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Psychology

Book Review-Delinquent Boys: The Culture of the Gang

How is it that one boy becomes a Boy Scout Eagle Scout and the other finds their way into a criminal gang?  This is the fundamental question that Delinquent Boys: The Culture of the Gang seeks to answer.  Parents of children wonder these questions before their children grow up and after their children have sorted their ways into different paths.  Other, more contemporary works, like those of Judith Rich Harris in No Two Alike and The Nurture Assumption, have described their view on the sorting process.  It was Ronald Marris’ Social Forces in Urban Suicide that caused me to pick up the book (published in 1955) to see what we might have lost in our understanding of how people end up dedicating their life to a disruptive counter-culture – and how others do not.

Delinquency Definition

Delinquency is, at its core, counter cultural.  It eschews the standards of “social convention.”  (See Choosing Civility, The Righteous Mind, and Trust: Human Nature and the Reconstitution of Social Order for more about social conventions and their influence.)  Cohen in Delinquent Boys describes the subculture as “non-utilitarian, malicious, and negativistic.”  That is, the behaviors seem to have no utility, are seen by the traditional culture as malicious, and generally have a negative view.

In so much as delinquency is counter-cultural and malicious it is seen by most as amoral.  (See The Righteous Mind and Moral Disengagement for more on morality.)  However, it would be more accurate to say that it operates on a different set of moral values.

The Desire for Status

Delinquents have not or cannot find status in the traditional culture.  They don’t fall into a category or class that has the kind of recognition and status that they desire.  They’re not the jocks.  They’re not the nerds.  They’re not the kind of kids that go to college.  Their frustrated attempts to find a way to achieve status leads them to a group where their willingness to be malicious is enough to earn them that status.  (See Who Am I? and The Normal Personality for more about 16 different motivators, including status.)

In this context, rules aren’t just to be ignored or even evaded.  Rules are to be flouted.  It’s the fact that they’re willing to openly defy rules that creates their status in the eyes of others.  Being just ornery is ordinary; they’ve got to do something to stand out from their delinquent friends.

Here and Now

Another characteristic of delinquents is their prepotency of short-run hedonism.  That is, they are focused on their current desires for pleasures with little interest in long-term consequences.  (See The Time Paradox for more on different ways of viewing time.)  This can easily be caused by a lack of belief that they’ll be able to reap the rewards of any long-term planning.  For those who have had too many adverse childhood experiences (ACEs), it may be difficult for them to see the stability necessary for long-term rewards.  (See How Children Succeed for more on ACEs.)

Delinquent Psychology

Let’s cut to the chase.  What are they thinking?  That’s what everyone wants to know.  There isn’t a single answer but instead there are a few generalizations that we can make.

First, their sense of self-esteem is unstable.  That is, they’re always struggling for status and approval.  Because of this, when their self-esteem is threatened, their ego’s defenses are automatically engaged.  (See Change or Die for more about The Ego and Its Defenses.)  A typical reaction is anger.  Anger, in Eastern traditions, is disappointment directed.  Disappointment is a judgement of something that missed the prediction or the standard.  (You can find more about this in my post, Conflict: Anger.)

However, anger isn’t the only outward sign of the struggle to maintain the façade of a positive self-esteem.  I explained in my post How to Be Yourself how projecting one image is difficult to maintain, like holding a gallon of milk out to your side.  Coupled with an inability to admit vulnerability, this creates a situation where the “boy” continuously struggles to be or do something that isn’t naturally possible.

While Delinquent Boys put on the airs of being immune to the kinds of hurts that others readily acknowledge, the truth is that they are often cut more deeply by them.  They believe that showing reaction to these hurts means they’re weak, and their culture won’t accept that.  We know that, for physical healing to occur, we need to provide the right conditions.  In many cases, that means either avoiding use or specifically targeting use of the injured part of our body.  We apply casts and define exercise regimens.  However, in the case of the hurts that occur in the Delinquent Boys, they can’t acknowledge the hurts or shape the way they move forward and grow.  (See Antifragile for more about how to recover better from hurts.)

Red vs. Blue

It is a common game.  Red teams are the aggressors, and blue teams are the defenders.  Whether the game is one of cyberwarfare or not, the teams are set up in direct conflict, and Richard Hackman’s work says that the red teams – whether they are less experienced or not – are more likely to be successful.  In Collaborative Intelligence, he explains both the situational and team dynamics that influence the success of each group.  Red teams are effective in part because they define themselves with an objective, where blue teams can only define themselves by not failing.  It turns out that defining yourself with what you’re not isn’t effective.

Delinquent boys are defining themselves with the idea that they’re not something.  They’re not the norm.  They’re not the establishment.  They’re not the suburban preppy kids.  They’re not going to be the hardworking folks that others step all over.  They’re different.  This has some utilitarian value.  It means that, if they fail, it’s trivial for their ego to deflect by saying whatever they failed at wasn’t important anyway.  However, because they can’t define themselves with a single thing, it’s hard to be successful at anything.

What does a motorcycle manufacturer with a poor track record in just about every aspect that one would want in a motorcycle company do to salvage its business?  Associate its brand with a culture of rebels.  Our desire to address under-addressed aspects of our personality is a powerful force.  Accountants and businessmen wanted to express their inner rebel, and Harley Davidson was there to help them do just that.  Instead of fixing reliability, they fixed their image in everyone’s mind that to own a Harley Davidson was to signal to the rest of the world that you’re a rebel.

The problem is that while “rebel” can be a part of your personality, it fails as a core part of a personality.  Being contrary to just be contrary doesn’t work in the long run.  You can’t anchor your identity to the idea of having no anchors.  So, Delinquent Boys are left adrift without anything to hold on to.

Counting “Nots”

A counselor once told me that you could tell when someone wasn’t saying anything real by counting the number of “nots” in their conversation.  Broadening this slightly to include other forms of negation, I realized that when someone says they want something, but they keep explaining it by providing negative examples, they either don’t clearly understand what it is they want – or they’re actively trying to prevent the person who they’re talking to from getting there.  This subtle form of manipulation is shame-inducing.

The person who is receiving the negative-laden explanation has no model to work from and therefore must continue trying random (or semi-random) approaches to address the need – only to be told that this, too, isn’t right.  The result is often demoralization and the feeling that you’ll never get things right.  In fact, in some cases this may be the point.

This is just one example of how trying to define in the negative doesn’t work – whether it’s intentional manipulation or simply because of attempts to define oneself by what we are not.

Unique – But Not Too Unique (Optimal Distinctiveness Theory)

We have inherent need to be accepted by others.  It’s wired into our evolution.  Jonathan Haidt, in The Righteous Mind, explains that we survived to become the dominant biomass on the planet not from strength but from our ability to be social.  We know that when we’re standing on our own – rather than as a part of a group – we’re at substantially greater risk.  In historic times, being expelled from a community was likely a death sentence.  Individually, we’re weak.  Together, we’re strong, and that leads to our strong desire to be accepted by others.  However, that’s not the only force deep in our psyche that struggles to bubble up into our feelings, beliefs, and behaviors.

The other engine that drives us is our need for uniqueness.  We believe that we must be different – and ideally better—than others.  We don’t want to feel like we could be replaced by someone else.  That’s why it stings to hear that a former employer or a former lover has replaced you too quickly.  It’s the loss of our feelings of uniqueness.  However, uniqueness requires difference – and too much difference means that we can’t be accepted.

We know that people accept others that are like themselves.  If you become too different, and distinguishable from them, you threaten the ability to be accepted.  The result is that we try to find the narrow path between acceptance and uniqueness.  This has been called “optimal distinctiveness.”

The key problem with optimal distinctiveness is that it necessitates that the problem is a wicked problem.  No two people will define the need for and the appropriate degree of individualization the same way.  (See Dialogue Mapping for more.)  Ultimately, there is no solution to how to be optimally unique and at the same time conforming.  It’s one of the key challenges of life for all of us.

School Shootings

It was Columbine High School in Columbine, Colorado.  It ignited a series of school shooting massacres.  It was also not the first time the perpetrators had made themselves known as delinquents.  Eric Harris’ blog had detailed his interest in harming others and some of his escapades with Dylan Klebold.  Both pled guilty to felony theft and were sent to a juvenile diversion program.  That was 16 months before the massacre.

Numerous others have followed in Eric and Dylan’s infamous footsteps, and more than we know have tried and were thwarted.  No Easy Answers walks through the Columbine Massacre and seeks to help us understand how bullying and a desire to feel strong created a situation that left Eric and Dylan believing their only option was to become powerful through a massacre.

Shifting the Blame

Delinquents have gotten quite fully into what Leadership and Self-Deception and The Anatomy of Peace would describe as a box.  Inside the box, people’s vulnerability drives them to behaviors that are inconsistent with their beliefs and harmful to others.  Eric and Dylan weren’t from bad families.  On the outside, their values would seem to be that of any other child.  However, it turns out that they found ways to do the unspeakable.  They managed to disengage their morality.  (See Moral Disengagement for more.)

Following the Columbine Massacre, both Eric and Dylan were vilified, a reasonable response to people having lost their children or friends as a result of the rage.  What they didn’t effectively do is ask what conditions were in place which allowed these boys to become this way.  Certainly, there is the role of the parents, the community, and the school.  However, what about the environment is key such that so many copycats have followed them?  Perhaps it’s their feelings of shame at the hands of unchecked bullies.  Perhaps it’s something else.

We know that people resist accepting the blame for the situations that they create.  Delinquent Boys are no exception.  Without granting innocence or shifting the blame, how can we look back into their past to see what conditions preceded their delinquency?  Maybe you can find the answer in a nearly 70-year-old book about Delinquent Boys.

Book Review-No Easy Answers: The Truth Behind Death at Columbine High School

It has been identified as the sentinel event.  The book No Easy Answers: The Truth Behind Death at Columbine High School is an exposition and review of the events leading up to the Columbine Massacre as well as the aftermath of the event.  I started reading the book not because of the latest school shooting but instead because it offered potential clues to explaining unexplainable behaviors.  In the more than 20 years that have followed the event, much has been written and considered – perhaps among the tragedy, there might be some value.

No Easy Answers

In the wake of the Robb Elementary School shooting in Uvalde, Texas, some were calling for finding resolutions to the school shooting epidemic.  Depending upon their particular political beliefs, the focus of the call to action was on mental health, gun control, or better school safety.  What troubled me quite quickly was the look for an easy answer.

At Columbine, it would be easy to dismiss Eric Harris and Dylan Klebold as deranged psychopaths, products of a hostile environment and poor upbringing.  However, having been to the Denver, Colorado suburb of Littleton that surrounds Columbine, the environment is anything but hostile.  By all accounts, both Eric and Dylan’s parents weren’t cruel or neglectful.  In fact, their parents would easily be considered above par in terms of creating home environments and engaging with their children.  Clearly, Eric and Dylan’s actions betray psychopathy – but how did this happen?

It’s not the case that they were just two “bad apples.”  Instead, we’ve got to look more carefully at the environment, the situation, the signs, and the gaps that allowed them to slip through.  As I explain in Fractal Along the Edges, things aren’t what they first appear.

The Environment

Judith Rich Harris, in The Nurture Assumption and No Two Alike, walks through the mechanisms that can cause two children born to the same parents and in the same environment to differ in the trajectories of their lives.  To blame the parents ignores the external factors over which the parents have no control.  To blame the parents either burdens them with having produced genetically damaged offspring – which isn’t truth – or to distort their home lives to fit a freakish version of the truth.

But if we absolve the parents of responsibility – which I’m not completely advocating – who is left?  What in the environment might contribute to the awful tragedy?

Bullying

The news is littered with the tragedy of students who take their own life because of the bullying that they receive – both physical and emotional.  Often, the bullying that these lost souls experienced went unreported.  Somewhere, they’d learned that they’d be blamed for the bullying.  They’d be told they’re weak, and they needed to just “suck it up.”  The authorities weren’t going to do anything about it anyway.  They’d only make things worse.  Whether these perceptions are true or only fears given inappropriate legitimacy, they exist in the minds of many of those who found themselves at the hands of bullies.

The same forces that drive some to give up and take their own life can drive the desire for revenge and rampage.  (See The Suicidal Mind for more on the connection.)  The forces that make someone feel weak and unprotected cause them to find their way towards strength and self-protection.

At the heart of bullying lies two concepts.  First is that someone is better than another.  That is, their position in the society grants them special privileges.  The second is that “might makes right.”

