The Suicidal Crisis

Suicide is one of those social realities we cannot ignore. It has the potential to derail your life.

In recent times suicide has been overshadowed by the COVID 19 pandemic. COVID 19 has had a profound impact on our world. It is not just the soaring death toll but the stress it has placed on our social systems.

We have all struggled with the changes to our world and how we live day to day.

Suicide shares certain things in common with COVID 19

(1) Suicide does not discriminate

Like COVID 19, there may be certain groups who are more at risk, but suicide has a wide reach.

Many people believe they will never have to deal with a suicide in their immediate family or circle of friends. The reality is no-one is immune. ‘Suicide does not discriminate.’

Dr. Jennifer Ashton is an expert in women’s health and appears regularly on Good Morning America.

Her husband of twenty-one years, Dr. Robert Ashton, was a brilliant thoracic specialist. They had two loving and talented teenage children. On February 11, 2017, eighteen days after their divorce was finalised, Dr. Robert Ashton (52) jumped to his death from the George Washington Bridge.

In her book, Life After Suicide, Dr. Jennifer Ashton says,

“Our family was immune from suicide…until we weren’t, until we found out the hard way that suicide is an equal-opportunity horror that strikes families regardless of race, colour, religion, age, education, occupation, achievements, or socio-economic status.”

(2) It is difficult to determine who is an imminent risk

Knowing how the COVID 19 virus spreads is essential to minimising the risk. It often comes down to identifying the close contacts, locating, and testing those exposed to the virus, and quarantining and treating the infected.

Contagion is also a term we associate with suicide. The notion of suicide can take hold, particularly among vulnerable people, such as, indigenous young people or young people with an eating disorder.

Understanding suicidal behaviour is challenging because suicidal behaviour is complex. It is easy to overlook or misinterpret the warning signs.

In an interview with Inside Edition, Dr. Jennifer Ashton said she did not see any red flags when it came to Robert.

“Rob had never been diagnosed with depression, never had any of the classic signs of severe depression that we learn about in medical school.”

(3) Communication is the key

The lack of clear communication has undermined the community response to the COVID crisis. The mixed messaging has caused confusion and weakened trust. One recent example has been the rollout of the vaccine(s) which have been hampered by scare campaigns, majoring on the risks of immunisation while ignoring the benefits.

Sadly, there is no vaccine for suicide. There is no expectation that we will ever attain ‘herd immunity.’ Sometime in the future COVID 19 will no longer be the threat it is now to human life. But suicide will remain.  

It is OK to ask someone you are concerned about whether they are having suicidal thoughts. But remember, ‘denial is a common response from people who are contemplating killing themselves.’ Listening is the key to effective communication. It is being attentive to what is said and what remains unsaid.

The Ashtons had met for over a year with family therapist Dr. Sue Simring to try and salvage their marriage. During one of the sessions Dr. Simring asked them if they were having any thoughts of suicide. Robert said a categorical No. Absolutely not.” As Jennifer later reflected, “Was he lying or had something happened to make him change his mind?”

How then can we know when someone we care about is experiencing a suicidal crisis?

Psychiatrist Igor Galynker, author of The Suicidal Crisis, has identified seven common themes of a suicidal narrative. We will explore their meaning and look at how they applied to our son, Adam, who took his life ten years ago. What seems obvious retrospectively was not part of our thinking during Adam’s final weeks.

1. Setting up unrealistic life goals

“Individuals with trait perfectionism tend to set lofty life goals, particularly if they carry a belief that others hold unrealistically high expectations of their behavior and will only be satisfied if these expectations are met.”

Igor Galynker

The final years of Adam’s life were characterised by ‘religious zeal.’ All other considerations came a distant second. His passion for ‘perfectionism’ included various activities such as tract distribution, personal witnessing, street preaching, financial support of Christian missions, and the spiritual disciplines of prayer and fasting. His behaviour could be described as driven, obsessive, and unbending. His intense focus and singlemindedness were admirable but unsustainable. He was headed for a crash.

2. Entitlement to happiness

“All of us have future expectations – expectations that once we succeed in our goals, happiness and fulfillment will follow. Sometimes, our expectations are not met, and we are left to come to terms with reality.”

Igor Galynker

Towards the end, Adam’s life became more constricted. His personal goals were difficult to discern. Activities he had enjoyed in the past were put to one side – personal fitness, playing the guitar, listening to music, cricket, rugby, fishing… He lost the capacity to feel joy, to celebrate, to let go. There was one exception. He delighted in the next generation of newborn babies, his nephews, Theodore and Elijah, and his niece, Scarlett.

