July 7, 2008

The Urge to End It All-- New York Times Magazine

Yesterday, New York Times Magazine published an article on their website which attempts to get to the bottom of who attempts suicide, who succeeds, and why and how that is. I found the entire article quite interesting, but there are a few sections that stood out to me in particular.

For generations, the people of Britain heated their homes and fueled their
stoves with coal gas. While plentiful and cheap, coal-derived gas could also
be
deadly; in its unburned form, it released very high levels of carbon
monoxide
, and an open valve or a leak in a closed space could induce
asphyxiation in a matter of minutes. This extreme toxicity also made it a
preferred method of suicide. “Sticking one’s head in the oven” became so
common
in Britain that by the late 1950s it accounted for some 2,500
suicides a year,
almost half the nation’s total.


Those numbers began dropping over the next
decade as the British
government embarked on a program to phase out coal gas in
favor of the much
cleaner natural gas. By the early 1970s, the amount of carbon
monoxide
running through domestic gas lines had been reduced to nearly zero.
During
those same years, Britain’s national suicide rate dropped by nearly a
third,
and it has remained close to that reduced level ever since.


How can
this be? After all, if the impulse to suicide is primarily
rooted in mental
illness and that illness goes untreated, how does merely
closing off one means
of self-destruction have any lasting effect? At least
a partial answer is that
many of those Britons who asphyxiated themselves
did so impulsively. In a moment
of deep despair or rage or sadness, they
turned to what was easy and quick and
deadly — “the execution chamber in
everyone’s kitchen,” as one psychologist
described it — and that instrument
allowed little time for second thoughts.
Remove it, and the process slowed
down; it allowed time for the dark passion to
pass.


The article then gives another example of two bridges only a few feet away, but the one with a slightly lower rail accounted for a greatly larger number of suicides than the bridge which would take a bit more time and effort to jump off- key elements in an impulse suicide, the article argues- and it also tells why people just don't go off the other one.

“At the risk of stating the obvious,” Seiden said, “people who attempt
suicide aren’t thinking clearly. They might have a Plan A, but there’s no Plan
B. They get fixated. They don’t say, ‘Well, I can’t jump, so now I’m going to go
shoot myself.’ And that fixation extends to whatever method they’ve chosen. They
decide they’re going to jump off a particular spot on a particular bridge, or
maybe they decide that when they get there, but if they discover the bridge is
closed for renovations or the railing is higher than they thought, most of them
don’t look around for another place to do it. They just retreat.”

Seiden cited a particularly striking example of this, a young man he
interviewed over the course of his Golden Gate research. The man was grabbed on
the eastern promenade of the bridge after passers-by noticed him pacing and
growing increasingly despondent. The reason? He had picked out a spot on the
western promenade that he wanted to jump from, but separated by six lanes of
traffic, he was afraid of getting hit by a car on his way there.

“Crazy, huh?” Seiden chuckled. “But he recognized it. When he told me
the story, we both laughed about it.”

Actually, I first took the reason of not getting hit by a car to mean that he didn't want to end up hurt and unable to jump, thus prolonging his life. It does make sense, in an odd sort of way, but I would've always assumed differently. Especially when it later says that people who are considered at high-risk of suicide generally choose less lethal methods such as OD'ing than those who commit suicide without a history of a mental illness or previous suicide attempt. So the at-risk is, in a way, " safer than one acting in the heat of the moment — at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself. "

Beyond sheer lethality, however, what makes gun suicide attempts so
resistant to traditional psychological suicide-prevention protocols is the high
degree of impulsivity that often accompanies them. In a 1985 study of 30 people
who had survived self-inflicted gunshot wounds, more than half reported having
had suicidal thoughts for less than 24 hours, and none of the 30 had written
suicide notes. This tendency toward impulsivity is especially common among young
people — and not only with gun suicides. In a 2001 University
of Houston
study of 153 survivors of nearly lethal attempts between the ages
of 13 and 34, only 13 percent reported having contemplated their act for eight
hours or longer. To the contrary, 70 percent set the interval between deciding
to kill themselves and acting at less than an hour, including an astonishing 24
percent who pegged the interval at less than five minutes.



When I first read this paragraph, I was just shocked. Less than five minutes. The time it took me to read two paragraphs of this article. Ages 13-34. No suicide note. Eva. Maybe she really was fine the last time we spoke. I don't know what to think.

As with every other survivor of a near-lethal suicide attempt that I spoke
with, Debbie told her story with an almost eerie poise. There was one moment,
though, at which she suddenly fell silent, where words failed her.


“You know, I hear myself describing all this,” she said, “but it seems
completely surreal. I feel like I’m describing a movie I saw or a book I read.
Even sitting here now and looking at that” — she motioned to her cane — “it’s
hard to believe this is something I actually did.”


I suspected part of her incredulity stemmed from the recentness of the
event; it had been less than three years. But perhaps it was also rooted in
something more profound. What united all the survivors I spoke with was a sense
of having been so utterly transformed by their experiences that, in essence,
they had become different people.


In California, I met with Ken Baldwin, a schoolteacher who, in the
grips of a deep depression 22 years ago, leapt from the Golden Gate
Bridge.


“I’ve had two lives,” Baldwin said. “That’s the only way I’ve ever been
able to describe it. Up to the day I jumped, that was one life, and now this is
another. I’m not so much a changed man as a completely different one, and that’s
why it’s so hard to even recollect what I was like back then, what I was
thinking.”

I feel this too. I was not so close to death as Debbie and Ken, but I still do. I've split myself in two: The Before and The After. Anything that happened pre-suicide attempt happened to the Other Mariah, anything after happened to me. I am rooted to the past and yet so distant from it at the same time. As for the "eerie poise," maybe this is what I call my ability to only write about my own experiences the same way I would summarize Jack and the Beanstalk.

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