Social Hierarchy

The animal kingdom is practically built on social hierarchy.  We find that some animals are perceived as leaders, and they are therefore granted special privileges.  The interesting question is what leads us to the coveted top of the hierarchy and what are the rewards that come with this social status.  In the animal kingdom, this is mostly strength and ability to fight.  However, as humans, we’re not the strongest, nor do we have the fiercest set of natural attacks, as Jonathan Haidt points out in The Righteous Mind.  What we do have is the ability to work together and our intelligence.  However, when you’re fighting your way to the top of the social hierarchy, how does this work?

In high schools like Columbine, the social hierarchy is driven in part by the kind of athletics you participate in.  The better your position and performance in a respected sport, the better your reputation, both with the other students and with the staff.  Football quarterbacks and starting centers get the highest spots in the hierarchy, where the captains of the chess and the debate team are less highly regarded.

This isn’t all bad, as Why Zebras Don’t Get Ulcers explains that stress can accompany not knowing your place in the social hierarchy.  However, it also explains that when those on the top of the hierarchy aren’t happy, they tend to take out their frustrations on those who are lower in the hierarchy than they are.

Might Makes Right

Historically, at the micro-level, physical prowess provided a mechanism for extracting pleasure from the infliction of shame and pain on the unfortunate souls who happen to be within range of the wrath.  The goal of this superficially is pleasure.  However, if Jonathan Haidt is right, this goes against one of the most powerful foundations of our morality: care vs. harm.  He explains in The Righteous Mind that there are six foundations of morality, including care/harm and authority/subversion, and we each value the foundations differently.

It’s challenging, because it’s necessary to practice Moral Disengagement in order to feel safe.  The capricious nature of the harm caused to others is intended to instill sufficient fear that people don’t – or rarely – directly challenge you.  It’s much easier to portray the illusion of strength when others are afraid to challenge you – constantly battling others can drain even the strongest.

I should be careful to say that I’m not condoning the behavior of attacking those lower on the social hierarchy – far from it.  I am saying that this is the normal order of things in the animal kingdom and unfortunately in “polite society” – it’s just the approaches changed.  In Reinventing Organizations, Fredrick LaLoux explains the evolution of organizations, from those only a half-step removed from physically beating people into submission to the more enlightened environments designed to encourage everyone.

Historically, history was written by the victors.  They were in power and controlled the narrative around what happened.  Thus, those who had the power shaped the way they were seen in the eyes of the populace.  While the world has now changed, as movements like Arab Spring have shown, we still must accept that much in our history books is near fiction.

Cynicism

When we speak about burnout, we explain that it has three defining characteristics: exhaustion, cynicism, and inefficacy.  (See Extinguish Burnout for free resources on burnout.)  What’s important here is that cynicism is an outcome.  It’s the outcome of feeling like you can no longer make a difference.  It’s a sort of resignation that all you can do is complain.

Some people reach this conclusion through a feeling of powerlessness.  They believe that they’re not strong enough to do anything.  These are the same sorts of people that become the best in their fields.  Anders Ericsson explains in Peak that people become motivated to get better, do the work, and focus on getting better.  In The Art of Learning, Josh Waitzkin explains his rise to the top of both the chess and martial arts worlds – including his psychological struggles.  Being the best is hard.  For some, giving up is never an answer; for too many others, it seems like the only option.

Direct competition isn’t the only way that people are confronted with reasons why they’re powerless.  In America’s Generations, Chuck Underwood explains how Generation X grew up with a growing awareness of how the world systems that we should trust were broken and corrupted.  From the Oval Office to the board room, the system was rigged against us – and there was nothing we could do about it.  It’s no wonder Generation X is one of the most cynical.

When you mix a deep sense that the system is rigged against you, constant bullying and belittling, a pressure from others to change the world, and the power that can be found in the form of guns and explosions, you’ve got the recipe for a massacre.

Guns

In the United States, we believe in the right to bear arms.  We believe that we can enhance our power by wielding a gun.  It’s the way that we see our heroes in movies overcome their enemies, and it’s an accepted part of our lives as well.  Many of those who enter the debate hold a strong opinion about guns.  Either they believe that the government is slowly out to erode or minimize these rights to have guns, or they believe that guns are the root of all evil and should be banned from existence.

The sparring goes back and forth between statistics that show more lax gun laws result in more gun-related deaths.  The opposition counters that this is only true when suicide isn’t factored out.  They recognize that suicide is the most common death due to guns, not murder.  They also counter that many guns are obtained illegally – as those used in the Columbine massacre were.  Albert Bandura shares his point of view in Moral Disengagement, where he comes down on the side of more gun control and less violence on TV.

Entertaining Violence

Another of the easy targets for the cause of violence was the entertainment industry: movies, music, and monstrous games.  Eric had been fascinated with the movie, Natural Born Killers, music by Insane Clown Posse, and created levels for the computer game, Doom.  Surely one of the was to blame for the massacre.  It’s a short distance from seeing violence and performing violence, right?  Not exactly.  Bandura is famous for his Bobo doll experiment, which proved that children could learn social norms by watching others.

However, the work of Erik Erikson in Childhood and Society explains that children should have developed the ability to discern fantasy from the real world well before Eric and Dylan were exposed to violence in the media.  No Easy Answers explains how the Klebold family intentionally shielded their children from violence, including the uneasiness about the children purchasing the game Mortal Kombat.  (For more about why Bandura’s perspective may not be right, check out The Blank Slate.)

The Reality of Television

While television was blamed as a part of the concern for the entertainment industry’s part, what was overlooked was the actual factual news that was being reported.  It’s one thing to look at movies and television shows and see actors portraying violence.  It’s another to realize that your president had oral sex in the Oval Office with an intern and got away with it.  It’s more than the fantasy violence that contributes to the situation.  It’s the real events that we see are allowing people to escape justice.  In America’s Generations, Chuck Underwood explains how there are milestones that shape each generation.  Generation X was shaped by mistrust of people, politicians, and the power of corporations.

We didn’t have reality television to the extent that it’s prevalent today, but television was still a mirror of our culture.  Where the television didn’t intrude was into the homes of those families where children were abused, and that, too, we discovered.  We saw that people who should protect children weren’t – they were the villains in the story, not the heroes – and it confused everything.

Bottled Emotion

When it comes to emotions, the illusion that we can ignore them is fading.  We’re beginning to realize that we can’t bottle emotions up.  We can’t turn them off.  We’re as much emotional beings as we are rational beings – if not more.  Jonathan Haidt explains in his Elephant-Rider-Path model that reason is a tiny human on top of a massive elephant.  (See The Happiness Hypothesis and Switch.)  Lisa Feldman Barrett in How Emotions Are Made explains some of the hidden processes that we go through to form emotions – and the power they hold on us after they’re formed.

The challenge was that Eric and Dylan were bottling those emotions – painful emotions – up.  As a result, they were emotional pressure vessels that were just waiting to explode.  When Eric’s grip on the difference between fantasy and reality waned just a little, it was all that was necessary to ignite the explosion.

Doing the Right Thing

What’s the right answer?  Certainly, not allowing others to be victimized and bullied is a good start.  However, at the heart of the matter is a complex interaction between dozens of forces, only some of which are visible.  This leads us back to the reality that there are No Easy Answers.  We may never know the real “truth” about Columbine.

Book Review-Capture: Unraveling the Mystery of Mental Suffering

One of the common challenges with those who are embroiled in mental suffering is that they feel stuck.  It’s almost as if their suffering has caught them in a net, and they can’t find their way out.  Capture: Unraveling the Mystery of Mental Suffering is focused on that idea – that people are caught by their mental suffering.  No matter which path they’ve been walking, somewhere along the line, they’ve stepped into a trap – and they’re struggling to free themselves from it.  Some are able to get free with support from medications and therapies, but some seem to be perpetually stuck.

Addiction

While on the surface mental suffering may not look much like addiction, as you look deeper, the similarities begin to surface.  In The Power of Habit, Charles Duhigg explains a cycle that he claims helps us define habits.  (His reading of the science is a bit weak, but, conceptually, the idea of a cycle is a good starting point.)  If you consider that addiction is simply the progression of a coping strategy becoming more controlling of a person, it’s easy to see how this is a reinforcing cycle.

Slowing that down a bit, you can look at The Globalization of Addiction and Dreamland about how difficult drug addictions function and how they’re driven by these progressive loops.  In particular, there’s a reinforcing shame cycle.  (See I Thought It Was Just Me (But It Isn’t) for more on shame and its effects.)  To understand the power of reinforcing loops, we can look to Donella Meadow’s excellent Thinking in Systems.  In short, when we have reinforcing loops without powerful balancing loops, any system can get out of control.

In the case of addictions, those reinforcing loops are initiated by the chemical and neurological changes.  Whether the addiction itself is chemically based or is simply the result of our internal neurochemical changes, the result is a system composed of powerful reinforcing loops with underpowered balancing loops.  One can argue that losing marriages, friends, finances, jobs, and most of the things that make life worth living would be powerful balancing loops, but often by the time that these kick in, the person is well under the control of the addiction.

Applying the same model to mental suffering, we know that many conditions – particularly suicide – are characterized by a cognitive constriction that prevents the ability to see a wider range of options.  (See The Suicidal Mind for suicide and cognitive constriction.)  In Drive, Daniel Pink explains that even mild forms of stress decrease performance through functional fixedness.  Specifically, research showed that even under mild pressure people wouldn’t recognize alternative uses for a container that tacks were placed in.

It turns out that it’s easy to constrict our thinking and difficult to expand it.  In Creative Confidence, the Kelley brothers explain that we’re all born creative, and it’s crushed out of many of us by the educational and commercial employment processes.  In The Fearless Organization, Amy Edmondson is focused on the creation of psychological safety as an antidote to the constriction.  Richard Lazarus, in Emotion and Adaption, explains how our fear is based on the probability of an event and the impact of the event – and that our ability to cope mitigates our sense of fear.  Fear is clearly an enemy to being able to think broadly.

One of the challenges we face with mental suffering is that most people bring it upon themselves by reinforcing negative thinking, which constricts thinking to negative thoughts, and this loop ultimately continues until it’s difficult to see or accept positive things in our lives.  This is the same kind of cycle that drives addiction.  The difference here is that there’s no external object to which an addiction is attached.  Instead, the addiction is to the negative thoughts that continue to loop and consume those who experience mental suffering.

The Illusion of Control

Always lurking in the shadows, shaping our feelings and our actions, is the desire for control.  We crave predictability and love the predictability that comes with the illusion of control.  In Compelled to Control, J. Keith Miller explains that we all want to control (others) but that none of us wants to be controlled.  One of the great revelations in The Hope Circuit is that Marty Seligman’s great discovery of learned helplessness wasn’t learned helplessness at all.  In fact, Steven Maier (one of Seligman’s colleagues) discovered that it was a failure to learn control – or influence – that kept animals from trying to escape mild shocks – even when escape was possible.

C. Rick Snyder in The Psychology of Hope explains that hope is a cognitive process based on waypower (knowing how) and willpower (desire). Inherent in the waypower aspect is the belief that if we do the right things, we can control the outcomes. While, at some level, we are aware that this isn’t the case, we suspend disbelief to engender hope and accept that while we believe we have control of the situation, we really only have varying levels of influence.

Judith Rich Harris explains in No Two Alike and The Nurture Assumption that even with our own children, we don’t have positive control of how they’ll turn out – as any parent of a teenager has undoubtedly discovered on their own.  The desire for control is an illusion – but it’s an illusion that we need to keep intact.

Influence Not Control

There’s a dim awareness that we don’t have control.  Where control implies 100% influence, we’re often arguing with ourselves about the degree of influence that we have.  In How We Know What Isn’t So, Thomas Gilovich explains that we often overestimate our capabilities.  Change or Die explains that our ego is well armed with defenses.  We will often keep believing in things because the alternative is unpalatable.  Incognito and The Tell-Tale Brain explain that we’ll use a variety of defenses as necessary to continue to keep our beliefs about ourselves even when the data clearly indicates that our perceptions are wrong.  Whether it’s denying that we have any physical limitations despite the rather obvious facts that contradict that belief or an amputee’s belief in phantom limbs, we have an amazing capacity to ignore the truth.

If we begin to accept for a moment that we’re not in control but rather have limited influence, we must contend with the fact that we’re no longer “in control” no matter how much of an illusion that might have been.

