SelfHarm and Suicidality FirstPerson Perspectives Thinking Differently About

Self-Harm and Suicidality: First-Person Perspectives Thinking (Differently) About Suicide David Webb

We must at all times remember, that the decision to take your own life is as vast and complex and mysterious as life itself. Al Alvarez, The Savage God

Suicidology – Survivor Perspective • whoever these experts are talking about it is certainly not me • the actual suicidal person – i. e. the survivor voice – is largely absent from suicidology. . . some notable exceptions. . .

Dissenting Voices 1 – Professor Edwin S. Shneidman (1918 -2009) • Emeritus Professor of Thanatology at UCLA • founder of American Association of Suicidology (1968) “every case of suicide stems from excessive psychache” Psychache: • psychological pain (not illness) • . . . due to thwarted or distorted psychological needs

Dissenting Voices 2 – The Aeschi Group http: //www. aeschiconference. unibe. ch/ • group of eminent suicidologists that meet in Aeschi, Switzerland, every two years • focus is on psychotherapeutic interventions with suicidal people The only innovative, critical, creative thinking in mainstream suicidology today.

Dissenting Voices 3 Preface: Let’s Talk About Suicide 1. My Suicidal Career and Other Myths 2. What Is It Like To Be Suicidal? 3. The Drug Addiction Detour 4. The ‘Mental Illness’ Circus Interlude: Who Am I? 5. Spiritual Self-Enquiry 6. The Willingness to Surrender 7. This Is Enough [ Epilogue: Who Are We? ] www. thinkingaboutsuicide. org

Why is the survivor voice absent? Suicide attempt survivors cannot help in the study of suicide because. . . 1. The only genuine suicide attempt is a successful one • offensive. . . but also wrong. . 2. We are crazy • suicide - by definition – is irrational madness

Suicidology – Part of the Problem Suicidology contributes to, rather than reduces, the suicide toll. Two main reasons. . . 1. “Stigma” – i. e. discrimination 2. Medicalisation of suicide. . . both are irrational, ideological, dogma. . .

“Stigma” Primary source of stigma – discrimination – is mental health laws that make us second-class citizens. Driven by. . . • fear • ignorance • prejudice Also stigma of psychiatric labels. . .

Medicalisation of Suicide European Commission “Suicide is primarily an outcome of untreated depressive illness” Foreword by Dr Michael Wilks “the fact that suicide is a preventable outcome of mental illness” A consensus? • who was included? • who was excluded? • a scientific consensus? . . . or a political one? Wahlbeck K. & Mäkinen M. (Eds). (2008). Prevention of depression and suicide. Consensus paper. Luxembourg: European Communities. http: //www. ec-mental-health-process. net/pdf/prevention_of_depression_and_suicide. pdf

The Politics of Suicide • primary motivations – fear, ignorance, prejudice • primary response - panic • primary goal - contain and control • medical profession willing accomplice of the state • . . . to justify psychiatric violence under guise medical treatment

Alternatives – Re-conceptualising Suicide Suicidality best understood as a crisis of the self: • ‘sui’ in suicide, both victim and perpetrator • closer to the lived experience • encompasses whole person – physical, mental, relational and spiritual • immediately raises important questions that suicidology largely ignores, especially … • who or what is this ‘self’ that is in crisis? • stigma-busting – no “them-and-us”, only us

Alternatives – “Mentally Healthy” Communities • prevention vs intervention • to minimise suicidal feelings arising • capable of sensible conversation on suicide • bring suicide “out of the closet” as public health issue – break taboo, prejudice etc • reclaim our personal power – individually and collectively • suicidal people at the centre

Alternatives – Talking About Suicide • not just as search for solutions • talking about suicide as a suicide prevention strategy A safe space to tell our stories. . .

I have never before read anything relating to suicide that speaks of suicidal feelings as being worthy of respect. The possibility that I may actually be able to honour these feelings is a totally new concept, one which has proven to be a catalyst for change and personal growth. David has provided me with a revolutionary approach to making sense of my own experiences. Josephine Williams suicide attempt survivor, Australia

Alternatives – Summing Up – my Rose Garden 1. Stop beating us up 2. De-medicalise suicide 3. Re-conceptualise as crisis of self (psychache) 4. “Mentally healthy” communities 5. Create safe spaces for suicidal people 6. Social model of madness -> CRPD 7. Research – survivors as researchers 8. Funding – stop wasting (lots of) money on what we know does not work

May your psychache be minimal Professor Edwin S. Shneidman