Sunday, 8 June 2014

Defying death - bring it on

Ouch. Someone hit me where it hurts, metaphorically, this week. All this prevention stuff you do, does it really work? Getting a hobby is not going to stop you from feeling like you want to die. Erm, no it’s not and the really honest answer is, I can't answer that. Yes, that’s right, I don’t have all the answers. And I had another great blog post all ready to go, but this feels important. Okay, so this challenge is somewhat over-simplified and it would take more than 140 characters in twitter to answer. In fact, more than this blog post, as part of the answer can be found in the culmination of thousands of research papers and the work of many passionate, dedicated organisations and individuals.

Can we count how many people didn’t die by suicide? Can we count how many people didn’t die of anything? Any prevention effort for mental or physical health is targeted, based on statistics and demographics and research, but you cannot with absolute certainty say that one particular thing prevented someone from doing something. Starkly, the answer to whether or not something works in suicide prevention is a matter of life and death. The person is either still alive or they are not.

Think of all the factors that lead to someone thinking about suicide. It is never just one thing, so it is unlikely that just one thing will help. Although there is a tipping point in both, and it’s on that precipice while the scales are still tipping back and forward that one small, tiny thing can change the tipping direction. It could be a kind word or smile – someone actually noticed me today. It could be a moment of revelation in therapy – suddenly I have clarity. It could be someone showed compassion – I am worth something. Anything that helps someone to believe that they are a worthwhile human being in the midst of their descent into the black hole of suicidal thinking, could be the lifeline that they need.

It is my hunch, from many conversations about suicide, that it is the big things in life that make people want to die. No one ever comes to the decision to take their life lightly and without thought and turmoil and pain. Big things like devastating loss, overwhelming sadness, paralysing fear, life-changing events. And it is the smallest things that make it possible to keep living. No matter how small and fragile that life force is, it has more power than death can ever have. Even in the blackest darkness a tiny pinprick of light has an impact and becomes a magnet for our attention and for our hope.

"Hope is the thing with feathers, that perches in the soul. And sings the tune without the words, and never stops - at all"      Emily Dickinson

So, if you ask me what makes a difference, I am inclined to say – something, anything – anything except nothing. If we do not reach out, people will die. Of course we have fantastic evidence-based interventions. Let’s have some more of that please. And also, no matter how difficult and uncomfortable and scary it can be, let’s keep talking about suicide. This is literally death-defying work.

If you’ve noticed that I have steered clear of statistics and quoting research papers, well done. It’s deliberate. That is not what this blog is about – there are many others out there doing exactly that, and doing it incredibly well. This blog is simply what I think, which has been influenced by too many people, books and academic papers to list. What comes out this end is my own process in making sense of it all.

Dr Murphy – signing off. Maybe something lighter next time…like shame, maybe?

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