Deconstructing "myths about suicide"

A few days ago, NPR's Talk of the Nation spoke with Thomas Joiner of Florida State University, a prominent researcher in suicidal behavior, on deconstructing "myths about suicide" Joiner has a new book out called Myths about Suicide in which he talks about this very thing.

Though I've posted about suicide before, I think it is still an important issue to discuss, especially as May is Mental Health Awareness Month. Like with many other disorders, suicide is often stigmatized as well.

There were several points in this conversation that Joiner made which really struck out to me. One was the myth that suicide is a selfish act. He explained that to those on the outside this is how it appears, but really what the suicide sufferer is thinking is, "my death will be worth more than my life to others." Although this thinking is mistaken, to the sufferer, it is true.

This often rings similar to those with eating disorders. On the outside, people think "how could someone with anorexia think they are fat? Can't they see they are not?" (I know this isn't the case for everyone, but just an example) Or it is like when we say we are "feeling fat" to someone, and they say "fat isn't a feeling." This may be correct, but to that individual, it feels real at the time.

Another point Joiner makes is that suicide is not an impulsive act. He says that even though suicide appears out of the blue for some people, often times, there has been a long built up process to it. If you think about it, it is really hard to kill yourself. Your body's natural reaction is to fight back and resist. For some, it is one reason why their body doesn't let them commit suicide.

He also mentions the film The Bridge, the controversial documentary about the San Francisco Golden Gate Bridge, a place where many have gone to commit suicide. For one year, the director and his crew, filmed people walking across the bridge, trying to determine which ones were vulnerable to jumping. In the end, they could not tell who would or would not. This deconstructs the myth that suicides are easy to tell. Even those that seem to be functioning well outwardly, inside the person is a mess and in misery. Again, this is so similar to eating disorders. How many times do people think we are okay just because we are weight restored, functioning, or look "normal"

One other myth Joiner discussed was the idea that if someone was really going to commit suicide, they would. He felt that physical barriers were important and was an underappreciated means of suicide prevention, especially as high railings have been installed at other historic buildings like the Empire State Building which dramatically reduced the number of suicides.

Since callers were invited into this show, there was one guy who had had several members of his family commit suicide. This led into the question of genetics which Dr. Joiner agrees contributes to suicides. He feels that genes, risk factors, personality traits, etc. operate via three aspects of his model which are learned fearlessness, burdensomeness, and alienation. He explains his model as:

I think that there are two main processes that have to develop and that have to collide to end in this catastrophe that is suicidal behavior. One has to do with the-I think very basic insight that death is inherently fearsome and daunting. Therefore it requires a kind of fearlessness, a fearlessness specifically about physical pain, physical injury and death, in order to enact it. So that's one process that's unfolding. It takes time to develop.

So does the other process, which has to do with: Why would people desire suicide in the first place? And I think it has to do with states of mind having to do with the idea - two ideas, actually one, that you're a burden, and one other - that's what I meant when I was referring to death being worth more than life kinds of thoughts; the other is that you're hopeless alienated, cut off and isolated from others. When these two processes combine, the desire for suicide spurred by alienation and burdensomeness, when all when that collides with learned fearlessness, that's when you see these catastrophes.

This makes sense to me and again resonates with eating disorder sufferers. There is the fearlessness of becoming malnourished, starved, unhealthy, or even dying. Then, there is the burden factor where we feel like we are burdens on our families and may not communicate how we feel to them or that we really need help. And with alienation, we often cut ourselves off from people and isolate to feed our disorders.

These same aspects could also be why a number of those with eating disorders do wind up committing suicide. These traits, brain chemistry, and feelings all collide, leaving the sufferer to feel suicide may be the only way.

I think this is one reason why I think education is important. Mental illnesses, in general, have so many stereotypes and we need to de-stigmatize and deconstruct the myths behind them.