3. Failure to redirect to more realistic goals

“Striving for goals is a universal human experience. People work to attain goals with expectations of self- fulfillment, happiness, and other positive emotions. When goals cannot be attained, humiliation, anxiety, depression, and other negative emotions result.”

Igor Galynker

The process of disengaging (from work) was particularly painful for Adam. It soon became clear, he could either comply with the medication regime or he could continue his work as a roofing plumber. He could not do both.

However, Adam chose his own path. His actions reflected his sense of resignation and the belief that he was a failure. He did not take the prescribed medication and he farewelled his workmates.

4. Humiliating personal or social defeat

“The magnitude of a social defeat involves not only the size of the “prize” but also the extent of the emotional toll the defeat imparts on the person who has suffered it. The latter could take the form of public embarrassment, shame, indignity, and dishonour.” 

Igor Galynker

Adam believed God had made it clear who he should marry. When the leadership of the church arranged a meeting with Adam and the family of the young woman, he was excited, believing the discussion would centre around their relationship and subsequent marriage. Adam called us on his mobile to tell us of these developments and his hopes for the future. We sensed his obvious excitement but had our concerns.

But the meeting was for another purpose entirely. It was to inform Adam that his behaviour toward this young woman was inappropriate and unacceptable. He was told he was to have nothing more to do with her and that he was no longer welcome at the church. We received a second call from Adam in which he asked that we might pray for ‘a broken heart.’

I cannot imagine the pain and humiliation Adam felt. His dreams were crushed. The respect he had earned for his dedication and service to the church was gone. He was abandoned, left to manage his feelings and emotions, left to deal with his brokenness, left to find a way to survive. It was a devastating outcome that would have tragic consequences.

5. Perceived burdensomeness

“Burdensomeness is defined as the sense that one is a burden to his or her family or loved ones. It is a mental state characterised by the perception that they would be ‘better off if I were gone.’” 

Igor Galynker

Perceived burdensomeness is a view that one’s existence burdens family, friends, and society. This perception could stem from the fact that one is indeed a burden – financially, emotionally, or practically – but it may also be an irrational thought – “My death will be worth more than my life to people that I care about” – that is present in the potential suicide’s mind.

People who have failed in their life goals and have been forced into a position of real or perceived financial and/ or emotional dependency feel like a burden to others.

Adam was shy and reserved. He struggled with social situations and was not one to seek the limelight. Adam developed an aversion to small talk. When visiting family or friends or attending an important event he would leave as soon as he was able.

Adam did not like to impose himself on others but occasionally requested a lift to family functions or special occasions.

Adam valued his independence and would have been embarrassed by the thought of relying on others, either financially or emotionally.

6. Thwarted belongingness

“The experience of loneliness or thwarted belongingness occurs when the fundamental need to be socially integrated or connected is unmet.” 

Igor Galynker

A person at risk of suicide perceives that they do not fit in. They feel alone, cut off, isolated. They believe that nobody genuinely cares about them or alternately nobody can relate to them and understand their situation. Feelings of isolation and loneliness undermine overall wellbeing and can be detrimental to a person’s physical and emotional health, resulting in stress, anxiety, or depression.

The two places Adam had come to expect acceptance, appreciation, and affirmation, the Church, and his work, were no longer accessible to him. There was his family, but even there, relationships had become strained. It may have seemed to Adam that it was preferable to pull back, to withdraw within himself.

7. Perception of no future

“People may have many negative experiences and emotions, but until they feel trapped in their misery with the door shut, there is always a chance that their circumstances may improve.”

Igor Galynker

The concepts of defeat and entrapment have similarities in that both foster negative affect and describe a loss that could be irreversible. Whether it is the inability to escape from defeating circumstances or the acute sense of being locked up in a bad situation, the perception is ‘there is no future.’

Adam could see no future. His life was unravelling and there were no obvious answers. The mental health professionals provided no meaningful ongoing support. The Church had distanced themselves and his work mates were no longer in contact. Which left his immediate family. We tried to be there for Adam, but we struggled to know how to respond appropriately, how to address the growing restlessness, how to provide hope.

Dr. Sue Simring, the Ashton’s family therapist, made the following comment following Rob’s suicide. She said,

“People will end their lives when they lose two things – hope for tomorrow, and a fear of death.”

Dr. Sue Simring

Author: Bruce Rickard

Reflections on Suicide and Staying Alive: My son's suicide changed everything. I felt an obligation to understand why anyone would want to end their life. My regular blog posts explore the causes and prevalence of suicide and what is needed to sustain a healthy mind and a hope-filled future.

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