Loss of Illusion

Obviously, when we lose the illusion of control, we lose hope, and that can lead us to burnout and depression.  (See ExtinguishBurnout.com for burnout resources.)  On the one hand, we need to accept that control is an illusion to free us from the burden of belief that everything is ultimately our fault; on the other hand, we must simultaneously retain the belief that we do have some degree of influence and that degree of influence may be enough.

We get caught in the belief of permanence in our current situation and our belief that we should have prevented it – but didn’t or couldn’t.  The result is a feeling of being trapped, greater stress, and, ultimately, our worlds narrowing into the perceived hopelessness.  (See Why Zebras Don’t Get Ulcers for more about the impact of stress.)

Responsibility

We cannot be ultimately responsible for things that we cannot control.  That is, we cannot accept all the blame if we only influenced the outcomes – but insufficiently.  Mistakes Were Made (But Not By Me) examines an under-acceptance of responsibility on the part of leadership.  While certainly this is a valid and important concern, we should be equally concerned when we attempt to take more responsibility than we are due for things that are largely outside of our control.  (See Happier for more.)

Those who suffer often take more responsibility than they should.  They shame themselves for not doing more when there was no way to know that more was called for – or ways that one could do more.  The burden of unnecessary and inappropriate responsibility buries us under weights of depression and disappointment that may be too much to escape.

If Only

When something bad, tragic, or unthinkable happens, we naturally question, “If only I had… would things be different?”  The problem with this line of thinking is that, at some level, the answer is always yes – you could have done something different.  The deeper philosophical challenge is how could you have known that more was necessary?  You begin to ask questions like: how would I change every response in ways that lead away from the result every time?  Often, these answers lead to hypervigilance and a breakdown.

We can’t undo the past no matter how much we may desire to do so.  Instead, we must find ways to take reasonable steps to prevent future occurrences while accepting whatever tragedy has already befallen us.  “If only” is dangerous, because it invites us into the loop where we recognize that we’re not capable of completely avoiding the future pains and intensifying the degree to which we second-guess ourselves.

None of Us Are Immune

Perhaps the most disturbing thing about the tendency for people to get captured is the reality that none of us are immune.  We’re all bombarded by sensory input every day and ultimately the wrong set of inputs at the wrong time given the wrong attention can launch us into a loop – capture – that’s hard to escape.  Nassim Taleb in Antifragile explains how we can build resilience but how that all resilience has limits.  After we’ve been impacted by something we need time to recover – and ideally build up resistance – if the next wave comes too quickly or intensely, we can be overwhelmed – and caught up in a negative cycle of mental suffering.

The fact that all of us are susceptible doesn’t change our desire or need to make things better.  We’ve got to accept the fact that we can be captured and work to develop the kind of skills that make our descent into the spiral less likely and easier to recover from.

The Other Side

While Capture has the unfortunate consequence of burdening us, it’s not always a negative cycle that we find ourselves in.  Sometimes, the same mechanisms that drive depression can be turned around on themselves and leveraged to the most amazing experiences.  The experiences that we find the most engaging in life are experiences of flow, which are remarkably similar – even if much harder to enter.  (See Flow, Finding Flow, and The Rise of Superman for more on flow.)

In the end, the greatest hope we may find is not that we eliminate the drivers that lead to mental suffering.  Perhaps the answer lies in harnessing these powers for the development of greater happiness and joy.  Maybe it’s time to Capture happiness.

Book Review-Definition of Suicide

It’s hard to address something that you don’t have a clear definition of.  That’s why Edwin Schneidman wrote Definition of Suicide.  He’s not the only person to tackle this definitional challenge, but he may be the person with the most experience.

A Rainbow of Colors

There have been numerous taxonomic approaches to suicide that often describe the lethality of the method chosen and the degree to which the suicide was intended.  The Neuroscience of Suicidal Behavior tackles the problem with these as well as the degree of planning involved.  However, as was highlighted there, there is invariably a continuum that things fall on that are difficult to distinguish.  For instance, what differentiates a parasuicide from a suicide?

More frustratingly, intent is very hard to infer and is therefore a dimension of great question, as Assessment and Prediction of Suicide reveals.  Schneidman’s own The Suicidal Mind explains that he believes communication of intent is a part of suicide.  (Since then, several others have questioned the percentage of people who do communicate their intent.  In particular, see Rethinking Suicide.)

Durkheim

Emile Durkheim is at the root of suicide research – but sort of accidentally.  His primary interest, it seems, was the application of statistics to public health concerns.  It turns out that one of the examples that he used was suicide.  As the first work of its sort, it is something that everyone comes back to – and unfortunately replicates.

Bacon’s Idols

Francis Bacon, whose scientific method helped to crystalize science, also wrote of philosophical works.  One aspect of those works that Schneidman calls out is the concept of idols – or sources of bias in our thinking.  Bacon’s idols, as explained by Schneidman, are:

  • Idols of the Tribe (Idola Tribus). These are fallacies that accrue to humanity in general.
  • Idols of the Cave (Idola Specus). These are errors peculiar to the particular mental makeup of each individual.
  • Idols of the Market Place (Idola Fori). These are errors arising in the mind from the influence of words, especially words that are names for such non-existent things as “mind” or “soul.”
  • Idols of the Theater (Idola Theatri). These are erroneous modes of thinking resulting from uncritically accepting whole systems of philosophy or from fallacious methods of demonstrating empirical proof.

 

These are perhaps some of the earliest views on cognitive biases.  It’s how we see things differently than they really (or objectively) are.  (See Why Are We Yelling and Thinking, Fast and Slow for more about cognitive biases.)

A Time for Dreaming

Death and sleep are often compared as relatives – sometimes as close cousins, and other times as siblings.  Sleep brings us relief, a chance to stall our pain and dream of happier times – either in the future or the past.  With the close relationship between death and sleep, it’s possible to see how some might desire death as both an ending of their current pain and, in a warped sense, how it might give them a chance to live the life of their dreams.  It’s possible to see how it seems more desirable.

The overlooked item, in the cognitive constriction of suicide, is that sleep returns to wake where death does not return to life.  While a decision to sleep is temporary, a decision to die is irreversible.

Not Quite Human

A challenge with some who die by suicide (or attempt) is that they feel somehow less than human and therefore undeserving of the grace and love that all mankind should show to one another.  In Moral Disengagement, Albert Bandura explains the need to make people less human to be able to inflict harm on them.  Phillip Zimbardo expresses a similar perspective in The Lucifer Effect.  What if suicide isn’t murder in the 180 degree, as Menninger suggests in Man Against Himself?  What if the thing that’s turned against someone is their belief in their humanity?  Schneidman shares one example where someone describes herself as an “it” or a “thing.”  Those sorts of descriptors minimize her own humanness.

The situation that created those feelings were stories I’ve heard before.  Pregnancies that were initially twins where one died in utero, and the parents told the surviving daughter that she killed her sister.  Another case where a father openly told his son that he should have peed inside his mother.  The list of these harmful parental responses to children is long, and unfortunately, the outcomes aren’t good.

Who Needs the Afterlife?

Sidestepping the topic of who God is, what our purpose is, and all of the religiously entangled parts, there’s an interesting question about who needs an afterlife if the life here is better.  Of course, whether you believe you’re coming back as a cow or you’re going to heaven, there’s no need to dislodge that belief.  But a more interesting question is one about what we can do now, regardless of our beliefs about afterlife.  What can we do to improve how we treat other humans such that we want them less harm?

Jonathan Haidt in The Righteous Mind proposes that we all have the same foundations of morality, the first of which is care/harm.  In short, we believe in more care and less harm.  However, despite this framework and the work of Robert Axelrod that confirms our cooperation isn’t an accident, and in fact is part of the Evolution of Cooperation, we find that too many people are suffering.

Improving someone’s condition even a little bit will help them make a different decision than suicide.  Instead of feeling hopeless, the improvement switches on The Hope Circuit and allows them to see that things can get better – since their degree of cognitive constriction may prevent that without a spark of hope.

Loneliness

In The Psychology of Hope, C.R. Snyder explains that hope is composed of two components: willpower and waypower.  There’s an aspect of this that he doesn’t address directly, which is the degree to which you believe the rest of the world is friendly or hostile.  In a hostile world, someone is always trying to prevent your success, while a helpful world is constantly trying to help you achieve your goals.  (This is the work of John Bowlby and Mary Ainsworth, and you can find more in The Secret Lives of Adults.)

However, even with a helpful view, you can get stuck in feelings of loneliness, which prevent the connection necessary to expect the world is helpful.  In Loneliness, it’s explained that loneliness is different than the state of being alone.  It’s about that sense of connection – and it can be critical.

The more we can help people who are feeling lonely feel more connected, the better off we all are – whether they’re suicidal or not.

Bankruptcy

Another way to envision suicide is that it’s declaring bankruptcy on life.  It’s the decision that you can’t make it better and you want to give up.  While this is tragic from the person’s point of view, it’s more complicated from the point of view of the others their life impacts.  Specifically, it means that people who knew the person feel as if their memories and experience with the suicidal person are somehow less important – at least less important to them.  They may even believe that the suicide invalidates their beliefs.

It’s easy to speak of the logical pieces of the situation.  Their pain.  The cognitive constriction that prevented them from seeing these memories.  However, that doesn’t help the hurting survivor who wonders what they could have done or why their perception of things was so different.

In the end, there may not be a suitable Definition of Suicide, it turns out we each may need to understand it in our own way.

Book Review-Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body

For the most part, popular psychology isn’t exactly positive on your ability to really change your core personality, your default way of being.  Sure, it accepts that you can learn new coping skills and occasionally better ways of responding emotionally, but for the most part, the assumption is that your core personality is set.  This runs in stark contrast to the research about neural plasticity.  Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body explains – with science – how our perception of things that are unchangeable may be changeable after all.

It’s a Mindset

In mainstream psychology, there are some acceptable conversations.  Carol Dweck explains that a difference in Mindset results in a difference in performance and the way that people respond to setbacks.  Anders Ericsson explains in Peak how the top of many professions got there through purposeful practice and how their brains are different because of their work.  Because this work is founded on traditional psychological and performance principles, there is relatively little push-back.  Even the work of Mihaly Csikszentmihalyi on flow, despite his observations of 5x performance and lasting effects, isn’t all that controversial.  (See Flow, Finding Flow, and The Rise of Superman for more on flow.)  Again, coming from a Western point of view, it’s largely accepted, like the medical machines that make the observations of the brain possible.

However, when it comes to the topic of meditation and mindfulness, there’s skepticism.  That’s particularly true if we rewind the clock 50 years or so and see how these ideas were shunned in the United States.  To be fair, there were charlatans and “snake oil salesmen” who sought to make money with no proof that anything they were selling actually worked and, perhaps in more than a few cases, a dim awareness that it didn’t.  Altered Traits is a walk through the research about how different forms of meditation and mindfulness have demonstrated efficacy in clinical trials and how the effects may be lasting – or even mind-altering.

Mindfulness and Meditation

In the interest of providing a framework for the remainder of the conversation, it’s important that I pause to say that “meditation” is a catch-all word for a variety of contemplative practices.  One of those is mindfulness – that is, the process of observing whatever comes to mind without any reactivity.  They’re observed and let go.  Other forms of contemplative practices are designed to focus on something – including a process like a body scan or breathing.  In those times focus is lost, the distracting thought is acknowledged and let go.

Because there are different forms of meditation, each of them seems to have different results in impacting our neural patterns.  That’s why research into the impact of these practices is often focused on a specific technique, so it’s possible to measure the impacts of that specific process.

That’s complicated somewhat by the fact that the techniques used by meditators varies with experience.  More advanced techniques are used by the meditators with the most experience, making it difficult to compare the results of the more fundamental forms over long periods of time.

After Enlightenment, Chop Wood

Collaborating with the Enemy quotes an ancient proverb: “Before enlightenment, chop wood, carry water.  After enlightenment, chop wood, carry water.”  The point is that while enlightenment may be a desirable goal, you return to the same life you left.  Or do you?  Heraclitus said that “no man ever steps in the same river twice.”  Meaning the river has changed and the man has changed – but changed how?

Those who had the experience of peace – or the high — that can come from a retreat or focused practice still realize that “after the high goes, you’re still the same schmuck you were before.”  But the research in Altered Traits seems to show that that’s not entirely true.  Much like Heraclitus’ man and river, it can be that the changes are so subtle that they don’t even register – but over time, they can make a big difference.

