PREFACE
Thank you for taking the time to look at this book. Even if you put it down after reading this page, I appreciate the fact that you are curious about how you might contribute to preventing suicide.
I want to be clear that I have not done formal research on this topic. I have counseled a few hundred people who were at risk of suicide over a forty-five-year career. I also worked on-call with Community Mental Health. I responded to situations where people were threatening to end their lives. Still, I don’t consider myself an expert on suicide.
This book is the result of reading, reflection, and asking questions. It attempts to answer three questions. (1) What conditions are common in the lives of people who attempt or are at risk of suicide? (2) What are the essential features of mental health that enable us to live healthier and more fulfilling lives so we can create an atmosphere where suicide is less likely? and (3) what specific things can we do in daily life to prevent suicide in our community?
My career has focused on understanding the essential functions and core principles of a healthy and fulfilling life. This informed my work in counseling, teaching, and community organizing. Understanding essentials provides a foundation for what we know and learn. They guide us on how to proceed without telling us precisely what to do.
I remember learning two ways to build a fire as a boy. One adult showed us how to meticulously stack kindling and larger pieces of wood into a carefully constructed pyramid. This worked when we had the right size and shape of sticks and firewood. But we failed during a winter camp-out when we tried to build a fire in a wood stove where the pyramid didn’t fit. Another adult took us aside and said: “Remember three essentials: A fire needs fuel, heat, and air. If you give it what it needs in an amount it can handle, you’ll build a good fire every time.” It worked. We saw that small pieces of wood burned hotter but needed to be spaced far enough apart to allow air to circulate. We also learned that closely spaced wood generated more heat as it reflected off two or more surfaces. It became easy to build a fire, and we learned to apply the essentials when challenged by new situations. I can now build a fire pretty much anywhere, even on a canoe trip after two days of continuous rain.
I remembered this lesson when I met Dr. Ralph Lewis in 1969. He used a similar approach to teach Natural Science. We kept in touch for over twenty years, and he challenged me to find the essential components of what was consistently helpful in my work as a psychologist. Identifying essential principles is an ongoing process of discerning, questioning, and fine-tuning in a search for simple ways to describe complex issues. It involves identifying patterns and relationships in a larger picture while checking details to ensure the principles work and make sense in the real world.
I came up with seventeen principles of stress management when I started teaching in the late 1970s. In the early ‘80s, the number was reduced to three. My understanding of what works in effectively managing and preventing stress can now be summarized in six essential principles.
Most suicide prevention efforts focus on secondary prevention – identifying and responding to people who may be at risk for suicide. This book emphasizes primary prevention – addressing conditions that contribute to people attempting to end their lives. Most of these conditions involve how we interact with others.
One reviewer of this book asked if it was more a book on how to live a healthy life than a book about preventing suicide. It is both. The best way to prevent suicide is for each of us to commit to living a healthy and fulfilling life. That involves addressing obstacles to being ourselves in an atmosphere of acceptance and belonging. Most of these obstacles are related to fear. Fear has been a component in almost every problem students and patients brought to me. Resolving fear has been essential to restoring natural functioning and creating healthier and more fulfilling lives. This process is described in more detail throughout the book.
This book is not intended to be a comprehensive summary of what’s known about suicide. It’s simply one person’s perspective on common conditions that can lead to suicide and what you and I can do to prevent it. This involves restoring balance in our lives and developing a way of thinking to see ourselves, each other, and our world more clearly.
Introduction
I was an immature twenty-one-year-old when my fiance abruptly ended our relationship. I felt worthless and ashamed. I was alone and always would be. I saw no path forward, only more rejection and humiliation. A longstanding fear that there was something fundamentally wrong with me was confirmed. On the drive home, I pointed my car toward a concrete pillar beside the road and pressed the accelerator to the floor. When I heard tires hit gravel and saw the pillar grow exponentially larger, something in me jerked the steering wheel back onto the highway.
I didn’t know what that something was at the time. After years of counseling people at risk of self-harm and working on-call with the mental health crisis line, I began to understand it. There’s a force deep within us that we all share. It’s what keeps a gazelle running when she is in the grip of the jaws of a lion. It keeps an ant struggling across the floor after it’s been stepped on. It keeps a shriveling flower alive until rain finally ends the drought. This life force is part of nature. It’s part of us.
I momentarily lost touch with the vitality of life when I aimed my car toward that concrete pillar – as had every person I’ve worked with who attempted suicide. Likely, most of the 45,799 people who killed themselves in the United States in 2022 (the highest number ever recorded) had a similar experience. I would imagine that the nearly 20% of high school students in the United States who reported serious thoughts of suicide – and the 9% who attempted to take their lives – also temporarily lost touch with the essence of life.
One in three teen girls seriously considered killing themselves in 2021. Over 900,000 people in the United States have taken their own lives since 2000 – more than the entire population of San Francisco. The rate is increasing despite good efforts to prevent it.
What’s happening? How do we lose touch with the essence of life? What’s going on in the body, mind, and emotions of people who try
to take their own life? What can we do about it?
