Society

Reflections on Suicide on ‘R U Okay? Day’

In recent centuries life has been construed as a gift from God and suicide, an insult/rejection of the will of God, a criminal offence. Those who attempted were jailed. When completed the deceased was refused burial in hallowed ground, the estate was confiscated by the state and the corpse was paraded, hanged and otherwise desecrated. Times change.

For much of the last two centuries medical authorities have insisted that all suicide was the result of mental disorder. In 2013 the WHO declared this a myth, but adherents remain. Suicide is more common among those with than without mental disorder, but there are more people in the world without than with mental disorder – thus, at least half of those who complete suicide are free of mental disorder.

In mid-August 2022 an Australian ex-champion rugby player and coach, Paul Green, died  by suicide. In all forms of the media members of the public expressed surprise and sadness, and advised fellow citizens to regularly ask each other about their personal lives and, “Are you OK?” A process portrayed as preventing suicide.

Journalists reported details of Green’s death. Newspapers stated “his best friends, family and even his wife had no inkling he was on the verge” of suicide. His mother is reported as saying she had seen no signs of depression. In Green’s last day he attended a child’s birthday party and behaved normally. A baffled friend stated, “It just doesn’t make sense”.

Some days later a close friend came forward and stated Green had been “battling mental health problem” since he retired as a player in 2004. However, this friend also stated, “he was generally happy”. The picture is complicated by the modern term “mental health problem” which sounds clinical but is, in fact, a euphemism for having some difficulties, not feeling happy, perhaps a bit grumpy.

Most accept that people who complete suicide are seeking to avoid negative feelings – disappointment/sadness – either in the presence or absence of mental disorder. But what do we know of our response to suicide, and do we expect that asking people, “Are you OK”, will change anything?

Earlier in evolution our lives were under constant threat. We have retained a useful emotional and physical responses to surprise – our heart rate increases, and we are immediately ready to fight or run away. When it is a nice surprise — a child comes top of the class, say — we jump to our feet, we can feel our heart pumping (a little), and we are a little unsure of quite what to say/do. When we are surprised by an unexpected suicide we are aroused/startled/rattled. But now death has entered the arena. Death means loss – the loss of the life of the deceased, the loss of an important object to friends and relatives. So, suicide is not good, and it would be much better if it didn’t happen.

When an individual is suffering, death may be welcome. It can be argued that Voluntary Assisted Dying is not a form of suicide – but the difference is semantic. The point is that while death involves loss, which is regrettable/mournful, it may also be welcomed by the deceased and some relatives who are fully acquainted with the facts. This is often overlooked and unbridled sadness is expressed in the case of suicide – especially given that from the outside, it often appears that surely something could have been done to fix the problem and avoid the death.

Part of the sadness expressed by observers is for the individual’s “lost years” – a notion quickly discounted by the Stoic philosophers. Some observers have their surprise/arousal and sadness magnified by a whiff of guilt. We too easily adopted the commonly promoted view that if we take care of our friends and acquaintances and frequently enquire after their emotional state, that suicide can be eradicated. While this thinking is generated and dispersed with the best of intentions, it is naïve.

The wish to die may be based on a wish to avoid a painful terminal illness or the consequences of reprehensible/criminal behavior. It may be the consequence of a lost partner, family, or fortune. It may be the consequence of a severe mental illness in which guilt and/or intractable sadness is a feature – in which case the individual needs the care of appropriate professionals.

Most of those who complete suicide are not escaping the consequences of exposed criminal behavior or severe mental illness. Most of us have deeply private lives. Most of us have secret wishes which have never been actualized, perhaps loved another who never reciprocated. Some wish they had studied more and drunk less. There may have been a long-forgotten episode of unfaithfulness, and the forgotten one is now wanting ‘to get in touch again’. There may be what the individual considered ‘friendly leg-pulling’ which has been labeled ‘bullying’, and the workplace justice system is about to hand down an era correct finding. The individual may have cast themselves at work and home as ‘the strong silent type’ and taken unspoken pride in having ‘coped’. For such people, admitting fragility could be the final straw. Thomas Jefferson may have found the harder he worked the luckier he got, but that is not always the case – some toil very hard indeed and are rewarded with very bad luck.

