Edwin S Shneidman y la suicidología moderna / Edwin S Shneidman and modern suicidology

ABSTRACT

Edwin S. Shneidman (13-05-1918 - 15-05-2009) is known as the father of contemporary suicidology. His work reflects the intensive study of lives and deaths, especially suicides, and is the mirror to his mind. Few people, like doctor Edwin S. Shneidman, are vouchsafed the rare opportunity to create a new discipline, to name it, to shape it, to contribute to it, and most importantly, to catalyze other competent investigators to invest in it suicidology. In his reflections, Shneidman does not know whether suicide was looking for him or he was looking for suicide. Part of his motivation on that day in 1949, when he discovered 100's of <suicide notes>> in the vaults of the Los Angeles Coroner's Office, was that he was restless and looking for some niche in psychology. He had an autonomic reaction with the feeling and knew that had discovered an unknown way to understanding the suicide behavior, and that suicide notes could be the golden road to the unconscious of suicide, and suicidology began. What Shneidman had tried to do in his career was to explain the word suicide. It is not taxonomy. Disregarding all of biology and genetics, suicide is essentially psychological pain. It is not entirely so, but that is what we can investigate and explicate. Shneidman's main contributions have been conceptual. He had made up words and concepts -suicidology, psychological autopsy, postvention, subintentioned death, psychache- where he felt then to be required to reflect some nuances of his thoughts, and he has given renewed emphasis on well-established words and concepts -perturbation, constriction, lethality- when he felt that they were more accurate than some of the current reductionistic jargon. Shneidman is first and foremost a suicidologist. His work in suicide can be subdivided as follows Definitional and theoretical, suicide notes, administrative and programmatic, clinical and community, and psychological autopsy and postvention. Shneidman, in his important book, Definition of Suicide in which he asserted a psychologically oriented definition of suicide <Western world, suicide is a conscious act of self-induced annihilation, best understood as a multidimensional malaise in a needful individual who defines an issue for which suicide is perceived as the best solution>>. Shneidman was asked to write the paper <<Suicide>> for the Britannica Encyclopedia. Shneidman decided he would not reproduce the usual tables of statistics of suicide among various countries at various times, but, instead, introduce a potpourri of then current ideas about suicide, a significant paper in the history of suicidology. It shifted the focus to the suicidal mind, away from the statistical. Shneidman through all his clinical and researching work, obtained the famous Ten Suicide Common Characteristics. Although we actually do not know how many commonalities there are, Shneidman's ten of suicide are 1. The common purpose of suicide is to seek a solution; 2. The common goal of suicide is cessation of consciousness; 3. The common stimulus in suicide is intolerable psychological pain; 4. The common stressor in suicide is frustrated psychological needs; 5. The common emotion in suicide is hopelessness-helplessness; 6. The common cognitive state in suicide is ambivalence; 7. The common perceptual state is constriction; 8. The common action in suicide is egression; 9. The common interpersonal act in suicide is communication of intention; and 10. The common consistency in suicide is with lifelong coping patterns. Also, suicide notes are synonymous with Shneidman's career. Shneidman seeked to illustrate the point that suicide notes -which, after all, are the penultimate act of that person's life- can be very informative when they are placed within the context of the thousand details of that person's life. Using that approach, the suicide notes are illuminated by the life, and many details of the life are tragically illustrated by the content of the notes. Shneidman's work was also programmatic. Perhaps the major pioneering administrative effort in Shneidman's life was his work at the LASPC (Los Angeles Suicide Prevention Center). The LASPC was started in 1955 with Norman Farberow and Robert Litman. It was the first comprehensive center and it became a model for prevention centers that pulled the troika of suicide prevention unto the modern stage. They represent three interwoven aspects of modern suicide work research, training and clinical service. In 1966, he was called to work at the Institute of Mental Health (NIMH), to draft a proposal for a National Program in Suicide Prevention. When Shneidman went to Washington, there were three suicide prevention centers in the country and three years later (1966-1969) there were more than 100. The paper <NIMH Center for Studies of Suicide Prevention>> is not only important because it outlines Shneidman's endeavors in suicide prevention, but it is also marked by its publication in The Bulletin of Suicidology. He neologized the word, suicidology, for that publication. In 1969, after three years at NIMH, Shneidman went to Harvard as a Visiting Professor and then to the Center for Advanced Studies of Behavioral Science, Stanford, as a Fellow. Next, Shneidman went to the University of California, Los Angeles (UCLA). He also, with others, created in 1968 the American Association of Suicidology (AAS). The Bulletin, after Shneidman left NIMH, stopped existing within a year or so. Thus, he wanted a journal for suicidology and created one, under the auspices of the AAS, the Suicide and Life Threatening Behavior Journal (SLTB). Shneidman's career in suicidology has not only been intellectual but also practical. The pamphlet, <Suicide>> -which sold for $.25- was published in 1967, a year after Shneidman went to NIMH. It was one of the first attempts to meet the responsibility to put out something for the public. It was a prevention effort at the community or public level, something he espoused all his life Prevention is education. He provided certain rules for treatment of suicidal people and prescriptive advice for the psychotherapist, suggesting a focus on the assessment of the patient's mental lethality. Shneidman's rule reduce the perturbation, and the lethality will come down with it. Therapy revolves around mollifying pain. Shneidman's key papers on the Psychological Autopsy and Postvention are noted. He outlined his thoughts about what one does after suicide and then labeled what was done with people after the dire event as postvention. His brief paper on the case of the bereaved sets forth the differences that distinguish professional sessions with survivors from ordinary condolence conversation. All his life, Shneidman strongly supported the care of the survivors. He reflected on the life-saving role that others can play in saving a potentially suicidal person's life. But Shneidman also ruefully reflects that, in the final analysis, it is the suicidal individual who must play the vital role of sustaining the drama of living to another day. Stepping back from Shneidman's collected works and his life, one is struck by the generativity, the sheer productiveness of his life.

