Suicide Is A Symptom — How We Talk About Suicide and Death Anxiety
Suicide scares people. When the topic is raised in conversation, often regardless of context, the reaction is furtive glances and shuffling movements. There is a sense of taboo about it. Even during my counselling training, when suicide was discussed, there would be a discomforting tension in the room. Built from awkward silences and expressions of fear that these trainee counsellors will have a suicidal client sit before them in the counselling room. Suicide terrifies a lot of people because they haven’t experienced that sense of wanting to kill themselves.
The way we discuss suicide
Suicide is one of those topics where how we talk about it has become an issue. For much of our time, it was said that someone committed suicide. For most, it isn’t seen as an issue and it is still regularly used in media and by most people. It is however increasingly seen as a stigmatising phrase. To ‘commit suicide’ recalls a time when suicide was a crime. It used to be akin to murder or rape. Therefore, its continued use is seen as a perpetuating of the stigma that killing oneself is a crime or sin. It is something wrong to do.
Mental health and suicide prevention charities campaign for the use of different language to speak about suicide. They offer ‘completed suicide’ instead of ‘committed suicide’. The phrases ‘successful suicide’ and ‘failed suicide attempt’ entered the discussion, trying to put a positive slant as they moved away from ‘committed’. For me, the entire discussion feels wrong. It feels as if it is led by people who wish to rescue rather than understand.
The definition of suicide is that it is the intentional act of killing yourself. Yet despite that definition, we refuse to use it as a verb. Not to make the connection, but it is an easy example — murder. To murder is to intentionally kill another person. ‘He murdered someone’ works as a verb. Yet with suicide, it is often died by suicide. It doesn’t make sense. It isn’t a suicide attempt if it fails. It is attempted suicide. I prefer to say that when I was a teenager, I almost suicided. I planned to suicide. By speaking of it as a verb, I feel it takes away much of the uncomfortable stigma around the conversation. Reduce the shame by removing the fearful language like committed or completed or successful. I recall one of Orwell’s rules on writing, where he wrote, ‘Never use the passive where you can use the active.’
Intention to suicide & ideation about suiciding
There are times when the very mention of suicide chills a person’s blood. I’m a qualified psychotherapist. It is part of my role to listen to those struggling with thoughts and feelings about suiciding. During my training and subsequent work in the field, I’ve heard many occasions where the topic of suicide prevents therapists from working with clients in need of help. Counsellors close down sessions as soon as a client discloses thoughts about suiciding. Supervisors tell therapists they can’t see a client who feels like they don’t deserve to live because the risk is too high. It creates a sense of fear around helping those looking for help.
The issue with such fears is that they miss a fundamental difference regarding suicidal thoughts, having a plan to suicide and following through with a suicide. For over a decade, I struggled with suicide ideation. Plagued with daily feelings that it would be easier to die. Thoughts about driving off bridges or into trees passed across my mind. Suicide ideation are thoughts about killing yourself. They do not mean there is intent nor a plan in place. Often they are uncontrollable. In psychological lingo, they are called intrusive thoughts because they burrow their way into your consciousness and force you to think about them.
Suicidal ideation is often a part of the human condition. It is said that one in four people struggle with mental health. According to the mental health charity, Mind, 1 in 5 people have suicidal thoughts. It is a chance than at some point, someone might experience suicidal thoughts in their lifetime. Life is a struggle and can take dark turns down to a point where someone might feel that life is not worth carrying on with. That does not mean they want to die. These are thoughts. They are not intentions. There is a difference.
When I was in my early teens, I struggled with my sexuality. I have written about this many times, but it is always worth exploring. Due to that struggle, depression hit me and one summer, I hit a low point. I was lonely. I kept to myself for the six-week holiday, except a family holiday. Yet in such loneliness, denial and despair, an answer came. Those suicidal thoughts turned towards intent. A plan crafted itself in my mind. A plan to end my young life. For days, it swirled around my mind. Yet, it never quite solidified. Never quite reached a moment of decision. I wanted to die. To escape the feelings of being trapped in my denial. But I guess I never found the courage to end it. I was too afraid of death. Or maybe I wanted to live. It has been a long time since those days.
