CHAPTER I

THE PROBLEM AND ITS BACKGROUND

Rationale

The term suicide, derived from the Latin word suicidium, is defined as the act of

intentionally taking one’s own life. This action often stems from the deep feeling of hopelessness

and being unable to create solutions for one’s experienced problems, which then results to the

victim seeing suicide as the only option left to solve the situation. However, these suicidal

behaviors must also be properly distinguished from other self-harming and self-injurious acts,

which may also be considered, but are not directly intended to cause one’s life to end. Self-

harming behaviors area form of mutilation through intentionally hurting oneself but may possibly

result in accidental suicide once they are taken too far, but their main intent is not suicidal.

Back in time, during the antiquity and Middle Ages, the pagans were not against the act

of suicide. The Council of Arles in 452 even stated, “If a slave commits suicide no reproach shall

fall upon his master.” In Rome, it was acceptable to commit the act of killing oneself as long as

they do not fall among the three special cases: those accused of capital crimes, soldiers and

slaves. It was considered forbidden and uneconomic for these people to die. Nevertheless, there

were philosophers who were against the suicidal acts. An example would be Pythagoras, he

believed that balance must be maintained in the world for there was only a finite number of souls,

an unexpected departure will destroy the balance. As time passed, the attitude of most people

towards suicide began to change. During Renaissance, Thomas More wrote in Utopia (1516)

“free himself from this bitter life… since by death, he will put an end, not to enjoy but to torture…it

will be a pious and holy action.” While in the work of John Donne’s Bianthanatos was the

1
opposite, he stated his defenses using Biblical figures and presented arguments that suicide

acts must be taken seriously and nature to sanction in certain circumstances. Centuries continue

to pass, the ideas of the people regarding this behavior became more diverse yet open, but the

act of suicide still has not come to stop until the present date, instead, it continues to increase.

The World Health Organization estimates that approximately one million people die from

suicide each year. This represents a global mortality rate of 16 people per 10,000 or one death

every 40 seconds. By 2020, it is predicted that the rate of death will increase to one every 20

seconds. Suicide rates during these last 45 years have increased 60% worldwide and are also

among the three leading causes of death with those aged 15-44 both in male and female. The

continuous increase of suicide rates among young people has been very alarming to the extent

that they are the group who are at the highest risk in a third of all countries. In Europe, the highest

suicide rates are reported for both men and women and nearly 30% of all suicides worldwide

occur in India and China.

In the Philippines, the suicide rate is most likely much higher now since many who suffer

from depression hesitate in seeking help. On the Seventeenth Congress in Manila, Monday of

July 24, there was a new law that was introduced. Republic Act no. 11036. It is “An act

establishing national mental health policy for the purpose of enhancing the delivery of integrated

mental health services, promoting and protecting the rights of persons utilizing psychiatric,

neurologic and psychosocial health services, appropriating funds therefor, and for other

purposes.” This was the very first legislation to recognize the fundamental right of all Filipinos to

mental health services so it was praised. But locally, last 2016, an official of Vicente Sotto

Memorial Medical Center (VSMMC) stated, “Cebu has the highest number of suicide cases in

the country” and he also added that the number is very alarming. In the hospital’s psychiatric

2
department, specializing in attempted suicide cases and mental health care, in a month received

more than 30 referrals from other departments of the hospital.

Suicide rates which continue to rise up until the current time gives us the reason to why

there is a need to study about this. Proof would be the World Health Organization’s statistical

reports, wherein suicide became part of the leading causes of death and most especially their

prediction that on 2020 the rate of death caused by suicide will be increasing. Researchers

believe that a way to decrease the rate of the suicides is to understand more on the perspectives

of the people who suffer from the suicidal thoughts which may result in doing the act. Gaining

deeper knowledge about their sides will help the population, who are willing to help in decreasing

the rate of suicide victims, in noticing those who are in need of help, since suicide gets it to power

from being invisible. Understanding deeply about their side can also give more hint on how to

comfort them, to talk to them and to be able to properly reach out to them and save them from

what they are suffering from. That way, many lives would be saved and more future could be

created that will surely contribute to the future of society.

Theoretical Background

This study is anchored on the Interpersonal-Psychological Theory of Suicidal Behavior by

Thomas Joiner which is supported by the theories of Edwin Shneidman, Aaron Beck and Emile

Durkheim.

The Interpersonal-Psychological Theory of Suicidal Behavior (Joiner, 2005) proposes that

an individual will not take his or her own life unless that person has both the desire and ability to

do so. This theory answers the basic questions, needed for people to gain a deeper

understanding in regards to the act of suicide, which are stated:

3
 Who are the people that desire suicide? The theory states that when people take in two

specific psychological states in their minds simultaneously, and this continues for a long period

of time, they will develop the desire of dying. These two psychological states are the perceived

burdensomeness and thwarted belongingness or social alienation. Perceived burdensomeness

is the view that the existence of oneself causes burden towards the family, friends and the

society itself. This view creates the idea within the individual that his or her death will be worth

more than his or her life, a view that represents a possible fatal misperception. Social alienation

or the low sense of belongingness is the experience that one is being pushed away from others,

not an important part of a family, a group of friends or another valued group.

What is the ability to die by suicide? Protecting oneself from harm or death is a powerful

enough instinct that few can overcome through force of will, and those few people who can have

already developed fearlessness of injury, pain and most especially death which according to the

theory is acquired through the process of repeatedly going through painful experiences which

causes it to be triggered. These experiences commonly include previous self-injury, repeated

accidental injuries, numerous physical fights and the like.