RESUMEN

En el año 2003 el suicidio se declaró como un problema de salud pública por la World Health Organization (WHO), y por tanto la Organización de las Naciones Unidas (ONU), junto con la Asociación Internacional de Prevención de Suicidio (IASP), declararon al 10 de septiembre como el <Prevención del Suicidio>>. Esto fue posible gracias al trabajo y dedicación del doctor Edwin S. Shneidman quien logró obtener la atención pública y política sobre el fenómeno suicida y sus graves consecuencias sociales. Edwin S. Shneidman (1918-2009), fue pionero en el campo de la Prevención del Suicidio además de un prolífico pensador y escritor de este tema, manteniéndose a la vanguardia en sus estudios y reflexiones durante más de 50 años. Su creatividad, sensibilidad y agudeza de conocimiento hicieron posible crear una nueva disciplina la Suicidología, término incluso que él mismo acuñó. Pocas personas tienen la magnífica oportunidad de crear una nueva disciplina, darle nombre, forma y trabajar para contribuir a ella de la manera en que él lo hizo; y más aún, para sensibilizar a otros investigadores competentes e incentivarlos a invertir en ella haciéndola crecer y ganarse un lugar importante en las ciencias de lo humano. El trabajo central de Shneidman, la Suicidología, está basado teoricamente, y de manera primordial en las causas psicológicas y sociológicas del suicidio. Creía que la vida se enriquece con la contemplación de la muerte y el morir; y concibió a la Psicología como la ciencia que debería estar presente en el estudio de estas formas de expresión de la compleja individualidad de la persona, pues consideraba al suicidio, básicamente, como una crisis psicológica. El estudio del suicidio y su propuesta acerca de que éste podría evitarse, se convirtieron en la pasión de su vida. Las contribuciones principales de Shneidman han sido conceptuales. Acuñó palabras y conceptos como suicidología, autopsia psicológica, posvención, muerte sub-intencionada, dolor psicológico. Su trabajo en el campo del suicidio puede ser subdividido así Evaluación conceptual y teórica del comportamiento suicida; Notas póstumas (o recados suicidas); Aspectos administrativos y programáticos; Aspecto clínico y de comunidad; Autopsia psicológica y posvención. Con motivo del primer aniversario luctuoso de Edwin S. Shneidman este artículo pretende ofrecer al lector un homenaje y un panorama de su labor en el campo de la comprensión científica y la prevención del suicidio. Aún más, este texto ratifica la idea de que marcó un hito en el estudio científico y clínico del acto suicida por medio de una revolucionaria perspectiva de investigación, obteniendo así el título de Padre de la Suicidología Contemporánea.