Before I continue speaking about contagion I would like to take a moment for a poetic interlude. Each stanza pf the following poem reminds me of the thoughts held by people at risk that I have helped over the years. The following was written by a 14 year old young man:
Through early morning fog I see
Visions of the things to be
The pains that are withheld for me
I realize and I can see…
I try to find a way to make
All our little joys relate
Without that ever-present hate
But now I know that it’s too late, and…
The game of life is hard to play
I’m gonna lose it anyway
The losing card I’ll someday lay
So this is all I have to say.
The only way to win is cheat
And lay it down before I’m beat
And to another give my seat
For that’s the only painless feat.
The sword of time will pierce our skins
It doesn’t hurt when it begins
But as it works it’s way on in
The pain grows stronger… watch it grin, but…
A brave man once requested me
To answer questions that are key
Is it to be or not to be
And I replied ‘oh why ask me?’
As I mentioned in the close of the last episode of this missive – “Suicide contagion is the exposure to suicide or suicidal behaviors within one’s family, peer group, community or through media reports of suicide and can result in an increase in suicide and suicidal behaviors.” Such exposure has been shown to precede an increase in suicidal behavior in persons at risk for suicide, especially in adolescents and young adults. Suicide Contagion can be manifested through Suicide Clusters, Copy Cat Suicides and Suicide Pacts.
- Cluster Suicides – consecutive suicides in an area among demographically similar groups. They are defined as multiple deaths that occur in a defined geographical area falling in an accelerated time. Clusters consist of more than three victims, typically ranging from 13 to 24 years old, and occur within approximately a one to two year period.
- Copycat Suicides – the emulation of another suicide that the person attempting knows of through local knowledge or media accounts of the original suicide.
- Suicide Pacts – an agreement by two or more individuals to die by suicide.
Suicide contagion can be minimized by
- Factual and concise reporting of suicide
- Not repeating reports of a suicide in a community as repetitive and prolonged exposure can increase the likelihood of contagion
- Acknowledging that suicide is the result of many complex factors while avoiding simplistic explanations the death was a result of recent negative events or acute stressors
- Not divulging detailed descriptions of the method of death can avoid possible duplication by others at risk.
- Not glorifying the person who dies or implying the death from suicide was an effective method of achieving a specific goal
- By addressing suicide providing information regarding the effectiveness of various treatment options and alternative and less harmful methods of coping with stressors
- By providing information such as hotlines or emergency contacts for those at risk
While we may assume the above list applies to media outlets it also applies to us as individuals. These guidelines can help us frame our discussion of suicide with those we know including our children.
We might assume open discussion of suicide would be something to be avoided. This assumption is based on the stigma and taboo we as a society attach to suicide. Society still attaches a stigma to suicide, and as a result it is largely misunderstood. The taboo nature of suicide serves to ensure that it remains a subject we avoid addressing in public. We don’t know how to talk about suicide, so we shut our minds to it. We whisper about it behind our hands but we hardly ever address it in the open. By talking about it openly we can begin to work towards preventing suicide. In a manner of speaking we can applaud the efforts of the 13RW producers though their method does not adhere to the appropriate media guidelines.
The reality is that actively acknowledging a death is the result of suicide can promote healing and minimize contagion risk. Publicly disclosing that a death was a suicide can help communities and schools direct efforts to reduce risk of contagion. Recognizing that suicide loss affects not only those closest to the individual but entire communities our silence can – and does:
- Make survivors of the suicide loss can feel isolated
- Serve as a barrier to seeking beneficial help by those impacted meaning that vulnerable persons will develop a greater suicide risk
- Lead to facts being replaced by rumor and speculation
- Reinforces the stigma and taboo of suicide further increasing the isolation experiences by those at risk
- Ignore suicide as a public health issue
Being open about suicide can effectively guide memorial activities and community education that have a healing effect that reduces the risk of contagion which we will talk about in the next episode. But before I leave for today I would like to return to today’s opening poem. It is actually something each and every one of you is familiar with. Maybe if I post the refrain that I left out between each stanza:
That suicide is painless
It brings on many changes
And I can take or leave it if I please.
In the 1970 movie MASH there is a scene called “The Last Supper,” in which Captain Walter “Painless Pole” Waldowski decides to kill himself after a “romantic failure”. In response, the MASH team wine and dine with him in a pre-death “wake”. Director Robert Altman asked a friend, Johnny Mandel, to compose a song that had to be called “Suicide Is Painless,” and it had to be “the stupidest song ever written.” Altman explained to Mandel he only had to write the music and that he would provide the lyrics. When “Director Dad” Altman discovered writing stupid lyrics was not as simple as he thought so he asked his 14-year old son Michael to write the lyrics for “the stupidest song ever.” For compensation 14-year old Michael got a guitar and a lifetime of royalties for the song. We got an interesting teaching tool to explain the warning signs of suicide.
Stay tuned for Episode 5
*You Are Not Alone. If you are thinking thoughts about suicide please contact:
IMALIVE.org, crisistextline.org, National Suicide Prevention Line 1-800-273-8255, International Resources