Perceived Burdensomeness

 Still Alice is an exploration of the descent into darkness or as one writer expressed it “becoming invisible within your own skin.”

Alice Howland (Julianne Moore) is a 50 year old professor of linguistics at Columbia. During one of her lectures she has a momentary lapse. Her concern is heightened when she becomes disorientated during her daily jog. She seeks medical help and is diagnosed as having early-onset Alzheimer’s. Her doctor closes the door on any possible cure. His words are stark and unapologetic, “With familial early-onset, things can go fast. And actually, with people who have a high level of education, things can go faster.”

Alice makes contingency plans for the day she is unable to answer a series of personal questions about her life. She produces a video detailing where to find a bottle of sleeping pills carefully hidden at the back of a drawer.

Why was Alice planning her death? Was it simply the loss of cognitive function she feared, the ability to think, remember and reason? Or could she see the impact her rapid degeneration would have on her loved ones? Did she fear she would become an unreasonable burden?

As discussed previously, Dr Thomas Joiner believes that when people hold two specific psychological states in their minds, simultaneously and long enough, they develop the desire for death. These two states are the perception that one is a burden and the sense that one does not belong.

Perceived burdensomeness is the view that one’s existence is a burden to family, friends, and society. This perception could stem from the fact that one is indeed a burden, but it may also be an irrational thought that says I am a liability to others and I have nothing more to offer. At its core is the belief that I am neither lovable nor worthy of rescue.

There are many types of experiences that can prompt a sense of burdensomeness – losing a job, incarceration, physical or mental illness, transitioning to retirement etc.

As Joiner says, “The idea is if somebody feels like they are a burden on the people they love, in other words, they have it in their heads, “My death will be worth more than my life to people that I care about.” If they think that’s true, even though it’s rarely true, it becomes an important precursor to the desire for death.”