In correlation with our study, which tackles about the perspective of the suicidal victims in

order to gain a deeper understanding of self-destruction, since the theory of Thomas Joiner gives

the psychological causes of the victim’s side, it contributes a concrete base of information that

can provide an avenue for the research to be elaborated further to achieve the desired answers

for the study.

The Interpersonal-Psychological Theory of Suicidal Behavior by Thomas Joiner is

supported by the theory of Edwin Shneidman, the Psychache Theory. He presents a bold and

simple premise: “Suicide is caused by a certain kind of psychological pain called “psychache.”

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Shneidman coined the term “psychache” and is defined as the unbearable psychological and

emotional pain that reaches intolerable intensity. Psychache is intolerable because it results from

basic needs that have been thwarted. (Shneidman, 1985) He proposed an extensive list of basic

needs, ranging from “affiliation” to “shame avoidance” to “order and understanding.” Through

this researchers proposed that the need to belong is the need central to the development of

suicidal desire, consistent with the findings linking social connectedness to suicidal behavior,

which can be related to Joiner’s concept of belongingness. In connection with our study,

Shneidman also stated a possible solution and key to preventing suicide. It is not so much about

the study of the brain, social statistics or mental diseases as it is the direct study of human

emotions. To treat a suicidal individual, there is the need to identify, address and reduce the

individual’s psychache.

Another theory which supports the Interpersonal-Psychological Theory of Suicidal

Behavior is the theory of Aaron Beck. In this theory, he emphasizes the role of hopelessness.

Beck studied people suffering from depression and found that they appraised events in a

negative way. He was able to identify three mechanisms that he believed were responsible for

depression: The cognitive triad of negative automatic thinking, negative self-schemas, and errors

in logic. The cognitive triad consists of three forms of negative thinking namely negative thoughts

about the self, negative view of the world and negative view of the future, wherein these three

can be related to Joiner’s concept of burdensomeness. The negative self-schemas are sets of

essentially negative and pessimistic beliefs and expectations of one’s own self which are usually

acquired during childhood as a result of a traumatic event. This can be related to Joiner’s concept

of belongingness since common causes of negative self-schemas are Death of a parent or

sibling, parental rejection and criticism, and bullying at school or exclusion from the peer group.

5
Lastly, logical errors in thinking. These systematic negative bias in information processing can

cause illogical thought patterns can result in great anxiety and depression towards an individual.

In relation to the Interpersonal-Psychological Theory of Suicidal Behavior, hopelessness

in belongingness and burdensomeness is required, together with the capability which is acquired

and results in serious self-harm. The individual goes through an escalating course of suicidal

behavior over time through habituation and in the end, will be fearless of death and gain the

greater possibility of doing a lethal act or suicide.

Lastly, the theory of Emile Durkheim. According to him “Suicide is not an individual act

nor a personal action. It is caused by some power which is over and above the individual or

super individual.” He viewed “all classes of deaths resulting directly or indirectly from the positive

or negative acts of the victim itself who knows the result they produced.” Having defined the

phenomenon, Durkheim emphasized collective social forces and dismissed other factors, most

especially the theory of many doctors and psychologists that people who commit suicide are in

a pathological state. He concludes that social disorganization or lack of social integration will

result in suicide. Thus, Durkheim classified different types of suicide based on different types of

relationship between the victim and the society.

He classified it into four different types. First is the “Egoistic suicide” wherein the victims

feel like they do not belong to society. They feel socially isolated or has no place in society. This

type of suicide can be related to Joiner’s concept of belongingness. The second type is the

“Altruistic suicide” which is defined as the type of suicide which occurs due to excessive

integration which leads the victim to lose his or herself and commit to a larger goal. Altruistic

suicide is similar to Joiner’s concept of burdensomeness. The third is the “Anomic suicide” and

this is the type which is caused by the sudden changes in the social position of an individual in

6
the society or due to a certain breakdown of social equilibrium. Lastly, “Fatalistic suicide”. This

occurs among people who live overregulated and unrewarding lives.

In conclusion, the correlation of each of the supporting theories to one another and rotates

around one theory, The Interpersonal-Psychological Theory of Suicidal Behavior, which serves

as the foundation of our study that focuses on the causes, impacts and possible solutions of

suicide as we get to understand more about the perspective of the suicidal victims. Through the

theories, it can give us an overview of the parts that are part of our study and the limitations of

our study. The theories also help in identifying the parts that are in need of further research,

clarifications and understanding for us to come up with conclusions and answers for our own

study. Thomas Joiner’s theory of suicidal behavior, which we connected to the theories that

support it, identifies many factors that researchers should assess and target to deeply

understand more about this serious issue.

7
Statement of the Problem

This study aimed to gain a deeper understanding of self-destruction by identifying what

triggers the act of suicide, the impacts on the victims and the possible solutions to reduce the

people who perform the act. The results of the study would be the basis for the proposed

Awareness Campaign.

Specifically, the study sought to answer the following questions:

1. What is the perspective of the suicidal victims in terms of:

1.1 its causes;

1.2 its impacts on the individuals; and

1.3 their possible solutions?

2. What relationships are observed between and among the following factors that result in

suicide:

2.1 Psychological; and

2.2 Interpersonal?

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 3. How does the identified cause affect the level of impacts to the suicidal victims which

results in them to push through the act of killing oneself?

4. Based on the findings, what can be the content of the Awareness Campaign to be

performed?

Hypotheses

The following statements are hypothesized by the researchers:

1. The reason why people attempt suicide revolves around the “thwarted belongingness”

and “perceived burdensomeness”. When individuals experience the severe feeling of

being a burden and alienated from other people, which causes a severe feeling of

emotional pain and depression, which leads to negative thinking about oneself and one’s

own life results to self-destruction.

2. The thoughts distract the suicidal victims from their everyday lives which disturb their

performances of their daily routines.

