by PG Quinnett · Cited by 49 — Rather, it is my feeling that the more we learn about dying, the more we learn about living. self- or other-assisted suicide under any circumstances. When the mares had been caught and corralled, Ivan’s son set out to break them to saddle
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SUICIDEThe Forever Decision New 3rd EditionBy Dr. Paul G. QuinnettDr. Quinnett is a clinical psychologist and the Director of the QPR Institute, an educational organization dedicated to preventing suicide. He has worked with suicidal people and survivors of suicide for more than 35 years. Author of seven books and an award-winning journalist, he is also a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Science at the University of Washington School of Medicine, Seattle, Washington.
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Compliments of the QPR Institute Suicide: the Forever Decision For those thinking about suicide and for those who know, love and counsel them. DISCLAIMER Both author and publisher wish the reader to know that this book does not offer mental health treatment, and in no way should be considered a substitute for consultation with a professional. The identities of the people written about in this book have been carefully disguised in accordance with professional standards of confidentiality and in keeping with their rights to privileged communication with the author.
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TABLE OF CONTENTSINTRODUCTION CHAPTER1 CHAPTER2 CHAPTER3 CHAPTER4 CHAPTER5 CHAPTER6 CHAPTER7 CHAPTER8 CHAPTER9 CHAPTER10 CHAPTER11 CHAPTER12 CHAPTER13 CHAPTER14 CHAPTER15 CHAPTER16 CHAPTER17 CHAPTER18 CHAPTER19 EPILOGUE Introduction 5You Don’t Have to Be Crazy7An Idea That Kills . 11Don’t I Have a Right to Die?. 13Are You Absolutely Sure?. 19One Step Back, Please. 25The Bug in the Cup . 27Loneliness .. 31The Good News About Depression 39Angry Enough to Kill Yourself? . 45Maximum Stress .. 50Too Hopeless to Hope. 58Drugs, Booze, and Fatal Mistakes .. 67They Won’t Love You When You’re Gone, Either .. 72 For Those Who Have Tried . 79What If You Don’t Succeed?. 83 The People You Leave Behind. 87 Time Heals . 92Getting Help 94A Philosophy of Life. 101Epilogue . 1051
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INTRODUCTION Dear Reader; I don’t know who you are or why you are reading these words. I only know that you have picked up this book and, for the moment, you are reading it. It is my hope that if you need this book, you will continue to read it. As an author, it would help me a great deal if I knew more about you. But I don’t and, unless we meet sometime someplace, we can never know one another. So we are stuck right here in the beginning. We are strangers and that is the way things will be between us. But this should not stop us. At least it will not stop me. I am going to write this book directly to you, as if you were sitting with me in my office. My office is a warm room. It is quiet and private. We have comfortable chairs and the phone doesn’t ring. No one will disturb us in my office. It is the office in which I do what psychologists often do-listen to people, talk with them, and try to help them with life’s problems. At the outset I must assume a couple of things about you. And while it is dangerous to make assumptions about people, because of our relationship, I will have to do it. I will assume that because you are reading this book, you have thought about taking your own life, or that you have already attempted to do so. Either way, I will assume you are greatly troubled and that you have considered ending your life. Assuming this to be true, I am going to talk to you about the pain of living and the consequences of dying, so far as I know about them. I am going to talk to you about suicide. And because your life is at stake, I am not going to fool around. I am not going to kid you. I am not going to mince words. Rather, I intend to be just as honest and straightforward as I know how to be. And because I have known many people who have wanted to kill themselves and too many who have, I have some idea of what kind of mood you are in at the moment. I know you may not be up to reading a book. But maybe you could read this one. I will keep it short. One of the reasons I have written this book is that suicide is an unpleasant topic. People do not like to talk about it. They do not like to hear that another human being is so troubled that he or she is considering self-destruction. But this silence is not good for us. It is not good for the troubled person and it is not good for those of us who may wish to avoid the fact that someone we know is so desperate and so alone that ending his or her life seems the only solution. It is time we talked, and talked candidly. Some people may argue that a book of this kind should not be written and that, somehow, talking plainly about suicide will increase the chances that a reader may die by suicide. I do not believe this is true, and several research studies support my opinion. Rather, it is my feeling that the more we learn about dying, the more we learn about living. And, when we have learned more about both, maybe we are better able to fully live all of the life we have left to us. Another reason I have written this book is that many people kill themselves without ever knowing that help was just phone call away. You wonder, in this modern age, how this can be. But it is true. So maybe this book will find its way into the hands of someone who never knew 2
