A contextually informed motivational premise of suicide

Abstract

A key limitation with most local studies on suicide is the failure to explain individual suicidality, even though individual vulnerabilities playa major role in the overall picture of suicide. The present research examines suicide from a psychological and contextual perspective, exploring motivation and emotions involved in the decision-making to attempt suicide. It used a qualitative methodology, using case studies as its main data collection tool. The study's sample involved six cases (three male and three female; mean age - 21), selected from among a population of in-patients admitted to a general hospital for treatment. Data analysis was informed primarily by post-Freudian, person-centered and cognitive theories of personality development. All cases reported two different but connected feelings in common: the feeling of 'rejection,' and that of 'un-wanted ness' by significant others in his/ her life. Another psychological concern was a sense of 'unworthiness', fuelled by the type of reasons expressed by intimate others (and in some cases, by the subjects themselves) to explain the social rejection of subject. A third concern was feelings of guilt, and shame. The final key observation was an internalized sense of self-pity and aggression, directed towards one's own self. The subjects showed a tendency to transform social rejection into self-defeating feelings and self-directed aggression, which ultimately motivated suicide. In most cases, subjects were convinced that their abusive experiences were wrong; yet their strong ideal images of self (whose validity is completely dependent on pleasing the authority figure), and strong feelings of vulnerability and helplessness against the abuser have stopped them from confronting the abuser. Furthermore, they have internalised and identified with the abusive system, which has created a sense of helplessness towards systemic pressures. Emotional boundlessness and enmeshed, rigid relationships have added to the complexity of the scenario. In some cases, suicide is provoked by a failure of 'splitting' in the face of a traumatic event. Suicide, in such an instance, has become the ultimate defense against a flood of repressed and suppressed material that surfaces, creating too much anxiety for the person to bear. In contrast to the conventional notion on motivation of suicide as instigated by the individual, the current study showed that external, social and developmental forces playa significant role in instigating as well as maintaining subjective motivation for suicide. The findings emphasize the importance for clinicians to look beyond current psycho-socio pathology of a suicidal client, to recognize and address deep rooted, development-related concerns, dysfunctional personality traits and cognitive explanatory styles in order to construct more effective preventive and treatment interventions for suicide.