Understanding Suicidal Tendencies: Empowering Pastoral Care and Therapeutic Intervention

Mely Wezah
Chizami Baptist Church, Chizami Village

The act of intentionally taking one’s own life is known as suicide. Suicide is a complex issue as it has been influenced by various factors. The case of suicide is increasing at an alarming rate and there is a need to address this issue. All faith traditions condemned suicide because they believed that human life belongs to God.Many Christians are reticent to talk about suicide and have developed a negative attitude towards them. In many ways, we failed to give maximum support and nurturance during their time of distress or emotional turmoil, leading them to take extreme steps. 

Every suicide is a tragedy that affects families, communities and the larger society and has long-lasting effects on the people left behind. In India, a total of 164,033 committed suicide in 2021 alone and the national suicide rate was 12, which is the highest rate of deaths from suicide since 1967.It was the second most common cause of death among 15 to 29-year-olds around the world in 2016. The strongest risk factor for suicide is a previous suicide attempt. Emile Durkheim concluded that the more socially integrated and connected a person is, the less likely s/he is to commit suicide. As social integration decreases, people are more likely to commit suicide. He has proposed four typologies of suicide such as egoistic suicide, altruistic suicide, anomie suicideand fatalistic suicide. 

Sigmund Freud’s first observation on self-destruction led to psychoanalytic theories and studies that have influenced the exploration of suicide. He hypothesized that the life and death drives were opposing basic instincts. The life drive was directed at reducing the tension associated with survival needs; the death drive was directed at eliminating the tension of life itself. Freud argued that the universal goal of all organisms is to return to the quiescence of the inorganic world and that repetition compulsion forms the basis of all self-defeating behaviours. He believed that the energy to kill oneself derived from an earlier repressed desire to destructive behaviours.The human is, after all, the only animal that kills itself.

Elaborating on Freud’s death instinct, Menninger claimed that every suicide is an inverted homicide, or ‘murder in the 180th degree.’ He conceptualized a suicidal triad consisting of the wish to kill (murder), the wish to be killed (guilt), and the wish to die (depression). The wish to kill was originally oriented to an external object and later introjected into the ego, leading to feelings of guilt for wishing loved ones dead. As one’s ego is destroyed by self-hate and guilt, a depressed, hopeless wish to die evolves, and a wish to be killed as punishment for thoughts of destroying others. Menninger linked suicide and self-harm to castrating or mutilating fantasies directed toward one’s parents and siblings.

Edwin S. Shneidmandelineated that suicide is caused by Psychache, an intense and intolerable emotional pain that is different from depression and hopelessness. The tortured individual seeks relief from his/her pain until there is no solution but death. Two types of needs: primary or biological and secondary or psychological. The psychological needs that are essential for life include, among others, love and belonging, a sense of control, a positive self-image, andmeaningful relationships. The frustration of these needs by failures, rejections, and loss leads to the development of psyche. 

In the Biological theories, the evidence indicates that suicide is most common in individuals who are unlikely to reproduce and unable to engage in productive activity; such individuals are least capable of promoting their genes. These genetic studies also suggest that genetic predisposition to suicide or suicidal behaviour may, at least in part, be independent of the genetic risk of mood or other psychiatric disorders. The serotonin neurotransmission system has received the most attention in candidate gene studies of suicidal behaviour due largely to the role of serotonin in mood regulation and studies showing altered serotonin function in suicide victims. Abnormalities in the serotonergic system have been widely implicated in suicidal behaviour and suicide. 

Robert W. Firestone did intensive research on inner voice and suicide. His findingshows how internal factors cause a person to end his/her life. Do people commit suicide because they hear and respond to an inner voice? Whose voice do they hear? Is it the voice of the deceased soul of a closely related person? Some believe so, an unseen spirit compelling them to commit suicide but the answer lies in the following.