I propose our response to unexpected suicide is shaped by our genetically inherited response to surprise, that is, physical and emotional arousal, programmed energy and preparedness to respond. And as suicide is a form of death and we have learned that death is distressing for both the subject and their associates, we accept that suicide is an event which would be better if it didn’t happen. These facts underpin our response to suicide – arousal and confrontation with death, which we wish we could eradicate. Our heightened arousal allows us to ignore facts and embrace silliness.

The last federal government adopted a Zero Suicide Policy. Suicide has occurred in every population around the world throughout history. To set zero suicide as our target is to set an unachievable goal and ensure failure. Almost as harebrained is the belief that suicide rates will be reduced if the media obeys sets of rules determined by ‘expert’ officials about how suicide must be reported. There is no evidence that controlling the way suicide is portrayed in the media has any effect on national suicide rates – nevertheless, the rules exist, are review and must be followed. This is magical thinking – wishing suicide would disappear and then leaping to the belief that if the population will do as we say, the desired outcome will be achieved.

Around Australia different groups have emerged which believe that suicide can be prevented if caring non-professional friends and neighbors show support/interest in their fellow persons and get those who appear to be “struggling” to express any difficulties/distress they are experiencing. There is no evidence this process reduces suicide rates. Group members are well meaning and keen to welcome and teach new operatives. A central feature of the toolkit of such groups is to ask the question “Are you OK?” or similar. This movement is well organized across Australia and September 8 has been designated the national “R U OK? Day”.

People attending professional counsellors and psychotherapists (dedicated, trained listeners) nevertheless sometimes complete suicide – so, the opportunity to ventilate is not a panacea.  The average person when asked “Are you OK” (or similar) by another lay person frequently responds with indignation or a fleeting smile and “Yeah, fine”.  Talking through one’s problems may well relieve some distress – particularly if it happens at the right time and place, with the right person. It is unclear if this can happen with one of the blokes from the footy club whom you think will likely consider you are a ‘weakling’ if you speak a word of need.

However, this fostering interest and support for others has merit. Different countries have different suicide rates (the Catholic Philippines has a rate of 2.2/100 000 p.a., while South Korea, which has cast off its old culture and is Westernizing as fast as possible, has a rate of 25/100 000 p.a.). Such differences have roots in culture and customs. It is probable that if we developed a more sensitive, caring, supportive culture, the suicide rate would reduce. Importantly, such changes would take time; as Victor Hugo said, “If you want to civilize a man, begin with his grandmother”.

Making a more supportive society, in which individuals can more freely speak about their needs and difficulties and receive assistance may prevent the emergence of some disappointment/sadness and associated suicidal thinking. This would be primary prevention, that is, suicidal thinking would not occur in the first place. This would be distinct from expressing support and trying to defuse suicidal thoughts once they have been born and grown. This, of course, is theoretical/idealistic and may have no practical application. The mechanism by which culture and customs might be changed would need to be determined.

In the meantime, we should aim to be as supportive to each other as we can and as the object of our concern can accept. A good starting point would be to behave as humane citizens.

Finally, we need to do no harm. If we advise well-meaning people that by asking others about their emotional problems and listening to their answers suicide will be prevented, we may be placing these Samaritans in danger. Suicide will continue and those who have followed the script but failed to avert the event may feel guilty and disappointed – in certain circumstances suicide may prove contagious.

Saxby Pridmore is Professor of Psychiatry at the University of Tasmania

34 thoughts on “Reflections on Suicide on ‘R U Okay? Day’

  • rosross says:

    Having had personal experience of deep depression where I could understand why people wanted to end their life, but knew it was something I would never do, and having had exposure to family members suffering mental illness, while also reading deeply and widely on the human psyche and condition through psychology, psychiatry, spirituality, and astrology, I have concluded that it is not possible to prevent others from killing themselves. I also have no doubt that in such a deep and terrible place, those who choose to end it all often believe they are doing what is best for others, as well as bringing to an end the ghastly horror of such depression and anxiety.

    Indeed, one is either the sort to commit suicide or one is not and no amount of are you okay, cheery chatter, or profound concern and availability to talk will change outcomes.

