MIND MOVES Tony BatesThe most striking feature of suicidal behaviour is that it is still the exception rather than the rule for human beings.
Why do we humans endure all that is thrown our way and not resort more frequently to terminating our lives, and with them our misery? Consider the facts: 30 per cent of our population meet the criteria for some form of mental illness in any given year. The remaining 70 per cent will very likely find themselves touched by loss, abandonment, illness, relationship conflict, unemployment, failure, or simply downright exhaustion. One has to wonder why we, as a species, are not leaping lemming-like off the Cliffs of Mother, in an act of aggressive defiance at the inevitability of suffering.
Although it's quite common for us to think morbid thoughts of suicide, we rarely act on these thoughts. Over 50 per cent of the normal population admit to having suicidal thoughts in the past five years. Think about that: one out of every two of your close friends may well have felt bad enough in recent times to actually contemplate suicide. Does that surprise you?
Perhaps you need to explore this in your own circle of friends. Among those afflicted by depression, the percentage is much higher.
Our capacity to overcome these thoughts is evidence of a deep resilience in humans that is more than simple willpower. Evolution has hard-wired our systems with an amazing capacity to weather the hardships of life and find a way forward. But why is it that some people feel so overwhelmed that suicide seems to them the only way out? What happens to turn a crisis into a suicidal crisis?
Hope is a key factor research has identified as critical in determining how we negotiate suffering. If people believe that their suffering will end, or that some possibility of rescue is likely, they can endure incredible discomfort.
In the absence of such a belief they succumb to hopelessness, which can leave them highly vulnerable to suicidal impulses. In Darkness Visible, his personal and very poetic account of his struggle with depression, William Stryon describes how the real problem for people who become depressed is that their "faith in deliverance" from this condition is often non-existent.
"The pain [of depression] is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come - not in a day, an hour, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul."
For a long time, we believed that people who were hopeless were people who had nothing to look forward to. Clinicians viewed them as people who had become separated from whatever dream they had for what might give their lives meaning and value. They saw the problem as one of depressed people becoming "disengaged" from their future.
But recent research has challenged this and offered a much more precise insight into the nature of hopelessness.
Two groups of people were asked to participate in a study of what the future held for them. People who were depressed and who had attempted suicide, and people with no such history, were each asked to identify what they felt would make their lives worth living.
Surprisingly, both groups came up with virtually identical sets of "hopes" for the future. This was quite contrary to what had been predicted. However, serious differences emerged when they were asked to rate how likely they felt it was they could bring about their hopes and how important they thought it was to have specific hopes for the future.
Those who had a history of suicidal behaviour had virtually no confidence in being able to bring about good events in their lives. They also differed from the non-depressed group in believing that it didn't help to have hopes because you would only end up being disappointed.
Contrary to the researcher's predictions that "hopeless people" are people who are disengaged from their future, they found that people who were vulnerable to suicide were those who were "painfully engaged" with their futures.
Those who had resorted to suicide had the same dreams as those who did not, but they had little idea of how to make them happen. They were conscious of exactly what it would take to make them happy, but they felt very unsafe in believing that good things could happen.
This research lends support to the recent emphasis of improving problem-solving skills in those with a history of recurrent suicide attempts. It is important not merely to have dreams but to think through our dreams and what we can do to make them happen. The results of this research have deepened our understanding of those caught up in a suicidal crisis. It does not answer all the questions posed, but it alerts us to one line of questioning that might lead to life-saving interventions.
The tragedy of suicide is a growing concern in this country. At their annual conference this week in Wexford, the Irish Association of Suicidology will explore the range of factors that contribute to this shattering event of human life. It will review the most recent approaches to prevent people resorting to this option, and address the problems of those who are left shattered in the aftermath of bereavement through suicide.