KNP3511 – PSYCHO-SPIRITUAL

ASSESSMENT AND THERAPY

RABBI GEOFFREY HABER, BA, BA, MA, DMIN, DD (HON.)

BCC (NAJC), CSCP (CASC), CSE (CASC), CE (ACPE), RP (CRPO)
DIRECTOR, SPIRITUAL CARE, BAYCREST
CERTIFIED SUPERVISOR-EDUCATOR, CLINICAL PASTORAL EDUCATION
ADJUNCT LECTURER, KNOX COLLEGE, TORONTO SCHOOL OF THEOLOGY,
UNIVERSITY OF TORONTO

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SUICIDE AND DOMESTIC VIOLENCE

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 CONTENTS

 What is Suicide?
 Suicide Triggers
 Underlying Causes of Suicide
 Suicide and Age
 Treatment and Suicide
 References

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SUICIDE

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 WHAT IS SUICIDE?
DEFINITION
 Suicide is death caused by injuring oneself
with the intent to die.
 Only humans knowingly take their own lives.
 Suicide is one of the leading causes of death
in the world.
 Parasuicides: unsuccessful attempts to kill
one’s self
STATISTICS
 Estimated 1 million people die by suicide
each year
 Every day, an average of more than 10
Canadians die by suicide. 5

 Suicide deaths average around 4,000 a year.

 WHAT IS SUICIDE?

SUICIDAL TYPES
1. Death seekers clearly intend to end their
lives at the time they attempt suicide.
2. Death initiators act out of a belief that the
process of death is already under way and
that they are simply hastening the process
(e.g. elderly and very).
3. Death ignorers believe they are trading their
present lives for a better or happier existence
(e.g. children, afterlife believers).
4. Death darers experience mixed feelings, or
ambivalence, about their intent to die, even at
the moment of their attempt, and they show 6

this ambivalence in the act itself.

 WHAT IS SUICIDE?
DISCUSSION
 Do you know of someone who attempted or
committed suicide? How did you feel?

PATTERNS
 Two major strategies used to study suicide:

1. Retrospective analysis
2. Suicide survivor studies.
 Suicide rates vary from country to country.

1. Cultural differences in religious affiliation,

beliefs, and degree of devoutness.
2. Suicide rates vary according to race, gender, 7

and marital status.

SUICIDE TRIGGERS

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SUICIDE TRIGGERS

COMMON TRIGGERS
1. Stressful events:
a. Immediate (e.g. combat, natural disaster,
negative life change)
b. Long-term (e.g. social isolation, serious
illness, abusive environment, occupational
stress)
2. Mood and thought changes:
a. Sadness, anxiety, tension, frustration, anger,
or shame
b. Hopelessness
c. Dichotomous thinking (viewing problems
and solutions in rigid either/or terms). E.g.
“Suicide was the only thing I could do”
SUICIDE TRIGGERS

COMMON TRIGGERS
3. Alcohol and other drug use:
a. Lowers a person’s inhibitions
b. Reduces his or her fears of suicide
c. Releases underlying aggressive feelings,
d. Impairs judgment and problem-solving
ability
4. Mental disorders:
a. 70 % severe depression (unipolar or bipolar),
b. 20% chronic alcoholism
c. 10% schizophrenia.
SUICIDE TRIGGERS

COMMON TRIGGERS
5. Modelling:
a. One suicidal act apparently serves as a
model for another.
b. Suicides by family members and friends,
those by celebrities, and suicides by
coworkers or colleagues are particularly
common triggers.
c. Especially among teenagers.
UNDERLYING CAUSES OF SUICIDE
UNDERLYING CAUSES OF SUICIDE

Psychodynamic View
 Suicide results from depression and
from anger at others that is redirected
toward oneself.
 Suicide is thought to be an extreme
expression of self-hatred and self-
punishment
UNDERLYING CAUSES OF SUICIDE

Sociocultural View
 Probability of suicide determined by
personal attachment to such social
groups as the family, religious
institutions, and community.
 The more thoroughly a person
belongs, the lower the risk of suicide.
 Conversely, people who have poor
relationships with their society are at
higher risk of killing themselves.
UNDERLYING CAUSES OF SUICIDE