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help was there and where to find it. Maybe this book will give someone that little bit of courage they need to ask for that help, or to hold on for another day or another week or until their life changes for the better and the thoughts of suicide begin to fade. Just one more note. I do not have any magic answers or quick solutions to life’s problems. I don’t think anyone does. So I won’t offer you any easy ways of living or simple solutions to the pain and suffering that seem to be a part of all our lives. But because this book is about suicide and nothing less than your life is at stake, I won’t apologize for what I have to say to you that you may not like. For all I know, this book may be the last thing you ever read. Paul Quinnett 3
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CHAPTER 1YOU DON™T HAVE TO BE CRAZYThe first thing I want to tell you about suicide is that you don’t have to be crazy to think about it or, for that matter, even to try it. Suicide is a solution. No matter what anyone tells you, suicide does solve problems, at least your problems. And if you succeed, it solves them once and for all. As you have no doubt already figured out, once you are dead nothing can hurt you anymore. Once you are dead you are beyond feeling bad. Once you are dead you can’t possibly care what happens anymore. Whatever pain you are in, it will end just as soon as you stop breathing. Since there is no point in kidding each other right here in the beginning, I won’t argue with you that suicide doesn’t work. It does. Or at least it seems to. Before this time in your life, my guess is that when you heard people say they felt like killing themselves, you thought they were crazy. Now, if you are in that same place, maybe you can see how they felt. For whatever reasons people think it, most of them will say you are crazy for thinking about suicide. Or, if you kill yourself, they will say you must have been crazy to have done it. But the truth is that most people who kill themselves are not mentally ill, at least in the way we think of people who are fiout of their minds.fl Yes, people who are psychotic sometimes kill themselves, but most people who die by suicide are people just like you and me; people who, for reasons I hope you will explore with me, have decided that life is just not worth living anymore. The great majority of people who attempt or complete a suicide are so sad or hopeless or angry that they simply can’t stand life anymore. Or they have been dealt such a terrible blow by life that they are overwhelmed and can see no other way to end the feelings of loss, stop the suffering and regain control over their future. But they are not crazy. And, most likely, neither are you. Later in this book I will talk in detail about depression, loneliness, anger, hopelessness, stress, and how these states of mind can influence us and trigger our thoughts of suicide. But for the moment I encourage you to try to read the book through from front to back so that you will understand the hows, the whys, and all the risks and consequences of trying to kill yourself. One of the things that happens when you begin to think about suicide as a way out is that you begin to feel better, sometimes a little better, sometimes a lot better. After all, when you’ve been stuck with a problem for which there seems to be no answer, finally finding one is a great relief. You might ask, “How can this be?” Because we humans are capable of imagining doing things we have never done or being in places we have never been, we are all capable of imagining what it might be like to be dead, or at least what it might be like not to be alive. Only man is capable of imagining his own death. We can play our death out like a role in a movie. We can close our eyes and see ourselves lying lifeless in a casket. Whether we will admit it or not, just about all of u s at some time or another, have imagined what it would be like to be dead. It is this powerful ability to imagine an end to our problems that makes thinking about suicide possible. And it isn’t like anyone can stop us from thinking about taking our own lives. It is our mind, our imagination, our ability to anticipate what death might be like that makes us human beings and no one, but no one, can stop us from being human. 4
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But this is okay with me. I don’t mind being ignorant. I don’t like being embarrassed because I don’t know something, but then nobody ever promised me I’d always know everything I needed to know when I needed to know it. And, unless you got a different guarantee than I did, I don’t imagine you’re any better off. But I think we can, all of us, hope that each day we will get a little smarter. And I have always felt that if I can look back at some dumb decision I made and say to myself, “Paul, that was a stupid decision,” then at least I’m not getting any dumber. So what has all this to do with suicide? What it has to do with suicide is this: when people start thinking about ending their own life, they generally don’t have all the facts. Since the majority of suicidal people are depressed and not thinking clearly, they may think they have all the facts, but they don’t. And, because suicide is such a permanent solution and one you can’t go back and remake, then for your own sake, perhaps you ought to make the decision only after you™re feeling good again and then only after you have considered all the facts. And I mean every single one. One thing I have learned from people who have thought about suicide and finally