PREVENTION OF SUICIDE
More than half of people who attempt suicide are depressed and hopeless, at the time
they commit the act. Suicide is a complex and multifaceted act.
1. Suicide Perspective
A person has suicidal thoughts if they act in a way that does not appear to
want to destroy themselves but can cause serious injury or death after a long
period of time. It is also called subintelligence death. Example: a diabetic patient
who refuses to be given insulin and does not comply with dietary rules. Those
who commit suicide often write letters showing evidence of suffering. Many of
the motives for suicide put forward by Mintz include, aggression that is reversed
against oneself, retaliation that causes feelings of guilt in others, attempts to
impose love on others, making changes to past mistakes, wanting to meet a loved
one who has died, escaping stress, destruction, pain, and emotional turmoil
Contemporary mental health professionals consider suicide in general to
be an individual attempt to solve a problem, in conditions of severe stress and
characterized by very limited consideration of alternatives finally suicide
emerges as the best solution. Some acts of suicide are committed due to a strong
desire to run away from painful self-consciousness, for example, feeling failure.
2. Freud's Psychoanalytic Theory
Freud considered suicide to be murder. When a person loses a loved one
at the same time is hated and melts that person into himself with aggression
directed inward. If the feeling is strong enough, then the person will commit
suicide.
3. Telici Sociolgis Durkheim
He distinguishes 3 types of suicide:
a. Egoistic suicide,
i.e. people who have little social attachment, feel alienated, and do not have
important social support.
b. Altruistic suicide,
which is carried out in response to social demands. Feeling very much part
of a group and sacrificing himself who is considered for the good of the
community. Example: harakiri in the Japanese masy as the only honorable
choice
c. Anomic suicide,
which is a sudden change in a person's hub with a person. Anomic is a feeling
of disorientation because what he believes to be a normal way of life is no
longer possible. Anomic causes imbalance in society.
Example: after a natural disaster regarding post-traumatic stress. Stress
experienced from seeing loved ones killed or injured and losing property. This
causes disruption of daily routines and without social support causes many
suicides.
4. Shneidman's Approach to Suicide
Suicide is a conscious attempt to find a solution to a problem that causes
deep suffering. For people who suffer, suicide as a solution to end consciousness
and unbearable pain – Melville termed it as "unbearable torture". When a person
is not in a state of suicidal thoughts that worries him, the person is able to see
more options for coping with stress. Shneidman argues that anxious thoughts are
the main characteristic of suicidal people and are not mental illnesses.
5. Neurochemistry and Suicide
Serotonin levels are linked to depression. Research shows a link between
serotonin, suicide and impulsivity. Low levels of the main metabolite serotonin,
5-HIAA, are found in people with depression, scozophrenia and various
personality disorders who commit suicide. Studies of the brains of people who
died by suicide revealed an increase in the binding of various serotonin receptors
(a response to decreased serotonin levels).
6. Predicting Suicide with Psychological Testing
A significant correlation was found between suicidal intent and despair.
Aaron Beck in his finding that hopelessness is a strong predictor of suicide is
stronger than depression. There are several things that can be measured, namely:
a. The self report,
a Reasons for Leaving Inventory measurement tool compiled by Marsha
Linehan, measures what is important to individuals such as responsibility and
care. By knowing something in someone's life we can prevent him from
committing suicide. This measuring tool can distinguish between individuals
who have the possibility of suicide and those who do not
b. For life satisfaction,
people who show relatively high levels of dissatisfaction are more likely to
commit or attempt suicide years later. For example, men who have the highest
levels of life dissatisfaction may be 25 times more likely to commit suicide
10 years later.
c. Cognitive characteristics,
people who are thinking about suicide have a more rigid approach to various
problems and have less flexible thinking. Limited thinking makes a person
choose suicide as a solution because they cannot consider various solutions.
7. Preventing Suicide
Prevention of suicide is to recognize in mind that most people who
attempt suicide suffer from a mental disorder that can be treated so that the risk
of suicide can be reduced. Another prevention is to ignore mental disorders and
concentrate on certain characteristics of people who are thinking of suicide
regardless of mental disorders.
Edwin Shneidman develops general strategies in suicide prevention
a. Reduces deep psychological suffering and pain
b. Opening eyes, by helping individuals see options other than extreme options
c. Encouraging the person concerned not to self-destruct
Example: a wealthy college student who is not married but is pregnant and
thinks about suicide with a well-thought-out plan. The only solution she can think
of other than suicide is not to get pregnant and become a virgin again. Shneidman
says writing down a list of options can have a calming effect. So that the student
was able to sort the list even though he found the wrong item, but he did not
commit suicide and thought of other solutions other than dying and returning to
being a virgin.
Some of the key points in suicide prevention according to Rudd, Joiner and
Rajab:
a. Troubleshooting, 2
b. Guidance on controlling emotions, trauma, anger and tolerating suffering
c. Creating strong and empathetic therapeutic relationships, building trust and
hope