Sociocultural View
 Three types

1. Egoistic suicides: people over whom

society has little or no control.
2. Altruistic suicides: integrated into the
social structure that they intentionally
sacrifice their lives for its well-being.
3. Anomic suicides: people whose social
environment fails to provide stable
structures, such as family and
religion, to support and give meaning
to life.
UNDERLYING CAUSES OF SUICIDE

Interpersonal View
 People will be inclined to pursue
suicide if they hold two key
interpersonal beliefs
1. perceived burdensomeness and
thwarted belongingness
2. psychological capability to carry out
suicide
UNDERLYING CAUSES OF SUICIDE

Biological View
 Low serotonin activity and brain-
circuit dysfunction among suicidal
people
 Contributes to aggressive and
impulsive behaviors
SUICIDE AND AGE

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 SUICIDE AND AGE
DISCUSSION
 Which group has the highest rate of
suicide?
SUICIDE AND AGE
 Likelihood of dying by suicide
steadily increases with age up
through middle age, then decreases
during the early stages of old age,
and then increases again beginning
at age 75.
 Three groups—children,
adolescents, and the elderly—face
unique problems that may play key
roles in the suicidal acts of its 19

members.
 SUICIDE AND AGE
CHILDREN
 Commonly preceded by such behavioral patterns as:

1. running away from home;

2. accident-proneness;
3. aggressive acting out;
4. temper tantrums;
5. self-criticism;
6. social withdrawal and loneliness;
7. extreme sensitivity to criticism by others;
8. low tolerance of frustration;
9. sleep problems;
10. dark fantasies, daydreams, or hallucinations;
11. personality change 20

12. overwhelming interest in death and suicide (Soole et al.,

2015; Wong et al., 2011).
 SUICIDE AND AGE

CHILDREN
 Link between child suicides and:

1. recent or anticipated loss of a loved

one,
2. family stress and a parent’s
unemployment,
3. abuse by parents,
4. victimization by peers (for example,
bullying),
5. clinical level of depression
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 SUICIDE AND AGE
ADOLESCENTS
 Suicidal actions become much more common after
the age of 13 than at any earlier age.
 Suicide has become the second leading cause of
death in this age group, after accidents
 Teenagers who consider or attempt suicide are
often under great stress.
 Suicide attempts are at least twice as common
among teenage victims of bullying as among other
teenagers.
 Stress at school seems to be a particularly common
problem for teenagers who attempt suicide.
 LGBTQ2S+ individuals are three times more likely 22
than other teenagers to have suicidal thoughts and
to attempt suicide.
 SUICIDE AND AGE

ADOLESCENTS
 Far more teenagers attempt suicide than
actually kill themselves—most experts
believe that the ratio is at least 100:1.
 While some do indeed wish to die,
many may simply want to make others
understand how desperate they are, or
they may want to get help or teach
others a lesson.
 Up to half of teenagers who make a
suicide attempt try again in the future,
and as many as 14% eventually die by
suicide. 23
 SUICIDE AND AGE

ADOLESCENTS
THEORIES OF WHY
1. High rates of competition leads to
shattered dreams and ambitions
2. Weakening family ties produce
feelings of alienation and rejection.
3. Peer pressure to engage in risky
behaviors.

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 SUICIDE AND AGE

THE ELDERLY
 Suicide among older adults is more
common than many people think.
 According to Statistics Canada, the
rate of suicide for older adults was
12.4/100,000 (23.0/100,000 for men,
and 4.5/100,000 for women over the
age of 65).
 Older males die by suicide more often
than any other group because they use
more lethal means when attempting
suicide.
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 SUICIDE AND AGE
THE ELDERLY
Why are older adults at risk?
 Experiences of loss such as loss of
health, loved ones, physical mobility
and independence
 Major life changes such as retirement,
change in financial status, a transition
into care facilities
 Fewer relationships and connections
as loved ones have passed away; also,
older adults are more likely to live
alone
 Feeling of being a burden to loved
ones 26

