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Understanding suicide from cognitive behavioural and strain theory perspective

  • Cognitive behavioural explanation

    Learned helplessness

    There has been a shift from behavioural to cognitive behavioural explanations of the emotional disorders. This may be exemplified by the changes made to Seligman’s (1975) learned helplessness theory over time. Seligman’s initial theory suggested that depression results from learning that one is not in control of a particular physical or social environment. The term learned helplessness stemmed from animal experiments that involve animals being placed in a place from which they could escape, for example by jumping over a low barrier. Following a mild electric shock, the animals quickly learned to jump over the barrier to avoid it.

    However, when they were prevented from doing so by being placed in a harness, they eventually learned to be helpless by inertia and not trying to change the situation. A number of studies used different procedures to demonstrate learned helplessness both in animals and humans. Those that went through these procedures evidenced ‘symptoms’ similar to clinically depressed individuals, including lack of motivation, passivity and disrupted learning stopped trying to avoid the shock even when the possibility of escape was open to them. They had learned that they could not avoid the shock and expressed their hopelessness in their inactivity.

    This mainly explains the situation among youths in Nigeria. There are so many problems in the country and Nigerians have tried their (very limited) ways to escape the problems without success such as applying for jobs countless times, crying their tensions out, seeking solace in relationships etc. They eventually then give in to the problems, feel incompetent, passive, tired, depressed. Some people adopt wrong means to pacify the feelings which prevented them from effectively coping with the problems, so they might either become addicted to substances, become antisocial or demonstrate other Behavioral problems while few others contemplate suicides.

    Check out this article on the scope and prevalence of suicide in Nigeria.

    Cognitive explanations

    Learned helplessness/hopelessness: Seligman’s behavioural model of depression was reformulated/revised in the late 1970s by Abramson et al. (1978), partly in response to the developing paradigm of cognitive psychology. The revised learned helplessness theory suggested that depression – or more accurately, hopelessness – was the result of three key attributional processes in response to both positive and negative events:

    • Internal/external: is the outcome of the result of some aspect of the individual, or some outside cause?
    • Stable/unstable: will the result happen every time, or is it changeable or random?
    • Global/specific: does the result occur in every situation, or only in specific circumstances?

    The situation of Nigerian youths can be explained harnessing these concepts; many youths feel less competent in changing their unfavourable situations especially their perceptions of such situations. The belief is always that problems are out of their control and that they are passive and victims that can only endure or give up. The misery in Nigeria, domestic violence, school failures etc and the pains that are felt in response to those circumstances are believed to be fully influenced by the environment. Therefore they have no control to alter or ameliorate the situation. This could happen in part due to the way children are nurtured in Nigeria. Children grow up in a way that ignores their personal responsibility rather children are raised in a way that emphasizes conformity to customs and conventions totally drowning the children’s voices and putting aside their individualism. This eventually leads to an identity crisis, confusion, deficient cognition and other psychological impairment which finally leads to suicidal intent and act.

    Nigeria is filled with numerous individuals (leaders too) who operate on distorted thoughts, consequently faulty decisions are made which then continues to manifest obstacles in the society. Nigeria is known to battle with a colossal number of problems: unemployment, faulty structures, poverty, poor leadership, prejudice, a brutal government, crimes, insurgency etc. These problems are persistent and consistent due to wrong attempts to resolve the problems by just superficially dealing with the problems. The problems appear stable over time and across situations within Nigeria, this brings about helplessness and which consequently bring about suicidal ideation and probably the actual act.

    Our brains are wired in such a way that we create schema about our experiences which cause us to easily make assumptions or generalize. Therefore we believe that the world is responsible for the way we feel therefore any similar situation, that has even a paltry characteristic is linked to their painful feelings that they conclude that life generally is unfair so they deeply feel helpless and hopeless, once the pains accumulate and becomes so unbearable, death thoughts fill up their minds.

