The following story discusses experiences of suicide.
India Guerrieri presented this reflection on her lived experience and role as a Lived Experience Practitioner at Neami at the National Suicide Prevention Conference 2024.
Introduction
At 12 years old I began to feel as though something was wrong with me. I no longer felt like I belonged to anyone or anything. I felt all consumed by a feeling of emptiness. During this time, I started to self-harm to cope with the pain I was experiencing.
After turning 13, I found myself in the emergency department. My parents had been called into my high school as teachers feared I was at risk of suicide. I remember the nurse looking over my selfharm and commenting that people like me were taking time away from serious cases in the hospital.
The following year I was referred to a psychologist who completed a risk assessment on me. As he finished my risk assessment he asked me with a confused look on his face, “I don’t understand why you’re so depressed. You seem to have a good life – are you sure this isn’t just attention-seeking?”
I was 19 when I had a suicide attempt. I had just left an abusive relationship. I was a shell of my true self. No longer able to recognise my reflection in the mirror, suicide felt like the only way out of my trauma and my pain.
After the suicide attempt, I felt an overwhelming shame. It became all consuming. I couldn’t reach out for help. I felt I didn’t deserve it. I told myself, “I am weak. I am selfish. It’s just attention seeking. If I was just a little bit stronger I wouldn’t feel this way anymore.”
Though no one within my family or peer group had ever said those words to me, the experts, the mental health clinicians and nurses who I looked to for care sent the message loud and clear. The shame, stigma, prejudice and discrimination that I endured throughout my teenage years had sabotaged my ability and willingness to reach out for help. For many people, that same hesitation to reach out has devastating effects.
Shame and stigma
Shame and stigma colour our individual and collective perception of suicide and suicidality. As humans, we can be quick to adopt very negative ideas about ourselves. Feelings of shame can make us believe “there is something intrinsically wrong with me”, something that we cannot change or affect. This is worsened by stigma, which is society’s real or perceived judgment of a person: “there is something intrinsically wrong with them.” Coupled together, shame and stigma become a nightmarish echo chamber confirming all our worst suspicions about ourselves and each other.
An Australian survey of 676 people found 30% – 40% of respondents viewed suicide as a punitive, selfish, offensive or reckless act. Another 20% – 30% saw suicide as a sign of weakness or a thoughtless, irresponsible, cowardly, senseless or attention-seeking act.
When those who are grieving or having suicidal thoughts notice that many people share these beliefs, it’s understandable that they don’t talk about their experiences. Stigma feeds shame which in turn leads to secrecy, discrimination and prejudice.
Thomas Joiner, a psychiatrist and someone who has a lived experience of suicide, coined the ‘Interpersonal Theory of Suicide’. Joiner suggests that the desire for suicide often stems from several key factors. This includes a sense of isolation and burdensomeness.
From the perspective of the interpersonal theory of suicide, shame may lead to suicidal ideation by increasing or worsening feelings of being a burden. Shame and self-stigma can ultimately create feelings of fear, blame, disconnection, and unworthiness. This damages relationships because the shamed individual attempts to hide, blame and withdraw from others.
Research shows us that stigma, prejudice and discrimination can lead to suicidality by contributing to increased loneliness, hopelessness and secrecy as well as reduced self-worth. This can stop people from seeking support and talking openly about their struggles.
Flipping the script
In my role as a Lived Experience Practitioner, I have noticed that by beginning to explore where negative perceptions of people experiencing suicidal ideation come from, we can have the most impactful conversations.
One activity we facilitate within the training is asking participants to think about the common perceptions that are held about suicidal people. The perceptions we often hear are that they are weak, selfish or attention-seeking. When participants hear these phrases, it becomes apparent to everyone in the workshop why suicidal people don’t reach out for help.
When we use stigmatising language, we only perpetuate feelings of shame, isolation and burdensomeness onto the person who is feeling suicidal. When we use this type of language we blame the person who is feeling suicidal, instead of looking at the social injustices many people face, which ultimately leads them to feeling suicidal.
Saying that someone who is experiencing suicidal crisis is selfish is not just wrong and harmful, it also stops us from being empathetic and instead we put up a barrier of judgment. It implies that we will continue to stigmatise suicide because it makes us feel better and more comfortable within these conversations. It takes the responsibility off me as a helper and instead places the shame and stigma onto the person experiencing thoughts of suicide.
Conclusion
Flipping the script on shame and stigma can’t be done alone. Changing perspectives on suicidality must be a collective action. We can’t take away someone’s suicidality, but when we begin to acknowledge and move through our own discomfort, we can change the way we perceive someone who has thoughts of suicide and in turn change the way they perceive themselves.
References
The Reciprocal Relationship between Suicidality and Stigma