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Ukraine: a psychiatrist’s point of view. Reports, thoughts, articles (1999–2004)
Y. Yur’yev

FOCUS GROUP “WHAT LEADS TO SUICIDE ATTEMPT AND HOW TO PREVENT IT”

Y. Yur’yev, T. Kovalenko

* Publication details:
Yur’yev, Y., Kovalenko, T. (2004). Focus group “What leads to suicide attempt and how to prevent it”. In: Yur’yev, Y. Ukraine: a psychiatrist’s point of view. Reports, thoughts, articles (1999–2004), pp. 136–142. Dnipropetrovsk: Porogi.

The discussion was held in the crisis department of Dnipropetrovsk psychoneurological hospital in a group of 10. The group included a psychiatrist (suicidologist), a medical psychologist, 7 suicide attempters and a relative of a person who committed a suicide.

Time: 10.30–11.45 in the morning.

T. — L.: What do you think leads people to commit a suicide attempt?

L.: Betraying and rudeness irritate me most of all. Usually people inclined to committing a suicide are very kind and vulnerable. They are very easy to be insulted; and what if there is a betrayer or a lout next to them…

T.: So, one of the reasons is betraying, isn’t it?

L.: Yes, I think, we can refer it to the majority of people. Nobody would go away from life if there were no betrayers and deceivers.

T.: Ten Commandments?

L.: Yes, but they are forgotten now. Everybody is trying to live by everyday laws, although they do not suit. I’m very kindhearted but I’ve been changed. I’ve trusted people, wanted to do good things, but I’ve got harm in response and it have made me severe.

T.: You have become severe? Do you feel sorry for that?

L.: I don’t know… In general I don’t feel sorry. Now I think not only about one day but also about the future. There was a situation: together with my husband we had 2 houses — the new one and the old one. I trusted him both. Then when we divorced, it wasn’t spontaneous… I didn’t think of the future then. He was mean to me: he took both houses and he sold the car. I’ve got nothing. And all these I’ve overcome by my own. Now I’ve become stronger.

T.: Should the kindness be able to stand for itself? Who or what can help people to stand for themselves? In what way kind, sympathetic and calm person can be taught to be stronger in life?

L.: Not by suicide thoughts.

T.: Right but how? How can he learn it by himself?

L.: You can learn it by one’s experience.

T.: But all people make mistakes. They also should be taught different behaviour manners for different situations. We all lack life knowledge. You said you were very kind person and then you became stronger and more careful. It helps you now. And what did you feel in the mentioned above situation?

L.: I felt insulted… I didn’t expect the betrayal from a close person. Unexpectedness made me stronger… I trusted the person I’d been living for so long… He betrayed me… I decided to die… I felt hopelessness because of his indifference…

T.: Tell me why most of the pain is made by closest people? Why does it happen so?

L.: Because we love them.

T.: Is it a response to our love? Hurting somebody in response to his love…

L.: Yes, that’s the life. Ten Commandments say love should be a response to love. But our life is so cruel!

T.: As I’ve understood, we permit our close people to hurt us…

L.: Yes.

T.: So, the most of the blame for all the things happen is laid on us.

L.: Yes.

T.: Or is it laid on surrenders? There is a contradiction. So, is it more our fault?

L.: I think it’s everybody’s fault!

T.: And what should we do to prevent it?

L.: People should believe in God and should live according to Ten Commandments… to live according to their conscience.

T.: What about you? What can’t you stand with? What insults you? What man’s features do you dislike for surrenders and for yourself?

A.: I also dislike rudeness, lie and betraying.

T.: Is that your own thought or you join L.? Who made you experience such negative feelings? Was it your family or close people?

A.: No, it’s me by myself.

T.: You don’t like some of your features, do you?

A.: Yes, I was so helpless in my life, I could do nothing… Why do I need such a life?

T.: Did you suffer a lot? You were not able to reply to offence, weren’t you?

A.: I could do nothing.

