Bridging the Gap: Exploring Spirituality in Suicidology

1. We must at all times remember, that the decision to take your own life is as vast and complex and mysterious as life itself. Al Alvarez, The Savage God

2. A Role for Spiritual Self-Enquiry in Suicidology? • originally wanted to interview other survivors • in particular, to look for spiritual themes in their stories • Ouch! • ethics approval (psychology) would be impossible • especially with my background! • Solution: • move out of psychology ... to “social sciences” • work solely with my own story • not as data but as “analytical tool” or lens • to examine suicidology for any critical gaps in the discipline

3. Suicidology • Comprehensive Textbook of Suicidology(2000) • Maris (psychiatrist), Berman (psychologist) and Silverman (psychiatrist) • “the science of self-destructive behaviors” • “surely any science worth its salt ought to be true to its name and be as objective as it can, make careful measurements, count something” • “suicidology has to have some observables, otherwise it runs the danger of lapsing into mysticism and alchemy” • Prevention of depression and suicide: Consensus paper, • Wahlbeck K. & Mäkinen M. (Eds). Luxembourg: European Communities, 2008 • “Suicide is primarily an outcome of untreated depressive illness”

4. Suicidology – What’s missing? • First-person voice – almost absent • even less than in mental health more generally • (though social factors are stronger – sociology one of three “parent disciplines” of suicidology along with psychology and psychiatry) • “suicide survivor” = bereaved by suicide (Aust, US) • Spirituality – totally absent • Comprehensive Textbook of Suicidology – preface: • the only mention of spiritual values/needs in 600+ pages is: • “the immense intellectual and spiritual debt that we all owe to our mentors and friends” ... to write this book! • (religion mentioned as protective factor – sense of community)

5. The Spirituality Gap “the ever-present and persistent gap between the patients who report that ‘spirituality’ is an important element in their personal identity and mental health, and doctors who have no way of entering, at least professionally or ‘legitimately’, into this spiritual language and terminology” David Tacey, The Spirituality Revolution (p201)

6. Re-thinking Suicide as a Crisis of the Self • Suicide is best understood as a crisis of the self: • ‘sui’ in suicide, both victim and perpetrator • closer to the lived experience • encompasses whole person – physical, mental, social/relational and spiritual • immediately raises important questions that suicidology largely ignores, especially … • who or what is this ‘self’ that is in crisis? • which invariably, one way or another, leads us to spiritual territory (for want of a better word) • Suicidology defers to its “parent disciplines” for concepts of self • i.e. does not examine most central concept for the discipline

7. A PhD in two volumes • Thinking About Suicide • first-person narrative • two voices – narrative and commentary • phenomenological “thick description” (Geertz) • plain language call for broad community conversation • Exegesis • Phenomenology of Suicidality • Anthropology of Suicidology • Integral Suicidology • Bridging the Spirituality Gap (appendix)

8. Preface: Let’s Talk About Suicide 1. My Suicidal Career and Other Myths 2. What Is It Like To Be Suicidal? 3. The Drug Addiction Detour 4. The ‘Mental Illness’ Circus Interlude: Who Am I? 5. Spiritual Self-Enquiry 6. The Willingness to Surrender 7. This Is Enough [ Epilogue: Who Are We? ] www.thinkingaboutsuicide.org

9. A PhD in two volumes • Exegesis • Phenomenology of Suicidality • Anthropology of Suicidology • Integral Suicidology • Bridging the Spirituality Gap (appendix)

10. Integral Model - 4 Quadrants External (visible) Internal (invisible) Individual Subjective Objective Behavioural (observable) Intentional (felt experience) Phenomenology Consciousness Studies Narrative Research Biology (medicine) Neuroscience (psychiatry?) Psychology (psychiatry?) Interobjective Intersubjective Collective Social (systems) Cultural Anthropology Ethnography Hermeneutics Sociology Epidemiology Ecology, Economics

11. Integral Model - 4 Quadrants Third-Person First-Person Singular Subjective Objective Behavioural (observable) Intentional (felt experience) Phenomenology Consciousness Studies Narrative Research Biology (medicine) Neuroscience (psychiatry?) Psychology (psychiatry?) Plural Interobjective Intersubjective Social (systems) Cultural Anthropology Ethnography Hermeneutics Sociology Epidemiology Ecology, Economics

12. In theory there’s no difference between theory and practice, but in practice, there is. Anonymous

13. Integral Model - 4 Quadrants Third-Person First-Person Singular • Observable behaviour • biology (brain) • diagnosis/treatment • clinical • risk assessment • behavioural psychologies • Lived/felt experience • personal, private • stories, self-talk, dreams • hope, purpose, meaning • ‘consumer’ perspective • ‘depth’ psychologies Plural • Mutually shared experience • shared meaning-making • collective story-telling • peer support • consumer delivered • services • Social infrastructure • hospitals, services etc • public policies, laws etc • workforce, training etc • social work • media

