Understanding suicidal behaviour

by Dr Jozelle Miller

Health Psychologist

Milton Cato Memorial Hospital

Suicide is the act of taking one’s own life on purpose. Suicidal behaviour is any action that could cause a person to die, such as taking a drug overdose (pain medications), ingesting poisonous substances or even crashing a car on purpose.

There is no single explanation that can account for all self-destructive behaviour. I will adopt the features posited by Edwin Shneidman,{{more}} a clinical psychologist who is a leading authority on suicide, when he described 10 characteristics that are commonly associated with completed suicide. Schneidman’s list includes features that occur most frequently and may help us understand many cases of suicide.

1.The common purpose of suicide is to seek a solution.

Suicide is not a pointless or random act. We must understand that, to persons who think about ending their own lives, suicide represents an answer to an otherwise insoluble problem or a way out of some unbearable dilemma. Take for instance teenagers, who find themselves wrapped up in some situation, where in their minds it is hopeless and it is going to cause them to either be publicly condemned or ridiculed. Recently, I heard of a young lady attempting suicide because someone had released some indecent photos of her on the Internet. Her attempt at suicide was a choice that was somehow preferable to another set of dreaded circumstances, emotional distress, or disability, which in her mind was much more feared than death.

Attraction to suicide as a potential solution may be increased by a family history of similar behaviour. If someone else whom the person admired or cared for has committed suicide, then the person is more likely to do so.

2.The common goal of suicide is cessation of consciousness.

People who commit suicide seek the end of the conscious experience; they desire to ‘skip out of reality.’ They feel that this will put a stop to what has become an endless stream of distressing thoughts with which they are preoccupied. Suicide offers oblivion. Visualize someone living in a situation where day in and day out they feel tormented by family members, persons in the community. My mind goes to someone diagnosed with HIV; so many times we hear of their torturous experience. This can undoubtedly trigger the thoughts of suicide for such a person.

3.The common stimulus (or information input) in suicide is intolerable psychological pain.

Excruciating negative emotions – including shame, guilt, anger, fear, and sadness – frequently serve as the foundation for self-destructive behaviour. These emotions may arise from any number of sources. For instance, a child believing he/she has caused shame and embarrassment on his/her family by the choices he/she has made.

4.The common stressor in suicide is frustrated psychological needs.

People with high standards and expectations are especially vulnerable to ideas of suicide when progress towards these goals is suddenly frustrated. People who attribute failure or disappointment to their own shortcomings may come to view themselves as worthless, incompetent or unlovable. Family turmoil is an especially important source of frustration to adolescents. Occupational and interpersonal difficulties frequently precipitate suicide among adults. For example, rates of suicide increase during periods of high unemployment (Yang et al.,1992).

5.The common emotion in suicide is hopelessness-helplessness.

A pervasive sense of hopelessness, defined in terms of pessimistic expectations about the future, is even more important than other forms of negative emotion, such as anger and depression, in predicting suicidal behaviour (Weishaar & Beck, 1992). The suicidal person is convinced that absolutely nothing can be done to improve his or her situation; no one else can help.

6.The common internal attitude in suicide is ambivalence.

Most people who contemplate suicide, including those who eventually kill themselves, have ambivalent feelings about this decision. They may be sincere in their desire to die, but they simultaneously wish that they could find another way out of their dilemma.

7.The common cognitive state in suicide is constriction.

Suicidal thoughts and plans are frequently associated with a rigid and narrow pattern of cognitive activity that is comparable to tunnel vision; they are more times than none able to see anything else but the problem. The suicidal person is temporarily unable or unwilling to engage in effective problem-solving behaviours and may see his or her options in extreme, all or nothing terms. As Shneidman points out, slogans such as “death before dishonour” may have a certain emotional appeal, but they do not provide a sensible basis for making decisions about how to lead your life.

8.The common action in suicide is escape.

Suicide provides a definitive way to escape from intolerable circumstances, which include painful self-awareness (Baumeister, 1990). The idea that when I am dead, I am done appears to be quite appealing. But from a spiritual standpoint, suicide can be likened to jumping from the frying pan into the fire, as taking one’s life is an ultimate sinful act.

9.The common interpersonal act in suicide is communication of intention.

One of the most harmful myths about suicide is the notion that people who really want to kill themselves don’t talk about it. Most people who commit suicide have told other people about their plans. Many have made previous suicidal gestures. Schneidman estimates that in at least 80 per cent of completed suicides, the people provide verbal or behavioral clues that indicate clearly their lethal intentions. No threat of suicide should be taken lightly, as even if the intent was not meant, it is still suggestive of a cry for help, and something in the person’s life needs to be addressed.

10.The common consistency in suicide is with life-long coping patterns.

During a crisis that precipitates suicidal thoughts, people generally employ the same response patterns that they have used throughout their lives. For example, people who have refused to ask for help in the past are likely to persist in that pattern, increasing their sense of isolation. It is therefore important to pay attention to any personality changes in persons.

Suicide Warning Signs:

o Excessive sadness or moodiness

o Sense of hopelessness

o Sleep problems

o Sudden calmness after a period of depression or moodiness

o Withdrawal or isolation

o Changes in personality and or appearance

o Dangerous self harming behaviour (excessive drinking; drug use; self-mutilation)

o Recent trauma or life crisis (eg death of a loved one)

o Making preparations for death

o Threatening suicide

Can Suicide Be Prevented?

Suicide can’t be prevented with certainty, but risks can often be reduced with timely intervention. Research suggests that the best way to prevent suicide is to know the risk factors, be alert to the signs of depression and other mental disorders, recognize the warning signs for suicide, and intervene before the person can complete the process of self-destruction.