    Many people who attempt suicide have deficits in memory and problem-solving skills, even in comparison with non-suicidal depressed individuals (Schotte and Clum 1987).  These deficits may make it difficult for such individuals to cope with stressful circumstances effectively and more likely that they will use ineffective coping strategies, including suicide. According to the cognitive model of suicide developed by Rudd (2000), based on Beck’s model of emotional disorders and the clinical experience of Rudd;  the components of the underlying cognitive triad are description or the self as worthless, unloved, incompetent and helpless, others as rejecting, abusing, judgmental, and the future as hopeless. In contrast to depression, whereby unhappiness/sadness predominates, the suicidal individual may experience a range of emotions, including sadness, guilt and anger. Thoughts may be concentrated on taking revenge, but this will not directly result into suicidal behaviour. 

    Psychological constructs (thoughts and emotions) associated with suicide occur at the same time as increased levels of physiological arousal and agitation: the profoundly depressed non-aroused individual will not have the motivation to attempt suicide. Like the case in Nigeria where many youths are so agitated to give a thought to suicide. Risk of suicide varies over time, with periods of acute risk interspersed with lower levels of risk.  High levels of risk occur when multiple risk factors converge. These may include situational stress; such as socio-economic issues of the country, activation of negative schemata; school failures or broken relationships could activate repressed memories of abuse or negligence,  emotional confusion and deficient coping skills; lack of adequate skills in form of emotional intelligence.

    Here are the desperate words of a young graduate close to suicide,  for whom the events of many years previously held a continuing and damaging influence: “I just can’t go on . . .  I’m worthless . . .incompetent. . .I cannot move on. . . this makes me a loser and useless . . .That’s why I failed my exams.  I won’t ever succeed, No one cares about me because I am so foolish and dumb bad and I can’t keep trying to fit into this cruel world. No one is ready to help me, my parents won’t accept nor love me because I am a failure. I can’t help my younger siblings, all my friends are doing great, I am so unfortunate and my existence in this world is meaningless and burdensome to my loved ones. I have tried to change my situation, but things get worse by the day. Without my presence, everyone will have peace, by the way, I am considered useless. They’ll get along without me.  They don’t need me.  I make them unhappy and when I am gone they will be happy again.  They don’t deserve to have me pulling them down, making them unhappy. I feel so terrible and weak, nothing I do is productive or appreciated. There is no job nor help to sustain myself. That’s why the best thing to do is to kill myself . . .  end my misery and theirs.”

    A suicidal act is directly linked to distorted thoughts which activates the sympathetic nervous system that consequently incites physiological arousal accompanied by acute mental pains. To resolve suicidal issues, the thoughts of victims must be influenced to restructure their thought process and replace maladaptive thoughts with functional thoughts. In addition to this, these individuals have formed their identity in their attachment to others and their acceptance therefore when they perceive that others have left them or may not accept them because they do not meet up with the conditions, they may feel so agitated that suicidal thought tends to soothe their mind. Meanwhile, they impulsively respond to their thoughts and that has become so ingrained that every thought and its proportional emotion lead to actions that corroborate such thoughts and emotions.

    Related article: What your personality says about your vulnerability to substance abuse

    Aaron Beck Cognitive Approach to Suicide

    In addition to the emotional distress experienced in psychiatric disorders, there are disorders/abnormalities in thinking and reasoning, collectively called cognitive disturbances. Dr. Beck described two types of cognitive disturbances observed in suicidal people. There are cognitive disturbances that occur temporarily (for a transient period of time) and resolve when other symptoms of the psychiatric disorder diminish. These are referred to as “state” cognitive disturbances. Trait cognitive disturbances are those which remain relatively constant, even when other symptoms have diminished or resolved. Dr. Beck found that hopelessness—unwavering pessimism even in the face of contrary evidence; is one such cognitive distortion expressed both in state and trait forms in suicidal people. He also found that state hopelessness is more often associated with suicidality in people with a borderline personality disorder, and that trait hopelessness is more frequently associated with depressive disorders.   