14. Spirit Soul Mind Life Matter ----------Physics Biology Psychology Theology Mysticism Integral Model – Levels of Consciousness Sources: Plotinus Aurobindo St. Teresa Grof Steiner Baldwin Habermas Maslow Buddhism Yoga Kabbalah Vedanta Theosophy Sufism Non-Dual Spirit

15. Singular Plural Holistic = All Quadrants, All Levels (AQAL) Third-Person First-Person Behavioural (IT) Intentional (I) Cultural (WE) Social (ITS)

16. How holistic is suicidology?

17. Singular Plural Gaps in Suicidology? Third-Person First-Person Behavioural (IT) Intentional (I) Cultural (WE) Social (ITS)

18. Singular Plural Gaps in Suicidology? Third-Person First-Person Behavioural (IT) Social (ITS)

19. Flatland “the great nightmare of scientific materialism was upon us (Whitehead), the nightmare of one-dimensional man (Marcuse), the disqualified universe (Mumford), the colonisation of art and morals by science (Habermas), the disenchantment of the world (Weber) – a nightmare I have also called flatland” Ken Wilber, Integral Psychology

20. Suicidology re-visited – dissenting voices 1 • Professor Edwin S. Shneidman • Psychache – “psychological pain that stems from thwarted or distorted psychological needs” • “the keys to understanding suicide are made of plain language … the proper language of suicidology is lingua franca – the ordinary everyday words that are found in the verbatim reports of beleaguered suicidal minds” • “It is the words that suicidal people say – about their psychological pain and their frustrated psychological needs – that make up the essential vocabulary of suicide. Suicide prevention can be everyone’s business”

21. Ed Shneidman on Biopsychiatry “No branch of knowledge can be more precise than its intrinsic subject matter will allow. I believe that we should eschew specious accuracy. I know that the current fetish is to have the appearance of precision – and the kudos and vast monies that often go with it – but that is not my style. Nowadays, the gambit used to make a field appear scientific is to redefine what is being discussed. The most flagrant current example is to convert the study of suicide, almost by sleight of hand, into a discussion of depression – two very different things.” DSM = “specious accuracy built on a false epistemology”

22. Dissenting Voices 2 – The Aeschi Group • Problems In Clinical Practice • even in the case of a severe depression, it is not the disorder itself, which initiates the suicidal act, but the "owner" of the depression, the individual itself • a striking discrepancy between patients' explanations of suicide attempts and those of examining psychiatrists • What's New: A Patient-oriented Approach • the patient's experience is conceptualized as the "gold standard“ • the patient's narrative is the basis of a shared understanding • 6th Aeschi Conference, March 20-23, 2011, Aeschi, Switzerland • Patient-oriented concepts of suicide: Trauma and Suicide • www.aeschiconference.unibe.ch

23. Do our mental health laws help or hinder suicide prevention? • scares people off from seeking help • can worsen or trigger suicidality • do they save lives or cost lives? • a gruesome calculation – what is an acceptable ratio? • primary source of “stigma” – i.e. discrimination • involuntary detention versus involuntary treatment • social model of disability – esp. human rights • replace Mental Health Act with Suicide Prevention Act • a question/challenge for the (LL) village ... • It Takes A Village To Prevent A Suicide

24. Singular Plural All Quadrants, All Levels (AQAL) = Holistic Third-Person First-Person Behavioural Intentional Suicide Prevention Cultural Social

25. May your psychache be minimal Professor Edwin S. Shneidman www.thinkingaboutsuicide.org

26. Further topics ... • Consciousness Studies – Chalmers, Varela etc • Phenomenology – Husserl, Zahavi etc • “a consensus seems to have emerged that Thomas Nagel’s expression ‘what it is like to be’ succeeds in capturing well what is at stake here” (Varela) • First-person research – data, methods etc • Concepts of self – see “Who Am I?” • “The Death of the Self in a Postmodern World” (Connie Zweig) • from the divided self (Freud, James) to the thoroughly deconstructed postmodern ‘fragmented self’ • Spirituality • Human rights – disability, social model etc

27. Consciousness Studies Genuinely multi-disciplinary – includes philosophy, neuroscience, psychology, psychiatry, cognitive science, computer science (AI), sociology, cultural studies etc etc ... spiritual wisdom traditions! “a consensus seems to have emerged that Thomas Nagel’s expression ‘what it is like to be’ succeeds in capturing well what is at stake here” (Varela) “sometimes terms such as ‘phenomenal consciousness’ and ‘qualia’ are also used here, but I find it more natural to speak of ‘conscious experience’ or simply ‘experience’” (Chalmers)

