Suicide & Self Destructive Behavior

The key to understanding suicide and self-destructive behavior comes from the awareness of the destructive thought processes that control such behaviors. Being cognizant of how self-critical thoughts can lead to a self-destructive downward spiral enables clinicians to better assess risk and design interventions for depressed and suicidal clients.
 
What happens in a child’s early life that leads to a person becoming self-destructive and/or suicidal? 

There are many factors — biological, environmental, and social — that interact to create the potential for a person to become self-destructive or to attempt suicide. Genetic factors, temperament, prenatal environment, a difficult birth, and lack of family support, can predispose vulnerability in infants in relation to environmental stress, poor social-economic conditions, accidents, illness, traumatic separations and loss. In addition, children are affected by abusive or dysfunctional child-rearing practices prevalent in our society. For example, in one study conducted by Felitti (2002) 52% of 17,000 individuals who responded to a survey (Kaiser Foundation Health Plan survey) experienced more than one “category of adverse childhood exposure” before the age of 18. These adults tended to have poorer physical and mental health outcomes and higher mortality rates than did those who experienced none or only one category of aversive childhood exposure.

The cumulative effects of a number of adverse childhood experiences are often manifested in individuals who possess a sense of “perceived burdensomeness” – who feel as though they are a burden to their family and friends. Another belief held by many suicidal individuals is one of “thwarted belongingness”– a feeling of not belonging anywhere, of being a misfit (Joiner, 2005). According to Orbach (2008), rejection, and especially rejection of the child’s physical nature, gender and bodily functions, can lead to defensive dissociation in the child. The acquired ability to disassociate, that is, to cut off from one’s feelings and bodily sensations when under stress, has been found to be still another contributing factor in suicide.
 
Identifying with the Aggressor

Under stressful conditions, the child identifies with the punishing parent in an effort to relieve the terror of being at the mercy of an out-of-control parent. (Ferenczi, 1929. Anna Freud, 1960). In identifying with the aggressor, the child incorporates the parent’s hostility toward him or her being expressed at that moment.  This incorporation represents an internalization of the parent at his or her worst, not as the parent is on average.
 

 
What is happening in the mind of someone who is suicidal?

Part of the person wants to live; part wants to die. But it’s the part that wants to die that is in control when someone is suicidal. This part is governed by a destructive thought process that colors the perception of self, others, and life in general. Understanding this fundamental ambivalence and the associated destructive thought processes is key to assessing risk and intervening effectively in suicidal crises.
 

 
What is the relationship between suicide and other forms of self-destructive behavior?

Suicide represents the final submission to a self-destructive process that exists, to varying degrees within each individual. There are three premises underlying our approach to suicide and self-destructive behavior: (1) A division exists within each person between the self system, which is life-affirming and goal-directed, and the anti-self system, which is self-critical, self-hating, and, ultimately, suicidal. (2) The anti-self system is made up of self-destructive thoughts that exist on a continuum from mildly self-critical to suicidal. (3) There is a corresponding continuum of self-destructive behaviors that are strongly influenced or controlled by these destructive thoughts, or “voices. These self-destructive thoughts or self-attacks range from those that lead to low self-esteem and inwardness (e.g., self-defeating thoughts) to thoughts that lead to self-annihilation (for example, hopelessness, giving up on oneself, self-harm, and actual injunctions to carry out a suicide plan).
 
The Continuum of Self-Destructive Thoughts and Behaviors

 
What is the most important thing to keep in mind when dealing with someone who is suicidal?

There are several communications to avoid when talking with a person who is in a suicidal crisis. Perhaps the most important thing to remember is to never say or do anything that might increase a sense of guilt or feelings of worthlessness in the person. At the same time, it is vital to say and do everything, within reason, to support the person’s positive sense of self and to make personal contact with the part of the person that wants to live.

Other important helper tasks can be found on PsychAlive.org’s Suicide Prevention Advice Page.
 
Learn more about warning signs and how you can help prevent suicide by visiting: PsychAlive.org’s Suicide Prevention Advice Page
 
If you are in crisis or feeling suicidal, help is available. Don’t hesitate to call the free 24/7 National Suicide Prevention Lifeline at 1-800-273-8255.
 

See a List of Suicide Prevention Resources