More on Suicide

I was discussing the difference between self destructive behavior and suicide with a colleague.  They are quite different, although you would think that suicide is destruction of the self, but it is not at all like that.  Let’s go back to the imprint as so many of my suicide attempts have done.   In most of these situations, there is an oxygen deficit, perhaps a heavy dose of anesthesia to the mother or being strangled on the cord. And after an agonizing attempt to get born, death approaches and there is a sense of impending relief.  That memory of possible relief is sealed in so that later in the face utter hopelessness, an impending divorce for instance,  death becomes the answer.  And attempt at suicide follows.  It is a memory of possible relief, stamped in, engraved that endures for a lifetime.   It is the end of the chain of pain, as it were, the logical denouement when current hopelessness can set off the primal, primordial hopelessness and death lurks.

You may wonder, how is it that hopelessness today sets off the same feeling during birth?  It is again the chain of pain, the links between levels of consciousness.  One way we see that link is through resonance; the current feeling sets off the same  deeper feelings until the whole system is engulfed in utter hopeless feelings; and worse, there is no scene attached to it as it is pure feeling, naked and unadorned, the exact same  feeling rising again to smother the person and make her suicidal. It is the most profound hopelessness. The current feeling, in short, has triggered off its progenitor with sensations of approaching death becoming paramount.

Let’s put it differently for clarity.  That early hopelessness is later expanded and ramified as the whole system and brain mature.  As each new brain system comes on line, it adds its emotional weight to the feeling.  But it is the same feeling with increased maturity and neuronal development.   It is that feeling that is the essence of depression; it  is the system’s effort to suppress the feeling that  produces depression.  So depression is not a feeling; it is what happens as that feeling is blocked from higher level  access. And when we unravel depression that is what we find: utter, unarticulated hopelessness. And  as it is felt and experienced with all of its pain, the depression begins to leave, at last. This is not done in a day because it is very deep, the end point of the birth agony, a cord around the neck, for example. This means that we must not trump evolution and feel it soon in therapy. We can only feel it as the body and brain allow, current hopeless feelings first, then the childhood compounding  and finally, the first line, brainstem component where the deepest  feelings always lies.  I use the word “compounding,” because these are not different feelings; they are the same feeling compounded.  The child just seems unhappy and sullen and no one knows  why. And certainly the child has no idea at all, nor do his teachers.  He is in the grasp of that early primordial, devastating feeling that no one can say or name.  It is literally “ineffable.”

What has this to do with self-destruction?  Let’s take literal destruction, cutting oneself.  This  is  a later ploy, making  hurt obvious.  It is a plea for help; “Please see my hurt. See that I hurt.” This in lieu of screaming out that hurt. And the cutter is not often aware of what she is doing or why.  It was never acknowledged by anyone because perhaps the parents had no idea of that hurt or even that such emotional hurt existed.  There are many aspects of this.   Her feeling was, “I’m trying to let the hurt escape,” even when she had no idea what is was.   She just knew  it was inside and it had to come out. She found out that it was exactly what we do; letting  it out in methodical  ways, so she no longer had to  cut herself.

Suicide, then, is a  deeper, earlier sensation/feeling with no behavioral possibilities.  And the hurt that some act out may have many different feelings involved.  They are, indeed, two different things.  Even though suicide attempts to destroy  the self it is not, oddly, self destructive like burning or cutting oneself.  And of course, it ramifies so that the destructive behavior takes on many forms.  Deliberate failure is one part.  Getting involved with crazy and violent people is another.  But it is not as direct as suicide.  Suicide means one final act.  It is not anything in the present that causes it; it is the result of a deep memory.    And yes,  if one could  then screaming it out could help temporarily; it would relieve the pressure.

There are some acts of suicide that are a cry for help; taking a certain amount of sleeping pills, for example.  And there are others that say, I really don’t want to live anymore; that is a jump off a bridge.  That is final, no call for help.  It all seems so helpless  and hopeless; they want to die for relief.  No more pain; that’s enough.

What we do is get patients, over time, down to those deep feelings that are so disturbing.  It takes time but when we get there it is pure relief, and it lasts.