Suicide: Impulsive vs Planned
Suicide is a serious health problem. The World Health Organization estimates that one suicide attempt occurs every three seconds and one completed suicide occurs approximately every minute (WHO, 2000). Each day, approximately 210 Australians attempt to end their life and each year over 2500 will commit suicide. Suicide in Australia kills 8.5 times more people than homicides and 1.5 times more than motor vehicle accidents. This means that more people die by suicide. Consequently, reducing suicide has become an important international health goal.
Suicide is considered to be an attempt to ‘communicate’ or to ‘solve a problem’. When a client is communicating a need, the counsellor’s perspective is to seek to clarify what and to whom the act of suicide will communicate. When a client is trying to solve a problem, the counsellor’s aim is to clarify what problem would be solved and committing to finding another way to address the problem. Suicidal behaviours include suicide, attempted suicide and suicide ideation.
- Suicide is any self-injurious act intended to end one’s life which results in death. It is defined as death by self-inflicted, intentional injury.
- Attempted suicide is any potentially self-injurious act intended to end one’s life but which does not result in death.
- Suicidal ideation is thinking about engaging in suicidal behaviour, with or without a specific suicide plan.
Categories of Suicide
Individuals contemplating suicide usually fall within two categories namely impulsive and planned suicide. Both categories should be taken seriously as they place the person at risk. However each category requires a different response.
Impulsive suicide thoughts can occur as a response to an individual experiencing a crisis or trauma. In a state of crisis individuals can lose the ability to control their thinking, behaviour and emotions. It is not necessarily the crisis or trauma that pushes the client in a state of crisis, but how the individual perceives the traumatic event. In this situation there is usually no history of self-harming thoughts or behaviour. Situations which cause pain, despair and distress can range from catastrophic events such a plane crash or earthquakes, to individual experiences such as being assaulted, a relationship break-up and death of a loved one. Conventional counselling techniques such as discussing the situation and problem solving can further deepen the state of crisis. However a crisis management approach assists in dealing with the here and now and provides counsellors with strategies to stabilise the client and reduce the risk of self-harm.?Once crisis management has been achieved, future counselling sessions can include more in depth discussions of the situation (Pelling, Bowers and Armstrong, 2007).
In the situation of a planned suicide, an individual is not in a state of crisis (or is in a mild state of crisis). Their interactions with others and their behaviours appear to be calm. The individual is focused and their thought processes (from their perspective) are rational. They will appear to be in control of themselves, but clearly not happy. After considering all options available to them, ending their life seems the best option. The individual is committed to solving the problem, even if this requires them to harm themselves.
Individuals who do not seek counselling are not ambivalent about suicide. Counsellors will not be visited by these individuals. Those who do seek assistance from a counsellor are ambivalent about suicide. Rather than wanting to die, the individuals are more likely to not want to live as they currently do. It is this ambivalence that counsellors can use to arrest the act while seeking alternative options.