A Note on Suicidality II

suicide

In my previous post I started explaining the distinctions between different kinds of suicidal behavior or thoughts. My argument was that you can distinguish between a suicidality that stems from thought – often recurring or present during an extended period of time – and suicidality that is triggered. The reason that I think this is important, is that these are different situations which possibly require different approaches.

Don´t get me wrong. I´m not saying that suicidal thoughts that don´t stem from triggers are rational – thus suggesting that people who suffer from these kinds of suicidal thoughts are fully accountable for their actions. When individuals have been through so much that they have reached this point, often their perspective has dimmed. The window through which they perceive life has become smaller and it is difficult to see  beyond it.

The difference is the reactionary nature of triggered suicidal behavior. Individuals who are triggered into feeling suicidal, might feel an intense urge to harm themselves while at the same time being bewildered by this very urge. While their system reacts, they might be aware of its unhealthy nature, but at the same time feel so overwhelmed by it that they can´t distance themselves from it and observe it from a rational place of mind.

This is a very creepy situation to be in. And here comes the reason why I think this distinction is so important. Healthcare providers (among which gender specialists) who deal with people who have experienced these kind of symptoms, need to be trained in ways to prevent these situations (by asking about the status of the patient), to recognize symptoms (when the patient talks about it) and take corresponding action.

That´s where your toolkit of different approaches comes in. It´s not helping to just urge the caretaker to look at things from a different perspective or to try and tone down their reaction. Instead, you want to locate the exact trigger and make sure the trigger disappears until the caretaker is stable enough mentally to not break down when they face it. Also, you want to provide methods that can help the nervous system get out of its frenzy.

Transgender healthcare providers in particular, whose position vis a vis the caretaker can be intimidating – they are, after all, the Gods of prescription and diagnosis – should be aware of the higher risks of suicide among transgender individuals, and handle their approach and blueprint of “treatment” accordingly. What is needed is a safe place, respect for any hesitations that arise, and genuine concern for the well being of the caretaker.

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