3. The best way to decrease the rate of suicide is to show concern and ask the people who

are showing symptoms of being suicidal. Ask them regarding their feelings and their

thoughts because showing them that there are people who care for them would decrease

their will to kill themselves.

4. The consecutive negative ideas about oneself and the negative relationships with other

people, either about being useless or being a burden, are the two main connections

observed between the psychological and interpersonal state of mind of a person that

results to suicide.

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 The different causes of self-destruction also have a different level of impact to the individual,

which either results in them to have suicidal ideation, self-harm or suicide attempts,

depending on what which of the causes the victim experienced.

Scope and Limitations

This study shall focus on the perspective of the suicidal victims in terms of the causes,

impacts and possible solutions that they can give based on their experiences. The suicidal

victims may either have overcome their suicidal thoughts, self-harm or suicide attempts or may

still be in the progress of overcoming it. But before the researchers will conduct the interview for

the suicidal victims, an interview will be conducted first for the psychologists. The selected

respondents must be within the area of Talisay City, Cebu and Cebu City due to the fact that

the researchers are simply students and have a limited given budget and time. These areas are

easier to access for the researchers. As for the interview, it will only touch on the basic concepts

of suicide, such as the factors that cause suicide, the signs and symptoms of a suicidal person,

possible solutions and the ways to approach a suicidal person. This is to gain basic concepts

about suicide and to ask for ideas and suggestions on how the researchers must approach their

next respondents, the sensitive set of respondents, who are the suicidal victims. The questions

that the researchers will create must be carefully done to not trigger negative effects on the

suicidal victims. The method that will be used in retrieving the necessary data for the study is

through interviewing the respondents through the smartphone with the use of the application of

Messenger. The suicidal victims will choose which method they will prefer, either voice call, video

call or purely chat. The researchers will agree with the respondents that they must not touch on

the personal issues of the suicidal victims which are beyond the agreement. The answers

expressed by the suicidal victim will be the collected data and will be analyzed.

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Be it stated that this study:

• Does not indulge deeper into the suicidal victim’s experienced cause

• Does not cover the perspective of the medical professionals regarding suicide, except for

the psychologists

• Does not cover the perspective of the non-suicidal victims

• Does not treat suicide as a medical condition or a pathological condition

Significance of the Study

The generalization of this present study would be a great contribution to the vast

knowledge. Vital results of the research could be highly significant and beneficial specifically

to the following:

Students. This study will give awareness to the students, especially about the sensitivity

of this issue. Suicide is not something that should be taken lightly, so through this study

students will be conscious enough towards their fellow students and other people in the

society who might be going through the problems of dealing with suicidal thoughts. This will

also help and give them several ideas on how to reach out to those people rather than

unknowingly making them feel worse.

Parents. This study will open the minds of the parents towards the health of their children,

may it be emotionally, mentally or socially. They will become more open about the fact that

suicidal thoughts may inevitably come into a person’s mind and their own children are not

exempted from this. Instead of simply brushing this issue off, parents will not think that the

suicide thoughts are merely just immature thoughts.

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 Psychologists. Since they are the people who are most exposed to the issue of suicide.

This study will help the psychologists to understand more deeply about the perspective of

the victims regarding self- destruction. It can give them more ideas and will serve as an

avenue of new knowledge that can contribute to their way of approach towards people who

are suffering from suicidal thoughts. Because they focus on studying the minds and behavior

of the people, our study can also contribute to their current researches and they may also be

able to come up with a new study that will surely benefit those people, which mostly includes

the overthinkers, depressed individuals and people who experience social alienation, who

are prone to suicide acts and could convince from to refrain such act.

Self-harming individuals, victims of social alienation, over thinkers and depressed

individuals. This study will help the self-harming individuals, victims of social alienation, over

thinkers, and depressed individuals by knowing that they are not alone in their fight. They will

be aware that there are people who are willing to protect and help them.

Society. This study will help the society be apprehensive towards the issue of suicide.

People will no longer neglect the fact that this issue has been getting worse as time passed.

The society will be more aware of the different perspective of the suicidal victims and that

way they can at least decrease the rising rates of suicide each year by not causing a trigger

to those who suffer from the thoughts of committing self-destruction but instead they will be

helping them overcome it.

Future Researchers. This study will contribute new knowledge to future researchers

about the issue of self-destruction. The future researchers can identify new problems that

they will gain from reading and understanding this study and can serve as the basis of

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 foundation for a new branch of study about this topic which came up through a discovered

new problem within our study.

Definition of Terms

For a better understanding of the different terms used in the study, the following are

defined conceptually or operationally:

Suicide. It is the act of intentionally taking one’s own life. It usually stems from the deep

feeling of hopelessness and being unable to create solutions for one’s experienced

problems.

Suicidal victims. This refers to the people who had or has a desire of wanting to kill

themselves. They either had an experience of suicidal ideation, self-harm and suicide

attempts.

Self-harm. This refers to the act of intentionally hurting oneself which may or may not

possibly result in accidental suicide.

Perceived burdensomeness. It is the view that one’s existence burdens family, friends,

and/or society. (Joiner, 2005)

Thwarted belongingness. It is the experience that one is alienated from the others, not

an integral part of a family, circle of friends, or other valued groups.

Suicide Ideation. This refers to ideas of wanting to take your own life or thinking about

suicide.

Self-Destruction. It is another term for suicide. The act of hurting or killing one’s own

self.

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 CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDIES

Suicide, the act taking one’s own life, is one of the intriguing issues that many researchers

want to explore. In correlation with our study, the aim to gain a deeper understanding of self-

destruction through the perspective of suicidal victims, this chapter presents the related literature

and related studies both from local and foreign sources. Those that were included in this chapter

help in familiarizing information that is relevant and similar to the present study.

