herself as fat.
Further, those who are in the grips of the suicidal mode often become mentally detached from those they love. In my work with veterans, I have heard many “near-death” narratives in two distinct categories. In the first category, I have heard the stories of several combat veterans who have nearly had their life taken from them in battle. In the second category, I have witnessed accounts of past suicide attempts. In comparing these two types of stories, I realized that there was a fundamentally different theme. This realization was what led me to the idea for the Warrior Box Project, an innovative suicide prevention initiative that was recently featured on NPR's Snap Judgment Memorial Day episode ("Shrapnel," Aired on May 24, 2018).
When people want to live, during what they think are the last moments of their lives, they connect with the voices and faces of loved ones. In the midst of a mortar attack, time may slow down, and they may suddenly “hear” the voices of their children or their wife, or a war buddy who has passed away in battle urging them to “stay in the fight.” The story of suicide attempts is usually different—in these stories, it is clear that interpersonal detachment is a core part of the suicidal mode. In a sense, people's demons become like the domestic abuser whose first move is to isolate his or her partner from the influence of those who love them. Demons will ambush those who suffer in silence, but those who break this dangerous code of silence often can regain their hope and will to live.
Finally, those who survive suicide attempts often look back on their crisis from a different perspective. They often gain a deeper appreciation for the reality that suicide would devastate their loved ones. Sometimes, seeing the reality of this collateral damage can be a strong deterrent for repeating a suicide attempt. In fact, many attempt survivors become vocal advocates for suicide prevention initiatives. Those who come through a dark time and regain a sense of hope and purpose have stories that can save lives. Those who are suffering need to hear stories of hope and recovery, especially from those in leadership roles. Attempt survivors can use the experience of being in the grips of the suicidal mode to persuasively argue that hope awaits us, even in the midst of some of our darkest days. Stories like this break the power of shame.
Let’s continue to build hope by talking openly about mental health and treatment.
Treatment can help. Our attachments to those we love and trust can save us. This battle is one we must take on together.
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In response to this blog post, I received this very thoughtful comment from a reader and am posting it as a part of this blog, because it shows how lived experience can be illuminating for all of us. Thank you to the reader who shared this feedback and personal insight:
Thank you for your article. I have often thought about how to argue against the implied selfishness of suicide, but have never been able to articulate it well. You have done so beautifully.
I am a suicide survivor who attempted to take my own young life, at age 23, with an overdose of antidepressant and anti-anxiety medications. Fortunately, my sister found me unconscious and was able to call an ambulance in time. After 2 years of therapy with a great psychiatrist, I recovered and, now, 30 years later, am still eternally grateful to my sister. What I remember most about deciding to end my life is that it was an unpredictable, lightning-fast decision, preceded by an upsetting event, during a time in my life when I was both depressed and anxious. I remember feeling pure relief when I made the decision to end all the pain. You mentioned the word “tunneling,” and that is a perfect word to describe my thought process. I blocked out all thoughts of how my actions would affect my loving parents, family, and friends. This wasn’t purposeful—it was simply what occurred. It was, as you said, an altered state of consciousness, and the lens through which I saw my life at that moment was so different from how I had previously, or would see it in the future. I didn’t intend to hurt anyone; I wanted to unburden my family and finally escape the pain. I felt hopeless in the truest sense of the word. And, no one saw it coming, including me just a few hours earlier. That is how unpredictable and instantly gripping I believe [suicidal thoughts can be].