 Chronic illness and pain

TREATMENT AND SUICIDE

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 TREATMENT AND
SUICIDE
Two major categories:
1. Treatment after attempted suicide.
2. Suicide prevention.
 Treatment may also be beneficial to relatives and
friends of those who complete or attempt suicide.
 The goals of therapy for those who have attempted
suicide are to:
1. keep the individuals alive,
2. reduce their psychological pain,
3. help them achieve a non-suicidal state of mind,
4. provide them with hope,
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5. guide them to develop better ways of handling
stress
 TREATMENT AND
SUICIDE

TREATMENT AFTER ATTEMPTED SUICIDE

 Applying the principles of mindfulness-based
cognitive-behavioral therapy guide clients to
accept many of the negative thoughts that keep
streaming through their minds rather than try to
eliminate them.
 Acceptance of this kind is expected to increase the
clients’ tolerance of psychological distress.
 Dialectical behavior therapy (DBT) being used
increasingly in cases of suicidal thinking and
attempts.
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 TREATMENT AND
SUICIDE
SUICIDE PREVENTION
 Suicide prevention programs and hotlines
respond to suicidal people as individuals
in crisis—under great stress, unable to
cope, feeling threatened or hurt, and
interpreting their situations as
unchangeable.
 Crisis intervention: help suicidal people
see their situations more accurately, make
better decisions, act more constructively,
and overcome their crises.
 Because crises can occur at any time, the
centers advertise their hotlines and also
welcome people who walk in without 30

appointments.
 TREATMENT AND
SUICIDE

SUICIDE PREVENTION
 During their initial contact with a suicidal person,
counselors try to:
1. establish a positive relationship,
2. understand and clarify the problem,
3. assess the potential for suicide,
4. assess and mobilize the caller’s resources,
5. formulate a plan for overcoming the crisis.
 Beyond such crisis intervention, most suicidal
people also need longer-term therapy.
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TREATMENT AND
SUICIDE

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SUICIDE POSTVENTION
 Postvention is the provision of crisis
intervention, support and assistance for
those affected by death by suicide.

 Bereavement support to survivors of a

death, including:
 crisis counseling,
 grief groups,
 funerals and memorial services.

 Postvention is a special kind of

bereavement support involving:
 suicide risk,
 stigma,
 guilt,
 complicated grief. 33
DOMESTIC VIOLENCE

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DOMESTIC VIOLENCE

Guest Speaker: Dr. Nazila Isgandarova

 Assistant Professor, Teaching-Stream in Islamic Spiritual
Care & Program Coordinator for the Master of Pastoral
Studies Program
 BA/MA Baku State University
 MA Carleton University
 MSW University of Windsor
 DMin Wilfred Laurier University
 PhD St. Michael's College, University of Toronto
 Nazila Isgandarova is a registered psychotherapist at the
College for Registered Psychotherapists of Ontario, and a
registered social worker at the Ontario Social Workers and
Social Service Workers. She is also certified American Board
of Forensic Professionals for the CMCC AMA Guides to
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Impairment Rating.
REFERENCES

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 REFERENCES

 American Academy of Child and Adolescent Psychiatry. (2021). Suicide in Children and Teens.
Washington, DC: AACAP Answer Center. Retrieved: https://
www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Teen-Suicide-010.as
px

 Comer, R. & Comer, J. (2019). Fundamentals of Abnormal Psychology. New York, NY Worth
Publishers.
 Government of Canada (n.d.). Older adults and suicide. Ottawa, ON: Health Canada. Retrieved:
https://www.mentalhealthcommission.ca/wp-content/uploads/drupal/2019-05/Older%20adults%20
and%20suicide%20fact%20sheet.pdf

 Government of Canada (2021). Suicide in Canada. Ottawa, ON: Health Canada. Retrieved:
https://www.canada.ca/en/public-health/services/suicide-prevention/suicide-canada.html
 Government of Canada (2020). Preventing suicide: Warning signs and how to help. Ottawa, ON:
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Health Canada. Retrieved: https://
www.canada.ca/en/public-health/services/suicide-prevention/warning-signs.html