1. Suicide – An Undiscovered Country?
‘The past is a foreign country: they do things differently there’
The Go-Between
LP Hartley

2. Suicide – An Undiscovered Country?
‘Suicide is part of human nature. Everyone must confront it sometime and come to terms with it’ Johann Goethe

3. Suicide – An Undiscovered Country?
Felo de se - a deliberate act of putting an end to one’s own existence, or committing any unlawful malicious act, the consequence of which is one’s own death Moral insanity (including suicidal mania) – where strong emotions and lack of willpower reduce the system, rendering it less capable of enduring fatigue, and thus depressing the vital powers.

4. Suicide – An Undiscovered Country?
Psoric –highs and lows, struggles with outside world, fearing rejection, insecure (epilepsy, cancer, leprosy).
Sycotic –secretive, defensive, suspicious, rigid, jealous (angina, anaemia, rheumatism).
Syphilitic –destructive, quitting, self-harming, distorted thinking (gangrene, insanity, blindness)
Tubercular –malcontented, dissatisfied, intolerant (caries, diabetes, malaria, pneumonia).

5. Suicide – An Undiscovered Country?
’To the person who commits suicide, it is a solution; to the observer, it is a problem’ Thomas Szasz

6. Suicide – An Undiscovered Country?
Freud – thanatos, tobesfried, death drive, compulsion to repeat, aggression against the self. An act linked to inability to tolerate reality and to autoerotic regression NeoFreudians – Otto Fenichel, Karl Menninger, Heinz Hartmann, Melanie Klein, Jacques Lacan, Eric Berne

7. Suicide – An Undiscovered Country?
Socrates – Wise Mind, Big Picture
Voltaire – The Zone
Macchiavelli – Mentalising
Hume – Self knowledge
Rousseau – Delayed Gratification
Aristotle – Realism
Pascal – Goals
Hegel – Pragmatism
Schopenauer – Satisfaction
Bentham/Payne - Sharing

8. Suicide – An Undiscovered Country?
‘No more; and by a sleep to say we end the heartache, and the thousand natural shocks that flesh is heir to: tis a consummation devoutly to be wished. Who would grunt and sweat under a weary life, but that the dread of something after death, The undiscovered country from whose bourn No traveller returns, puzzles the will, and makes us rather bear those ills we have Than fly to others that we know not of?

9. Suicide – An Undiscovered Country?
Multiple morbidity
Prior attempts
Hospitalisation
Substances
Discord
Alienation
Bullying
Offending
Contagion
Abuse
Gender

10. Suicide – An Undiscovered Country?
Collapse of ego Self reproach Low self esteem Magic thinking Annihilation of internal persecutors Liberation Projection of guilt Punishment

11. Suicide – An Undiscovered Country?
Anger – offence against the self
Anxiety – threat to self
Guilt – transgression of moral imperative
Sadness – irrevocable loss
Shame – falling short of ideal

12. Suicide – An Undiscovered Country?
Threats of harm
Abuse or victimisation
Isolation
Chaos
Marginalisation
Loss of control
Disengagement
Stunning
Disintegration

13. Suicide – An Undiscovered Country?
WHO Total
Adolescents
Ireland
4 (15)
3 (25)
Russia/NZ
2 (80)
1 (60)
Baltics
1 (100)
2 (60)
Netherlands
3 (18)
4 (10) UK
5 (12)
5 (10)
Latin
6 (6)
6 (8)

14. Suicide – A Shared Vision?
Awareness
Support
Prescription
Help seeking
Coping
Contracts
Outreach
Monitoring