The metaphor of a ‘suicidal career’ in the literature of suicidology is an attempt to highlight the multi-dimensioned complexity of a suicidal history. It can be a useful metaphor if we use it to learn the most important lesson in any study of suicide, which is to be extremely wary of any sweeping generalisations about why someone chooses death rather than life. It also encourages us to think about suicide in a more holistic manner that encompasses the whole person – their body, mind and spirit within a complex social and historical context.

Although my own story is perhaps an illustration of a suicidal career, I am personally uncomfortable with this metaphor. It defines me too much in terms of my suicidal history so that it feels like one of those sticky labels that we find so often in mental health where only the label is seen and the person behind the label becomes invisible. And like some other mental health metaphors, most notably the metaphor of ‘mental illness’, it can become a dangerous myth if taken too literally.

There are many myths around suicide and they tend to fall into two categories. The popular myths are those found in the general community and are based largely on fear and ignorance which, given the taboos around suicide, is hardly surprising though still hazardous for the suicidal person. The professional myths are those you will likely encounter from the professionals you might turn to for help if you are feeling suicidal, and also suicide prevention academics and bureaucrats.  You will find much fear here too, though it is often suppressed by a silly – and distinctly unhelpful – attitude that it is unprofessional to reveal to your clients the fears you feel.  And rather than the ignorance that feeds many of the popular myths, it is typically prejudice that underpins many of the professional myths.

I’ll first mention some of the more pervasive and harmful popular myths but it is the professional myths that follow them that are of greatest concern.  It is the professional myths that lie behind the often inadequate and sometimes harmful interventions we currently find so that, in the end, they are some of the biggest obstacles to more effective suicide prevention.

Popular Myths

It is common in any discussion about suicide to mention some of the popular myths around suicide.  Here’s a sample from a quick scan of the internet:

• People who attempt suicide are just selfish or weak.
• People who talk about or attempt suicide are just trying to get attention.
• People who talk about suicide do not kill themselves.
• People who attempt suicide are crazy.
• People who talk about suicide are trying to manipulate others.
• When people become suicidal, they will always be suicidal.
• Most suicides occur without warning.
• You should never ask a suicidal person if they are thinking about suicide because just talking about it will give them the idea.

These are all common but false beliefs about suicide and there’s plenty of others that you’ll find mentioned in the suicide literature, where you will also find more accurate information to counter these myths.  But there’s also some others that only rarely, if ever, get mentioned.

It can’t really be that hard to kill yourself

A good friend of mine was once tactless enough to say that if he was going to kill himself then he would make sure he got it right first time. In fact it is quite difficult to extinguish the life force within us, especially with modern emergency and medical services. A topic that is much discussed among suicide prevention experts is the lethality of the various methods people use to try and kill themselves. For instance, firearms and throwing yourself under a train are particularly lethal (reliable), hanging and jumping from high places less so but still very dangerous, and drug overdoses are notoriously unreliable. Despite this, I’ve met two people who have put a rifle under their chin, pulled the trigger and survived and many people have jumped from high places and also survived. One of the hazards of trying to kill yourself is that if you survive it you might also find yourself maimed with serious and permanent injuries.

The only genuine suicide attempt is a successful one [2]

The myth that it is easy to kill yourself feeds a more serious myth that the only genuine suicide attempt is a successful one, which in turn can be found behind some of the other most popular myths, such as it’s just attention seeking. This myth is a especially offensive to those of us who know the seriousness of our intent when we tried, but failed, to kill ourselves. It becomes a particularly insidious myth, though, when we find it among the professional myths discussed below.

Suicide is a cowardly act … taking the easy way out …

These myths are a bit like the myth that a suicide attempt is just a cry for help. I admit to being cowardly about pain and not having the courage to jump from a high place, but this is more about the choice of suicide method rather than the choice to die. And although some suicides are probably spur of the moment impulses – though this is also another myth looked at below – I suspect most suicide attempts, such as mine, come after a long and painful struggle. Such a struggle should be respected even if you disapprove of the suicide that it might eventually lead to. Similarly, to suggest suicide is taking the easy way out is really quite peculiar. It is a very serious decision that I think few people take flippantly. On the contrary, it would be far more helpful if struggling with the decision to live or die was recognised as a heroic struggle.

