Savižudžio sąmonė

by Edwin S. Shneidman, Vilija Poviliūnienė (Translator)

Psichologinis skausmas yra sąmonę užvaldęs skausmas, sielvartas arba gėla. Šio skausmo esmė psichologinė – perdėtai išgyvenama gėda, kaltė, baimė, nerimas, vienišumas, baimė pasenti arba mirti kančiose. <..> Savižudybė įvyksta, kai psichologinis skausmas laikomas nebepakeliamu ir aktyviai siekiama mirties, kad pagaliau nutrūktų nesiliaujantis kankinantis sąmonės srautas. Savižudybė yra tragiška sielos drama. Analizuodamas ir gilindamasis supratau, kad dėl stipraus psichologinio skausmo nusižudoma tik labai retais atvejais, bet kiekviena savižudybė yra susijusi su pernelyg dideliu psichologiniu skausmu.

Genres: Psychology, Nonfiction, Mental Health, Mental Illness, Health, Research, Philosophy

151 pages, Unknown Binding

First published January 1, 1996

About the author

Dr. Edwin S. Shneidman (born c. 1918) is a noted American suicidologist/thanatologist. He with co-workers from the Los Angeles Suicide Prevention Center provided a major stimulus to research into suicide and its prevention. He was the founder of the American Association of Suicidology and of the principal United States journal for suicide studies, Suicide and Life Threatening Behavior. He is Professor of Thanatology Emeritus at the University of California and lives in Los Angeles.

Reviews

[Mehwish · Rating 5 out of 5]

Edwin Shneidman, a suicidologist and a thanatologist has written this book with humane sophistication. It is one of those few books by a specialist who managed to rescue it from the glorious yet ignorant field of medical psychiatry and placed it where it belongs – “ This book is a forthright effort to revitalize the topic of suicide by looking in a fresh way at suicidal phenomena as they play themselves out in the mind of suicidal people.”

His absolutely brilliant and heart-touching question that we all need to ask people who are depressed or suicidal is: Where do you hurt? This is a very powerful question and would signal the person that the hurt has been acknowledged and would help reduce the anguish.

There are three case histories narrated verbatim by the people who attempted suicide and survived. These personal insights were extremely painful to read and had a recurring theme of psychological pain and frustrations. Edwin goes on and explains the workings of the mind to a great length.

My favorite part from the book was “Clues and Constrictions”. Edwin suggests that every completed suicide or attempted suicide always leaves plenty of clues behind. These hints and suggestions are sometimes left by the subconscious mind and at other times intentionally to seek intervention. This is of course not entirely true because there are cases where people do not leave any trails of their psychologically shattered self. He urges us to keep our eyes open. The second part of this chapter was on the dichotomy of options perceived by the person who is suffering from psychological pain. It is either do or die situation. Either I solve this or I die. Either life or death. This is 100% true, I have been there and I know this is how it works. The focus is entirely constricted - a dangerously binary view. What I had not known previously and what Edwin suggests is pushing this circle of focus a little bit outward. Introducing more alternatives to suicide and the psychological problem on hand. This will help in enlarging the view and breaking the dichotomy.

Another chapter was dedicated to discussing in detail the following 10 commonalities of suicide:
1) The common purpose of suicide is to seek a solution
2) The common goal of suicide is cessation of consciousness
3) The common stimulus of suicide is unbearable psychological pain
4) The common stressor in suicide is frustrated psychological needs
5) The common emotion in suicide is hopelessness-helplessness
6) The common cognitive state in suicide is ambivalence
7) The common perceptual state in suicide is constriction
8) The common action in suicide is escape
9) The common interpersonal act in suicide is communication of intention
10) The common pattern in suicide is consistency of lifelong styles

The final few chapters dealt with psychotherapy and personal reflections.

In the closing paragraph of the preface, Edwin wrote: “The principal goals of all my writing on suicide for the past 45 years have been to be helpful and to relieve pain. I live with the hope that I am not deluded in this aspiration.” These were the most compelling words I have ever read in suicidology.

