High Suicide Rates in Northern Ireland – an Essay

Here in Northern Ireland we have the dubious distinction of having the highest rate of suicide in the UK for two years in a row.   Like many people bereaved by suicide (my own husband took his life back in 2011) I’ve come to realise that there is not always an obvious reason for the suicidee’s actions even if they left a note – yet conversely there can sometimes be several contributing factors.  Asking why then, just appears to come with the territory, even if answers are less than forthcoming.  When it comes to our community we can do no less since it is an extension of us and we are all components of the whole.  So for the purpose of this essay and also out of a personal interest, I am asking ‘why are the suicide rates so high in Northern Ireland?’

The first answer that will spring to the mind of many is that we are a post conflict society.  Studies undertaken by the Ulster University have shown that 40% of the population have suffered some sort of serious trauma either emotionally or physically as a result of the troubles.  17% have seen someone killed or injured.  It is for this reason that Northern Ireland also has the highest rate of PTSD in the world, one of the main hallmarks of which is emotional numbing.  

As well as being challenging to the sufferer, depersonalization makes it difficult for them as parents to meet the needs of any children they may have, the ramifications of which become clearer when examined in light of numerous studies demonstrating that the emotional availability of the primary caregiver is a major determinant of the quality of the attachment.  La Freniere (2000, p.g 72)  According to Bowlby (1986, p.g 178) there are five observable responses that make up attachment behaviour in infants; sucking, clinging, following, crying and smiling.  It is the primary caregivers response to these that provides the lessons the child needs to form expectations and beliefs about their own and other people’s behaviour, including whether or not they are loveable or deserving of love and whether or not others can be relied upon to help protect and support them.  

It takes no great leap of imagination then to embrace the possibility that a nation of PTSD sufferers might bring to birth a completely new generation of poorly attached individuals who see themselves as being unimportant, undeserving of love and affection and who feel that the world in general is disinterested in them and cannot be relied upon for support.  Ultimately these negative internal working models predispose them to suicidal ideation.

This can be seen quite starkly when you compare the results of poor attachment with factors that may trigger suicide.  Some of those that overlap include, 

• Depression
• Anger
• Hostility
• Lack of empathy
• Negativity
• Sensitivity to blame
• Sensitivity to rejection
• Isolation due to lack of trust
• Poor self esteem
• Low levels of actual or perceived support
• Relationship problems/breakdown
• Inability to accept loss

In view of my understanding of attachment theory and how it impacts our society on such a scale, therapists obviously find it fundamental to try to ascertain which parenting style their patients have been exposed to.  On a personal level, a clearly depressed acquaintance of mine presented with pronounced low self-esteem, poor working memory, depression, sensitivity to rejection, anger and over investment in relationships.   Over the years she has disclosed that her parents had been extremely authoritarian and cold towards her and her siblings.  This accounted for the beliefs she held about herself and others and eventually, she recognised that this is where they originated from.  Being able to talk about it openly propagated trust and assured her of my support without the possibility of rejection.  She felt understood and valued when the effort was made to truly listen.  Her self esteem grew – not much, but enough to be observable.

One thing that did occur to me during our friendship, is that not all of her siblings were affected in the same way as she was, even though they were brought up in the same manner.  In fact two of her brothers are very strong minded confident people with good relationships with family and friends.  This would seem to contradict Bowlby’s conclusion that ‘prolonged deprivation of the young child of maternal care has grave and far reaching effects on his character and so on the whole of his future life.’ Bowlby and Robertson (1951, p.g 46) 

He also stated that ‘good mothering is almost useless if delayed after the age of two and a half years’ Bowlby and Robertson (1951, p.g 49) thus indicating that no amount of good experiences thereafter can undo the damage done.  I find the statement ‘good mothering is almost useless’ quite an emotionally loaded one, especially in view of Bowlby’s own childhood experiences.  Bowlby and his 5 siblings were cared for by household staff in a distant part of the house and only bought to see their mother between 5 and 6pm in the drawing room as if they were visitors rather than family members.  Aged 9 he was sent to boarding school.  He later said to his wife, ‘that he wouldn’t send a dog to boarding school at that age.’  

His early experiences clearly influenced his work, possibly more so than he understood himself.  I believe that in developing his attachment theory he was either unconsciously or deliberately pointing the finger of blame at his own mother and saying ‘look what you did to me.  No matter what good things you did later, nothing can undo the damage done.  It’s unforgiveable.’  It may seem far-fetched to believe this was a driving force behind his work but he is not the first person in the field of psychology to be driven by his personal experiences; both Rogers and Freud overtly were too.  Although this can be a good thing, it can result in an inflexible outlook that may cause an individual to exclude certain hypotheses or views that simply don’t fit with their experiences.  I believe that Bowlby fell into this trap when he indicated that the damage done by maternal deprivation is permanent and that it is an inevitable consequence.

