On suicide prevention. A new look

When I was looking through campaigns for the World Suicide Prevention Day (which was on 10 September), I thought they were more of the same. In this post, I want to suggest a different approach. Note, that this post might be considered controversial for some.

And so, when you google World Suicide Prevention Day 2021, you will see slogans such as:

  • You are not alone.
  • Reach out if you’re not OK
  • There is hope
  • We are here to listen

They come in many versions and are accompanied by posters full of facts.

As much as I support suicide prevention activities, I keep thinking that such slogans are not particularly good. A poster telling me I’m not alone is hardly a way to tell me anything about me. In other words, it is very optimistic to think that just because you will tell someone they are not alone, they will respond by something like:

  • Gosh, of course I’m not alone, why didn’t I think about it earlier?

And so, as I’ve been bombarded with messages of more conversation and the world which is not as bad as one might think, I started thinking about what I would put on a suicide-prevention poster. And I have come up with three ideas.

Before I start, a reservation is needed. This post is an expression of my ideas. I haven’t done any research; I don’t know whether what I am suggesting would work. This post is an attempt to look at suicide prevention in a different way.

The first strategy comes from suicide letters. In my book on suicide notes (Discourses of Men’s Suicide Notes). One of the themes I wrote about was notes which suggest that suicide doesn’t end things. Frequently, note authors would promise continuing love, taking care of the persons they left behind, sometimes even being in touch. One of the most ironically sad notes said (I quote from memory):

  • I will love you till the end of your life.

To which you can only say: no, you won’t. You won’t be there to love anyone, you will be dead. Your life (and love, care and all other things) will end, they will be no longer. And here is the first strategy. Perhaps, it would make sense to base part of a suicide prevention campaign on the message that suicide ends everything. No,

  • you will no longer love you loved ones.
  • you will no longer take care of your children.

Of course, I see at least one immediate challenge: could such a campaign be seen as guilt tripping. And I’d say, yes, it could. But the question that is worth asking is what’s more important. Suicide prevention and saving a life or the putative ethics of the method? For if we think it’s acceptable to force someone off the train platform before jumping, guilt tripping seems way less coercive.

You could, of course, formulate the message less aggressively. Something like:

  • Suicide – there is nothing afterwards.
  • Suicide – it’s the end of everything.

Let me now talk about the second strategy. In my latest book, co-authored with Justyna Ziółkowska, we wrote about the suicide process (Discursive Constructions of the Suicidal Process). Basically, we were interested in what people who are about to take their life, do, say, a day, an hour, a few minutes before death. We had two sources of data: interviews with people who attempted but didn’t kill themselves and suicide notes left by people who did commit suicide. It turned out we had some extraordinary, sometimes heart-breaking of people who were engaged in the act of killing themselves. Sometimes it took minutes, sometimes we read it took days. Some were stories of stories of meticulous preparations, sometimes of only waiting for the death to come.

The question that I keep asking is about the point of no return. Is there such a point? Can you actually step back? But if you can, perhaps, it’s something a suicide-prevention campaign could use. Messages such as:

  • You can always step back.
  • It’s not too late to choose life.
  • It’s not too late, until it’s too late.

Perhaps driving the message that the commitment to action can be broken, can be waived, can be useful at least for some. Let’s tell people about to commit suicide that they don’t have to do it, that starting the process doesn’t mean going through with it.

The third strategy, again, also comes from suicide notes. Time and again, men writing their farewell letters represented their suicide as a gift. And so, their notes contained statement like: I’m the scourge of your life, so, I give you a final gift, my death. Perhaps then instead of saying you’re not alone to someone who is so lonely they cannot contemplate another option, saying

  • Suicide is never a gift.
  • Never ‘gift’ a suicide.

would work better. Just maybe.

Every time I read messages such as “It’s OK to talk” or “It’s OK not to be OK”, I find them only irritating. Obviously, they are very well-intentioned, but for me they construct people they address as if they were not in touch with reality. Are ‘we’ really saying that people don’t talk about their darkest experiences because they don’t know “it’s OK to talk”? Are we saying they will now start, just because a poster says so? I do doubt it, I must admit.

In contrast, what I am proposing comes from people at the precipice. I suggest messages that counter, challenge the stories from the farewell letters or interviews immediately after the attempt. In other words, the messages I propose “follow the people”, respond to them. Not to what they ‘think’ should be the message, but to their stories themselves.