decided to do it is that once they’ve made their mind up, they suddenly feel better. In fact, some of them have told me they feel wonderful. “Now I know what to do!fl they have said. And this is exactly what happens to any of us once we have finally found a solution to a problem we’ve been struggling with. It is as if we have set down a huge burden and, in setting it down, we feel a great relief. But just one minute. Sure, suicide will stop the hurting. Suicide will make all the problems go away. Suicide will end the nightmare that living has become. But is it really as simple as all that? Isn’t it a bit scary? And isn’t it awfully final? You might think that last question is a silly one. Of course suicide is final. But you might be surprised to learn that the younger a person is, the less he or she knows about death and the finality of death. But the older you get, the more death you see and, in the process, you come to know that a suicide attempt that ends in death is truly a final decision. As a friend of mine who works with suicidal young people recently said, “Some kids think suicide is a fad. They have a big problem and they say, ‘I think I’ll try suicide this week. If it doesn’t work, I’ll try something else next week.'” Next week! If I have a job ahead of me in this book it is, more than anything else, to convince you that what looks like a quick and easy solution actually isn’t all that quick and easy. As often as not, suicide is a complicated, messy business and creates as many problems as it solves. True, you don’t have to be crazy to think about it or maybe even try it but, if you’ll forgive the joke, suicide can be dangerous to your health. 6
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CHAPTER 2AN IDEA THAT KILLSWhat I want to talk to you about in this chapter is just where you got the idea of taking your own life in the first place. It didn’t just pop into your head one day from out of nowhere. But since I can’t ask you where you got the notion, I’m going to have to do my best to help you figure this out for yourself. Take a minute right now and ask yourself, “When did I first start thinking about taking my own life?” Now ask yourself, “Have I known anyone who died by suicide?” Because human beings learn a great deal from each other, all of us are subject to examples set for us by people we know, by strangers, and by famous people. We learn which fork to pick up at a formal dinner by watching the person next to us. We learn what to wear to the dance by watching what other people wear to dances. Most of us cut our hair long or short, depending on what most other people our age are doing with their hair. For those of us who live in America, we all know Marilyn Monroe died by suicide. We know the novelist Ernest Hemingway killed himself. We read about people killing themselves all the time. And sometimes we think, “If someone like Marilyn Monroe, with all her beauty and money and success, can kill herself, why shouldn’t I?” Or maybe someone in our family died by suicide. If one of our parents died by suicide, then we might well ask ourselves, “If dad couldn’t take it, how can I?” Or maybe one of our best friends died by suicide. Or someone at school. If we look around our own hometown and read the papers or watch the news on TV, one thing is very obvious: people are killing themselves all the time. While not exactly a pastime, people all around us are making attempts on their lives. In the time it took you to read this small section someone, somewhere in the world died by suicide and dozens more made an attempt. According to the World Health Organization, suicide is a leading cause of premature death. It is estimated more than one million people die by suicide each year in the world, or more than 2,700 people per day, and approximately 80 of these are Americans. What does this tell us? What this tells us is that we got the idea of dying by suicide from someone else. We didn’t think of this solution all by ourselves. Suicide is hardly a new idea and people have been doing it for as long as there have been people. And so, if we somehow have got hold of the idea of solving our problems by suicide, then we must have got it from someone — a friend, a family member, a famous person. Someone, somewhere has shown us that suicide is something we too can do. And when someone else has shown us the way, is it easier for us to take the same route? The research on this is very clear: When a famous person like Marilyn Monroe kills herself, the suicide rate rises. It is as if the people who had been thinking their problems were insoluble saw, by Marilyn’s example, that self-destruction was a real possibility. Maybe they said, “If it was good enough for Marilyn, it is good enough for me.” 7
