The high incidence of suicide among US military veterans is a terrible problem. More than forty veterans kill themselves every day. This is 1.4 times the rate of suicide in society at large. In order to deal with this problem, information is important. The terms that we use to discuss suicide are important. One term that has been used for years can be dismissive and even dangerous. The term is suicidal gesture. What is a suicidal gesture? The implication is that a person fakes an attempt at suicide in order to gain attention or to manipulate others.
Suicidal Gesture Explanations
Over the years several explanations have been given for the term suicidal gesture.
One explanation says it is “like a one person play in which the actor creates a dramatic effect, not by killing or even attempting to kill himself, but by feigning an attempt on his life.” (AIRBAIRN, G (2010) ’Who is responsible when ’attempted suicide’ goes wrong?)
Another is that “a person leads others to believe that he has just made a suicide attempt in order to communicate that he is in distress or to influence the behavior of others in some way.” (Suicide among soldiers: a review of psychosocial risk and protective factors.)
And another is that it is “an unusual but not fatal behavior as a cry for help or to get attention, or a suicide gamble, when patients gamble their lives that they will be found in time and that the discoverer will save them.” (Traumatic Suicide Attempts at a Level I Trauma Center)
Suicide Attempt Versus Suicidal Gesture
On one level, among medical and psychiatric professionals, it is useful to understand the mechanics of how someone arrived at the emergency room having attempted suicide. There are individuals who decide to end their lives, make plans, and commit suicide. Often those close to them are surprised as well as shocked as they did not see it coming. And there are those who seem to be continually embroiled in controversy, intense interpersonal drama and who may even threaten to end their lives. Putting the pieces together after the fact can be useful in understanding how to reduce the incidence of suicide in the future. In that sense, sorting out how much unhealthy interpersonal interaction has gone on before someone attempts to end their life is important.
Suicidal Gesture as a Dismissive Term
Did the person in the emergency room “really” intend to kill themselves? Or were they trying to get back at someone, manipulate someone, or gain power over those around them? Were they really serious about ending their life or was it a “cry for help”? If you ask professionals who have dealt with suicides, they will tell you that all too often someone who may well have been making a cry for attention or help ends up killing themselves. And those who carefully plan a suicide may not succeed. Dismissing a suicide attempt as a “gesture” instead of the “real thing” is not only dismissive. It is stupid and dangerous.
Fallout From Calling a Suicide Attempt a Gesture
If a patient who attempted suicide is sent back to a dysfunctional family with the message that it was only a gesture and not the “real thing,” the odds of the person getting any significant help are minimal. The same may be true if that message is sent to other treatment professionals whose professional lives are a constant sorting of priorities and triaging the highest to lowest risk in their flow of patients. It is a sad fact that much of life is a learning curve and that fact applies to suicide attempts. Practice makes perfect and a person who did not know what they had to do to end their life will learn from their first attempt and increase their odds of success the next time.
The point is that anyone who has tried to or may have tried to end their own lives needs to be taken seriously. Risk factors like depression, PTSD, substance abuse, social isolation, recent military discharge, and more need to be assessed. These people need to be funneled into appropriate treatment programs with attentive follow up. This happens when a suicide risks and attempts are taken seriously. That is the risk of using the term suicidal gesture outside of a strictly professional setting.
