For quite a while now I have been thinking about the voices that we hear in the social media world of suicide prevention. It seems like most of those voices are those who have gone through the pain of loss. Losing a loved one - a partner, child, sibling or friend to suicide brings with it immense pain and for some they have been able to channel their loss to reach out and support others. It has led to the establishment of charities such as The Jordan Legacy, Suicide&co and R;pple and helped to motivate others to talk openly about their bereavement and campaign for mental health.
But it has also made me wonder what stops those of us who are ‘suicide survivors’ from talking so publicly. While there are some notable exceptions - I know first hand that shame and guilt can play a huge part in keeping men silent. Roman Kemp talks in his book, ‘Are You Really OK?’, about the challenges of people not wanting to say the word suicide out loud - whispering it instead, ‘like it’s dirty’. He likens it to ‘the characters in Harry Potter books that can’t bring themselves to say the name ‘Voldemort’ because even the word scares them shitless’. Research suggests that more than three-quarters of men feel they can’s confide in those closest to them about their problems - and that same statistic applies to the proportion of suicides that are men. In order to confront this problem - where, as men, we drive our feelings underground - we need to understand what’s driving those feelings.
When we delve beneath the surface of why men die by suicide we start to explore the pain that men are trying to escape when they attempt suicide. The second theory that I find really helpful in understanding the feelings around suicide is Edwin Shneidman’s theory around ‘Suicide is Pain’ that Dr Susie Bennett explores in her Male Suicide Research Instagram posts. I think that the reason why I find it so powerful is that his theory of "psychache" provides a compassionate and insightful perspective on why individuals might choose to end their lives. He emphasises that pain is a tool - it’s the body’s way of telling us that something is wrong and that something needs to change. In looking at suicide as psychological pain we can start to minimise those feelings of guilt and shame.
Psychache is a term coined by Shneidman to describe a specific type of mental anguish. Unlike physical pain, which can be easier to identify and treat, psychache is a profound emotional and psychological pain. It’s the kind of pain that feels all-encompassing and unbearable, deeply affecting a person's thoughts, feelings, and overall mental state.
Shneidman argued that psychache arises from unmet psychological needs. These needs can vary widely among individuals, but common ones include the need for love, acceptance, belonging, self-esteem, and purpose. When these needs are not met, it can lead to feelings of hopelessness, despair, and intense inner torment.
The Roots of Psychache
To understand psychache, it’s essential to recognise the variety of psychological needs that humans have. Shneidman identified several key needs, including:
The Need for Love and Belonging: Men are inherently social beings. We crave connection, affection, and acceptance from others - be it through sports teams, clubs or work. When we feel isolated, rejected, or unloved, the emotional pain that results can be overwhelming.
The Need for Achievement and Purpose: Having a sense of purpose and feeling like we are making a meaningful contribution can significantly impact our mental well-being. When men feel that their lives lack purpose or that they are not achieving their goals, it can lead to a profound sense of emptiness.
The Need for Self-Esteem and Respect: Self-worth is crucial to mental health. Men need to feel valued and respected by others, and importantly, by themselves. Ongoing feelings of worthlessness or failure can contribute significantly to psychological pain.
The Need for Control and Predictability: Feeling in control of our lives and having some predictability can bring with it a sense of security. When life feels chaotic or uncontrollable, it can trigger intense anxiety and stress.
How Psychological Pain Leads to Suicidal Thoughts
Shneidman believed that when our psychological needs remain unmet over time, the resulting pain can become so intense that suicide appears to be the only escape. It’s not that men necessarily want to die; rather, they want to end their unbearable pain. In this context, suicide can seem like a solution to what feels like an insurmountable problem.
Addressing and Alleviating Psychological Pain
Understanding that suicide is often driven by intense psychological pain rather than a desire for death is crucial for providing effective support and intervention. Here are some ways to help alleviate that pain and support those who might be struggling:
Listen and Validate: One of the most powerful things you can do for someone in pain is to listen without judgment. Validate their feelings and let them know that their pain is real and significant.
Encourage Professional Help: Therapy, counselling, and other mental health services can provide vital support. Mental health professionals can help individuals identify and address unmet psychological needs and develop healthier coping mechanisms.
Promote Connection: Encouraging social connections and fostering a sense of belonging can help mitigate feelings of isolation and rejection. Whether it’s through family, friends, support groups, or community activities, building a network of supportive relationships is crucial.
Help Set Achievable Goals: Assisting someone in setting and achieving small, manageable goals can help rebuild a sense of purpose and accomplishment. Celebrating these successes, no matter how small, can boost self-esteem and motivation.
Help Develop Coping Strategies: Developing healthy coping strategies for dealing with stress, anxiety, and other negative emotions can be incredibly beneficial. Techniques such as mindfulness, meditation, breathwork, relaxation exercises and journalling can help individuals manage their psychache more effectively.
The Importance of Compassion
At the heart of Shneidman’s theory is a profound compassion for those who are suffering. Recognising that suicidal thoughts often stem from intense psychological pain rather than a desire for death can shift the focus from condemnation to understanding. This perspective encourages us to offer support, empathy, and practical help to those in distress.
Edwin Shneidman’s theory of psychache provides a valuable framework for understanding the intense psychological pain that can lead to suicidal behaviour. By recognising the unmet psychological needs at the root of this pain, we can better support those who are struggling. It reminds us of the importance of compassion, connection, and proactive intervention in alleviating psychache and preventing suicide.
If you or someone you know is experiencing suicidal thoughts, it’s crucial to seek help immediately. Reach out to mental health professionals, crisis hotlines, or trusted individuals who can provide support. Remember, there is help available, and no one has to face their pain alone.
There is further information on my support page, but if you would like to reach out to me for support, click on the link below.
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