Let me end with a note on suicidology. I must admit that all too often I find it tedious. I keep remembering following a major suicidological conference where one of the celebrity speakers decided that after 90 (I can’t remember how many exactly) risk factors had been found, suicidology should find another 30. Everybody applauded and off they went to find another 30. Greeeeeeeeat….

As has been pointed out several times in publications critical of mainstream suicidology, it has been saying the same things (mostly by the same people, too), over and over again, never challenging itself. There are so many well-trodden paths in suicidology and suicide prevention, you can make a motorway network out of them. And ‘we’ still can’t wait for another suicidological celebrity who will suggest yet another brilliant idea which will make suicidology even more as it is.

I have little doubt that this post will go unnoticed. It might be because it’s not worth noticing, I fully accept this. Thought do remember that the ideas are hardly mine. They come directly from the people who either committed suicide or made a serious attempt to do so. But perhaps, a little bit, it will also be ignored because it asks suicidology to leave its comfy plush armchair and its awe and admiration of its leaders. And if this is the reason, maybe, just maybe, it’s a worth sparing a thought on this.

 

 

 

 

 

 

 

8 Comments
  1. First, Dr. Galasiński, I wish you the best in your research. I really like the idea of trying to understand suicidal or depressed people through their own words.

    In response to something the first commenter said, I have a long history of suicidal thoughts, and for me the idea that death would be the end of everything *is* a relief. It’s not so much wanting to die as wanting the pain to stop and seeing no other way to end it.

    I don’t believe in an after-life, but I wonder if some of the people who write about loving others from beyond the grave are thinking of that, either because they believe they’ll no longer be in pain in an after-life, or because they know their loved ones believe in an after-life.

    To address a point in the post, yes, people don’t talk about their darkest thoughts because they think it’s not OK. (I do agree that seeing a poster saying it’s OK to talk is pretty much worthless.)

    There’s a lot of shame and guilt associated with feeling depressed or suicidal, and I’ve sometimes gotten unsympathetic or even hostile reactions from people close to me when I’ve told them I’m feeling that way (“If you meant that, you’d be dead by now,” “You’re not trying hard enough,” etc.). It can be devastating to get that kind of message when you’re already vulnerable.

    Even people who are sympathetic often don’t know what to say or do. They feel anxious and possibly burdened, and some of them will try to fix you without understanding where you’re coming from (“Why don’t you just…”). (That bit about trying to fix you without understanding also goes for some professionals, IME.)

    I don’t want to burden or upset anyone, and I don’t want to be blamed or judged, so these days I usually keep quiet when I feel that bad. (I have one trusted friend that I sometimes confide in when I’m really close to the edge.)

    I appreciate that the Samaritans have a self-determination policy. Being believed, maybe even understood, and seen as having agency is important to me when I’m in that state, and it’s one of the few things that makes the pain more endurable. I wish more people knew how valuable it is.

    FWIW, one of the underlying problems in my life that contributes to my despair is prolonged economic insecurity. I’m wholeheartedly behind George Scialabba when he says, in his book Being Depressed, that financial support for the depressed and suicidal would be an extremely valuable approach to the problem of suicide.

    1. Thanks Mary for sharing your experiences, your voice on this topic is the most valuable in this kind of discussion. I’m sorry you’ve had some bad responses when you’ve been in distress, and I really wish you the best in the future.

  2. I normally read your posts and experience lots of lightbulb moments, however in this piece I don’t think I agree with the first and last strategy (I would caveat that I don’t have personal experience of suicidal thoughts but I am a Samaritans volunteer so have some understanding of how their approach plays out). I think shame and guilt is such a big factor and carrying these thoughts around alone in your head seems to compound the distress. I find Samaritans self-determination policy (‘of course we hope you won’t end your life but if that’s your decision we won’t try to talk you out of it’) often stops the caller from being defensive and oppositional, which allows them to give a more balanced appraisal of their options. It’s rolling with resistance, and often leads to the person weighing up in favour of living. I think messages such as ‘suicide – it’s the end of everything’ echos the common reasons people want to end their life (to end their distress), and I wonder from this lens, would it be effective, or would it simply sound like a relief?

    1. Dariusz Galasinski

      Thank you for your response. I started writing a reply but it’s got too long. I will respond in a post.

  3. Aleksandra Zarosa

    Noticed! 🙂 Finally something different from ‘It’s OK to talk’… Thank you!

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