After Mass a cupla weeks ago I joined other parishioners in the Hall for tea. Some items were being sold for the Missions. I bought a wee book about diabetes for a few quid. I'm on my own since 1989 - after 19 years with my partner - so I like now & again to have a word or two in a 'safe space' with other folks. What happened shortly after I collected a cup of tea and joined two ladies at a wee table took my breath away, left me shocked and saddened, and to a degree quite angry within myself. Neither lady knew me by name nor I them. So we introduced ourselves. The inevitable 'And what do you do, Philip?' friendly enquiry was raised after the ladies briefly explained their raison d'etre that day. Since I quit college/univ teaching 5 years ago, having 'escaped' in 1998 from my major pension-building 'career', and thereafter engaged in counselling/psychotherapy/suicidology via research & private practice, I'm inclined to say: 'I'm a therapist these days'. Unsurprisingly, on that day, the ladies wondered - as is sometimes the case - what sort of therapy. In no time at all, mention of my two suicide research projects (2001 & 2010) in our local univ's school of psychology led to the disclosure by the ladies of the particular circumstances a 12 year old schoolgirl's sudden death some days earlier. Sometime later I found a brief report on page 2 of a local morning paper (Irish News 21 May 2019) headlined 'Tributes paid to schoolgirl (12)'. The news report said the poor kid had 'died suddenly over the weekend'. The above mentioned ladies knew little more than the press reporter but the scant information known or rumoured about the tragedy led us, that Sunday morning, to lament somewhat inconclusively our northern Irish 'suicide epidemic'. I'll write more about all of this soon. It's particularly galling that despite the extensive local, and massive global research bank of relevant data, research, professional insights like Joiner's much admired 'Why People Die by Suicide' (2005), and more theories about suicide than you could shake a stick at, we're still unable to do much about the brutal cruelty implicit in human self-slaughter. I join with others in offering most sincere condolences to all this wee girl's family, friends, school chums, teachers, and neighbours regarding their incalculable loss.
A recent 'Guardian' article by Steven Morris was head-lined "Judges lower benchmark for inquest decisions on suicide" (11 May 2019). The gist of their lordships' decision in an English/UK Appeal Court (10 May 2019) was to change the evidential standard for coroners and juries to be 'sure that someone has taken their life' from 'criminal' - i.e. beyond a reasonable doubt, to 'civil' - i.e. 'more probable than not'. Morris's article says this landmark ruling is likely to cause controversy and deep upset among those 'for whom suicide carries a deep stigma'. The case being appealed related to the death of the late James Maughan, found hanged in an Oxfordshire prison cell. At Maughan's inquest (Morris reports), the coroner Darren Salter advised jurors that although there was 'not enough evidence to be sure he had intended to kill himself', they could conclude that on the balance of probabilities the deceased had taken his own life. Later, in the English/UK High Court, his family disputed the coroner's decision to advise a 'suicide verdict' rather than an available alternative 'open verdict'. That court ruled, Morris says, 'unexpectedly' that the standard of proof for suicide should be the balance of probabilities. The Appeal Court backed their High Court colleagues. Nearly three weeks later I've no information that the English/UK Supreme Court (or dare I say pre-Brexit European Court/s) are, or will become, involved.
A few days before this on 8 May 2019, the Guardian published a Press Association (PA) report headed "Keith Flint: not enough evidence for suicide verdict". In this case the deceased was a 'celebrity' singer found hanged, having consumed cocaine, alcohol and codeine. The senior coroner for Essex (England) Caroline Beasley-Murray recorded an open verdict. She was reported by PA to have concluded as follows: "I've considered suicide. To record that I would have had to have found that, on the balance of probabilities, Mr Flint formed the idea and took deliberate action knowing it would result in his death. Having regard to all the circumstances, I don't find there is enough evidence for that." Beasley-Murray also ruled out death by accident where Mr Flint 'may have been been larking around and it all went horribly wrong'. She further commented (PA reported): 'We will never quite know what was going on in his mind on that date and so that's why I am going to record an open conclusion'. PA reports that police found 'no suspicious circumstances', nor any third party involvement. The late Mr Flint's family did not attend the inquest and no witnesses were called to give evidence in person. I have no access to any written evidence available to the coroner. Other than postmortem evidence, no mention was made of a psychological autopsy being carried out, although such investigations are believed, rightly or wrongly, to be standard procedure before any inquest takes place into a death where suicide is considered a possibility.
I have been pondering the meanings implicit in the word 'intention' with regard to both of the above mentioned unfortunate deaths of Mr Maughan and Mr Flint. This takes us to 'motivation' which clearly precedes 'intention'. What motivates, i.e. drives or energises an intended, i.e. planned action? In neither of the above reported fatal cases, was that key question posed, considered or answered. If either of these men were suspected of being murdered, i.e. evidence existed of third party involvement, the suspected but unknown killers' motivation would be a vital area of interest for the criminal justice process. But context is everything. Suicide is not understood to be self-murder despite the near equivalence of meaning of each term. Murders are never over for those bereaved by such a horror, even when the culprit killer/s is identified, prosecuted and incarcerated. Similarly, survivors of bereavement by suicide are 'changed, changed utterly' and crushingly, by sudden, serious, unanticipated, total loss. Yet the resources deployed in investigating suicide are minuscule, while unlimited criminal justice energy and expertise is available in relation to murder.
IRELAND AND THE BIG LIE
[Blog 7 April 2018]
I was thinking about ‘the big lie’ – a ploy relied upon by politicians most recently in UK by Brexit campaigns (leave/remain) and earlier, before the US presidential election, and repeatedly since then by the execrable Trump and his duped disciples. Currently both UK and Russian governments are disputing and arguing by way of ‘the big lie’ (viz. ‘we’re right, you’re wrong’) regarding which of them, if either, is responsible for the life-threatened predicaments of the (allegedly) poisoned retired spy Sergei Skripal and his daughter Yulia. [And I wish both a speedy return to ‘good health’.]( https://en.wikipedia.org/wiki/Poisoning_of_Sergei_and_Yulia_Skripal )
Wikipedia (https://en.wikipedia.org/wiki/Big_lie) to the rescue with a reliable definition:
“A big lie (German: große Lüge) is a propaganda technique. The expression was coined by Adolf Hitler, when he dictated his 1925 book Mein Kampf, about the use of a lie so "colossal" that no one would believe that someone "could have the impudence to distort the truth so infamously."
IRELAND’S BIG LIES
The big lie has always been a dependable ally of Irish political charlatans in their lust for power over the rest of us. In Ireland, our big lie predated Hitler’s drivel by several decades. It currently proclaims: Northern Ireland’s political, social and economic problems are down to the British connection: Irish unification is the only answer. Currently one Irish political party bases its entire policy platform (“A United Ireland by any and all available means”) on that big lie. The remaining parties, or ‘gangs’ as I prefer to think of them, including those elected to Dail Eireann, i.e. the Oireachtas or legislature of the Irish Republic (Fianna Fail, Fine Gael, Labour, Solidarity-PBP, Independents 4 Change, Social Democrats, and independents) live in the complex, real world of 2018 et seq. The remaining elected representatives (you know who you are) wrap themselves in the mummifying blanket of that big lie, attached to, depending upon and viewing their world through its distorting lens.