Related Literature

Every year, suicide is among the top 20 leading cause of death globally for all ages.

Unfortunately, suicide is difficult to prevent, in large part because the prevalence of risk factors

is high among the general population (Schwartz-Lifshitz, Zalsman, Giner, and Oquendo, 2013).

Although preventing suicide is difficult, that does not make it impossible to prevent suicide.

From the ideas of Christian Nordqvist (2018), suicide begins from suicidal thoughts or

suicidal ideation. This is the act of planning suicide. Suicidal ideation can occur when a person

feels they are no longer able to cope with an overwhelming situation. This could stem from

financial problems, the death of loved ones, a broken relationship, or a devastating or debilitating

illness (Nordqvist, 2018). Grief, sexual abuse, financial problems, remorse, rejection, breakup

from a relationship, and unemployment are the most common situations that trigger suicidal

thoughts. Nordqvist (2018) also recommended the following tips from the National Institute for

Mental Health to prevent someone from doing the act of self- destruction: (1) Asking them.

Studies have shown that asking someone if they are thinking about suicide does not increase

14
risk. (2) Keeping them safe by staying with them and removing all means of committing suicide.

(3) Listening to them. (4) Encouraging them to open up to a helpline or anyone who could be a

support to them. (5) Following up with them even after the crisis has passed. Remember that

many people experience suicidal thoughts at some time and many of them find a solution

(Nordqvist, 2018).

From the article Understanding Suicidal Ideation by Shawn T. Smith Psy.D.(2011), he

states that categorizing suicidal behavior as something like “depressed” and “manipulative” does

not explain the problem and generally skits the real source of suicide ideation. “Suicide is a

problem-solving behavior” is the kind of thinking that fuels suicide. In the mind of a person who

may be considering suicide, the act of taking one’s own life may be the best way to eliminate the

pain an individual may be experiencing. To acknowledge the thought that suicide is a problem-

solving behavior is uncomfortable for it may appear that an individual appears to edge

dangerously close to doing the act. We don’t have to agree with the desire to die in order to

empathize with the pain lurking behind that desire (Smith, 2011). The thought of suicide most

often occurs when a person feels they have to run out of solutions to a problem that seems,

inescapable, intolerably painful, and never-ending (Chiles and Strosahi, 2005).

Though there is always the temptation to argue with an individual who is suicidal,

especially that common line which says: “Suicide does not fix everything”, from the perspective

of a non-suicidal individual that may be true, but from a person considering suicide, they perceive

that the act of self-destruction is the only thing that will end their pain. Ironically, arguing this

point can increase a person’s resolve to end their life (Smith, 2011) hence, there is an alternative

effective approach to suicidal ideation.

15
 According to Smith (2011), the following tips are the best way to approach a suicidal

individual: (1) Understand that to the mind of the person contemplating suicide, it appears to be

an effective way to end their pain. We need not endorse suicide in order to understand that their

pain seems to be intolerable, inescapable, and interminable. Most importantly, we can

acknowledge that thoughts of suicide represent a desire to solve problems. (2) Identify and

discuss the sources of pain that exist behind suicidal ideation. When we shift the focus to the

sources of pain, then we can discuss solutions other than ending a life. Often, the very act of

putting words to vague and overwhelming feelings shines a light of rationality on our problems

and expands our willingness to explore a broader range of solutions.

Locally, here in the Philippines, health experts from the Department of Health (2018) also

explained that suicide can be prevented. Depression is the most common health problem

worldwide. In 2015, there were some 300 million people suffering from it (Salangad, 2018). 3.3

million Filipinos or 3.3 percent of the population in 2012 suffered from depressive disorders and

the worst consequence of depression is suicide. People who cannot handle it end up in

committing suicide. Every year, close to 800,000 people take their own life all over the world

(Salangad, 2018). Even though no one will never know if a person will be committing suicide or

not (Sison, 2017) the Department of Health encourages everyone to help those individuals who

are showing signs of mental disorder. Mental health disorders can be associated with persistent

sadness, loss of interest, change of appetite, low self-esteem, intermittent sleeping pattern, and

poor concentration (Brabante, 2018).

Related Studies

Van Orden, Witte, Gordon, Bender and Joiner (2008) conducted a study which relates to

the suicidal desire and the capability for suicide by testing the Interpersonal-Psychological

16
Theory of Suicidal Behavior among adults. The Interpersonal-Psychological Theory of Suicidal

Behavior proposes that an individual will not die unless he or she has both the desire to die by

suicide and the ability to do so. Three studies were done to test the theory’s hypothesis.

In the first study, they revolved around the question “Who wants to die by suicide?” and

tested the hypothesis of the Interpersonal-Psychological Theory of Suicidal Behavior that the

joint presence of thwarted belongingness and perceived burdensomeness predicts suicidal

desires. Many pieces of literature and previous studies also support that individuals with lower

levels of belongingness and a higher level of perceived burdensomeness will experience suicidal

desire but no studies have directly examined both constructs. Thus, Study 1 attempts to address

this gap in the literature. Their participants were 309 undergraduate students. Majority of them

were females. The participants were asked to complete a self-report questionnaire packet and

the responses to the questions about suicide were screened by the researchers. The result of

the study was as predicted that both belongingness and burdensomeness were both related to

suicidal ideation. (Van Orden, Witte, Gordon, Bender and Joiner, 2008)

In the second study, they revolved around the question “Who can die by suicide?” and

tested the hypothesis that experiences with pain, provocation, and past suicidal attempts will

allow the individuals to acquire the ability to do lethal self-injury. To test this, the participants

were assessed for suicide risk by a graduate student clinician. The result of the study showed

that the lowest level of acquired capability were those individuals with no past single suicide

attempt, followed by those with a single past attempt and the highest level was those individuals

with multiple suicide attempts. Thus, greater levels of acquired capability were found among

those with greater numbers of past attempts. (Van Orden, Witte, Gordon, Bender and Joiner,

2008)

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 In the third study, they focused on the question “Who is at great risk for suicidal behavior?”

