The Suicide Detective misses evidence

The Suicide Detective misses evidence
Wounded Times Blog
Kathie Costos
June 27, 2013

There is a really good article "The Suicide Detective" on the New York Times by Kim Tingley. It is long but a good read. Right now I need to point one part of it out.

The Army has made a "major investment" in this research on top of what they already spent and this goes back to 2009!

A major investment of money and manpower from the Army is set to revolutionize the scope of collecting data on suicidal behavior. Nock and his team are participating in the Army Study to Assess Risk and Resilience in Servicemembers, which got under way in 2009 and is the most comprehensive investigation of suicide ever undertaken. The Army’s access to thousands of volunteers who lead comparable lifestyles and excel at following instructions offers a unique laboratory for Framingham-scale longitudinal studies. Nock envisions, for instance, one day beaming the I.A.T., Stroop and other tests to servicemembers’ phones daily — a technological feat unthinkable a decade ago. Those scores might reveal suicidal thoughts in real time. They might also offer a way to monitor patients known to be at high risk and call them if they seem to be entering a dangerous frame of mind.

“Right now, we ask people if they’re suicidal,” Nock said. “And if they say yes, we give them medication to try and make them less depressed or less anxious or less psychotic or to have a more stable mood. And then we talk to them. We do talk therapy. And essentially talk them into not being suicidal anymore. And this over all as a strategy for many people does not seem to be curative.” But if doctors could see which patients are suicidal at a given moment, they might be able to retrain their self-destructive thinking based on their test scores. If, as the I.A.T. seems to suggest, associating yourself more with dying than with living increases your risk for suicide, breaking that association might decrease it.

To find out, Nock is developing computer tasks that he hopes could help get people, through rote practice, to identify more with being alive than dead. His researchers are also starting to test whether training people to think more positively about the past and the future makes them less likely to attempt suicide. Nock often talks about “turning levers,” as if he were a railroad-switch operator manning an existential junction. “Can we think of suicide as resulting from problems with memory or cognition or attention?” he said. “And if so, can we then turn levers on those things to make people less likely to think about suicide? So, it’s not giving a pill; it’s giving a training.”

I am not as happy as I thought I would have been with the title of this article. There is nothing new. People commit suicide for one very simple reason. They have lost hope that the next day could be any better than the day they are suffering in. The reasons their lives are miserable is long and complicated but the loss of hope is the end for far too many. The evidence has been documented by families for far too long.

Some people commit suicide over financial reasons and job loss. Their families are suffering and they feel helpless to change that. Some face health problems with a diagnosis of prolonged suffering and no hope of cure. Some are lonely with no one to talk to or let them know they matter to at least one person on this earth. It all comes down to hope.

With Combat PTSD, it is far different than what civilians face. For the men and women in the military, most had never thought of doing anything other than being in the military, or members of the National Guards. The only other group close to them is law enforcement, followed closely by firefighters, but that group is a bit different because they, for the most part, do not do their jobs with violence. The troops and law enforcement do.

They face the threat to their lives as part of their jobs on a daily basis. They also face the fact that they may have to use violence in response. For them, just like all other humans, they face the same issues everyone else does but they have the added risk factors from their jobs. Survivors guilt is even harder to treat but while it cannot be "cured" they can live better lives with the right treatment.

Just as experts acknowledge there is no one size fits all medication for them, they must also acknowledge there is no one size fits all answer to treating their physical body or their spiritual body. What works for one does not work for all in anything however if researchers continue to avoid the spiritual part of the whole veteran, they will never discover what will offer them the most hope for tomorrow being any better than today is.

One more reminder is 2012 was the highest suicide total on record.