Sunday, 24 March 2019

Suicide: The Decriminalisation Of First-Degree Murder Of Self

Suicide was once a criminal offence in the United Kingdom.  

Calling it “committing suicide” sparks an instant alignment with “committing murder”, and it is a sort of murder: murder of the Self. It’s the angriest act against the Self. Attempted suicide is a violent act of self-destruction.

We often associate suicide attempts with desperation, depression, powerlessness and having had enough of this world.  

However, if we look deeper into the wound from where suicidal ideation flows, we will find self-hatred, anger with self and others, and a drive to annihilate one's own existence.  

But what happens when you try, and it goes "wrong"? Wrong in the sense that you have survived it.  

In the 1970s, my psychotically depressed uncle escaped from the mental health hospital where he was supposed to be incarcerated for his own safety. He travelled to the underground station nearest to his family home, took himself onto the platform, and jumped in front of a speeding tube train, planning to end his life.  

Much to his disappointment, he fell between the tracks, and survived. What was the result of his failed attempt?  A new message entry went into the wound from where suicidal ideation flowed: "You can’t even get suicide right!"

Today, there are websites that outline the directions on "how to" kill yourself, not leaving any room for error. Specific methods, instructions and assistance on how desperate people can do a desperate thing in planning their own execution: a sort of suicide euthanasia. The UK Legal system considers these sites as possibly holding criminal liability for complicity in another’s suicide, if it can be proven that the person used the site.    

As psychotherapists and counsellors, where does our responsibility lie when a client utters: “I wish I were dead?”  

Are we to automatically raise the alarm with the emergency services; do we trigger our contractual agreement on breaking confidentiality; do we contact next of kin? Should we brush it off as the client seeking attention and should we really be in a position to play judge and jury on whether or not they mean it?  

How do we know that it isn’t a manufactured focal point so that we are both diverted from the real issue?  Is this how the client gets some extra care from their therapist?  Have we missed the risk factors that are staring us in the “blank canvas” of a face that we bring into the room?

There is a voice, a voice that criticises, condemns, punishes, and goads.  

When that doesn’t succeed, the voice morphs into an empathetic, understanding and gentle confidante, who understands the pain and the reasons why, and so helps with the plans.  

Should that not work, then there’s always the voice that lists all the affronts that have caused personal offence over a lifetime. Suicide suddenly makes sense again, to the one who is wishing to extinguish their own light.

So, returning to our responsibility in our role as psychotherapist and counsellor, I would suggest it’s up to us to work with each client individually to identify whether theirs is a cry of frustration or anger, a cry for help or, the most painful of all, a real and desperate cry of despair calling to us to try to help them find a way to give their individual life meaning.

The key, as always, is to listen, and to hear.

Photo by Lorenzo Maimone on Unsplash

Friday, 15 March 2019

Lent – A Fast For The Good

Christians around the world are presently marking the period of Lent, the 40 days that started with Ash Wednesday and leads up to the most important period in the Christian calendar, Easter.

Lent is the time that followers of Jesus Christ remember his life on earth – his time alone in the wilderness, his self-reflection and self-sacrifice, ending with the ultimate sacrifice: his crucifixion.

While there, Jesus prayed and fasted and it is through awareness of this that Christians use Lent to reflect on themselves, their lives and their own way of being – past, present and future.

Hand-in-hand with this often goes the giving up of something a person values – for example: chocolate, alcohol, sweets or cutting out something that means making a personal sacrifice of their own. 

And it is not only in the Christian religion that the idea of giving up meets with approval from teachers and followers. The Jewish faith has Yom Kippur, the Muslim faith, Ramadan, with each religion deeming an annual period of fasting necessary for spiritual understanding and growth.

So, can fasting be of benefit to those with no particular religious belief? And can it ever help us with our mental state? 

Modern fasting nowadays tends to be confined to a regular day or two rather than the 40 days in biblical times which stretches modern day thinking. We have an abundance of food choices in the developed world so it is hard to imagine such a time frame when we could go without food. Nor would it seem like a good idea.

However, we do seem to be connecting more with ideas from ancient times. 

Hippocrates was a great fan. The physician and founder of modern medicine on whose oath doctors still swear, advocated eating only once a day, using food “as our medicine”. However, he warned: “To eat when you are sick is to feed your sickness.” 

Similarly, the philosopher Plutarch advised: “Instead of using medicine, rather fast a day.”

Advocacy for this style of short-term food restriction or fasting is gaining popularity once more. To start with, there’s the obvious benefit of weight loss through a limit of calorific intake. For those who want to see a quick result, it’s likely to bring a speedy feeling of satisfaction and an improved mood. 

Then there’s the matter of what food affects us in what way - Hippocrates believed the mind and body were inextricably connected (i.e. you are what you eat) and the more we know about what a food is made up of, the more we learn about how it can affect us. 

Chocolate helps lift our serotonin levels, making us happy, as do carbohydrates, which can calm us down. Caffeine can perk us up but for some it may increase nervousness or anxiety. 

If all these foods may have an effect on an individual’s mood, it stands to reason that the process of fasting, too, may effect some form of change. So, going “cold turkey” and doing without any food so to speak might be just what the doctor ordered. (As an aside, isn’t it interesting how much our words and phrases are linked with food –  “cold turkey”, “I can’t stomach that”, “that’s too much to absorb”?)

There’s a lot of discussion on the internet about fasting and some research has been undertaken but not enough to come up with a definitive argument. 

As a result, I’ve done my own unscientific poll among a number of regular fasters to get their take on it. The general consensus is that, once the body has got used to the idea of no food, it works for them.  

Here are some comments: 

“I eat during an eight-hour window each day which gives me 16 hours of fasting. Some of that time, I’m asleep of course. Otherwise, in that period, I drink only water and green tea.

“Since I’ve been on it, I’ve been feeling much better. I rarely get depressed when following it. And I don’t get the lethargy of constantly digesting.”

Another continual faster said she tried to do it three consecutive days a month:

“I start off hungry but my body seems to be getting more into the groove – I’ve been doing this for more than a year now.

“After the initial period – when I’m definitely way outside my comfort zone – I do feel calmer and have more of a sense of tranquillity with me. I also feel a sense of achievement because I’m doing something that takes quite a lot of effort and control. I’m impressed with myself and that stays with me.”

This faster stresses she does eat during the period, but not more than 600 calories a time, and she makes sure that two of the days are at a weekend.

I’ll leave the last word to Dr Robin Lawrence, consultant psychiatrist and founder of 96 Harley Psychotherapy who himself believes in the power of fasting. 

He says: “I have become convinced that fasting is good for my mood personally, I generally try to stick to a 5:2 regime, though sometimes it’s observed in the breach ….”

Photo by Kamil Szumotalski on Unsplash