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And when a Japanese teen idol killed herself by jumping to her death, at least six teenagers also killed themselves within just a few days. Some of them jumped and most left a note indicating they had taken their cue from her example. The same thing happens closer to home. When one or two kids in a high school kill themselves, more kids are likely to kill themselves. And if someone in a family dies by suicide, the rest of the family members are more likely to die by suicide. Right or wrong, we all learn by example. One suicidal man I worked with was very serious about ending his life. His wife had had an affair with another man, his kids were in trouble, and his job was not going well. I asked him where he got the idea of taking his own life. “Well,” he said, “both of my parents committed suicide.fl I had never met a man whose mother and father had both killed themselves. But I knew that whatever I might be able to say to him about why he should go on living, I was up against the two most powerful and influential people in his life, mom and dad. “I was only five when they did it,fl he said. “So I don’t think it bothered me too much.fl But of course it had. As we worked together, he was able to tell me that every time he had faced a tough problem in life, the idea of committing suicide had crept into his mind, almost against his will. It was as if, despite his promise never to kill himself as his parents had, he could not stop thinking about it. And now that his life was going very badly, he could not keep the thoughts out any longer. So in a way this man really had no chance to avoid thinking about suicide. It had been there since his first memories. It was as if his parents had given him a terrible gift. They had shown him that, when life becomes unbearable, this is what you do. So I need to ask you once again, just where did you get the idea of taking your own life? Has someone who was close to you shown you the way? Has a parent or a grandparent or an uncle or an aunt or a friend set an example for you? Or have you compared your misery with someone whom you thought you knew and decided that if suicide was good enough for them, it is good enough for me? If your answer is yes, then I will ask you one simple question: Is your life, your problem, your particular pain, exactly like theirs? Are you an identical person in an identical crisis? I think your answer has to be no. Because, like it or not, we are all entirely separate, entirely different, entirely unique human beings. There has never been anyone exactly like us on the planet before and there will never be anyone exactly like us on the planet in the future. However much we may not like ourselves or however much we may regret what we have done or have become, we are at least one-of-a-kind persons, the likes of which this world will never see again. And, being such unique creatures, shouldn’t we make our own unique decisions? 8
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CHAPTER 3″DON’T I HAVE A RIGHT TO DIE?”A lot of suicidal people I’ve worked with have asked me this question and, frankly, I don’t have a very good answer. In a way, I’m glad I don’t. But since I imagine you may have asked yourself this same question, I’m going to share with you what I have told others. First, it is not for me, a psychologist, to say whether you have a right to die. There is nothing in my training or background or personal experience that gives me any special knowledge about the subject. I am not a minister or a priest or any kind of church authority. I am not a judge. If anything, I have been trained to save lives, not to help people end them. At least from a legal point of view, I think I can give you a partial answer: No, you do not have an absolute right to kill yourself. At this moment in the history in America and most other countries it is still against the law to attempt suicide and if you try it, unpleasant legal consequences may follow. Although it rarely happens now, not so long ago people were put in jail for attempting suicide. But in the last few decades suicide has become less of a crime and more of a symptom that something is desperately wrong with people who try it and that, if given some help, they will give up the idea and get on with living. Frankly, there is a great deal of confusion about this right-to-die business. On the one extreme are those people who argue no one has a right to die under any circumstances and, on the other extreme, are those who say all of us have a right to die any time we so choose, including by suicide. Most of the right-to-die debate centers around the issue of whether a person who is terminally ill or very old and sick and not expected to improve with sometimes painful treatments, has the right to refuse medical care and/or request medical assistance in dying. There are groups of people organized to push for legislation that would permit physician-assisted “death with dignity” for those who are terminally ill. And there are those opposed to any form of self-or other-assisted suicide under any circumstances. While some might disagree, it seems to me that the goals of both groups are humane and none, so far as I know, argues for the right to suicide if you are young and healthy. Perhaps if we could all look forward to competent medical care and sophisticated pain management at the ends of our lives, this debate would evaporate. So unless you have recently gotten the word that you are terminally ill and about to die sometime in the near future, I’m going to assume that you are thinking about suicide for different reasons. You might ask, “What happens if I attempt to kill myself and don’t succeed?” Every state and most countries have some kind of involuntary-treatment law that permits a judge, on the basis of professional testimony, to put you in a hospital for treatment and to prevent you from making further attempts on your life. The government must prove you are mentally ill and therefore need treatment, but it can generally do this without all that much trouble. You lose, however temporarily, your civil rights when this happens. As we have already discussed, however, while most people who die by suicide are depressed and suffering from a brain disorder, you do not have to be psychotic to take your own life. In fact, 9
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