I’ve wondered long and hard about why they cling unquestioningly to this mythical cure all for Ireland’s ills. One obvious reason is that Sinn Féin [SF] - for that’s what they call themselves: it translates, appropriately as “Ourselves”, or even “Ourselves Alone”- the political voice of a failed, and now (we’re told) dissolved, violent revolutionary gang of assassins, do not know when they are beaten. Wikipedia (https://en.wikipedia.org/wiki/Sinn_Fein) again to the rescue, tells us what we, who survived the 30 years plus of Irish slaughter by PIRA and other equally murderous ‘loyalist’ killers (1966-1998), already know only too well:
“Sinn Féin is the largest Irish republican political party, and was historically associated with the IRA, while also having been associated with the Provisional IRA (PIRA) in the party´s modern incarnation. The Irish government alleged that senior members of Sinn Féin have held posts on the IRA Army Council. However, the SF leadership has denied these claims. The US Government has made similar allegations.
“A republican document of the early 1980s stated: "Both Sinn Féin and the IRA play different but converging roles in the war of national liberation. The Irish Republican Army wages an armed campaign... Sinn Féin maintains the propaganda war and is the public and political voice of the movement".
That ‘propaganda war’, included use of a variation of the big lie, when Sinn Féin’s then national chairman Mitchell McLaughlin’s (2005) agreed with the arrogant, contradictory and nonsensical assertion, articulated on RTE, the Irish national broadcaster:
‘that the IRA was “the only legitimate government of Ireland”’.
Multiple sources accessed, including on 8 April 2018 at: https://www.newsletter.co.uk/news/mitchel-mclaughlin-claimed-jean-mcconville-s-murder-was-not-a-crime-1-6517640
To conclude with a cupla vignettes, illustrated by newspaper reports, discussing how two now middle-aged former IRA volunteers, and SF members/supporters, cope with the wretched legacy of their violent revolutionary roles in ‘the war of national liberation’.
The above named petitioner recently engaged in widely publicised defamation litigation in Dublin, Ireland. I shall simply repeat here some of what ‘The Irish Times’ (published online 15 February 2018), an Irish newspaper of record, reported about Mr Kehoe. A former IRA volunteer, who was jailed in 1974 for possession of firearms, Kehoe received a 12 year sentence of imprisonment for attempted kidnapping in 1983 during which gunshots were exchanged with members of An Garda Siochana, the Irish police service.
“When [it was] suggested he [Mr Kehoe] could not now pick and choose which parts of the IRA campaign of violence he supported and which were OK, Mr Kehoe replied: “I would say most or all the campaign was wrong for violence, it was wrong that people were killed”. He agreed that while he saw his activities in the historical context, the vast majority would see it as criminal. Mr Kehoe agreed that the 1,196 people killed by the IRA during that campaign never got to do things he had . . . Asked was he proud of his activities in the IRA, he said: “No. I would not be proud”. When counsel asked: “Are you ashamed?” he replied: “I would be, in a context” (“The Irish Times”, 15 Feb 2018).
Kehoe’s statements were unprecedented. For a currently active Sinn Fein member like Kehoe to concede that the IRA’s serial killers (1970-1998) were criminals represented a major shift in that duplicitous political gang’s attitude to the past behaviour of their paramilitary partners during “the war of national liberation”.
By contrast, a former “senior” Sinn Féin national chairman and past elected representative (Mitchell McLaughlin) refused to acknowledge that the PIRA's controversial killing of a mother of ten young children, Jean McConville, in the early 1970s, was a crime, as he claimed it had taken place in the context of political conflict (http://news.bbc.co.uk/1/hi/northern_ireland/4186887.stm). This represented Sinn Féin’s deployment of the big lie (i.e. it’s OK to kill as long as it’s for our political cause) to escape responsibility for murder. Politicians from the Irish Republic, along with the Irish media, strongly attacked McLaughlin's comments in 2005 (https://en.wikipedia.org/wiki/Sinn_Fein).
To my knowledge, no Sinn Féin or PIRA member, other than Kehoe, has yet publicly acknowledged their shame regarding their involvement, directly or indirectly, in PIRA’s 30 year killing spree. In the next paragraph, a second former PIRA volunteer’s self-reported behaviour and his attitude to it, is summarised. It represents the lamentable outworking of a variation of a Mitchell McLaughlin-type big lie that appears to facilitate a good night’s sleep for this flawed individual.
According to “The Irish News” (5 April 2018) it was reported that this gentleman, an IRA volunteer, was appointed in 2017 to the NI Victims and Survivors Forum, whose function includes helping a government agency, the NI Victims & Survivors Commission, in “understanding the needs of victims and survivors”. It is beyond irony to attempt to get your head round what McClenaghan’s expertise in this area might be. Other forum members were not informed of his PIRA past. And what did the bold Robert say 7 years ago about that? As reported in the “The Irish News” (5 April 2018):
“. . . McClenaghan said [in 2011] he was ‘immensely proud’ of having been an IRA member in the mid-70s, during which he learned to use weapons to ‘kill people’ and planted bombs ‘big and small’ in central Belfast . . . he expressed no remorse for any loss he may have inflicted on others” (“The Irish News”, 5 April 2018).
If you can endure it, you can listen to bomber McClenaghan and watch his selectively self-justifying blethers in a 36 minute Dutch film “When the war ends” (https://vimeo.com/85810659), released in 2011, that makes no reference whatsoever to the lives lost, and innocent fellow citizens injured, maimed and traumatised, directly or indirectly by his terrorist* brutality, in conjunction with his deluded mates, before he was apprehended and jailed for 12 years in 1976. He was apparently released on licence in 1988, but we have incomplete information about what he then got up to.
I am a pacifist. In my opinion, there is never any justification for taking the life of any human being. If you are against capital punishment, as I am, then it’s a straightforward read across to hold that human life is priceless in all circumstances. I’ll let you engage in your “what about” debate with yourself about killing fellow-humans in self-defence, in a “just war”, or by abortion.
As for the dirty, deceitful, power-lusting killing spree, admitted by and indulged in by Kehoe, McClenaghan and their deluded mates: this was and remains a salutary example of how not to problem-solve Irish political issues. The fact is that McClenaghan and his mates, and their mirror-image counterparts identifying as British loyalist/unionist in outlook, were led into murderous, criminal acts, as armed pawns in a power game planned, orchestrated and led by so-far unidentified, psychopathic manipulators – the armchair generals – from the secret safety of their anonymous backgrounds. These cold-blooded killers were previously naïve, simple-minded, easily led but essentially ‘good human beings’, before being “radicalized” by the lies and false promises of Irish republican / British loyalist propagandists. They morphed into automaton-like puppets on a real life stage, using explosive munitions and automatic firearms to take the lives, and to destroy the livelihoods of their neighbours, other ‘good human beings’, at massive cost but zero benefit.
Over 30+ years from mid-1960’s to late 1990’s, Kehoe, McClenaghan and hundreds of their like-minded psychopathic mates, both in and out of “uniform”, sent over 3,500 fellow-citizens to the slaughter, into the ground decades before their time. For a really convincing demonstration of what Irish / British terrorist (aka political) violence delivered, be prepared to weep while having an extended look at ‘Lost Lives’ (McKitterick et al., 1999/2004). This masterly publication briefly but comprehensively describes the violent circumstances of each of these prematurely ‘lost lives’.
Of course the most blatant ‘big lie’ that continues to be spouted day and daily by Irish republican propagandists relates to and underpins their false claim that they had no alternative but to take up arms in the 1970’s, 1980’s and 1990’s against the British state. Anyone who wishes to take the time, will eventually acknowledge, understand and accept that during those decades, Irish terrorism was neither justified nor justifiable as a problem-solving approach to the Irish National Question. I’ll conclude with a relevant sentence or two in response to the question: was PIRA terrorism justified:
“No, I don’t believe so. There was a peaceful civil rights movement, it was operating in a country that had a democratic process. In time the inequalities could have been addressed by peaceful protest and the political process. The violence of the IRA only delayed that process and caused untold suffering to both communities.” ( https://www.quora.com/Was-the-Irish-Republican-Army-justified published 2 May 2014 and accessed on 15 April 2018.)
