Mass suicide: historical and psychodynamic considerations

Mass suicide can be defined as the simultaneous suicide of all the members of a social group and is closely linked to the human dimension of existence, although the social and cultural context may vary. In fact, the term mass suicide can also be used to describe situations in which a particular population has reacted to oppression by denying all normal activities of sustenance, with the intention of bringing about a traumatic metamorphosis in a cultural context (colonization, exploitation by other populations), thus transforming a catastrophe in which a passive role is played into one constructed actively. Therefore, mass suicides can be subdivided into two categories: (a) hetero-induced, typical of defeated and colonized populations forced to escape from a reality that does not acknowledge their human dignity and (b) self-induced, in which the motivation is related to a distorted evaluation of reality, without there being either an intolerable situation or a real risk of death. The mass suicides that have taken place in the last 20 years are all related to the establishment of religious sects; the mystic delirium created within the sect leads to the self-destruction of the group as being interpreted as an act of self-assertiveness.     

Rational suicide: a test of the prescriptions of Epicurus concerning suicide

The purpose of this research was to test the hypothesis that the individual who believes death is the end and who expects to experience more displeasure than pleasure over the remainder of his life will choose suicide. College students (N = 272) completed questionnaires measuring their beliefs about after-life, expectations of pleasure and displeasure should certain negative events happen to them, and expectations of suicide should these negative events happen to them. Support was not found for the hypothesis. The students who believed that death was the end stated that they would choose to live even if negative events promised them a life of greater displeasure than pleasure.     

Rational suicide among the elderly.

Old age, in and of itself, should never need to be a cause for self-destruction. But suicide and assisted suicide carried out in the face of terminal illness causing unbearable suffering should be ethically and legally acceptable. This paper outlines a perspective on rational suicide--the final exit--among the elderly.     

The psychological autopsy: methodological considerations for the study of adolescent suicide

The psychological autopsy has been employed to study risk factors for completed suicide for more than three decades. Despite a wide range in methods of approach to families and interview techniques, the studies show high compliance and remarkable consistency of results across a wide age range and diverse geographic samples. The convergent evidence is that the diagnostic information obtained is both reliable and valid, although it is likely that such an approach will be more specific than sensitive. Integration of data obtained through psychological autopsies with data obtained through biochemical, toxicological, and epidemiological approaches is likely to deepen our understanding of suicide. Successful completion of careful psychological autopsy studies should enable investigators to examine intensively patients who resemble suicide completers, thereby transcending the inherent limitations of this important first step in the investigation of suicide.     

Rational suicide and the crisis of terminal illness

Abstract

One of the controversial issues facing counselors in the 1990s is whether or not suicide may be considered a rational choice for clients with terminal illness. This article begins by reviewing the definition of rational suicide and the literature and statistics pertaining to suicide and terminal illness. Then various issues related to rational suicide as a treatment option are addressed, including moral and ethical issues.     

A trainee psychotherapist’s heuristic exploration of losing a mother to suicide

ABSTRACT

Suicide bereavement is a newly developing field of research in the UK, yet over 6,600 people take their own lives here every year. This heuristic inquiry aims to explore the lived experiences of trainee psychotherapists bereaved by maternal suicide. It examines the lived experiences of the researcher and two participants, with data collected through interviews, dreams and journalling. The findings revealed five themes: 1) It’s not just about the suicide, 2) The pain continues – attachment, abandonment and fear, 3) Left with all the unprocessed feelings – “the shit”, 4) Trigger after trigger – complicated experiences of psychotherapy training, 5) A catastrophic loss that no one “gets”. Implications for the counselling and psychotherapy profession are discussed.     

Values and the psychotherapist

One cannot live without encountering the problem of values. Certainly, one cannot go through psychotherapy without becoming involved implicitly and explicitly in the problem. Nor can one engage in psychotherapy as a therapist without bringing certain convictions about values into one's work. These convictions may or may not be specifically communicated to the patient, but they underlie the therapist's activity; they help determine the goal he sets for himself and his patient; and they are consciously or unconsciously reflected in his questions, statements or other reactions.“^1,p.1     

Permitting suicide of competent clients in counseling: legal and moral considerations

State statutes, case law, and professional codes of ethics in the mental health professions typically stress either a duty or the permissibility of disclosing confidential information in order to prevent clients from seriously harming themselves. These sources are intended to address cases where clients are deemed to be suffering from cognitive dysfunction for which paternalistic intervention, including involuntary hospitalization, is considered necessary to prevent self-destructive behavior. The counselor's moral and legal responsibility is less apparent when mentally competent clients desire suicide as release from irremediable suffering due to severe physical illness, and this desire is defensible within these clients' value systems. This paper will explore moral and legal dimensions of a counselor's decision not to intervene in such cases. The concept of permitted suicide will be introduced and defined, and guidelines for its application developed.     

Cultural considerations in adolescent suicide prevention and psychosocial treatment

Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community- based interventions are discussed, along with future opportunities for research in intervention development and evaluation.     

The child psychotherapist and multi-disciplinary assessments for the family courts

This paper focuses on the contribution child psychotherapists can make to assessments for the family courts. It arises out of work undertaken as a member of a multi-disciplinary team in a small specialist family centre. The paper illustrates the way in which detailed observation and psychoanalytic thinking are used in the assessment of parent-child relationships. The paper seeks to highlight the way in which the impact of abuse and trauma on babies and very young children is often underestimated and to illustrate ways in which the team of this particular family centre addresses this issue in its recommendations for court.     

Suicide as an interpersonal phenomenon: Dyadic methodological and statistical considerations in suicide research

Interpersonal risk and resilience factors are prominent in current conceptual models of suicide. A growing body of empirical evidence links suicidal thoughts and behaviors to a range of interpersonal phenomenon adding further support to the value of this line of inquiry. At present, research on interpersonal phenomenon focuses on assessing individuals' perceptions of interpersonal phenomenon, such as appraisals of burdensomeness, experienced loneliness, and thwarted belongingness. As this line of research continues to develop, we argue that it would be valuable to consider incorporating conceptual models of interpersonal phenomenon and corresponding methodological approaches from closely allied fields. After providing a brief overview of interpersonal models of suicide, we present an introduction to conceptual models of interpersonal phenomenon developed in relationship science, describe how these models can be applied to the study of interpersonal phenomenon in suicide research, and close with a guided tutorial on data collection and statistical analysis methods for testing hypotheses derived from these conceptual approaches. References for additional reading are provided, and the Appendix S1 provides simulated data sets and statistical code for the analyses in the tutorial section.     

Healing presence in the psychotherapist

Abstract

Throughout graduate school I felt compelled to become a fine psychotherapist. Implicit in that motivation was my curiosity about what makes a psychotherapist effective. My curiosity was inspired by my experience with one therapist who helped me activate profound transformation. After identifying intuitive inquiry (Anderson, 1998, 2000, 2004) as my research method, I explored that experience through meditation, reading, and conversation and eventually identified her healing presence as the core quality that differentiated her from other therapists I had known. Though technique and experience are important, I sensed that it was her healing presence that allowed her to use technique and experience skillfully. Throughout Cycle 1 of intuitive inquiry, the “text” that claimed me was my personal experience of her healing presence, her ability to be present, to connect with me, to see me, and even, to love me. Through intuitive inquiry, I was able to expand my understanding of the healing presence of a psychotherapist to incorporate the experiences of many others.