T.: What do you mean? Can you tell us about your feelings and thoughts you’ve had while trying to commit a suicide?

A.: It was very difficult for me… There were helplessness and pain… There were some misfortunes that broke me down. I had problems connected with my job.

T.: Did you warn your close people that you were rather bad and that you couldn’t go further?

A.: Yes, I told I was bad… But those who are on the edge of committing a suicide do not warn anyone. They do not perform it in public.

T.: But did you warn your family?

A.: No.

T.: Do you feel sorry for being alive now?

A.: That I’m alive now… No, I don’t feel sorry!

T.: Here is B. who was a witness of a suicide. We don’t want to hurt you… did your brother have weighty reasons to go away? Did he ask for help before committing a suicide?

A.: He didn’t ask for any help… he didn’t speak to anyone.

T.: So, was it a real shock for you, a complete unexpectedness?

A.: Yes, he is a kind of person who never shares his thoughts.

T.: Did he speak to you or your Mom before the suicide?

A.: My Mom was in hospital.

T.: What is the reason of his death? What do you think?

A.: I don’t know.

T.: How old was your brother?

A.: 22.

T.: Did he have any disease?

A.: Yes, two ulcers and hernia.

T.: Did he feel bad… Did he feel worse lately?

A.: No… He was dating a girl, they were going out.

T.: May some unpleasant moment in their relationship be the reason? Was he upset, irritable, suppressed?

A.: No everything was ok.

T.: Do you condemn him?

A.: No.

T.: Do you think we are right discussing the topic now?

A.: Yes, we are right.

T.: So, is there a need to find the reasons and to understand people who commit suicides?

A.: Yes, there is!

T.: What kind of advice can you give to a person who has such thoughts and wishes? Let us give the word to D. What do we need to do if a difficult situation appears? Imagine that your friend comes to you and says that he wants to commit a suicide. What would you say and in what words would you calm him down or would you avoid the topic?

D.: I wouldn’t calm him down. It would mean I agree his weakness.

T.: So, there is no need to regret him. But he is your friend. And you can see he is ready to commit unrecoverable dead. Would you just go away?

D.: If he is a weak person, he’ll commit a suicide.

T.: So, you don’t have any pieces of advice…

D.: We need to find some solution together. In what way we can achieve his aims. We need to find different ways of solution and to choose the optimum.

T. — H.: What kind of advice you could give to your friend?

H.: I would plead her not to do it.

T.: In what way? What arguments would you find?

H.: I think it happens to everyone. We need to take it easier.

T.: Easier?

H.: Not to take it for granted.

T.: Each of you has own situation. So, H. means we need to take life easier. She has a problem with her husband, he is cheating and wants to leave the family. Now her life has changed, she’s decided to live for herself and for her children.

T. — K.: And what you can advise to your friend in such situation?

K.: There are bad and good periods in our life. And if it is bad period there will be good period next. We shouldn’t dramatise.

T.: K., do you agree that sometimes a person can exaggerate? We are talking about problems. You and your boyfriend have different ways of life perception. You like cheerful parties and he thinks in a different way.

K.: Well, generally yes.

T.: So, what you would recommend to a person who has the same problem?

K.: I would recommend finding the reasons, understanding his inner state first, finding out all the weak points.

I.: So, we need some knowledge and support, am I right?

K.: It depends on a person. If he wants to be regretted then let him be regretted.

T.: We can sympathize and support him emotionally.

C.: Yes, we shouldn’t let them be alone with the problem.

I.: We’ve found another problem, the problem of loneliness. Each of us is lonely and must solve his own life problems by himself. It’s good if there is someone next to you, somebody who would help. But we should rely upon ourselves.

C.: Yes, we need to know such moments in our lives. I know them. If I have a drink I lose control. Drinking is allowed to me.

T.: What would you advise to your friend? (to J., A.)

J.: I would take her to psychologist and psychotherapist, to a person I know. I would recommend her to go to a specialist.