[Cooper Cooper · Rating 4 out of 5]

The late clinical psychologist Edwin S. Shneidman studied suicide for five decades. A disciple of the famous Henry A. Murray, Shneidman applied his mentor’s “need-press” theory to suicide, maintaining that suicide is virtually always triggered by unbearable psychological pain (“psychache,” he called it), which in turn is triggered by failure to satisfy key psychological needs. What needs? They vary with the individual, but based on Murray’s work Shneidman developed a “Need Form” (see below), which profiles a person’s “need pattern” by assigning values to 20 categories of need.
The “need profile” indicates what needs are most important to a given individual—needs which, when deeply frustrated, might lead to suicide. In this book, Shneidman presented case studies of three attempted suicides with very different need profiles.
According to Shneidman there are “ten commonalities of suicide” that cross all profiles. These are:
1. Purpose—seek a solution
2. Goal—cessation of consciousness
3. Stimulus—unbearable psychological pain
4. Stressor—frustrated psychological needs
5. Emotion—hopelessness/helplessness
6. Cognitive State—ambivalence
7. Perceptual State—constriction
8. Action—escape
9. Interpersonal Act—communication of intention
10. Pattern—consistency with lifelong style of dealing with problems.

Interesting observations:
*Only 2-3% of those who threaten suicide actually commit it
*90% of those who commit suicide tip off their intention beforehand (“communication of intention”)—either by actually threatening to do away with themselves, for example, or by straightening out their affairs (e.g., preparing a will), or (especially) by giving away valued possessions.
*As the potential suicide gets close to acting, the focus of attention narrows (“constriction”), so that she tends to think in terms of black-or-white, all-or-nothing (called “dichotomous thinking”)—as in, “Either I win back my boyfriend or I’ll commit suicide—there’s no other choice.” [This narrowing of focus sounds very much like what happens in hypnosis—is “constriction” a perverse form of self-hypnosis?:]
*Virtually all potential suicides veer between living and dying—many hope that somebody will come to their rescue before they actually kill themselves.

According to Shneidman, the keys to dealing with a potential suicide are to take him seriously, establish trust (“rapport”), widen his perceived range of options (overcome “constriction”), stand strongly on the side of living versus dying, help the person solve practical problems, and finally, help him modify his pattern of needs to increase the likelihood that they will be satisfied in the real world.
This is a good common-sense book, in simple language, by a psychologist who was one of the world’s leading authorities on suicide. A useful read.


NEED FORM
(% for each item, adding to 100%)

______ABASEMENT—the need to submit passively, to belittle oneself

______ACHIEVEMENT—the need to accomplish something difficult, to overcome

_____AFFILIATION—the need to adhere to a friend or a group

______AGGRESSION—the need to overcome opposition forcefully, to fight, to attack

______AUTONOMY—the need to be independent and free, to shake off restraint

______COUNTERACTION—the need to make up for loss by re-striving; getting even

______DEFENDANCE—the need to vindicate the self against criticism or blame

______DEFERENCE—the need to admire and support, praise, emulate a superior

______DOMINANCE—the need to control, influence and direct others; dominate

______EXHIBITION—the need to excite, fascinate, amuse, entertain others

______HARMAVOIDANCE—the need to avoid pain, injury, illness, death

______INVIOLACY—the need to protect the self and one’s psychological space

______NURTURANCE—the need to feed, help, console, protect, nurture

______ORDER—the need to achieve organization and order among things and ideas

______PLAY—the need for fun; to seek pleasure for its own sake

______REJECTION—the need to exclude, banish, jilt or expel another person

______SENTIENCE—the need to seek sensuous, creature-comfort experiences

______SHAME-AVOIDANCE—the need to avoid humiliation and embarrassment

______ SUCCORANCE—the need to have one’s needs gratified, to be loved

______UNDERSTANDING—the need to know answers, to know the hows and whys

[Michael Connolly · Rating 4 out of 5]

Modes of Death

The author states that there are 4 modes of death:

• Natural
• Accident
• Suicide
• Homicide

Psychic Pain

The author states that people become suicidal when they are in unbearable psychic pain. Suicidal people often believe that their psychic pain is greater than that of the average person. Suicide is seen as an escape. The suicidal person disconnects from memories of loved ones.

