Objetivos específicos

For some participants the overall experience of suicidal thoughts was often frightening, although there were significant moments of what may well be a dangerous calm. For other participants the experience was more one of obsessive, agitated preoccupation. Quotes presented in the section above have already described suicidal thoughts, and sometimes actions, as frightening, even terrifying. The

frightening nature of suicidal thoughts may be linked to an ambivalence about the outcome and a struggle against the suicidal desire.

I’ve had patches … where, you know a handful of times, I’ve been very much in that [suicidal] space but, I think it’s more frightening knowing that I can, I know what the result can be, but it’s also I know that this lifts and I know I can get through this as well

Part of what makes the experience frightening is a sense that the onset of the suicidal state is not controllable or understandable.

What frightens me about it is that I never thought this would happen to me having worked so hard to get where I had got. I can deal with depression

but it’s scary when all the things you thought you knew were no help to you.

Because it still, it scares me, terrifies me still, but it’s there, … I don’t understand why it’s there. I don’t think there’s a reason sometimes, it just is there, so that makes it more frightening. I’m just trying to understand it better…

One participant had concluded that, rather than being frightened, he needed to learn to live with the suicidal feelings.

I used to be scared of the suicidal feelings, always pushing it away. But I made friends with it in the end, you need to learn to live with it.

Some participants identified a difference between an impulsive suicidal state and a state of planning. The impulsive state involves a spontaneous reaction to intense distress, while the state of planning is more compulsive in nature. While frightening in prospect and retrospect, at the time, the state of planning reaches a point of calmness. The person feels cut off from those around her (or him), in a kind of suicidal bubble. This was clearly articulated by a woman who contrasted her impulsive suicide attempt with subsequent experiences of being on a path toward a planned suicide.

…. and it was a spontaneous thing, it wasn’t something that was planned. And I have been in that space [i.e. of planning] which is more frightening I think even than this particular episode.

…

The spontaneous thing is frightening because you know you can just do that, but the planned stuff it almost, .... there’s a real calmness that comes, that comes all over me anyway … It’s almost a euphoria that can come through too, and it’s you’ve accepted this and this is a real peace that comes with that decision, and people have no sense of where you’re at. They just don’t have a clue. It’s much different to that distress that I felt that time ...

Others also identified a sense of calmness or resolution of torturous tension that comes with making a decision to act on suicidal thoughts.

When you have decided to kill yourself you feel happy, not happy, relieved. You’re looking forward to being dead

For some participants the experience of being suicidal had an obsessive, preoccupied quality, which, in Shneidman’s (1992) terms, involved a perceptual constriction in which the person’s narrowed focus on suicide is such that he or she cannot see outside it.

I was obsessed with killing myself, totally obsessed, nothing else had entered my mind. …

I’d forgotten [about a family special day], even though I’d known in the morning, the obsession in my head about suicide just overtakes everything.

Perceptual constriction may be present also in the state of suicidal planning described earlier, but in contrast, the obsessive, preoccupied state does not come with a feeling of calm (not at least until the moment of actually making an attempt). There is a sense of struggle and resistance to the obsession. The participant quoted here described her life during this period as

I just did not have a life, it was just torture. …

And I can’t control how long it’s going to take. I just try my hardest not to attempt suicide, just try every avenue for that life, lifeboat, to help me, and if it’s not there then I’m more likely to attempt suicide.

The experiences described here bring to mind the quote from Shneidman (1984) about 'anguish over the plight of the writhing self’ (p.321). Shneidman’s concept of

unbearable psychological pain was manifest in participants’ descriptions of their psychological state at the time of the suicide attempt and at subsequent times of feeling suicidal. The nature of this pain was consistent with conceptualisations in the

literature of the suicidal state of mind (see literature review in Chapter 3). However the core painful experience was not the same across all individuals. Where one participant spoke of hopelessness, a core feature according to Beck and Weishaar (1990), another was driven by a sense of being a burden on a loved family, as identified by Joiner et al. (2009):

and what I was wanting to do was alleviate that pain cos I felt like I’d been a burden for so long

However in a different family situation, one of marital conflict and some violence, another participant spoke of escape rather than burdensomeness.

In line with Maltsberger’s (1988) clinical descriptions, one participant described a sense of bitter estrangement and aloneness as well as self-hate:

My parents hated me and I hated myself. and

At one time I hated myself so much I wanted to kill myself in a really painful way.

One participant spoke of self-punishment while several spoke of a painful feeling of uselessness or worthlessness.

… it might have been to punish myself as much as it was to kill myself, I think, because I was going through a period of feeling particularly useless

One of the reasons I was so suicidal was because I wasn’t myself. You feel worthless.

Several participants spoke of feeling ‘so desperate’, conveying an impression of agitation or Shneidman’s (1992) ‘perturbation’. In contrast two participants presented images of unpleasant stillness. A woman spoke of being ‘dead inside’, consistent with states described by Hendin (1991). A man described his suicidal states as:

There’s nothing moving inside you and

You’re empty, no spirit

Hendin (1991) argued that the feeling dead inside phenomenon came about because of efforts to block out rage and despair. His argument was that repressed (or possibly suppressed) rage and despair lay underneath the feeling of deadness. Some kind of related phenomenon may have been occurring for these two participants. While the woman partly attributed her feeling of being ‘flattened’ and ‘dead inside’ to the effects of medication, she was also describing a period of severe hopelessness and despair. The internal deadness was associated with losing hope, or perhaps with an exhausted repression of the pain of hopelessness. The man who felt ‘nothing moving inside’ during a persistent suicidal episode, had spoken of a tornado of feeling and a release of anger at the time of his suicide attempt shortly before. He described a ‘big build-up to the suicide attempt’, full of grief and trauma, a series of painful losses and an outburst of physical aggression. He concluded:

It was like a tornado building up and then bang, it came down and thumped me.

and

It was good to get all the anger out.

However it seemed that after the anger was released, what replaced it (at least at the conscious level) was the feeling of emptiness and ‘nothing moving’.

In addition to discussing the painful emotional disturbance, several participants commented briefly on a cognitive dimension, acknowledging there was an irrational element to their suicidal thought processes.

... at the time you think you are thinking clearly but you’re not thinking clearly.

One participant specifically referred to black and white thinking as identified by Weishaar and Beck (1992) (and perhaps discussed in her sessions with her psychiatrist).

… basically I said to myself, I was applying for it [a flat of her own], and black and white thinking as usual, either I get the flat or I kill myself.

Overall the participants’ experience of suicidality is consistent with the literature on the phenomenology of the suicidal state. Both the literature and the participants describe a range of experiences, such that, despite some convergence, there is not just one experience of being suicidal. The element that perhaps gains greater prominence in the accounts of participants than in the literature is the frightening nature of suicidal thoughts. This brings to life more vividly and intensely an element of the struggle usually discussed in the literature in terms of ambivalence.