In the book Working with suicidal individuals I propose there are 5 common responses to closing the suicide escape hatch. One of which is a reaction of relief.
I had a good example of this recently with a person who opted to close that escape hatch and over a period of the next week began to have a sense of relief about doing so.
How does one conceptualise this theoretically?
It seems reasonable to conclude that the person feels a drive or urge to kill self and there is a part that also wants to live. This I have presented before as the suicidal ambivalence.
By closing the escape hatch they get a sense of “Now I don’t have to do it”.
A metaphor perhaps could shed some light on this.
A person has been told they have to do some kind of public presentation, a speech or musical performance for example. The person feels considerable disquiet about this (as many do). They are then subsequently told that the whole event has been cancelled due to lack of funds and will probably never happen. The person then feels considerable relief.
If this metaphor applies then the drive to hurt self is seen as following some kind of directive which is directing you to do something you don’t want to do but which you have agreed to. A new directive then tells you that you do not have to do it any more. The show has been cancelled.
As I say closing the suicide escape hatch must not be done with all suicidal people as some will then be worse off for doing so. But how does one articulate those clinical circumstances when closing the suicide escape hatch is a good thing or a bad thing to do.
The example given implies that when the urge to kill self is experienced as a directive from another then closing the suicide escape hatch is indicated. When the suicidal urge is not experienced as such a directive then closing the escape hatch may be contra indicated.