Suicide is one of those problems that a lot of smart minds have thought about, yet few answers satisfy. Instead, we rely on a patchwork of suicide prevention methods (like fences on bridges) and suicide hotlines, staffed by ordinary people trained in crisis interventions.
And while the number of people committing suicide over the past two decades has remained consistent (around 30,000 people a year commit suicide in the U.S.), the suicide rate has enjoyed a steady decline of approximately 0.7% per year (a 13% drop from 1985 to 2004)(Barber, 2004). The decline hasn’t been brought about by superior public health policy, government action, or even the Internet. It’s largely been brought about by the decline in firearm suicides, the leading method of suicide (followed by suffocation and then poison). Men are 3 1/2 times more likely to commit suicide than women.
Guns are a huge risk factor for a successful suicide, because they are one of the most lethal methods available. 90% of those who survive a nonfatal attempt do not go on to die by suicide, meaning that the impulsive, irrational act of a suicidal attempt is what we must try and stop. Hence the reason for the fences and suicide hotlines. If we can get most people past the crisis point, the vast majority of them will live.
But what about those people who are suicidal and make it to the emergency room after a failed attempt? Could we do something more to help the 10% of people who do end up successfully committing suicide?
A column in today’s Boston Globe Magazine today presents the poignant story of the writer, Peter Bebergal, who lost his brother to suicide, and how a group of researchers at Harvard are working to better identify people who are still suicidal when in a hospital:
What clinicians need is some other measure beyond external evidence that could assess whether someone like Eric is capable of suicide in the near future. Four years after my brother’s death, Harvard researchers at MGH are experimenting with a test they think could help clinicians determine just that. It focuses on a patient’s subconscious thoughts, and if it can be perfected, these researchers say it could give hospitals more of a legal basis for admitting suicidal patients.
Of course, I can’t help thinking about whether such a test could have saved my brother. But I also wonder: Would it have been ethically right - or even possible - to save him even if he didn’t want to save himself?
This missing piece in the suicidal puzzle is what prompted the innovative research study now in its final phase at MGH. The study, led by Dr. Matthew Nock, an associate professor in the psychology department at Harvard University, is called the Suicide Implicit Association Test. It’s a variation of the Implicit Association Test, or IAT, which was invented by Anthony Greenwald at the University of Washington and “co-developed” by Dr. Mahzarin Banaji, now a psychology professor at Harvard who works a few floors above Nock on campus. The premise is that test takers, by associating positive and negative words with certain images (or words) - for example, connecting the word “wonderful” with a grouping that contains the word “good” and a picture of a EuropeanAmerican - reveal their unconscious, or implicit, thoughts. The critical factor in the test is not the associations themselves, but the relative speed at which those connections are made.
The research is still ongoing, so we don’t know whether this type of psychological testing will actually work or not. But it’s intriguing to imagine that our unconscious minds might give away our “true” thoughts when it comes to something like suicide. It could become as valuable a test as the ones we use to assess whether someone had a stroke and is at greater risk for a future stroke.
The next step, Nock realized, was to use the test to determine, from a person’s implicit thoughts, whether someone who had prior suicidal behavior was likely to continue to be suicidal. It would give doctors a third component, along with self-reporting and clinician reporting, and result in a more complete picture of a patient. Nock doesn’t assume that a test like the IAT would be 100 percent accurate, but he believes it would have predictive ability.
I believe any tool that can be used to better predict future behavior is a potentially valuable one. Especially when that future behavior might be the taking of one’s own life.
Read the full article: On the Edge
Reference:
Barber, C. (2004). Trends in rates and methods of suicide: United States, 1985-2004 (PowerPoint presentation). Harvard Injury Control Research Center.
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8 Comments to
“Delving Into Your Unconscious Mind to Prevent Suicide”
Johnny, seriously, for the love of pearl, stop using the word “Irrational.”
In one sentence you claim that ‘few answers satisfy’ why suicide exists and in the next sentence you directly claim a reason for it.
You cannot have your cake and eat it too.
It’s interesting that the suicide rate has fallen in correlation to the increased use of pharmceuticals in the treatment of depression and bipolar disorders.
Sorry, I make no claim for the “reason” of suicide. It is and always has been an irrational, impulsive act done in a moment of crisis.
While it may seem perfectly rational to weigh one’s choices in life and choose to end it, I can’t think of a single recorded incident where someone who wasn’t suffering from depression made the same rational choice. Suicides exists exclusively within depression (or some other serious mental disorder).
Suicide prevention is an irrational act.
Most of the interventions we refer to as suicide prevention amount to little more than, “This is a rope; if you see a rope, cut it.” Tertiary interventions do little to affect change in the problems that underlie suicidal ideation, except to pathologize the victim and placate social guilt. I believe they are such primarily for political and economic “reasons” - additionally and sociologically, we are a society that rationally and compulsively distances itself from its own complicity in this problem, as it does with many other social ills.
There are many reasons for suicide and it is dangerously reductionistic to categorize all acts of suicide as “always” anything.
We do have the power to affect the problems that underlie such drastic actions, and to do so I believe we must change the way WE as a society view and treat each other - long before THEY reach the emergency room or the teetering chair.
James your comments on these blogs could be harmful to someone who is thinkimg of suicide. Please just stop. You made your point. If u must keep it up email dr. John. People who read these blogs sometimes are looking for a reason not to kill themselves. Some hope or a way out. When people say its not irrational blah blah blah it just feeds a very self destructive fire inside a person who is self destructive. OK? Please stop.
I found a bizarre method Korean companies use to prevent suicides: Fake your own death. I’d love to hear a psychologist’s take on this.
http://www.businesspundit.com/samsung-stops-suicides-through-well-dying-courses/
Most people are just wired to cling on pathetically to life, and simply cannot empathise with those of a different mindset.
I realize this comment is probably unnecessary at this point, but…
Steph, if calling something ‘irrational’ was the basis by which we stop certain behaviors, psychologists would be out of a job.
I am not condoning suicide. I am, however, against alienating an already depressive person even further by labeling their potential choices as ‘irrational.’
Calling someone irrational is just another blow to the already fragile sense of self. My purpose in not wanting to call suicide ‘irrational’ is to give people a better sense of self. To give them a sense of value in their beliefs (however consequential they might be). To give them a sense of responsibility and accountability for their actions and to give them a voice! People (it can be argued) spend their whole lives trying to be heard. And they commit suicide because they’re not. Suicide (perhaps) is that ACT of wanting to be heard, wanting to matter.
So, again, while I do not condone this choice of action, I am not going to sit here and take away a person’s last desperate act of wanting to matter by calling him/her ‘irrational.’
All they want (arguably) is to be heard and valued! And I feel that continually calling them (or THEIR actions) ‘irrational’ does away from that valuing and hearing!
We’ve essentially muted the muted with the word ‘irrational.’ And this is neither fair to the individuals who decided to commit suicide or to the individuals who are contemplating it.
I’d like to think we can come up with other reasons, motivations, labels, etc., to negate the act of suicide. And that was all I was (however, adolescent of me; my apologies for that John) pointing out…
James
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Last reviewed: By John M. Grohol, Psy.D. on 23 Jul 2008
