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Dr. Bob is Robert Hsiung, MD,
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Posted by one woman cine on January 29, 2007, at 13:45:26
In reply to Re: 'Not always a cry for help' -, posted by muffled on January 29, 2007, at 13:40:00
Posted by wishingstar on January 29, 2007, at 15:19:13
In reply to Re: 'Not always a cry for help' -, posted by muffled on January 29, 2007, at 13:40:00
Interesting article. That's great that their program has been so effective. But I'm not sure I agree with all (most) of his beliefs about what it means to be suicidal. His program obviously worked, but I'm wondering if the reasons for it working arent exactly what he is assuming.
He suggests that the fact that students dont come for counseling after an attempt shows that it isnt really a cry for help. Thats possible, but I think he may be ignoring huge issues here. For instance, can the student afford it? Is he/she embarrased? Too afraid of the stigma attached to therapy? Afraid of trusting someone they dont know (a counselor)? Afraid their parents will find out? There are all kinds of factors that keep people away. I'd say that many people who attempt suicide may be people who naturally have trouble reaching out for help when they need it or when things start to get bad, and that's how it escalates into a suicide attempt. (Of course thats by no means always true, but I think it can be). I also think (and have no evidence to back this up, just an idea) that rates of suicide attempts in college students may be higher than normal to begin with, not because of higher rates of major depression, but because of the demands of college - moving away from home for the first time, school and time demands, etc - things that pass quickly. For that group, who probably doesnt have a significant ongoing mental illness, I think suicide is absolutely a cry for help. A "this is way too much, I cant handle it all" cry, which sometimes resolves itself by a few days in the hospital or a medical scare related to an attempt. I'd be interested in seeing some data about the characteristics specific to this group of students. I just dont believe that it's really about power and control in as many students as he's suggesting it is.
One other thing I found very interesting was when he mentioned that some students cite the times they were suicidal as being bright spots in their lives. I dont understand this at all and I dont really know what it means about the student or their situation, but I'd love to get that.
I dont mean to rip this apart. There were things I agreed with in the article too, but I just wanted to comment on that. Perhaps I'm a little hypersensitive because I'm not far out of college myself and personally, my own issues were not as he described. Oh well. Something to think about. Thanks.
Posted by caraher on January 29, 2007, at 15:24:42
In reply to 'Not always a cry for help' -, posted by one woman cine on January 29, 2007, at 13:01:30
What's missing for me is any account of students who choose not to continue at the University after an attempt. Because the University can kick you out if you refuse therapy over 90% now go, which is good. But what happens to the rest? Do they commit suicide after they get kicked out? Since they started this approach they've had 1,531 "incidents;" this means as many as 150 students have left. If 20 or so of them committed suicide soon afterward it appears the chief success in terms of campus suicide rate is to make sure they are no longer students when they die.
On one hand, I'd guess the program actually does some good if it's getting people to accept help. (Though one might also wonder how effective therapy is with a resistant patient.) But on the other hand, it also seems likely that the ones who get kicked out might be the ones most likely to try again and succeed.
Posted by one woman cine on January 29, 2007, at 15:26:04
In reply to Re: 'Not always a cry for help' -, posted by wishingstar on January 29, 2007, at 15:19:13
I like what he said about community and accountability - & another big proponent is a father who lost his son to suicide.
I don't think the article is blaming anyone - but I think it's interesting to think of things alternatively. This research shows that there are ways to decrease suicide, although it feels counter-intuitive.
Posted by one woman cine on January 29, 2007, at 15:30:48
In reply to Re: 'Not always a cry for help' -, posted by caraher on January 29, 2007, at 15:24:42
Universities now have policies that if you attempt suicide etc. - they can ask you to leave until you are "safe" to go back - so that is already being instituted. Schools don't want to be sued by parents either - so either way, you can be asked to leave...
Scary, but that's the general trend nowadays....
there have been two famous cases - one in Hunter and one in Georgetown, the students were allowed back after a lengthy court battle, but it was really tough.
Posted by caraher on January 29, 2007, at 15:36:55
In reply to Re: 'Not always a cry for help' - » wishingstar, posted by one woman cine on January 29, 2007, at 15:26:04
> This research shows that there are ways to decrease suicide, although it feels counter-intuitive.