McKitterick, D., Kelters, S., Feeney, B., Thornton, C. and McVea, D. (1999/2004) Lost Lives –the stories of ther men,women and children who died as a result of the Northern Ireland Troubles. Edinburgh/Mainstream Publishing Company (Edinburgh) Ltd
Oxford Dictionary (2018) Terrorism, defined as violence against civilians for political ends. Hence ‘terrorist’*: a person who uses unlawful violence and intimidation, especially against civilians, in the pursuit of political aims.
Accessed online on 13 April 2018. [https://en.oxforddictionaries.com/definition/terrorist]
SUICIDE IS NO ACCIDENT
Suicide is no accident. Think about it. The implication becomes clear: that a cause/effect relationship within the human mind links unbearable psychological pain (Shneidman, 1993) to irreversibly lethal behaviour that kills the pain but that tragically and coincidentally destroys the decision-taking mind. Hence an aeons long search goes on for a General Theory of Suicide, exemplified most recently in the work of O’Connor (2011) and Joiner (2005). I hasten to add that I am not a member of any global search squad. Rather I am interested in understanding the idiosyncratic nature of each lethal event of human self-destruction. For me, and many others, shocked and distressed by family suicide, prevention is no longer possible: we have become survivors of bereavement by suicide. And choices exist, that are inevitable, unavoidable and essential, regarding our response to what has happened. Either, we can invest scarce energy in analysis of the impossible, i.e. how I, and/or others, might have prevented our family suicide event/s, or we might consider, in some systematic and disciplined way, how to deepen our understanding about what happened, not least inter alia to secure some fraction, large or small, of absolution in relation to our catastrophic loss. Understanding suicide is, I would argue, a prerequisite for reducing the incidence of suicide, including its prevention, for example by way of the recent heavily publicised “Zero Suicide” movement: you’ll not easily change what you don’t understand.
Some think that ‘suicide prediction skills’ are a logical way ahead for countering suicide. Some say these ‘skills’ involve an awareness of both suicide ‘risk factors’ and counter-suicide ‘protection factors’ and their balanced application in psychotherapeutic work with each suicidal client. And I am sympathetic to the apparently rational nature of this approach. However most suicidologists will not disagree that such an apparent master/servant relationship between an expert therapist and a vulnerable client, may neither fully reflect nor align well with person-centred counselling theory and practice. In what follows I discuss some helping principles for reducing an individual’s suicide impulse by facilitating the individual to understand it and thereby to take control of it. [Note that I do not intend to refer to medical psychiatry nor the DMS nor pharmaceutical pathology in what follows as I am content to possess neither relevant qualifications nor practical knowledge of these esoteric areas.]
The CAMS approach seems to be an attempt to situate therapist and client in a relationship of equals. This may also be as close as psychotherapy can get to a self-help, life-saving approach to suicide prevention.
Joiner, T. (2005) Why people die by suicide. Cambridge, MA: Harvard Univ Press
O’Connor, R.C. (2011) The Integrated Motivational-Volitional Model of Suicidal Behaviour (IMV). Accessed on 18 July 2017 at http://www.suicideresearch.info/the-imv
Shneidman, E.S. (1993) Suicide as psychache. Journal of Nervous and Mental Disease. v181:145–147
POLITICAL MURDER AND DOMESTIC SUICIDE IN NORTHERN IRELAND
AUTHOR: Philip O’Keeffe PhD MSc Reg MBACP (Accred)©2017 [Comments & queries: firstname.lastname@example.org ]
Almost the same number of lives were sacrificed in Northern Ireland’s (NI) 30 year ‘Troubles’ (3,600) as were extinguished by suicide (3,300) in the 15 years following the Good Friday / Belfast Agreement (1998). It is suggested that NI society’s response to political murder (1968-1998) attracted unlimited state investigative resources while domestic suicide (1998-2012) was largely ignored. The lives of survivors of bereavement, whether by political murder or by domestic suicide, are changed utterly as they attempt in the aftermath to come to terms with their unconscionable losses. This article argues therefore that each death by suicide, should be as fully investigated as if it were by murder. To fail to do so represents an ongoing missed opportunity to understand the actualité of suicide in NI and to supply an evidence base for realigning currently unsuccessful reduction and prevention policies. (140 words)
AFTERMATH OF POLITICAL MURDER
Over 3,600 deaths by violence in UK/Ireland resulted from a 30 year-long attempted coup d’etat by a few hundred armed, Irish, irredentist revolutionaries that was vigorously resisted by UK state police and military power, allegedly in collusion (Cadwallader, 2013; Urwin, 2016) with renegade UK state forces and armed loyalist paramilitaries, in a ‘dirty war’ (Dillon, 1990) from mid-1969 until a truce was ratified by way of the Belfast/Good Friday Agreement (http://cain.ulst.ac.uk/issues/violence/cts/fay98.htm#tables; Belfast Agreement, 1998).
Each fatality and alleged perpetrator is given a brief, cursory mention in the Cain Website (2005 et seq) and in Lost Lives (McKitterick et al., 1999-2008). However those left to mourn these horrendous, but essentially and ultimately purposeless losses of their family member, merit little mention and negligible attention. Today – June 2017 – what are now known as legacy issues – the unanswered “when?”, “how?”, “where?”, “why?” and “by whom?” questions about each of a vast majority of these killings – dominate the North’s/Northern Ireland’s/North-east Ulster’s (hereafter NI) political agenda. Along with current issues related to Irish language and “equality” – the latter still undefined but whose civic & cultural absence from NI is said to be evident to all – what to do to assuage the unresolved predicament of grief-burdened survivors of 3,600 plus unjustified and savage losses, remains unaddressed: hence legacy issues.
An attempt was made in 2007/09 by a Consultative Group on the Past (2009) whose remit was summarised in the report’s Executive Summary, as follows:
“On 22 June 2007 Peter Hain, the then Secretary of State for Northern Ireland, announced the formation of an independent Consultative Group. The Group was asked to:
consult across the community on how Northern Ireland society can best approach the legacy of the events of the past 40 years;
make recommendations, as appropriate, on any steps that might be taken to support Northern Ireland society in building a shared future that is not overshadowed by the events of the past;
present a report, which will be published, setting out conclusions to the Secretary of State for Northern Ireland, by summer 2008 (Note: Report published in 2009).
The Right Reverend Lord Eames OM, former Archbishop of Armagh, and Mr Denis Bradley, the first Vice-Chairman of the Policing Board, co-chaired the Consultative Group on the Past. The following were members of the Group: Mr Jarlath Burns, Rev. Dr. Lesley Carroll, Professor James Mackey, Mr Willie John McBride MBE, Ms Elaine Moore, and Canon David Porter.
Mr Martti Ahtisaari, former President of Finland, recent Noble Peace Prize winner and founder of the Crisis Management Initiative, and Mr Brian Currin, former chair of the South African Prison Audit Committee and founder of the National Directorate of Lawyers for Human Rights, acted as international advisers to the Group. Mr Jeremy Hill acted as the Group’s Legal Adviser.” (Consultative Group on the Past, 2009)
Unfortunately, following a massively negative response in a public consultation upon the report, NI political parties could not agree to implement any of the Report’s recommendations (BBC, July 2010). Eight years on, the ‘Troubles’ legacy issues continue to fester, unrecognised, unacknowledged, unameliorated: they remain painfully alive in the memory for thousands of surviving relatives and friends of the murdered – including seriously injured people – their numbers gradually diminishing by time’s attrition.