In theory, it proposes that those at greatest risk both desire suicide and are capable of suicidal

behavior. With the use of both acquired capability and perceived burdensomeness, they

predicted the clinician-rated risk for suicide, above and beyond the contribution of other risk

factors. In this study, the participants consisted of 153 adults, 83 women, and 70 men, from FSU

Psychology clinic and the procedures, followed, were similar to the second study. The result

stated that the interaction of acquired capability and perceived burdensomeness predicted

clinician-rated risk for suicidal behavior (Van Orden, Witte, Gordon, Bender and Joiner, 2008)

Hence, the result of the three studies proved the Interpersonal-Psychological Theory of Suicidal

Behavior.

A local study conducted by Colucci, Kelly, Minas, Jorm, Nadera (2010) relates to

guidelines for helping a suicidal person conducted in the Philippines, which is a Delphi

consensus study. The study aimed to create some guidelines for how a member of the Filipino

public should provide first aid to an individual who is suicidal.

For the methods of the study, guidelines were produced by creating a questionnaire which

contains all possible first aid actions and asking an expert panel of 34 Filipino mental health

clinicians to rate if which of the listed possible actions should be included in the guidelines. A

systematic search of relevant proofs and claims made by authors of consumer and guides and

websites served as the basis for the content of the questionnaire. Through a web survey, the

panel members were asked to complete the questionnaires. The rating was done for three

rounds and at the end of each round, items that were able to reach the consensus criterion were

selected for inclusion in the guidelines. Panel members were also requested in the first round to

18
give suggestions for any additional actions that were not addressed in the original questionnaire.

The responses were then used to create new items.

The result of the Delphi process was a set of agreed-upon action statements. It started

with 138 statements, 48 new items were created based on the suggestions from the panel

members during the first round, the following are examples of such items: (1) An important

warning sign for suicide is if a person expresses in words or actions the desire or hope that they

will die (including praying that God may take their life). (2) An important warning sign for suicide

is if a person is not doing usual important tasks, such as household chores, going to work or

school. (3) The first aider should be aware that the absence of a belief in God may increase the

risk of suicide. (4) The first aider should ask the suicidal person if they have experienced a

change in their spiritual/religious practices or beliefs (e.g. an increase or decrease in prayer or

church attendance). (5) The first aider should take the suicidal person in the nearest safe place

(e.g. church, hospital, or police station). (6) The first aider should ask the suicidal person if they

would like the first aider to contact someone for them, such as a friend, family member or trusted

religious leader. (7) The first aider should consider the suicidal person's spiritual/religious beliefs

and refer to these to try to prevent the person from taking their life. (8) During the suicidal crisis,

the first aider should encourage the suicidal person to spend time with their significant others

(e.g. family, friends or religious leader).

Out of the186 items, 102 were able to meet the consensus criterion. The statements

were then used to develop the guidelines.

The growing awareness of suicide as a major health problem is a reason to why there is

a need to develop a suicide first aid guidelines for community members, and training programs

based on these, which might also contribute towards changing the society’s attitude towards

19
suicide and the people who consider suicide. In a World Health Organization news release, it

was stated that “It is important to realize that suicide is preventable.” By coordinating with the

local experts to agree on a set of first aid guidelines, and by making the guidelines easily

accessible to everyone, it can convey that message that suicide is preventable, suicide is

everyone’s business and everyone can contribute to its reduction.

CHAPTER III
RESEARCH METHODOLOGY

Research Design

The researchers used the phenomenological approach, the psychological study of

subjective experiences, for achieving the main goal which is to gain a deeper understanding of

self-destruction through the direct perspective of the suicidal victims.

Research Locale
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 This study was conducted within the area of Cebu City and Talisay City which is located

on the island of Cebu in Central Visayas, Region 7, Philippines.

Cebu City is the country’s oldest city and the first class highly urbanized city in the island.

It was the first Spanish settlement and the first capital of the Philippines. Cebu City is also the

fifth-most populated city in the nation and the most populated in the Visayas, as proven by the

2015 census which showed that it has a population of 922,611 people. Located in the middle of

the eastern side of Cebu Island, it is the center of a metropolitan area called Metro Cebu which

also includes the cities of Carcar, Danao, Lapu-Lapu, Mandaue, Naga, and Talisay; and the

municipalities of Compostela, Consolacion, Cordova, Liloan, Minglanilla, and San Fernando.

According to the census during 2015, Metro Cebu had a total population of 2,849,213 which

makes it the second-most populous metropolitan area of the nation, after Metro Manila in Luzon.

On the other hand, Talisay City is a third class city in the province of Cebu, Philippines.

According to the 2015 census, it has a population of 227,645 people. Primarily a residential and

trading center, Talisay lies within the Metro Cebu area. It is bordered to the north by Cebu City,

to the west is the city of Toledo, to the east is the Cebu Strait, and to the south is the town

of Minglanilla. The name of Talisay is taken from the magtalisay tree which is abundant in the

city. The city comprises 22 barangays: Biasong, Biasong, Cadulawan, Camp IV, Cansojong,

Dumlog, Jaclupan, Lagtang, Lawaan I, Lawaan II, Lawaan III, Linao, Maghaway, Manipis,

Mohon, Poblacion, Pooc, San Isidro, San Roque, Tabunoc, Tangke, and Tapul.