Actually, if you look at what they actually *do* and not the explanations he gives I think it makes sense that their rates go down:
1. As I mentioned, the students who don't comply leave, and if they die they aren't on-campus suicides. This may not be a significant number; I have no idea. But even if it isn't,...
2. They are being pro-active in seeking out students who need help. Counselors make multiple calls to get students to keep appointments. If you are afraid to ask for help, don't know how, or don't want to, it doesn't matter - they're coming for you once you're on their list.
I'm sure others, like me, have sat around wondering, "I feel like killing myself, but I haven't so far... maybe I can just live with this and don't need help." Or "I don't think anyone can help me with this. Under the "invite and wait" approach people with those sorts of thoughts are less likely to go get help than someone who has a counselor call five times saying, "Look, we know you've made a threat (or whatever) and you really do need to come in and get help." The decision is made for the indecisive.
Posted by one woman cine on January 29, 2007, at 17:33:39
In reply to Re: 'Not always a cry for help' -, posted by caraher on January 29, 2007, at 15:36:55
"I'm sure others, like me, have sat around wondering, "I feel like killing myself, but I haven't so far... maybe I can just live with this and don't need help." Or "I don't think anyone can help me with this. Under the "invite and wait" approach people with those sorts of thoughts are less likely to go get help than someone who has a counselor call five times saying, "Look, we know you've made a threat (or whatever) and you really do need to come in and get help." The decision is made for the indecisive."
I'm not sure the article is saying "making the decision for the indecisive" is the way to decrease suicide rates - that's not what I inferred but we may just disagree. I think idea can be gleaned from this - but the idea of the community and accountability in self- care/self-guradianship is where the money is at....
I think that was one of the main points of the article - not being forced/coerced into getting help. Thta everyone was a participant (university and student) in trying to rectify the problem.
Posted by one woman cine on January 29, 2007, at 17:35:00
In reply to Re: 'Not always a cry for help' -, posted by caraher on January 29, 2007, at 15:36:55
plus, he made mention of the fact it was sometimes a power stuggle - I don't think the system/method would work if students in the "power struggle" were forced to seek help....
Posted by caraher on January 29, 2007, at 19:52:24
In reply to Re: 'Not always a cry for help' -, posted by one woman cine on January 29, 2007, at 17:33:39
> I'm not sure the article is saying "making the decision for the indecisive" is the way to decrease suicide rates - that's not what I inferred but we may just disagree.You're right, the article did not say that at all. It was just a possibility I floated for why the results aren't really all that surprising or counterintuitive.
Posted by caraher on January 29, 2007, at 19:56:44
In reply to power struggle » caraher, posted by one woman cine on January 29, 2007, at 17:35:00
> plus, he made mention of the fact it was sometimes a power stuggle - I don't think the system/method would work if students in the "power struggle" were forced to seek help....
But they in fact did pressure students into counseling. And apparently it works better that way.
My point was that the "power struggle" interpretation is not truly a "fact." It's more an interpretation he makes based on his years of experience. I'm just saying other ways of thinking about what's happening are consistent with the effectiveness of the counseling changes they made.
Posted by cubic_me on January 30, 2007, at 13:02:26
In reply to Re: 'Not always a cry for help' -, posted by caraher on January 29, 2007, at 19:52:24
What an interesting article - thankyou for posting it.
Like Wishingstar, I don't really feel it 'fits' me either (I'm a college student), but I can see where they're coming from.
caraher, you make some really interesting points, and I tend to agree with your thoughts on what happens to those who get kicked out for not going to the sessions and the thoughts on how 'pressuring' in to therapy would probably work with people for whom attempted suicide was a cry for help, although it's strange that after an attempt (before the program) no-one used the councelling services.
Posted by toojane on January 30, 2007, at 16:07:34
In reply to Re: 'Not always a cry for help' -, posted by cubic_me on January 30, 2007, at 13:02:26
> although it's strange that after an attempt (before the program) no-one used the councelling services.
I don't think it is strange at all. I think the way psychiatric professionals treat you after a suicide attempt is criminal. Try to do those kinds of things to a "sane" person and they'd be jailed so fast their heads would spin.
The assumption that if you don't want to have anything to do with them, it MUST be because you are power tripping in some kind of self-important power struggle is laughable.
