This is a “thought bubble”. It is an illustration depicting thought. (Photo credit: Wikipedia)
I am thinking about the impossible to know with a reasonable level of certainty. What do two people have to do or not do to make a marriage work or die a flaming death much like mine? AC/DC’s song “Shot Down in Flames” comes to mind. While I admit that the world is probably a safer place for all involved if I live alone, I wonder what it was that I obviously did or did not do. I know what my problem with the whole grown-ups behaving badly thing is/was. No need to cover old ground, or extremely tainted water under a falling bridge.
I realize that having a diagnosis such as Bipolar tends to knock you a little sideways, and your perceptions of yourself in relation to the world changes a bit (maybe more than a bit). However, once you have recovered your senses, and you happen to be a highly functional mentally interesting person, shouldn’t things get easier not more tedious? Yes, I flew off the handle one too many times, but once again, I wasn’t the one who could not leave my computer sometimes for days on end. I tried to communicate, but how do you communicate with someone who does not know how to communicate with you? It’s like clapping with one hand (thanks to Anthrax for that analogy).
What are you supposed to do with someone who has no desire to really get to know who you are apart from your interestingness, and does not seem to have any desire to learn anything substantial about Bipolar? I, upon receiving said diagnosis, went out and read everything that seemed legitimate. How can you battle that which you do not understand fully? Answer: you cannot effectively deal with any illness unless you know what you are dealing with.
This was supposed to be forever, but I guess that’s a big fairy tale society tells little girls: your knight in shining armor will come and all will be sparkly and shiny and smiley and happily ever after. They lied. I think I met my knight in shining armor, and ditched him to get married to a man who turned out to be a far cry from the “face” he put on during the courtship. I am sure he feels the same about me, but I really do not know how to be anything but myself. He knew my moods weren’t completely handled, but he said, no problem, he could handle it. Apparently not.
So, now I am in my early 40’s looking at starting all over again. Dating in my 30’s was not a problem because of said knight in shining armor. I never had to worry about someone to go drink beer and listen to blues bands with. He was always there for me, in all ways. What the hell was I thinking? Now, I am left to pick up the wreckage that used to be a perfectly satisfying life. I did not have self-worth problems, I did not have problems with how I looked, I did not have a problem with how feminine I was or was not. I didn’t have a problem with a lot of things. As I imagine he didn’t either. But, I wasn’t shattering his masculinity every single day.
i think that I took him very much by surprise when I actually did file for divorce. I had mentioned it several times over the past couple of years, but he never thought I would actually take any action. He said everything I said was just talk and more talk, no action. Well, I guess you shouldn’t threaten me physically. I don’t cotton to that very well. I just wish I could pinpoint where it all went wrong. When I became unhappy with him and he with me. I play it over in my mind, and nothing seems to just pop out at me. I think I became upset with myself when I stopped getting mad about his Internet activities. There was no point. i was just wasting breath. I do not know, but I do not think I will try it again anytime soon. Talk about a learning experience. Never again will I allow myself to be treated like that. I am surprised I didn’t see it until the very end. After all, I grew up in an emotionally abusive family. I should have seen it for what it was and left much sooner. Maybe then I wouldn’t feel so scarred. Again.
English: Emotions associated with anger (Photo credit: Wikipedia)
Apparently there are five stages identified by the mental health professionals to be the cycle of loss and grief. (I do not know if this is a series that implies linear psychological movement or if a person oscillates between stages) They are in order:
Denial & Isolation ~ This is the stick your head in the sand and pretend nothing is happening phase. Actually, it is the first reaction to finding out very bad emotional news such as the death of a loved one, the loss of a relationship, etc. This phase allows a person to block out harmful words and to hide from the facts. It is a temporary response meant to get a person through that first wave of pain. It is not intended to last forever.
Anger ~ This is the phase where you point an enraged finger at everything and everyone. In reality, this phase arrives after the masking phase of denial & isolation wears off and the reality and pain of the situation reassert themselves, and we are just not quite ready for them. During this phase, we tend to deflect the most intense emotions by redirection and expression as anger. This anger can be pointed at anything or anyone. One may also feel guilty about feeling angry and become even more so.