I recall what my ‘boss’ (deceased, RIP, 1985) in the civil service said – he was given to thinking aloud – in the late 1970’s about the then ongoing so-called “Troubles”: he said that our ability to keep careful, accurate, objective, criminal statistics offers confirmation that society hasn’t broken down: in other words each of these cowardly assaults, each one of these premature deaths, each of these inhuman crimes merits close attention so that when the killing stops, justice might be upheld.
This topic – referred to by some optimists as a truth and reconciliation process – is notionally on the agenda for current UK election (June 8) and possible ‘second Stormont election in a year’ although our uncompromising, solution-resistant, mirror-opposites bigotry could ensure little if any change in NI’s political, cultural or civic architecture, as expressed in 19 July 2010 (BBC, 2010).
AFTERMATH OF DOMESTIC SUICIDE
Recently some academics calculated that the numbers of NI citizens deceased by suicide, viz. 3,300 premature dead, during 1998 to 2012, i.e. 15 years since the above-mentioned truce (see ‘Belfast Agreement, 1998), was on a par with (See http://www.thedetail.tv/articles/suicide-kills-as-many-as-the-troubles: Torney, 2014) those 3,600 poor pawns, murdered during NI’s futile, power-lust driven slaughter by neighbours of their neighbours.
So what about a truth and reconciliation process for the grief-burdened survivors of these 3,300 innocent dead? Estimates vary (Berman, 2011) about how many individuals bereaved by a suicide, may be adversely affected materially and psychologically:
“. . . at least six loved ones are directly affected by the death . . . likely an underestimation [that] may not account for the emergency responders, health care providers, co-workers and acquaintances also affected by the suicide.” (Young et al., 2012)
Are these suicide deaths not as equally ‘horrendous, but essentially and ultimately purposeless’ as those murdered souls? The author’s family suicides (1982 & 1989) seriously adversely affected at least 31 immediate family members, partners, children, parents, siblings, nephews/nieces, in-laws. Could ‘public opinion’ in NI, per a consultation process and some level of political agreement generate a humane way to alleviate, assuage, and ease the pain generated by each of these losses, other than in our customary short-lived wringing of hands, that frequently morphs into longer lasting feelings of complicated grief, confusion, impotence? The wise Shneidman (2001) had no doubt that:
“each sad case [of a death by suicide] should be assessed, understood and treated in its own idiosyncratic psychological terms.” (Shneidman, 2001: 203)
The forward focus of the NI Stormont Government’s health department and local academic researchers to some extent ignores suicides legacy issues other than to add ‘bereavement by suicide’ as an additional suicide risk factor, to an already burgeoning list (Scottish Government Social Research, 2008) for relatives, friends, and colleagues of the suicide deceased. This has a well intentioned purpose – honourable we must accept – to reduce future suicide quanta. Interestingly, their joint policy approach relies almost exclusively on an emphasis upon a disputed relationship that’s said to exist between ‘mental ill-health’, including ‘Troubles’-related trauma, and suicide. This ‘cause/effect’ myth and the psychiatric energy invested in adhering to it have not yet halted NI’s escalating ‘suicide rates’. See Torney (2014) for references to Bamford (Ulster University), and Stormont health department, illustrating their reliance upon this failed ‘all our eggs in one basket’ approach.
In the author’s view, the sooner we move away from ineffective ‘mental ill-health-related’ suicide prevention approaches, policies and practices, the sooner we might come to understand, as a starting point, that human suicidal behaviour in another person is as idiosyncratic as that person’s unique fingerprint, and may not otherwise be comprehended. The late Edwin S Shneidman, PhD, acknowledged in suicidology as one who knew more than anyone about human suicidal behaviour, did not rely upon portmanteau metaphors like mental health, mental ill-health or mental disorder when communicating his insights into suicide in innumerable books, journal articles, and media and personal interviews:
“It is my belief that our best answers, as therapeutic suicidologists, cannot come from medicine or physiology or group behaviour or epidemiology or sociology, not from Kraepelin nor the Diagnostic and Statistical Manual of Mental Disorders, and certainly not from Smith-Kline Beecham.” (Shneidman, 2001: 201)
Rather, as a psychologist, he focused on psychological needs, emotional responses and ‘psychache’, a word he invented to describe unbearable psychological pain:
“Shneidman . . . described suicide as a "drama of the mind." He coined the term psychache, which is the psychological pain -- consisting of negative emotions and unmet psychological needs -- that an individual experiences. It differs from physical pain since it stems from emotional, rather than physical, discomfort. Psychache creates an overwhelming amount of distress in an individual so that he or she perceives suicide as the only way to escape the pain” (Clinical Tools, 2017).
Shneidman (2001: 203) explained further that if unrelieved psychological pain was a major source of suicide ideation, then, as an initial step, the helper might gently and compassionately invite the sufferer to answer questions like: ‘Where do you hurt?’ and ‘How may I help you?’
Earlier it was noted that ‘bereavement by suicide’ is a risk factor for suicide (The Right to Health Campaign, 2016). The “Safer Campaign” relied upon a World Health Organisation (2014) report to assert that:
“Studies . . . show that people who die by suicide often know someone who did the same recently and that ‘those who are affected or bereaved by suicide have themselves an increased risk of suicide’” (Right to Health Campaign: the SAFER campaign, 2016: 6)
And so the ‘where do you hurt?’ question may also usefully be gently put by therapeutic helpers to survivors of bereavement by suicide. This might be a start: but unless the helper – whether psychiatrist, psychologist, general medical practitioner, mental healthcare worker, psychotherapist/counsellor, Samaritan volunteer, social/community worker or simply friend, neighbour, colleague or bystander – has the knowledge, the time, the capacity, the humanity, and the developed skill to listen to the sufferer, actively and with compassion for as long as it takes, then we waste everyone’s time and need not have bothered. Such listening may need to be available to sufferers for a lifetime, because the pain of loss of a loved one by suicide may indeed be life-long for survivors. But is this all that’s required?
TRUTH PROCESS FOR SURVIVORS BEREAVED BY SUICIDE
You’ll have begun to notice that, in the author’s view, there may be a cross-over that connects the psychological needs of survivors of loss, due to NI’s bigotry-fuelled, political conflict (1969-1998) with survivors of loss by domestic suicide subsequently, viz. 1998-2012, and currently. The obvious difference here is that murder is against the criminal law while suicide, since 1966, in NI, 1961 in England/Wales and 1993 in Irish Republic, is not. [Suicide is not unlawful in Scots Law (https://en.wikipedia.org/wiki/Suicide_Act_1961).] With murder, the perpetrator is guilty of a serious offence, punishable in UK/Ireland on conviction by lengthy imprisonment. With suicide, the alleged perpetrator is not amenable, being dead. But legacy issues for both sets of bereaved, although different, do have much in common.
Four of these questions immediately arise – see above – for suicide bereaved as for murder bereaved: these are the unanswered “when?”, “how?”, “where?”, and “why?” queries. The fifth “by whom?” question becomes the focus for a criminal investigation where murder is suspected while a crime file is not opened where death is by apparent suicide. Readers will be familiar with the UK/Irish police statement’s formulaic words, viz. no suspicious circumstances, customarily used where cursory investigation of a death scene by police, that rules out natural, accidental or homicidal causation, leads rapidly to a conclusion by police that no crime has taken place, i.e. death was probably by suicide. Answers to the above four questions represent overlapping territory occupied by both sets of mourners. A truth and reconciliation process to examine legacy issues for survivors of political murder would seek answers to all five questions while such a process for suicide survivors would focus only upon four questions. At this point, any practical outcome from these comparisons evaporates: legacy issues for murder are on NI’s current political agenda while legacy issues for suicide are not.