Research Participants

The respondents for this research were the Psychologists and the suicidal victims. The

Psychologists were selected through Purposive sampling technique, five (5) were chosen and

were all located in Cebu City. The sampling method was done through handpicking of subjects

21
and the researchers relied on their judgment as the respondents were selected. On the other

hand, Referral or Snowball sampling technique was used in selecting the suicidal victims. The

researchers selected a total number of twenty (20) respondents who are suicidal victims located

in both Talisay and Cebu City. The sampling method was conducted starting from the first

element which was selected from the population and was asked to recommend other elements

that will fit the description of sample needed. As the suicidal victims are classified to be a

sensitive population and were also difficult to identify, this is said to be the most effective

sampling method for the said respondents.

Research Instrument

The researchers involved the use of a semi-structured questionnaire, which was used as

a guide for interviews done by the researchers. Questions were listed and prepared for the

researcher to be guided on the interview towards the satisfaction of research objectives, but

during the interview, there were additional questions encountered.

Some certain questions that were prepared and included in the semi-structured

questionnaire were the following:

For Psychologists

1. What are the common causes that usually triggers the idea of suicide to an individual?

Which causes only triggers self-harm? Which triggers a complete suicide?

2. What are the psychological factors that may result in suicide?

3. What are the interpersonal factors that may result in suicide?

4. Are there usually signs and symptoms?

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 5. What could be the effective solutions that we, the non-suicidal individuals, could apply to

help the suicidal victims?

• How to approach them?

• How to make them open up?

• Are there questions that may trigger them that we should avoid asking?

For Suicidal Victims

1. What caused you to think or to do the act?

2. Did your thoughts and actions affect you in your normal life? How?

3. How were you able to handle your thoughts and actions?

4. Were you able to overcome all these? If yes, how?

5. For you, what would be the best solution that could be done for or of the suicidal victims

for them to overcome or handle their thoughts and actions?

Data collection procedure

For the purposes of this research, in-depth interviews were used. The researchers

interviewed the Psychologists first with the aim to gain a brief background about the concepts of

suicide and to gain ideas on the ways to approach and create questions for the suicidal victims.

After collecting data from the Psychologists, it was then followed by the interviews for the suicidal

victims.

The interviews used were semi-structured, allowing new ideas to be brought up during

the interview as a result of what the interviewee says. A guide was prepared, and the researchers

made use of open-ended questions, allowing for a discussion with the respondents rather than

a straightforward question and answer format. Its main advantage is that semi-structured

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interviews allow informants the freedom to express their views in their own terms and can provide

reliable, comparable qualitative data (Crabtree B, 2006)

Data analysis

Grounded Theory was used to analyze the collected information from the interviews. This

type of data analysis is also called Analytic Induction which means analyzing the specific

collected data and attempts to generalize an answer from it or develop a causal explanation of

a certain phenomenon. Having a systematic and rigorous process of collecting and analyzing of

data makes it as its main advantage. Furthermore, the grounded theory offers the capability for

researchers to interpret the qualitative data collected that leads to the fulfillment of research

objectives.

CHAPTER IV
PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

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 This chapter oversees the presentation, analysis, and interpretation of data gathered by

the researchers. This study aims to gain a deeper understanding of self-destruction by identifying

its causes, impacts and the possible solutions through the direct perspective of the suicidal

victims. The researchers applied the phenomenological approach, the psychological study of

subjective experiences, with the use of semi-structured questions and used the grounded theory

to analyze the collected information from the interviews.

The respondents of this research were the psychologists and the suicidal victims. The

researchers interviewed the psychologists first to gain a brief background about the concepts of

suicide and to gain ideas on the ways to approach the suicidal victims, researchers then

interviewed the suicidal victims after gathering the data from the psychologists.

4.1 Results of the interviews for the psychologists

These questions were prepared and included in the semi-structured questionnaire:

6. What are the common causes that usually triggers the idea of suicide to an individual?

Which causes only triggers self-harm? Which triggers a complete suicide?

7. What are the psychological factors that may result in suicide?

8. What are the interpersonal factors that may result in suicide?

9. Are there usually signs and symptoms?

10. What could be the effective solutions that we, the non-suicidal individuals, could apply to

help the suicidal victims?

• How to approach them?

• How to make them open up?

• Are there questions that may trigger them that we should avoid asking?

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These answers were generalized from the conducted interviews by the researchers:

According to our first set of respondents, the psychologists, the common causes of

suicide is the combination of unhealthy psychological wellbeing and emotional wellbeing. These

are the internal or biological factors, having mental health issues like depression, bipolar

disorder, schizophrenia, anxiety disorders. Causes of these are usually because of the

individual’s suffering from abuse, sickness, bullying, trauma and the like. People who are also

exposed to suicide, for example, a close friend or family member committed suicide, are also

most likely to commit suicide. There are also the external or social factors which cause to the

act of suicide such as stress losing a loved one, losing a job, losing financial funds, experience

bullying, feeling isolated and drug abuse. There are no specific causes that trigger only self-

harm or only completed suicide since it depends on the emotional state of the person. At the

moment the individuals feel hopeless, alone and sad and when they think that there is no other

way out of the situation they are experiencing and they have no more reason to go on with their

life then it triggers their thoughts and actions.

The psychological factor that results in suicide is having a mental disorder which involves

depression, which is also linked to anxiety and panic disorders and social phobia due to

excessive worrying, fear, terror, and consciousness. Another mental disorder which is related to

depression is the bipolar disorder, it is due to unusual mood changes such as feeling euphoric

at times and sometimes feeling depressive thus affecting the way the individual thinks.