Bargaining ~ The “if only” phase. Bargaining is a normal reaction to feelings of helplessness and vulnerability and often represents a need to regain control. I call this the “if only” phase because a person in this phase is thinking to themselves “if only I had been a more behaved child, my parents would have stayed together” or “if only I had noticed the changes sooner, my husband would not be as ill as he is.” Basically, one is telling oneself that “if only” they had been or done x,y, and z, then everything would have turned out differently. This is a much weaker line of defense against the pain that is reality. Whatever has happened is done. There is nothing to bargain for or with at this point.
Depression ~ a fairly obvious stage, i would think. There are two types associated with mourning. The first is a reaction to the practical implications of the loss. Sadness and regret play a big part in this phase. It is kind of an extension of the bargaining phase in that one regrets things one has done, and experiences remorse because one is still going through the “if only’s”, but is about to come out the other side into the reality of what has happened. The second type of depression that occurs is much more subtle and perhaps, more personal in nature. This is the phase in which one is quietly preparing themselves to separate from and say goodbye to someone or something we love(d) goodbye. This is the deeply personal sorrow at one’s loss, and is uncomfortable because while one is still deeply sad, at the same time, a person is preparing to move on.
Acceptance ~ or in my opinion, a form of enlightenment. This is not a phase that everyone reaches. Some people may never move past denial and anger. It is not a brave and noble thing to deny the inevitable and the opportunity to make our own form of peace. This phase is very quiet and withdrawn, however, it is not a period of happiness, although it must be distinguished from depression. Coping with a personal loss is a deeply individual and singular process. No two people will grieve a loss in the same way. Nobody can help a person go through it with more ease or to understand the very personal emotions one is experiencing. The best thing one can do is to allow oneself to experience the pain when it comes because resistance will only prolong the process of healing. I call this a form of enlightenment because if one can work their way through this maze, and come out of it changed for the better and more at peace with oneself and the world around you, you have achieved a form of enlightenment, in my opinion.
i thought I had already prepared myself for the loss and grief of the death of my marriage. I had been unhappy for at least two years, apparently completely missed by my husband. I thought I had already decided the relationship was over and that I had been alone for awhile. Nope, I was really wrong. When something like a divorce is just a thought, albeit a very serious thought, one is still married. There is still hope for change if both parties are willing to put in some serious work, and both parties are willing to work on changing things their partner is really unhappy with. But, even counseling is an exercise in futility if even one person is not on the same boat. When one person feels that the other is the one who needs to do all the changing while they continue happily along with their own odious behaviors, even the most skilled therapist will not be able to effect any change in the marriage.
That is how it seemed to me in my own relationship. I was the one who was mentally “interesting.” I was the one who got angry and yelled and threw mini-tantrums. I was the one who just couldn’t get with the program which was my husband could watch Internet porn all day, but I could not bring a male friend to the house. Apparently, I was the “only” woman who ever had any problem with his viewing porn. I had no problem with it either, just not 8 or 9 hours a day, every day. Eventually, it got to the point where I wasn’t even saying anything about it because that was a pointless way to spend breath. I just let him do it, and continue doing it, and I would periodically make unhappy grumbling noises about a divorce which he erroneously thought of as a threat or an ultimatum to get him to slow down. It wasn’t either, it was a certainty. It was just a matter of when.
I truly have been questioning why I stayed in a relationship that so obviously emotionally and insidiously verbally abusive for so long. I am not a weak willed person, at least I did not think so. Yet, I stayed in a relationship that was incredibly abusive in the ways that leave no visible marks but eventually erodes your sense of who you are in the most basic of ways. I no longer think of myself as attractive (I couldn’t live up to the women on the Internet), I no longer think of myself as a sexy, feminine woman, I question my rationality, I question everything i once held to be true about myself. I question my worth to anyone. Hell, I question my worth to myself. I think I am moving between denial, anger, and depression. Even that I am unsure of. I cannot figure out how I could have let this happen to me other than hope springs eternal, and I thought maybe one day he would wake up and realize what I was worth to him. He knows now.
