Suicide Prevention

Suicide prevention

In quad 2, a speaker from 113 came to EUC to give a talk about suicide prevention. Not many people attended. We think it is crucial to be able to talk about this, discuss and face the reality of it and deconstruct the taboo around it.

What we will do in this article is summarize some of the topics discussed in the workshop, while also integrating some personal experiences (this will be written in italics so you can skip over it easily if you are not interest in it). Hopefully you will find some useful information and at the end I will list some contact numbers and websites you could reach out to if in need.

Disclaimer: we are in no way a mental health care professional, so we've written from our personal experiences and integrated it with the information of the workshop. We have asked Katie, our student counsellor to look over it, and integrate/correct any missing information.

The times we are living in are strange and uncomfortable. We are also going through a very delicate and unique age in our lives. However, we might play it down, find it cool and exciting it can also be scary.You are officially an adult, you have to take care of yourself, pay your bills, clean your home, cook decent meals, study and pass exams, find new friendships and people to surround yourself with. And then sometimes there come these awful existential questions that seem to take over your mind and freeze you into inaction and self-doubt,

“What am I even doing with my life? Is this who I want to be? Should I have done something differently? Do I like who i am becoming?”.

In these covid times, we think it is especially hard to face these questions, to discover what you like, what motivates you, what drives you. Life can feel empty, difficult and lonely. We all have moments where we just don’t see the point, we cannot push ourselves to put in the effort to do, experience and feel because let’s face it, it is not easy.

Most of us at some point in our lives will think about ending it, taking the “easy way out”, to just be done with it. According to the WHO, around 800,000 people commit suicide each year, in the Europe region that number stands at 128,000, and for every successful suicide, there are approximately 20 attempts. That equates to approximately 2.5 million attempts each year in Europe alone. We do not aim at depressing you with these numbers - what we would like to get across is that this is not an individual problem. You are not alone, many people feel alone and isolated and alienated.

There are various stages to the process, suicide is not a thing that just pops up in one’s head. It is usually quite painstakingly thought about and premeditated. As illustrated in the picture below the first stages are invisible, but crucial. It is here that talking, asking, and engaging in the difficult conversation should take place.

Thoughts are very common and happen to many, not that that isn’t worrying, but often most people do not really wish to act on these thoughts, they are aware that it is a passing cloud, they do not really want to make an end to their life. Nevertheless, these thoughts can be extremely invasive, intrusive, violent, and crippling. It is crucial to address these thoughts and deconstruct them, to question them so that they do not become dogmas and absolute truths. Thoughts can easily cement themselves in someone’s mind. We have all at some point experienced a negative spiral of thought you can get stuck in, like: “I’ll never be able to pass this exam, I’ll never pass this course, I’ll fail at uni, I’m stupid and worthless, I’ll never find a job and be proud of myself…”. For some it is easy to stop the process in its tracks and prevent it from slipping downhill, for others this is extremely hard. Cognitive distortions play a large role in this, we generalize, focus on the negative, and predict the future, assuming the worst.

Cognitive behavioural therapy (CBT) is one of the most widely used therapeutic instruments that aim at putting into question negative beliefs, thoughts, and assumptions. It is an easy tool that can be used by anyone, it requires some time and consistency but has been ultimately shown to be successful. In the box below, we will outline how a common exercise works with an example. We highly recommend you try it out. The purpose is both that of giving you a different look and deactivate cognitive distortions, as well as lowering your emotional level. Often when we are stuck in a negative thought pattern, everything seems overwhelming, dark and hopeless, we are deeply handicapped in these situations to think logically and rationally and a simple exercise like this can help to make more sense of our thoughts.

WISH

However, in some cases there is an actual wish, suicide is really seen as the solution, often the only one. It has been observed that when there are three factors combined the wish gets transformed into a plan. All three are quite common, we might all feel lonely, misunderstood or a burden to others at times, the danger zone is entered when these thoughts become constant core beliefs and all three co-exist.

As shown in the diagram, the three factors are:

1. Feeling alone, different, misunderstood, alienated and like you do not fit in. Feeling like you are not contributing in any way to the world, your social contacts, family, work, study.

2. Feeling like a burden to others. Like they would be ultimately better off without you, even if they might tell you otherwise. The role of friends and family is crucial here, repetition is key, giving compliments and small acknowledgments can really make a difference.

3. Not being afraid of death and feeling that one is capable of actually going through with the act.

PLAN → PREPARATION → ATTEMPT

When a plan is made there is a mental envisioning of how things would go. When, where, and how. At this stage there is usually a strong perseverance to go through with it. You might notice in yourself or in the person you are worried about that they become calmer; it may seem like they are doing better. In the person’s head the turmoil and indecision has ended, a decision has been made and they are at peace with it. The next phase is that of a concrete preparation, which might mean acquiring the tools needed, writing letters, tying up loose ends. The following stage is the attempt which might result in a suicide.

When engaging in a conversation about this topic or when you yourself are struggling it is crucial to become aware of what stage you are in, how far you would go and how specific all the details are.

To be more explicit I will give you the example of myself. I have had thoughts about suicide since the age of 10, and they were not just thoughts, I really wished to be dead. However, when I was younger, I was still very much afraid of the idea of death, so I never envisioned or made a plan; I dwelled in the second stage. Later in life I lost this fear and that is when I started to see a course of action take form. The thing that I believe saved me was the feeling that I would hurt my friends and family. I was painfully aware of the excruciating despair death could cause, as one of my best friends passed away in a car accident at the age of 18. Even after four years her parents still carry her urn everywhere with them, they will never completely recover. I did not want to be a catalyst for such pain and so my plan remained a plan.

113 has put together this recapping pampleth for people who are in contact or are worried about someone in their surroundings:

It can be very intimidating and scary to engage in such a conversation. There is the fear of saying the wrong things, of triggering someone, of putting ideas in someone’s head and of getting personally too sucked in.

There is an affective technique that is used, not only in these situations, but other difficult engaging talks as well, it is called reflective listening:

In a conversation where you engage with this type of active listening, you show interest, empathy, and attentiveness, using both body language and verbal affirmation. Often people in a despairing state are confused and will not be able to grasp fully what is going on in their head, therefore it is crucial that you listen and report back, paraphrasing what you understood from them. This will help to avoid misunderstanding and give more clarity to the speaker themselves. Often hearing someone else say out loud their thoughts can be triggering and will help them understand the severeness of the situation. It is important that you also add the implicit, do not be afraid to communicate to them what you think they might be feeling or thinking of doing, direct, concrete, and precise answers can be extremely helpful and relieve the burden from the speaker to actually have to pronounce such dark thoughts.

At the end try to summarize what has been said. Try to not pronounce any judgement or any of your own feelings, this will help the speaker feel safer and it will help you to maintain a less intense emotional involvement, which might not be beneficial at this time.

SAFETY PLAN

Make a safety plan or make one together with your friend/family member you are concerned about. It might be extremely helpful to sit down, take your time and do it together with someone you care about, feel loved by, as this process can be extremely intense.

The dutch suicide prevention organization 113 has an online form that is easy to fill out: https://www.113.nl/sites/default/files/113/2020%20middelen/Veiligheidsplan%20113.pdf

The form however is only in dutch so we will here give an English overview of what it entails, so that if you feel the need or want you can make your own safety plan:

We hope that this piece has been helpful to you or anyone you know who is exploring thoughts of suicide. Please contact a trusted healthcare provider for further advice.

With love,

W&J Co