It’s dangerous to look at a multifaceted problem like suicide from a single lens, but if you had to pick a single view, Suicide as Psychache is a better place than most.  Before continuing, it’s important to recognize that Edward Shneidman is credited with founding the American Association of Suicidology and has written several other books.  (I’ve reviewed some of his other books: Clues to Suicide, The Cry for Help, The Suicidal Mind, and Autopsy of a Suicidal Mind.)

Gestapo

The German Secret State Police are no more, but that doesn’t stop people from imagining similar organizations preparing to knock down their door and destroy their lives.  There may, in fact, be other organizations, entities, people, and circumstances that are coming, which will radically alter someone’s life in a negative way.  However, what matters more from the perspective of suicide is whether a person believes that there are negative and particularly oppressive things to come.

Rick Snyder explains that hope is a cognitive process, not a feeling, in The Psychology of Hope.  People who are struggling with suicide have often lost their way and can’t find hope any longer.  Maybe that’s because they don’t see a way out.  Maybe it’s because they’ve begun to see the world as a negative and unhelpful place.  No matter what the cause, they need a way to feel like they’ll avoid being trapped in a negative life.

Perturbation

It’s anxiety or uneasiness.  It’s a sense that something isn’t right.  (See Cognition and Suicide and Suicide: Understanding and Responding for more.)  However, the impact that Shneidman saw on patients was that it caused cognitive constriction.  The more they became anxious or disturbed, the fewer options they could see – and the more that suicide seemed to become the only option.  (See The Suicidal Mind, Treating Suicidal Behavior, and Cognitive Therapy for Suicidal Patients for more on cognitive constriction.)

Movement

Suicide is sometimes conceptualized as people who desire death.  That’s probably literally correct, but it obscures an important point.  It misses the reason why they desire death.  In most cases, individuals desire death to escape life or some aspects of life.  They want to escape from the suffering and pain that they’ve endured or that they anticipate.  They’re not moving towards death as much as they’re moving away from negative aspects of life.

This creates an opportunity and an important way to reduce the probability of suicide.  If we want to reduce suicide, we need only help people see that their life is worth living – both for themselves and for others.

Over Center

There’s a technique in physics where a latch is “over center.”  In that condition, the more force that is applied, the more that the latch is maintained.  It’s an expression of the forces working in the system.  Kurt Lewin in Principles of Topological Psychology explains how forces kept people in different states, and how, at times when the forces changed, there would be enough energy to change the person’s state.

When Henry Murray conceptualized “press” – which may have been an analog for “pressure” – he was speaking of the forces that drive people to change their state.  (See Love’s Story Told for more on Murray.)  Murray was a mentor and friend of Shneidman’s.  It’s possible that both men saw the same patterns emerging as Lewin.  They saw that people could get into states that were hard to shake them from – either protective against suicidal ideation or caught in suicidal ideation.  (See also Capture for how it’s possible to get caught.)

Suicide in Genius

In 1921, Lewis Terman initiated a study of 1,528 gifted people, people selected for their above average intelligence.  Several others have picked up the mantle to run the longitudinal study to completion.  The good news is that the study has maintained a very low dropout rate over the decades.  The bad news is that, of the geniuses recruited, 22 people had died by suicide by 1960.  That means that, while the general population suicide rate was around 12 per 100,000, the Terman geniuses had a rate of about 1450 per 100,000 – or over 100 times the rate.

More recent research hasn’t shown similar results, but the rate is startling.

Mind the Gap

One of the possible reasons for the disparity may be the expectations that people have for their lives – and how their actual lives worked out.  Of Terman’s subjects, many came out with very normal, average, and ordinary lives.  If they had become wrapped up in the idea that they were special and gifted but found themselves in an average or below average social station and career, the gap between their internal expectations and their real state might have created the conditions for suicidal ideation to flourish.  (See Perfectionism for more.)

The Banal Suicide Note

Much of Shneidman’s career was focused around the promise of suicide notes (the first set he “borrowed” without permission).  However, in the end, he found them pedestrian and banal.  He found that his optimism was crushed by the reality of the completely unremarkable nature of most suicide notes.

He comments that the very act of writing a “proper” suicide note with insights might remove the conditions necessary to make an attempt.  This is certainly consistent with James Pennebaker’s work in Opening Up, where he saw that writing a narrative organized thoughts and reduced the force of trauma.

You Can Always Commit Suicide

The truth is that someone can commit suicide if they’re committed.  (See Suicide: Inside and Out.)  It’s always an option no matter how repulsive we on the other side may find it.  The key to this statement – which is echoed in a slightly different way by David Jobes in Managing Suicidal Risk – is that it allows for the idea that it could be the right answer in the future, it’s just not the right answer now.  Until we’ve taken every step, tried every option, to make life better, it’s just a future possibility.

That’s an important shift that allows the suicidal person to delay the idea without giving it up entirely based on the request of some professional that they barely know.  Of course, you want to ensure they know that life is also an option – but a life free from the suffering.

If you remove the psychache, then you remove the need to die by suicide.  That’s the power of viewing Suicide as Psychache.