    In his past study, Dr. Beck reported robust differences in the suicide rate and the clinical course of suicidal behaviours depending on the diagnosis of borderline personality disorder. In a prospective study of patients admitted to a hospital emergency room for a suicide attempt, Dr. Beck found that a diagnosis of personality disorder was associated with an 8.2% risk of suicide during 5 years of follow-up, as compared to 4.6% in those diagnosed with depression with no personality disorder. He also noted that approximately 99% of those who attempted suicide during the follow-up period of this study, qualified as having an affective disorder at the time, including those diagnosed with a personality disorder. Dr. Beck described that the clinical hallmark of borderline personality disorder is an emotional disturbance in response to minimal, or perceived, environmental stimuli, with heightened sensitivity to abandonment.

    Emotional modulation, inhibition, controls, and coping skills are inadequate in these patients. They are not able to maintain normal mood states (euthymia), in other words not depressed, nor excessively elated. They experience little or no control over their depressive and suicidal feelings due to their distorted thought patterns. Eighty percent of the people with borderline personality disorder in the study also had substance abuse problems, as opposed to 65% of those people who did not have this diagnosis.

     People with personality disorders often experience emotional instability and intense distress therefore suicide occurred at times of acute distress. He reported that cognitive therapy significantly reduces suicides and suicide attempts in patients with borderline personality disorder. As little as 10 weeks of therapy would be effective; the therapy will help restructure the destructive and maladaptive thought patterns that increase the release of cortisol or other physiological responses that put a person at high risk of ending their lives in attempts to put a stop to their seemingly endless psychological pains

    According to Dr. Beck, suicide attempts related to depression occur at times of severe depressive symptoms. These episodes of severe depression reflect profound hopelessness and generalized cognitive distortions. Individuals who survive a suicide attempt can have their condition of depression significantly managed and alleviated and of course  achieve a euthymic state again, although the hopelessness persists for a particular number  of these individuals. Dr. Beck reported that cognitive therapy significantly mitigates hopelessness and has more effectivenessthan imipramine (an antidepressant medication).

    Dr. Beck also reported that cognitive therapy “has an essential impact on suicide ideation, as well as hopelessness, and not necessarily influenced by placebo.” Different studies in different countries, according to Dr. Beck, show that cognitive problem-solving techniques significantly reduce the  number of suicide attempts per month, and delay the period of time to next attempt. In summary, according to Dr. Beck, cognitive therapy is effective in reducing suicidal behaviours in two disorders, borderline personality disorder and depressive disorder. Cognitive distortions are simply our thought patterns that involve the mind convincing us of something that isn't really true. These maladaptive/inaccurate thoughts usually work to reinforce negative thinking or emotion which actually only exist to keep us feeling bad about ourselves. Cognition is the ultimate aspect of the mind which influences our actions, whenever it is filled with negative or faulty thoughts, we experience many problems which might lead to suicidal ideation or behaviour. The alleviation of suicide, according to Dr. Beck, is resolved through altering/mitigating the cognitive distortions and/or replacing with more constructive thoughts; e.g., learning coping skills to reduce the negative effects of faulty beliefs; by replacing the negative thoughts and often adopting mindfulness.

    As stated earlier, the behavioural problems of youths in Nigeria resulted from faulty socialization which leads to the formation of unhealthy personalities that then become predispose them to suicides and other problems. Many youths in Nigeria through a survey reported unhealthy personality constructs.

    Strain Theory

    This theory proposes that competing and conflicting pressures in an individual’s life will generate strain, that noticeably manifests as perceived tension, strain, and worry, often outside of conscious awareness. In excess, the resulting distress can become so unbearable that the victim typically seeks  a way out to put a stop to their painful experience. For some people, suicide could be seen as an absolute remedy  to flee these conflicting strains. The Strain theory of suicide was developed on the basis of the existing theoretical framework of deviant behaviour. Durkheim’s notion of anomie, Merton developed his anomie theory of deviance based on the notion of anomie raised by Durkheim, he believed that individuals were anticipated to become successful through “outdoing” others within a competitively structured society.

