“I think one of the things that’s generally useful when we think about suicide is to have some understanding of what’s going on in people’s minds,” says lead psychologist Dr. Eoin Galavan.
We outline some of the conclusions about suicide that psychologists have agreed on over the last few decades.
“There are some ideas that can help us shed light on a suicidal person’s thoughts. One is when people feel they are a burden to others, that others would be better off without them.
“A feeling of separation, isolation or loneliness is another. A feeling that people don’t care about you. The idea that there is no connection or value in your presence. And that other people wouldn’t miss you when you were gone.”
Then there is the problem of fearlessness.
“It’s an idea that people sometimes have
get to a point where they are no longer afraid of self-harm.
“The way to get there can be diverse. But it can include things like self-harm, excessive drug or alcohol abuse, and other practiced or practiced suicidal behaviors.
“When a crisis hits, the suicidal behavior itself doesn’t seem as scary as it would otherwise have been – because they’ve embarked on a journey where they’ve sort of become accustomed to the idea of dying by suicide .”
Having a basic understanding of what might be going on in a person’s mind can help inform conversations.
“One of the first things is practical security. Does the person have an active plan? Do they have access to lethal means?
“It can be a scary question – but it’s a really important question. Because it opens up the possibility of negotiating, restricting or withdrawing access to lethal agents.”
There isn’t one version of suicidal struggle, explains Dr. Galavan.
“You could say that for some people, suicidal crises come and go. But for others, this is something that lingers with them for a longer period of time.”
Just because someone is thinking of suicide doesn’t mean they will act on it.
“A person who is feeling overwhelmed might think something like ‘I wish I wasn’t here’ or ‘I don’t think I can handle this, maybe I’d be better off dead.’ But it never goes beyond that.
“Another person could start imagining a method they could use and start planning. And yet another person might actually engage behaviorally in the process that leads to an attempt.
“As you move down that spectrum, the number of people gets smaller and smaller. In other words, the vast majority of people who contemplate ending their lives don’t think twice about a method and don’t try.”
How is it possible to reach someone and make a difference?
“I would say again, it is huge
Variation. The level of belief is something that varies greatly.
“The hallmark of the suicide struggle is ‘part of me wants to live, part of me wants to die.’ So we can become afraid that the desire for death is so overwhelming that there is nothing we can do to change that person’s trajectory.
“But if a person is still alive, the desire to live has always been stronger than the desire to die.”
It’s really important to keep this in mind. That even when a person is feeling very bleak and very confident that death by suicide is the answer, “every part of them that has chosen otherwise has been more powerful up until now.”
“This fight is a flexible thing. It is
fluid and rarely static.”
So how do we know if there is a risk? A large number of people who have attempted suicide will have talked about it in the weeks and days leading up to their attempt, said Dr
“That’s important to know. If someone has said they are thinking of killing themselves, then no matter how they said it, more thought needs to be given.”
However, this will not always be the case.
“One of the real dilemmas with suicide is that it’s often a very private struggle and extremely difficult to predict. So we can’t say for sure who will or won’t kill themselves. But we can identify the things that make it more likely.
“People who self-harm are more likely to die by suicide, but the vast majority of people who self-harm don’t die by suicide. People who talk about killing themselves are more likely to try, but the vast majority of people who talk about killing themselves don’t try.”
It creates what he describes as a kind of perpetual dilemma with suicidal tendencies.
“Everyone is scared of this horrible outcome, but it’s very unpredictable and we can’t absolutely predict who will and who won’t.”
With this in mind, he says the rule of thumb is to take any suicidality seriously and open up dialogue.
“Until that conversation happens, you never know where the other person is. For example, it would not be uncommon for someone to commit suicide—but also be very ashamed of it.
“They may find it extremely difficult to tell anyone where they are. It might come out there in a weird way.”
If you open the conversation and the person says they are not considering suicide and would never do it – then, as Dr. Galavan insists, all is not lost. But the most important thing is that by opening the conversation, you demonstrate your willingness to go there.
“Saying it’s okay to talk about it can be a really important message for someone who is in deep distress, who is having a very hard time seeing things getting better, who is contemplating suicide. The message that it’s okay to talk about it and that there may be a way forward can be important.
“So the rules of thumb are: we can’t predict it; we should take all suicidal thoughts seriously; and we should always be ready to open the conversation.”
To offset the stigma surrounding suicide, it’s important to maintain an empathetic mindset.
“If we think about the things that really help people, it’s for them to feel connected and cared about. Everyone can identify with feeling unloved, overwhelmed, hopeless and desperate – because those are parts of being human.”
This type of empathic thinking helps dispel the stigma surrounding suicide that it’s bad, shameful, and different.
“I think it’s about finding the human struggle. And finding ways to identify with it. Because we are all human, we all suffer, we can all identify with these things to some extent.”
Regarding the specific emotions that bereaved families will feel when they are bereaved by suicide, Dr. Galavan that while there is no typical version of it, there is a certain complexity to loss by suicide.
“Some of that complexity comes from the idea that they did this to themselves. Which can leave a person feeling angry, confused and struggling with why they did it. People often feel guilty because they should or could have done something differently. They almost feel punished by a tyranny of “what if?” It can be excruciating.”
It is important to remember that death by suicide is unpredictable. There is probably nothing you could have done differently that would have guaranteed a person to choose life.
“Sometimes people die by suicide and everyone around them knew they were having suicidal thoughts and they all did their best and the person committed suicide anyway. There is real pain and anguish in that loss, and it can be extremely difficult to come to terms with.”
The other important thing to know is that people find a way to move on
after such a loss.
“Though it is painful and tragic, over time people find a way to live with the loss.”
Generally, if someone has a family member who died by suicide, they are at an increased risk compared to the general population. Broadly speaking, there are two types of reactions to the death of a family member by suicide – those who tend to be reluctant to the idea and those who become more vulnerable.
“If you can identify with a person who did this thing, you may be more likely to be able to do it. We don’t know very much about what divides people into these two responses.”
To someone feeling suicidal, he says, “First thing would be, ‘Well done you stuck with it this far. Please press pause and think about the possibilities to get support and help.
“If you’re near something that’s likely to hurt you, put some distance between you and whatever that might be, and then start thinking of a list of the people — maybe even write them down.” — who you can call to talk about accessing help .”
If you are affected by any of the following
Here Samaritans Ireland can be contacted 24 hours a day on 116 123. Visit samaritans.org for more details and support
https://www.independent.ie/life/family/feeling-like-theres-no-way-forward-please-press-pause-and-consider-the-options-for-getting-support-and-help-41869877.html Do you feel like there is no way forward? “Please press pause and review options for support and assistance.”