T.: Good, but before the specialist, in the crisis moment…

J.: I would abstract her attention, I would make something up…

T.: So, you would try to tune her thoughts in another wave. (to S.) May be with the help of alcohol you are trying to suppress some soul discomfort.

J. — C.: You need the treatment.

C.: Yes. I think you lead yourself up to depression.

I.: So, the other reason is depression. If you feel that there is something wrong you need to find help. What do you think, if there were some TV programs discussing these topics would it be useful?

J.: It would be nice. People who need knowledge and who are interested would watch these TV programs.

T.: So, people of definite education and prosperity. So, there is another topic — we need to improve our knowledge and to perfect ourselves.

T.: I’ve noticed that we all are tired; today we’ve worked hard!

We have defined some reasons that lead to committing a suicide. You have selected them by your own. There are problems connected with our personal features and with the way we react to difficult life situations. There is emotional vulnerability and disbelief in own strength. There is a problem of loneliness, inspirituality, and unwillingness to live according to religious laws. There are different diseases, somatic as well as mental, for example, depressions; alcohol and psychoactive drug addiction. We also have defined those things that help us to avoid a suicidal risk:

In the following groups there was a discussion of the topic. Here is an example of what do participants of the other groups say.

T.: Did you have any thoughts about it?

Y.: The truth is that since childhood, which I didn’t really have, there were thoughts and I wanted to do it. And it happened: when I returned from the army I wanted all and at once — family, apartment. And it happened so that I met a girl I studied with, and then she got pregnant. There was marriage; we lived together but in one and a half year we realised that we do not suit each other. It was difficult, I started drinking, and problems appeared because of the drinking. Once while we were sitting in the kitchen I said: “Let me take a treatment and we will get divorced”. She said that if I get the treatment we would have a good life together. But after I took the treatment we got divorced and a chain of misfortunes occurred. My mum had problems and I didn’t have any work. I felt lonely and noticed that I could do little in life, at work and in my private life. Thoughts of m being a looser appeared, a desire to deprive myself life appeared, at hand were the pills that there was a desire to swallow.

T.: Are you afraid of loneliness? You are so attractive.

Y.: But I betrayed my wife. I broke up with her and lived with another woman.

T.: Do you feel sorry for that?

Y.: I do now and I’d like to return. I thought she wouldn’t be able to live without me. She waited for me for a long time, but when I came she said that she got tired of waiting. She became a real strong woman who solves her problems.

T.: And the other woman? What was wrong with her?

Y.: I don’t know. I did my efforts in order we’d be together.

T.: What do you think was the reason of your taking the pills?

Y.: The reason was my wife rejected to live with me.

T.: What did you need on that moment? Did you need help of your wife or just attention of another person? Did you need to be listened to? What exactly?

T.: I needed my wife not rejecting me so categorically.

Y.: Ok. Now a question to you, — B. Have you had cases when life appeared to be useless, invaluable and senseless?

B.: When I was 45 my son was killed. He went to a disco and never came back. I found forces to burry him, to take it, as it was his destiny. But on that very moment I realised that there is nothing for me to do anymore, that my life stopped. I had a desire to sink or to hang up; I just wanted to be with him.

Y.: Did you have the only son?

B.: Yes. On that moment I did understand those weak people who couldn’t find forces and grief suppressed them.

Y. (to everybody): Tell me what can’t you stand in people?

Y.: Most of all impudence and meanness irritate me.

L.: Neglecting others.

A.: I can’t answer this question now. There are people who haven’t made any harm to you but you don’t like to communicate with them.

S.: I don’t like double-faced people.

T.: And how would you prevent a person from such unrecoverable deeds? What would you say to a person who wants to leave?

L.: We shouldn’t take it to heart.

S.: There is a way out from any situation; life is the only valuable thing that a human has.

Y.: I would patiently listen to his problem, would talk to him, convince him that everything can’t be in bad colours, the light would definitely appear.

As we can see from the discussion the problem causes a great interest among the participants of the group and quite frank discussion of the questions.

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