    However, deviant behaviour is influenced by society because it establishes the rules promoting this personal pursuit of “success” on the other hand fails to supply the means and opportunities needed to achieve this success. With this contradictory/conflicting environment of high aspirations and lack of standard means for achieving fulfilment and or success, individuals would experience  massive personal pressure, and thus would have little choice but to reflect deviant behaviours as a coping strategy for this strain. Because of this, Merton identified strain within the social organisation instead of on  the individual level.

    Based on the idea of Merton’s theory of deviance, Agnew proposed a more General Strain Theory which changes the main target to a more individual level. Here, deviant behaviour is viewed as the overt expression of negative emotions, such as depression, anger, and frustration, which are suffering in response to strains. Thus, suicide as a covert deviant behaviour could epitomise a means to flee despair and hopelessness feelings  of perceived strain and pressure.

    It should be noted that strain in this theory  comprised of a minimum of two sources of competing for pressure, and not just the experience of a single unpleasant experience (i.e., it's not just a particular one source  of daily challenges such as stress from work or home). For instance, if the two social facts are non-contradictory, there would be no onset of strain. An instance is, when we encounter pressure at school it might be from countless homework to be submitted within a particular time frame, or could be from some disagreement with a colleague or lecturer; all these are singular sources of stress and thus not strains. A strain within this context would result from a minimum of two conflicting social factors, such as pressure to date the lecturer to get good grades or complete the same numbers of assignments from more different lecturers (when the course you are studying was initially forced on you) all through the school session. With this, we will understand that strain is more frustrating than simple daily challenges/hassles, and the argument has been made that in additional extreme instances, the consequential negative emotional responses for a number of individuals can be so intense, painful or unbearable that it could increase predispose them more to committing suicide. Recent ideas in strain theory suggest that a strain could result from one or quite more of the below four kinds of conflicts:

    (1) Differential values- This is when two contradictory  social values or beliefs exist in an individual's lifestyle at an equivalent time, the person would undergo value strain. For instance, in Nigeria, wealthy criminals and brutal political leaders are highly respected yet moral acts are highly valued. If these two opposing values (corruptive achievement, moral) hold an identical level of importance during a person’s life, that individual will experience intense strain. But if one value is more important than the opposite, there would be little or even no strain. There is a significant clash of several values in Nigeria. What we preach or instruct  children differ from what we practise or reflect. Telling a child to be patient and calm, however, this child observes that his or her parents are always fighting with either each other or others, or the child is continually exposed to each war movies. Children learn vicariously, they watch what adults practically do and the consequences of such behaviours are focused on as well. There is also attention they pay to synchronous movement, whereby seeing that many people around them practically exhibit particular acts will motivate them to do the same.  Another problem is many of our values are not well defined and communicated especially practically.

    (2) Disparity between aspiration and reality - The existence of incongruity between an individual's desires/goals and the actual reality in which the person lives, leads to the person having an experience of aspiration strain. For example, many people develop an ideal of achieving success in some aspects of life, such as a career; completing university and then secure job. However, there are many factors, such as lacking social status, poor academic performance, and lack of job opportunities that might hinder this from happening. As a result, their actual self in reality (being a graduate) would come into conflict with their aspirations (get a job, own a house, take care of their family) and thus create strain.

