Parasuicide

I don’t wanna die
But I’m not keen on living either
Robbie Williams

According to an online Medical Dictionary- 

Parasuicide: An apparent attempt at suicide, commonly called a suicidal gesture, in which the aim is not death. For example, a sublethal drug overdose or wrist slash. Previous parasuicide is a predictor of suicide. The increased risk of subsequent suicide persists without decline for at least two decades.

There are so many interpretations of and presumptions about parasuicide. 

I think for many people, suicide attempts are mistaken for suicidal gestures.  And in many others, suicidal gestures are viewed as attention seeking or somehow unimportant, something to be shrugged aside and consigned to the pile of “ingenuine, attention-seeking largely-female quite-pathetic cries-for-help”.  One huge problem with this attitude is that it can lead people who have made suicidal gestures to worsening acts of self-harm, in order to prove whether to themselves or others, that their actions are “real” and “valid” despite the fact that their outcome is not death.  It also trivialises the act itself: not intending suicide, or a feeling of “not caring” about the outcome of a (para)suicide attempt, does not detract from the fact that any self-harming act can be harmful, or fatal.  Nor can it be ignored that an act like that stems from something, from somewhere.  People do not act in a vacuum, and people do not cause themselves potentially lethal damage for fun.  Many people take such drastic measures without asking for help afterwards- some people die after overdoses they did not intend to kill themselves with.  Some people bleed to death after a cut not meant to kill.  Others make what they see as irreversible acts to end their lives, yet survive.  I was hospitalised this year for having real, convincing, unwavering conviction that I should die.  But I’m still alive.  The line between a “true” suicide attempt and parasuicide can be thumb-breadth, can be barely discernible.  Minimalising any such action on the basis of its ultimate outcome is dangerous and ill-informed.

In no other circumstance is the extent of an illness measured by the failure to die.  In fact, In no other illness is survival seen as a failure.

It’s an old joke and a seriously unfunny one, that “I tried to kill myself and I couldn’t even get that right”.  Why should someone feel guilty for having woken up to see another hour?

It’s a tricky one: if someone doesn’t necessarily intend to end their lives but acts in a way that could make this the consequence, what assumptions should be made, and which actions taken?  I understand why people (professional and otherwise) find it difficult to know what to do about “parasuicide” but it becomes dangerous when, rather than erring on the side of caution, people choose to ignore or minimalise the dangers of self-harm (in its broader sense).

It is also a huge problem that people who did not necessarily intend to kill themselves are then made to feel ashamed of their actions and cannot discuss them honestly- for example, constantly discussing an act of self-harm in terms of a suicide attempt is of no therapeutic benefit, as it bases all discussion on a faulty premise.  There can be, but isn’t always, a big difference between having tried to commit suicide, and having acted in a way that resembles a suicide attempt in all ways but one: the ultimate intention.  If people were able to be honest about which was which, communication and dialogue between the people who hurt themselves and the people who try to look after them could be much improved.  If I could say “I took the paracetamol because I really wanted to hurt myself/ I wanted part of myself to die/ I wanted confirmation of how awful I was feeling/ I actually don’t care if I die or not” then I could work with that, rather than basing all conversation on the untrue or semi-true premise that “I took the paracetamol because I wanted to kill myself.”

As a teenager, I overdosed more than thirty times.  For a number of these, I was taken to hospital and received appropriate medical treatment.  For others, I told no-one, received no treatment, and waited around for days on the off-chance of liver collapse, uncertain as to how that made me feel.  I spent a large amount of time convinced I was going to die, but not wanting to let anybody know: it is a frightening place to be from the inside and, from the outside, it should seem a worrying one.  How unwell do you have to be to treat the prospect of death so lightly?

As I’ve mentioned before, there was an element of looking for attention in a number of my self-harming acts as a teenager.  But there were others I kept quiet, close to my chest, more dangerous. [ N.B. Keeping quiet or not is, again, not a measure of the seriousness of either action or intention.  Most people who kill themselves try to talk about it first.]  Each time, I took greater and greater risks until finally I was hospitalised for six months.  I feel sad for people whose cries go unheard (or worse, are ignored) and who are not given that chance to find different ways of expressing negative feelings.

But it happens all the time.

The key, as always, is honesty.  And the lock, as always, is rusty as fuck.

(I may update this further later- keep your eyes peeled like lychees if you’re interested)

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