    Perhaps the irony is that there is more suicide today, in an age when sharing, baring, talking is encouraged than there was in generations past when it was not. The sound byte approach of R U OK, simply reflects the ‘quick fix’ mentality of our age. Suicide is too complex to be solved by having a conversation. The question as the article touches upon is whether such campaigns do more harm than good. Who would know?

  • lbloveday says:

    I posted the following on a The Daily Telegraph article on Paul Green’s death wrt R U OK:
    .
    “Someone asked me and I told him I was old enough to look after myself and maybe he should do the same. End of friendship”.
    .
    REJECTED, as are most of my comments.

  • rosross says:

    @lbloveday,

    The problem with something as trite as RU OK is that it is trite. If we are concerned about someone then that is not what needs to be asked. And for men in particular, if so asked, the response would be that which you have given.

  • Katzenjammer says:

    I suggest, with no real knowledge or experience of it, that for a suicide, it’s their way of taking control of the putcome of the situation as they perceive it, where they can’t imagine theer can be any possible resolution. If there’s any validity in this idea, then “RU OK” would just reinforce their view of how dire it is by their friend’s matched perception. Perhaps a better opening could be “There’s a way out of it” to generate a productive conversation. Not an expression of wmpaty, with “RU OK” but a gesture that’s like an offer to borrow the mind of the friend. It’s like stating “I can see parts of your situation from outside, and can help you think through it”, even if you can’t. It’s purpose is to generat a conversation.

    This might be a silly idea, but I thought I’d put it out there. in case it isn’t. I don’t know.

  • Katzenjammer says:

    A few finger slip typos – look for the neighboring keyboard letter. “wmpathy” = “empathy”.

  • Brian Boru says:

    Katzenjammer; I think you are onto it. Aside from the situation of guilt about the past and maybe even then, it’s about what a person sees as their future.
    .
    From my untrained point of view, if someone can’t see a positive future, then for some, suicide is a risk.
    .
    I think that’s why suicide rates are so high amongst young people in remote indigenous communities. It’s why farmers who have never known any other way of life and up to their eyes in debt see it as the only way out. It’s also why veterans who have been left adrift fall.
    .
    We all need to be able to see a positive future and RU OK by itself doesn’t give that.

  • Brentyn Graham says:

    I like Rosross’s reply. I’m not sure I absolutely agree with(? her) conclusion that it is not possible to prevent others from killing themselves. However, having said that, I believe that the friend of mine who did suicide had planned it for a period beforehand and nothing would have stopped him, and he was his normal self to the end, and we were all astounded but agreed there was no indication. But, I also believe there are those that attempt suicide without really wanting to follow through. Though I don’t know any of those and I only mention it for the sake of others thoughts on the subject.
    I also agree with rosross and lbloveday that to ask someone ruok seems too trite for words for such a serious thing. But maybe that is the question to ask in the second example I gave. I don’t think I would like to be asked it.

    • rosross says:

      @Brentyn Graham,

      There is no doubt some suicides are a ‘cry for help,’ but others are just badly managed. No doubt this is why men are generally more successful at killing themselves, having taken a forensic and clinical approach to the matter. Of course some women can also do this, but, in general, when men attempt suicide they succeed. The left brain function is nothing if not practical.

      And perhaps woven into all of that is the female instinct that ‘someone might help’ while the male instinct would be, ‘no-one can help and I must solve this myself.’ That is of course a massive generalisation but there are elements of truth contained within.

  • Doubting Thomas says:

    I have a deep aversion to official and/or quasi-official attempts to “cure” perceived public behavioural problems. For example, I question whether painting large white ribbons onto the RAAF’s C130 aircraft and other florid displays of official virtue signalling are, in practical terms, any more effective in altering violent behaviour towards women than the endless anti-smoking campaigns are in stopping people from smoking. The RU OK nonsense is just such a crock. I imagine that it is yet another product of some bright young consultant being paid six figure sums like Dan Andrews recent hirings to “fix” the Victorian Ambulance Service’s diversity problems. Do something! Anything! But don’t forget the press release.

  • Katzenjammer says:

    Years ago I watched a mother sort out a conflict between her two kids, fighting over sharing a plastic toy owned by one of them. To deflect the conflict she took it from the younger and handed it to the older who owned it from a birthday gift. He immediately threw it into the fireplace where it melted. That was his way of expressing comtrol over his posession. The ultimate control – remove it from all questionable circumstances.

