Some suicides happen impulsively. Some suicides are deliberate and result from a rational decision to end physical suffering and pain. Many people have occasional suicidal impulses and do not act upon them, and some people endure physical pain and suffering for lengthy periods of time without seriously considering suicide. In this article I want to examine the frame of mind in those for whom suicide IS an option, whether or not such people actually kill themselves.
A surprisingly large number of people have an open “suicide option”. This option is a conscious willingness to consider death as a legitimate solution to a difficult problem. If you ask whether suicide is an option for such people, they can give you a direct answer, because it is always a conscious choice. They see suicide as a legitimate and reasonable solution to life’s problems, at least under certain circumstances. I have for a long time been interested in the developmental histories of people with suicidal options, and I have noted certain consistencies, both in their historical development and in their subsequent life styles.
To carry out a decision to kill oneself the suicide option has to be actually open. A close friend of mine, facing a certain and painful death from cancer, decided quite rationally to end his life. When the moment came, however, he discovered to his own surprise that he was quite unwilling to actually do it. Another psychologist friend (who had been in therapy for many years with little change) told me that “knowing I can always kill myself is the only thing that keeps me going.”
For a suicide to take place, there must be as a minimum an open suicidal option. Some people have this option, and others do not. Where does it come from? Many psychotherapists have asserted that the decision to die is made in childhood, when it is seen as a solution to an intolerable and inescapable situation (Haiberg, Sefness and Berne, 1963; Boyd, 1972; Drye, Goulding and Goulding, 1973). It is unfortunately not difficult to find instances of deliberate suicides carried out by children.
Children have a limited capacity to understand the real nature of death. They also have a very limited ability to deal with difficult or even unbearable situations, such as a brutal or sexually predatory parent or total abandonment. They have few choices in reality. They can’t move away or seek shelter from other sources; they are in fact helpless. Their resultant anxiety can be overwhelming when they see no way out of their suffering.
One way they may find of reducing anxiety is to make a plan that they can actually carry out. This decreases the feeling of helplessness that makes the pain so unbearable. When children discover that suicide is a choice they can make and actually carry out, their anxiety is relieved, though the subsequent depression and sadness is not. The price of that decision (which I will discuss later) is not obvious. It is important to note that the function of the suicidal decision/option is an immediate reduction in anxiety.
Holloway (1973) described the suicidal decision in children as an “escape hatch”. It takes the form “If things get bad enough, I can always kill myself”. People with this escape hatch frequently find this thought passing through their minds. It becomes something of a crutch, used consciously to decrease anxiety in a difficult situation. As such, it is reassuring and rewarding, a reaffirmation that the person is neither powerless or helpless.
It is necessary to understand how important the suicidal “crutch” is in decreasing anxiety. As an anxiety reducer, the suicidal decision is constantly reinforced, even in situations not in themselves critical. It is actively seen as a solution to many of life’s problems. There is a price, however. Keeping this option open requires that the person be able to see life as something that can always be left. To get too attached, to love too deeply, to become too successful, to be too happy, make leaving life more difficult.
Many times I see people (including clients) back away from positive experiences, avoid intimacy and love, sabotage success, but tolerate a mediocre and lackluster and “safe” existence. They do so to protect their “solution”, because reducing their anxiety is more important to them than chancing success and failure. They seem to live as if they cannot move too far away from the graveyard or the “safety” of the grave. To be ready to go on a trip, one must keep one’s bags packed. They seem to believe that real happiness would somehow leave them trapped, a thought they find unbearable. Death becomes a security blanket, a promise of escape. But it is also an escape from life, an avoidance of any passionate commitment to make things better.
Others allow themselves more happiness and success, but in their minds they attach a condition for continuing to live. They remind themselves that “if things go wrong”, meaning if they lose their money or their life-style or their loved partner, they can exercise their suicidal option. There is a tentative quality to their happiness and success; their willingness to continue in life is based on the chance that life will continue to meet their demands. No one with a suicidal option, placed in the situation of the Swiss Family Robinson, would have the endurance or will to create a good life from disaster. If life becomes overly painful, they neither make things better nor endure them with grace. People associated with them are frequently aware of the tenuousness of their commitment to life.
The result of this half-hearted life style is that the person with the suicidal “escape hatch” is very prone to depression. They are frequently aware that there is something missing, that somehow their happiness and love are incomplete and unsafe. Their marriages, their careers, their education, their therapy all have the mark of limited commitment. Because of this failure to commit, they have a sense of alienation from others, a distance from life that isolates them.
So we see four kinds of consequences for keeping the suicidal option open:
1) A general failure to commit wholly, to connect to others wholeheartedly;
2) A basic passivity toward the ills of life and an unwillingness to commit oneself to correct them;
3) An overall pessimism about life sufficiently intense to make the fantasy of death an effective reliever of anxiety;
4) A willingness to trade the anxiety over being helpless and abandoned for a general mild and predictable depression and alienation.
In the next part I plan to discuss how one gives up the suicidal option. The references cited in this note are available on request.
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