2010, Number 4
Salud Mental 2010; 33 (4)
Edwin S Shneidman y la suicidología moderna
Ana-María Chávez-Hernández, Leenaars AA
Full text
Language: Spanish
References: 29
Page: 355-360
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ABSTRACT
Edwin S. Shneidman (13-05-1918 − 15-05-2009) is known as the father of contemporary suicidology. His work reflects the intensive study of lives and deaths, especially suicides, and is the mirror to his mind.Few people, like doctor Edwin S. Shneidman, are vouchsafed the rare opportunity to create a new discipline, to name it, to shape it, to contribute to it, and most importantly, to catalyze other competent investigators to invest in it: suicidology.
In his reflections, Shneidman does not know whether suicide was looking for him or he was looking for suicide. Part of his motivation on that day in 1949, when he discovered 100’s of «genuine suicide notes» in the vaults of the Los Angeles Coroner’s Office, was that he was restless and looking for some niche in psychology. He had an autonomic reaction with the feeling and knew that had discovered an unknown way to understanding the suicide behavior, and that suicide notes could be the golden road to the unconscious of suicide, and suicidology began.
What Shneidman had tried to do in his career was to explain the word suicide. It is not taxonomy. Disregarding all of biology and genetics, suicide is essentially psychological pain. It is not entirely so, but that is what we can investigate and explicate. Shneidman’s main contributions have been conceptual. He had made up words and concepts −suicidology, psychological autopsy, postvention, subintentioned death, psychache− where he felt then to be required to reflect some nuances of his thoughts, and he has given renewed emphasis on well-established words and concepts −perturbation, constriction, lethality− when he felt that they were more accurate than some of the current reductionistic jargon.
Shneidman is first and foremost a suicidologist. His work in suicide can be subdivided as follows: Definitional and theoretical, suicide notes, administrative and programmatic, clinical and community, and psychological autopsy and postvention.
Shneidman, in his important book, Definition of Suicide in which he asserted a psychologically oriented definition of suicide: «Currently in the Western world, suicide is a conscious act of self-induced annihilation, best understood as a multidimensional malaise in a needful individual who defines an issue for which suicide is perceived as the best solution».
Shneidman was asked to write the paper «Suicide» for the Britannica Encyclopedia. Shneidman decided he would not reproduce the usual tables of statistics of suicide among various countries at various times, but, instead, introduce a potpourri of then current ideas about suicide, a significant paper in the history of suicidology. It shifted the focus to the suicidal mind, away from the statistical.
Shneidman through all his clinical and researching work, obtained the famous Ten Suicide Common Characteristics. Although we actually do not know how many commonalities there are, Shneidman’s ten of suicide are: 1. The common purpose of suicide is to seek a solution; 2. The common goal of suicide is cessation of consciousness; 3. The common stimulus in suicide is intolerable psychological pain; 4. The common stressor in suicide is frustrated psychological needs; 5. The common emotion in suicide is hopelessness-helplessness; 6. The common cognitive state in suicide is ambivalence; 7. The common perceptual state is constriction; 8. The common action in suicide is egression; 9. The common interpersonal act in suicide is communication of intention; and 10. The common consistency in suicide is with lifelong coping patterns.
Also, suicide notes are synonymous with Shneidman’s career. Shneidman seeked to illustrate the point that suicide notes -which, after all, are the penultimate act of that person’s life- can be very informative when they are placed within the context of the thousand details of that person’s life. Using that approach, the suicide notes are illuminated by the life, and many details of the life are tragically illustrated by the content of the notes.
Shneidman’s work was also programmatic. Perhaps the major pioneering administrative effort in Shneidman’s life was his work at the LASPC (Los Angeles Suicide Prevention Center). The LASPC was started in 1955 with Norman Farberow and Robert Litman. It was the first comprehensive center and it became a model for prevention centers that pulled the troika of suicide prevention unto the modern stage. They represent three interwoven aspects of modern suicide work: research, training and clinical service.
In 1966, he was called to work at the Institute of Mental Health (NIMH), to draft a proposal for a National Program in Suicide Prevention. When Shneidman went to Washington, there were three suicide prevention centers in the country and three years later (1966- 1969) there were more than 100. The paper «The NIMH Center for Studies of Suicide Prevention» is not only important because it outlines Shneidman’s endeavors in suicide prevention, but it is also marked by its publication in The Bulletin of Suicidology. He neologized the word, suicidology, for that publication. In 1969, after three years at NIMH, Shneidman went to Harvard as a Visiting Professor and then to the Center for Advanced Studies of Behavioral Science, Stanford, as a Fellow. Next, Shneidman went to the University of California, Los Angeles (UCLA). He also, with others, created in 1968 the American Association of Suicidology (AAS). The Bulletin, after Shneidman left NIMH, stopped existing within a year or so. Thus, he wanted a journal for suicidology and created one, under the auspices of the AAS, the Suicide and Life Threatening Behavior Journal (SLTB).
Shneidman’s career in suicidology has not only been intellectual but also practical. The pamphlet, «How to Prevent Suicide» −which sold for $.25− was published in 1967, a year after Shneidman went to NIMH. It was one of the first attempts to meet the responsibility to put out something for the public. It was a prevention effort at the community or public level, something he espoused all his life: Prevention is education.
He provided certain rules for treatment of suicidal people and prescriptive advice for the psychotherapist, suggesting a focus on the assessment of the patient’s mental lethality. Shneidman’s rule: reduce the perturbation, and the lethality will come down with it. Therapy revolves around mollifying pain.
Shneidman’s key papers on the Psychological Autopsy and Postvention are noted. He outlined his thoughts about what one does after suicide and then labeled what was done with people after the dire event as postvention. His brief paper on the case of the bereaved sets forth the differences that distinguish professional sessions with survivors from ordinary condolence conversation. All his life, Shneidman strongly supported the care of the survivors.
He reflected on the life-saving role that others can play in saving a potentially suicidal person’s life. But Shneidman also ruefully reflects that, in the final analysis, it is the suicidal individual who must play the vital role of sustaining the drama of living to another day.
Stepping back from Shneidman’s collected works and his life, one is struck by the generativity, the sheer productiveness of his life.
REFERENCES