    I don’t think suicide is an expression of dispair. I think it’s the ultimate way of taking control. No-one else, and no constraints have any bearing any more. It’s a gesture that unequivocally states “I’m in control”

    “RU OK” can prompt the thought “Yes, I’n OK. I know what I need to do to end this situation in my way.

  • Doubting Thomas says:

    Further to the above, I’m reminded of my nine years in boarding school and other periods where I suffered severe depression. In less PC days, sufferers were often advised that God helps those who help themselves. More brutally, but in my experience a no less effective way than kid glove treatment, was to simply advise the person to get up off their belly and walk.

  • gareththomassport says:

    Over my General Practice career, several patients committed suicide, all of whom were male and had families.
    Most had received treatment in the form of psychological interventions and/or medications, and their mental turmoil had been recognised and responded to.
    While the trigger in each case will never be fully understood, a simplistic “RUOK” seems to me to be a typical media response to a complex problem. One could draw parallels with the Media’s position on climate or Covid policy, lacking any depth or true understanding of the issue. Doing something, no matter how innane, is all that matters.
    I fully agree with Prof Pridmore’s thoughts.

  • rosross says:

    @garthethomassport,

    Depression is complex and medication often makes it much worse. It would be interesting to know rates of suicide in the medicated compared to the unmedicated.

    It is hardly surprising that males are more likely to commit suicide and to do it effectively given the psychological, emotional and mental nature of males in general. Males are hardwired to ‘find a solution’ and to do so effectively. They are also less inclined to admit to what they see as a weakness and are often less aware of their inner ‘workings’ in order to understand why they feel as they do. There are exceptions of course.

    When I walked the bleakest of paths, and wanted to avoid social contact, I forced myself to do it and made a point of stating upfront that I was feeling a bit down, in order to ‘warn’ others if I appeared weird. Oddly, as I discovered years later, very few if any detected my state of mind and soul. It is tricky because if someone touches you beyond the defences you are likely to burst into tears and that is hard enough for females but more so for males. Learning to cry in front of others is the first step. But the walls we erect to defend our quivering vulnerability in the depressive pits, are tall and strong and grow stronger every day. No-one can get in and some believe they can never get out and I suspect those are the ones who choose to die.

    I learned from watching a clinically depressed parent as a child, when mental illness was something which shamed the individual, that – it is not the way the world is but just the way you feel, and, while the world may not change, the way you feel can and will change, and it is hope that holds us together in such places and the belief that ‘this will never end’ which consumes some.

    Having said that, I learned through time, experience, exploration and much reading that befriending depression and refusing to fear it, diminished it enormously. The same with panic attacks. So much so, that by my forties depression and anxiety were infrequent and brief visitors who did not set up camp for weeks or months as they had in the past.

    I do believe that mental illness has deep roots in psyche and soul and that if the inner work can be done, the symptoms will no longer be needed. This too shall pass speaks more powerfully than RU OK.

  • lbloveday says:

    “Learning to cry in front of others is the first step”.
    .
    Not even close to an expert on crying, but I’d suggest one would need to cry alone before doing that – I’ve done neither to my knowledge although I guess I would have when I was a baby.

    • rosross says:

      @lbloveday,

      I should have explained it better. Accepting that one can ‘break down’ in some way in front of others is an important step. And yes, everyone is different and some cry more easily than others although we have to let ourselves cry and many men have been programmed to stop that happening.

      You don’t have to cry alone before any of it, but accept that you may ‘fall apart’ in front of others. That acceptance diminishes the fear and the tension.

