We need to talk about suicide

May 24th, 2014  |  Published in Euthanasia; Suicide, Favorites

[If you are feeling fragile, rather than continuing to read, you may choose to talk to someone you trust; in Australia, you can also call Lifeline on 13 11 14 or visit beyondblue.org.au;  in another country, contact your local support service.]

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Have you seen bumper stickers that say ‘Touched by the road toll’?

Probably.

Have you seen ones that say ‘Touched by suicide’?

Probably not.

Su5And yet, death by suicide is more common than road accidents and the most common form for 15 to 34 year-olds (click here). This situation is unlikely to correct itself, and if governments persist in creating socioeconomic conditions that breed despair, it falls to community to work for change.

The first step is breaking the silence.

Dr Philip Nitschke, euthanasia campaigner, says we need more words for suicide, and he could be right from his end-of-life point of view. After all, we have several words for killing another person – murder, manslaughter, negligence, accident – so why not for killing oneself?

Mainly, however, I think we need more words about suicide. Fears that talking about it will trigger ripple effects are now seen as misplaced (click here) and in this post I raise five questions for discussion and comment.

1. What do people say about their own suicidality?

Not enough, says David Webb, who completed the world’s first PhD on suicidality by someone with first-hand experience (click here).

Dr Webb has made a huge contribution to bringing lived experience into broaderSu10 awareness. His website provides excellent resources (click here) and his view of the importance of first-person accounts is now more broadly recognised (click here). He describes his own experience as a crisis of the self, and vehemently opposes reducing diverse personal stories to a single story of mental illness.

What might we learn, he invites us to consider, by asking people about their own experiences?

2. And when family and friends are affected?

Many of us (perhaps most) are likely to be touched by suicide at some stage in our lives through family, friends, and colleagues, and hence to come to know the devastating grief, silence, and stigma (click here).

Last year, a young man in my brother’s extended family killed himself. When I asked my brother how he and his family were doing, he told me the date of the funeral, and then changed the subject.

Some years prior, my sister died an extremely uncomfortable death. She had a PEG feeding tube and when I asked if she would rather it was removed she said she wished she had not survived an earlier coma, and that she had her parish priest to talk to.

My brother did not want to talk, and my sister was politely telling me to mind my own (non-religious) business. Neither of these felt like helpful conversations, and I was perhaps overly reticent to avoid coming across as the ‘expert psychologist sister’.

But I wonder what other people would do in similar circumstances?

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3. What about indirect contributors?

Suicide can also touch lives in ways that are less direct than family, friends, and colleagues. One group who can be indirectly affected are train drivers (click here and here). I had not thought about this until I met my first counselling client who was a train driver, and got a glimpse of how it would be sitting in that driver’s seat, horrified, aware of what was about to happen but powerless to stop it.

This person’s experience was many years ago, at a time when drivers were sent back to work the next day. We have made progress, but not enough. We are more aware, but not sufficiently. There are still blind spots and silences.

Who else is ‘touched by suicide’ that we should be more aware of?

4. What if death seems preferable?

Su13Choosing one’s own death has some currency in relation to terminal illness, but what about cases in which the unbearable pain is primarily sociopsychospiritual?

A woman I worked with in counselling died by suicide nearly twenty years ago. It was excruciating – for many people, including me. For her, though, I am as sure as it is possible to be that bringing about her own death was about reclaiming power. This knowledge did not, however, short-circuit my questioning, sense of responsibility, self-doubt, and deep sadness.

Over the journey, particularly working with asylum seekers who have been threatened with deportation, I have known some who have experienced equivalent levels of despair, but were fortunately granted permanent visas and the possibility of rebuilding their lives. This is not always the case, and I would fully understand someone taking their own life rather than facing torture and death in the country from which they fled.

I think we need conversations within counselling professions (and the community more generally) about unbearable psychic pain. Medical professionals are more progressive in their domain, and some practitioners risk prosecution to stimulate law reform (click here, and here).

There are, of course, conflicting positions about collusion in suicide (click here and here) but shouldn’t we at least be having the conversations?

5. How can helping be helpful?

Some of the ‘help’ David Webb describes over his own suicidal journey – blaming, judging, Su9panicking, diagnosing, prescribing, and institutionalising – was, he notes, not helpful, and sometimes harmful. One response he did find helpful involved bearing witness – without judgement, false empathy, or trying to ‘fix’ him (click here).

In my own work as a psychologist I have aimed for a process that allows exploration of the space between suppressing and indulging suicidal feelings that Dr Webb describes. The challenge has been to do so without breaching professional requirements for risk assessment and duty of care.

This is not a simple navigational process and the line can be blurred and unpredictable. It is hardly surprising that practitioners err on the side of caution, but a process designed for clients should not easily backflip into one that protects the backs of counsellors.

In other words, how can we make sure that helping is helpful for those it is meant to help?

My thoughts in this post – about the lived experience of suicidality, how to help professionally and personally, how to start having conversations about unbearable psychic pain, and how to become more nuanced in our thinking about suicide – are no doubt the tip of the iceberg.

