Understanding Suicidality: A Holistic Approach to Crisis and Mental Health

1. We must at all times remember, that the decision to take your own life is as vast and complex and mysterious as life itself. Al Alvarez, The Savage God

2. Suicidality as a Crisis of the Self • Suicidality is best understood as a crisis of the self: • ‘sui’ in suicide, both victim and perpetrator • closer to the lived experience • encompasses whole person – physical, mental, relational and spiritual • immediately raises important questions that suicidology largely ignores, especially … • who or what is this ‘self’ that is in crisis? • Myth: “depression is the major cause of suicide”

3. Individual Collective Integral Model - 4 Quadrants Exterior Interior Subjective I It Objective Behavioural (observable) Intentional (felt experience) Phenomenology Psychology/Psychiatry • Validity: aesthetic • personal meaning/values • integrity, sincerity • Validity: empirical • observable, measurable • testable, repeatable Its We Inter-Objective Inter-Subjective Social (systems) Cultural Sociology/Ecology Anthropology • Validity: ‘functional fit’ • cohesion, efficiency • ecological, economic • Validity: moral • shared meaning/values • ethics, justness

4. In theory there’s no difference between theory and practice, but in practice, there is. Anonymous

5. Singular Plural 4 Quadrants of Mental Health & Suicide Third-Person (visible) First-Person (invisible) • Lived/felt experience • personal, private • stories, self-talk, dreams • hope, purpose, meaning • ‘consumer’ perspective • ‘depth’ psychologies • (DBT) • Observable behaviour • biology (brain) • diagnosis/treatment • clinical • risk assessment • behavioural psychologies • (CBT) • Mutually shared experience • shared meaning-making • collective story-telling • peer support • consumer delivered • services • Social infrastructure • hospitals, services etc • public policies, laws etc • workforce, training etc • social work • media

6. Spirit Soul Mind Life Matter --------Physics Biology Psychology Theology Mysticism The Full Spectrum (Levels) of Consciousness Sources: Plotinus Aurobindo St. Teresa Grof Steiner Baldwin Habermas Maslow Buddhism Yoga Kabbalah Vedanta Theosophy Sufism Non-Dual Spirit

7. Singular Plural Holistic = All Quadrants, All Levels (AQAL) Third-Person First-Person IT - behavioural I - intentional WE - cultural ITS - social

8. How holistic is suicidology?

9. Singular Plural ‘Evidence-Based’ Suicidology Third-Person First-Person IT - behavioural I - intentional WE - cultural ITS - social

10. Singular Plural ‘Evidence-Based’ Suicidology Third-Person First-Person IT - behavioural I - intentional WE - cultural ITS - social

11. Flatland “the great nightmare of scientific materialism was upon us (Whitehead), the nightmare of one-dimensional man (Marcuse), the disqualified universe (Mumford), the colonisation of art and morals by science (Habermas), the disenchantment of the world (Weber) – a nightmare I have also called flatland” Ken Wilber, Integral Psychology

12. Special mention • The Aeschi Group • Problems In Clinical Practice • even in the case of a severe depression, it is not the disorder itself, which initiates the suicidal act, but the "owner" of the depression, the individual itself • a striking discrepancy between patients' explanations of suicide attempts and those of examining psychiatrists • What's New: A Patient-oriented Approach • the patient's experience is conceptualized as the "gold standard“ • the patient's narrative is the basis of a shared understanding • 5th Aeschi Conference, 4–7 March, 2009 • “Suicide attempters: To hospitalize or not to hospitalize?” • For more: www.aeschiconference.unibe.ch

13. Singular Plural It Takes a Village Third-Person First-Person IT - behavioural I - intentional Suicide Prevention WE - cultural ITS - social

14. Do our mental health laws help or hinder suicide prevention? • scare people off from seeking help • can worsen or trigger suicidality • do they save lives or cost lives? • a gruesome calculation – what is an acceptable ratio? • primary source of “stigma” – i.e. discrimination • involuntary detention versus involuntary treatment • social model of disability – esp. human rights • replace Mental Health Act with Suicide Prevention Act • a question/challenge for the (LL) village ... • It Takes A Village To Prevent A Suicide

15. Ken Wilber Integral Psychology: Consciousness, spirit, psychology, therapy, Shambhala, Boston 2000 Integral Spirituality: A Startling New Role for Religion in the Modern and Postmodern World, Integral Books, Boston 2006 The Integral Vision, Shambhala, Boston 2007 David Webb 'Self, Soul and Spirit: Suicidology's blind spots?' New Paradigm September 2003 - online at www.vicserv.org.au/publications/new_para ‘Bridging the Spirituality Gap’ Australian e-Journal for the Advancement of Mental Health (AeJAMH) Vol 4(1) 2005 - online at www.auseinet.com/journal Or contact me: davidwebbo@gmail.com

16. We must at all times remember, that the decision to take your own life is as vast and complex and mysterious as life itself. Al Alvarez, The Savage God