Unfulfilled Needs

Some of the more common unfulfilled needs causing psychic pain:

• Achievement
• Autonomy
• Dominance
• Health
• Love
• Order
• Respect

Not Out of Character

A careful examination of the person’s past tends to show that the suicide is in character with the person’s past behavior, and not an anomaly. Coping mechanisms for past crises give clues on likelihood of suicide. Running away from ones problems is a predictor of suicide.

Constricted Choices

Impaired judgement accompanies depression. Suicidal people develop a tunnel vision, where they feel that their choices are constricted. They feel that they have only a narrow range of options to deal with their crisis. They may feel that the only option left open to them is suicide.

[stephanie · Rating 5 out of 5]

one of the first books to try and understand the suicidal mind outside of the typical freudian reasoning. schneidman believes there is something he refers to as "psychache" and until that is relieved, the spectre of suicide will remain. it's short, accessible, and i think, fascinating. it's definitely a landmark text in psychology, and it sparked my interest in suicidology massively.

i appreciate that he doesn't pity the people who killed themselves, and doesn't condescend to them, but merely wishes there was a way he could have helped them - though he admits, often times he would have had no clue how. this book might raise more questions than answers, but i think it was really important for its time and place in the growth of the field.

(he's the founder of the suicidology research center at UCLA, the first center in the world to focus only on suicide.)

[Einzige · Rating 3 out of 5]

An electric typewriter of a book

The Suicidal Mind has an electric typewriter feel to it as it sits oddly between two worlds, its empirical and Freudless but at the same time lacks the rigour that has come to be expected while building large theories based off a few particularly interesting case studies.

As for the ideas in the book the novel and worthwhile ones have largely become part of the orthodox understanding so there is not that much to be gained from reading it. Of course because the author was allowed to conduct less than ethical research (eg just photocopying a large number of suicide notes that were kept in his work place at Department of Veteran’s Affairs) it is simply more interesting.

For those who are interested the main discovery in the book is that suicide is motivated by psychological pain and not physical suffering/bad circumstances themselves and that by addressing this psychological pain and providing options to sufferers it can be managed.

[Jessica Anthony · Rating 5 out of 5]

This book was truly one of the most beneficial resources I had read on my grief journey. Despite this book being published in 1996, the content and scientific research in the book is still relevant today.

I think the reason I found this book so beneficial was because the book explored why people choose to end their life and the phycological research behind it. For someone who is fixated on the “Why” having a book talk about it, rather than the focal point being on the aftermath (which is what I find most book focus on) was such an invaluable resource. I definitely will be referring back to this book throughout my lifetime.

[Thea G · Rating 3 out of 5]

Very difficult to read. Gave me great insight into the psychology of suicide.

[Shelley Diamond · Rating 3 out of 5]

This one has a lot of useful information. I think it's the best of the Shneidman books.

[The Angry Lawn Gnome · Rating 2 out of 5]

I can't believe Shneidman considers his psychache concept remotely close to proven, because it simply is not, at least in this book. But we go from a section of dogmatic assertions stating exactly this and hop right into...three case studies, each one obviously carefully chosen to illustrate this or that point. (Talk about selection bias! - And this after ALREADY excluding anything outside a "Judeo-Christian" culture [p.5])

Actually, the best is indeed saved for the end here, with the last two chapters. A wee bit creepy, when Shneidman describes his sometimes deliberately manipulative therapeutic style, but both chapters seem cut almost from a different cloth from the rest of the book. In them Shneidman looks back over his career and does indeed have some interesting things to say.

I think this is one I'll circle back to in a few months, but overall I can't say I'm anything but disappointed.

[Chase · Rating 4 out of 5]

In The Suicidal Mind, Dr. Edwin Shneidman attempts to systematize committed suicides and the suicidal impulse via hundreds of collected suicide letters and by performing what he refers to as "psychological autopsies" on committed suicides. The way the information is presented is clean and some sections concerning a patient that Shneidman himself treated reminded me a bit of Oliver Sacks, though it seemed to me Shneidman's logical approach overpowered his empathy more often than not.
This is a short book, being only about 170 pages or so, but it packs a lot in. It is by no means an encouraging or "enjoyable" read, but I would call it a necessary read for anyone interested, confused, and/or affected by suicide in some way. It sheds some light on a taboo topic without resorting to sugarcoated hogwash, instead laying a logical and (arguably) scientific foundation for examining suicide and its associated mental states.