I have received the divorce papers. It is official; I am divorced after approximately 4 years of marriage. I do not really know how I feel about it now that it is a reality that I can read as many times as I want on page two of the Divorce Decree. And, believe me, I have been doing just that. That cannot be healthy. My anti-anxiety medication refuses to work, the mood stabilizers are on holiday to Jamaica (or where ever that postcard came from “Wish you were here!”). I am alternately very quickly through mania and depression. Mostly at the same time.
I mailed the required copies to my ex-husband as New Mexico law and I would presume most states, if not all, has this clause. He found out that the divorce was final, I think on Thursday. I found out about a week earlier. It was surreal to read those papers. I think in my mind that it was going to take longer to process the divorce packet. It took two days from the date of filing. It was so fast. My mom and I finalized the papers on a Tuesday, filed Wednesday, and by Friday I was divorced.
I really do not know how I feel about this. I have been waiting for him to change his “habit” for two or more years now. I thought I had worked out the abandonment and neglect that was part and parcel of this marriage. I have been alone with someone for so long that I thought living alone would be easy, and I would just drop into my old routines. That hasn’t happened. I feel sad and depressed. I feel like a complete failure. I have done everything right in my life’; with a few notable exceptions. Why couldn’t I get this right? Why couldn’t he get it right? Its not like he hasn’t had practice. He’s been married three times, and divorced three times. Although, I have noticed a pattern, he stays married for about 3-4 years and then gets divorced. Is he leaving them? Or, are his “habits” so odious that they leave him? He doesn’t need a wife; he needs a friend with benefits and a maid.
I didn’t expect to feel loss. i thought I had been through that already, too. Apparently not. I feel loss, I feel grief, and I feel relief and elation. I feel like I have been having a mixed episode for about three weeks. If I am manic with not too much depression, I can get things done, if I am depressed and slightly manic. I sit and mourn.
I have no more access to a car, so it is looking like my Buddhist activities are going to cease as they are on Sunday, and the Sunday buses rune every hour at inconvenient times. So, that’s not an option. As this spiritual philosophy has kept me grounded for almost 5 years, I do not know what I am going to do with out it. I cannot in all good conscience keep asking people for rides to meetings and events as it may be years before I can get a car, and that is a serious imposition.
I do not know why, but I feel little to no emotion about this whole divorce experience, event, to-doing, whatever. I feel like I should feel sad or lonely or depressed or have that ache in your chest that one gets when one loses someone close to them. But, I have none of these feelings that signify grief over something lost that should have and could have been something extraordinary if we had worked at it. Maybe, that is the problem; perhaps, I have already grieved. Sometime during the past two years, but especially the last year, I think I knew the relationship was dead. At least it was for me.
I was exhausted, tired, and worn out by his out and out refusal to make any change in himself or his “habits”. He didn’t need to change. Everything was my fault including his little problem with porn which he claims his other women didn’t mind. I highly doubt that, and think they didn’t say anything so they wouldn’t rock the boat. He was/is very touchy about this subject which, to me, means he knows he has a problem.
So, I sit here and wait, wondering when the crash is going to come as I know it will eventually. So far, I have been angry and mad, and that has staved off the emotional cliff I am bound to walk off of any time soon. But, being angry and mad take up so much energy, and are so counterproductive that I cannot sustain them as a wall against other feelings. I will fall. It is just a matter of how far. This particular situation is about second or third on the Rahe Life Stressors scale, and I am sailing through it. Something is wrong. Something is very, very wrong with this picture. I am the annihilistic realist. I am not Mary Poppins when it comes to stuff like this. I am usually by now, extremely depressed to the point of non-function and somewhat suicidal. However, I am none of those things, and I find that a bit unnerving as it is a huge deviation from my norm. I am calm, and that’s not right.
My mother and I filed the final Divorce packet about two days ago. He never officially answered the summons alerting him to the Petition for Divorce action being taken against him. It was due at the Civil Relations or Domestic Relations clerk’s office 30 days after the summons and a copy of the “Lawsuit” (I guess is what it really is) were served to him. He said about 10 days after the 30 were up that he needed to get to court to file his response. I told him his 30 days was up about 2 weeks before. I do not understand this guy. He gets a traffic ticket in Los Lunas, and makes damn good and well he knows where the courthouse for that region is, and what time he needs to be there. And, he goes at the appointed time and date. What is so different about answering a Summons alerting you that your wife is leaving?
