Updated: Apr 20, 2021
This story is based on Shneidman’s “psyche ache” and its source in physical, biological, spiritual and social relationship difficulties. The focus is on “cause and effect” efforts to understand suicide. First, something on the term itself.
Suicide is a mode of death that’s been with us throughout human history. It was largely treated as a stigmatized death, often criminalized or treated as a mortal sin. The word was not coined until the mid-17C in search of a more neutral, less judgmental term for acts of self-killing. Two Latin words (sui = self; cide = kill) were linked to replace disapproving phrases like “murdering oneself”. Over time, the intended neutrality was re-stigmatized with all the old negatives.
“ Suicide is a mode of death that’s been with us throughout human history.”
Our scientific and lay person understandings of linear and non-linear cause and effect guides a great deal of what we think and do about suicide. Thinking that suicide (effect) is caused in a linear way expects cause and effect to be proportionally connected. If depression is considered a cause of suicide, linear predictability would expect minor depressions might lead to a minor outcome (e.g. thoughts but not unbearable mind pain; minor but not a fatal injury). If an imminent terminal disease was seen as the cause of a pre-emptive suicide, the proportional similarity would see it, for many of us, as justifiable and acceptable.
When a small causal factor leads to a disproportional effect (suicide or serious injury), the response tends to be negative, perplexing, unacceptable, scornful, etc. because the effect is not proportional to the cause. If a large causal factor occurs and the result is no thoughts of suicide or self-harm, the outcome is applauded as a miracle, the result of extraordinary resilience, etc. Linear thinkers would say suicide should have occurred except for divine or chance intervention. The possibility of an acceptable non-linear result would not be entertained.
"When a non-linear perspective is applied both proportional and disproportional outcomes can be recognized."
When a non-linear perspective is applied both proportional and disproportional outcomes can be recognized. A small disturbance in a person’s life could trigger an impulsive and unexpected suicide. Conversely, a small gesture of support at a critical moment could rapidly counteract the likely suicide outcome of a person at heightened risk.
As lay or professional/scientific people, we’ve largely been educated and socialized to expect linear cause and effect explanations of almost everything. Scientists continue research for the precise predictors of suicide. Dispelling the dominance of linearity is not easy. When we embrace non-linearity, leading-edge pursuits become exciting and worthwhile. “Thoughts of suicide” at the beginning of a causal web are likened to a significant non-linear bifurcation (e.g. fork in a road) ‘triggered’ by almost any initial condition relationship connection that ‘flips a switch’ from ‘no thoughts of suicide’ to ‘conscious thoughts of suicide’. Once this occurs, the causal web is activated. All suicide possibilities are possible. This is why serious attention is given to the presence of conscious thoughts of suicide. What’s behind this choice is not the ‘root’ cause, but more likely to a relationship pattern connected to biophysical, social, spiritual difficulties and mind pain that might be modifiable to the point of a bifurcation that turns off the suicide switch. A metaphor related to the off/on ramps of a freeway helps to visualize the bifurcation switches in a non-linear process. What causes the entering and exiting is not precisely predictable, but once on an ‘on’ ramp, suicide risk is on an accelerating pathway.
"If we stick to traditional linearity, we will always be public apologists about the absence of precise predictability."
If we stick to traditional linearity, we will always be public apologists about the absence of precise predictability. Credible state-of-the-art knowledge will quickly erode. Becoming grounded to a non-linear perspective will give us credible confidence to say that a lot is known about inter-connective conditions that can, at sensitive dependent moments in life, trigger the suicide switch. As suicide-safer living advocates, we will be honest about the lack of precise predictability but with leading edge confidence in knowing how to recognize psych ache invitations and how to find out if the suicide switch is on. If on, we have a range of knowledge and skills that will equip both people with thoughts as well as caregivers and societal norm makers with the ability to foster sensitive dependent bifurcations in helping to turn the suicide switch off for short (safe-for-now) to longer (recovery to growth) periods.
The story ends as a suitable fit with one of Shneidman’s good news statements, “seen in this light, almost every case of heightened lethality and elevated suicidal risk is potentially amenable to psychotherapeutic redress”. And, from the LivingWorks network of safety perspective, it would include the collaborative engagement of suicide first aid responders, natural supports and other societal resource supports along with changes in cultural norms to effect sustainable suicide-safer living.