Review: Critical Suicidology

Book Review Critical Suicidology

Critical Suicidology Edited by Jennifer White, Ian Marsh, Michael J. Kral, and Jonathan Morris

This book comprehensively talks about suicide and suicidology. It asks where suicidology is going and how to do the research needed to understand it better. I have broken down this review with a sum of the chapters in the book. The first chapter talks about suicidology and what is meant by the term. It also talks about defining suicide research. Nomenclature was discussed and I thought about the tower of babel paper written by O’Carroll (O’Carroll, Berman et al. 1996). Agree with author that you cannot diagnose suicidality like this paper and later Silverman points out (Silverman 2006). It is too fluid and changes on sometimes an hourly basis. The complexity of suicide and suicide ideation varies between individuals. I was also disappointed that Dr. Julie Cerel’s work on suicide survivors was not mentioned despite being published at the time of the book. There was mention that at least 7 people are affected by suicide which Cerel’s research disputes. According to her research, as many as 125 people can be affected by one single suicide. Bereavement research is not mentioned.

Chapter two was a bit confusing as it gave grounds for quantitative research but then changed gears and wanted qualitative research as the “best”. Author appears a little disgruntled that the editor of the leading US based suicide journal, Suicide and Life Threatening Behavior, seems to say one thing but do another. They looked at a few years of studies and found most of them were quantitative yet the editor wanted qualitative. It goes back and forth. At the end, the author sides more on mixed studies (qual and quant) analyses.

Chapter three is about Indigenous youth. This is a special population that needs more attention. Prevention efforts should be what the youth is needing rather than someone else. A power struggle of whether the intervention needs community support or individual support is discussed.

Chapter four talks about youth in general. It was a hard chapter to read as it reminded me of my past struggles.

Chapter five discusses women and how they were expected to care for others and shamed which caused them to be depressed or they were abused. Help seeking was encouraged but some women were shamed further so was not good help. It’s true that men are at greater risk of dying by suicide than women as they often choose more lethal methods. Women have less lethal suicide attempts and gender norms need to be included in the character of women who attempt or self-harm.

Chapter six talked about narrative therapy of suicide survivor loss. Interesting to learn of narrative therapy and that someone got their PhD in suicidology. The narratives of a bereaved survivor were touching. Very sad.

Chapter seven deals with collaborative care, no us/them directive. No diagnosis to prevent stigmatization in treatment. Like that they use whole person rather than diagnosis to treat suicidal ideation and behaviors. Works of Jobes, Lenaars discussed.

Chapter eight is a lived experience chapter written by someone with BPD and how positive psychology helped her. Interesting but thought author was talking around in circles. Kept saying she had recurrent suicidality but then would talk about lived experience and being an academic.

Chapter nine talks about social violence and hate that cause suicide rather than individualize a person’s suicide. Solidarity helps to mitigate when a person dies by suicide. An interesting chapter.

Chapter ten talks about youth suicide among queer identities. How gay men are attributed in film to be sad and suicidal to forming the identity of lesbian/gay/bi. Confusing as fuck with the verbiage.

Chapter eleven discusses poetry in facing suicide survivors. Interesting chapter about how words can convey feelings.

Chapter twelve is about Inuit suicide and how it was high before prevention programs took hold in the community. Best treatment was at the community level rather than individual involvement. Youth suicide decreased when there were peer support and increased when peer support networks weren’t available. Brilliant example of how a sense of belongingness can help to decrease suicide.

Chapter thirteen talks about reimagining youth suicide. Goes back and forth about chapters throughout the book and other research.

Overall, a very important book to have if you are serious about suicidology.

O’Carroll, P. W., et al. (1996). “Beyond the Tower of Babel: A Nomenclature for Suicidology.” Suicide and Life-Threatening Behavior 26(3): 237-252.

              Suicidology finds itself confused and stagnated for lack of a standard nomenclature.  This paper proposes a nomenclature for suicide-related behavior in the hope of improving the clarity and precision of communications, advancing suicidological research and knowledge, and improving the efficacy of clinical interventions.

Silverman, M. M. (2006). “the language of suicide.” suicide and life threatening behavior 36(5): 519-532.

ramblings 4

My blog had quite a lot of views and comments yesterday which made me happy for a little while but I was in a deep funk and still am in a deep funk. I don’t know why but I should stop reading about suicidal stuff because it is giving me ideas. I know I already have them in my head but I keep thinking, if I am not suicidal, then should I kill myself? As the saying goes, you should NOT kill yourself when you ARE suicidal. Mostly that is because you are thinking irrationally. But if you have been thinking irrationally for so long, does it become rational at some point? That is where my thinking is heading. I tend to think about killing myself nearly every day. I have yet to act on it for various reasons. Usually it is an in the moment type of thing but lately I have been thinking of a plan and a date. I KNOW it is because of the time of year. Every late September/early October I get seriously depressed, more so than anything. Since 2005 I have planned my death every single year without fail. I don’t know what it is about this time of year that makes me want to kill myself. I know that baseball season is over and that saddens me to no end. I no longer see pitchers on the mound and balls and strikes being called. Right now it is Postseason but I know that baseball will truly end by mid-October. Around that time is when I always think of ending my life.

I don’t know why this time of year brings me to my knees. I just don’t feel like life is worth living anymore. It is a seasonal pattern but doesn’t fit the usual SAD (Season Affective Disorder) criteria (mostly because I have recurrent depression throughout the year anyways). If it did fit, I probably would not be so crazy this time of the year. I’d get a light box and be done with it. But this is something more. I call it the black dog as I show more signs of depression than at any other time of the year. I just feel so worthless and guilty that all I can do is think about my own demise. The physical symptoms I get is more psychological pain, lethargy, fatigue, loss of pleasure and loss of interest (also known as anhedonia), loss of appetite, crying for no reason, worthlessness, guilt, etc.

I don’t know what takes me out of the black dog. Sometimes it is just perseverance, sometimes it is just means extra support from my therapist and psychopharm. I also have the hospital when it gets too much to bear, but I only use that as the last resort. Some people would say that is not right but I have had over thirty hospitalizations over the past twenty years that I know when I need to be in and when I don’t.  Though there is some literature saying that the hospital is under-utilized for suicidal patients the same can be said that it is over utilized as most clinicians do not know how to treat suicidal clients. And that bothers the hell out of me because there is (going on my Jobes soapbox) there is an assessment form easy to use and is applicable to all modes of therapy called the Suicide Status Form (see Jobes, 2009). If more clinicians used this, there would be less hospitalization and suffering and possibly less suicides. Granted my therapist tries to use this during each suicidal crisis but I wave her off. Not because I am a hypocrite, but because it was my idea and not hers mostly. Could this save my life? Possibly but the thing that bothers me is that she only uses one piece of the form. If you are going to use the form, use the whole of it. It will make your notes easier and all you have to do is have each person sign it (it is a collaborative effort on both the client and clinician parts). I love this ingenious form but I hate it when it is not used properly. But then my therapist has known me for upteen years now so knows what information to get from me to get me away from my suicidal thinking. Another form that is NOT used at all that should is the psychache form by Richard Holden at Queen’s University in Canada. That I have used to monitor my psychache and even modified the form for my needs. Every journal I have has the psychache scale in it. I would reproduce it here but it’s not kosher and I don’t want to get in trouble with the web police for copyrighted information. Holden wrote the article in 2001 and it is printed in the Canadian Journal of Behavioural Science, 33(4), 224-232. I find Jobes and Holden to be the best suicidologists in the world because they have come up with assessments that are clinically useful and empirically validated.