Every person, while they grow, incorporates negative attitudes/feelings into his/her personality that are alien and hateful to self. Although these voices are harboured inside, they exert a profound limiting influence on each person’s life. Whereas some of the attacks are conscious and people acknowledge these self-critical thought patterns; others are more deceptive, remaining unconscious and accessible yet doing an enormous amount of damage. People are hurt not necessarily by the charges that are levelled against them but by whether the external attacks coincide with their internal self-attacks coincide which their internal self-attackcan be badly hurt, if unconsciously they agree with the criticism. So, the inner voice is made up of conscious and unconscious components that obstruct the ongoing motivational field and cause varying degrees of maladjustments. The internalisation of negative parental attitudes and damaging childhood experiences contribute to the formation of the anti-self-system. The voice is a continuous, although not always conscious, process that is carried inside one’s brain usually not open to external interpretation because it remains unspoken. Everyone has negative voices but people who are suicidal, have negative voices that dominate their thinking and block their ability to think positively.

All major religions such as Christianity, Islam, Buddhism and Hinduism have traditionally condemned suicide because they believe that human life fundamentally belongs to God. Suicide was a fairly common occurrence in the early church which tended to approve of self-sacrifice and martyrdom. St. Augustine strongly opposedany form of self-murderthereafter the church began taking a different view. He appealed to the Sixth Commandment and its prohibition against murder. Augustine agrees with Socrates that our lives belong to God and therefore nohuman has the right to end by themselves. Over time, many in the Church came to see self-murder as an unpardonable sin. St. Thomas Aquinas reaffirmed Augustine’s view that suicide is a sin.The Bible did not explicitly mention suicide as being right or wrong, but it does contain verses that fall into some categories of sinful behaviour and emphasize the value of life and the sanctity of human existence. In the Ten Commandments, God commands in Exodus 20:17 that no one has a right to take another man’s life. 1 Cor. 3:16 talks about our body as God’s temple.Ending one’s existence is ending a human existence, and therefore a sin. 

A talk on suicide and its preventive measures is the need of the hour. Sadly, many people including the church avert this issue and consider it a taboo; or an act of evil spirits or associated with the devil. Everyone is much concerned about the consequences; salvation. However, logically, had these people received support and love from people around them, including the church, such suicides would have been prevented or minimized. The church has a bigger role in preventing and saving the dying souls. We have to show constant love, and care, and create hope for them. They should be reminded that human beings are created in the Image and likenessof God with a divine purpose. We must ensure that God is there in their midst of distress, loneliness, emotional turbulenceand hopelessness. It is the responsibility of each human to nurture, support and help the suicidal. A non-judgmental attitude is important as most of their talks and behaviour is at heart an attempt to communicate distress. Some hold that suicidal behaviour is always a sign of emotional and mental distress and that suicidal communication by word or act is always a cry for help. It is said that most suicidal people respond well when that communication is received by a sensitive, concerned listener.The nature is complicated but that should not be an excuse because suicide is 100% preventable. 

The purpose of therapeutic intervention is to help people with suicidal tendencies gain insights into their thoughts, feelings, and behaviour. It allows them to express emotional reactions (anger, guilt, shame and loss) to varied experiences of life, develop self-esteem, self-respect, self-understanding, maintain relationships with others and enable them to have a better understanding of their own life. Some of the important steps to be taken in dealing with suicidal: Take the suicidal warnings/clues seriously, create rapport, explore the plan to commit suicide in detail, no-suicide contracts, deal with feelings rather than the behaviour, trace the history of crises and its management, evaluating the consequences, evaluating the options, application of religious resources, co-operation of families, follow up and referral.

The stigma associated and the blame game of labelling them as evil spirits or Satan possessed with the suicidal and family need to be eliminated. The church has to empower, make a concrete plan and impart biblical teachings to save their souls. They should be sensitive as their communication by word or act is always a cry for help. We should continue to extend love, care and support to the suicidal. Being non-judgmental and listening with empathy will make them find meaning in their life. The study on inner voice created an awareness to be cautious of early family communications at home. One of the trademarks to overcome suicidal tendencies is to give importance to healthy parenting.