Suicidal ideation is a clinical term used to describe thoughts of suicide or wanting to take one's life. These thoughts do not occur suddenly, but rather evolve over time in individuals who eventually attempt suicide. Generally, this evolution follows four distinctive stages.

  1. Acknowledge:

People are born with a sense of self preservation. Upon hearing for the first time, about an individual who has committed or attempted suicide, the natural sense is one of repulsion. The first stage in the evolution of suicidal ideation requires a loss of this repulsion. The person somehow acknowledges that suicide in some individuals is understandable and tragic.

  1. Accept:

Accepting that under overwhelming circumstances, suicide would be acceptable for himself marks the second stage in the evolution of suicidal ideation. In many suicidal individuals, accepting suicide as a possible action in their own life, never resolves. Even when this individual decides to never commit suicide, he still has the memory of feeling that this would be an acceptable action. It is my experience, these memories continue to haunt the individual even when clinically doing well.

  1. Anticipate:

The third stage in the evolution of suicidal ideation involves the anticipation that at sometime in the future, suicide is inevitable. As this individual decompensates, plans to commit suicide begin.

  1. Action:

The last stage in the evolution of suicidal ideation involves action, which takes two forms.

In the first form, action involves a sudden decision and suicidal activity. This action occurs at the spur of the moment and shows little organization. The result is a poorly planned overdose or other possibly lethal action.

In the second manner, action takes the form of a plan. In this plan the individual decides on a day and the action necessary to end his life.

We are born with mental reflexes designed for self preservation, which makes the concept of suicide repulsive. The evolution of these complex ideas to those in which an individual carries out a suicide attempt, do not occur in one step, but rather by a series of, in many instances, irrepressible changes in thinking.

The suicidal individual first acknowledges that certain individuals are justified in attempting suicide. Secondly, this person accepts that if the situation becomes intolerable, suicide would be an acceptable response. Next, suicidal ideation anticipates that sometime in the future the act of suicide will be carried out. The last stage in suicidal ideation involves action, either actively with a plan or as a sudden poorly organized action.

In no way does the description of the stages in the evolution of suicidal ideation defend the act of suicide. The act of suicide is an irrational reaction to what is perceived as an unrelenting overwhelming sense of pain. This is a complex set of thought processes which do not occur quickly, but rather evolve over some period of time. Recognizing the early stages in the development of suicidal ideation could benefit the individual, by directing effective intervention, early in the course of this evolution.

WMD 2007

Posted 23rd February 2007 by SPages


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