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60 of 63 people found the following review helpful:
4.0 out of 5 stars
The Suicidal Mind, February 6, 2000
With over forty years of experience to support him, Dr. Shneidman concludes that "our best route to understanding suicide is not through the study of the structure of the brain, nor the study of social statistics, nor the study of mental diseases, but directly through the study of human emotions". It is his belief that those persons who commit suicide do so to either avoid or to terminate unbearable psychological pain due to the persistent frustration of vital psychological needs. The psychological needs that he refers to were first described by Henry A Murray in Explorations in Personality (1938). According to Dr. Shneidman, most suicides are partially attributable to one of five clusters of frustrated psychological needs: 1) thwarted love, acceptance, and belonging; 2) fractured control, predictability, and arrangement; 3) assaulted self-image and the avoidance of shame; 4) ruptured key relationships and attendant grief; and 5) excessive anger, rage and hostility. The suicide is not so much a factor of the particular need but rather the intensity of the frustration of whatever need is basic to the functioning of that person. It is the goal of the psychotherapist, or therapist in general, to recognize the psychological needs of the suicidal patient and to help the patient see alternatives to suicide that will alleviate their psychological pain. Dr. Shneidman offers no data to support his conclusion, only forty years of experience studying suicide as a clinician and researcher at UCLA. In The Suicidal Mind, he uses three case studies to illustrate the application and utility of his basic hypothesis. Indeed, his hypothesis is basic; that is, it seems obvious that suicidal persons are experiencing severe psychological pain. The usefulness of this book, therefore, is not so much in understanding and accepting this hypothesis, but rather in appreciating the patterns of thinking common to most suicidal patients and in the humanistic approach he takes with treating such distraught individuals. Most useful, perhaps, is the way in which he demonstrates how the perceptual state of suicidal patients becomes constricted and it is the challenge and the task of the clinician to widen the perceptual blinders. The suicidal mind effectively has become dichotomous, desperate, and unable to entertain more than two choices - life as I want it or death. Interestingly, it seems apparent to Dr. Shneidman that suicidal individuals seem to be ambivalent about death and would choose not to commit suicide "if they didn't have to". His approach is skewed predominantly towards the art of medicine as opposed to the science; his book is valuable in that by elucidating key features of the suicidal mindset, he shows clinicians how to empathize with and understand suicidal patients. What this book lacks is scientific data to support his viewpoints. Indeed, he went so far as to create a "Psychological Pain Survey", but he fails to describe any scientific endeavors to determine the significance of psychological pain to subsequent suicide risk. There are a number of ways in which he could have demonstrated in a scientific manner the particular psychological needs, the intensity and duration of need frustration, and the subjective intensity of psychological pain as they correlate with suicide risk (ie., subsequent suicide). Many studies have already demonstrated the correlation of such parameters as social isolation, unemployment, serious physical illness, and psychiatric comorbidity with suicide in specific populations; ie - alcoholics (Murphy, Suicide in Alcholism, 1992). Such scientific data is necessary to confirm the utility of Dr. Shneidman's insight for achieving the ultimate goals of studying the suicidal mind; to identify those at risk for suicide and subsequently to prevent it. Nonetheless, the ideas put forth by Dr. Shneidman reinforce the fact that medicine is both a science and an art. Antidepressant medications have proven to be a major therapeutic breakthrough in the treatment of suicidal patients, but long term benefit (ie, happiness) will likely be difficult to achieve without addressing the psychological processes that drove them to this desperate point in the first place.
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20 of 20 people found the following review helpful:
5.0 out of 5 stars
Worth Reading, September 15, 1999
By A Customer
My brother killed himself several weeks ago and I found this book useful in trying to understand his emotions and mindset before he took his life. A combination of reading this book, talking to people who knew him, and thinking about his life experiences makes me feel that I understand him better than I did before and helps me answer why he selected suicide as THE solution.I found the online book review at The American Journal of Psychiatry helpful in deciding to buy this book. I wish the book was organized differently, but then it would be a different book wouldn't it :)
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20 of 20 people found the following review helpful:
4.0 out of 5 stars
Brought me back from the brink, April 24, 1999
By A Customer
I hadn't read any books on suicide before, so this one was extremely helpful in making me realise that there are many "commonalities" between suicidal people, so I'm not the only one who's insane. He gets a bit tough in the conclusion, saying that we have to face the grim harsh reality of life, but that sort of makes me feel a bit better - just the fact that he spells it out. In other places he mentions that everyone feels down and has contemplated suicide at one time in their life - I s'pose I feel like disputing the severity of many other people's "down" feelings, because otherwise they would have been regular visitors to Emergency wards. However, this is countered with his comments about how suicidal people often have grandiose thoughts about how they're the only ones who feel such deep pain. So am I grandiose and isolated and living in a fantasy world of my own? Or just affected by a biological mood disorder? Well, it gives me something to think about, and has given me quite a bit of hope. I don't know whether this effect will be temporary or not, but at least I've gained a greater understanding of why I get to the suicidal stage and how there are many other people out there who feel the same (even though I doubt that this is the majority).
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