      • lbloveday says:

        “Accepting that one can ‘break down’ in some way in front of others is an important step. And yes, everyone is different and some cry more easily than others although we have to let ourselves cry and many men have been programmed to stop that happening”.
        .
        Anything “may” happen, and “break down” has many different forms, but I put the chances of my doing that in any form as the same as my going on a dinner date with Sarah Hanson-Young.
        .
        Why would I have to let myself cry? I recall as a young boy visiting my mother in hospital and my biological father telling me “it’s alright to cry”, presumably because my sister was. Again as I recall, I thought “how do I cry”? “Fight or Flight” was inate as was, I believe, my protective nature, but how do I force, rather than let, myself cry? And what possible good would it do for my mother? What good does crying ever do for anyone? I don’t stop myself from crying, it just does not happen.
        .
        It conjures in my mind Rufus Dawes in “For the Term of His Natural Life”, when he was silent during the 100 lashes ordered by Maurice Frere, Frere therefore ordered the whipping to continue and Dawes breaks his silence, effectively crying, in order to bring a halt to his torture. That I understand, it had a purpose and achieved that purpose.

  • Brentyn Graham says:

    Rosros as you have described, depression is a dreadful thing and unless one actually suffers from it or has someone very close with it, can fully understand the depth of fragility.
    As you say, the problem is unique.
    and unique problems need unique and well thought out approaches
    I remember sitting with my Aunt long ago outside a cafe when she saw an elderly woman very teary. She went and sat by the lady and took her hand, patted it and said ” there there dear what’s the matter”.
    That was my aunt’s nature and in that instance was exactly the right approach.
    I believe some depressions to be clinical and therefore irreparable without medication. In those cases the advice given to Doubting Thomas in his youth would not be the best at all

    • rosross says:

      @Brentyn Graham,

      A complex, multi-faceted problem for complex, multi-facted human beings.

      I don’t believe depression is clinical and in fact such a diagnostic approach is historically recent and has arisen in a drug-based world sourced in science-medical belief that all can be reduced to the material and mechanical if not the chemical. Modern psychiatry wants to be seen as a ‘hard science’which of course it cannot be, given the nature of the human mind, and so the desire to be able to diagnose, label and drug accordingly is great.

      Yes, no doubt there are chemical changes at work but what comes first? We humans are not mere bags of chemicals as the drug industry would have us believe. And in fact the clinical approach to depression is now being challenged as I read recently. And rightly so. It never made sense to me.

      Analysis: Depression is probably not caused by a chemical imbalance in the brain – new study
      20 July 2022

      Writing in The Conversation, Professor Joanna Moncrieff and Dr Mark Horowitz (both UCL Psychiatry) report on their new research showing no clear evidence that serotonin levels or serotonin activity are responsible for depression.

      Yes medication can have an impact but how much of it is placebo is the question? What is known is that the human organism will quickly adapt to the synthetic chemical intervention and any efficacy is quickly lost, at least in physical and chemical terms. The placebo effect can however endure.

      There is no doubt that medication can help some people over a debilitating ‘hump’ but it solves nothing beyond diminishing symptoms at least temporarily which allows emotional and mental ‘breathing space.’

      I have found the work of Stanislav Grof interesting on the topic and his book, Spiritual Emergency, takes the view that mental illness/depression are signs that there is a spiritual emergence manifesting as a spiritual and psychological emergency.

      But everyone is different and each must find their own way.

      • lbloveday says:

        Anthony Daniels in his article “The Linguistic Termites Are Every­where” in this month’s Magazine discusses Depression and I repost my comment on his article:
        .
        My mother’s husband of 55 years died and her doctor immediately prescribed anti-depressants based solely on her presumably (and actually) mourning his death. I don’t pretend to be a doctor but I am pleased that she took my advice and threw them away – how has it come about that natural grief at the loss of a loved one is determined to be a medical condition to be treated with medication?

        • rosross says:

          @lbloveday,

          Doctors these days are pretty much secretaries ordering tests and chemists prescribing drugs. They have minimal understanding of the function of a human organism and have drug schedules to meet.

          Since they have no concept of natural and healthy depression following loss, then prescribing drugs is all they can do.

          Your mother was wise to toss out the toxic drugs.

  • john mac says:

    “R U Okay ” is yet another virtue signal , useless beyond redundant. Designed to make the “carer” feel as if they’ve done something noble . I agree with rosross (as usual) in that we are deluding ourselves to think we can prevent another’s suicide. I’ve witnessed a few , and some were predictable , some out of the blue and despite efforts on my , and others’ behalf , still happened. The more affluent the west has become (and decadent) the more prevalent suicides . The deliberate side-lining of religion has left so many bereft of hope , and in an era of instant gratification , devastation is put to the fore. I notice that many “Influencers”- social media creations and sensations , are prone to committing suicide , almost self-fulfilling if you ask me . The Therapy industry has a lot to answer for .

