There is arguably no more frightening a discovery for a parent who one way or another finds out their child has considered or attempted suicide or intentionally harmed themselves.
It evokes powerful emotional reactions, can seemingly come ‘out of the blue’, although certainly not always, and is often very difficult to comprehend. A great deal has been learned about suicide and self harm in young people during the past decade or two. Psychological research has given us some insight into these complex phenomenon and this article seeks to outline briefly some of this information.
Thinking about suicide is common, as research show us that as many as 25% of teens aged between 12-15 will consider it at some point, and this figure is a sharp increase compared to those aged 10 or younger (1%). In Ireland we have a particular problem with suicide and self harm amongst our young people, being ranked fourth in European countries for completed suicides in the 15-19 age groups across boys and girls. This compares to our overall standing as being ranked 21st out of 31st.
Why do young people consider taking their own lives?
There are many possible answers to this question however Thomas Joiners Interpersonal theory speaks volumes. He posits three elements that are the universal pathway to suicidal behaviour. In other words regardless of all other risk factors these three are always present, and therefore essential in understanding the suicidal person.
The first is Perceived Burdensomeness, in other words the young person believes something along the lines ‘they’d be better off without me’. It begins with a perceptive of ineffectiveness, ‘I can’t cope with school’, which leads to a sense of this negatively effecting others ‘My parents will be relived if they don’t have to deal with me anymore because I’m causing them so much stress’; which progresses to ‘if I’m not around, it will benefit them, they will be better off without me.’
The second element is thwarted belongingness ‘nobody cares about me’. This is a profoundly important aspect of all our lives, to feel like we belong, that we are loved and valued and valuable to others. This is a particularly acute need during adolescence when peer relationships take on immense importance and sensitivity to these relationships becomes intense. This is why experiences such as social exclusion or bullying are such powerful drivers of suicidality amongst young people. Connectedness in the family system is also extremely important during adolescence despite the urges to individuate and become independent.
Thwarted connectedness and perceived burdensomeness create the desire for death. However young people also need to have developed sufficient fearlessness of physical injury to enact a suicide attempt. This can develop through many avenues including high risk behaviour, repeated self harm, physical assault or abuse being some typical examples. It is when the desire for death exists in the form of perceived burdensomeness and thwarted belongingness coupled with fearlessness of bodily injury, that suicide becomes particularly likely: ‘they’d be better off without me, nobody cares, and I’m not frightened of hurting myself anymore’.
Why do young people hurt themselves?
There are many reasons why people hurt themselves, but again there are some common themes that seem to run through the stories those who self harm tell us. Self harm is typically preceded by some form of negative emotional state, or negative self state the person wants to change (anger, hurt or intense self hate for example). Self harm is typically followed by a reduction in negative emotional states and the presence of a sense of relief. Self harm is most often performed with the intention to reduce negative emotional states however other motives include self punishment, a way of combating dissociation, sensation seeking and ironically as a way of avoiding suicide. This last one is complicated by the fact that self harm increases the risk of suicide by increasing over time fearlessness of bodily harm.
What to do?
Addressing suicidality or self harm with a young person is not an easy thing and there is not a one size fits all response. Typically for example, if a psychologist is working with a young person to address either self harm or suicide they will conduct a thorough psychological and psychosocial assessment sometimes lasting several hours, to get an understanding of the unique meaning of suicide or self harm for each young person. As such the following are simple guidelines but more in-depth analysis of your child’s difficulties may be required.
Do’s
- Listen and empathise (I want to understand with you how you have come to this – can you help me understand)
- Identify if they are thinking about suicide, if they have made plans, have access to lethal means. If so reduce this access by removing any obvious objects like pills, blades, ropes etc., particularly from the bedroom.
- Ask about reasons – discover what the problems are and think about other ways to solve them other than suicide. Sometimes simply sharing a problem is enough to make it diminish in intensity. Also keep in mind that while you as a parent might care the most anyone ever will about your child, you might not be the easiest person for them to talk to about their problems.
- Help the young person find out about or contact others who have had and survived the difficulties they are struggling with
- Make a plan to get them help and follow up
- Take all expressions of suicide seriously
Don’t’s
- Sweat the really small stuff. If it’s not that big a deal let it go, particularly during times of stress. Communication is key in understanding what the small stuff is and what is more serious.
- Judge ‘You shouldn’t feel or think this way’
- Dismiss ‘Ah he’ll/she’ll be grand it’s only a phase’
- Ignore warning signs
- Provoke ‘Go on then if you’re going to do it!’
You can find out more about supports and workshops for parents or concerned adults at this page.
Help information:
- Samaritans 116 123 or email jo@samaritans.org
- Pieta House 01 601 0000 or email mary@pieta.ie – (suicide, self-harm)
- Teen-Line Ireland 1800 833 634 (for ages 13 to 19)
- Childline 1800 66 66 66 (for under 18s)
- yourmentalhealth.ie
- Aware 1800 80 48 48 (depression, anxiety)
- National Suicide Helpline 1800 247 247 – (suicide prevention, self-harm, bereavement)
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