Suicidal response to frustrated needs

Why do people take their own lives? Because they experience intense psychological pain and their thinking has narrowed to the point that they see death as the “only” way to escape the pain.

That was the view of Edwin Schneidman, who was one of the world’s great authorities on suicide, and whose 1996 book, The Suicidal Mind, I have been reading and would recommend.

What causes the psychological pain? According to Schneidman, a person in enough pain to take his or her own life is likely to have been frustrated in relation to one of five sets of human needs.

First, thwarted love, acceptance and belonging. Second, frustrated needs for achievement, autonomy, order and understanding. Third, the avoidance of shame, humiliation and disgrace. Fourth, a breakdown in key relationships frustrating the need to belong or to nurture another person. Fifth, excessive anger, rage and hostility arising from, among other sources, frustrated needs for dominance and aggression. These human needs were outlined by the psychologist Henry Murray in 1938 and his work was an inspiration to Schneidman.

The key point Schneidman makes again and again is that suicide arises from the need to escape psychological pain. The person who takes their own life has probably considered and rejected the solution of suicide many times. Eventually, the point of view narrows to the extent that loss of consciousness through suicide is seen as the only way of getting rid of the pain. It is that “only” that does the harm: it shuts off the other avenues that usually exist, even if they are not appealing at the time. The person’s thinking becomes, in Schneidman’s term, “constricted” – the person no longer sees the bigger picture.

Many suicide notes show a concern for the family and others loved by the person who is about to inflict this horror on them – yet the thinking is now so distorted that the contradiction between loving people while hurting them in this way does not seem to be understood by the note writer.

Some hope for intervention by others can be found in two of Schneidman’s conclusions. First, for most people, the really acute, dangerous suicidal impulse lasts for short periods: hours or days and not months or years. If they can get through this period they may not go on to kill themselves – and indeed many who are rescued at the last minute go on to live to old age (I am sorry if this hurts people who were hours or minutes away before the event and arrived too late to save a loved one but it is important information).

Second, Schneidman was convinced that suicidal people are ambivalent to the end. They want to die but they want to live. According to Freud, having opposite motivations at the same time is a normal part of human nature.

According to Schneidman, the key to helping suicidal persons is to explore what frustrated needs are behind the psychological pain they are suffering and to help them to see that death is not the only way to help ease that pain. Many experience the frustration of needs without taking their lives. What counts is the intensity of the pain felt by the individual – the importance of the frustrated need and the intensity of the pain caused by its frustration will vary from person to person.

That is why it is so important to identify what is behind the pain and to explore other ways of reducing that pain: and that applies whether you are helping a suicidal person or if you are the suicidal one.

Padraig O’Morain (pomorain@yahoo.com) is a counsellor accredited by the Irish Association for Counselling and Psychotherapy