Notice how there is always something wrong with the suicidal person and never anything wrong with the 'service' being offered. If you are selling cookies and I don't want to buy them, generally it's because your cookies suck. So what this guy did was force people to eat his cookies, under threat of expulsion. Doesn't mean his cookies are good. It just means he figured out a way to make people choke them down. The ones who want to stay in university swallow his cookies. The ones who refuse to eat them get thrown out.
Posted by cubic_me on January 31, 2007, at 4:13:05
In reply to Re: 'Not always a cry for help' - » cubic_me, posted by toojane on January 30, 2007, at 16:07:34
> > although it's strange that after an attempt (before the program) no-one used the councelling services.
>
> I don't think it is strange at all. I think the way psychiatric professionals treat you after a suicide attempt is criminal. Try to do those kinds of things to a "sane" person and they'd be jailed so fast their heads would spin.But surely people wouldn't know that about the councelling service if they didn't try it in the first place? I know two people at my university who have used the councelling services after a suicide attempt, it wasn't great, but they tried it.
>
> The assumption that if you don't want to have anything to do with them, it MUST be because you are power tripping in some kind of self-important power struggle is laughable.I wasn't assuming that at all, ofcourse, the councelling service may have the reputation from hell. I just found it interesting that no-one went, I don't know the reason why (there could be 100 different reasons)
>
> Notice how there is always something wrong with the suicidal person and never anything wrong with the 'service' being offered. If you are selling cookies and I don't want to buy them, generally it's because your cookies suck. So what this guy did was force people to eat his cookies, under threat of expulsion. Doesn't mean his cookies are good. It just means he figured out a way to make people choke them down. The ones who want to stay in university swallow his cookies. The ones who refuse to eat them get thrown out.
>
>I understand this totally, but these people hadn't tried (or even seen) the cookies before deciding not to buy them. Although, like I said, perhaps the cookies had a bad reputation.
Posted by one woman cine on January 31, 2007, at 7:47:00
In reply to Re: 'Not always a cry for help' - » cubic_me, posted by toojane on January 30, 2007, at 16:07:34
> > although it's strange that after an attempt (before the program) no-one used the councelling services.
>
> I don't think it is strange at all. I think the way psychiatric professionals treat you after a suicide attempt is criminal. Try to do those kinds of things to a "sane" person and they'd be jailed so fast their heads would spin.
>
> The assumption that if you don't want to have anything to do with them, it MUST be because you are power tripping in some kind of self-important power struggle is laughable.
>
> Notice how there is always something wrong with the suicidal person and never anything wrong with the 'service' being offered. If you are selling cookies and I don't want to buy them, generally it's because your cookies suck. So what this guy did was force people to eat his cookies, under threat of expulsion. Doesn't mean his cookies are good. It just means he figured out a way to make people choke them down. The ones who want to stay in university swallow his cookies. The ones who refuse to eat them get thrown out.
>
>I'm sorry you feel this way - that's not the feeling I took away from the article.
"I think the way psychiatric professionals treat you after a suicide attempt is criminal. Try to do those kinds of things to a "sane" person and they'd be jailed so fast their heads would spin."
This statement you made is a big assumption and generalization.
I posted the article because it spoke of community, accountability and how to reduce the completion of suicide. It was an alternative view of a difficult subject.
"The assumption that if you don't want to have anything to do with them, it MUST be because you are power tripping in some kind of self-important power struggle is laughable."I don't think this statement is fair either. I find nothing funny about suicide and the attending issues.
Posted by one woman cine on January 31, 2007, at 7:47:31
In reply to Re: 'Not always a cry for help' - » cubic_me, posted by toojane on January 30, 2007, at 16:07:34
Posted by toojane on January 31, 2007, at 8:02:48
In reply to Re: 'Not always a cry for help' - » toojane, posted by cubic_me on January 31, 2007, at 4:13:05
> But surely people wouldn't know that about the councelling service if they didn't try it in the first place?
Maybe not THAT counselling service but if they survived a serious suicide attempt, they would have almost surely have had contact with some kind of psychiatric service, by force if they were committed. What I was trying to say was that experience can be aversive.
> I wasn't assuming that at all, ofcourse, the councelling service may have the reputation from hell.
