Tag: schizoaffective disorder

My suicidal career:

I write about this not in the sense that Ronald Maris created it as that would be a completed suicide and I am not dead. But my relationship with suicide is a long one, from the time I was eight up until now. It is a struggle I deal with on a constant basis. It along with my depression makes life very unlivable for me. I often think about death in so many ways. I plan my death in so many ways yet I am unable to act on it.

When I was younger, I had no problem acting on my impulses to kill myself. But then protective factors such as my niece and nephew entered my life and I couldn’t bring myself to go ahead and kill myself. The loss was too great for them. I couldn’t imagine what my sister would say to these young kids who adored me. They were my saving grace whenever I had a bad day and really wanted to end my life.

Then chronic pain entered my life and made the balance of protective factors seem out of reach. I felt that I had to ignore them in order to let myself get into the suicidal mind frame to end my life. And I got there several times in the last few years. I had one friend call me every single day for a week until the storm had passed. I had therapy with my therapist several times a week. Nothing stopped the pain and the hurting that I was feeling. And when the pain got worse, so did the suicidal feelings. The feelings turned into plans that never were executed. This is the story of how it evolved and how a few suicide attempts lead to more hospitalizations than I can count.

I first thought about killing myself at the age of eight. I don’t remember the particulars but I thought it would be a grand idea not to be alive anymore. This got worse when I was nine. I really thought that ending my life was the answer to my problems. I hated myself because I felt like I was a burden to my family. I felt I had let them down somehow. I started planning my death at my birthday that year because I couldn’t stand the pain of living anymore. But for some reason, the age ten had a significance for my family and my mother was throwing a big party. I don’t know why she was throwing the party and making a big deal out of it but I figured I might as well stick around and see what I got. I was disappointed that I didn’t get a tape recorder that I wanted. I didn’t try to kill myself that year. But I did try later that year when I had an argument with my mother that now I don’t even remember what we were fighting about. I just told her I wish I was dead and went to my room to try and kill myself. I placed a pillow case over my head and prayed for death to come take me away. It didn’t work. The pillow case was too breathable. I was left crying in my room what seemed like hours. I don’t recall if my mother ever checked on me. I hated my life from then on. Suicide was always on the back burner for me.

This is a book detailing my career in suicide and the journey I went on to deal with it. There have been a couple of close calls but nothing recent, though I still feel the need to kill myself at times. But I do not act on my thoughts. I have attempted suicide many times and according to all the statistics, I should be dead. The one study that I often am in awe at is the one where they found that suicide attempt reactions often predicted future suicide deaths. I am in that category of not wanting to live yet I am still here. I am the outlier. And I hate being the outlier.

This story is my life that centers around my suicidality and the works that helped me get through it. Without finding the American Association of Suicidology, the works of Edwin Shneidman and David Jobes, I doubt I would still be around to talk about my life in this way. There are concepts of these people that I hope to explain in layman’s terms so people know about them because they have had a deep impact on trying to keep me alive.

The first is Edwin Shneidman’s conception of the word psychache. It is a word used to describe psychological pain which is defined as the combination of hopelessness, despair, loneliness, guilt, worthlessness, unbearable anguish, intolerable pain, and helplessness one feels when in deep despair. It is the pain one feels that is deep within you when contemplating your life. His other concept, the twenty frustrated needs is another brilliant sign of what constitutes suicide. They are:
ABATEMENT The need to submit passively; to belittle oneself
ACHIEVEMENT To accomplish something difficult; to overcome
AFFILIATION To adhere to a friend or group; to affiliate
AGGRESSION To overcome opposition forcefully; fight, attack
AUTONOMY To be independent and free; to shake off restraint
COUNTERACTION To make up for loss by retrieving; get even
DEFENDANCE To vindicate the self against criticism or blame
DEFERENCE To admire and support, praise emulate a superior
DOMINANCE To control, influence, and direct others; dominate
EXHIBITION To excite, fascinate, amuse, entertain others
HARMAVOIDANCE To avoid pain, injury, illness, and death
INVIOLACY To protect the self and one’s psychological space
NURTURANCE To feed, help console, protect, nurture another
ORDER To achieve organization and order among things and ideas
PLAY To act for fun; to seek pleasure for its own sake
REJECTION To exclude, banish, jilt, or expel another person
SENTIENCE To seek sensuous, creature-comfort experience
SHAME-AVOIDANCE To avoid humiliation and embarrassment
SUCCORANCE To have one’s needs gratified; to be loved
UNDERSTANDING To know answers; to know the hows and whys