  • Occidental says:

    No argument here with the authors opinions, but I would like to add, do not use The Philippines catholicism as an explanation of its low suicide rate. It is a country where honour, integrity, honesty, and bravery are but words. Therefore unlike say Korea, it is impossible to lose “face”, and feel social opprobrium. The people are lovely nonetheless, quite like children.

    • rosross says:

      Given the suicide rate in Catholic Ireland is the 17th highest for Europe it is hard to make a case for The Philippines. Are suicide rates lower in Third World countries where people have lower expectations and a higher chance of dying anyway?

    • pmprociv says:

      I’d be rather sceptical of statistics on suicide from the Philippines, especially when compared to South Korea. There is a big gap in health standards between both countries, and in a highly religious society, mention of suicide can be taboo. Even here is Oz, many suicides can be masked, e.g. fatal, single-vehicle accidents.

  • Lewis P Buckingham says:

    About three years ago one of the street people with whom I associate made the comment, ‘If you weren’t crazy before you watched SBS news you sure would be afterwards’.
    In this context the station warns people about disturbing information being screened or just screens it anyway with an appropriate grave or horrified voice. We even have various phone numbers flashed on the screen , beyond blue etc after the hot media description of violent hostilities or accidental death.
    Speaking to some they find they are less anxious watching such media, the phone numbers don’t help as much as turning it off.
    One wonders how being treated humanely would be part of the mileau for the jumper affected by the big short and long term terminal decline of Bed n Bath n Beyond, mimicking the aftermath of the Wall Street Crash.
    Perhaps to put things more formally, as Christ advised:
    ‘Love one another as I have loved you’
    However there is a real place for psychiatry, including pharmacological manipulation, as some have self destructive thoughts and act on them when pushed.
    We need to support our psychiatrists, who are only human and may routinely lose their patients, to the approbation of grieving and board complaining relatives and the following insurance claim.
    Just after graduating as a Vet some 50 years ago I was advised where it came to the rectal examination of a horse,
    ‘If you have not killed one yet, you simply have not examined enough of them’.
    Being a psychiatrist is not for the fainthearted, ‘their blood should be bottled’.

  • Elizabeth Beare says:

    When I retired I did some telephone counselling work, where training included a suicide prevention course. We were told to elicit from someone whether they felt they wanted ‘out of it’ and perhaps were even considering ‘ending it all’ (i.e.. implying by suicide) or similar words. Many people seeking comfort in stressful situations might say yes, they had considered that and some would say that was what they were calling about. Your next question though was to ask ‘Do you have a plan?” If they came up with a plan indicating they’d really thought about what they could do, then the instruction was to take it more seriously and move into active prevention mode, seeking their location and intentions, perhaps alerting a flying squad if it seemed necessary. If no, then they were more likely to be generally miserable and talking over options for improving their mental state/situation/feelings etc was probably worthwhile. Of course many other factors of each call’s tone and content came into it. Some people are always going to suicide and of those most won’t call first.

    I found it useful but exhausting voluntary work, 6-7 hour shifts (they were short of personnel), take only up to an hour with each call, wind it up then unless urgent still, and the next call would come in immediately after that. There is so much human misery out there, we have lost a lot of capacity to listen to each other (screen life can do this) and there was so much family breakup and loneliness. Did it for two days a week in my first two years of retirement. I think the service actually did a lot of good when a simple friendly listener able to focus on bringing out the caller’s desires and options was needed and it sometimes saved lives as well as being a point of referral to other services for a range of problems and needs. Mostly, there wasn’t much available though apart from pamphlets and very poor coordination between agencies.

  • Alice Thermopolis says:

    Brian Boru
    “From my untrained point of view, if someone can’t see a positive future, then for some, suicide is a risk.”
    According to the abbot at my Buddhist temple, a very cheerful chap: “The secret of life: everything is out of [our] control.”
    He also asked about any/every event: “Good? Bad? Who knows?”
    For Samuel Beckett, one should always: “Try again. Fail better.”