OH NO. I did not mean that YOU were assuming suicidal people were in a power struggle. That was the premise of the doctor in the article.
I was troubled by the attitude of the doctor in the article. Not by you at all
Posted by toojane on January 31, 2007, at 8:27:16
In reply to Re: 'Not always a cry for help' -, posted by one woman cine on January 31, 2007, at 7:47:00
> "I think the way psychiatric professionals treat you after a suicide attempt is criminal. Try to do those kinds of things to a "sane" person and they'd be jailed so fast their heads would spin."
>
> This statement you made is a big assumption and generalization.
No. This statement I made is from personal experience and absolutely true. I did not make a "cry for help" I tried to kill myself because I wanted to die and unfortunately I failed and was committed. The things that happened to me while I was committed against my will on a psych ward were criminal. The fact that I would avoid such "help" at all costs is not because I am in a "power struggle" with anyone.What I was trying to convey is that I think the problem lies within the system, not in accessing it.
I used a metaphor of cookies to say that instead of their looking at their own recipe and making changes to make them more edible, they sit and say we have these delicious cookies and no one is eating them. Their solution is to force people to consume them.
> I posted the article because it spoke of community, accountability and how to reduce the completion of suicide. It was an alternative view of a difficult subject.I found the article offensive. Especially the part about the "challenge to the student's privilege to heap violence upon himself." If the writer/researcher wants to talk about community responsibility, I want to know where the community was when many of these suicidal people were being horribly abused to the extent that they are traumatized to the point where they want to die. The dynamics of self-abuse are complicated and that sentence is rife with judgement and ignorance.
> "The assumption that if you don't want to have anything to do with them, it MUST be because you are power tripping in some kind of self-important power struggle is laughable."
>
> I don't think this statement is fair either. I find nothing funny about suicide and the attending issues.I agree. There is nothing funny about suicide. But I found myself laughing sadly at the assumptions being made in the article.
Posted by one woman cine on January 31, 2007, at 8:37:29
In reply to Re: 'Not always a cry for help' - » one woman cine, posted by toojane on January 31, 2007, at 8:27:16
"If the writer/researcher wants to talk about community responsibility, I want to know where the community was when many of these suicidal people were being horribly abused to the extent that they are traumatized to the point where they want to die. The dynamics of self-abuse are complicated and that sentence is rife with judgement and ignorance."
I don't think the article was discussing anyone one person so I don't personalize it.
I'm sorry you had a bad experience with pdoc's etc. but I think it's a stretch to assume there was no community for the suicidal students in the article.
Posted by toojane on January 31, 2007, at 9:00:17
In reply to Re: 'Not always a cry for help' - » toojane, posted by one woman cine on January 31, 2007, at 8:37:29
> I'm sorry you had a bad experience with pdoc's etc. but I think it's a stretch to assume there was no community for the suicidal students in the article.Hmmm. It is hard having a conversation through posts, especially about "hot" topics. I'm somehow not expressing my points well. I was not trying to say that there was "no community for the students."
I was troubled by the point being made in the article that students were "heaping violence" on themselves while they had a duty to their community not to. Intellectually, I understand that stance but emotionally it angered me.
I see it as holding the students accountable to be non-violent to themselves while there is no attendant accountability within the larger community (not just the educational one) to not do violence to them. So, you can be horribly abused and nothing is done by your community to help you but when you are suffering from the aftereffects of that abuse and your behaviour is a consequence of that abuse, it is you who are condemned for not meeting your community responsibilities of non-violence.
I don't know if that is clearer or not. Obviously, suicide is a very emotional topic. I have not meant to offend anyone, just to express my point of view.
Posted by one woman cine on January 31, 2007, at 9:13:47
In reply to Re: 'Not always a cry for help' - » one woman cine, posted by toojane on January 31, 2007, at 9:00:17
No offense taken - but I think that you have said you felt abused after your experience - I'm not sure that can be translated into the students experience.
"I see it as holding the students accountable to be non-violent to themselves while there is no attendant accountability within the larger community (not just the educational one) to not do violence to them."
My take on it - is students & a community can feel "abused"/victimized by suicide attempts/self-harm - there is a PTSD reaction to those that have experienced this -(see the thread on social as an example) - there can also be an equal reaction by those who attempt suicide/self-harm.
