Life not worthwhile?

There may well be several readers of this website for whom this is an important page.

I have not mentioned suicide and self-harm up to now and the website has been in existence for many years. My apologies for this omission. It is a difficult topic and I may not have referred directly to the subject because of my own anxiety, not to mention my own history. I took the view that this is one topic where small, safe experiments did not fit.

Now I believe I was wrong. I am going to have a go.

I was helped, here, by my attendance at an on-line event relating to the subject in September 2021.  I was fortunate to hear some very insightful speakers. I gained some confidence to speak out from their approach to this topic.  More importantly, I was made to realise that this page is not likely to do harm. I, like so many others, may have been ruled by the myth – or so it would seem to be a myth – that talking about suicide and self-harm can make it more likely to be acted on.  Speaker after speaker challenged this conclusion.

So, let’s see what can be said?  The on-line presentations raised some interesting possibilities for some safe experiments.   Let me consider what small steps can be devised when some-one is so hard-pressed that life does not feel worthwhile?

I would like to start by returning to the work of Margaret Stroebe and others. Indeed, a small number of safe experiments can be found on the page where I discuss their different view of the bereavement and loss. processes. The illustration that might help most of all – and produced elsewhere – is as follows:

 

 

M Stroebe and H Schut The dual process model of coping with bereavement: rationale and description  in Death Studies Apr-May 1999;23(3):197-224.

….. where  the concept of oscillation is central. According to Stroebe and Schut, healthy grieving means engaging in a dynamic process of oscillating between loss-oriented and restoration-oriented coping. In short, when I grieve I can expect to move rapidly between confronting and feeling my loss,  and avoiding or adjusting to my loss.

To absorb this material further, I would recommend the reader to read Rory O’Connor’s book When it is Darkest (2021), published by Penguin Random House. Rory is Professor of Health Psychology at Glasgow University and he has devoted his life to the study of suicide and prevention of suicide.  O’Connor does not talk directly about Stroebe’s view of recovery after bereavement but his book talks usefully about the ambivalence people report when contemplating suicide and self-harm.

The vacillating nature of our impulses that O’Connor describes seems rather similar to the process described by Stroebe and Schut and summarised in the illustration above. Note the connection between this ‘oscillation’ and my list of dysfunctional thinking, to follow. It would appear that our thinking can oscillate when we feel under pressure; perhaps demonstrating the conflict between  Social Engagement System (Ventral Vagus) and primitive response to threat (Dorsal Vagus). 

To be more specific, O’Connor refers to being valued and valuable, inferring that valuing ourselves can be an antidote to suicidal images and thinking. He offers up the powerful, yet simple gesture – the smile.  Here is the simplest of safe experiments for we can all smile at others, at at ourselves (best done in a mirror!). How come is this so potentially powerful? O’Connor points out that “social connection is one of the building blocks to saving lives“.

Later on, I will add some of my own antidotes.

O’Connor uses his book to identify fourteen myths about suicide. One of them is “those who talk about suicide are not at risk of suicide” This is important as so many small, safe  experiments can involve conversation and talk. He tells the story of Ryan and the woman in the park. You could be that woman, or you could be Ryan and keep looking around when it is not easy to do so. You may be relieved to notice how a smile may promote conversation and change, but O’Connor is inviting us to accept that this action may not be enough and sufficient to help others see the choices in front of them.

This raises the question: should we be on the look-out for options and alternatives?  This has led me to offer you a challenge;  a specific, important experiment that:

Considers your own safety when surrounded by dark thoughts and bad feelings

AN EXPERIMENT

There are a few things I would like you to do before acting on any dark thoughts. If you are feeling life is not worthwhile, I’d ask you to read through this page and consider any suggestions that intrigue you. Please take some time to consider the options available to you. It’s not enough to say: I do not want to feel suicidal thoughts. There are a lot of things we do not want in our life and/or hear in our heads. This experiment offers you a little bit more than that.

As with any safe experiment, the task is to find out what is do-able and, indeed, small enough to become do-able. Please proceed to create do-able options one step at a time and just notice when you feel safer.

Some pointers that may recommend this experiment to you may include:

    • Feeling suicidal and experiencing extreme pain;
    • Not having the resources to cope.

We can change any feeling and sensation. That’s what affect regulation is about. We can increase our coping resources – often with everyday actions. Any experiment using Subject Units of Discomfort (SUDS) demonstrate the ups and downs of our experiences over time. Feelings and sensations come and go; they will pass.

START A SAFE EXPERIMENT by putting something in writing. This can be better than keeping thoughts in your head. Some people write to themselves when they are in a good place.  That way, they have something concrete to get hold enough when in not such a good place.

This may be a step too far, but is there some-one you can trust, with whom you can leave a copy of your notes to yourself?

Some questions I’d ask you to consider as you develop your options. These questions are intended to reduce the risk of acting on the suicidal thoughts:

  1. What are warning signs or triggers that indicate I am feeling more out of control?
  2. What have I done in the past that helped when I was in a similar situation?
  3. What ways of coping do I have available to me, now?
  4. What can l do to help calm myself, now?
  5. Are there ways of thinking that make self-soothing difficult?
  6. What alternatives are there to these known patterns of negative thinking such as:

Selective attention: only consider this thing, not that thing, e.g. “there, I told you, its always like this”. Antidote: to stand back and notice how you can attend to the wider picture. This may give you an exception to the rule. One exception may be enough and sufficient.

