On ‘suicidal thoughts’
Some time ago I wrote a post about the question ‘Are you suicidal?’. To no avail, I suggested that the question is counteruseful, as it doesn’t ask me about what I want to do, but about what I am. Today I want to focus on another common phrase – ‘suicidal thoughts’.
Let me start with the ‘thoughts’ bit. Even though I rarely think about my thinking, when I do, I tend to refer to it in terms of an action. In other words, I tend say things like: I think, I thought, I am thinking. Very rarely do I think about having ‘thoughts’ (unless I mean opinions, but that’s different). This is because, I would imagine, I focus on the process, a continuum. The word ‘thoughts’, on the other hand, suggests that my thinking is not processual, but, rather, shall I say, modular. Here comes one thought, then another, then, maybe, yet a couple more. Counterintuitive? Probably. Still, such constructions have a point.
You see, I think that the thoughts in ‘suicidal thoughts’ are the easily identifiable objects, objectively existing in some (psychological) reality. Yes, you guessed, they are just like the zillion of symptoms in the diagnostic manuals. If you have depressed mood, loss of confidence, guilt, or indecisiveness you simply need ‘suicidal thoughts’ and not ‘a patient who thinks about killing themselves’. That would be so unhelpful. So, given the above, people will continue to ‘have thoughts’, as it suits nosological classifications.
But what about ‘suicidal’? Well, when I talk to people about their experiences, including experiences of suicide attempts, they talk about all sorts of things. They talk about their relationships, their lives, their ill-fated love, mostly very unhappily. The same is with suicide notes about which I have just written a book. Men writing them write about all sorts things, interestingly, for the most part they don’t write about suicide. I have no idea what they ‘really’ think, still, it seems there is quite a lot on those men’s minds at that time.
And here comes my question: are they having ‘suicidal thoughts’? The answer, interestingly, is both yes and no. Yes, because such thoughts (may) lead to suicide in the case of farewell letters; no, because they don’t focus on suicide. The phrase ‘suicidal thoughts’ is just an oversimplification. A complex process is reduced to a simple label, as if when you think about suicide, you must think about the act itself. Judging by interview data and suicide notes, this is way off the mark.
And here comes the point of this post. New Scientist has recently published an article about an anti-suicide drug. In the text we read that it is targeting people with suicidal thoughts. I don’t want to engage in a discussion about pathologising suicide or treating ‘thoughts’ (I have mostly reservations about it), but what is a complex, time-extended experience is changed into a clear and unproblematic object of medical action. It’s so clear that the drug for suicidal thoughts/ideation has been transformed into an anti-suicide drug. The fact that there is no clear evidence of a relationship between ‘suicidal thoughts’ and suicide itself seems not to be a problem (in fact, there is research which suggests that in some cases a suicidal plan is protective).
At the moment suicidology is interested in the phrase ‘commit suicide’, a discussion which, I think, makes too many easy assumptions. The problem is that ‘suicidal thoughts’ are, in my view, considerably more problematic than ‘commit suicide’, except there is no discussion about the phrase. Even if there were one, I do realise, of course, that ‘we’ are very unlikely to stop using ‘suicidal thoughts’. The phrase is one of the cornerstones of suicidology. Stopping to use it is just about unthinkable. And yet, I would argue that it is more problematic (though in different ways) than the disliked ‘commit suicide’.
This is because the phrase makes things easier. It simplifies reality, making it more accessible and way less complex. “Commit suicide’ changes suicide into (im)moral action, ‘suicidal thoughts’ makes it simple and clear. On balance, I’d rather suicidology dealt with the illusion of simplicity.