The After Is the Before for the Next During

The continued cycle of improvement is what the complicated statement “the after is the before for the next during” means.  Said differently, whatever skills, experience, and capabilities you developed during this meditation you bring with you to the next one, making it possible for it to be easier, deeper, or better.  Of course, there’s no straight-line improvement, but repetition makes it easier.

One of the key skills of the advanced meditators is the capacity to settle their minds quickly – on demand.  While average or moderate experience meditators may take a few minutes to settle down, the expert meditators seem to flow into it as quickly an easily as stepping into the next room.  I can’t share this experience with meditation – but I can share it with flow.

Most of my career has been built on the need to get into flow – in different situations.  Sometimes, it’s writing code.  Sometimes, it’s writing books, articles, or blog posts.  Sometimes, it’s presenting in front of thousands of people or facilitating a group of ten leaders.  They’re all different environments where I must get into flow to be effective.  In The Rise of Superman, Steven Kotler brushes the way that various athletes push themselves into flow.  For me, it’s a sort of mental trick normally accompanied by very familiar and very loud music.  Once I’ve dropped into flow, I instinctively turn the music down.  I’ve had to drive myself into flow so frequently that it generally – but not always – comes easily.

Eudaimonia

It was Aristotle’s word for flourishing, fulfillment, accomplishment, or well-being.  It’s the positive in positive psychology.  (See Positive Psychotherapy: Clinician Manual, The Hope Circuit, or Flourish for more.)  The aims of positive psychology and the spiritual-philosophical roots of meditation are well aligned.  The aim to move beyond human suffering to compassion or loving-kindness.

There are many nudges in the Eastern tradition that the goal of enlightenment or even fruits of meditation shouldn’t be for yourself.  The goal of the practice shouldn’t be because you’ll benefit yourself but rather the benefits should be something positive for humanity.  In other words, not just flourishing for oneself but flourishing for all mankind.

Focus on Others’ Suffering to Forget your Troubles

When you help others – when you care for others – you forget your own troubles and concerns.  Atul Gawande in Being Mortal explains that something as simple as a plant can reduce mortality of those living in senior centers.  Twelve-step groups have known for some time that the best way to get someone through their addiction is to get them serving others quickly.  Like in meditative practices, you’re encouraged to find a coach with more experience than you – in twelve-step terminology, a sponsor.  However, twelve-step groups take it further when they encourage you to take on a mentee.

Aaron T. Beck, whose work on cognitive behavior therapy and depression is the cornerstone of treatments today, is credited with first saying that when you focus on someone else’s suffering, you forget your own troubles.  This is true – but with the caveat that this may not always be the best answer.

Sometimes, people use their focus on others’ problems to look down on them – or to avoid dealing with the issues at the heart of their troubles, and this can ultimately cause more pain and suffering than had they just dealt with their own issues first.  It’s a delicate balance.

The First Person to Benefit from Compassion

Who is the first person to benefit from your compassion?  The answer is you, according to the Dalai Lama.  It’s the opposite of harboring anger for someone else.  In The Road Less Travelled, Scott Peck explains that harboring anger is like taking poison and expecting the other person to die.  Harboring compassion, however, is hoping that others benefit from you taking vitamins.  We develop compassion for others’ benefit and in turn reap some of the rewards.

They Are All One

When Neem Karoli was asked which path (approach to meditation) was best, his answer was “Sub ek!” – Hindi for “They are all one.”  Though various approaches differ and have aspects that are more focused in one direction or another, ultimately, all the roads lead to the same place.  It’s a place where people are better people.  That’s probably the best way to think about Altered Traits – better people.

Book Review-The Resilience Factor: 7 Keys to Finding Your Inner Strength and Overcoming Life’s Hurdles

Resilience is a common term these days.  Everyone wants to build resilience.  Everyone wants to know how to make people recover rather than crumble from challenges.  I picked up The Resilience Factor: 7 Keys to Finding Your Inner Strength and Overcoming Life’s Hurdles, because I was looking for secrets that would have given Alex what he needed to be more resilient.  Life hit him with the loss of a former shipmate, and he couldn’t recover from it.  In the end, I didn’t find what I was looking for – but that doesn’t mean that you can’t.

Seven Skills

The summary of the seven skills the book teaches are:

  • LEARNING YOUR ABCs: When confronted with a problem or challenge, are you ever surprised by how you react or wish you could respond differently? Do you ever assume that you know the facts of a situation, only to find out later that you misinterpreted them?
  • AVOIDING THINKING TRAPS: When things go wrong, do you automatically blame yourself? Do you blame others? Do you jump to conclusions? Do you assume that you know what another person is thinking?
  • DETECTING ICEBERGS: Everyone has deeply held beliefs about how people and the world should operate and who they are and want to be. We call these iceberg beliefs because they often “float” beneath the surface of our consciousness so we’re not even aware of them.
  • CHALLENGING BELIEFS: A key component of resilience is problem solving. How effective are you at solving the problems that you encounter day to day? Do you waste time pursuing solutions that don’t work? Do you feel helpless to change situations? Do you persist on one problem-solving path even when you see that it’s not getting you where you want to be?
  • PUTTING IT IN PERSPECTIVE: Do you get caught in what-if thinking in which you turn every failure or problem into a catastrophe? Do you waste valuable time and energy worrying yourself into a state of paralyzing anxiety about events that have not even occurred?
  • CALMING AND FOCUSING: Do you feel overwhelmed by stress? Do your emotions sometimes come on so quickly and fiercely that you can’t seem to think straight? Do “off-task” thoughts make it hard for you to concentrate?
  • REAL-TIME RESILIENCE: Are there times when counterproductive thoughts make it hard for you to stay engaged and in the moment? Do certain negative thoughts tend to recur over and over again?

Personal, Permanent, and Pervasive

Three dimensions clearly indicate how well someone will respond to a situation.  Will they be resilient or are they likely to become hopeless?  The dimensions are:

  • Personal – Is this situation about me or not about me?
  • Permanent – Is this situation permanent or temporary?
  • Pervasive – Is this globally applicable or only in this situation?

The more that things are viewed as being not about me (not personal), temporary (not permanent), and situational (not pervasive), the more likely it is that someone will shrug off the situation and continue working.  The more that the opposite is true, the more likely it is that someone will get stuck.

Realistic Optimism

Optimism – as long as it’s grounded in reality – is a good thing.  Barbara Ehrenreich criticizes it in Bright-Sided for deliberately ignoring things and self-deception.  However, I argue that we all have a bit of self-deception happening – and it’s not all bad.  It’s when our optimism diverges too far from reality that it’s a problem.  After all, as The Hope Circuit explains, learned helplessness was re-understood, with the capabilities of an fMRI machine and a map of the brain, to be the failure to learn control – even if we rarely truly have control.  It turns out that depressed people more accurately assess their skills – but that isn’t a good thing.

As Viktor Frankl explains in Man’s Search for Meaning, some optimism that is unfounded can be more harmful when the beliefs about what will be happening fail to occur.  As a result, the real trick is to find ways to look at the glass as half-full without deluding yourself into the belief that it’s completely full.

Self-Efficacy

Related to optimism is your beliefs about yourself.  Do you believe that you can get things done, or do you believe that you’re incapable of doing anything right?  Do you believe that you have skills, strength, and value, or do you believe that you’re weak, useless, and without value?  The greater degree to which you believe you have self-efficacy, the better you’ll be able to maintain hope and thereby be more resilient.  Rick Snyder in The Psychology of Hope explains that hope is a cognitive process built on waypower (knowing how) and willpower (the will to continue).  Self-efficacy is about maintaining the power to get things done.

Cognitions Don’t Cause Emotions

Despite what The Resilience Factor says, cognitions don’t cause emotions.  They’re related and they influence emotions, but they don’t cause them.  Lisa Feldman Barrett explains in How Emotions are Made that they’re guided by physical reactions and then are shaped by our experiences and expectations.  A better understanding of how emotions are formed is found in Emotion and Adaptation, where Richard Lazarus decomposes the process and helps us to understand the mechanisms that are in place.

Daniel Kahneman explains in Thinking, Fast and Slow that most of our cognitive is spent in a basic pattern matching system he calls System 1.  In this mode, we look for patterns in our environment and do the actions that we did last time – if they were successful.  In this pattern matching mode, it’s hard to say that there’s cognitions happening.

So, while we know that how we feel about something, especially our previous experiences, shape our emotions about it, previous negative experiences in similar situations will unfairly cloud our perception of current reality.

It’s All in the Interpretation

If we break things down, our emotions and our resilience is in how we interpret a situation.  While there are stressors in the environment, it’s our reaction to those stressors that matters.  If we interpret negative outcomes of the stressor as high probability and high impact and judge that our ability to cope is low, we’ll be stressed.  The greater degree to which we’re able to perceive the stressor’s impact as improbable, small, and within our ability to cope, the less likely we’ll feel stressed.

Stress has serious long-term negative consequences that are well explained in Why Zebras Don’t Get Ulcers.  Suffice to say, the more we can avoid chronic stress, the better off we’ll be.

So, while it may seem like self-delusion and self-deception, when we ground our assessments in reality and evaluate things from the perspective of truth rather than fear, we are more likely to make accurate assessments and less likely to be emotionally triggered.

Visions of the Future

One key aspect of perspective that is useful is a perspective about a positive future.  In The Time Paradox, Philip Zimbardo shares how we all see time differently from past negative and positive to present fatalistic and present hedonistic – and to a future focused view.  When we have a positive future view of time, we expect that things will get better in time.

I often share that time has a very long arc, and things that appear to be intractable today may someday be solved.  Problems that we believe are unchangeable are all washed away in the sands of time.  Even the well-built pyramids of Egypt are fading over time – and statues like the Sphinx are in serious need of a nose job.  Nothing is forever.

Guilt is Garbage

Guilt has an evolutionary benefit of helping us to change our beliefs and behaviors based on negative outcomes.  However, our negative bias can get us stuck in processing and reliving our guilt repeatedly.  This approach to guilt – constantly reliving it – is bad for us and for everyone.  Once we’ve apologized, learned from the event, and hopefully changed our behavior, we need to learn to let it go.

Guilt that is internalized too much moves from being that we’ve done something bad to shame, which is the assessment that we are bad.  Shame is a sticky substance that is hard to free our psyche from and one that serves no purpose.

Analyzing Anxiety

Most people don’t have a clear definition of anxiety, particularly in terms of how it relates to fear.  Fear is a specific concern about a specific possible occurrence.  Anxiety is a fear based in the idea that we can’t even tell where the threat will come from.  Anxiety is therefore more challenging to eliminate in our beliefs, because we’ve got very little to put our fingers on.

Anxiety at its core is the belief that we’ll encounter a stressor suddenly and that it will overwhelm our capacity to cope.  If we want to reduce anxiety, we need to focus on how we can authentically build a person’s sense of self-efficacy – or, said differently, their personal agency.

Many people with anxiety believe that they feel powerful and able to take on life’s challenges but generally there’s something buried deep inside that prevents them from fully believing in their value and ability to overcome.

Personal Agency, Self-Efficacy by Any Other Name

When speaking about people’s ability to get things done, I most frequently use “personal agency” rather than self-efficacy, because personal agency is inclusive of the availability of time and resources that go beyond someone’s sense of skills.  Personal agency is the heart of resilience.  The more personal agency you have, the more resilience you have.  (We speak a lot about personal agency in our work on burnout, which you can find at https://ExtinguishBurnout.com)

Underlying Beliefs

Our underlying beliefs can sometimes prevent us from accessing our personal agency.  We believe that we shouldn’t show our strength or that it’s not the right time or place.  Sometimes, our underlying beliefs about ourselves and about the world are so hidden that we can’t see them ourselves – even when we try.  Sometimes, they’re the echoes of the voices that we heard in our childhood that we now believe are our own.

Finding these beliefs is often about asking why, despite our desire to change, we’re not changing.  Immunity to Change is a helpful framework for discovering what limiting beliefs are holding us back.

Catastrophizing

The anti-power to resilience is catastrophizing.  That is, the propensity to evaluate things in the most negative possible light.  The stressor is certain, and its impact overwhelming.  A friend and comedian has a routine where he speaks about how his mom was a master at catastrophizing.  She went from he couldn’t take care of a dog to he couldn’t take care of a baby and he’d be arrested for child neglect – all in the space of a single breath.