[Genna · Rating 3 out of 5]

This book is about 20 years old, so the work is a little outdated. However, I found the individual case studies very interesting. I think the aim of this book is to gain a better understanding of what it's like to be suicidal, what the thoughts are, what the feelings are so that you can put yourself in another person's shoes. The author offers suggestions for "hints" we can pick up on for suicidality, which I think is helpful, but may not be true for every single person. I think it would have been helpful to have a chapter on treatment at the end. Overall, I wouldn't suggest reading this one because it's kind of old, but the basic points still apply so it's definitely not a waste of time.

[Tori · Rating 5 out of 5]

Reread 7/20/13

5 stars

Learned a lot all over again.


Finished 9/1/07

Four stars

19 - Excellent discussion of what leads to suicidal impulses and what can be done to prevent suicide. Very eye opening. Considering that it was written by such an expert in the field - I think the book is fairly easy for the average person to understand.

[Kate Rosenberg · Rating 4 out of 5]

I had forgotten until recently that I read this book and was entranced. It's short, but frank. Truly scary, heartbreaking, intriguing, scholarly... It's a fabulous read for those who don't mind this somewhat taboo subject.

[Anna · Rating 5 out of 5]

WARNING: DO NOT READ IF YOU ARE SUICIDAL! this book is meant for academia, not for self help.

[Hind · Rating 5 out of 5]

..

[Marian · Rating 3 out of 5]

Shneidman's offering on the topic of suicide has some useful offerings, but the methodology puzzled me. Coroner's files were used to gather data and make conclusions. Suicide notes, for example, were examined. Do the dead have a right to privacy and peace? This reminds me of the debate about tissue rights - - when our biopsied tissues, for example, can be used for research and profits without our knowledge. So, because of his described data collection methods, even if legal, are not ethical in my opinion. Additionally, his interventions for helping the distress of the suicidal patient are more oriented to psychology than social work. I am of the opinion that the economic, social, and psychological milieu are blended into the chaos of a suicidal mind; the ratios may differ by individual, but seeing a therapist won't solve problems of economic ruin, homelessness, or life distress. In that, therapists and suicide hot lines are not as able to actually help people destroyed by modern societal conditions as they may wish. Shneidman does not develop these shortcomings. I note that Shneidman makes a grave error on page 160 where he claims, "in suicide, there is often the feeling that one's pain is somehow special and greater than the pain and suffering of others, making is unendurable in a special way-bordering on a feeling of grandiosity." Yikes! Is it not the judge of the emotions of the suicidal soul the model of grandiosity? I do like the inclusion of Emperor Hirohito's pronouncements from August 1945 and the Shneidman identification of "the two main antidotes to suicide: the sense of futurity; and the redefining of the key term. . ." to choose to endure the unendurable and suffer that which is unsufferable (p. 161). More often, advisors focus on the latter, endurance through suffering. The emphasis on futurity is often forgotten in favor of the now. Futurity requires a culture and society of hope. I posit that our current economic and social structure must improve to provide a better chance for people to see past today. Shneidman includes this quote from Robert Litman, "People commit suicide because they cannot accept their pain, because the pain does not fit in with the concept of themselves, with their personal ideal" (p. 159). I agree. The best societies would enable us to reach for our personal ideals. For those studying human distress and suffering, this is a useful entry in the literature. I removed two stars because of my discomfiture with the methodology and the rights of the dead to peace and privacy.