Such contrasts between ‘Troubles’ murders and post-‘Troubles’ suicides are blatantly evident in media responses. Each of our 3,600 murders was fully reported in depth by print journalists who based their articles on police statements and later court reports. Editorial decisions about what ‘news’ is reported rely upon that nebulous concept known as ‘newsworthiness’. Very few of our 3,300 suicides made it to print media. Murder in NI, particularly political – or using the current, ‘peace process’ mantra, conflict-related – killing is always newsworthy. Suicide is not. Exceptions exist where editors may consider that a particular suicide-related incident meets ‘public interest’ criteria that facilitate media reportage. The term ‘public interest’ belongs to a parasitic class of imprecise, but influential subjective terms like ‘mental health’, ‘mental illness’ , ‘mental disorder’, national interest, ‘the right thing to do’, ‘what matters’ and so on employed by journalists, politicians and propagandists and described by an unnamed senior BBC news figure, in a study about the media, privacy and public interest (2002):
“[public interest] will always be a grey area . . . I don’t see how you can logically, and rationally, impose some sort of blueprint which enables you to know whether it’s in the public interest or not . . . . National interest these days can mean whatever the government wants it to mean, in a particularly cynical way. Public interest, by the same token, could easily mean whatever the editor [or owner] of a newspaper wants it to mean.” (Morrison & Svennevig, 2002: 8)
Relevant local examples where ‘public interest’ may determine the extent, if any, of media reportage of suicide include public coroner’s inquests, murder/suicide incidents, multiple suicides meeting specific, restricted, geographical or time-related criteria, sometimes referred to as ‘suicide clusters’, so-called celebrity suicides, child/young person suicides, suicides enacted in public places, and so on:
“The Coroner will seek to establish the cause of death and will make whatever inquiries are necessary to do this e.g. ordering a post-mortem examination, obtaining witness statements and medical records, or holding an inquest . . . The NI Coroner’s Service ‘inquire into deaths that appear to be . . . unexpected or unexplained, as a result of violence, an accident, as a result of negligence, from any cause other than natural illness or disease, or in circumstances that require investigation.’ NI Courts Service (2017)
Because public inquests into deaths by suicide in NI are infrequent, the outcomes of coroners’ investigations do not often enter the public sphere. In recent years academic researchers have secured restricted, partial access to records of deaths by suicide, and by undetermined intent, as identified by NI’s local coroner’s service. Some recent findings are described next.
SUICIDE RESEARCH AND THE FOUR QUESTIONS – WHEN, HOW, WHERE, WHY.
With few honourable exceptions, suicide research in UK/Ireland uses quantitative methods, focused on numerically large-scale statistical analyses of commonalities rather than a qualitative approach that may focus upon one or more individual case studies. Each approach seeks to understand human suicidal behaviour as a window into suicide reduction and prevention. The four questions may be considered by either research model.
A recent research paper (Benson et al., 2017) explored the use (and abuse) of prescribed medication by suicide deceased using a quantitative analysis of coroners’ records of 1,371 suicides, including ‘police reports, medical notes, and statements from next of kin’ (p3). At the outset, it is clear that researchers’ interest was narrow, being largely restricted to deceased’s use (or not) of prescribed medication in relation to their medical status before and at death. However, researchers also had access to each deceased’s ‘socio-demographic variables [and] details relating to the suicide [that] included the method of suicide, adverse events prior to suicide and . . . suicide notes (if any)’. It’s evident that only the ‘why?’ question remained unanswered since coroners files may have provided adequate factual evidence regarding the ‘when?’, ‘how?’ and ‘where?’ of each suicide.
The paper (Benson et al., 2017) identified that medication prescriptions for over half of the deceased were for ‘mental health disorders’ (51.7%) while under half of the deceased were prescribed for ‘a physical condition’ (45.2%) and almost a third (31.6%) were prescribed medications ‘for both mental and physical health conditions’ (p6). Over one in 20 (6.7%) died by overdose while under one in 10 (7.9%) died by drowning. No information was available in the paper about how the remainder (85.4%) died.
The glaring absence in this research, albeit meticulous, cautious and expert, but limited, is that it tells the reader nothing about the deceased individual’s suicide trajectory: we learn nothing about the ‘why?’ question. Edwin Shneidman’s classic text (2004) examined in detail one man’s death by suicide: he demonstrated that it is possible to get close to an answer to the ‘why?’ question – but only if a coroner or a researcher completes the potentially complex investigative work involved and can command sufficient resources to achieve this.
SUICIDE – A DRAMA OF THE MIND
Essential reading for researchers who customarily employ quantitative methodology is Edwin Shneidman’s classic case study (2004). In a short text (177 pages) Shneidman joined eight expert colleagues in investigating the recent death by suicide of Arthur, a 33 year old lawyer, apparently by drug overdose. Arthur’s mother Hannah gave Edwin a copy of Arthur’s eleven page hand-written suicide note which he included in his book (Shneidman, 2004: 165). Hannah asked Edwin if he might be able to offer her some insights and some solace about her boy’s death (p3). This is indeed the ‘why?’ question that family members, friends and colleagues of our 3,300 deceased ask: please may we have some insights and solace about the sudden, violent, premature, tragic death of our fellow human? [The author has personal experience of this continuing unmet need, 34 years later, for ‘insights’ into his family members’ deaths that were not available despite his participation in two excruciating public inquests.] Shneidman’s response to Hannah was that he ‘would try to generate information, hoping there would be insights and solace in that new material’ (p5).
This ‘new material’ consisted of nine verbatim, (edited for anonymity) transcribed interviews with Arthur’s relatives (4), friends (3), his psychotherapist and his treating physician. This ‘evidence’ – described by Shneidman as a ‘psychological autopsy’ (p xiv) – along with the suicide note were shared with eight of Shneidman’s professional colleagues, all ‘world-class experts in suicidology’, and each produced a short report. In particular, they were invited to comment upon what, if anything, might have been done to save Arthur’s life.
Readers can access and read Shneidman’s text for themselves. I recall being surprised and a bit disappointed when, during a ‘networking’ conversation at a local suicide prevention seminar, a professional acquaintance, reputedly an expert in suicidology, conceded that they had neither heard of nor read Shneidman’s text. It may be that a psychological autopsy following a suicide is as good as it gets for survivors. Clearly Arthur’s grieving mother did not have access to such a detailed investigation into Arthur’s death prior to Shneidman’s intervention. Nor have I regarding our two family deaths.