It is almost like he is a child, and if he puts his hands over his ears and eyes, it will all go away. I really do not think that he realized that I was deadly serious this time. He had said that I was all talk and no action when it came to leaving the relationship. Hmmm, I guess not. I spent about 2 weeks packing and moving, and I moved to an apartment about 10 days ago. My mom then discovered there is different paperwork to be filed in a Default Judgment scenario which is what we now have. So, with my mom helping (as a private attorney, she filed lots of Divorce cases before she moved to the City), I filed the Default Judgment packet asking the Judge to please dissolve the marriage, and return to me to my rightful name. I never did feel comfortable having taken his last name. Foreshadowing, perhaps? At any rate, those are the two things that I want: the marriage from hell dissolved, and my name returned to me.
I do not think he knows what he did with all his passive-aggressive and narcissistic behaviour. I have taken steps backwards due to his verbal and emotional abuse and neglect. I no longer feel a sense of self-worth (if I was worthy, then he would have not been on the Internet looking at and watching porn), I no longer feel I am attractive or even the slightest bit sexy (see comment above), I have lost self-esteem (whatever that is, i know that I have lost it), I treat myself badly, I feel very unlovable and not wanted in any way, shape or form,etc. And, all he had to do to keep his marriage was get out of Pornography “fun-land”, read a damn book about my main illness, Bipolar disorder type I, and show me that I was wanted and appreciated. That is all he had to do. Instead, he did the opposite. He would claim that only three things were important to me: my mental health, my self, and my cat. He left something out. He was important to me; I loved him (or thought I did), and all I really wanted was for him to be happy, but I am now guessing he is not capable of true and lasting happiness or contentment.
Hopefully in about 2 weeks, i will be rid of this foul and toxic relationship, I will have my name back, and I can go ahead with the work of healing and putting back together everything he undid. All those years of therapy, and this asshole wipes out about 2 years of progression towards my stable madness.
English: Bob Marley live in concert, just a couple of years before his death (Photo credit: Wikipedia)Hobby (Photo credit: Sergey Yeliseev)
Today, another blogger, ajaytao2010, volunteered me to pick out two awards from a total of thirteen. As, I am approaching the “big” move out of the house I used to share with a man I thought was something he turned out not to be, I am feeling a little like I am on a hammock that is rocking violently in a late summer wind. I am alternating from irritable (big defensive wall) to profoundly sad (no defenses there). I got married with the idea that this would be the only marriage i would ever have. I was in my late 30’s when I got married. I waited until I thought I had found the right man. I was very wrong as I often am. One of these days I am going to get this “life thing” right, I swear. i just do not know what a happy life looks like. I have never really had one. Not even as a child. I thought too much and analyzed the life out of things; probably why I am a great researcher. but, happy, no. Weird to other people and kids at school, yes. I wasn’t normal until I hit college, and realized that all the weirdos from high school had congregated there. Now, I wasn’t weird or strange or any one of a number of descriptors used over the years. I was accepted, I was allowed to explore ideas and philosophies. I was encouraged to explore, to inquire, to question, and to be myself (which was still a bit odd).
At any rate, I have been moving out of the house that was supposed to be a “fresh start” for my husband and myself, but nothing changed except me. I became less emotional which may or may not be a good thing. He continued with his way of life (of which I highly disapproved). It is almost like the status quo was fine for him, but I needed to work on myself. I was always in the wrong, always on the receiving end of small but biting barbs; I was being abused, and I recognized it. I had been trying to work up the courage to leave, but he always sweet talked me back, and then it would all start over again. We finally had the deal breaker fight a couple of months ago, and I went to bed that night determined to instigate divorce proceedings. I had told him that I would divorce him if he didn’t at least try to curb certain activities. He didn’t and told me to stop threatening. I said that it was a certainty. And, so it came to be.
