Dismantling the myths about suicide: "outdated and obsolete ideas persist that do not help to reduce it"

All of our history weighs on him, from the Greeks to the modern age, going through a significant medieval period, in which suicide was imposed as a sin.. Countless currents of thought have flown over it, and all disciplines have tried to understand it: sociology, anthropology, philosophy, medicine… It is known that in each of our civilizations taking one's life has its own nuances, from ancient societies in which voluntary suicide was accepted up to convictions related to it related to honor. For example, the suicide of the Japanese writer Yukio Mishima is well known, but also that Plato spoke out fiercely against taking his own life after his teacher, Socrates, voluntarily accepted a death by poison in Ancient Greece.

The result of this overwhelming residue is that, to this day, when Spain is facing alarming suicide figures, a large number of myths persist among us, in the form of set phrases that are sometimes said without thinking, and that make it difficult to problem solution. Meanwhile, professionals demand a national prevention plan that is equal in endowment to the fight against gender violence and traffic accidents. Some of these deeply embedded ideas among us are “if he says it, he doesn't do it”, “you don't talk about suicide”, “whoever takes their own life is because they are crazy”, “they just want to attract attention” or “you have to be very brave.”

But those who in our country work on this issue point out many more and, above all, the importance of dismantling them as a giant step when it comes to getting fewer Spaniards to feel so much anguish as to think about leaving. “Suicidal motivations are imbued with cultural influences. And we don't understand it the same in the West as in the East”, confirms Miguel Guerrero Díaz, clinical psychologist at the Marbella Community Mental Health Unit and head of the Cicero Suicidal Behavior Prevention and Intensive Intervention Program. As he explains, “the psychiatrization of suicide from the Enlightenment is decisive in the current vision we have of suicide.”

Guerrero is also the author of an analysis, Reflections on suicide from a historical perspective, published in the Psicoevidencias Bulletin in 2019, in which it is recalled that the motivations for taking one's life remain the same as thousands of years ago, and marks as important the publication in 1621 of the book Anatomy of Melancholy, by Robert Burton, “the first author to propose suicide as a result of an alteration”, “It represents a historical milestone as it is considered a true precursor of future scientific postulates of the 19th century. Burton cries out for tolerance and mercy for the suicide by stating that there is no demonic possession, but rather a melancholic temperament caused by an excess of black bile.”

Until, between the 19th and 20th centuries, the French sociologist Émile Durkheim (1858-1917) “thought of suicide not as an individual phenomenon but as a markedly social one.”. The social causes (economic crisis, poverty, isolation, social changes, excessive social regulation, etc.) and not the individual ones, originated the suicidal act”.

Pedro Martín-Barrajón, head of Emergencies of the Princess Psychologists 81 network, also points out that “outdated and obsolete ideas persist about suicide and mental illness that make their prevention difficult and even increase the damage to survivors”. Myths that are also still present among health workers and the medical community. “One of the real challenges is getting the majority of people to stop thinking that 'this happens to others' and not in ordinary families like ours,” warns this expert.. With them and others who work in the field, in addition to various investigations, we analyze the most common ones.

“If he says it, he doesn't do it” / “He just wants attention”

The emergency firefighter, specialist in suicide care, Sergio Tubío, says that “this type of assertion is a mistake”.. And that, before saying them, we should think that when “someone has suicidal ideation, they value death as a way to escape hopelessness and suffering”. In that distressing vital moment, “impulsivity arises, but also ambivalence”, that is, there is a kind of balance within one between “anchoring to life” and the need to flee from pain. Let what is good in that person's life win in the balance. “Our job is to get him out of that 'tunnel vision and give up the attempt,'” adds Tubío.

In addition, according to the study carried out among health professionals by Martín-Barrajón in 2019, Presence of myths about suicide in emergency and emergency professionals, it is known that 41.9% of emergency professionals answered that this statement was true”. On the contrary, “according to data from the Spanish Society of Suicidology, 18% of the patients who committed suicide had consulted their primary care physician the same day, 66% had done so during the last month and 75% in the last three months”. In addition, 60% asked for help during the last week. And close to 40% of primary care physicians are unaware of the suicidal history of patients, of which between 1 and 10 have suicidal thoughts and intentions.”

“You have to be very brave to commit suicide”

Guidelines on how to communicate and report suicide are very clear in this regard.. “Suicide is a source of suffering and is not related to moral values, nor model behaviors or that make the suicidal person someone to imitate.”

42.9% of the specialists who responded to the survey on myths about suicide prepared by Martín-Barrajón validated the statement, and this professional insists on the error of “attributing stable and permanent personality characteristics to suicide”. “The literature on suicidology shows that suicidal risk is much more universal, daily, and at the same time unknown, since 50% of the general (non-clinical) population will experience moderate-severe suicidal tendencies throughout their life. life,” he says.

“If he commits suicide, he is crazy”

The assumption that a person with suicidal ideation has a mental illness doesn't help either.. Pernicious statements such as “I would be sick in the head” or “Did I have depression? They are very frequent and popular,” says Martín-Barrajón. And specialists have already shown that “there is a weak association between psychopathology and suicide”. “For those who continue to doubt: you don't have to have a mental disorder to have suicidal behavior,” insists the Princess 81 expert. “No suicide genes have been identified,” he says. Related to this topic is what specialists call “definition bias”: “Thinking of suicide as the active search for death, when in reality it is a behavior that seeks to stop psychological pain”. That is to say, it does not help to persist in repeating that a person thinks about suicide because they want to die, being more appropriate to say other statements, such as that they suffer so much that they have come to think of taking their own life.

“If you've tried it once, you'll try it again”

Labeling people, and believing that someone who has attempted suicide will always be suicidal is also deeply rooted socially.. The more humanized care, support and accompaniment we do with these people, the more prevention we will be doing”.

“Suicide is not talked about”

Another of the myths that continues to cause the most damage is the belief that “talking about suicide can lead to it, or be a stimulus”. “Today we know that instead of encouraging suicidal behaviour, addressing it responsibly in the media or in individual interviews with patients at risk can give a person other options, or time to rethink their decision, and therefore prevent it.. Empirical evidence shows that asking or talking about suicidal behavior does not have negative consequences in the general population or in the clinical population.”

The same happens in relation to the publication of information about suicide.. The idea is already obsolete -it is clear- that talking about suicidal ideation infects the phenomenon. Now there is an emphasis on talking about it with extreme prudence and responsibility. “More than 20 years ago, the WHO provided style guides,” recalls Martín-Barrajón, “and a specific one was published in the Community of Madrid.”

In fact, “silence and occultism around suicide are one of the main stumbling blocks of prevention, and that interferes the most in requesting help, and in the possibility of being able to provide it, because what is not known is not prevented”.

“Suicide is a public health issue”

It is. But not only that: it is above all a social problem and one that we can all help reduce.. In this sense, regarding the presence of these myths among health workers, as mentioned, the Cicero Program specialist recalls that they are, after all, “people inserted in the same community with the same biases, myths, prejudices and erroneous beliefs”.. It encourages, yes, to establish “an exercise of conscious self-exploration, without blaming ourselves, because we have been educated that way”, in relation to what preconceived ideas we accumulate about suicide.