Academic journal article Journal of Mental Health Counseling

Linking Life- and Suicide-Related Goal Directed Processes: A Qualitative Study

Academic journal article Journal of Mental Health Counseling

Linking Life- and Suicide-Related Goal Directed Processes: A Qualitative Study

Article excerpt

Note: A shorter version of this article was presented at the Conference of the European Society for Suicide Prevention, Copenhagen, 2004.

Previous analyses of the narratives of 40 persons hospitalized in a general hospital after suicide attempt found that they described their suicide attempts as goal-directed processes, sometimes planned in advance, sometimes executed spontaneously. They also described short-term actions, mid-term projects, and long-term careers reflecting goal-directed processes related to maintaining and developing their lives. In this qualitative study that reports on a re-analysis of these data, the research participants' narratives were examined for links between life-related and suicide-related goal-directed processes. The analysis followed a distinction between a goal-directed view of suicide processes and a dynamic systems view. The findings indicated that some links were goal-directed and consistent with the reasoning of life-maintaining projects. These "top-down" links between life-related and the suicide-related goal-directed processes reflected the goal-directed view of suicide processes. Other links indicated a substantially limited capacity for goal-directedness, reflecting the "bottom-up" dynamic systems view. Finally, it third group of links reflected a mix of "top-down" and "bottom-up" processes. Implications are offered for mental health counselors working with suicidal clients.

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Suicide acts, despite their high rates and repeated occurrence, are extraordinary events. Some authors (e.g., Maltsberger, 2004) indicate that suicide involves a complete break down of any order in the person's life. Others (e.g., Maris, 1981) suggest that suicide is part of long-term, orderly processes. We need to unpack this apparent dichotomy in terms of both breakdown and orderly processes as they are experienced in clients who have attempted suicide.

The present study uses an action theoretical view of suicide acts and the processes that precede suicide. This view is premised on an understanding of suicide as goal-directed action (Michel & Valach, 1997). Like other everyday human actions, suicide attempts and other self-destructive behaviors involve the intentional and goal-directed actions of the person both in the short-term, self-destructive act itself, and in longer-term projects and careers of which the self-destructive acts are a part. Michel and Valach (2001) showed that self-destructive and suicidal processes could be seen in terms of joint goal-directed action. The "processes" we refer to in this article include actions, projects, and careers and their associated verbal and non-verbal behaviors, cognitions, feelings, and social interactions. This term applies equally to processes that are life-affirming or life-destroying. In as much as these processes are related to each other, we can also refer to them as a goal-directed system.

In the reports of research participants after a non-lethal suicidal act, we were able to identify short-term suicide actions, mid-term suicide projects, and a long-term suicide career, all of which the participants constructed as goal-directed processes (Valach, Michel, Young, & Dey, 2002). These narratives referred to both suicide-related and life-related processes (that is actions, projects, and careers related to life instead of to suicide).

The specific question addressed in this article is how persons, after a suicide attempt, link suicide-related and life-related processes, that is, how they switch between their life goal-directed system and their suicide goal-directed system. The linking of these processes is a segment in the stream of actions that allows a quick switch from being engaged in one system to pursuing another. This phenomenon has not been investigated extensively. Specifically, in terms of the narrative of a suicide attempt, we identify this link in the case when an action of an everyday project is suddenly followed by an action related to an existing suicide project. …

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