I have no knowledge as to the extent of use of a ‘psychological autopsy’ (PA) methodology for some, all or even any of the 3,200 suicide deceased in NI from 1998 to 2012. Some perhaps serious flaws have been identified in psychological autopsy, for example, the illogical attempt to assign a reliable psychiatric diagnosis of mental disorder upon someone – the deceased – by interviewing someone else (Hjelmeland et al., 2012). Further, Salvatore (2015) offers a detailed, somewhat critical examination of PA that also suggests the need for change:
“. . . psychological autopsies remain a practical and viable research strategy for use in gathering information about the background, actions, and experiences of suicide victims. However, their use should be untethered from the mental illness model of suicide and not be restricted to trying to define the mental states of the deceased who took their lives.” (Salvatore, 2015: 13)
What has been briefly examined above is the clear contrast that separates NI society’s approach to political murder from its consideration of domestic suicide. Whether there is ever a determined attempt to reduce the existing gulf between the quantum of scarce public, taxpayers’ resources variously deployed in investigating these tragedies remains to be seen. Unlimited public funds appear to be available to investigate the consequences of 30 years of political murder, while comparatively negligible amounts are dedicated to the aftermath of domestic suicide. Currently this latter issue does not feature strongly enough as a discrete element in NI government programmes (Right to Health Campaign, 2016). Local human rights charities, like Participation and the Practice of Rights (PPR), have had some recent success in highlighting the physical and psychological health needs of potentially thousands of survivors of bereavement by suicide. What remains ‘off the table’ however is energetic strategic action in NI with respect to Edwin Shneidman’s dictum regarding the uniqueness of each suicide death:
““each sad case [of a death by suicide] should be assessed, understood and treated in its own idiosyncratic psychological terms.” (Shneidman, 2001: 203)
This represents a lost opportunity for learning about, and enhancing, our understanding of the actualité of human suicide, and how more insightful prevention and reduction strategies might be designed and implemented so as to replace over time our current, largely unsuccessful policies.
[3634 words (excl references)]
Bamford (2011) Accessed on 18 May 2017. https://www.ulster.ac.uk/bamfordcentre/the-bamford-centre
Benson, T., Corry, C., O’Neill, S., Murphy, S. and Bunting, B. (2017) Use of prescription medication by individuals who died by suicide in Northern Ireland. Archives of Suicide Research, 0:1-14
BBC (2010) Information accessed on 11 May 2017 at: http://www.bbc.co.uk/news/uk-northern-ireland-10677957
Belfast Agreement (1998) Information accessed on 11 May 2017 at: http://cain.ulst.ac.uk/events/peace/docs/agreement.htm
Berman, A.L. (2011) Estimating the population of survivors of suicide: seeking an evidence base. Suicide and Life-threatening Behaviour, 41(1), 110-116
Cadwallader, A. (2014) Lethal allies: British collusion in Ireland. Cork, Ireland: Mercier Press
CAIN Website (2005 et seq) Cain Web Service: Conflict and Politics in Northern Ireland. Accessed on 10 May 2017 at http://cain.ulst.ac.uk/index.html
Clinical Tools (2017) Medical education for physicians. Accessed on 11 May 2017 at: http://www.larasig.com/node/1695
Consultative Group on the Past (2009) Report. Accessed on 11 May 2017 at: http://cain.ulst.ac.uk/victims/docs/consultative_group/cgp_230109_report.pdf
Dillon, M. (1990) The dirty war. New York, NY: Routledge
Hjelmeland, H., Dieserud, G., Dyregrov, K., Knizek, B.L., and Leenaars, A.A. (2012) Psychological autopsy studies as diagnostic tools: are they methodologically flawed? Death Studies, 36, 605-626
McKitterick, D., Kelters, S., Feeney, B., Thornton, C. and McVea, D. (2007) Lost lives: the stories of the men, women and children who died as a result of the Northern Ireland Troubles (2nd Edn). Edinburgh, Scotland: Mainstream Publishing Company
Morrison, D.E. and Svennevig, M. (2002) The public interest, the media and privacy. BBC, London. Accessed on 22 May 2017 at: http://downloads.bbc.co.uk/guidelines/editorialguidelines/research/privacy.pdf
NI Courts Service (2017) Website accessed on 22 May 2017: https://www.courtsni.gov.uk/en-GB/Services/Coroners/about/Pages/coroners_about.aspx
Participation and the Practice of Rights (PPR) (2017) Accessed on 2 June 2017 at: http://www.pprproject.org/about-ppr
Right to Health Campaign (2016) Families bereaved by suicide: the right to timely and appropriate support. The Safer Campaign. Page 6. Belfast, N. Ireland: Participation and the Practice of Rights (PPR) Accessed on 31 May 2016 at: http://www.pprproject.org/launch-of-safer-campaign
Salvatore, T. (2015) Do 90% of suicide victims have serious mental illness? Psychological autopsy studies, psychopathology, and suicide. Discussion draft 8 April 2015. Available at
Scottish Government Social Research (2008) Risk and protective factors for suicide and suicidal behaviour: a literature review. Joanne McLean et al. Web only publication. www.scotland.gov.uk/socialresearch
Shneidman, E.S. (1995) Suicide as psychache. New York, NY: Jason Aronson
Shneidman, E.S. (1996) The Suicidal Mind. New York, NY; Oxford University Press.
Shneidman, E.S. (2001) Comprehending suicide. Washington, DC: American Psychological Association
Shneidman, E. S. (2004) Anatomy of a suicidal mind. Oxford: Oxford University Press.
Stormont Health Department (2017) Health Improvement Policy Branch. Accessed on 1 June 2017 at https://www.health-ni.gov.uk/contacts/health-improvement-policy-branch
Torney, Kathryn (2014) Suicide kills as many as the ‘Troubles’. The Detail. Accessed on 10 May 2017. http://www.thedetail.tv/articles/suicide-kills-as-many-as-the-troubles
Urwin, M. (2016) A state in denial: British collaboration with loyalist paramilitaries. Cork, Ireland: Mercier Press
World Health Organisation (WHO) (2014) Preventing suicide: a global imperative. Accessed on 31 May 2017 at http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/
Young, I.T., Iglewicz, A., Glorioso, D., Lanouette,N., Seay, M., Hapakurti,M. and Zisook, S. (2012) Suicide bereavement and complicated grief. Dialogues in Clinical Neuroscience, Vol. 14, No. 2, p178
Philip O’Keeffe PhD MSc Reg MBACP (Accred)©2017
Caveat: This paper may be copied and circulated but only if the author’s name and copyright are acknowledged.
A New Theory of Suicidal Behaviour
Imagine my surprise when finding yet another theory of suicidal behaviour on offer to add to the existing fifteen or sixteen already available to suicidology. I mention this because unfortunately I’ll not be able to make it to Boston (Harvard Medical School) on 9 December 2016 to hear Tom Joiner deliver his latest insights upon ‘a new theory’. But why ‘surprise’, I hear you say.
Well it takes me back to Aristotle’s ‘well-known’ definition of truth:
“To say of what is that it is not, or of what is not that it is, is false, while to say of what is that it is, and of what is not that it is not, is true.”
[Accessed on 22 Aug 2016 at http://plato.stanford.edu/entries/truth-correspondence/]
Further ‘research’ via Dr Google offered the following from ‘Daniel Super, Game Programmer’ on the subject of opinion and truth:
“People have many different opinions because they have different life experiences and perspectives. Very little can be said with absolute certainty outside the realm of mathematics.
In many things there may be no truth at all. Moral questions cannot be answered definitively for all possible conditions, even the ones that seem obvious like ‘is it immoral to kill another human?’ have notable exceptions in most people's eyes. As for religions, I'm convinced that none of them even remotely approach any sort of truth.”]
[Accessed on 22 Aug 2016 at https://www.quora.com/Why-do-people-have-so-many-different-opinions-Is-there-only-one-truth-to-things].
So here’s my argument. I shall not attempt here to delineate any or all 15 or 16 theories about human suicidal behaviour, but you can find out more here (Lester, 1994). I tend towards the view – or it’s my opinion – that each act of suicidal behaviour, properly defined, is unique. The exhaustive efforts by suicidology to categorise, classify, typify, generalise, compare, contrast and/or rationalise human suicide behaviour represents, in my opinion, mission impossible. That is not to say that a journal article by David Lester (1994) offering a method for studying the lives of those deceased by suicide by application of multiple theories of suicide was not a more than useful exercise. It does make interesting reading.