  • pmprociv says:

    Prof. Pridmore, thanks for such a sensible and sensitive article, the most rational consideration of suicide I have read in recent years. And it’s reassuring to see so many thoughtful responses. As the only species (to my knowledge) that is aware of our individual mortality, the inevitable extinction of our species and, indeed, ultimately our planet, perhaps it’s surprising that suicide doesn’t occur far more frequently. After all, life is often challenging, and requires considerable and ongoing investments of time and effort, without guarantee of satisfactory reward. When the prospect of eternal peace provided by death outweighs the burden of staying alive, it’s easy to see how that fateful decision might be taken.
    Losing my life partner of 28 years to suicide was an extremely traumatic experience for me and our two children, but even after 25 years, we still think she had no choice but to act as she had done. With irritating physical ailments piling up on an underlying emotional instability, compounded by menopause, her life clearly had become unbearable — and its abrupt end provided relief even for us survivors, who still miss her intensely. Preceding years of expensive professional help had proved fruitless — and, shortly after her death, I was phoned by both her psychiatrist and psychologist to reassure me that it wasn’t our fault, that there was nothing we could have done to prevent her death, and that they both had been expecting it for a long time (although neither offered a refund!). I was amazed at how many of her friends (both recent and from ages ago) and colleagues, firstly had no inkling that she was so inclined (“she had it all!”), and secondly, felt extremely guilty about not having been more sensitive, considerate or helpful to her. I found myself having to reassure and console them.
    For those thinking religion offers a salve, the irony of it all is that my wife had been a devout Christian when we married, but over the years lost faith as her health issues mounted; towards the end, she’d become an atheist. convinced that no “loving” deity would ever afflict one of its most faithful and compliant followers so cruelly. She didn’t want any afterlife, just an escape from this one.
    Having also lost other colleagues to suicide over the years, and having treated survivors of attempted suicide, I’m convinced that, as an individual approaches that final act, they stop talking about it, but ruminate more over how and when to do it, awaiting the appropriate opportunity. Those who talk incessantly of ending it all are generally not the ones to worry about.
    It irritates me no end to be repeatedly given counselling phone numbers during ABC and SBS news broadcasts, nothing more than public virtue signalling. The RU OK? campaign is also idiotic, clearly invented by advertisers rather than professional counsellors. It imposes responsibility on untrained friends and associates, who’ll feel guilty should the protagonist suicide whether asked that question or not. And how many people feel comfortable in handling someone who does speak frankly of their mental state? Most people would prefer to change the subject, or even run away.
    As if to highlight the knee-jerk, irrational approaches to suicide, The Conversation recently had an article deploring the high suicide rate in males older that 85 years, advocating this should be a subject for public health intervention!
    https://theconversation.com/suicide-rates-reveal-the-silent-suffering-of-australias-ageing-men-187925
    I find this frankly bizarre, betraying a total lack of empathy and revealing profound ignorance of the survival issues confronting senile men. Growing old myself, I find my sympathy for that group also growing; senility alone should be sufficient grounds for euthanasia.

  • Elizabeth Beare says:

    Alice, I tend to think ultimately everything is out of our control, like your Buddhist priest, but I cannot conceive how it could be a useful way to live and to bring up children and earn a living. We must invent reasons if we cannot find them ready-made, for there are more levels to life than the contemplative. An old friend of mine once said that there is always Mozart to give meaning to life and that keeping busy with others was the clue to the rest of it.
    And pmprociv, I think the value of telephone help lines is that they do put distressed people in touch with those who might have some idea, however basic, of how to assist those in psychic pain. Guess that answers Alice’s question too, about is it worth it to work those phones. I thought it was one of the most worthwhile and rewarding things I have ever done. Even though I opted out after a couple of years and there were others much better at it than I was so I could still learn a lot; some had done it for years. Volunteers are always needed. Willingness to undergo training is essential.