We can dampen catastrophizing by attempting to ground our thoughts in reality.  Asking questions like, “Has this ever happened?  What was the result last time?  And what’s different?” can sometimes break us free from the grips of an overwhelming prediction.  Other times, it’s the question “So what?” that allows us to see the resources at our disposal.

If you want to be resilient, you’ll have to rewire away from catastrophizing, and Hardwiring Happiness can help with that.

Denying Existence of the Problem

The real limiting factor is our ability to believe that we’re understood, and sometimes in their attempts to help us, other people minimize our problems to the point of denying their existence.  If you’ve never ridden on a plane before and are frightened, someone saying that it’s the safest form of travel isn’t just useless, it’s invalidating your concerns without hearing them.

So, on the one hand, we can acknowledge that our catastrophizing isn’t reality –but on the other hand, we want others to follow our path and understand how we got there.  We need to be understood even if the perspective we’re taking isn’t objectively real.

Changing the Perspective

When we’re looking at our resilience, it’s as simple and complex as looking for different alternatives, evidence, and implications.  It’s simple in that they’re just a few things to be done – but saying them is much easier than doing them.  Perhaps in that gap is The Resilience Factor.

Book Review-When It Is Darkest: Why People Die by Suicide and What We Can Do to Prevent It

You never know how fate is going to deal a hand.  In the case of Rory O’Conner, he was going to be led towards suicide research only to find that the person who led him there would die by his own hand.  O’Conner wrote When It Is Darkest: Why People Die by Suicide and What We Can Do to Prevent It to share his research and life journey around the topic of suicide.  In it, he covers some familiar ground – and some ground unfamiliar.

A Plane Full of People

It was said that the average number of people impacted by a suicide was six.  This ignores Robin Dunbar’s work, as I discussed in my post High Orbit – Respecting Grieving.  The research of Julie Cerel in 2018 places the number of people impacted by a suicide at about 135.  With this, we’ve moved from those who are most devastated to also include those impacted by the death.  However, everyone in this list will feel the impact of the death.

One hundred thirty-five people fit on a Boeing 737 aircraft with a little room to spare – but not much.  Every suicide impacts the equivalent of a plane full of people, people who are all in some way grieving the loss of someone who they feel died needlessly.

Trapped

Feeling trapped is one of the key indicators that someone may be suicidal.  Hopelessness, to express this another way, has a higher correlation to suicide than depression.  The tricky part is navigating the waters where someone feels trapped to understand whether the reason they feel trapped is real or simply perception.  Viktor Frankl in Man’s Search for Meaning explains the situations in the Nazi concentration camps.  He speaks of the atrocities that were committed and how simple things like the way that people approached their imprisonment and impending death has a remarkable impact on their outcome.

It turns out in suicide research that there is a difference between externalities and feeling trapped compared to an internal feeling of entrapment, which may or may not have external factors.  It seems that the walls that we build ourselves are more likely to trap us and lead us towards suicide.

Hope and Trust

Feeling trapped is the absence of hope.  That absence of hope leads to the conclusion that the pain will never end, and things will never get better.  (See The Psychology of Hope for more on what hope is, and The Hope Circuit for more on why it’s important.)  One of the aspects of hope that is interesting is not only our belief in our own personal agency and how we can power through what is necessary to change our results but also the impact of the relative benevolence of the world.

The more that we can believe the world will help us, the more hope we can maintain.  Our belief in a benevolent world in which we trust in others is a protective factor for suicide in a world of challenges.

Perfectionism

Perfectionism seems to lead to suicides – particularly the socially-prescribed perfectionism where we believe that others expect more from us than we’re capable of giving.  This is, for better or worse, a perception, and that perception may or may not match reality.  We can find that our boss really is demanding – or we can find that we perceive our boss as demanding.  From a psychological view, there is no difference.

At an organizational level, we create safety, like Amy Edmondson lays out in The Fearless Organization, by accepting people as they are – including their faults.  (See How to Be an Adult in Relationships for more on accepting.)

The tricky thing with perfectionism is teasing out whether it’s the environment that expects perfection or whether the person themselves is projecting their perfectionism on the environment.

Poor Sleep

One of the most overlooked aspects of daily life is the need for sleep.  It’s the time when our brains perform needed maintenance.  When we don’t get it, things start to fall apart.  Sleep is an undercurrent that flows through Why Zebras Don’t Get Ulcers and How We Learn and is key to The Organized Mind.  It’s the driver for PTSD – in that disrupted sleep prevents the integration and sense-making of the events.  Opening Up and Transformed by Trauma both speak to the need to make sense of our traumatic experiences, and that’s what sleep does: it allows us to make sense of our world.

The negative impacts of sleep deprivation have been used as torture and hazing rituals.  Unfortunately, when you just can’t sleep and no one is forcing it on you, it’s harder to resolve.  People often feel powerless to build better sleep if they only know that when they close their eyes, they’re failing to get rest.

In the context of this conversation, sleep disturbances seem to be correlated with higher rates of suicide.

The Power of Connection

We do know that there are things which help reduce the burdens and appear to reduce suicide rates.  Perhaps the simplest of these is to try to understand and accept another person.  Many stories exist about people who were yearning for a connection they couldn’t find, and therefore they decided to die by suicide.

As simple and powerful as connection is, it isn’t always that simple.  Learning to just listen for understanding and not try to problem-solve is a skill that must be learned and relearned repeatedly.  Even if you don’t connect with someone well, their decision to die by suicide isn’t your fault.  As I explained in The Psychology of Not Holding Children Accountable, you can’t be responsible for something you can’t control – and you don’t control others.

Not Escaping but Accepting

Ultimately, the ability to cope with the slings and arrows of life is more about finding ways to accept yourself rather than trying to escape yourself.  Certainly, there’s always room for all of us to grow, but that doesn’t mean we’re wrong, broken, or unworthy.  Finding the narrow path with being happy for where you are today while being willing to continue to grow is what Carol Dweck explained in Mindset.  The fact that you’re not perfect or the best isn’t a sentence, it’s an opportunity.  In a way, it’s a way to accept life’s unfolding.

It allows us to have positive future thoughts about the relationships and experiences as well as the prosperity and joy we’ll have.  We know that positive future thoughts are associated with lower suicide rates.

Low Effort, High Results

Some of the most promising aspects of our world are our ability to find low-cost, low-effort interventions that can have a profound effect.  Simple letters mailed on a predictable interval may be systematized and not very personal, but it’s a signal to the person who is struggling that someone cares about them and will notice when they’re gone.

It seems like these letters provide just enough time for people to ponder how much people care during the brief windows when suicide seems like an option – or the only option.  The tragedy and opportunity in suicidal moments is that they tend to be quick and fleeting.  If we can only find strategies that allow them to pause for a bit, we’re likely to help them When It Is Darkest.

Book Review-Rethinking Suicide: Why Prevention Fails, and How We Can Do Better

When you read a lot, you start to realize that many books fall into a common pattern.  They offer small enhancements on what you already know – that is, until you find the book that causes you to rethink what you know.  That’s what Rethinking Suicide: Why Prevention Fails, and How We Can Do Better does.  It questions what we know about preventing suicide, including how we identify those at risk and what we do to treat those who we believe are at risk.  Taking a slightly heretical view, Craig Bryan walks through what we know – and what we don’t but assume we know.

Heresy

I have no problem with heresy.  I know that sometimes it’s necessary to move forward.  As Thomas Gilovich explains in How We Know What Isn’t So, we often believe things that aren’t true, and those beliefs hold us back.  More recently, Adam Grant expresses the same sentiment in Think Again.  My friend Paul Culmsee and Kailash Awati wrote two books that are intentionally heretical – The Heretic’s Guide to Best Practices and The Heretic’s Guide to Management.

The need for heresy comes from our desire to think of the world as simple and predictable.  However, reality doesn’t cooperate with our desires.  The Halo Effect explains that we live in a probabilistic world – not a deterministic world.  That means we can’t expect that A+B=C – we can only expect that A+B often leads to C, but occasionally leads to D, E, or F.  Certainty is an illusion, and a rudimentary understanding of statistics is essential.

Douglas Hubbard explains the basics of statistics in How to Measure Anything in a way that is sufficient for most people to realize how their beliefs about the world may be wrong – and what to do to adjust them to more closely match reality.  Nate Silver in The Signal and the Noise gives more complex examples in the context of global issues.  Despite good resources, statistics are hard, and few people believe that the world is anything other than deterministic – and therefore believe understanding statistics isn’t important.

Suicide is Wicked

Wicked problems were first described by Horst Rittel and Melvin Webber in 1973.  I speak about it in my review of Dialogue Mapping, which explains the process that Rittel designed, Issue Based Information System (IBIS), to help minimize the negatives when working with wicked problems.  (I’ve also got a summary of wicked problems in the change models library.)  One of the ten criteria of a wicked problem is that there is no definitive formulation of the problem.  We have that with suicide, as we struggle to measure intent and categorize behaviors as suicidal, para-suicidal, or non-suicidal.

The conflicts in the space of suicidology are seemingly limitless.  Some believe that we must prevent all suicides – but others recognize that some lives aren’t worth living.  We struggle with the sense that people believe they are burdens, but we fail to accept that, for some people, they may be right.

Because suicide is a wicked problem, our objective can’t be to “solve” or “resolve” it.  Instead, we’ve got to treat it like a dilemma, seeking to find the place of least harm.

Misdirection

One of common attributes of science is the accidental discovery of correlations that don’t mean causation.  In Thinking, Fast and Slow, Daniel Kahneman explains the difference and how we often confuse them.  The first step to finding causation – or, more accurately, factors influencing the causation of the negative outcome – is to identify which things are correlated to the negative outcome.

We’ve got a long list of things we know are correlated to suicidality: low cholesterol, low serotonin, high cortisol, toxoplasma gondii infection, brain activation patterns as measure by an fMRI, and many more.  (See The Neuroscience of Suicidal Behavior for more on toxoplasma gondii.)  In most cases, the correlation rates are too low to be a possible causal factor.  However, they may point to the right answer that we’ve not yet found.

In Bryan’s studies, he considered that suicidal ideation might correlate with deployments.  However, it seems that this may not be the root issue, as he also identified other factors – including age and belongingness – that seemed to be important.  It’s possible, as others have suggested, that belongingness – not deployments – may be driving the suicide rates.  (See Why People Die by Suicide for support about belongingness and other ideas.)

Sometimes the misdirection that we find in suicide research is self-induced.  Confirmation bias causes us to interpret what we see in ways that are positive to our point of view.  I cover confirmation bias at length in my review of Steven Pinker’s The Blank Slate  (The first post of the two-part review covers more from the book.)  The short version is that you’ll find what you look for, and you won’t see important things when your mind is distracted trying to justify your decisions or process other information – as The Invisible Gorilla explains.

Which Way Do We Go?

Bryan raises an important philosophical question with, “If something isn’t working, doing more of that same thing probably won’t work either.”  Of course, as a probabilistic statement, he’s right.  If we have lots of experience that demonstrates that something doesn’t work, we probably don’t need to do more of it.  However, this is countered with the fact that many things need to build pressure, power, and energy to overcome inertia.  This leads to the key question about whether we should keep doing the same thing – or try something different.

I’ve struggled with this question for years.  Jim Collins in Good to Great calls it the Stockdale paradox.  It comes up repeatedly.  Entrepreneurs wonder when they should give up.  There are plenty of stories about how they had to hang on to the very last before they could succeed – however, we don’t hear the stories of the entrepreneurs who held on too long and lost everything.  Those aren’t the stories that “make it into print.”

So, I fundamentally agree that we’re doing things in suicidology that are proven to not work, and we need to stop doing them.  However, I’m cautious about giving up on unproven, new approaches that may not have had the opportunity to prove themselves yet.

With No Warning

Conventional thinking about suicide is that people send out warning signals – or at least we can devise some sort of assessment that results in a clear risk/no-risk determination for people.  However, it appears that this isn’t reality – and it’s certainly not true in every case.  Bryan walks through the math that indicates for every person who speaks about suicidal ideation and later dies by suicide, 17 discuss it but die by something other than suicide instead.  We pursue universal screening with the idea that if people describe themselves as struggling with suicidal ideation, they need to be treated immediately.  Best case, this will generate roughly 20 times the number of “false positives.”  In short, even the signals that we believe are the most compelling may be so buried by noise that they cause as much harm to system capacity as they do good.