When you have frustrated needs your thoughts of suicide go up. One feels the need to be loved and nurtured and when that doesn’t happen a certain loneliness occurs and it is painful. According to Shneidman, one must rank these needs so the final sum of all is 100. I have never been able to rank them but I find that these needs are important in everyday life. He got them from another psychologist, Henry Murray in his famous book explorations in personality. The theory is that frustrated needs are a causal factor in suicide. Decrease the frustration and reduce the suicide. Then you have the ten commonalities of suicide (suicidal mind):
I. The common purpose of suicide is to seek a
solution.
II. The common goal of suicide is cessation of
consciousness.
III. The common stimulus in suicide is intolerable
psychological pain.
IV. The common stressor in suicide is frustrated
psychological needs.
V. The common emotion in suicide is
hopelessness-helplessness.
VI. The common cognitive state in suicide is
ambivalence.
VII. The common perceptual state in suicide is
constriction.
VIII. The common action in suicide is egression.
IX. The common interpersonal act in suicide is
communication of intention.
X. The common consistency in suicide is with
lifelong coping patterns.
Within suicide you have a vocabulary of suicidal terms. The list is exhaustive but I have a few favorites:

Hopelessness, psychache, lethality, perceived burdensomeness, thwarted belongingness, press, perturbation, fearlessness and competence.

Perceived burdensomeness, fearlessness, competence, and thwarted belongingness are not Shneidman’s term but of another suicidologist Tom Joiner. I read his book why people die by suicide and found it fascinating. It really is a good read and helped me to understand my suicidality a little better.

Hopelessness, the feeling of being lost in hope, that nothing is ever going to change, that things will always be the same no matter what.
Psychache is defined as despair, intolerable anguish, hopelessness, guilt, worthlessness, and unbearable psychological pain one feels. It is like pain in the heart that no one else can feel. Your heart feels heavy and you feel like a burden because of it. Nothing soothes this pain. No medication can touch it. And suicide seems like the only answer for this type of pain and anguish.
Lethality, the degree to which someone is at risk for suicide. Whether it be a loaded gun or a few bottle of pills or some cuts on the wrist. This is what determines how suicidal a person is and how they are going to act. If the risk is high and eminent, involuntary hospitalization is called for. If the risk is low, then more contact is need and assessment at every visit.
Perceived burdensomeness, the idea that you are a burden to those around you but in reality you are not,
Thwarted belongingness, the idea that you don’t belong anywhere and feel the need to belong somewhere. It is a very awkward and lonely place that hurts very badly. Everyone wants to feel like they belong somewhere or to something and when that need is not met, they feel detached and alone.
Press, similar to stress. It is as if the building of the press is similar to the pressure of a volcano ready to explode. It can lead to further perturbation and make things worse.
Perturbation, the need to feel or do something to ease the pressure and anguish and despair they are feeling and to feel better. It can lead to want to do something but the idea is that you need to do something to relieve the pressure of the feelings on your chest.
Fearlessness, the absence of fear. In this regard, it means that people may be fearless when trying to take their life, like a type of Russian roulette.
Competence, the meaning is the level of competence to carry out the means for their suicidal plan. Examples include rope for hanging, gun handling and shooting, knowledge of drugs, etc. High competency is a high risk factor.