So, today, a blogger who has just started reading the convolution that is my life gave me two awards for my blog. Like I said, i do not really need awards to validate myself (that was me in college; I was defined by being the best student in the class), however, it is very nice and humbling that someone would actually not only read my esoteric writings about everything, but would find it interesting enough to follow it, and to deem it worthy of a couple of awards. Like I said, it couldn’t have come at a more opportune time in my life; recognition and validation of any kind is very appreciated when one has not heard much of it. So, one again, Ajaytao2010, thank you very much. I receive them with appreciation and gratitude. 🙂
Washington DC – Foggy Bottom: Watergate Complex (Photo credit: wallyg)
I would like to know when I became responsible for an irresponsible person. I am not in control of bill paying anymore, and somehow, the bills are not getting paid. Now, we are low on coffee creamer because I have bipolar disorder and when under heavy emotional stress, I do not sleep well, if at all. So, now that’s my fault too. Did I have anything to do with the Cuban Missile Crisis? Yes, even though I wasn’t even born yet. I do not think my parents were even married at the time, but it is my fault that Castro almost blew us from here to kingdom come. Trickle down economics didn’t work, because something about me wouldn’t let it. Never mind that I was like 10 or maybe 12. I still had some influence on that misguided idea. Do not how, but I am responsible. Oh, and the biggie, the Watergate scandal. i was responsible for that too. No one knew that a toddler plated those tape recorders. Toddlers are dangerous. Better watch out for them, especially if they are walking. They are so impressionable at that age.
I cannot wait until I am completely moved out of this hell-hole. I have never in my life felt so beaten down for reasons I do not understand. i cannot get anything right. Everything is about my having bipolar disorder. NO IT IS NOT!!!!!!!! Most of the time, if I am mad about something, I have a legitimate right to be angry. If I am happy, them I am just happy. It is not a manic episode. If i am sad, then I am simply sad. No depressive episode in sight. Most of the time recently I have just been irritated beyond my capacity for stupidity. I have never suffered fools lightly, and I can no longer put up with the behaviour of my soon to be ex husband. He is acting like small child. Placing blame on external sources, when he is a Nichiren Buddhist and should know better. Your problems and solutions are within not without oneself.
Maybe I am the irrational one. Fuck if I know! Maybe my reaction to his childishness is irrational, but I have done my best to keep things low-key. I am beginning to lose my grip on things. I feel like throwing stuff that breaks. That would be satisfying. My attempts at rationality are reaching their end. Not that I would ever do this, but I think he needs smacked upside the head to see how immature and stupid he is acting. I have had it. I can no longer sleep right, I never know when the next verbal or emotional attack is going to come from and for what reason. Let him play on the online dating sites. I only wish I cold find a way to tell these women that he is a façade and nothing else. He comes on charming and smooth, reels you in, and then his true nature starts coming out. Okay, girls, i warn you that he will be spending about 8 hours a day looking at other naked women. You are going to end feeling as sexy as a fat cow. He will never tell you that he loves you. He will never tell you that you are beautiful; forget your girlish notions of romance. You are in a world of hurt if you get close to him. He is a loser.
There, I feel better. i am no longer responsible for the deficit. 🙂
Me, personally, I would lock myself in the bathroom with a bottle of chardonnay, and some lavender scented bubble bath.
Okay, all the funny stuff is over, and you are struck by your realization that someone you have loved does not and has not nor will they ever see you as a walking, breathing, and sensitive person that happens to also HAVE Bipolar disorder. They see you for your disease and they choose to define you as a walking pathology. How do you fight the preconceived idea that you are bipolar and that is all you are to them? You have become a non-entity, and realize you have been invisible for a long time. Is that why you fight about really stupid stuff? Negative attention is better than no attention; I think it was Skinner who came up with that idea (?) It really doesn’t matter who said it. It is part of the “woe is me” model of ongoing, chronic mental illness. I do not agree with this “woe is me” approach on many levels.
First, the afflicted individual is saying to him/herself, I am just an illness, I am not a person. And, therefore people can do anything they want to me because I am like a disease popsicle.