But that’s people who indicate in some way that they have suicidal thoughts – what about the people who don’t indicate?  Surely, we should be able to determine their risk for suicide.  Surely, we’d be wrong.  First, the facts: there aren’t any tools that have demonstrated sufficient discriminatory capabilities.  Second, the statistics are heavily against the probability that we’ll be able to accomplish the goal.  With a suicide rate at roughly 1:7,000, the event is just too infrequent for our tools to detect it – even if it were persistent, but it doesn’t seem like it is.

There are countless cases where people had spent nearly no time considering suicide before attempting.  With the benefit of someone to interview, it’s possible to get direct answers about the timeline – as opposed to psychological autopsies that can only guess at what happened.  Clearly, there are some biases in self-reports, but too many cases of too many people who have nothing to lose by describing their planning indicates there was no – or very little – time spent planning.

If this is true, it makes the possibility of assessment accuracy even less likely.  In short, there’s no warning – and that makes it impossible to predict.  (Joiner expressed similar concerns about the lack of indication and planning in Myths about Suicide.)

Jumping

From the outside looking in, it appears that people jump from a normal state to a suicidal state without any warning.  This may be a strobe-light-type effect because we’re not sampling frequently enough, or it can be a literal truth that the transition between states is almost instantaneous.  In The Black Swan, Nassim Taleb explains improbable events and how things can move from one state to another rapidly.

Bryan’s view of this is expressed best in a figure:

Here, the risk of suicide can transition rapidly from low to high-risk – and vice versa.  Bryan makes the point that the velocity of and mechanisms for the transition need not be the same in both directions.  It’s possible to transition quickly in one direction but to have the opposite transition be much different.  Consider inertia.  An object in motion gives up very little of its momentum to friction until it stops.  Once it stops, it takes a considerable force to break inertia.

A different, less known, example would be the transition in a plane between lift occurring over the wings and a stall.  In a stall, the wings generate substantially less lift than the same forward motion not in stall.  Most folks think of a stall as the aircraft falling out of the sky, but in reality, the flow of air over the wings has been disrupted and is no longer generating the low-pressure region that creates lift.  I share this example because very small changes in the surface of the wing – or its leading edge – can create stall conditions in situations that would normally not be a problem.  Pilots pay attention to the angle-of-attack of the air moving across the wing, as they know that this is the most easily controllable factor that can lead to – or avoid – a stall.  When the angle of attack exceeds the tolerance, the resulting stall can be somewhat dramatic.

Bryan’s work here is reminiscent of Lewin’s work in Principles of Topological Psychology, where he created a map of psychological regions with boundaries.  Bryan’s work extends this to 3-dimensional space.

Sucking My Will to Live

Often, suicide is conceptualized as ambivalence.  It’s the struggle between the desire to live and the desire to die.  Unsurprisingly, those with a desire to die had a higher suicide rate.  Those with the highest desire to die and the lowest levels of wishing to live were six times more likely to die than everyone else.  However, even a small reason for living was often enough to hold off the suicidal instinct.

The problem is, what happens when the reasons for living collapse – even temporarily?  Consider that the reasons for living are a very powerful drive, as explained in The Worm at the Core.  Perhaps even low levels are powerful enough to hold off a desire for death.  But our desire for living and our desire for death are not fixed points.  Rather, they’re constantly ebbing and flowing as we travel through life.  The greater the normal state of reasons for living, the less likely that the value will ever reach zero.  Perhaps reaching zero reason for living requires hopelessness.  Marty Seligman has spent his career researching learned helplessness and our ability to feel control, influence, or agency in our world.  In his book, The Hope Circuit, he shares about his journey and the power of hope.

Certainly, there are life events and circumstances that invoke pain and lead us towards a desire for death.  When we experience loss and how we grieve that loss are important factors for ensuring that we don’t feel so much pain that our desire to die overwhelms our reasons for living.  The Grief Recovery Handbook explains that we all grieve differently, and it pushes back against Elizabeth Kubler-Ross’ perspectives that we all experience – to a greater or lesser degree – the same emotions.  In On Death and Dying, she records her perspectives on the patients that she saw in the process of dying.  In summary, the process of grief is the processing of loss – and we all do it differently.

Marshmallows and Man

When Walter Mischel first tested children at the Stanford Preschool, he had no idea that he’d find that the ability to delay gratification would predict long-term success in life.  His work recorded in The Marshmallow Test offered a variety of sweets – including marshmallows – which children could eat then, or they could wait while the investigator was out of the room for an indeterminate amount of time and get double the reward.  It’s a high rate of return, but only if you can defer the temptation long enough.  Those that did have self-control did better in life.

It comes up because, in Bryan’s map, one of the dimensions is risky decision-making.  Those who can defer gratification are less likely to make risky decisions.  Whether it’s the Iowa Gambling Task or other tasks, we can see that being able to be patient for small wins and identify winning strategies leads us to believe we can get more in the future – and seems to reduce our chances that we’ll take the suicide exit.  Evidence seems to show that tasks that are particularly difficult are those where the rules change in the middle and the things that worked before no longer work.

The research seems to say that those who are at increased risk for suicide may recognize that the rules have changed and therefore they should be using a different strategy – they just don’t seem to do it.  It’s not just that they don’t recognize the rule changes, they try to apply the old rules to the new situation, and it doesn’t work.

Rules for Life

Two key things can help people survive suicide.  First is just finding a way to slow down decision making to allow for things to recover and building braking systems to halt downward spirals.  Slowing decision making is familiar to anyone who has heard how to deal with anger.  The common refrain is count to ten, take a walk, and give it time.  Building braking systems to stop spiraling self-talk is trickier but is possible.

There are three proven effective strategies for suicide prevention – Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy for Suicide Prevention (CBT-SP), and Collaborative Assessment and Management of Suicidality (CAMS).  All the other strategies are unproven or disproven despite their prevalence.  As was discussed in Science and Pseudoscience in Clinical Psychology, people do a lot of therapies that aren’t proven and continue to hold on to therapies that have been disproven.  Tests like the Rorschach inkblot tests and Thematic Apperception Test (TAT) fail to meet the standard for federal evidence but are still routinely used.  The Cult of Personality Testing explains the fascination with these sorts of disproven (or mixed results) methods.

Changing the Game

The thing is, the message isn’t that all hope is lost and there’s nothing to be done.  There are a lot of things that can be done to reduce the prevalence of suicide – it’s just not the things we think or even the things that we’ve been doing.  Simple approaches like blocking paths by adding anti-suicide fences to bridges or adding locks to guns make a difference.  Rarely do people change their preferred method, and frequently it only takes enough time to unlock a gun for the feelings of suicidality to pass.  (Judged by the fact that the suicide rate decreases in the presence of gun locks.)

We may have to start thinking of suicide like we think of traffic accidents.  We know that they occur at a relative frequency, but we can’t say who will – or won’t – be involved.  The result is that we must work to make things safer through eliminating threats or instituting barriers.  Maybe the best way to make a change with suicide is to start by Rethinking Suicide.

Book Review-Critical Suicidology

Critical Suicidology can either refer to the critical need for people to become more versed in suicidology or being critical of suicidology’s progress – or both.  While suicide rates vary country by country and year by year, they’re climbing and globally are at about 16 per 100,000 people.  That’s a tragedy that generally lands suicide in the top ten list of mortality in the United States every year.  However, because of the stigmas associated with it, it’s often underfunded, poorly understood, and, in some cases, even taboo.

Rethinking Research

The research that is published in the various journals that cover suicide is woefully insufficient to move the study forward.  There are many quantitative studies but few studies of interventions.  Too many rehash the same associations that are already known.  People who abuse alcohol and those with depression are at greater risk of suicide.  There is the continued repetition of the sociological impacts to suicide.  Older white men beware, because you’re at the greatest risk – but, of course, that isn’t something you can directly intervene to change.

Critical Suicidology has a strong emphasis on the need for more qualitative research.  I agree in part but certainly not to the degree proposed.  The key isn’t in what there should be more of but rather what there should be less of.  It’s too easy to process the statistics available and translate them into risk maps based on useless, relatively unchangeable criteria.  The proposal for qualitative research is to increase understanding of what the drivers are – instead of just repeating an endless stream of numbers.

On this point I agree; however, I think that the better option is to find approaches to interventional testing to see if what we already know can be operationalized into solutions.  We know that Toxoplasma gondii reduces rats’ fear of cat urine, and that it infects 30-40% of the world population.  We have simple tests and treatment.  It would be great to know if we can reduce suicide by simply treating a parasite that causes us to lose our fear of death.

Maybe it’s a good idea to take the fMRI research that identifies activation patterns in the brain that seem to lead to suicide and convert them to be used with qEEG machines, which have a substantially lower cost both in terms of acquisition as well as the time to get to a result.  In less than 15 minutes, we should be able to identify the patterns that seem to lead to suicide.  If we can identify these people, we can get them into treatment.  If part of the problem is brain activation patterns, we can teach meditation and mindfulness to change those activation patterns.

We know that serotonin, cortisol, and are low cholesterol all are correlated with suicide – maybe we can use artificial intelligence to discover relationships with these three indicators that give us a good sense for who is at risk for suicide.

While I strongly support the need to get better ideas about what the root causes are and even agree that qualitative studies are the best way to get at these, I believe that the greatest need is interventional studies to see if we can apply what we already know more broadly.

What Answers

It’s true, as the book says, that we need to understand what our research goals are before we can choose appropriate methods to answer them.  I think we can always gain more clarity, but in general, we know that we must solve the problem of detection and the problem of protection.  We, of course, need to learn in more detail how we’re going to accomplish this.  However, I think we’ve got plenty of things queued up for appropriate interventional research.

The Negative Case

A key point that leads to wanting more qualitative research is the fact that many people with the identified risk factors – like depression and alcoholism – don’t die by suicide.  Many don’t attempt suicide.  If these are causal factors, then why do so few with the conditions go on to attempt or complete suicide?

It’s my belief that we’re talking about a recipe that needs to have certain ingredients that come together at the right times to end in a tragic result.  Consider making bread.  Most breads require flour, sugar, water, yeast, and salt.  If you have all of these – plus the special things called for in specialty recipes – then you can make bread.  You must have enough of all these.

Maybe depression is a key ingredient, but all of us have some degree of sub-clinical depression (without even accounting for the fact that depression diagnosis continues to rise).  Maybe having a clinical level of depression makes it easier to get the right ingredients – but the question remains what are the others?

Intolerable

What makes a situation intolerable?  Many people who struggle with chronic pain find ways to manage it and don’t fall into hopelessness and suicide.  Others who suddenly feel vulnerable for the first time – or the first time in a long time – find the situation intolerable and resort to suicide.  Certainly, the answer to tolerating the world is the development of coping skills.  However, what coping skills are they, and how do we ensure that people know how to appropriately deploy them?

If we want to reduce the rate at which people find themselves in intolerable situations, we can start first with coping skills.  But in the spirit of social justice, we should evaluate the situations under which we could prevent the situations that require coping skills.  We can’t prevent the tragic death of someone close to us through accidental or homicidal means, but we can address systemic persecution and victimization.

Suicide is the Solution

Suicide is often framed as a problem to be resolved – and appropriately so.  However, there’s a different conceptualization of suicide that may make it easier to work with.  What most people fail to realize is that suicide is a solution.  It is a solution to the problems the person believes they have.  It may be a bad solution, the wrong solution, etc., but for them, it appears to be a solution.  Understanding this framing gives us the opportunity to look backwards into the causes that make people’s life so unbearable that suicide seems like the right option.  In The Suicidal Mind, Shneidman describes suicide as an escape from psychache (psychic pain).

In some societies, however, suicide is a reasonable option.  When someone is elderly and feels as if they’ll become a burden to their kin, they can choose suicide as an option.  In some places in the United States – under strict regulation – there are laws which allow for others to support someone’s suicide.  We approach suicide as if every suicide should be prevented, but there are many cases where the alternative is worse than death.

Should I Say or Not

The tragic news is that 70-80% of people who die by suicide do so after having told someone about their intent.  Those people didn’t know how to respond in a way that helped the person survive.  We should better equip everyone to support others when they’re suicidal.  However, it’s equally tragic that 20-30% of people who are considering suicide never tell anyone.  They don’t help others understand their struggles so they can share it and help lessen the load.  They believe that they are alone and don’t reach out.