28. The ‘Hard Problem’ of Consciousness (Chalmers) “The really hard problem of consciousness is the problem of experience … subjective experience is just one other natural phenomena that each of us has as biological beings” “a major research problem even for a neuroscientist - they found themselves having to attend to this question of subjective experience whether they wanted to or not” “There is an explanatory gap between the functions and experience, and we need an explanatory bridge to cross it” Varela: “A large body of modern literature addresses the ‘explanatory gap’ between computational and phenomenological mind”

29. The ‘Hard Problem’ of Consciousness (cont’d) “To deprive our scientific examination of this phenomenal realm amounts to either amputating life of its most intimate domains, or else denying scientific explanatory access to it. In both cases the move is unsatisfactory.” (Varela)

30. Consciousness and Traditional Science “It would be wonderful if reductive methods could explain experience too; I hoped for a long time that they might. Unfortunately, there are systematic reasons why these methods must fail” (Chalmers) “An analysis of the problem shows us that conscious experience is just not the kind of thing that a wholly reductive account could succeed in explaining” (Chalmers) 1. Neuro-reductionism: deny the phenomenon 2. Functionalism: explain something else (e.g. behaviour) 3. Mysterianism: the ‘hard’ problem is unsolvable 4. Non-reductionism: irreducibility of consciousness/experience

31. The Irreducibility of Consciousness “I’ve come to the view, fairly reluctantly, … that you can’t wholly explain subjective experience in terms of the brain … you need to actually take something about subjective experience as irreducible, just as a fact of the world and then study how it relates to everything else” (Chalmers) “A theory of consciousness should take experience as fundamental … as a fundamental feature of the world, alongside mass, charge, and space-time” (Chalmers) “lived experience is irreducible, that is, that phenomenal data cannot be reduced [to] or derived from the third-person perspective” (Varela)

32. First-Person Data Varela: “lived experience is where we start from” … which requires ... “an explicit and central role to first-person accounts” … because ... “first-person data concerning subjective experiences are directly available only to the subject having those experiences” Chalmers: “the distinctive task of a science of consciousness is to systematically integrate two key classes of data into a scientific framework: third-person data about behaviour and brain processes, and first-person data about subjective experience” “both third-person data and first-person data need explanation”

33. First-Person Data(cont’d) Varela: “A satisfactory science of consciousness must admit both sorts of data, and must build an explanatory connection between them” … and so ... “the moral is that as data, the first-person data are irreducible to third-person data, and vice versa”

34. First-Person Methods - verbal reports “by far the most straightforward method for gathering first-person data relies on verbal report” • problems: • difficulties verbally describing experiences • e.g. of listening to music • they require language • e.g. not possible with infants, non-humans, also fluency • accuracy and reliability of subjective reports • e.g. memory, honesty • interpretation can be corrupted by theory • e.g. “the illness speaking”

35. First-Person Methods “should take first-person data seriously, and should proceed by studying the association between first-person data and third-person data, without attempting a reduction” (Chalmers) “our methods for gathering first-person data are quite primitive, compared to our methods for gathering third-person data … the former have not received nearly as much attention” (Chalmers) “first-person methodologies are not quick-and-easy. They require a sustained dedication and interactive framing before significant phenomenal data can be made accessible and validatable” (Varela)

36. Formal First-Person Methods • Introspectionist psychology • “We need to give back to introspection the good name that it had before the 19th-century psychologists Wundt and Titchener ponderously trivialized it.”(Edwin S. Shneidman) • Phenomenology • “the subjective is intrinsically open to intersubjective validation, if only we avail ourselves of a method and procedure for doing so” (Varela) • Eastern meditative traditions • “It would be a great mistake of western chauvinism to deny such observations as data and their potential validity.”(Varela)

37. David Chalmers (Consciousness Studies): first-person data are “data about subjective experiences that are directly available only to the subject having those experiences” “The distinctive task of a science of consciousness is to systematically integrate two key classes of data into a scientific framework: third-person data about behaviour and brain processes, and first-person data about subjective experience” “our methods for gathering first-person data are quite primitive, compared to our methods for gathering third-person data … the former have not received nearly as much attention” “a major research problem even for the neuroscientist – they found themselves having to attend to this question of subjective experience whether they wanted to or not”

38. Francisco Varela (neuroscientist): “to deprive our scientific examination of this phenomenal realm amounts to either amputating life of its most intimate domains, or else denying scientific explanatory access to it. In both cases the move is unsatisfactory” Varela & Shear, The View From Within

39. Chalmers and Varela on Spirituality The Buddhist traditions and other contemplative traditions have a lot to offer … these guys have been studying subjective experience for many years from the inside, they’ve been gathering what we might call the first person data about the mind David Chalmers it would be a great mistake of western chauvinism to deny such observations as data and their potential validity Varela & Shear