People are grateful (relieved) when they survive a suicide attempt

Although this is undoubtedly true for some people, it becomes a myth when it is generalised to always be the case. Like many others, I was profoundly disappointed when I found myself waking up in hospital and furious with those who revived me. There is no sense of failure quite like failing at suicide. When this myth is made as a universal generalisation, what it really reveals is a denial in those who utter it, a kind of stubborn refusal, to accept the reality that some people choose to die. Such head in the sand attitudes are not helpful.

Suicide is a youth problem

Although this myth is thankfully fading as the real data becomes more widely known, it still persists. Its origins can be traced to the alarm that was raised, quit appropriately, about the increase in the rate of suicide among some young people, especially young males in rural areas, during the 1980s and 90s. This was exacerbated by the understandable concern we have when a young life is lost. Indeed, Australia’s first suicide prevention program that emerged around this time was specifically focused on youth suicide. But the real data shows that suicide is not particularly a youth issue. And the good news is that, although still of concern, the alarming rate of increase in youth suicides appears to have turned around in recent years.

Suicide is immoral, sinful

This myth is particularly prevalent and particularly unhelpful. Moral or religious – or indeed legal – taboos offer little protection against suicide. While religious fears of sinning may protect some believers (though clearly not all), they are simply irrelevant to many of us these days. There was no moral anguish in my suicidal contemplations, no right or wrong, no good or bad. I was simply looking for a way out of my pain. Negative moral or religious value judgements about suicide are not only a major obstacle to a better understanding of suicide but also an obstacle to helping the suicidal person. I would never seek help from anyone who regarded suicide as sinful or immoral. It’s not all that long ago that our legal system learned this and suicide was decriminalised so that it could be addressed as a health, not a legal, issue. Unfortunately, the professionals we seek help from are not required to disclose their own moral or religious beliefs about suicide, which can be a very big problem.

Depression (a chemical imbalance in the brain) is the major cause of suicide

The popular view that depression is the main cause of suicide is the most serious myth about suicide and the biggest obstacle to a better understanding of it. This myth and also its bastard cousin, the myth that depression is a chemical imbalance in the brain, are not based on any solid scientific evidence but rather on a sustained public relations exercise by the professionals. This is examined a little further below but also at greater length in the mental health chapter later on.

Professional Myths

The only genuine suicide attempt is a successful one – revisited

You will find in the suicide literature an argument that suicide prevention should focus on completed, successful suicides rather than unsuccessful suicide attempts. One reason offered for this is the rather pedantic view that, by definition, suicide requires a real death. A related argument is that unsuccessful suicide attempts tell us very little about ‘real’ – i.e. completed – suicides. There is a common taxonomy among the experts that distinguished between suicide contemplators, attempters and completers as though they are three very different kinds of behaviours, or indeed three very different kinds of people. Such assertions are actually contradicted by the common knowledge that contemplating suicide is a precursor to any suicidal act and that, indeed, one of the strongest indicators of risk for successful suicide is a previous, unsuccessful suicide attempt. Not many people suicide successfully their very first time. This myth is not only the source of its popular equivalent mentioned above but also numerous other harmful popular myths. Of more concern, though, is that this myth limits the scope of our enquiry into why people suicide to a very narrow perspective.

Suicide is an impulsive act

You will also find in the suicide literature the claim that suicide is an impulsive act. The problem with these studies is that they only look at the time between finally taking the decision to kill yourself and then acting on it, which may indeed be quite a short time. But this helps little with our effort to understand why people choose suicide which, as mentioned above, usually follows a long and painful struggle of many months or years. As with the previous myth, this myth narrows the scope of our enquiry far too much. We need to investigate the source of suicidal feelings and the often long gestation period between them first arising and finally, if ever, acting on them.

Suicide is a violent act

Yet another myth found in the expert literature is that suicide, like homicide, is a violent act. Karl Menninger summed up his theory of suicide as Selbstmord, or ‘self murder’, also described as “murder in the 180^th degree”. Although this concept may sometimes be useful for psychoanalysing the motives behind some suicidal urges, it falls into the common trap of being a sweeping generalisation. It also implies a violence that does not correspond with how many people describe their suicidal feelings. While some suicides probably do occur in a fit of frenzied passion, my own experience was that the actual moment of taking that ‘killer hit’ was really a moment of extraordinary calm. Once the decision has been made and all the preparations taken care of, a sense of relief and even peace can arise when at last the moment comes when all your struggles are finally over. I have heard of others who report similar feelings of calm at this critical moment – indeed this brief moment of peace can sometimes be enough to change your mind. But the myth of the violent, suicidal frenzy persists.