Ten years on, Leenaars’ (2004) important, 460 page text offered additional insights into understanding suicide that (he argued) are essential for psychotherapists (and others) working in suicide prevention. On his first page, he stressed the uniqueness of each human being: “We must do justice to the fascinating individuality of each person [that] is humankind’s complexity . . . this is as true for suicide as for any behaviour. Suicide is complex.” (Leenaars, 1994: 1). Shneidman (1985) agreed, arguing that “each suicide is an idiosyncratic event . . . there are no universals, absolutes or ‘alls’ ” (Shneidman, 1985: 121). “To understand what [suicidal behaviour] is about, one has to know the problem that [suicide] was intended to solve” (Shneidman, 1985: 129).
Harvard Medical School (2016) Assessing and treating self-destructive behaviours. Two day course, Dec 9-10 2016. Fairmont Copley Plaza Hotel. Boston, Massachusetts
Leenaars, A.A. (2004) Psychotherapy with suicidal people: a person-centred approach. West Sussex, England: John Wiley and Sons, Ltd
Lester, D. (1994) Research Note: A comparison of 15 theories of suicide. Suicide and Life-Threatening Behaviour, 24(1), Spring 1994
Shneidman, E.S. (1985) Definition of Suicide. New Jersey: Jason Aronson Inc.
DEATH: SUICIDE v MURDER
A few nights ago, in bed, I made the effort to get up, find a pen and paper and write down some thoughts about death, murder and suicide.
Recently close to where I live in Belfast, a 91 year old woman, just returning from the Post Office having collected her state pension, was assaulted on the street by a criminal thug and robbed as she arrived home. I believe that this unfortunate, innocent, fellow citizen has survived after being hospitalised but clearly her sense of herself, her personal safety and integrity are “changed utterly” and negatively by her experience. Police afterwards issued a leaflet to folks in our neighbourhood appealing for information, presumably not unrelated to our local streets being included in a voluntary crime prevention scheme called “Neighbourhood Watch”. I hope that the above-mentioned cowardly miscreant is rapidly identified and removed from society until he learns some manners.
Back to death, murder and suicide. Death is “the only certainty” for humans, as for all forms of mortal life – cell, plant, animal and human. Let’s just agree that the life cycle represents “an iron law”, unavoidable and indisputable (https://en.wikipedia.org/wiki/Iron_law) for my garden’s daffodils, as for my late pet dog, Basil, as well as for everyone, including me and you, good reader, who has lived, is living or will live on planet Earth. We’ll leave for the time being extraterrestrial life (per Webster-Merriam “coming from or existing outside the planet Earth” - http://www.merriam-webster.com/dictionary/extraterrestrial).
I’ll try to shorten this up.
Murder, across the globe, is regarded as a crime. The saga of Cain and Abel resonates (https://en.wikipedia.org/wiki/Cain_and_Abel). Each human death is a murder if and when directly attributed to the intentional actions of another or per Dr Google: “the unlawful premeditated killing of one human being by another” (https://www.google.co.uk/#q=murder). And each such death is idiosyncratic. It is investigated, vigorously or otherwise, by governmental agencies seeking to identify the culprit. Lessons are learned or at least attempted by relevant media publicity. As for those left to grieve the loss through murder of a loved one, states generally accept their duty to bereaved citizens to ameliorate their loss by compensation, and, in some cases psychological support in the aftermath. In Northern Ireland, the Victims Support organisation provides this service:
“Victim Support NI is a charity supporting people affected by crime. We offer a free and confidential service, whether or not a crime has been reported and regardless of how long ago the event took place. We are an independent organisation - not part of the police, courts or any other criminal justice agency.” (http://www.victimsupportni.co.uk/)
SUICIDE NOT A CRIME
So that’s alright then. Now let’s look at death by suicide. Here since 1966, suicide is no longer a crime:
“The Suicide Act 1961 (9 & 10 Eliz 2 c 60) is an Act of the Parliament of the United Kingdom. It decriminalized the act of suicide in England and Wales so that those who failed in the attempt to kill themselves would no longer be prosecuted.
The text of sections 1 and 2 of this Act was enacted verbatim for Northern Ireland by sections 12 and 13 of the Criminal Justice Act (Northern Ireland) 1966. The Act did not apply to Scotland, as suicide was never an offence under Scots Law (https://en.wikipedia.org/wiki/Suicide_Act_1961).
In the Irish Republic (variously Republic of Ireland, Ireland, The South) the crime of suicide lasted for over a further quarter century until 1993:
The Criminal Law (Suicide) Act, 1993 at section 2 provides: (1) Suicide shall cease to be a crime (http://freepages.genealogy.rootsweb.ancestry.com/~irishancestors/Law/Suicide.html).”
Just like that – yesterday a crime alongside murder, viz. self-murder, but today not so. Reading the parliamentary debates (Westminster, Stormont, Leinster House – Ireland) leading up to legislative changes from 1961 to 1993 is revealing indeed. More on that may (DV) feature in a later blog, including the recent awakening in UK / Ireland of arguments in favour of legalisation of a so-called “assisted death” movement. Ironical indeed, given our national propensity to ‘assist death’ for political (i.e. power seeking) purposes in Ireland most recently for over 30 years from 1966.
SUICIDE v MURDER
For today, I’ll simply contrast our society’s treatment of suicide with that of murder. Clearly each suicide is idiosyncratic in nature, like any other death event. Police services, representing state resources, refer to deaths by suicide as having “no suspicious circumstances”, in other words, no crime. However, suicidology (“the scientific study of suicidal behaviour and suicide prevention” - https://en.wikipedia.org/wiki/Suicidology) has tended to focus upon prevention, paying most of its attention to what are known as “suicide rates”, then to the attributes of those fellow-humans deceased by apparent suicide, and finally to supposed cause/effect relations between a ‘do nothing’ approach and the material / psychological elements of ‘suicide prevention’ strategies. Unfortunately, psychological autopsy, the method most often relied upon in related research, is deeply flawed:
“. . . as a diagnostic tool psychological autopsies should now be abandoned. Instead, we recommend qualitative approaches focusing on the understanding of suicide beyond mental disorders, where narratives from a relatively high number of informants around each suicide are systematically analyzed in terms of the informants’ relationships with the deceased (Hjelmeland et al., Death Studies, 36: 605–626, 2012).
The incidence of death by suicide, represented in statistics, is as reliable as the human, bureaucratic recording systems that generate them. Making comparisons across countries based upon “suicide rates” may represent a waste of time and effort:
Incidence of suicide tends to be under-reported due to both religious and social pressures . . . and possibly completely unreported in some areas. Since the data might be skewed, comparing suicide rates between nations is statistically unsound. (https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate).
One of the dominant stupidities of suicidology is its reliance upon comparisons, its search for commonalities, and its quest to generalise causes of suicide – most culpably represented in the ludicrous notion that all suicides are rooted in mental illness/disorder/disease. I tend to share Heidi Hjelmeland et al’s view that suicidology needs a paradigmatic shift from quantitative approaches (i.e. counting them) to “qualitative approaches focusing on the understanding of suicide beyond mental disorders” (cited above).
EACH SUICIDE IS UNIQUE
Each suicide needs investigated by the state “as if” it was a murder, albeit self-murder. Only when each citizen, from birth to death, is valued equally in social systems that render ‘profit’ below ‘people’, will our society begin the journey towards arriving at a deeper understanding of the human behaviour called suicide. This may not happen or even begin to happen anytime soon. Still Carroll and McCann (People before Profit Party) were recently elected to our local legislature. So don’t give up . . . . never give up.
