Sarah Gaer and Jim McCauley dismantle the myths about suicide so that people with suicidal ideation can get the help they need.
Talking about suicide is never easy or comfortable—and I had been warned endlessly about the challenges that I would face trying to train firefighters on this topic. In my role as suicide prevention specialist for the Riverside Trauma Center, I recently had the opportunity of training the entire Springfield, Massachusetts Fire Department about suicide. Contrary to predictions, I found the fire fighters to be interested and open to learning new ways to help people. Because of their role, firefighters often times meet people at their most vulnerable moments, a time when they can help the most. Through my training of these firefighters, I came to have an incredible depth of respect and appreciation for our public safety workers who dedicate their lives to protecting their communities.
My training with the firefighters also reminded me how many myths still exist about suicide. These myths result in perpetuating the stigma about depression and suicide and make it harder to get potentially suicidal people the help they need to get their lives back on track. As I challenged the firefighters to rethink their ideas about suicide, I realized that these myths are widespread in our communities and we must confront them so we can reduce this most preventable disease.
Myth 1: If I ask someone about suicidal thoughts, it might plant ideas that weren’t already there.
This is something that people really do worry about but the truth is there is far more danger in not talking about suicide than in talking about it. Generally people are either thinking about it or not and while we know that being exposed to a suicide death can increase risk (known as contagion), evidence demonstrates that asking about suicidal feelings and educating about suicide actually decreases risk.
When we ask a person if they are having suicidal thoughts from a place of genuine care for them, what we are actually doing is showing that they matter to us. If we are able to ask from a non-judgmental place, then we are implying that such thoughts and feelings are not “crazy”. In fact the Center for Disease Control performed a large scale study in 2008 and found that more than 8 million Americans reported having had suicidal thoughts in the previous year. This shows pretty clearly that thinking about suicide is common. The study also clearly showed that most people who think about suicide do not go on to complete or even attempt.
Myth 2: People who “really” intend to die by suicide keep their plans to themselves: So if they are talking about it, we don’t need to worry.
WRONG, WRONG, WRONG! This is one of the most dangerous myths there is around suicide as it often creates a false sense of safety if someone’s loved one is openly talking about feeling suicidal. On too many occasions I have spoken with survivors who had been told this and so when their loved one expressed clear intention, they thought they were still in a safe zone. The guilt these survivors feel is overwhelming and their somewhat justifiable anger about being given inaccurate information is completely understandable. If someone is talking about suicide, they are thinking about it and if they are thinking about it, it needs to be taken seriously and asked about.
Myth 3: If someone really wants to die by suicide, they will do it!
Most people who attempt suicide do not want to die. They are seeking escape from the intense psychological pain they are in. Fewer than 5% of people who make attempts go on to die by suicide. The majority of suicidal people will resolve their suicidal crisis within a few weeks. When we look at the same study by the Center for Disease Control in 2008, we see that over 1 million Americans had made a reported attempt on their life and yet completed suicides were reported at 35,000 that year. This data suggests another explanation: Taking one’s own life is not an easy thing to do. Taking our own life means overcoming our natural instinct to survive which is the most basic of human drives. Thomas Joiner, who is considered one of the leading experts in Suicidology, explores this concept in detail. He argues that people who made attempts but did not die could not overcome their natural instinct to live.
Myth 4: If you stop a person from killing themselves, he/she will just find another way.
Common sense makes us think that this would be true but the research tells us a different story. What we are learning is that if we can keep someone safe when they are acutely suicidal, there is a very good chance that they will not make an attempt afterwards. While we argue that suicide is not as impulsive as people have previously suggested, (as supported by the fact that most people who make an attempt and/or complete suicide have made references to their intent in the week previous to the attempt) we also know that there often times is an impulsive element. Generally how this looks is that the person has been contemplating, likely even has a plan and some level of intent but what makes them act on all of that in the moment is a trigger. That trigger can be many things, loss of a job, criminal charges, a relationship ending. Sometimes it is even less dramatic such as an argument with a loved one. All these events can act as the “straw that broke the camel’s back”, triggering the impulsivity at that moment.
Here is the good news. We are finding more and more that if we can get a person safely through this time, chances are very good that they will no longer be suicidal. Really this makes sense. Think about the level of distress that you felt in the moments after a big argument with your wife. How did you feel 3 hours later? How about the next day? How about a week later? For most of us, the intensity will decrease in a relatively short period of time but sadly many suicides will occur in the hours immediately following the trigger event. If we can support the person through those critical hours, it is likely their distress will decrease and the suicide will be avoided.
Why is challenging these myths so important? Because these myths have created a lot of misunderstanding around suicide and often times make attempt survivors or people who are considering suicide feel even more judged and isolated, two emotions that we know can increase a person’s risk. They also decrease the ability and willingness to prevent suicides and support people who are suffering with suicidal ideation. For every death by suicide, dozens of family members and friends are impacted by overwhelming grief. Their lives will never be the same. Suicide prevention is not just about saving the suicidal person but also preventing the suffering of their loved ones that in many cases, will be lifelong.
Photo: ncanup / flickr