Black-and-White thinking: this can only be this, not that, .e.g “when I am like this, I can only think of harming myself“. Antidote: Finding yet more exceptions. Can you change Black-and-White into colour or, at least, sepia in the first place?

Catastrophising: using only superlatives such as ‘only’, always, never and forever. Antidote: editing superlatives out of your everyday language.  Often they are simply exaggerations adding little to the point you may want to make. Consider, instead ‘provisional’ language such as: ‘possibly’, ‘occasionally’, ‘from time to time’, ‘it may be [this] or may be [that]’. OK, this language is not so sexy or dramatic, but it can be more fitting to the occasion!

Magnification: like the heavy drinker looking at a bottle of beer and seeing it grow ever bigger in front of them. Antidote: defocus your eyes and re-focus several time.  Glance around the room and describe where you are and what you can actually see, now. Notice how easy it is to drift back into past memories or anticipate the future. When you ‘just notice’ this natural tendency, bring yourself back to now, repeating what you can see as you look around. Look out of a window to widen your vision and o the same thing.  Can you see images change? Can you do something similar with your ‘ears’?

Minimisation: “Oh, I’ve tried that and it’s never worked“. Antidote: keep in mind that any action will lead to either a small defeat or a small victory or to a mixed result.  If something does not work, then do look for something just a little bit different, just to try it out for size.

Over-generalisation: again,” it’s always like this. Every time I try it, it ends up like this.” Antidote: allow your natural curiosity to look for something else. Be specific with yourself. Curiosity may help you step beyond repetitive behaviour and to find the exception to the rule. It’s out there, somewhere.

Using ‘try’:  as a cover for doing nothing as it is not worth it. Antidote: as above, edit your language. It’s not easy as words slip out so quickly. Therefore, knowingly slow down your rate of thinking and speaking. This may give you a chance to edit effectively. Controlled breathing and slower, a little deeper breathes can help, sometimes.

Negative automatic thinking, or NATS: all the examples described here could be a NAT. The only requirement is that the thought arises without  encouragement and on a repetitive basis.  Antidote:  coming of auto-pilot and thinking something very consciously – even if ti feels strange and embarrasssing.  Such conscious thoughts include affirmations as alternatives to ‘darker thoughts’.

Personalisation: this is the only way I can sort this out. Antidote: ask other people: what might they do.

… and the rude one:

Mustabation such as:  “I should always put other people first”, “I must get this right; perfectly right”; “I should know better”, “I must be strong and keep in control”, “I must succeed” or “I must agree with others” etc

the antidote here is to edit out ‘value’ words such as ‘should’, ‘ought’, ‘right’, ‘wrong’  and, in  particular, ‘why‘ in favour of speculations such as “what would happen if ….,” “is it possible  ……” “how might I …...”? These speculations are best done in the ordinary, everyday situations, rather than in the crisis of the moment.  This experiment works when you’ve practised it a lot and are more confident about how you can use this antidote. This is true for most of the antidotes listed here, so use these experiments this afternoon, this evening and tomorrow morning.

For the rest, there’s not much point in summarising some of the things I do. You tell me: what safe experiment can you identify or devise that may alter some distortions in your thinking just a little bit?

That said, I have pointed to other experiments in this website, using the blue hyperlinks.

I will now summarise and encourage you to consider some actions that might be available, now

  • asking a close friend what they would do when they felt as I do, now?
  • If necessary, imagine what they might say to you.
  • consider: are there things I can ask my friends or family to do for me?
  • what could others do that would help me, now?

Would it help to make a note of your thoughts,  here and now?

THEN: take a different kind of action by ASKING for information, advice or guidance from:

A Friend or relative

A Health professional

A Telephone helpline

 

A further experiment to consider: what is a safe place for me?

I can take myself away from here, to somewhere else or I can go to somewhere else in my head (using visualisation):

When I get there: consider how do I assess the present risk to me and reduce it?

Make a resolution to remove unwanted medications – take them to pharmacy.

Throw away blades.

Re-read your own notes on the warning signs or triggers that make me feel more out of control. Consider: what something can I do that is just a little bit different?

Are there better places to be – other than staying home, alone, in bedroom, brooding. For example, arranging to be with other people.

Take some time to seek a song on the internet by Harry Chapin called A Better Place to Be.

Look back and remember what I have done in the past that helped?

What other ways of coping do I have? For instance, phoning a family member or friend or a professional.

Re-reading and re-writing my thoughts and feelings to remind myself of alternative ways of looking at things. Thoughts and feelings do not harm; indeed, identifying feelings can be liberating for some people.

Practical relaxation to calm and soothe myself: for instance, focus on my breathing and slow it Just noticing the experience and naming it. Here, do something else a little bit different may offer some relief.

If you’ve got through this before, remind yourself what you did and be aware that I can get through it now”. “This will pass”. [Please keep in mind that our neuro-chemistry means that nothing stays the same, for always.]

How about: “I will feel better tomorrow and be grateful that I did not die”.

These are just some of the useful tools you and I can use when just noticing our depressed feelings (some are listed on the hyperlinked page; the whole page may be worth a read).

Create as many tools to design your own experiment by BEING CURIOUS ….. AND STAYING CURIOUS

Will this curiosity enable you and I to STOP-LOOK-LISTEN  when it is just possible? Is there any safe experiment that will help us build up our options so we do not discount ourselves out of the equation and, thereby, out of living.

 

Return to:

Welcome

What is a nudge?

Designing a nudge

Limits to nudging 1

Limits to nudging 2

Taking the scenic route

Learning to be a little bit different does not happen in a straight line