REASONS TO CHANGE HOW I AM LIVING, BEHAVING, BEING IN THE WORLD
There’s one great reason and it’s about integrity – to match my ‘walk’ to my ‘talk’ starting today, now.
I spend too long every day achieving nothing more than existing for another day – another day older, still lonely, low mood, unhappy, frustrated, dissatisfied, tired out, feeling aches and pains, fixed on a screen, or lying around dozing in the chair.
Until just now I failed to connect my online life with this sad, unfulfilled ‘actual’ life, my short life. And it’s the time-wasting, unproductive online life that is killing me.
Listening to Eckhart Tolle’s short video, I related most strongly to his bubble metaphor. Each bubble floats free in the air moving about as the breeze takes it. Yet a child’s finger reaches for it . . . . touches it . . . . and it’s gone . . . . just as if it had never been. Eckhart’s notion that each of us, me in particular, is represented in that bubble metaphor: now in this moment you’re here, you seem to have some sort of actuality, an existence . . . . for a few wet days and then an instant later . . . . gone, emptiness, formlessness replaces each of us . . . . and I’m in that moving flow of human bubbles awaiting the child’s touch. . . . but totally denying that reality in how I live my life.
It’s good therefore to be blessed with this timely insight. Question is what am I going to do about it today.
Philip O’Keeffe PhD©2016
Since July 2015 I've attended several CPD meetings to meet professional accreditation criteria. Most recently, on 11 Nov 2015, I participated in a 'free' seminar organised by Contact, a N Ireland charity that administers a 24 hour telephone help-line - Lifeline - for the vulnerable and/or at risk of suicide. If you're familiar with the Samaritans listening organisation, Lifeline listens, but also seeks with the caller's informed consent and when judged appropriate, to engage in a therapeutic mode. A Lifeline telephone counsellor may offer face-to-face counselling, by a colleague, that is described as 'wraparound'. In short, a Lifeline counsellor may become an available, accessible provider of brief family therapy (up to six sessions). I'm unsure of Contact's training syllabus, but Lifeline's approach appears to be influenced somewhat by David Jobes's Collaborative Assessment and Management of Suicidality (CAMS) model described as "a collaborative . . . approach to assessing and managing suicidal risk [that emphasises] individual differences in treating suicidal clients [accepting] that there is 'not a one size fits all way of understanding all suicidal people' ”. (www.psychalive.org). You can get much more about this approach via the afore-mentioned website.
One serious issue for therapists in "helping people at risk of suicide" is the quality and depth of their informed compassionate empathy, including aptitude, education/qualifications, training and effective hands-on experience. I'd be interested to learn from colleagues about how well they feel that they meet these criteria - I would argue they're necessary but perhaps not sufficient - for working effectively with souls at risk of self destruction. Why not sufficient? For the most obvious yet largely intractable of factors: establishing connection with these almost invariably isolated souls who often suffer unbearably yet in silence behind a mask of 'normality'.
Helping theory has demonstrated beyond any doubt that I cannot help a fellow human without establishing and maintaining an effective therapeutic relationship. I recommend the late Dr Israel Orbach's approach (article available on request from me or your local library) "Therapeutic empathy with the suicidal wish: Principles of therapy with suicidal individuals. Israel Orbach. American Journal of Psychotherapy; 2001; 55, 2; 166-184. Read what Dr Orbach says about his 'uncompromised confrontation of self-destructiveness' and how you can learn to work compassionately and more effectively with the client at serious risk.
One final point re the November 2015 Contact seminar. One attendee describing himself as a psychiatrist, stressed the individualistic - I would use the term idiosyncratic - nature of human suicidality, defined as 'tendency towards intentional self-destruction'. Each of us is a unique representation of the species, and worthy of inestimable respect as such.
I plan to complete and submit the lengthy consultation document on the future of the Lifeline service to the DHSSPSNI. At the outset, I cannot envisage the NI Ambulance Service as a suicide prevention organisation. Further, my view is that bottom line GB government austerity considerations appear to hover like a thunderstorm over the current Contact-managed, much admired, effective and efficient life-saving Lifeline service. I shall argue accordingly in my submission.
YOU WANT TO HELP? THEN GET THE LIFELINE CONSULTATION DOCUMENT COMPLETED AND SUBMITTED IN TIME - BY THURSDAY 19 NOVEMBER 2015 LATEST.
Just a brief note about one 'death by suicide' known to me that has again come to my mind in recent days. In this case a long past, seriously abusive experience may have been an early initiator, a primary generator, a first cause that years later killed a good man long before his time. I say 'may' because there's no way directly and/or conclusively to attribute a 'cause/effect' relationship between this historical abuse and his self-destructive behaviour. And his death was quite unexpected and 'out-of-the-blue'.
Imagine that you, a young 'black' man, aged about 16 years, one of a family of nine, live peacefully, legally and respectfully in a 'white'-dominated lower middle-class UK neighbourhood. You are the youngest of seven siblings, six boys and one girl. Because you are 'black' you, like your siblings, go to a 'faith' school across town wearing your school uniform. Each school-day, you walk 'against the traffic' as it were, to a bus stop 400 metres away while local youths, alighting from a bus, walk from an adjacent bus stop past you en route to a 'state' school nearby. Similarly, you complete your return journey home 'against the traffic' as 'state' school students hurry past you en route to their bus.
Your older brothers and sister have never experienced any difficulty en route to or from their 'faith' school other than the effort to catch a bus to town in time to reach class or to get home in good time. In any case, by this time, all your siblings have 'left home' and you live with your now elderly parents.
However, one day in the early 1970's without warning, on your way home after stepping off the bus and almost home, you are attacked and seriously assaulted by unidentified person/s. Passers-by help you home. The assailants are not identified but are described as being state school students by way of their distinctive school uniform. For unknown reasons, police are not informed about this crime by the 'Samaritans' nor by your family.
A few years before the incident, a serious, violent, long-lasting (1966-1998) political conflict had erupted in the UK region where you lived . Your family members have never been involved in anything unlawful - indeed several of your relatives have served with honour in local and overseas state police services. Nor are they actively 'political' other than in voting in state elections.
During your remaining school-days and until you acquire a motorcycle and attend university, you are 'escorted' by your father or a sibling or a friendly neighbour to your school bus. On your return journey, you alight from your bus early and stay in a friend's house (the H family) until you are again escorted home.
Although the incident was reported by phone shortly after the event by one of your siblings to a senior school staff member (unidentified, refusing to give his name) this person dismissed the incident, noting that as it allegedly took place away from the school campus, involved unidentified assailants, and was not (yet) reported to police, nothing could or would be done by the school. This was stated defensively and without any expression of sympathy for the injured person.
About 15 years later, the victim of this assault died by suicide. It's clear to me, based on my own detailed knowledge of the victim, his family, the local neighbourhood and a then current, poisonous lawlessness feeding off a 'low risk of detection', that this assault was carried out by aggressive, criminal bigots. The assaulted person would have been identified to his bigoted assailants as 'one of them' (a hated minority 'black' outsider) by his school uniform.Since the victim was on his own, these cowards were able to carry out their dirty, unprovoked assault without fear of detection or redress.
I think about this unsolved crime often. I deeply regret that it may well have been an unfair, unjust, illegal 'lighting of a fuse' that created at least a contextual element for the catastrophic, personal explosion that killed an innocent man years later.
I wish that I had been able to do more at the time of the assault and afterwards. Requiesquat in pace (1989).