I am interested in responses to the issues I have raised, and additional ideas, insights and comments are also warmly invited, including sources of hope.

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Best Themis blessings…Joan Beckwith.

 

 

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10 comments on “We need to talk about suicide”

  1. This article is by Clancy Martin, a philosophy professor who lives with “a chronic urge to die” going back to his early childhood. It is a long, self-reflective piece, which I found very interesting, but which could also be confronting and triggering if his experience resonates. https://highline.huffingtonpost.com/articles/en/life-in-the-psych-ward/

  2. “Ending the silence on suicide” in The Saturday Paper (5/12/15): https://www.thesaturdaypaper.com.au/news/media/2015/12/05/ending-the-silence-suicide/14492340002705

  3. JennyR says:

    Thank you for addressing this topic – introducing me to Dr Webb and raising 5 thought-provoking questions. It is such an important issue. Many of our lives are affected by suicide. I have 2 close friends whose children have died from suicide; experienced deep fear for family members; and supported families and communities through such deaths.

    The issue draws me to the national backdrop. I fear for our community given the on-going dominance of a dehumanising economic and political climate. ‘Business’ and busyness are bullying care and compassion; stress and pressure are distorting health and well-being; and meanness and cruelty are becoming national characteristics.

    Somewhat unexpectedly, in the critical need to talk about suicide, I find hope. By opening conversation, listening to one another, finding language, and respecting the sacred space within and between us, maybe I/we reconnect with living and enabling one another to live. Maybe I/we may reconnect with being human and humane.

    I welcome the opportunity to listen to, learn from, and engage with those who know about surviving the urge to suicide and with those of us who remain confused, concerned, and disturbed.

    By the way, I suggest our need to talk about suicide has no borders – with no ‘need’ for border security, border control, border protection, or detention. Indeed, such distortion of ‘need’ highlights the critical issue of accurate, truthful, and dignified language.

    • Thanks for your comments, JennyR. I was particularly taken by the idea of finding hope in talking about suicide. For me that certainly resonates and perhaps has something to do with the essential intimacy of such conversations – you can’t really have them without talking about and exposing feelings and once you do that the chances of empathy increase. In other words, they are potentially rehumanising conversations, and hence an antidote to the national backdrop you describe.
      I agree about the vital contribution of those who have survived the urge to suicide. As in so many areas, learning about the direct experience is invaluable and yet too often neglected.
      I think Dr Webb has done a superb job, and I would highly recommend his book that he based on his PhD work (http://thinkingaboutsuicide.org/about-the-book/)
      Joan Beckwith.

  4. Lorraine harrison says:

    In regards to supporting someone who is talking about killing her or himself, my experience has been to be a good listening ear. It does sound simplistic, but people know when you are ‘not present with them in their serious time of need. Providing an open listening ear, being present, giving the person your time and it may take some time so be prepared for this.

    I think the policy thrust of our current government will not help people who may be deeply distressed and down e.g. young people and the 6 months unemployment policy, and the general cutting back on welfare in general. These are not good signs for showing and leading a caring and socially responsible society, and may leave many people despairing and depressed.

    • I agree, Lorraine. Listening, really listening, sometimes beneath and around the words, is incredibly important, and perhaps the greatest gift one person can offer another.
      You are also right about the increasing despair in current sociopolitical times in Australia. I keep hearing about people feeling desperate about the future, for their children and themselves, and the changes such as the $7 Medicare co-payment haven’t even kicked in yet.
      To say nothing of what is happening to the community services sector under the current regime, and to sources of support being ripped away because of funding cuts.
      The times call for activism, civil disobedience, whatever (non-violent for me) means it takes to generate change…Joan Beckwith.

  5. Here’s an article from the Good Weekend (24 May 2014) in which a man talks about his own suicidality and links it to his diagnosis of schizophrenia:
    http://www.theage.com.au/comment/in-praise-of-peaceful-protesters-20140529-zrrqr.html

  6. Anne DeSouza says:

    This is the suffering of my community. The YouTube clip is a poignant cry from our First Nations Elders. They mourn most days of the week. http://www.youtube.com/watch?v=ibuVK_HnFXU. Thanks for the opportunity to share. PS I am not an Indigenous Australian and so do not speak on their behalf. This is simply what I witness. Anne

    • Thanks for this, Anne DeSouza. The YouTube says a great deal in a short time, particularly in the lead up to Sorry Day and Reconciliation Week. I was powerfully struck by the simple statement that “You have to go and sit down with people and learn from them”. Of course we do, so why are we not doing a whole lot more of it? The grief is so very deep and profound and the sense of searching is unimaginable…Joan Beckwith.

    • Anne, this article that appeared in the SMH (26 May 2014) seems important. It refers to an elders’ report on preventing youth suicide and self-harm, stresses the importance of listening to the elders and recognises that they are the people who can heal their communities:
      http://www.smh.com.au/national/choosing-lore-and-life-the-campaign-against-aboriginal-youth-suicide-20140525-38whk.html

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