But i do agree - it's complicated between abuser and abused - & it's not clear who is who (or both at the same time?) at any given moment.
"it is you who are condemned for not meeting your community responsibilities of non-violence."
I don't see it as condemning - I see there has to be accountability - how does that happen within a larger community?
We are all responsible for ourselves & our behaviors.
But thanks for clarifying. I'm sorry the article upset you.
Posted by toojane on January 31, 2007, at 9:56:09
In reply to Re: 'Not always a cry for help' -, posted by one woman cine on January 31, 2007, at 9:13:47
> No offense taken - but I think that you have said you felt abused after your experience - I'm not sure that can be translated into the students experience.
We don't know the student's experience. Which is what I'm trying to point out. The doctor concludes they don't come for counselling because they are in a power struggle. I think it is just as possible that they find the counselling being offered distasteful or condescending or abusive or fill-in-the-blank and that is why they do not go. There are huge assumptions being made in the article about the student's motivations for not going to the school's counselling service. None of them look at the quality of the service being offered, only the quantity. I don't remember it being mentioned anywhere in the article that they did an indepth study of the student's reasons and opinions.
Posted by Meri-Tuuli on January 31, 2007, at 11:16:12
In reply to Re: 'Not always a cry for help' - » one woman cine, posted by toojane on January 31, 2007, at 9:56:09
Hello
Well I just read the article and I thought I'd comment. I thought it was quite accurate really, well certainly regarding me and my suicidal feelings.
For me, I've often said 'I'm going to kill myself' and its pretty much like he says - its about giving back the power of your life to you, because by saying it you're giving yourself control because you can always 'escape' if things get worse or whatever. It means you can be in the reality because you have the option of escape.
I know it gives me courage and control when I say it although I'd never act on it. Anyway.
Posted by toojane on January 31, 2007, at 11:53:46
In reply to Re: 'Not always a cry for help' -, posted by Meri-Tuuli on January 31, 2007, at 11:16:12
Hi Meri-Tulli
> thought it was quite accurate really, well certainly regarding me and my suicidal feelings.For me, I've often said 'I'm going to kill myself' and its pretty much like he says - its about giving back the power of your life to you, because by saying it you're giving yourself control because you can always 'escape' if things get worse or whatever.
I think that is a very common view of suicide. It is also a very personal and private one, a way of negotiating your relationship with what can at times be an intolerable life.But concerning the article though, how does that translate for you in your relationship with any psych professionals? Should you/have you been/are you currently forced into counselling because of your suicidal feelings?
When you say you are going to kill yourself, is that only to yourself or are you saying it to others? Do you think that saying it out loud changes its purpose/meaning?
> I know it gives me courage and control when I say it although I'd never act on it. Anyway.So you never have made an attempt? You struggle with ideation though or don't view it as a struggle because it gives you "courage and control"?
Posted by toojane on January 31, 2007, at 14:18:08
In reply to Re: 'Not always a cry for help' -, posted by one woman cine on January 31, 2007, at 9:13:47
> We are all responsible for ourselves & our behaviors.If only that were true. In a perfect world.
> But thanks for clarifying. I'm sorry the article upset you.I've been thinking about why it upset me so much. I've figured out it is the use of coercion and the way the use of coercion is justified by statistics that purport to measure something I don't believe they are measuring (Wishingstar's post points out many of the problems with the study).
I think it is dangerous to confer power to one group over another. You do that believing/hoping the more powerful group is benevolent and that absolutely is not necessarily true. In this situation, the students do not have the option to refuse "help" whether they experience it as helpful or not. You can read this board to easily find a very small sampling of some abusive therapeutic relationships. Now imagine the posters were forced to participate in them under threat of expulsion.
Posted by one woman cine on January 31, 2007, at 19:19:38
In reply to Re: 'Not always a cry for help' - » one woman cine, posted by toojane on January 31, 2007, at 14:18:08
I understand your point - but there are rules of conduct in every community so the participants feel safe and can trust the environment. The rules vary from community to community but I do not think *keeping oneself safe* is a bad rule.
I personally would want to be part of a community where everyone had accountability for their actions.
I would not want to be part of a community where it's OK to commit suicide because you don't want to get help.
I'm not sure if this is what you said, but the threat of expulsion for not getting help would seem fair.
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