Sunday 13 March 2011

Help-seeking in suicide

What brings me to this thought is the perception - one which I don't
think is true - that there are a significant percentage of 'help
seeking' suicides by women.

Across the Western world women attempt suicide more often than men by a
significant amount. Men use much more violent methods (or successful
ones if you want to call it that) which is why it is commonly know that
men kill themselves more. It's also reasonably well know that women
attempt more.

The explanation is this idea of help seeking suicide. I'm not sure where
this idea comes from. Perhaps I'm missing understanding. The idea is
that some people try to kill themselves to seek help, predominantly women.

I've aware of the perceptions within mental health that some people kill
themselves or attempt to or say they're going to kill themselves to get
attention. I can guess this is something which may come from certain
personality disorder diagnoses which are sensationalised within the
mental healthcare circles. I can guess it's one of these things which
isn't common but people think it is.

I can imagine a misperception where the evidence that people who sought
help after a failed attempt felt better might be construed as they
should have sought help before then in some sort of Chinese whispers
sort of way this mutated into the idea that there is a significant
portion of people attempting suicide to seek help.

I don't think people consciously attempt suicide for any other reason
than they want to die. Certainly from the research on suicide notes the
common theme is a specific sort of pain named psychache. This is the
overridding evidence from the work of one of the world's most
significant suicidologists, Edwin Schneidman. He researched suicide
through suicide notes. His work lead him to the concept of a pain being
the most significant factor.

While people seek help afterwards they often don't seek help before.
Well...except the do. Many, many people contact the Samaritans service
in the UK. It's far higher a number than you might think.

Many don't. Apart from the Samaritans there are few other avenues for
people to seek help. Even therapists and doctors are risky because of
their professional 'ethics' where they may have to inform on their
patient/client which can result in their detention.

There's a salient reason for that. People who want to kill themselves
don't need help. Those who have made a conscious choice (and even those
who are making it in haste) are not in need of people to tell them not
to do it or health services to therapise them out of it. Others may go
through suicidal feelings and thoughts and want to be rid of them. These
are the people who seek help. Those who want to die already have their
solution.

The question of what to do is complex because it is complex. One might
suggest that help must be sought because people shouldn't kill
themselves. I'd definitely agree it is preferable that people don't take
their life. It is not an absolute though. Suicide has been
decriminalised across the world.

Suicide attempts can be factors of temporary situations and the feelings
of wishing to die may come as a result of these circumstances. The mind
can get too wrapped up in society and the real world and everyday things
so it forgets the bigger picture. The suicides caused by changes (almost
invariably lowering) of relationship, financial, socioeconomic or other
forms of status or other constructs where a person moves from high to
low are often associated with suicide attempts.

There is the experience of an external voice in person's stream of
consciousness or a thought different to their "I" telling them to kill
themselves too. This may be quite alien to many people but schizophrenia
comes with a very, very high suicide rate. I would guess a significant
number of the suicides each year are by people experiencing psychosis.

But let's take schizophrenia as an exzample to dissect the complexity of
suicide. In the time around first episode psychosis the suicide rate is
really high. People first going through the experience of psychosis
which ends up with a diagnosis of schizophrenia often try to take their
own life. This is an action within or a reaction to the 'delusion'
which, for them, can be very real. This risk presents at other times too
when acute psychosis returns.

There is another type of suicide in people with schizophrenia. Bipolar
as well too I think. It's usually later in life and it's not during a
period of 'unwellness'. The best word I can use was the one used in the
paper I read it in ages ago. They called it "burnout suicide" which to
mean means a long process exhausted the individual's soul. Rather than
the typical sort of depression or other mental condition suicide this
one comes with length to the process which arrives at the decision.

I wouldn't want these suicides to happen either but of all the types
described it's this last one which I find hard to say is a bad thing. It
is a bad thing that people get to this stage in their life but it is not
something society has any choice over when it comes to them taking their
own solution.

There are other types of suicide but when it comes to suicide as a form
of help seeking I think it's a total load of fucking bollocks concoted
by stupid mental health professionals who have no idea what it's
actually like and are just, as usual, making judgements upoen things
they'd never understand because they'd never been through it.....or
perhaps it's one of those situations where a mistruth came out of a
truth, that while people do seek help afterwards and while it may have
been good for them to seek help before making an attempt many people
consciously are thinking of taking their own life and that is pretty
much the sole reason why people take their life. Because that's what
they wanted to do at the time and that's what they were thinking of
before they did it. There are cognitive theories I'm sure but the one I
prefer is the work of one person. He dedicated much of his professional
life to the understanding of suicide.

Of course there's one better way to understand suicide. Don't talk to a
psychologist. Don't talk to a psychiatrists. Fuck their theories. Talk
to someone who's been through it. Their lived experience is worth more
than gold.

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"