Schizophrenia may also result to suicide due to how it affects people’s thoughts, feelings, and

behaviors, having delusions and hallucinations.

The interpersonal factors that may result in suicide include the person’s relationships.

A percentage of suicidal people are never married, going through a divorce, lost an important

26
person, experience abuse, having severe sickness and doing substance abuse. Those people

do not have loved ones that make them feel that life is still worth living. But also, people who are

in a relationship go through suicidal attempts because they experience extreme stress with their

partners or family members.

Warning signs of a suicidal person include talking about having no more reason to go on

with life and thinking that suicide is their only solution. Another symptom is when a person starts

to harm their own selves and say or do unusual things, such as giving away possessions,

which may give a hint that he or she is saying goodbye. People should also be careful when

someone seems calm after a depressive episode, the person might be having thoughts of ending

his or her life which is the reason to why the individual seems to be already recovered.

Effective solutions that non-suicidal people can apply to help the suicidal individuals are

recognizing the signs and symptoms of suicide. First, talk to the person and ask if they want

to see a therapist let them know that someone cares and will listen to their problems, these

remove the feeling of loneliness and isolation. Let them know that depression does not last

forever and that it can be treated. Second, act. Do not leave the person alone and ask for

assistance from his or her loved ones. Take away any possible method such as weapons and

medications. Lastly, encourage them to seek professional help. Do not ask them why they are

like that, blame them for their situation or act shocked about the situation, it will only make the

person isolate himself or herself even more and be guarded.

4.2 Results of the interviews for the suicidal victims:

These questions were prepared and included in the semi-structured questionnaire:

• Which of the following has the interviewee experienced?

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  Suicidal Thoughts

 Self-harm

 Suicide Attempt

6. What caused you to think or to do the act?

7. Did your thoughts and actions affect you in your normal life? How?

8. How were you able to handle your thoughts and actions?

9. Were you able to overcome all these? If yes, how?

10. For you, what would be the best solution that could be done for or of the suicidal victims

for them to overcome or handle their thoughts and actions?

These answers were generalized from the conducted interviews by the researchers:

Based on the conducted interview for the second set of respondents, the suicidal victims,

100% of the population experienced the first level to suicide which is suicidal ideation, 92%

experienced self-harm and 67% experienced suicide attempts.

The causes varied in each suicidal victim, but there were common causes that could be

identified based on their answers. The top common cause that the suicidal victims experienced

was related to their family problems, it was then followed by the issues in their love life, followed

by academic pressure, depression, anxieties, and even friends, which is linked to peer pressure,

were also identified as a cause for their actions. Some respondents also confessed that the

experience of being victims of bullying and social alienation also became the cause of their

actions.

The thoughts, actions, and attempts affected the majority of the respondents negatively

as they went through their daily lives. The victims became distracted, most especially in school

28
and their grades were also affected, it was because their minds were preoccupied with their

problems hindering them from focusing on their studies. Their minds could not think straight and

were filled with negativity and their interactions from the people in the society also declined while

continuing to pretend as if everything is alright. There were two of the respondents who

experienced only suicidal ideation who admitted that their thoughts did not really affect their daily

life because according to them, it was not that severe.

Though there were some of the suicidal victims who still experience and suffer from this

but are working on overcoming their thoughts, actions, and attempts, most of the respondents

who were interviewed were able to overcome their suicidal ideations, self-harm and or suicide

attempts. According to what they have shared, the majority were able to overcome and handle

it through their religious belief, which is by constantly praying. This was then followed by handling

it through distracting themselves or diverting their attention to something else to keep them busy.

The suicidal victims also added that it is important to engage in physical activities, look for new

hobbies and hang-out with people to help alleviate and overcome their suffering. This caused

them to gain realizations on what is right and wrong from their actions.

The interviewees’ suggested solutions for self-destruction were all similar. The solution

that they have identified, based on their experience, that a suicidal person must do is still related

to the religious beliefs. One must have faith and must have hope. Also through praying and being

God-fearing, God will be able to help them during their darkest days. Other than that, it is also

important to vent out their emotions rather than keeping it all in. They explained that a suicidal

individual must look for someone they can trust and who are willing to listen to them rather than

keeping in all the negative thoughts.

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 As for the solution that the non-suicidal people can do to help the suicidal victims,

according to them, all that they have to do is to simply talk, ask and be there for the suicidal

person. The interviewees confessed that they would prefer if their friends, family, and other loved

ones will be the one who is to approach them willingly and remind them that they are important,

give them encouragement and advice.

It is also important to keep in mind that non-suicidal people must be open-minded while

talking to them and never judge them or belittle their experience for they are very sensitive and

easily affected. That way, the suicidal victims will be able to feel their worth and understand that

there are people who still care for them which will make them realize that they are not alone in

this world.

Based on the findings, after connecting all of the data gathered, the researchers implied

that suicidal victims are the people who experience a severe interpersonal problem, especially

family problems, which then affects them psychologically and creates a negative impact to their

daily life and the effective way that the non-suicidal ones can do to help them, based on the

answers of the interviewees, is to first be aware when a person is showing signs and symptoms

of being suicidal. After that, people must not hesitate in approaching the suicidal people first, to

ask them, talk to them, listen and remind them of their worth, that way they could feel that there

are people who still care and are concerned about them.

