Franklin James Cook

Suicide Prevention Pioneer Edwin Shneidman Dies at 91

In People, Prevention on May 18, 2009 at 8:38 am
(Genaro Molina, Los Angeles Times)

(Genaro Molina, Los Angeles Times)

By Franklin Cook, SPNAC Editor

Edwin S. Shneidman–a heroic figure in the field of suicide prevention, a man whom I often call the father of modern suicidology–died Friday at his home in West Los Angeles at age 91.

Los Angeles Times senior editor Thomas Curwen followed Shneidman’s life, and in an obituary today, summarizes highlights of his career and his thinking about the nature of suicide and its prevention:

Shneidman, one of the founders of the Los Angeles Suicide Prevention Center, believed that two simple questions — “Where do you hurt?” and “How may I help you?” — could begin to unlock the suicidal impulse.

Shneidman, along with Norman Farberow and Robert Litman, established the center in an abandoned tuberculosis hospital on the grounds of Los Angeles County Hospital in 1958. Staff members offered counseling and support over the phone to the depressed and suicidal. It represented a radical idea in mental health care in America.

Research into suicide — and suicide itself — was largely shunned and stigmatized. In time, the Suicide Prevention Center captured the popular imagination in movies and books and became a national center for studying the enigma of suicide.

Shneidman viewed suicide as a psychological crisis and — as did Albert Camus — as the “one truly serious philosophical problem.”

“Suicide is a complex malaise,” Shneidman said. “Sociologists have shown that suicide rates vary with factors like war and unemployment; psychoanalysts argue that it is rage toward a loved one that is directed inward; psychiatrists see it as a biochemical imbalance. No one approach holds the answer: It’s all that and more …

“You don’t understand psychopathic murder by slicing [Jeffrey] Dahmer’s brain, and you won’t get E=MC2 by slicing Einstein’s brain,” he says. “Unfortunately, it’s in the mind. And the mind is not a structure. It is an ephemeral concept.”

Another excellent remembrance of Shneidman is available on Huffington Post: In “A Good Man, A Good Death,” Dr. Mark Goulston summarizes his “long time mentor and beloved friend[‘s]” view on what constitutes a good death, as well as providing several additional links to material about Shneidman.

In my opinion, there is no more profound explication of the nature of suicide and, simultaneously, no more practical outline of the principles to consider in effecting its prevention than is found in Shneidman’s “Ten Commonalities of Suicide,” which appear in his classic The Suicidal Mind:

  1. The common purpose of suicide is to seek a solution: A suicidal person is seeking a solution to a problem that is “generating intense suffering” within him or her.
  2. The common goal of suicide is cessation of consciousness: The anguished mind of a suicidal person interprets the end of consciousness as the only way to end the suffering.
  3. The common stimulus of suicide is psychological pain: Shneidman calls it “psychache,” by which he means “intolerable emotion, unbearable pain, unacceptable anguish.”
  4. The common stressor in suicide is frustrated psychological needs: A suicidal person feels pushed toward self-destruction by psychological needs that are not being met (for example, the need for achievement, for nurturance or for understanding).
  5. The common emotion in suicide is hopelessness-helplessness: A suicidal person feels despondent, utterly unsalvageable.
  6. The common cognitive state of suicide is ambivalence: Suicidal people, Shneidman says, “wish to die and they simultaneously wish to be rescued.”
  7. The common perceptual state in suicide is constriction: The mind of a suicidal person is constricted in its ability to perceive options, and, in fact, mistakenly sees only two choices-either continue suffering or die.
  8. The common action in suicide is escape: Shneidman calls it “the ultimate egression (another word for escape) besides which running away from home, quitting a job, deserting an army, or leaving a spouse … pale in comparison.”
  9. The common interpersonal act in suicide is communication of intention: “Many individuals intent on committing suicide … emit clues of intention, signals of distress, whimpers of helplessness, or pleas for intervention.”
  10. The common pattern in suicide is consistent with life-long styles of coping: A person’s past tendency for black-and-white thinking, escapism, control, capitulation and the like could serve as a clue to how he or she might deal with a present crisis.

SPNAC readers may download a copy of “10 Commonalities” that is formatted as a handout.

Related SPNAC post: “Edwin Shneidman’s Meditations on Death Are Full of Life

Please also see Curwen’s 2001 feature story about Shneidman and his work in the Los Angeles Times Magazine, “Psychache.”

[The abridged URL for this post is http://tinyurl.com/PreventionPioneer .]

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