There’s certainly an aspect of this that is the impulsivity that some have when becoming suicidal.  There’s also an aspect, I’m sure, of how safe people feel to express their thoughts about suicide.  What might happen to them if they do share their thoughts?  All of that leads people to not share their thoughts of suicide and instead suffer alone.

Minimization

Of those who heard of the plans for suicide and weren’t able to help enough, there are some who will minimize the concerns or blow them off.  They think, incorrectly, that if people want to suicide, they’ll do it.  They won’t just talk about it.  (See Myths About Suicide for more.)  Even if they’re serious about the attempt, they may minimize the situations that lead the person to feel as if suicide is the answer.

Never having been trained in techniques like Motivational Interviewing, they don’t realize that it’s important to validate someone’s experience before convincing them that they can change the way they see it.  In short, the suicidal person who often believes they need to be heard feels even more disconnected.

Defining Moments

They’re called defining moments because they are the moment that define our lives.  The problem is that people are all too quick to call a death by suicide a defining moment.  Too many people who die by suicide have their suicide labeled as their defining moment instead of looking at the best they had done or the totality of their life.

For many, the tragedy of suicide follows a sense that they’re can’t ever be enough.  There is pressure to perform or to conform to other standards.  The result is an unsolvable stress.  Too many people who die by suicide are high achievers who have standards that they can never meet.  The result is they do amazing things their entire life and, in their desperation, end up believing suicide is the answer, and people then define them by their desperation instead of their achievements.

Diagnosis

A diagnosis – of any kind – feels like an inescapable label.  Someone stamped a label upon you, and it won’t peel off.  However, one of the insights from Critical Suicidology is that diagnosis exists not on you but in the space between you and the person that tried to apply the diagnosis.  While a great deal of progress has been made on repeatability of mental health diagnosis, they’re still rather subjective in most cases.

Furthermore, the implications of the label aren’t well articulated.  People believe that the diagnosis means something that it may – or may not.  When we’re considering how other perceive us – which is what a diagnosis is – we should consider that it’s their perception that will have some degree of truth and some degree of fiction about us, and the same goes for the person making the diagnosis.

Meaning in the Suffering

Everyone has suffering.  Buddhism and Christianity both share stories that comment on the fact that everyone has suffering.  They leave little doubt that there is suffering in every life.  However, what’s different is how people respond to that suffering and find meaning in it.  For some, the meaning is divine intervention, something that God has willed.  For others, it’s a newfound calling, something that becomes a new purpose.

In twelve-step programs, one of the keys is service so that people can leverage their pains to support the growth of others.  (See Why and How 12-Step Groups Work.)  If you want to help someone avoid suicide, the right answer may be to place them with others who are potentially suicidal so they can leverage their experiences to help others.

Responsibility to Heal

No matter what factors in life have led to your having been hurt, it’s your responsibility to heal yourself.  You must do whatever must be done to accomplish the healing, so that you’re not hurt as easily again.  (See Hurtful, Hurt, and Hurting for more.)  Perhaps one way that you can start healing is to get Critical Suicidology and to get critical of the ways that you think about suicide.

Book Review-Suicide: Understanding and Responding

Ultimately, what people want is to know how to respond to loved ones, colleagues, and community who are potentially suicidal in a way that helps them to recognize their value and allows them to make the decision to continue living.  Suicide: Understanding and Responding seeks to create a guide for understanding something that is largely not understandable and responding in ways that reduce the probability of a suicide attempt.

Positive Alternatives

Edward Shneidman in The Suicidal Mind said that “only” was the four-letter word of suicide – as in people believe that suicide is the only option.  Another way to think about the problem is that the positive alternatives to suicide have lost their credence.  Even if they’re able to see that there are options, they believe these options aren’t viable.  Maybe they perceive them as too difficult or too improbable.  In any case, the alternatives lose their salience.

Another problem with decision making and suicide is that people don’t really do rational decision making, as acknowledged by Gary Klein in Sources of Power and Irving Janis in Decision Making.  Instead, we evaluate alternatives until we believe we’ve reached a solution that’s good enough.  Barry Swartz in The Paradox of Choice explains that this is “satisficing” – and it’s often the best way to make decisions for future happiness.  This is obviously not the case with suicide, since there is then no future in which to be happy.

With satisficing, we make sequential evaluation of alternatives until we discover one that we believe is “good enough.”  If the limitations of suicide are sufficiently obscured from consciousness, it’s possible that suicide is perceived to be a valid alternative.  Perhaps this is one of the reasons why it’s important to restrict means of suicide from those who might consider it a valid option.  If you can delay the ability to act for a short time, it’s possible that the suicidal individual will decide that it wasn’t such a great option after all.

They may discover that the pain (physical or psychache) they are feeling is temporary, contextually dependent, and isn’t about them.  In this discovery, they realize that there are other options to end their pain than suicide.  In fact, the solution may just be to be patient.

Helping

One of the challenges in helping others, whether medically or psychologically, is to help at the right time, the right way, and in the right amount.  Many have explained that you shouldn’t do for someone the things that they can do themselves but should do those things they need but are not able to do themselves.  This simple framework allows for decisions based on how they’ll help the other person without enabling them.

There are two embedded challenges.  The first is understanding what they need.  How can you determine what someone needs in a general sense?  The answer may be that subjective experience leads to these decisions.  Of course, that’s not very repeatable.

The second challenge is in the form of what the other person can do for themselves.  Sometimes it takes pushing for people to enter into conflict or exercise in ways that are uncomfortable.  It’s not that people can’t do these things, it’s that they don’t naturally want to do these things, and as a result, they should be nudged or even pushed into doing what they can.  Unfortunately, this is generally uncomfortable for both parties.

Keen Why

Suicide, from the point of view of those left behind, is often a senseless act.  Though the person dying by suicide may have had their reasons and reasoning, this is often not available to the survivors.  The result is confusion on the part of survivors as they try to discover why their loved one could have possibly done such a thing.  Shneidman explains that there is never such a thing as a needless suicide.  In the mind of the suicide, there was a keen need that was withheld.

When assessing the risk of suicide, it’s important to consider what it is that people are missing in terms of their needs.  There are many answers to what people need that they don’t seem to get.  The key is understanding which of those things are the most important to the person, so that they can be given strategies to get what they need.

Four Factors

There are four psychodynamic factors that seem to have an impact on suicide:

  • Acute Perturbation – General upset
  • Heightened Inimicality – Hostility, particularly self-hostility
  • Sudden Cognitive Construction – A failure to recognize alternatives
  • Cessation – The idea that there will be an end to the pain, suffering, or struggle

The perturbation may be the intensification of the ambivalence towards death and suicide.  Specifically, it can be that the considerations for death that had been previously repressed may be coming more to the surface.  (See The Worm at the Core for how we suppress thoughts of death.)  Inimicality might also be described as thwarted or frustrated needs.

Intent

Intent is at the heart of whether something would be considered a suicide or not – and intent is hard to infer when the person isn’t available for questioning.  Intent ranges from the completely intended to predicable outcome and eventually arrives at completely unintended.  At the completely intended end, there are some indicators of that intent,  including a suicide note.  However, the low rate at which these notes are left behind (see The Suicidal Mind) makes it a poor indicator of intent.  Techniques like the psychological autopsy are retrospective reviews of artifacts and interviews with those whom the suicide interacted with and can often convey a sense of intent, but they too are difficult to get precision from, and their cost makes them prohibitive in most cases.

Some of the most difficult situations to infer intent from are those situations where the death appears to be an accident but may have been something different.  Consider the single-car auto accident where the car impacts a tree, an embankment, or hurtles off a cliff.  Who is to say whether the driver lost control, consciousness, or their will to live?  Undoubtedly, some deaths ruled as accidents are in fact suicides disguised as accidents.  In many of these cases, we’ll never know what the true cause is.

Some situations, like death through cancer or through freak acts of nature are safe from the possibility of intent because of their unpredictability.  It’s good that there need not be any serious consideration given to intent yet sorrowful for those who lost a loved one.

Relieve the Pain

There’s no singular approach to working with suicidal patients and friends that ensures they will disavow the idea of suicide.  It’s true that if someone really wants to die by suicide, they’ll eventually accomplish it.  However, conversely, if you’re able to reduce the pain just a little, you may be able to restore hope that their pain and problems will end and therefore life may be worth living.  As prediction machines, we’re quick as humans to project ourselves into the future when the small reductions in pain would continue until there’s no pain left.

Hope itself is an amazing thing, and Rick Snyder explains in The Psychology of Hope that it’s two pieces: waypower (knowing how) and willpower (willingness to try).  Often, the pain will drive a willingness to try, but without any sense for how to escape the current pain, they may be stuck and try nothing.  (See The Hope Circuit for more on learned helplessness.)

Bankruptcy

Suicide is, in essence, declaring bankruptcy on life.  There’s a sense that it will never be possible to be happy and therefore suicide is the only option left.  More than declaring bankruptcy in the present, the survivors can often interpret the suicide as in some way invalidating their memories of the person.  The memories of happiness and the joyful times shared seem as if they may be illusionary – as if, somehow, they weren’t enough to prevent the suicide.

This perspective is certainly understandable, but it simultaneously fails to recognize the cognitive constriction that face those who die by suicide.  It’s probably true that the people who die by suicide couldn’t recall the happy times that they had with the survivors.

Not Today

One of the bits of wisdom in 12-step programs is the decision to live life one day at a time.  You don’t have to make a decision to not suicide forever – it just has to be for today.  Related to this is that, for suicide, you don’t need to suicide today – it can be deferred.  Strangely, knowing that it’s a decision that never will expire as an option makes it less desirable.  (See Influence and Pre-Suasion for more on how this functions.)

Losing Your Mind or Death

What if you had to choose between losing your mind or death?  Which would you choose?  It’s an odd question, since both bring an end to consciousness, but it’s one that, strangely, suicidal people consider.  Some feel as if they’re slowly losing their mind.  They can feel as if crazy is creeping up on them, and they don’t know how long they’ll be able to hold out.  Then they’re left with an impossible choice.

Obviously, losing one’s mind doesn’t exactly work like this unless there’s an underlying physical cause, but at the same time, it’s a real fear that many face in fleeting moments or as a more serious consideration.  Maybe sometimes the solution to preventing a suicide is helping people understand that they’re not going crazy – no matter how much it may seem like that is the case.

Offspring

One of the factors that is sociologically associated with lower suicide rates is marriage.  Consistently, those who are married have a lower risk for suicide.  Many hypotheses for this have been put forth, including the closeness of the relationship, the time-to-discovery for an attempt, and others.  One of the more interesting considerations is sense that the desire to protect one’s offspring and relatives may remain even if it’s been subdued in the protection of oneself.  It appears that people will avoid suicide if they know that others are depending on them.  This may be the source of the marital protective force that’s been seen in the data.

Steven Pinker in The Blank Slate, Jonathan Haidt in The Righteous Mind, and Robert Axelrod in The Evolution of Cooperation all hint at an odd bit of genetic programming that allows us to sacrifice ourselves without violating Darwin’s evolution and survival of the fittest proposal.  The short version is that by saving our children, we’re ensuring the survival of our genes even if in doing so we ensure our own death.  This behavior extends to “like-groups” – presumably cousins and other relatives – who carry some percentage of genes that are the same as ours.  Obviously, genes can’t make you too willing to give your life, or there’d be no one to benefit from the altruistic act.

It seems like the complex web of protecting our genes may be able to be subverted for ourselves without subverting other aspects of the gene protection.  That may be at the heart of why people who are recovering for addiction are encouraged to serve others.  It may be the path back to restoring the protective forces for ourselves.

Loneliness

One of the factors that can drive people towards suicide as an option is the feeling of loneliness.  Loneliness the book makes the point that being alone and loneliness are different.  Loneliness is a feeling that can occur while you’re alone or while you’re in a room filled with people.  In fact, Sherry Turkle in Alone Together puts forth the idea that while we’re objectively less “alone” because of the connectivity that technology brings, we’re equally not connecting in ways that fulfill our needs – and therefore may feel more loneliness.

If you want to reduce the loneliness of someone – whether they’re considering suicide or not – the solution is simply to try to understand them, their perspective, and their situation.  When you feel like someone understands you, loneliness must take a back seat to the feelings of being understood.

Nothing Left to Lose

It’s a problem when someone with nothing left to lose, like a death row felon, is free.  The rules of morality and social convention have no hold over the person who no longer has anything to lose.  (See How Good People Make Tough Choices for more.)  Suicidal individuals no longer fear death and therefore must be approached cautiously.  (See The Worm at the Core for more about the fear of death.) There’s no telling what they might do.