Second, as demonstrated by a person I thought was intelligent, everything that goes wrong can be tied directly to the fact that you ARE bipolar. Yet, anther example of the stupidity that goes into creating the stereotypes and stigma of having a mental issue. It’s people like this that continue to spread the epidemic that is the stigmatization of mental illness; why would anyone willingly tell someone their story if they knew it would be used to stab you in the back with it? Repeatedly. I over heard said person talking to an old neighbor and actually told her we were getting divorced because of MY BIPOLAR. Ummm. Hello, I am the one who filed for divorce! Doesn’t that mean to you, “Oh shit, I’d better figure out what is going wrong?”
We are not getting divorced because I have bipolar, it is because you are addicted to Internet Porn (which I have repeatedly told you I disliked), it is because you have become emotionally and verbally abusive towards me. You set me up every time. You make sure that I have no money, that I have limited access to your car (I let you use mine without question). All of the classic signs of abuse. You have no idea how much you have hurt me in the name of helping me out the life I had which was a perfectly good one, I had friends, I went out. You complain we never went anywhere. Well, maybe if you weren’t so fucking vain that you have to look like an Armani suit every time you go anywhere. You are losing sight of the reason’s I decided to divorce you. I have not sight of mine, or maybe you never knew the reasons why the marriage fell apart. HINT: it happened the night you threatened me with bodily harm. I don’t take that from anyone.
You have consistently treated me like a walking destructive force of nature, and yes, I can be. However, I haven’t been that way in many moons which if you were not busy with your porn. you would have noticed. You treat me like I am negative, defeatist, blah blah blah. You made me into that. Stupid @^#@! *&%^ you! I am out of here in less than a week. Do not fear I will take the Internet away with me, I will take my friends away with. You are pathetic.
How do you recover purpose as well as self-worth when someone had hurt you so badly, that you do not know who to trust, who’s mask is better than the next one. what is their real personality, basically paranoia? Is it allowable paranoia, is it valid paranoia, or is that one voice in you that says trust no one? Or are you filtering through your rather warped and damaged lens? Is it really your fault? Probably, since every thing is his mind eventually comes around to illness. He can’t even tell when I am manic or when I depressed. That’s the extent of observation It’s like a cave man grunting upon the finding of meat. That’s about the level of functioning he has. He is a cave man grunting upon finding meat, but never looks past that to see if there is more.
English: In 2005 a fence was added to Tromsøbrua because it was one of the most used bridges by people who wanted to commit suicide at the time. Norsk (bokmål)â¬: I 2005 ble det montert et gjerde på Tromsøbrua fordi den var blant de mest utsatte for selvmord og selvmordsforsøk i hele Norge. (Photo credit: Wikipedia)
The Way Out, or Suicidal Ideation: George Grie, 2007. (Photo credit: Wikipedia)
This is part Two of the commentary on “The Interpersonal-Psychological Theory of Suicidal Behavior.” The following sections will elaborate on the three main components. One caveat: this theory is more geared to people with mood disorders, but not the more common personality disorders like Borderline Personality disorder.
The first question was “What is the desire for suicide, and what are its constituent parts?” Joiner states that two deeply held beliefs or perceptions must be held at the same time, and for a long period of time. The first is an unwavering state of “perceived burdensomeness” which is defined by the view or perception that one’s life/existence burdens family members, friends and/or society, in general. Joiner states that this produces the idea that death would be preferable and of more value to family, friends, and society at large. This perception ~ it is important to note ~ represents a potentially fatal misperception.
Past research, although not direct empirical tests of the Theory of Interpersonal-Psychological, have found that “perceived burdensomeness” especially toward family is correlated with suicidal ideation among community participants and high-suicide-risk groups (DeCatanzaro 1995). Past research has also documented an association between “perceived burdensomeness” and suicidal ideation.
Direct tests of the theory have been supportive, as well. In two separate studies of suicide notes, the raters detected more expressions of being a burden in people who had died by suicide compared to those who had tried but had survived. It also occurred in people who had died by suicide using a violent means versus those who used less violent methods. People who committed suicide using a gun for example, showed a higher degree of burdensomeness than those who chose a less violent method.
In a study of psychotherapy outpatients showed a measure of “perceived burdensomeness” was a healthy predictor of suicide attempt status, and of current suicidal ideation even while controlling for powerful covariates such as hopelessness (Van Orden, Lynam, Hollar, & Joiner 2006.)
