Map of life expectancy at birth from Global Education Project.

Monday, October 24, 2011

The deadly gift

That is our self-awareness, and the psychological and social complexity which it contemplates. This makes being human extraordinarily interesting, but sometimes unendurable. As Christabel Owens and others note in their very interesting paper, Recognising and responding to suicidal crisis within family and social networks (British spelling there, not a mistake), almost one million people take their own lives every year.

Suicide is a surprisingly significant cause of death, but it's obviously a far greater tragedy than most more prevalent causes. It takes the lives of many young people, and it often leaves survivors feeling guilt as well as the pain of loss -- not to mention the pain the decedent must have been feeling, often completely unknown to others, or misunderstood.

Owens et al interviewed the loved ones of people who had killed themselves, and they find much that may not only be of practical help to people in similar situations, but also enriches our understanding of our shared condition. It seems to many of the survivors that the deceased had great difficulty, for various reasons, in communicating his or her distress; that the ambivalence that possibly suicidal people often feel is likely to be interpreted as meaning that the suicidal intent is not to be taken seriously; that it is often difficult for us to understand the inner lives even of people with whom we are intimate; that people do not want to be intrusive or seem to compromise the autonomy of loved ones; and that they also do not want to violate privacy or disrupt other people's relationships.

In fact, there is no harm in asking someone who seems deeply distressed whether they have contemplated suicide, or in inquiring about ambivalent or conflicting signals. There is no harm in encouraging people to get help. At the same time, people should not punish themselves with guilt for missing the signs which, as it turns out, can be difficult to interpret and act upon. I hope that this research, and other information which is available (e.g., American Foundation for Suicide Prevention) will reach more people.

As far as I know, only we, among the sentient creatures, feel our way in the world keenly enough that continuing sometimes becomes intolerable. Let's try to make the world a little less cold.


kathy a. said...

thank you for writing about this, and for the link to a suicide prevention resource.

i've dealt quite a few times with people who were suicidal, and at least one turned out to do it. one whom i knew to be depressed died some years after we lost contact, and i'm pretty sure that was a suicide. it's really difficult. taking it seriously and trying to get them to help is good advice.

i'm told that having a plan and having access to means are real danger signs. when my friend's son died at age 12, she was definitely ready to follow him; i enlisted the hospice nurse and got the heavy meds out of the house immediately. (and bless that nurse; she understood exactly my concern, and told the family it was normal protocol.)

one of my son's friends died recently, an overdose and possible suicide a few months after his beloved girlfriend died in a bike accident. this young man's friends were all worried -- he spoke of suicide after his GF died, was in bad shape -- and then he seemed to be doing better. his friends carry this sack of grief and guilt, wondering what they could have done; i can't imagine what his parents feel.

kathy a. said...

i've also heard that suicide survivors -- those who wanted to die but that was somehow prevented -- usually don't feel the same way later. the depths of despair seem endless, but they are not; and often whatever fed that despair is treatable or fixable to a tolerable degree.

those left behind -- oh, man. it is a real and painful burden. all those questions about why. all that guilt. and the anger, the betrayal, even as they are trying to remember why they loved this person. i know there are recommendations against guilting a person who is suicidally depressed, but think the flip side is mentioning that they are loved and that they are important to others.

i'm really glad that nurse and i flushed all the morphine and god knows what else the afternoon my friend's son died. flushing is not the environmentally-sound method of disposal, but it was an emergency. it probably wasn't totally a lie about this being "protocol" with hospice; i'm pretty sure the nurses are trained with suicide prevention, somewhere in the training about helping with grief.

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