Shneidman’s greatest questions: Where do you hurt and How can I help?
After I had a meltdown in late 2005 and was slowly recovering in 2006, I was taking a psychometrics class at college to earn my psychology degree. Psychometrics is a fancy name for psychological testing and validating tests and assessments on various things. As I was recovering from a deep suicidal depression, I was curious to see if there were any measures on psychological pain in suicide. I wrote my first draft of the term paper with 20 some odd articles all doing various risk assessments and testing of suicide ideation but none of them dealt with psychological pain, which was what I was aiming for.
The professor tore my first draft apart and even, however vaguely, accused me of plagiarism. I wanted to get a good grade in this class because it would help my further advancement in psychology. I went back to the drawing board. I searched for pain and psychological pain in the library databank. About only 5 articles showed up, at the time. I am sure I was doing it wrong. I looked up the articles and found Shneidman and Holden. Dr. Holden was based out of Queen’s University in Canada. He came up with a psychache assessment that I found useful in my therapy. I kept that article and shared it with my therapist. Then I queried everything on Shneidman and hit the jackpot. His work was in psychache, psychological pain. I read everything I could on him and his followers. I saw my idol David Jobes’s early work on the Suicide Status Form. It wasn’t appealing to me at that time. I was more interested in the psychache of the matter.
I read Dr. Shneidman’s book, The Suicidal Mind. Holy crap! This was about “me”. I knew I had to read everything this guy wrote but it measured in the hundreds so I focused on what was available now. I tried to read his books that were solely written by him but they were few and outdated. He wrote many chapters. The two questions that I kept coming across were “where do you hurt” and “How can I help?” No one had ever asked me those questions all my years in therapy. Not even my current therapist at the time asked until I brought it up to her.
These questions were the basis of how he helped suicidal people over his career. He brought them other options for suicide by learning things about their predicament. Then he ranked them in order of importance. As he slowly worked with them, suicide became less of an option on the list, which was good. It didn’t mean their risk of attempting was any lower but they could see that it wasn’t something that had to do right then and there as there were other options. That is what suicide prevention is, finding other solutions to the problems someone is facing other than suicide. Sometimes it works, sometimes it doesn’t. There was a case in which Shneidman talked to a Hispanic male who attempted suicide by gun shot. He blew off half his face and needed multiple surgeries and was in intense pain from his injuries. Dr. Shneidman counseled this man until he was well enough to leave the hospital. They kept in touch but as time went on, the contact got fewer and fewer. The young man died by suicide by that method a few years later. It was a sad case. The importance of the story is that contact is useful even after the initial attempt has passed, be it with postcard or phone calls or text messages. This isn’t an entire protective factor but it can be. Some people who think of suicide and even go to plan it, get through their circumstances never to think about it again. Others make an attempt and it is a kind of “wake up” call and they never think about doing something like that again. Then you have the people that are chronically suicidal, who make multiple attempts. These are the people most at risk of ending their lives by their own hand. It is these people that need the most help and patience. This is where the framework CAMS (Collaborating, Assessment, and Managing Suicidality) comes in handy. Check out their website https://cams-care.com/?pgnc=1
My blogging adventures for the month
In addition to my daily blah blah blogs, I will be writing about suicide prevention and about things related to it. A friend of mine gave me a few ideas on the subject as well as writing stories about what it is like being a patient in the hospital. I can go one for days with that one as I have had many hospitalizations spanning many years. I will also write some stuff on what I think works best to prevent suicide and why therapists NEED to be trained and use what they learn in their practice. Otherwise, what is the purpose of spending money or attending a seminar in suicide prevention and not use it?? That just irritates me.
I slept in three hour increments last night, giving up around 1000 or so. I washed up and shaved the back of my head to make it bald. I need to put in a new razor because it’s not as close as it should be. I’ll do that later. I then had a bowl of cereal before getting dressed and leaving to catch the bus. I brought my Bluetooth headset with me but I couldn’t get it to turn on. I think the battery died. I tried charging it while at the bus stop but couldn’t get it to work right. I put it away and pulled out my wired headset.
I dropped off the cookies I made to my barber. He loved the cookies. Then I went to Starbucks for my breakfast sandwich, espresso, and some cookies. I was able to charge my Bluetooth while there. I still have it charging on my laptop. I got kind of antsy after writing in my journal for a bit so went to CVS to look at shavers. I found one that I liked but it was $50. I made note of it on my phone and then went to catch the bus. Luckily it was late as they changed the time to 1220 not 1230 for the fall schedule. I got to the bus waiting area around 1222.
It was muggy by the time I came home. I went to Walgreens as I had a prescription to pick up and I wanted some Reese’s peanut butter cups. They had them on sale so I grabbed 2 packages. My ankle was hurting by the time I got home. I was sweating and needed to clean my sneaker off on my “good” foot as I stepped in some gum. I couldn’t wait to get to my room to cool off.
I was talking more with my friend about suicide prevention and how it’s gone to hell. She was telling me how she lost friends on Facebook because of her new adventures that are away from suicide related stuff. She had made that decision a few years ago as she felt it was time to move on to what she wanted and not live in her sister’s death by suicide. Sibling suicide survivor is hard because it really doesn’t get talked about. She was a strong voice for a while. Now it’s mostly parents that have a voice. A few brothers or sisters have come forward but it’s rare. The stigma is so great that it’s not helping the situation, even though studies have shown that sibling survivors have also thought or attempted suicide. They need care too, not just the parents.
My friend had sent me her blog that she is posting tomorrow and wanted my feedback. I was struck that she included my mentor, Dr. Shneidman’s questions, where do you hurt and how can I help? The Zero Suicide squad has gone away from that concept and really have no substance in helping preventing suicide because they really have no clue other than asking about it and how to go about asking about it, least that is my perception of it. Something about that concept was bugging me and it wasn’t until she brought about those questions that I figured out why it was bothering me so much. The sense of asking where it hurts or what is the one thing that won’t make you suicidal, or how can we make this a life worth living despite the pain of living has been lost. Some are still advocating for it but I worry that for every say 20 therapists that go through a training on suicide prevention, only 1 or 2 will actually take it to heart and use it in their practice. I will write more about this for those that care.
Shneidman was an important man in the evolution of suicidology. I think about him more during this month than any other because he advocated for suicide prevention. Stay tuned to learn more about this great man.