Lastly, if you feel suicidal, please get help or call 1-800-SUICIDE, 1-800-273-TALK

FYI: the Discovery Health Channel is broadcasting "Six Nights of Understanding" series, showcasing individuals' experiences with Anxiety, Rage, Dissociative Disorder, Schizophrenia, Addiction, Bipolar Disorder, Hoarding, and Obsessive Compulsive Disorder. Thanks Dr. Deb for posting this!

Can pro-anorexia websites be attributed to suicide?

Ever since the publishing of the Newsweek article about Pro-Anorexia websites moving to Facebook, there has been a lot of discussion about the allowance of these groups on such public social domains. Well, now there will be more fury to the fire.

Almost a year ago, a 13-year old girl named Imogen D'Arcy from Leeds, England, committed suicide. In a note found by her parents, it was learned that Imogen had body image issues and felt "fat" and "ugly." Upon investigation, it was found that in the weeks leading up to her death, she frequented pro-anorexia websites and had the lyrics to the song, "Courage" by Superchick on her computer.

Her mother's take on the pro-anorexia websites: "Imogen accessed internet suicide sites on her computer and whilst these were not the root cause of her suicidal thoughts, these sites provided her with the means and guaranteed the success of her actions."

I think this is a tragic case, and it is obvious, there must have been a lot going on in this young girl's life. Perhaps if she had received treatment (none of the articles said she had as it seemed her parents were not aware to what she was feeling), she could have been helped. (Another article here about pro-anorexia websites and this case. Warning: images may be triggering)

I certainly agree with her mother that the pro-anorexia websites cannot be blamed for D'Arcy's already suicidal thoughts, but I think there is real fear with discovering the "means." Now, I know most people going to these websites are not looking at ways to kill themselves, but rather want to be in a place where they feel others understand them and/or are looking for tips to lose weight. Still however, it's the whole idea that these types of things can be taken too far, and especially for someone already in an unstable state both emotionally and physically.

So where do we draw the line?

Over the years there have been several controversial books about suicide. One rose to number 1 on the New York Times Bestseller List after its publishment and is now in its third edition. However, that book has been banned in France, though is available in 12 languages. Another book was pulled from the market after it seemed like a "how-to" manual.

I don't know what the best options are here as it seems like nothing is a win-win situation as people are desperate for information. In the end, if someone is in the mindset of suicide, they find a way.

If you are suicidal, please call a hotline or speak to someone you trust.

Related post: study on anorexia and suicide

*Note: I'd normally post the links about the books mentioned above, but I do NOT feel comfortable with this.

Anorexia and suicide

This week, a new study out of the University of Vermont was published about anorexia and the intent of suicide. While it is a well established fact that anorexia has the highest mortality rate of any psychiatric disorder of which suicide is particularly high, how seriously is it really taken? Suicidal acts have often been considered a call for help, a wish not really to die but to end the pain. Or for those who have succeeded, a call for help gone wrong. In this study, researchers looked at nine cases of anorexic women who committed suicide through extreme measures--measures where the likelihood to die was insurmountable despite having anorexia. Researchers concluded that their intent was to die by a quick means.

Although I think this is a unique set of research in this field, and I understand where the researchers are headed, I have slight problems with it too besides that the sample size is small. It's either that people do not hear about these types of cases, ie eating disorder individuals hanging themselves, setting themselves on fire, jumping in front of moving objects, etc. which were outlined in the study, or that these are the extreme portion of cases. Recently, we heard about the death of Polly Williams from the documentary "Thin" by an overdose of sleeping pills. Then several years ago, there was Anna Westin who died from an overdose of anti-depressants if I remember correctly. Both of these were more well known cases and used more common methods of suicide. While I agree that overdosing is not a guarantee for success of suicide, I think the intent is still there for many sufferers.

The one thing I do think is very important out of this type of research is to recognize the seriousness of suicidal tendencies among those with eating disorders. Then, perhaps, we can help prevent these type of tragedies, or better yet actually get health insurance to cover treatment costs.