The second condition that must be present, and have been present for a period of time is the concept of “low belongingness or social alienation” ~ which is defined as a sense of being alienated from others, or not an integral part of a family, circle of friends, or other valued group. As with research on “perceived burdensomeness,” there is a great deal of evidence that this factor is implicated in suicidal behavior. Although, very little of this evidence derives from direct empirical tests of the Theory of Interpersonal-Psychological of Suicidal Behavior, a strong case can be made that that of all the risk factors for suicide, ranging from the molecular to cultural levels, the strongest and most predictive support has emerged for indices related to social alienation (Boardman, Grimboldeston, Handley, Jones & Willmott, 1999.)
The connection between belonging (or its absence) and suicidality has been established for a number populations including adolescents, college students, the elderly, and psychiatric inpatients. What I find interesting is that suicide rates go down during times of celebration (people are coming together to celebrate a common event); Joiner, Hollar & Van Orden, 2006. Suicide rates also go down during times of collective crisis such as the 9/11 bombings, and for about a week after the assassination of President Kennedy (people pull together to commiserate.)
Direct tests of The Interpersonal-Psychological Theory of Suicidal Behavior
Conner, Britton, Sworts & Joiner evaluated 131 methadone patients who displayed a high level of “low belongingness,” and found that it predicted a lifetime history of suicide attempts that were not accidental overdoses. The association was specific to actual attempts and not suicidal ideation. This association crossed demographics, correlates of suicidal behavior and other interpersonal variables.
The third component is the “acquired ability to enact lethal self-injury.” Feelings of “perceived burdensomeness” and “low sense of belonging” may instill a desire for suicide, but they are not sufficient on their own to produce an attempt. The third element of the ability to inflict lethal self-harm has to be in place. At this point, the theory assumes a fight with one’s innate self-preservation instincts. However, according to the theory, a person having fought this battle repeatedly and in different settings instills the ability to override the self preservation instinct ~ should such an individual want to do so. Experiences often include previous self-injury, but can also include repeated accidents numerous physical fights; and occupations like physician and front-line soldier in which repeated exposure either direct or vicariously to pain and self-injury produces the acquired ability to commit the act of suicide.
The basis of this proposition is primarily an “opponent-process” theory which suggests that repeated exposure to affective stimuli results in the stimuli being unable to exact the same response, and instead the opposite reaction is strengthened (Solomon, 1980). Based on this, it is hypothesized that the capability to commit suicide comes from repeated exposure to painful or fearsome experiences. This results in habituation and a lessening of the fear or pain response. Thus, the capability to end one’s own life is largely due to this habituation.
The basic implication of this habituation is that past suicidal behavior will cause individuals to become “immune” to the pain and fear of self-injury making future attempts more likely. A history of suicide attempts has been found to be a strong predictor of future attempts, suicidal behavior, and completed attempts (Joiner et. al., 2005). The highest levels of “acquired capability” were reported by people with multiple past attempts as the theory would predict.
Acquiring the capability to commit suicide is not limited to past behavior ~ it can be acquired by habituation to other fear or pain-inducing behaviors (e.g., non-suicidal behavior like cutting, self-starvation, physical abuse, etc.). For example, the behavior of cutting oneself has been shown to anticipate a higher likelihood for suicide attempts and those who have a longer history of self-injury, use of varied methods tend to report an absence of pain during self-injury ~ all indicative of habituation and tolerance (Nock, Joiner, Gordon, Richardson, & Prinstein, 2006). Aside from direct exposure, the theory also puts forth the idea that vicarious exposure to pain and injury may produce the capacity for suicide. Physicians fit in this group with high suicide rates despite many protective factors (hawton, Clements, Sakarowitch, Simkin, & decks, 2001).
The Interactive Nature of the Theory
The interactive nature of the theory suggests a three-way relationship between the main concepts. Particularly, the ideas of “perceived burdensomeness” mustbe present with “low sense of belonging” to produce the will to die. However, that will or desire will not be acted upon unlessin the presence of the “acquired capacity” for lethal self-harm.
To date, four studies have looked at the interactive nature of the model. All have shown significant statistical interaction among the three major concepts even while controlling for covariates such as depression, gender and age.