Crafting a plan for suicide takes a person closer to killing themselves. It is a moment when safeguarding bells ring and therapists are called in. It is a moment when prevention becomes key. Yet, for many, having a plan does not mean action will be taken. For many, having a plan becomes a final resort. It is an option on the table as they balance what they wish to do with their lives. This is when people examine their lives and put conditions in place. If life doesn’t get easier in six months, then they will end it. If a certain thing does not go the way they need it to, they will take that option. In a way, it can make them feel more in control because they have the option to suicide. For my role a psychotherapist, this is when I put into place a safety plan.
Intention to kill yourself is when the issue of suicide becomes a real possibility. It is when a person reaches a point of wanting to enact their plan. It can be a conscious, deliberate choice. Or it can be a trauma response that in spontaneous and a product of disassociation. It is at this moment, that I, as a psychotherapist, would act to break the confidentiality of the therapy session and contact emergency and crisis services, including ambulance and police. There are a number of things that can get a person to this point. According to Mind, 1 in 15 people attempt suicide. In 2020, 5,224 people suicided in England and Wales.
Gender Paradox of Suicide
In the UK, three quarter of those who suicide are male. Suicide is the highest killer of men aged 18–45. High than cancer or car accidents. In 2020, 3,925 registered suicide deaths were male, and 1,299 deaths were female. However, the paradox comes when you look at the data. Whilst men are more like to suicide, more women attempt suicide. However, the method of suicide is different between men and women.
Men often choose a more lethal and violent method of suicide than women. A study in the UK in 2005 found that men might have a higher suicidal intent, which might explain why they choose the more violent and definitive method. If I had followed through with my suicide plan, I would certainly have died unless I had been found or stopped in time.
Suicide is not selfish
There is an opinion widely espoused that suicide is a selfish choice. Whether it be inconveniencing travellers or leaving behind loved ones, people, when they hear of a suicide, say how could that person be so selfish. Having heard the stories of those coping with suicidal ideation and intent, whether they be clients or friends, I have never heard a selfish reason given.
For myself, my suicide ideation focused on two things. Firstly, I wanted to die because I couldn’t reconcile my sexuality with my religious faith. That was when my intention was at its highest. On two occasions, aged 14 and 17, I planned my suicide. Secondly, when I worked passed my denial and moved on to trying to live, the ideation that plagued me informed me that death would be preferable. I now feel free of any suicidal thoughts or intentions. However, when I was in the worst of it, I never felt a selfish need. Rather it is a sense of being overwhelmed. That it would be easier and preferable to the lives of others if I did kill myself. It felt as if my suicide was actually a gift to others.
Often, the theme running throughout the lives of those who have spoken to me about suicide is a sense of being overwhelmed. They feel that life is too hard. Too painful. Their minds won’t leave them alone. Their traumas were triggered too often for them to recover. The communities, relationships and societies crushed them down with pressure. Suicide feels like an option of escape. From feeling trapped.
For those who have never or rarely experienced such a thing, it can be difficult to understand why a person would kill themselves. But to those amid such pain or struggle, it feels like a choice that is worth considering.
Recovery is possible
If you scroll through social media, you might see a person tweet or post about a time when they either considered or attempted suicide. Having obviously survived, they might say that they are happy to have survived and are glad to be alive. I am in that group of people. It is not the case for everyone as is obvious. I have spoken with those who feel that surviving is worse and that they will try again. But for me, I am happy to have survived.