We must teach our kids that suicide is not an option

This myth particularly irritates me. I first heard it one morning on the radio from a well known child psychologist and it made me sit up in bed screaming “Noooo!” At first glance it seems reasonable enough, one of those seemingly obvious mum and apple pie home-truths. But not to my ears. To me it was not only untrue but dangerous. Suicide is a solution. If you kill yourself the pain will stop. Guaranteed! In saying this, I am not in any way advocating suicide, but he should have said that we need to teach our kids that there are better options. This may seem like hair-splitting, but consider the consequences. I know that I would never seek help from someone who thinks this, which is just another denial of the validity of my feelings. If I am seriously considering suicide then I already know that it is a very real option. And I also know that a person who does not understand this cannot help me. By making this bold assertion, almost stamping his feet in protest, this psychologist automatically makes himself irrelevant to those he seeks to help.

Suicide is a gendered issue

You don’t often hear this myth explicitly stated but it is sometimes lurks just below the surface of some genuine gender issues in the suicide literature. One occasion when I heard it stated explicitly was a keynote speaker at a suicide prevention conference who said that suicide is predominantly a male issue. His argument was based on well known data that shows a four to one ratio between male and female suicides in most countries around the world (China and India being two notable exceptions). This is a huge difference between the sexes so his argument conceivably had some credibility. But it is contradicted by equally well known data showing an almost reverse ratio of typically around three female suicide attempts for each male attempt. The first problem with this myth is that it implicitly assumes the myth that the only genuine suicide attempt is a successful one. But the real gendered issue is not that men are more frequently suicidal than women – on the contrary – but that men tend to use more lethal means when they do decide to kill themselves. Once again the need is to focus on the full history of suicidal feelings rather than just the act of attempting suicide, whether successfully or not.

Depression is the major cause of suicide – revisited

Suicide is usually regarded as a mental health issue, which in turn associates it with so-called ‘mental illness’. These are all assumptions – more myths – that are central to what this book seeks to challenge, so later chapters looks at these issues in greater detail. For now, I just wish to highlight that it is a professional myth that is the origin of the pervasive popular myth that depression is the major cause of suicide. Although heavily promoted by the medical profession and drug companies, there is little scientific evidence to support the claim that depression is a genuine medical illness that causes suicide. Advocates of this position confuse correlation with causation because so-called depression, like suicidal feelings, is just another set of symptoms of psychological distress. The great disaster of this myth is that once the professionals assume that depression is the cause rather than just another symptom, they then look no further for whatever the real causes are. And then, typically, they resort to the biological ‘solution’ of drugs rather than addressing the psychological, social and spiritual roots of suicidal feelings.

Suicidal behaviour justifies involuntary medical treatment

This myth follows directly from and relies on the previous myth, which can be re-stated as the myth that suicide is primarily a medical issue. Once all these mythical assumptions are made it then becomes a small step to claim that suicidal people need medical treatment. Another not so small step then typically follows that says we must take this medical treatment regardless of whether we consent to it or not. The argument here is that this enforced medical treatment will save lives but, once again, there is no real evidence to justify this assertion. If the same rules for testing the efficacy and safety of other medical procedures were applied to forced medical treatment then the lack of evidence for it would simply not permit it. On the contrary, there is a strong common sense argument, as well as a recognised human rights argument, that forced medical treatment does more harm than good. I have come to the view that mental health laws such as we have in Australia actually contribute to the suicide toll rather than reduce it. But no-one even dares to investigate whether this might be so.

Conclusions

Although the human rights issues around psychiatric force occupy much of my time and energy these days, they are not the focus or purpose of this book. The purpose of my study of suicide following my recovery was to examine suicidal distress as a crisis of the self rather than the consequence of some notional mental illness. In particular, I wanted to give voice to spiritual needs and values, and spiritual ways of knowing, as relevant and important for our effort to understand suicide better, at least in some cases such as mine. These themes make up the latter part of this book.

But before we can get there, it is necessary to expose and debunk the many common myths and misunderstandings that currently contaminate any discussion of suicide, not only in the general community but amongst many of the professional experts. I have briefly discussed some of these myths here but there are other, even more fundamental myths that also need to be exposed.