Most suicide prevention efforts focus on identifying warning signs and providing mental health treatment. This is important, but the mental health system in the United States is under-resourced and difficult to access. Improving these services is necessary, but it’s not the whole picture.
Looking back at myself as an immature twenty-one-year-old, I don’t see symptoms that would have qualified me for a mental health diagnosis. Still, I came within a second or two of joining the statistics. I’ve never talked with anyone who later took their own life, but I have worked with people who lost loved ones to suicide. There were often no
indications of mental health concerns before death. I’ve heard of several other reports where suicide was totally unexpected, with no prior indication of depression or other mental health issues. Research shows that this is not uncommon. Suicide is not just a mental health problem – it’s a community concern.
That brings “What can we do about it?” closer to home. We can’t leave everything to the professionals. First of all, there aren’t enough of us. Second, the seeds of suicidal thinking often begin to sprout long before warning signs become evident.
How we view ourselves and our world is formed, to a great extent, by how we are seen and treated by others. Those who feel judged, rejected, or bullied are more likely to become suicidal than those who feel accepted and respected. People who feel lonely, isolated, or excluded are more likely to attempt suicide than those who have a secure sense of belonging and meaningful connections.
Unfortunately, the lack of belonging and connection is becoming increasingly common. US Attorney General Vivek Murthy wrote, “We need to acknowledge the loneliness and isolation that millions are experiencing and the grave consequences for our mental health, physical health, and collective well-being. (NY Times, April 30, 2023)
Everyone I talked with who attempted or thought about ending their life came to a point where they had an overwhelming feeling that they “can’t take it anymore.” Everything I’ve read about suicide says essentially the same thing. There are several ways to get to this point. Mental health issues explain some of it, but people also try to end their lives in reaction to loss, pressure, pain, humiliation, being a burden to others, exhaustion, judgment by self and others, and a lack of meaning and purpose in life, among other things.
When I reflected on “What’s happening when people experience these things?” and “What are the common features?” a pattern became clear: There’s a narrowing and darkening of perception along with increasing physical, mental, and emotional tension that builds up to “I can’t take it anymore.” I looked at the list of warning signs for suicide and reflected on people I’ve worked with. Each warning sign was preceded by an increase in tension and a narrowing of perception.
Helping people deal with increased tension and narrow perceptions has been a primary focus of my work and study in counseling and teaching for over four decades. I decided to write this book to offer a perspective to help you understand what’s happening in the body, mind, and emotions that lead to someone thinking about ending their life. I hope it will lead you to think about how we might live our lives in ways that prevent others from taking theirs.
My work focuses on clarifying essential components that explain how things work, what goes wrong, and what works. This book summarizes essential points I believe are important when addressing conditions that may contribute to suicide. A lot of information can be condensed into a few words. Some reviewers said they spent more time thinking than reading. I suggest you do the same. Pause now and then, take time to reflect, and connect it with your life. Is it different than what you thought? – how? Does it fit with your experience? – in what ways?
The book is structured so you can read or scan according to your interests and inclinations. There is a brief summary at the end of each chapter. Most chapter headings are written as questions, followed by a list of short statements summarizing my response. These become subheadings for the following text. An expanded table of contents lists all of the headings and subheadings. This format allows you to quickly scan essential points while making it easier to return for more detail. It also allows students and participants in classes or study groups to choose topics that fit their current needs and interests.
You will find similar subheadings under many questions – some essentials apply in many different situations. For example, Balance is part of the response to many questions. Anything we might do to effectively reduce suicide will be easier when we’re more in Balance.
I also don’t assume you will have read what came before, so you will see some repetition. I have tried to offer fresh insight each time an essential is repeated. Hopefully, this will deepen your understanding of the importance of that concept.
There are three parts to the book. Part One identifies what I understand as the seeds of suicide. A lack of belonging and a build-up of physical, mental, and emotional tension can lead to a breaking point. An overwhelming desire to stop pain and emptiness takes over one’s vision.
Sometimes, tension builds slowly until something pushes us over the edge. Other times, a single incident sets off a self-escalating cascade that overwhelms us. In both cases, we become entirely blinded by pain and absorbed by thoughts of how to stop it.
Part Two describes the essentials of mental health – the basic conditions that lead to a healthy and fulfilling life. Striving for improved mental health takes us in the opposite direction of suicide. Restoring Balance, understanding emotion, and learning to see and think more clearly not only improves our lives – it also makes us more sensitive to the needs of those who may be at risk of self-harm.
Part Three describes specific steps you and I can take to reduce suicide and improve health and well-being in our communities.
The Appendix offers a list of suggestions and resources for responding to someone who may be at risk of suicide, excerpts from a previous book related to restoring Balance, and a description of the effects of suicide on those left behind and how we can support them.
This book offers a perspective on suicide by describing the essentials of what’s been effective in my work. I hope it will help you become a part of the growing number of people working to reduce the likelihood of suicide devastating their community.
Bring Truth to Fear 