Dr. Rob,
Recently I was severely depressed over the death of a close family member. During this time, I started to have thoughts of suicide and while I would never have acted on them I was thinking about it enough that I started to read about suicide online.
What I found startled me. I found "suicide blogs" where people count down the number of days until they kill themselves. And this forms its own little culture with some people writing in to talk the writer out of killing himself or even to encourage him to do it. The furthest I've seen it taken is for the commenter to ask the writer to form a suicide pact.
My understanding is that many of the sites aren't real but I still think that glorifying something like suicide is unhealthy, especially when someone who is intense emotional pain may not realize that.
I suspect you think the same but I'd like to hear more about your take on blogs such as these.
Thanks
You are correct. I do think it's wrong. Who in the mental health field wouldn't? I've heard about these sites and they basically glamorize suicide and portray it as this hip trend that everyone should be considering. Whether the sites are real or bogus, anti-suicide groups are working hard to prevent this type of material from reaching the internet and many countries are asking their governments to get involved.
In graduate school students are taught to treat any and every suicidal thought and gesture seriously. This does not mean that you should attempt to hospitalize every person who mentions thoughts of killing themselves (with a clinical approach such as that you will ultimately alienate your clients as they will feel unable to open up and be honest with you). What it does mean however is when thoughts of self-harm and death do come up they need to be discussed: are these simply passing thoughts of dying? Does the client actively think of ways to hurt himself? Do the person's religious beliefs (if any) prevent her from taking any action? Have these thoughts occurred in the past and, if so, how were they dealt with? It is common for people who are struggling to at least entertain thoughts of death and by telling clients this fact you can free them up to talk openly about their thoughts. It is only when their thoughts might morph into action that a Psychologist is faced with the prospect of needing to hospitalize a client against his or her will. This is not only the code of mental health practitioners but also the law.
There is an important and often misunderstood fact about suicide: people do not commit suicide because they want to be dead. People kill themselves because they don't want to suffer with their intense psychological pain anymore and cannot think of another way to free themselves from it. I had a professor say to me "tell a suicidal client that you won't stop him from killing himself once he doesn't feel depressed anymore. Promise him that. Promise him you won't even try to stop him if he isn't depressed anymore. Then watch what happens over time. Once he's not in such a horrible spot he'll lose some interest in the suicide plan." Whether there are exceptions to this or not, every single suicidal person I have spoken with has agreed that if they could simply feel better they might want to stick around. This admission by a client is an opening to offer help and the possibility of thinking and feeling differently. This is usually is quite helpful. With time and intervention most people are able to stop thinking along these lines.
Unless a writer explicitly stated that he was not suicidal I would follow my training and treat the blog as valid and serious even if I ultimately look like an idiot for doing so. This would be despite many people's take that the site is possibly a complete hoax and that the writer is a total is seeking attention, web traffic or simply gets off on playing with peoples' emotions. I have no firsthand knowledge of how many sites are real versus fake; regardless it is a twisted enterprise.
Writers of real suicide blogs should know that they are in all likelihood depressed and both need and deserve help. Bogus writers need to realize that they are using the most extreme form of self-harm to generate traffic for their websites and are duping naive and vulnerable people into thinking that suicide is a wonderful thing. This is essentially self-absorbed manipulation and exhibitionism. In other words they are ill. I say this in the pejorative sense because they are the ultimate attention whores. I feel sorry for these people. Maybe at one point they were very depressed and needed help. But now they see their former struggles as a way to garner pity and approval. Either way it's a disturbing mess.
Posted by Rob Dobrenski at 2:29 PM