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Abstract
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Many years ago, I was on a television program about suicide which took calls from viewers. With only a couple of minutes before the end of the program, a call came from a woman whose alcoholic husband continually beat their children and threatened suicide. What should she do? Luckily, the question was given to a colleague of mine to answer. Her thirty-second response was that, as long as he kept beating the children, he probably would not kill himself. But if he stopped beating the children, the risk of his suicide was greater. I remember thinking what a good response that was from a theoretical perspective and how useless it probably was from the point of view of that wife. This anecdote does, however, indicate the difficulties of living with and, for the therapist, counseling the chronically suicidal individual.
In the 1970s, suicide researchers began to focus on those suicidal individuals who make repeated attempts at suicide, surviving each time. One of the earliest suggestions was that these individuals were not really suicidal, that is, they did not intend to kill themselves. Kreitman and his British colleagues (Kreitman, et al., 1969) suggested therefore that the term attempted suicide should be abandoned and replaced with parasuicide for first-time attempters and especially for multiple attempters, and European journals today still use the word parasuicide. However, the 1980s have witnessed a growth in the use of the term self-injurer or for those taking overdoses self-poisoners for first-time and repeated suicide attempters. These terms clearly avoid the implication that repeaters are trying to kill themselves.
Research into those who make multiple attempts at suicide has revealed that they are more often diagnosed as having an antisocial or other type of personality disorder, more likely to have received psychiatric treatment in the past, more likely to be unemployed and to have a criminal record, and more likely to be alcohol abusers (Lester, 1983). Occasional studies have suggested that repeaters are more often younger, female and from the lower social classes. Thus, repeaters appear to have a chronic maladaptive life style in many respects of which multiple suicide attempts appear to be but one component...
Language: en |