Suicide
A Failure of Communication
One million deaths annually from suicide: "global" mortality rate 16 per
100,000, one death every 40 seconds.
Suicide one of three leading causes of death 15-44 years
Suicide attempts 20 x > completed suicide.
Suicide 2% of the total global burden of disease.
Youth highest risk in 30% developed and developing countries.
90% Mental disorders (depression, substance abuse)
Complex socio-cultural factors
Socioeconomic crisis (loss of loved one, employment, honour).
Rates
Gender Differences
Myths and Gestures
Suicide / attempted Suicide / Para Suicide
Completed acts – more males
‘Cry for help’ more female
Mistake to look at ‘completed’ deaths - add
both attempts and deaths
Suicide / Para Suicide
Different methods – males guns / females poisons
Females roles / taboos
Misdiagnosis – accidental firearm deaths (Israeli
soldiers)
Less lethal poisons - India insecticides etc and less
likely to survive
‘Causes’ of Suicide
Multiple factors build to ‘threshold’
Sadness, hopelessness, despair, depression
Pain and hurt, feeling different, unwanted
Bullying, abuse, anger, rage
Cry for help , unheard, frustration
‘trigger incident’ – row, failed exam ..
Availability of method (gun, drugs etc)
Communication -Areas to Consider
Attitudes and reactions to death / suicide
of another
Reaction of Peers
Reaction of Parents
Attitude towards own death
Facing the reality of death
First Reactions
Mixed Emotions
Disbelief
Denial
Making Sense of Nonsense
Why?
Finding False Answers
Blame
Responsibility
Self Punishment
Guilt
Self deprecation
Unloved
Unworthy
Work Through Loss
Failure to deal with death / suicide
Failure to work through loss
Leads to harmful emotional consequences
Risk of repetition / replication
Working through loss / hurt
Justification
Blocks to working through loss
Over identification
Denial
Justification
Keep a sense of reality - remember their good points
and their bad points - but most of all remember that
they did this because they were in pain, they were
disturbed, upset and could not cope with life. It is a
sadness that they were not able to deal with life, that
they were not helped to cope with their problems.
Heroes and Copycats
Death of Chatterton
'Cut is the branch that might have grown full straight
And burned is Apollo's laurel bough.'
Myths
Suicide is a form of self harm.
Not looking after yourself
Putting yourself in danger or taking risks
Harming your body with drugs substance abuse
or alcohol.
Not eating depriving your body of what it needs.
Over eating
Hurting or harming yourself - cutting, scratching.
Suicide ‘gestures’
Suicide
Cry for Help?
Missed Communication
Not being heard
Frustration – Anger – Fury
Revenge
Suicide is a vengeful act
Suicide is an aggressive act - it hurts people
around us - it leaves behind pain and
destruction.
It is not just self harm it also harms others -
especially harming those close to us.
Suicide / homicide axis
Adolescent Issues
Immediacy – precipitous action
Lack of consequences
– Adolescent Invincibility
Future time perspective
Permanency of death
A ‘better place’ – religion / taboos
Tantrums and Hurt
Need to hurt and strike out –
repercussions
‘They’ll be sorry’
He’s gonna miss me
Talk now!
Barriers to Communication
TRUST
Trust ----- Betrayal
Misplaced trust ------- set up for betrayal
Untrusting ------- Untrustworthy
Barriers to Communication
Insecurity / Unpredictability
Reaction to communication / Consequence of action
Consequence of action ---- Predictable ----- Security
Consequence of action ---- Unpredictable ---- Insecurity
Consequence of action ---- Absent ---- Worthlessness
Communication
Breaking silence
Indirect communication
Acting out
Self Harming
Delinquency
HELP!!!
Who are we taking to?
PARENT
ADULT
CHILD
Indirect / covert communication more potent than direct / overt
Suicide risk - statements
What is each statement really saying?
Alternatives depending on
– way things are said and communicated
– ‘who’ is talking
Consider -
pseudo adult / parent
Vengeful child
My family would be better off
without me
Depression / passive - watch for increased
energy
Vengeful attention seeking
Family symptom – scapegoat - DANGER
Next time I’ll (take enough pills to) do
the job right
Don’t think you’ve got away with it.
P/C conflict /control issues
You brought me into this world. I’ll show you I
can leave it. You cant control me. I can do
this.
I wont be in your way much longer
Hints threats
Little voice ‘please help me’
Settling affairs- writing notes
Doing it quietly – dangerous serious
Doing it flamboyantly - manipulation
Karen … ‘Lady Macbeth’ attention seeking
Laura … quiet determination
Risk Factors
Feeling of ‘not belonging’
Don’t fit
Not normal
Different
developmental issues
sexuality
Risk Factors – Self Hatred
Let everyone down
Failure
Cant live up to expectations
‘Unpardonable sin’
Risk Factors
Associated factors
Abuse / Bullying
Drugs / alcohol
Sexual issues / identity
Common thread ….Secrecy / non communication
‘Un connected’
Level of Communication
PARENT
Protection
Guidance
Affirmation
ADULT
Appropriate information
CHILD
Empathy
Positive Communication
Honestly listen , empathise and inform
without denial or minimising.
Don’t avoid the word suicide
Don’t appear to judge – suicide is not
‘wrong’ - but is undesirable
Be accepting of suicidal feelings without
endorsing them
Positive Communication
Face reality together – (future may be bleak)
Find a positive focus – (eg bravery, honesty,
desire to find a solution, wish to help others)
Other Considerations
Consider your own feelings and agenda
Are you minimising or reassuring to
protect yourself
Communicate
The way to defeat and prevent suicide is
to communicate, to listen to others and
to talk to others when we have
problems. The solution is to keep
working on our problems, to have the
courage to stick with life and to help
others to do the same.
Active Communication - Art
Active communication - Art
Active Communication - Drama
Active Communication - Poetry