Murder-Suicide or Suicide-Murder

Though murder-suicides are rare, they happen.  An interesting challenge comes from whether the person first considers murder and then acquiesces to suicide, or if they decide that they’re going to die by suicide and they need to take one or more people with them.  There’s obviously no one, simple answer.  However, it seems that though we call it murder-suicide because of the (required) order of events, perhaps it would be more accurate to describe it as suicide-murder if we consider the thinking process that happens.

If you’ve already decided on suicide, you can extract revenge on those who have tormented you through murder without concern for the consequences.  They’re not going to kill a dead person, nor are they going to imprison a corpse.

Worthlessness

Joiner in Why People Die by Suicide frames it in terms of burdensomeness.  That is, people feel as if they’re a burden to others and they’d be better off dead.  Here, the word goes less far and describes feelings of worthlessness leading to a desire for suicide.  Worthless is the sense that you can’t generate value to others or humanity – or perhaps not enough to offset the costs that you bring to the world.  Feelings of worthlessness are often a natural consequence of failure.

For some, they’ve picked up some sense that the love and protection that they get from others is performance-based.  That is, that they will only receive love and support from others as long as they perform.  Because of messages they’ve received from their family of origin (mother, father, siblings, etc.) they’ve come to believe that their worth to others is in what they can do for them.  Without any sense of inherent worth, a failure generates feelings of worthlessness and the fear that they’ll never be loved.

The degree to which this is truth or simply perception isn’t relevant.  What’s important is that the individual has developed a perception that they can’t fail if they want to be loved, cared for, and supported.

On Their Terms

At some level, those who call to a suicide help line are asking for help, and while the saying goes, “beggars can’t be choosers,” it doesn’t apply here.  They want to get help – but only the help they want and in the way that they want it.  In a suicidal person’s constricted vision, they may not be able to accept the communication approach and pattern used by the person on the other end of the line.  As a result, the person answering the phone line may need to deviate a fair amount from the official protocol to first form a connection with the caller and from that start to understand then persuade them.  (This is consistent with Motivational Interviewing.)

This extends into a general sense that if they can’t get life on their terms, then they don’t want it on any terms.  In other words, if they don’t get what they want, they’re taking their ball and going home.  In this case, that means suicide.  It’s an extreme sense of feeling as if you’re not heard and valued as you are and as a result, you’re not longer willing – or able – to bend, adapt, and change for the chance to be heard.

Self-Soothing

One of the learnings from having a child is that sometimes the right answer is to let the child cry.  It sounds cruel and heartless, and it’s clearly not the only strategy that can be used.  Sometimes, it’s important for a parent to establish that the child is okay and safe.  It’s even important to demonstrate warmth, compassion, and caring, so that the child can establish a perspective that the world is helpful not harmful.  However, there are times when the right answer is to allow children to cry.

The experience of resolving a sense of pain ourselves is critical to our development.  We can’t avoid all pain because to do so robs of us our experience with resolving it.  Chicks need to escape their shell on their own and sea turtle babies need to find their way to the sea.  (See The Psychology of Recognizing and Rewarding Children.)  Without a sense of efficacy in self-soothing and resolving problems – some self-efficacy – it becomes impossible for someone to face an adversity and believe that they can overcome it themselves.

Calm the Panic

If someone can’t calm the panic that they feel in themselves about their situation and the resulting psychological pain, then the people around them must find ways to help them calm the panic.  While not totally self-reliant, the ability of others to bring forth, encourage, and enable the capacity to shut down the pain that is being felt is perhaps the most important thing that one human can do for another.

Pain itself is, as was said above, a necessary teacher.  However, as Nassim Taleb explains in Antifragile, we need the right kinds of challenges at the right times and in the right amounts to be able to grow.  When we teach people to self-soothe or calm the panic, we’re enabling them to regulate the amount of pain they feel from the challenges facing them so that they can bring them into a range that encourages growth rather than feeling oppressive and crushing.

Overstrivers

One of the psychic pains that can drive suicide is the idea that you’re not “enough.”  That is, you’re not good enough to be loved and accepted as a human being.  While we all face the challenge of feeling like we’re enough at times, some of us are locked into a more persistent struggle.  The irony of the situation is that those people who are larger than life, who are more than enough by other people’s standards, are sometimes not enough in their own eyes.

Many people who are high performers became high performers because of a sense of drive.  They wanted to be more than they were.  While in the context of a growth mindset, this is good, it can be that the driver itself may cause a different kind of problem.  (See Carol Dweck’s work Mindset for more on a growth mindset and its benefits.)  What may be driving it isn’t necessarily a sense of acceptance of the current state and a striving for more but instead a longing to be something more than today so that they’re finally enough.

Some situations exacerbate these feelings and may even lead to suicidal ideation.  The overstrivers believe that that they’re not good enough – and can never be good enough – so the world is better off without them.  This isn’t true, but to them it feels true.

Somebody to be Loved By

There’s an innate need in people to be understood and even loved.  We long for acceptance in ways that convey that our existence matters.  We’re created as social beings having evolved with the primary advantage being our ability to have a theory of mind.  (See The Righteous Mind and Mindreading for more.)  When deprived of love, we find ourselves seeking it out in ways that may be self-destructive or ultimately harmful but that quench the immediate, burning need.

Sometimes, the suicidal individual can’t find a way to feel loved by others.  Whether they are or are not is immaterial.  Their capacity to accept the love that others are pouring into them is somehow blocked or thwarted.  To help a person who is considering suicide as an option, sometimes all that’s necessary is to be present and allow them to recognize that other people do care and that they love them.

Grass Must Not Be Greener

One of the challenges of the early Christian church was the attractiveness of heaven.  If today’s life is hard and the afterlife is all good, why not end the life part today and move on to the afterlife part immediately?  Unfortunately, more than a few people came to this realization, and suicide became a problem for the church, which was trying to increase its numbers.  (See A Handbook for the Study of Suicide.)  That’s why the church made suicide a sin.  By making suicide a sin, they could simultaneously maintain the psychic benefits of a glorious afterlife and remove suicide from the list of methods that could get you there.

Whenever we’re looking at ways to shape the decisions of others, the ultimate answer is easy.  If you can make the option you don’t want them to pick always undesirable, then few will pick it.  (It’s not all because some people have a rebellious spirit.)

Support Withdraw

A disproportionate number of suicides happen while therapists are on vacation.  This creates a struggle for therapists who need to find ways to recharge themselves and simultaneously don’t want to put their patients at greater risk.  There are solutions that therapists can take advantage of by having others that their patients can talk to in their absence.  However, the greater observation is the fact that the patients react to the perceived withdrawal of support.

It’s not that they believe that the therapist will be gone for good necessarily (though that is a possible thought).  It’s simply that they don’t know how to cope with today given the perceived withdrawal of support.  It’s like they’re literally leaning on the therapist when they suddenly disappear.

Interfering with Freedoms

On the opposite end of the spectrum are those situations where it’s believed to be necessary to interfere with the freedoms of suicidal individuals so that they are deprived of the chance to take their own lives.  There are, undoubtedly, situations where this is the right answer.  However, there are also times when depriving people of their liberties to save their lives may be precisely the wrong thing.

Suicide is driven, at least in part, through a feeling of helplessness and the involuntary loss of freedom encourages that feeling.  You necessarily reduce someone’s internal sense of personal agency when you restrict their freedom.  Thus, the short-term protection can come at a long-term cost.  You cannot hold someone indefinitely.  At some point, you’ll have to return them to their own freedom and sometimes at great peril.

So, it makes sense to involuntarily restrict someone’s freedom if there is no question about their intent to harm themselves, but when there is no clear indication, it may be a bad choice.

Patient Proactive

The ultimate goal of any therapeutic approach should be to empower the individual towards their own life separate from therapy.  It’s not appropriate or effective to keep patients in therapy indefinitely.  That means it’s necessary to continue to enable the patient to solve their own problems and, more specifically, learn to cope with life with progressively less external support.

Therefore, every patient interaction should be structured to enable them to solve their own problems rather than the therapist being seen as the expert to which the patient must always come.  (See A Way of Being and Motivational Interviewing for more.)

Separating Despair and Depression

Despair (hopelessness) is different from depression – and it’s more indicative of a situation that requires immediate care than depression.  While depression is a solid indicator for suicide, it’s less predictive than hopelessness, so it’s important to distinguish between depression and despair – with despair requiring more attention and faster intervention.  Depression, because of the diagnostic criteria, is a more long-term condition.  Despair (lack of hope) covers a person unexpectedly and profoundly.  It’s therefore difficult to detect with much advance warning – and it’s difficult for patients to muster defenses against.  It comes when people least expect it.

When encountering people who are in active despair, we must find ways to help them see that things will change for the better – even if it is difficult for them to see that at the moment.

Acceptance through Presence

Sometimes the things that need to be done are so simple and unremarkable that they’ve overlooked.  Often people believe that no one cares and that no one is listening.  Sometimes the intervention is just being present with people and listening.  By being present and listening you convey acceptance of them as a human being and an interest in who they are.  Sometimes this can help them recognize their own value and personal agency.

Often, the stories of those who have attempted or completed suicide are clear about their feelings that they’re not heard or even more explicit about aborting their plan should so much as a single person give them a hint that they’re not alone in the world – that someone cares and recognizes them as a human being.

Tread Water for Now

Being present is one way of treading water.  While you’re being present and listening, few people will actively attempt suicide.  Instead, they’ll be in the moment with you – and that may be all that’s necessary for the suicidal impulse to subside.

If you can point to the finality of a suicide as a solution and acknowledge that the option will always be available to them, they don’t have to choose it now.  For now, all they have to do is survive today.  They don’t have to solve their long-term happiness and the prevention of future pain.  They just need to make today livable.  (See Stumbling on Happiness for more about our lack of predictive powers for what will make us happy.)

No Control, Lots of Hope

Therapists have relatively little control over patients’ lives.  They may have powerful clinical prowess and amazing techniques, but these all pale in comparison to the other forces in a patients’ lives – the other 160+ hours of their week that they’re not with the therapist.  So, while it’s not possible for therapists to accept complete responsibility for the outcomes of a patient, that isn’t to say that they shouldn’t try to make the situation better.

Just because we don’t have control doesn’t mean that we can’t hope that our degree of influence is enough.  In many cases, it can be that the influence that the therapist has is sufficient to convert a tragedy into a triumph.  There’s no way to know which will be which.

The Liberty and Control Coin

Jonathan Haidt in The Righteous Mind calls one of the foundations of morality the strive towards liberty and away from oppression.  Here, the word used is control – whether it is perceived as oppressive or not.  What we realize is that the more liberty someone has, the less control we have.  Conversely, the more control that we exert over someone else, the less liberty they have.  They’re inseparable because they are opposite sides of the same coin.  This creates challenges when trying to limit access to potentially lethal means for suicide and the need to ensure that the person retains their sense of liberty.

Responsibility and Control

One cannot be responsible for something they don’t control.  That’s a truism that extends beyond the bounds of suicide and is a point of challenge, as we’ve taught parents that they are responsible for their children while fully admitting that parent can’t control their children.  This is particularly true as children get older.

Because parents often feel responsible for their children even if they don’t have control of them, they struggle when children don’t do what the parents expect.  This is particularly true of parents whose children die by suicide.  They have no way of accepting their responsibility for the death of their child – and they shouldn’t.  We collectively need to acknowledge and share that, most of the time, parents are no more responsible for their children’s suicide than a therapist is responsible for the mental illness of a patient.

Both can try to create conditions for better mental health and feelings of love and support, but neither can be responsible.

Things Worse than Suicide

While suicide is a tragedy, we can’t forget that sometimes there are fates worse than death.  Some situations are so laden with pain and suffering that we shouldn’t be so hasty to eliminate suicide as an option.  We show compassion to our animals to euthanize them when they’re in too much pain from which they can’t recover, yet we often are unwilling to allow humans even peaceful deaths due to natural causes.  Instead, we attempt everything we can to extend life – even if the person whose life we’re saving would say it’s not worth living.  Sometimes the best – and most difficult – thing that we can do is to allow someone the grace to decide that suicide is the right answer.  That’s one of the reasons why understanding and responding to suicide is so hard.

There are no clean answers.  No quick fixes.  No magic bullets.  However, there is some wisdom in Suicide: Understanding and Responding.

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