As I studied the academic and professional discipline known as ‘suicidology’, what first jumped out at me was the almost complete absence of the actual suicidal person. With just a couple of notable exceptions, you never heard directly from the suicidal person in their own words. The first-person voice of those who had actually lived the experience of suicidal feelings was apparently not on the agenda of suicidology. I was bemused and stunned by this but further study soon showed that this was no accidental oversight but rather the inevitable consequence of ideological assumptions at the very foundations of suicidology.

One of the major references in suicidology is the Comprehensive Textbook of Suicidology edited by three of the best known people in the field. They define suicidology as “the science of self-destructive behaviors”, asserting that “surely any science worth its salt ought to be true to its name and be as objective as it can, make careful measurements, count something”.  Furthermore, “suicidology has to have some observables, otherwise it runs the danger of lapsing into mysticism and alchemy”.

This definition of suicidology effectively excludes the first-person knowledge and expertise of those who have lived suicidal feelings by rejecting them as invalid data. The first-person ‘data’ are not observable or measurable and therefore, in the eyes of suicidology, not objective and must be excluded from the discipline. But a science of suicide based on these assumptions will at best only give a partial and incomplete understanding of suicidal thinking and behaviour.  Something vital will always be missing.  An understanding of the lived experience of suicidality and what it means to those who live it is needed to complement and complete the efforts of suicidology to understand, explain, predict and prevent suicide.

Suicidology’s prejudices against the first-person voice – i.e. first-person data, knowledge and expertise – are neither rational nor scientific. Rather, they need to be seen as an ideological commitment to what some call scientism, an obsolete view of science that recognises only one kind of knowledge. This is the same scientism that we find in the medical profession and its hierarchy of what constitutes valid scientific evidence, which may be fine for testing new drugs but is simply inappropriate for understanding the dark invisible interiors of the lived experience.

So the first challenge in my studies was to argue for the legitimacy and importance of the first-person voice of those who have lived suicidal distress, and I wrote some formal academic papers making this argument. But the most important expression of this argument is to give voice to my own experience of suicidal despair through this book. The aim here is not to attempt any generalisations from my individual, personal experience but rather to contribute my story to the meagre body of first-person data currently found in suicidology. A second purpose is to use my story to draw attention to some serious shortcomings in suicidology.

When it came to spiritual needs and values and spiritual ways of knowing, their absence from suicidology was even more complete than the absence of the first-person voice. This can be illustrated by quoting again from the Comprehensive Textbook of Suicidology where in the preface the authors acknowledge “the immense intellectual and spiritual debt that we all owe to our mentors and friends”. Spiritual values and needs, it seems, play a part in the writing of a book but otherwise receive no other mention in the 600+ pages of what claims to be a Comprehensive Textbook of Suicidology.

To conclude this chapter on the many myths about suicide, the most serious and most harmful myth is the fallacy of scientism at the foundation of suicidology. I have the greatest respect for traditional, empirical, so-called ‘objective’ science, when it’s practised well. The many benefits of this way of knowledge are obvious. But science becomes scientism when it claims objective knowledge as the only valid knowledge and excludes other ways of knowing. This is not good science, it is not even rational. It is ideological, which makes the argument against the prevailing ‘collective wisdom’ of suicidology not just an intellectual argument but also a political one.

It hurts me personally when I encounter suicidology’s blind faith in scientism because it denies me the validity of my own experience and my own understanding of my suicidal history. This blindness by the experts is especially hurtful in its denial of the spirituality that was the source of my recovery and central to my wellbeing as I live it today.

But more than any personal hurt for me, the scientism of suicidology perpetuates many of the harmful myths about suicide and, with them, a shallow and inadequate understanding of what drives some people to choose death rather than life. This is a calamity. Many people continue to take their lives needlessly because of suicidology’s ideological commitment to an incomplete and inadequate view of what constitutes valid knowledge. Many people are being deceived into taking drugs and other interventions that often don’t help and are sometimes harmful, especially when forced upon them without consent. For some, these abuses from those they seek help from at a time of deep despair can push them over the edge into suicide. But most of all, people struggling with suicidal distress are not having their struggle respected as it should be and are not receiving the kinds of assistance that would help many of them. The many myths of suicidology are in fact part of the problem of suicide in the world today, rather than part of the solution.

---