[Max · Rating 4 out of 5]

22 『자살하려는 마음』 - 에드윈 슈나이드먼, 서청희 안병은 옮김
⭐⭐⭐⚡
p128 - 자살은 선택할 수 있는 한 방법으로 그냥 내 마음 한구석에 보관해 뒀죠. 그렇게 하는 것이 더 안전하게 느껴졌어요.
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정신통에서 기인하는 '해결책'으로서의 자살의 과정을 저자가 직접 접촉한 에린, 카스트로, 베아트리체라는 세 사람과의 소통과 연구, 그리고 또다른 사례들을 통해서 보여준다. 주제 자체가 갖는 무거운 날카로움 때문인지 어렵지 않게 이해할 수 있는 글로 설명한다.
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자살자나 시도자에 대한 이해, 상황의 불우함과 불안함이 당사자의 내면에 뿌리를 내려 고통을 심화시키는 인생시기의 장면들을 구체화해서 보여주는 측면에 비해 ㅡ '누구에게나 고통의 순간이 있다'는 식의 일반화를 강조하며 당사자들의 고립감, 지속적인 고통의 체화와는 유리된 결말을 맺는 데서... 책의 완결성 어딘가가 와그작 무너져내린다.
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안락사를 지지한다. 경제적인 이유로 죽음을 강요받는 경우가 분명 나타날 거라는 반대 의견을 알고 있지만, 고령화를 따라가지 못하는 복지와 심화되는 부의 불평등 속에서 어떤 대안도 없이 끔찍한 고통을 안고 벌어지는 죽음보다는 안락사가 낫지 않겠으며, 어쨌든 반대는 쉬우나 돈은 절대 나눠지지 않는다.
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세계는 이미 안락사를 용인하는 기류가 강해졌으며, 딱하게도 이 책은 안락사가 허용하는 사유들에 관해서 당사자성 어느 하나도 고려하지 못한다.
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슈나이드먼과 교류한 셋 중 한 명은 후유증으로, 한 명은 권총 자살로 세상을 떠났다. 저자를 탓 하는 것은 아니다. 고통은 어떠하다고 말하는 것은 쉬우나, 고통을 실제적으로 조정하거나 조절하는 것은 전문가에게도 어렵다는 사실이 발견될 뿐이다.
ㆍ
이 책을 읽는 게 쉽지는 않았다. 분량에 비해 비싸다는 점 외에도 사춘기 이후 언제나 하나의 선택지로 죽음을 염두해 둔 오랜 시간을 살아왔기에 이 책의 어느 부분이 방아쇠가 되진 않을까 하는 염려도 있었다. 파스칼의 보험 성격으로 유지하는 삶이나 신앙 같은 것에 딱히 설득되지도 않고.
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도덕적인 이유, 타인의 상실감까지 고려해야 하는 건 고통의 무게를 더할 뿐이다. 개인에게 있어 사회기준으로 유통되는 도덕은 고통에 앞서지 못하고, 상실감은 시간에 희석되기 마련이지만, 영원한 수원水源을 가진 듯한 고유의 고통은 아물지 않는다.
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이유없이 어느 날 등장한 불면증이나 종이 한 장 따위의 차이로 미래가 완벽하게 다른 색깔이 되는 세계에서 눈에 밟히는 건 폐지를 줍는 노인들이나 해피빈 탭에서 도움이 절실한 사람들이지 연금생활자가 명의를 빌려주고 가욋돈을 버는 노동없는 삶이 아니다.
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분명히 고통은 누구의 인생에서나 불가피한 존재이지만 고통은 결코 평등하지 않다. 선천적, 혹은 후천적으로 겪는 신체적 고통이나 환경과 상황에서 기인하는 것은 결과 질감이 다르다. 141억 위자료가 어떤 재벌에겐 감내할 만한 지출이었겠지만 몇 억에 생과 사를 오가는 경우가 보다 흔하다.
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정규분포의 대다수도 그러할진대 일상의 고통이나 회복하기 어려운 기회 손실이 각인된 삶에게 주어진 미래야 딱히 지속할만한 유인이 없다.
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끔찍한 이야기로 느끼는 분들이야 이미 이 글을 안 읽고 있겠지만, 이 책이 제재를 정의하는 것과 다른 #데이비드게일의일생 같은 죽음이 아주 없지도 않다.
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p.s. 안전한 죽음이 불안전한 삶을 버티는 것보다 나쁘다고 할 수 있는가.
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#자살하려는마음 #한울아카데미 #에드윈슈나이드먼 #edwinshneidman #자살학 #심리부검 #책 #독서

[Somu]

Not sure what to rate this book honestly. So I think I’ll just leave it empty for now. It was an interesting look into suicide and why people end up doing it. I particularly liked the inclusion of people’s stories. That helped make the book less academic and have a bit more humanity which is important when dealing with a book like this. I actually cried when reading particular stories that’s how much I was moved. Overall I would say it’s an interesting read and I would recommend for people who are interested in the topic. I will say however that this might require some experience with academic non fiction books. This isn’t a non fiction you just pick up as your first one. It wasn’t necessarily challenging for me because I’m used to reading these types of books for the past 7 years because of my degree.