  • Elizabeth Beare says:

    Recently I bought two easy-reading novels for $25 in combo, to cheer me up at eighty. The first one didn’t work at all, because I’d failed to realise it was about dementia. “Still Alice” by Lisa Genova had a blurb of ‘now a major motion picture’ and ‘million-copy best seller’ – sure to be a romp, I said to myself in a hurry, looking only at the youngish looking woman on the cover. Alice turned out to be an academic woman aged fifty at the height of career success who gets diagnosed with very quickly progressive early Alzheimer’s. The novel tells the interior story of her thoughts and eventual disintegration, and also creates a suicide dilemma which is played out in her family. How do you tell your disintegrating self that it is time to take the pills and die, when you don’t feel quite ready to take them yet? The novel is hopeful enough to persuade sufferers that a slow fade is preferable, more moral to family and more fair to self, than the pills. But that is one we all fear.
    The second book I haven’t read yet. I am hopeful that it tells a tale more likely to encourage one’s continued existence on this earth, which is more to my taste, as I so much hate to miss out on anything; so as long as I am around I guess I can always find some reason to stay. Even if it’s only breakfast. Or Mozart. This novel is intrigueingly titled ‘The One Hundred Year Old Man who Climbed out of the Window and Disappeared’ by Danish Jonas Jonasson.. Apparently the man in the novel went out on the rantan because he didn’t want to blow out the candles on his cake. It is supposed to be very funny as the old chap re-engages with the world and its politics. That what they say and I’ll let you know sometime if ‘they’ are right!

  • pmprociv says:

    It seems the latest frenzy of angst about suicide, with the RU OK campaign, was triggered by the recent suicide of yet another celebrity, ex-champion rugby player and coach, Paul Green. Politicians need to be seen as caring and considerate, and to be doing something positive. What we weren’t old, although it’s intimated in this article, is Paul’s psychiatric history: was he being counselled, given a diagnosis, placed on medications? From my reading, his could be almost a textbook case of bipolar disorder, but for the public (and maybe many of his friends and associates) it came as a bolt out of the blue. It’s perfectly understandable that he should not want to publicise such an affliction; imagine the effect that would have had on his career. My first wife kept her illness (also BPD) secret, knowing it would have been the end of her successful specialist medical practice. But it’s not fair, in Paul’s case, for the public now to be withheld this information, for it implies that he could have been “saved” had he sought professional help– which is probably what he’d been doing for some time, I’d guess years, but obviously without “success”.

  • rosross says:

    What many fail to appreciate is that certainty is only ever an illusion. A comforting one, but illusion all the same. There is no certainty, no perfect world, no safe place as I learned living in an African war zone, but also, if there is no safe place, then there is no unsafe place. Most of life comes down to luck as it seems soldiers quickly learn.

    Perhaps when we accept our ability to change what happens to us is extremely limited and that our own power is sourced in how we relate and respond to what happens to us, can we find freedom and peace of mind.

    Quote: In his novel All Quiet on the Western Front (1928), Erich Maria Remarque claimed: ‘Every soldier owes the fact that he is still alive to a thousand lucky chances and nothing else. And every soldier believes in and trusts to chance.’ Despite the level of mastery of drills and skills, there was a recognition by many I served with that Remarque was right. In war, human experience is taken to extremes. Survival is determined by multiple variables outside your control. Once you have been in a situation where your survival appears to be down to random luck, you are inevitably changed.

    https://psyche.co/ideas/what-luck-in-war-reveals-about-the-role-of-chance-in-life?utm_source=Aeon+Newsletter&utm_campaign=7c07942f23-EMAIL_CAMPAIGN_2022_09_05_11_40&utm_medium=email&utm_term=0_411a82e59d-7c07942f23-70539277

  • Alice Thermopolis says:

    Elizabeth Beare: “Alice, I tend to think ultimately everything is out of our control, like your Buddhist priest, but I cannot conceive how it could be a useful way to live and to bring up children and earn a living. We must invent reasons if we cannot find them ready-made, for there are more levels to life than the contemplative.”
    Elizabeth, Agreed. That said, for me Ajahn Brahm’s take on life is more than “contemplative”, as rich as investigating the nature of”suffering” has been for him and his fans: “suffering is asking the world for something it can never give you.” “How many times should we forgive someone? Always one more time.”
    His first book: “Opening the Door of your Heart.”; also titled: “Who ordered this truckload of Dung?” A lot of videos of his BSWA talks online too.
    My old English teacher once wrote: “life is times of gladness, times of sadness, with long periods of survival in between.” If life teaches us anything, perhaps it’s humility.

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