    The greater the gap between aspiration and reality, the greater the strain. For instance a person that fails his exams and aspires to be a graduate with an amazing job may feel really bad and hopeless and might consider no other alternative but suicide. There is often a wider gap because many youths lack the abilities and are ignorant of the effective means to reduce the gap to feel more at peace. Some people have unrealistic aspirations and also are not aware of their ideal-self due to lack of self-analysis and mindfulness. Our aspirations are believed to be our heaven but are often created not according to our true desires but based on expectation and conformity to the outside world. As a result, sometimes when some of these aspirations are realized, we may still feel really anxious, this prompts some people to give up because they discover it’s not necessarily about achieving those things.

    (3) Relative deprivation-when an economically poor individual perceives that others from identical background have attained greater wealth and resources, they may experience deprivation strain. This strain occurs in response to the interpretation that, relative to others, they have not acquired resources that are obtainable, and perhapse that they are “owed”, this could then be an impetus for strain. In contrast, when an individual is not aware of the success or status of others in their group, or if they believe they have achieved appropriate resources, they will not feel deprived in relation to similar others. As the perception of deprivation intensified, the level of strain simultaneously increased This explains why a number of people who often use the social media experience strains because they get to see other seemingly successful people and conclude that they are unfortunate.  For example, a person with failed relationships may get to see love birds online, a person that is academically poor might get to see a successful graduate etc.

    (4) Lack of coping skills for a crisis-when confronting a life crisis, some people are not able to deal with, or adapt to stress effectively, leading to coping strain. The experience of a life crisis, such as loss of money, end of a relationship, or death of a loved one, is not uncommon. But the crisis on its own is not enough to generate strain. Rather, strain results only under circumstances where the individual does not have the skills (especially coping skills)  to deal with the events effectively.  Those with poorer coping skills have more intense experiences of coping strain.  Many Nigerians are so unconscious and narrow-minded that they do not even see a need to acquire soft (coping) skills to aid their thought process, improve their emotional intelligence and promote their relationships. One of the important thing to learn is that they need to stop using a faulty standard for measuring their success. They need to acknowledge and embrace the uniqueness of every individual and be more open-minded and less impulsive.

     The strain theory of suicide proposed that suicide is usually preceded or incited by psychological strains. A psychological strain is formed by a minimum of two stresses or pressures, pushing the individual to different directions. Strains are often a consequence of any of the four conflicts: differential values, a discrepancy between aspiration and reality, relative deprivation, and lack of coping skills for a crisis. Psychological strains in the form of all the four sources have been supported with a sample of suicide notes that are shared on social media. However, it appears that lack of coping skills coupled with at least one of the four conflicts results in suicide. More so, a typical Nigerian would have experienced at least three of the conflicts (if not the four). This theory also explains why men commit suicide more than females because of the ascribed roles and pressures placed upon men when they have low abilities and skills to meet up with the expectations due to lack of opportunities or economic advantages. Women are sometimes nurtured in ways to deal with challenges and to express their true feelings, this imbibes certain coping skills in them. Women easily admit their need for help therefore they easily get one to improve their well-being in all sense of it. Indeed, strain theory provides profound insight into the social influences that could predispose or precipitate suicidal intents and or attempts. This insight may aid in policy-making as regards necessary intervention to mitigate rate of suicide in Nigeria.

    Check out another article that examines suicide from biological, pschodaynamic and socio-cultural perspective.

    References

    Abramson, L., Seligman, M., & John, D. (1978) Learned helplessness in humans: Critique and reformulation. Journal of abnormal psychology, 87(1)41

    Beck, A., Steer, Robert A., Beck, Judith S. & Cory F. (1993). "Hopelessness, Depression, Suicidal Ideation, and Clinical Diagnosis of Depression". Suicide and Life-Threatening Behavior. 23 (2): 139–145. .

    David, E., & George, A. (1987) Problem-solving skills in suicidal psychiatric patients. Journal of consulting and clinical psychology 55 (1), 49.

    Durkheim, E. (1951). Suicide.Translated by Spaulding, J. A. & Simpson G.New York: The Free press

    Merton, R. K. (1957). Social Theory and Social Structure. New York, NY: The Free Press

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