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 CHAPTER V
SUMMARY, FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

This chapter presents the summary or the research work undertaken, the conclusions

drawn and the recommendations made as an outgrowth of this study:

Summary
The researchers conducted the study with the aim to gain a deeper understanding of self-

destruction through the perspective of the suicidal victims in terms of its causes, impacts and

possible solutions. According to the researchers, if the people, especially the non-suicidal ones,

will not think and treat self-destruction as a medical issue and will look and investigate this from

the perspective suicidal victims, basing on their experiences, then the people will be able to

come up with effective ways to approach and help the suicidal ones. The researchers used the

phenomenological approach, the psychological study of subjective experiences, and conducted

the study within the area of Cebu City and Talisay City, Cebu. The respondents of the study

were five psychologists, who were interviewed first to gain a brief background of the concepts of

suicide and to gain ideas on how to properly approach the suicidal victims. They were selected

through a Purposive sampling technique. Next respondents were the twenty suicidal victims,

31
who were chosen through Referral or Snowball sampling technique. Semi-structured

questionnaires, which served as a guide for the interviews done, were prepared for the

respondents to collect the desired data and Grounded Theory, which means analyzing the

specifically collected data and a general answer out from it, was used to analyze the collected

information from the interviews.

Findings of the Research

The findings of the study are as follows:

1. What is the perspective of the suicidal victims in terms of:

1.1 Its causes

Based on the perspective of the suicidal victims, the top causes of self-destruction

are family problems, which was then followed by issues in love life, followed by academic

pressure, depression, and anxiety. The individuals experienced the severe feeling of

emotional pain which was caused by the problem they went through and this resulted in

constant negative thinking. The cause was not further specified by the interviewees

considering the high level of sensitivity of the respondents.

1.2 Its impacts on the individuals

According to the suicidal victims, this affected their daily lives negatively. They

became more distracted, most especially students in their school which affected their

grades. Their minds were preoccupied and were filled with negativity which hindered them

from thinking straight. Despite that, the victims admitted that they also had to pretend as

if they are not going through anything to not affect other people with their negativity.

1.3 Their possible solutions

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 In regards to their suggested solutions based on their experiences. For the people

going through either of the three levels to complete self-destruction, it is important to lean

on religious beliefs. The best solution that they can do for themselves is through constant

prayers and being God-fearing. They also added that looking for a distraction and keep

oneself busy will be able to help. Other than that, it is also important to express the bottled

in emotions to someone whom the suicidal victim trusts and is willing to listen. As for the

solutions that the non-suicidal people can do to help the suicidal ones, all they have to do

is to simply talk, ask and be there for the suicidal person. The interviewees explained that

it is much preferable if the family, friends and other loved ones will be the one to approach

them willingly and remind them that they are important, give them encouragement and

advice. It is better to approach them first especially when it is noticeable that something

is not right, rather than waiting for them to be the one to approach, which at times does

not happen. The non-suicidal people must be open-minded to their problems, and must

never judge and belittle the suicidal victims for what they are going through. Always keep

in mind that they are very sensitive and are easily affected. That way, the suicidal victims

expressed that it alleviates their feeling if they are able to feel their worth from other

people, most especially the ones important to them and understand that there are people

who still care for them in this world.

2. What relationships are observed between and among the following factors that result in

suicide:

a. Psychological

b. Interpersonal

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 From the results of the interview with the suicidal victims, the suicidal ideation, self-

harm and suicide attempt commonly stem from an interpersonal factor, a problem within

that factor. The problem then caused a trigger which negatively affected the individual

psychologically and this resulted in them to experience anxieties, depression, and

extreme negative thinking which then leads to self-destruction.

3. How does the identified cause affect the level of impacts to the suicidal victims which

result in them to push through the act of killing oneself?

The identified causes did not align to a specific level of impact to the suicidal

victims. It varied in every person depending on their emotional state and their capability

to handle their experience.

4. Based on the findings, what can be the content of the Awareness Campaign to be

performed?

Based on the findings, the content of the Awareness Campaign must first highlight

the fact that family problems are the top causes of what leads a person to self-destruction.

A message must be addressed to the parents regarding the alarming results, and the

content must also include the solutions that the suicidal victims suggested based on their

perspective. People must also be informed through the awareness campaign that other

than family problems, other interpersonal factors are not exempted from the causes of

suicide such as problems in love life and friends, bullying, social alienation and the like.

Input words of encouragement for the people, most especially the non-suicidal ones, to

be more willing to reach out to the suicidal victims.

Conclusions

Based on the findings of the study, the following conclusions are drawn:

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 1. The researchers conclude that the reason why people attempt suicide revolves more

around with their problems in correlation with the interpersonal factors which causes

severe emotional pain and leads to extreme negative thinking about oneself and one’s

own life, thus, results to self-destruction.

2. The researchers conclude that the thoughts distract the suicidal victims from their

everyday lives which disturb their performances of their daily routines.

3. The researchers conclude that the effective solution to be done for the suicidal victims

is to approach first, talk, accompany and show concern to the people who are showing

symptoms of being suicidal.

4. The researchers conclude that self-destruction commonly stems from the problems in

relation to the interpersonal factors which causes a trigger that will affect an individual

psychologically and leads to intense emotional pain and negative mindset.

5. The researchers conclude that the causes of self-destruction do not have a specific

level of impact on the individual. It will simply depend on the individual’s capability to

handle his or her situation.

Recommendations

Based on the findings and conclusions presented, the following recommendations are

suggested:

1. The researchers recommend that parents and the rest of the family members must be

mindful of the problems that arise from their home and how this affects the members of

the family. They must also be sensitive to the emotions of other members in the family

and be more open to one other.

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2. The researchers recommend that people must be careful about what they say or how

they interact with others. Keeping a good interpersonal relationship amongst one another

is a way to decrease the increasing rate of suicide.

3. The researchers recommend that people must act and approach the person immediately

who are showing signs and symptoms of being suicidal rather than ignoring them.

4. The researchers recommend to the future researchers that an in-depth study must be

conducted to what specific type of family problem greatly affects an individual.

36