The Interpersonal-Psychological Theory is promising with growing empirical data to support it. It suggests that clinicians be aware of their patients’ levels of belongingness, sense of burdensomeness, and acquired capability (especially previous attempts; my own therapist spent 10 minutes today assuring herself that I wasn’t writing an elaborate suicide note. Far from it, mostly these days I am irritable) as this awareness may aid in suicide risk assessment and therefore, being able to target therapies.
English: Image for mental health stubs, uses two psych images – psychiatry (medicine) and psychology (Photo credit: Wikipedia)The Way Out, or Suicidal Ideation: George Grie, 2007. (Photo credit: Wikipedia)
For a long time, I have wondered why I and some friends (including my ex fiance’s sister’s completed suicide) of mine have attempted suicide either once or several times. When a good friend of mine attempted suicide about 20 years ago, when she was finally able to talk again (she swallowed a cocktail of pills), she said she had been drinking and it had finally hit her that this guy she was head over heels for was never going to let go of his feelings for his ex-girlfriend. So, she almost lost her life over some guy. I, myself, have a few attempts under my belt, but mine usually seem to be without reason. At least no good reason I have been able to come up with. My ex-fiance’s sister successfully committed suicide at the age of about 36, and about one month after her birthday. She, too, had a history of mental illness and suicide attempts. Please note that this post does NOT mean that I am suicidal.
I am simply interested in the “whys” of attempted and completed suicides. What are the specific set of circumstances that have to be present for someone to consider taking their own life? Why are we the only creature in the animal kingdom that does commit suicide? I have been interested in this for most of my life. For example, using myself, I have probably attempted suicide about 5 times, maybe 4. I was always a pill popper as I cannot abide the idea of cutting my wrists or using a gun. Too painful and too messy. However, each time I tried and was really set to die, I would call 911. Why would I do that? Maybe it was an effort to garner attention, or maybe I really did mean to die but failed because my desire to live was stronger, or maybe it was my way of saying I need help (I never have had an easy time asking for help even when I clearly need it).
So, after much research recently and over the years, I have finally found a complex but simple theory that I feel is a valid theoretical explanation as to how a person could overcome the self-preservation instinct and also what conditions need to be present to induce someone to think of killing themselves. It is called the “Interpersonal-Psychological Theory of Suicidal Behavior” by Thomas Joiner, PhD. He specializes in the research of the psychology, neurobiology and treatment of suicidal behaviors and other conditions. He was recently awarded the Shieldman Award by the American Association of Suicidology for excellence in the field of suicide as well as the Guggenheim fellowship.
This is going to be part one which will introduce the theorist, and the premise of the theory. Part two will discuss the theory itself, it’s parts and conclusions.
The Interpersonal-Psychological Theory of Suicidal Behavior
The basic questions that this theory asks are: 1) What is the desire for suicide, and what types of thinking lead to suicidal ideation? And, 2) What is the ability to die by suicide, and in whom and how does it develop?
Question one: “The Interpersonal-Psychological Theory” asserts that when people hold two very specific mind states for an extended period of time, they will develop a desire to die. These two states, which I will go into in part two of the post, are “perceived burdensomeness” and “low sense of belongingness/social isolation.” Both of these must be present to come to the desire to die by suicide or suicidal ideation.
Question two: “The Interpersonal-Psychological Theory” states that, in general, the self preservation instinct is so powerful that very few people can overcome it by force of will. The few that have been able to cross that barrier have developed a lack of fear of pain, injury, and death through repeated exposure to painful and/or provocative events. These experiences often include previous self-injury, but can also include repeated accidental injuries, numerous physical fights; and occupations such as a physician or a front-line soldier in which repeated exposure to pain and injury is common either vicariously or directly.
What are the current empirical data for this conceptualization? Some of it is indirect although a growing body of empirical support is accruing.
So, those are the basic questions this theory seeks to answer, and having been suicidal in the past, it has a strong resonance because this theory explains exactly where my head was at at the time of the attempt. I will go further into the parts and empirical support and conclusions in part Two.
A Bipolar Journey Through The Rabbit Hole 