The last time I had a suicidal thought stick in my mind clear as day. Or night as the case was. It was in early 2019 and I was working a night shift in a petrol station. My life was a mix of good and bad, but during those months, it had taken a difficult turn. It was 1 AM and I stood in the sweet aisle of the shop. I refilled chocolate bars on the shelves from the trolley full of boxes behind me. Exhaustion cradled me. It was night 25 out of an eventual 29 nights in a row (I had two night jobs that covered every day of the week). A flurry of thoughts flooded in. The one leading the charge was ‘Wouldn’t it just be easier to die?’ It felt like it was on repeat. Every third or fourth thought took me back to that line. Like I was arguing its merits and cons to myself. Yet these were just thoughts. I had no intent. No plan. I didn’t want to die. I wanted to live. I had a wedding approaching. I didn’t know about a two-year pandemic approaching. I was training to be a psychotherapist.
Looking back, it felt like a death throe of the last-ditch attempt. Because since that day, no thought of suicide has resurfaced. I have obviously considered suicide as is displayed in this article. But no intrusive thought or intent for myself has appeared.
Death anxiety and purpose
Each time I see someone react with fear or discomfort to the very topic of suicide, I wonder what has stirred them. For those who have experienced it or experienced a loved one’s suicide, it seems easier for them to address it. To me, it appears that those with little or no experience of suicide find it the hardest to discuss. I have long wondered why.
Death anxiety is a sense of fear and anxiety about dying. It is believed by some to be a root cause of much of human behaviour. These include the desire to continually prolong human life, to be memorialised after we die through our work or family or to believe in a form of afterlife. It is an obvious anxiety, especially if you believe that this is our one and only life. You have one chance.
It is death anxiety that might be a cause of why people feel so uncomfortable around suicide. They themselves fear dying and cannot understand a desire to kill themselves. Therefore, when someone brings that desire before them, they react with fear, judgement, with confusion.
The trainee therapist who immediately stops a session when they hear a smidge of suicide ideation and demands an ambulance be called is not acting in the interests of their client. They have been triggered by something. I believe they have been triggered by their own death anxiety.
A person who scoffs at the idea of it being anything other than selfish might be using a judgement to hide away from the recognition that suicide ideation can pounce upon anyone. That each one of us has the potential for this aspect of the human condition. It terrifies them that they might one day kill themselves or simply consider it when they are already so afraid of death. I have seen and heard numerous other examples.
There is a study that shows that those who work with suicidal clients are less likely to have death anxiety. I believe the work I do as a therapist, throughout my training and subsequent work since being qualified has helped me recover from suicidality. When those thoughts of suicide seeped through my mind, I felt a deep sense of loss. That I was without control. That life was not kind to me because I had no secure future. Simply struggling day by day. No purpose. No cause.
Yet the work of sitting with others, listening, really listening to their struggles, their pain and holding it in a therapeutic space provided me with a sense of purpose. A sense of meaning. By helping others explore their lives and heal from their traumas, I see the worth of life. Feeling that if these individuals can sit in front of a stranger week after week and dig deep, then I owe it to them to do the same for myself. So, I have and continue to do so. And by finding a greater understanding of myself, the sense of suicide has drifted away.
My Recovery
Recovery from suicide is possible. But I cannot tell you the answer. For at this time, I am not sure I have a definitive answer as to how I recovered from mine. Especially during a time of global trauma from the Coronavirus Pandemic. I can say what might have helped. The work I do as described above. The joy of marrying my husband surrounded by loving family and friends after a year and a half of lockdowns. Being a therapist who sees a therapist and using therapy to dig deeper towards my authentic self. The desire or instinct to suicide pales in comparison to such things.
Yet I do find myself wondering where they are. I spend so many years with the thoughts of suicide, that it sometimes feels odd to be without them. I do know that whilst having those thoughts was exhausting and painful, I do not regret them. I remind myself of them and how I survived them every day through a pendant and ring with the inscription of Memento Mori. It means Remember Death. I remember surviving. Surviving my mind. And I use that memory to move forward and to work with those who seek to survive as well.
