Suicide – A simple question: Why?

I remember my shock at the news of Anthony Bourdain having been found dead in a hotel room in France. It flicked up on my iPhone;  an impersonal notification that could have been about the change in the weather.  It was the second suicide of a celebrity in the last week.  The other was that of Kate Spade.

 I was an avid fan of Anthony Bourdain’s extraordinary sense of adventure, irreverence and his ‘drag you in boots and all’ with his masterful use of language. I was a regular viewer of his shows and he was one of the few chefs I would watch on TV.

I read somewhere that someone referred to him as a culinary Hemingway. Perhaps that should have been a warning, a signal somehow that sometime he too, could end his life so abruptly when it appeared that he had everything.

Why

Isn’t that the ultimate question that stays with us when someone has taken their life?  For me it is an important question professionally but also personally. Anthony appeared to have made it.  He was successful in the classic definition in our society. He seemed to have it all. Good looks, fame, fortune and celebrity.  It appeared that he had overcome  his own demons. So what more could a man want?

Naturally there was an instant reaction by the media.  It too, seemed to be propelled by shock and confusion about why Anthony Bourdain would take such a final step. The focus instantly fell onto mental health. Depression, anxiety and the generic label of ‘mental illness’ are the common explanations about why people take their life.

Is it that simple?

Here’s a much neglected observation. A CDC study found that 54% of Americans who died by suicide had no known mental health illness. As a psychologist, a psychotherapist and a philosopher, the stark reality is that there is no single explanation for someone’s suicide. So what are the factors involved, and how can we deal effectively with what appears to be an epidemic?

Some causes of suicide

Rather than making a list of reasons for suicide, I’m going to focus on the types of emotional experience that in my clinical experience that causes the sort of suffering that can lead to someone making the decision to die. They are in no significant order because in the majority of cases, a person who is suicidal is assailed by more than one of these experiences.

The pain

Pain comes not simply in physical forms but it comes in psychological forms, something that I refer to as anguish. Frequently the two can be closely related to each other. I have frequently dealt with people with chronic physical pain. It can be sufficient enough to ‘drive one to suicide’. Like a snake eating itself the two can be a devastating combination.

Anguish however does not need to have a physical aspect. It can emerge in itself.

Alienation

Many people contemplating suicide feel that they are alone, that no-one understands their suffering. One of the most common causes in men’s suicide is that they are often quite literally alone and lonely. Men are not good at sharing either their feelings nor their thoughts, especially if the man feels that expressing feelings is not ‘manly’. Collectively men are not good at forming and maintaining intimate relationships that allow them to feel connected enough to be authentic and vulnerable with others. Phrases like ‘man up’, ‘toughen up’ and ‘pull yourself together’ interfere with being open about our suffering.

Irrational thoughts

The most common irrational and destructive idea is that my significant others, like spouse, lover, kids and friends are going to be better off when I’m gone. The fact is that no-one is ever better off.   In fact those people who have lost someone close to suicide are never the same again. A friend of mine committed suicide when we were in our early thirties. I was one of the last people to have seen him alive. I still wonder if I could have said, or done something that may have prevented that. All of us are changed when someone we know kills themselves. The closer we are the more traumatic and impact it has on us. But it stays with us for life, never to be erased.  As a therapist I make this very clear to my clients who are having these sorts of thoughts, and I make sure that they not only understand this intellectually, but more importantly, emotionally.

Anger

Sometimes we can be so angry that we feel overwhelmed by it. Sometimes it is strong enough to make us enraged. And sometimes we feel that the only way is to take it out on ourselves. So self-harm can lead to committing suicide.

Impulsivity

Impulsivity often goes hand in hand with anger and rage. It is not a planned thing, it is something that happens in the moment.  In a moment of extreme distress an impulsive choice acted on immediately can be literally lethal.

Drugs and Alcohol

These have an enormous impact on a personas state of mind and are frequently part of the reason why a person becomes suicidal. It is important to understand that this is not simply while they are intoxicated. Often people act on their impulse when they are sober and/or coming down, that is when they appear sober. 

Depression

This is almost self-explanatory. However it is important to understand that depression can be masked. Many people commit suicide not in the ‘pit’ of their depression, but rather when they are going down or coming up from the ‘pit’. In fact they may appear to be quite ok, and even appear to be cheerful.

Psychosis

Similarly to depression a high risk period is not when the person is psychotic.  When a person is experiencing an acute psychosis they are not usually capable of being cognitively organised.  This prevents them from being able to plan and act in an organised manner.   However when they emerge from that state they can experience significant despair and this may lead them to making the decision to end their lives.

The contagion effect

Suicide has a ‘contagion effect’. That is the phenomenon of indirect exposure to suicide or suicidal behaviours influencing others to attempt to kill themselves. This can occur in the broader population or within smaller communities.

It is why, most importantly, suicide should never, ever be glamourised.

This is by no means an exhaustive list I could extend this list further. Also keep in mind that these factors can interact.

What to do

I truly believe that one of the most powerful antidotes to suicide is intimacy. I’m talking about having closer relationships within our relationships and communities. It its about fostering a sense of unconditional regard for each other as human beings irrespective of our differences. In this context we become more emotionally expressive and authentic where vulnerability is not judged as a weakness.

From the Making Good Men Greatframework being inclusive of each other, being accepting of differences, being open with expressing positive feelings for someone in pain without judgement and working with each other helps to reduce the risk of someone committing suicide.

Most importantly:

There is help.

If you or someone you love is in crisis or needs support right now, please call Lifeline on 13 11 14 or BeyondBlue on 1300 224 636. If it is an emergency please call 000.