A hands-on personal way of dealing with suicide Image

The tragic death this week, apparently by suicide, of the young Galway hurler, Niall Donoghue, shows the crying need to fight the scourge of self-destruction in modern Ireland. Below, is a link to a long interview I did with suicide prevention counsellor, Dr Jim O’Donoghue, for the Irish Independent earlier this month. Dr O’Donoghue strongly believes that the present system of suicide prevention and the treatment for dealing with suicidal feelings is not at all sufficient, He believes we need a far more holistic, realistic and imaginative approach. When I put this interview on the website and tweeted it yesterday, it got a tremendous reaction. I now wish to put the contact number for Dr Jim O’Donoghue is 087 222 9679 and a link to his clinic. http://jim-odonoghue.psychotherapist.tel/

Also included below,  to accompany the interview, are further views on this fundamental and complex subject from Joan Freeman of Pieta House, the centre dealing with suicide and self harm, and from Dr Brendan Kelly, a consultant psychiatrist at the Mater Hospital in Dublin.

A hands-on personal way of dealing with suicide
Dr Jim O’Donoghue is a man who sleeps with a phone by his bed, on 24 hour call to a dozen patients who are on suicide watch and who have made a promise that if they ever get suddenly overcome with a self-destructive urge, they are at least to call him first. That is the deal.

Jim O’Donoghue (73) will not like me writing this. A quiet, self-effacing man, with a trim beard, he does not like to draw attention to himself, or to dramatise the whole phenomenon of suicide. But then there are many things about suicide that we are not supposed to say. We are not, for example, suppose to use the word ‘commit’ since commit used to suggest a crime and sin. For years, we didn’t even acknowledge that what was suicide was suicide at all, and even now initial reports of an incident such as that recently in West Cork, when a father took his own life, and that of his 3 year old daughter, is described ‘as a tragic incident’ – code for ‘probable suicide.’

However, we have come a long way and at this stage it would be hard to ignore the phenomenon that is suicide in our society, and in particular Irish society, where it is affecting all classes but especially young males in rural areas. It is quite simply a modern scourge which, as broadcaster Joe Duffy put it, is ‘whipping through our communities, and yet people still prefer to look the other way.’ Duffy has highlighted the issue on his radio programme and spoken to the families of its victims, including those who feel that it is being too easily dismissed as a mental health problem and not one where communities can reach out and help those who are suffering silently.

Jim O’Donoghue would concur with this view. A Clinical Psychotherapist and Director of Castlebar Counselling & Therapy Centre, he is a veteran of dealing with suicide prevention and his Castlebar service is one three such centres, with others in Dundalk and in Gardiner Street in Dublin. A residential unit called the Kedron centre was, established in Edenderry, Co Offaly, with a staff of 28 but has since closed for economic reasons. The entire service is a non-profit making charity and fees are kept to a minimum, with many clients being seen for free.

Originally, a clerical student pupil at All Hallows, O’Donoghue departed a religious vocation to work with the pioneering Dr Ivor Browne in Grangegorman hospital. In the so-called boom years, he established his own counselling service and at this stage of his life, he has lost any timidity about speaking frankly about suicide, and about our limited way in dealing with it. He believes that we are too easily associating it with mental health issues, as well with alcohol and drug abuse. It is more fundamental and, in our whole approach, we are confusing the catalysts with the cause. Anti-depressant drugs are not the solution, he says, and, in many cases, they may be making the situation worse.  He also believes that millions are being spent on useless research, to tell us what we know already.

Suicide, argues O’Donoghue, arises from an inherently unconscious impulse which has become catalysed during a crisis. People can go through life untroubled and then suddenly, with an upheaval, everything loses meaning and purpose. Most interestingly, he believes that this is linked to something that happens to the unborn child during pregnancy, specifically during the second trimester in the womb. This is a highly formative time – a ‘healing time, a spiritual time’ – and something can happen externally to the parents, such as a financial or domestic crisis, which affects the unborn child much later on. This may seem a radical thesis, but it is one which is also being explored in research into psychophrenia and bi-polar disorder.

Under pressure, much later in adult life, this foetal trauma can be activated. The unconscious rises and becomes unblocked, says O’Donoghue. And the person goes into a sort of trance, which is suicidal. Of course, ultimately we can only speculate as to what actually pushes people to the extraordinary step of taking their own lives, and some observers may find such speculation ambitious and even macabre, but is it not much worse to do nothing and block off such speculation?

In such a deepening crisis for the suicidal person, something deeply unconscious is hit, which says ‘I shouldn’t be here.’ A death wish develops, explains O’Donoghue and the survival instinct turns into an energy which is the very opposite. I talk to O’Donoghue about the death of Fine Gael TD Shane McEntee, for example, and the disbelief that such a thing could happen. I expressed my own unease that the taboo has been too easily broken, and wonder should suicide victims such as former Wales manager Gary Speed, be given a minute’s silence at football grounds. But he feels that, in many ways, it is the opposite and suicide is being brushed away as an inexplicable event or a mental illness. This is also a complaint of the families contacting Joe Duffy, who feel that there is a deep seated unwillingness ‘to cope with, or acknowledge, grief, despair and hopelessness.’