[Salli · Rating 4 out of 5]

A very readable book; most of the technical word usage is explained when used. I am in no way versed enough to comment on the science. It is helpful that Mr Shneidman is clear that there are other schools of thought both historic and modern about the causes of suicide. His views do coincide with my limited experience of the matter. The case studies were illuminating, but I do worry in general about science based on single studies and about proof in a social science context - though there was much supporting evidence, the conclusions can really can only be relatively judgement based. Individual cases do of course bring the whole subject to life.

I would recommend this as a useful read for anyone studying the subject at a non doctoral level.

[Rita-Jane · Rating 5 out of 5]

I've never felt so understood, or understood my mind in the way this book helped me too.

If you've ever contemplated taking your life, or know someone who has, and want to understand and help, read this book.

Everything is explained simply and thoroughly enough to be super accessible. Schneidman is as equally scientific as he is empathetic, it's obvious that he has a genuine love of the science but also genuine empathy for the people involved in his research.

This was published in 1996 so I don't know how up to date the specific science is, but as someone who has had thoughts like the people Schneidman wrote about, I found it extremely relatable and accurate.

[Robert Bogue]

After someone close to you commits suicide, the nearly universal response is to try to understand what they were thinking. How did they come to view suicide as the only (or best) option? That's the question that The Suicidal Mind seeks to answer. What is it that makes people commit suicide? Shneidman's description is robust, but it all comes down to psychological pain that he calls "psychache."

Read more

[Hikaru · Rating 1 out of 5]

I tried with this, making it a few pages at a time. And I just couldn't finish it. Clearly the author has never been suicidal and it shows. The case studies are all pretty much the same in terms of reason and the only differences is execution. There's no real analysis. As someone who has been suicidal, I feel like most of this didn't describe any of my thought processes. Can't slog through this anymore.

[Hannah · Rating 1 out of 5]

Disappointing. His research shows that one of reasons for suicide is a child minded person who had a failed relationship with their father and felt unhappiness towards never bonding with him. That point, alone, made me shake my head at this book. I doubt that not having a father growing up is that significant of an event to cause life long unhappiness regardless of other positive role models. However, his 10 characteristics of suicide is more believable.

[Jasper Hudson · Rating 5 out of 5]

the title is confronting, and the subject is dark but the unpacking of suicide and complex mental health disorders helps clarify the nuances of the human psyche. I would highly recommend this for anyone who has been impacted by losing someone to suicide, or has experienced challenging mental health concerns. It is an optimistic analysis of an abstract topic.

[Sam · Rating 3 out of 5]

Good supplemental reading for CAMS training in reference to "drivers" or psychological pain that leads to suicide. This book would be most helpful for clinicians who want to understand suicide. I think it's very brief on treatment strategies, and talks about basic therapeutic interventions.

[Vicente del Cid · Rating 3 out of 5]

I see glimpses here of something really fascinating. I feel prompted to research the topic more, and in that regard the book is a triumph. Maybe it’s just more difficult for non-fiction to resonate with me the way a narrative does.

[Sophie Lynne · Rating 4 out of 5]

As a suicide survivor, and having lost my dearest friend to suicide, I wanted to know more.

This book is a broad look at a very complex topic. The concept of "Psychache" is spot on.

[Shal'tiar · Rating 4 out of 5]

Every therapist should probably read this.

[Amanda Marotz Roemer · Rating 4 out of 5]

Excellent book on suicidology

[Cathy · Rating 4 out of 5]

Great read of the why’s people commit suicide and in many ways it’s due to psychache, the human emotion and the fractured psychological needs. However, it really needs to cover about the why people are suicidal due to their situation, socio economics, their race and generational trauma. I found this book helpful somewhat but also quite limiting.