Tag: suicide attempt

thinking about stuff

by Midnight Demon, posted in suicide attempt

I finally found the book I was looking for. I read some of the introduction, which clearly states the book is “for clinicians by clinicians”, then read the part about the Aeschi working group guidelines. If everyone is working toward stopping suicide, why can’t someone who is suicidal be a representative of the group? Who would really know what it is like to be suicidal better than someone who is ACTUALLY thinking about ending their life? The whole concept of the Aeschi is to bring clinicians to a patient orient model rather than a physician/clinician knows best model. I have read this book repeated and this is the first time that I got angry at it. I used to marvel at the insights these clinicians have. But now I am second guessing that they don’t know anything. Maybe it just is that I am in a pissy mood and feel like no one cares, that I have cried wolf too many times and that my despair just isn’t important anymore. I don’t know. I do believe that the attitudes need to be for the patient rather than the comfort of the clinician. That part I do believe in.

I was going through the book and I forgot that when I was at the last conference, I had the book chapter authors sign it. I got the John Hancock of my favorites. I kind of laugh because they don’t know that I am crazy and who would ask for an autograph at a professional conference? I even had my consultant sign his chapter. I talked with him after the conference. I don’t think he knew just how much it meant for me to have his autograph in my book. I now have two books signed by David Jobes. Not that it increases the value of the books to anyone but me.

I kind of am in a low mood. I am in mega pain and can’t fricken sleep. I haven’t gone over to the dark side but I know it’s coming soon as I get over tired enough. This really sucks. I am trying to listen to music to help drown out the emptiness of the room but it’s annoying me more than helping. I hope the demons don’t come out tonight. I already emailed my psychiatrist once tonight and I have a feeling I will write something more depressing if Mr. Hyde comes out.

In the book after the forward by Marsha Linehan, I wrote Styron’s cauldron piece. I can’t remember why I did that. But it just seemed fitting. There are a lot of notes in the book that I took. Some I can’t even read my own handwriting! I hate when that happens. I know I am not a suicidologist as much as my therapist thinks I am. I might know a lot about suicide but that doesn’t make me a suicidologist. I am just not quite there yet.

writing bug today

by Midnight Demon, posted in depression

I know this is my third blog of the day but I can’t help it. I have the writing itch and I can’t seem to stop it. I just can’t stop thinking about what I have been writing today about suicide and it has not really triggered me but I feel like I can’t stop it.

A fellow blogger wrote a comment about the frustrated needs in my last blog. I guess I wasn’t too clear about that. Frankly I am not too clear about it myself, only in the respect that I can see it myself and maybe that is not really clear. I will have to research it more as there are some top ones that always get people to think about suicide when their needs are frustrated or not met. I know succorance, validation, and affiliation are some of the top ones. I don’t know if this will make sense if you haven’t read my other blog, (my suicide career), it talks about frustrated needs as a precursor to suicidal thinking. It is the buildup of these unmet needs that might lead to suicide. Everyone has them, and most are met but for those that are mentally ill it can be challenging to have each of them met and feel satisfied with them. And all of this is related to the father of suicidology, Edwin Shneidman. He was a great guy that thought long and hard in the path of suicide prevention. He so wanted a psychometric assessment to evaluate suicidal thinking. Unfortunately, what he came up with was not always sound and easy to perform. Luckily, his successor, David Jobes, has been able to have a validated and empirically sound assessment called the suicide status form. Unfortunately, copyright laws prevent me from posting a new form. There is however one that has been filled out online if you search for it. I have used this form in my therapy and it has helped me. You can get it in his book Managing suicide Risk. I have made copies and have it in a word doc for easy copying.

I don’t know why I am thinking about this today. I have been up since three thirty this morning writing and writing and writing. Now my writing partner has come up with something else for me to write and somehow have it crossed linked to our blogs as tomorrow is National suicide prevention day. This is a wild idea. Hope it works out well for the both of us.

my suicidal career (short version)

by Midnight Demon, posted in blogging, depression, suicide, suicide attempt, suicide attempt survivor

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.

random 654

by Midnight Demon, posted in blogging, depression, suicide, suicide attempt

The shipping box for my new laptop came today. Now I just have to drop it off at FedEx to ship it. This will give me a chance to go to my old Starbucks hang out in Wellington. I hope that I can take my sister’s car tonight to drop it off, otherwise it will have to be tomorrow morning.

So far my day is going ok despite my allergies flaring up. I have had two sneeze attacks since getting up at noon. I woke up at three-thirty in the morning and fell asleep around six. I slept for about six hours. But I was productive during the early morning hours. I got to work on my book (nothing triggering) and came up with at least six pages. I am excited because this line of writing will be at least fifteen or so pages, if I am able to keep it up.

I am feeling less depressed than I was yesterday. I have more energy and I hope this isn’t a crash before a fall. I still am worried that I am going to lose my data on my laptop. But seeing that I have what I need, my blogs and book, I am not so worried. I have my music on my phone that I can always back up and Amazon has all my music is on cloud. The rest of the music is on CDs (actual CDs not CDRs) so I can always make copies of those to put it back on my phone if need be. It is weird working on my old laptop. I forgot how different the keyboard is. I am just hoping that I don’t have any more blue screens of death or that my monitor screen get funky.

This week is National Suicide prevention week. I think there was a chat on twitter about it that AFSP and Mayo clinic were holding. I wanted to see what it was about but I missed it. I don’t usually say anything, unless they discuss treatment options. Then I will put in my two cents about Jobes’s CAMS and the Aeschi model. More clinicians need to be aware of these two similar modes of therapy if they ever want to get the suicide rates down. Course the biggest hurdle is actually getting the person the help he/she needs before they act. I know it wasn’t easy for me to reach out and get the help I needed in the beginning. It took me several calls to Samaritans before I ever saw my first therapist. And I only saw a therapist after I tried to kill myself because I felt like no one would believe me otherwise. I was an intelligent teen and didn’t seem to have any behavior problems so I just felt like they wouldn’t believe me. I felt that if I cut my wrist, it would give me more creditability. After all, my own mother didn’t believe me when I told her I was suicidal. And it took the school nurse to convince her that I needed help.

There were no anti-suicide campaigns at my high school, least none that I recall. I know now they have a counseling center as well as a health center at the school, thanks in part to the movies they have made around the school and other donations. I don’t know how I got through high school as I was extremely depressed and suicidal. But I guess part of it is the connection I made with the school nurse. After I had my problems, I saw her nearly every day just to say hi and chat for a few minutes. I think those chats were the most helpful.

While I was up in the wee hours of the morning writing, I was also reading a little bit in the Comprehensive Textbook of Suicidology. I wanted to see if they had anything about “suicide careers” by Ronald Maris. And to my surprise it did. I don’t know why I wrote this book off. It also has Shneidman’s ten commonalities of suicide. I also included that in my chapter that I am writing. I think I will make what I am writing a blog post. It will be long as already it is almost seven pages or I could just write about it separately. I haven’t decided yet what I am going to do. But I am glad that I don’t have to go searching for “pathway to suicide” by Maris to find the definition of “suicide career”. The way he defines it, is a lifelong depressing road that ultimately leads to completed suicide. In the book, he uses Sylvia Plath as an example.

In finding this little tidbit of information, I feel energized to continue writing a book that talks about the newer age treatment of suicide rather than the old. I talk about my experiences and hope that one day someone will read my book and not feel so alone. Maybe they will have attempting, maybe they have been thinking about it. I will never know.