So what is the solution? O’Donoghue believes that we need more pastoral and spiritual leadership in our community and that people are starved of hope and meaning. The obvious observation here is that the collapse of religious worship has created a tremendous vacuum. O’Donoghue himself is impatient with the Catholic church’s preoccupation with institutional matters as opposed to inner spirituality. At one stage, he was very involved with the Clinical Theology association which established a link between psychiatry and theology.

And there is a strong spiritual aspect to his approach. Very much so: it is about an integrated, holistic approach which deals with the disturbed person in all their aspects, and not just the biomedical analysis. ‘We need an integration into the consciousness and behaviour of the patient of all that is personal, individual and subjective on the one hand, with all that is historic, communal and universal on the other’ says O’Donoghue. ‘This includes attention to the phylum, the ancestral skeletons in the cupboard, who in some ways can be found to be crying out for healing in the symptomatology of those who come for help.’

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In the context of Ireland, and especially rural Ireland, with its strong sense of the past and of families and ancestry, this must be especially important.

‘We need to look at all that we are psychologically, familially, relationally, historically’ explains O’Donoghue ‘and this is expressed in emotion, in feeling, in spirit and in dispiritment. Everything in life matters. Nothing is alien, irrelevant or distant. We have a resonance and a kinship with everything and it is only in the experience of this that we can dance with life. A really scientific approach would take all this into account.’ The mere prescription of anti-depressants is a completely inadequate response, he adds.

Instead, the approach requires a compassionate skilled response that can open up the possibility of another perspective on life for the suffering patient. And this is where the hope arises, for it is by going to the darkest space and lancing the boil, so to speak, that a release can be created.  O’Donoghue described the moment, and the potential turnaround, in language that is both eloquent and ultimately uplifting.

‘When we work with someone who is suicidal’ he explains ‘at the point where she or he feels that all hope is gone, that death is preferable to life –  and this we might say is the darkest moment in the process – we find if we listen and empathize carefully that this is a place of paradox. There is a tiny space there between the perceived end of all suffering and something different that is not named. There is a synergy of polarities at this point that if sensitively handled can be the mid-wife to a new dance with life. At this bifurcation point, a full therapeia is possible if it is met by someone who is outside of, but in tune with, at this moment. No medication can bring this moment about but rather it can help to block it off.’

‘It is only the empathic intuition of a highly trained, and open therapist that can penetrate with direct qualitative knowing, this slender space between the two worlds of death and life and offer a return to a new order’ he stresses. ‘Here lies an instant of opportunity which ‘taken at the flood’ hands back to the suicidal person the powerful energetic potential of his or her life.

It is a heartening and inspiring thought, and a consolation that such an escape can exist. For this observer, just listening to Dr Jim O’Donoghue, is a therapy in itself,

So what it must be for people suffering is incalculable. Little wonder, he keeps his phone with him at all times. For the rest of us, he is someone absolutely worth listening to, instead of ignoring the suicide phenomenon that is tearing up our communities and treating purely it as a mental health issue.

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Positive: Nuala Whelan, above, whose husband killed himself 10 years ago, has come to terms with what happened and says ‘life is to be enjoyed, not endured.’

View of Dr Brendan Kelly, Consultant Psychiatrist, Mater Hospital, Dublin :

Individuals who experience suicidal thoughts need understanding, compassion and support. This support varies from person to person. Most individuals require time and engagement with family and friends in order to feel a sense of belonging and see a way through present difficulties. For others, this may not be available or enough, and there may be a need for counselling or psychological therapy. Individuals with depression require understanding, support and specific treatments, in the form of psychotherapy, medication, social support or a combination of all three. While suicide itself may appear to be an individual act, it invariably impacts on others and on society. A public health approach highlights ways in which society can take steps to reduce suicide and self-harm, through public education and various specific measures (e.g. regulating the sale of paracetamol). There is no “one size fits all” approach to self-harm and suicide. There are always alternatives to self-harm and suicide. As a society, it our duty to make these alternatives accessible, available and acceptable to those who need them, when they need them most.

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Joan Freeman ( pictured), Psychologist and founder of Pieta House Suicide and Self Harm Help Centre

The crucial element in helping those with suicidal feelings is the involvement of the public. At Pieta House, we see this as the third crucial aspect of a three-pronged approach. The first is dealing with the issue at primary care level, such as through the medical service. The second is through organisations like our own. And the third is the awareness of the public in dealing with people with suicidal tendencies all around them. This is the frontline: the people all around us, our family and friends and perhaps people who don’t even know. We need to be open and vigilant to all the signs, especially as so many suffering people do not ask for help. Pieta House currently has a campaign called Mind Our Men, because more men die by suicide than women. Of the average ten suicides which occur each week in Ireland, eight of them are men. And there are many more suspected suicides through drownings and single vehicle car accidents. The statistics are truly damning, with about 11,000 presentations per year related to attempted suicide in Ireland.

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