I also believe the emphasis he placed on monotropy was politically motivated in part since his ideas were presented to a post war society in which many were now calling for the women who had worked during the war years to return to their full time housewife and mother roles so that returning service men might have jobs available to them.  He even listed a mother working full time alongside, war, famine as things likely to cause damage to a child’s development.  Interestingly, a few years later Schaffer and Emerson conducted studies on 60 infants in the city of Glasgow which showed babies to be quite capable of forming multiple attachments and that these are formed as a result of the significant adult’s responsiveness to their attachment signals.  Schaffer and Emmerson (1964, no. 94)

This ability to form attachment to others when biological parents are not meeting the needs of the child might account for my acquaintance’s siblings not being affected in the same ways by their upbringing.  Since they are younger I suspect that their older siblings filled their emotional and physical needs in lieu of their parents.

Another issue in our society, one that is partially related to the high suicide rates is that of wide spread sedative use.  Once again Northern Ireland is a world leader in this respect.  According to yearly studies the average age most begin using antidepressants is 31 years for males and 32 years for women.  Interestingly this coincides with the timing of the ‘mid-life crisis’ (a term which Levinson coined when he said ‘mid-life crisis refers to times of great difficulty in the middle years.’) Levinson (1978, p.g 159).  It is of note too that Erikson’s life stage model places emphasis on love being the key developmental task at this point.  In addition to this he proposed that the crisis all must negotiate during the middle years is that of intimacy over isolation.  

The problem is though, that ‘the capacity to be involved in an intimate, loving relationship requires a sufficient sense of self and sufficient trust to be willing to reveal oneself truthfully to another person.’  Steinberg et al (2011, p.g. 438)  So forming one’s own identity and developing the ability to trust is crucial in being able to successfully negotiate this life stage.  Bronfenbrenner’s nested model shows how our environment, including; schools, religion, neighbours, politics etc can impact our development.  He examined how these interact and affect each other regardless of how young that person might be.  Over the last few decades massive changes in education, economy, diversity, gender, religion and morality have taken place within Northern Ireland, thus garbling the identity of us as a society.  Seen under the lens of the aforementioned theories it is likely then that this period of identity confusion has filtered down through the very fabric of our society until it has reached many of us on a personal level making it difficult to establish meaningful relationships.  It is perhaps this loss of self, societal identity and poor attachment due to transgenerational trauma that has resulted in many 30 somethings being prescribed sedatives and the soaring rates of suicide.  

What I have learnt in relation to research on this subject has informed my understanding of my personal life as well.  I believe that early childhood separations from my mother have no doubt affected me and have influenced my relationships into adulthood.  Unlike Bowlby though I do not believe that I’m a helpless victim with no choice but to receive the after effects of this like some kind of sentence.  I did go on to form attachments to other family members and afterwards with my parents as children are apt to do.  Children can overcome these things as evidenced by successful adoption statistics.  His own life evidenced this dichotomy. He achieved much in spite of his disadvantages.

Much of Bowlby’s research was based on the idea that attachment is a mechanism produced by the evolutionary drive for survival and yet he chose to ignore one very important implication of that.  Evolution teaches us through the fossil record and the ever changing world around us that all life forms adapt to reach their full potential regardless of obstacles.  And that is what I feel I have been doing over the years in spite of my upbringing as have many others. We have the ability to adapt.

Many of the theories covered by research in this field do not take the evolutionary aspect into consideration.  In their insistence that all humans must follow some clearly defined pathway of development, they disallow any accommodation of difference, let alone hope for improvement, should a developmental stage not be negotiated in the prescribed time.  I believe that this uncompromising viewpoint of the human race potentially poses a threat to good professional practice.  A therapist with a loose belief in the truth that all well researched theories possess, based on reasoning and experience as well as one who embraces the countless possibilities for diversity, is, in my opinion, in a much better position to assist a client than one who pigeonholes and assesses.  It is vital, as friends, parents, professionals and individuals that we believe in the ongoing potential of ourselves and of each other.

For me, developmental theory is too much about meeting or not meeting certain expectations and that is not the type of mindset I subscribe to. It’s rigidity is harmful. Instead I prefer to place my hopes on the innate desire to self actualise that all living organisms have.   The founder of the humanistic approach to psychology, Carl Rogers, spoke of potatoes kept in his family basement that were long forgotten about and how even they had striven to grow, sending their white shrivelled shoots towards the window where they could receive light in order to survive.  This belief in the desire for life to ‘find a way’ enabled him to work with terribly damaged clients and still retain the hope and belief that they could change.  I think developmental theory can be melded with these ideals but only when used with flexibility.

References – 

LaFreniere.P.J (2000) Adaptive Origins : Evolution and Human Development (first edition) US: Psychology Press

Bowlby.J (1986) Attachment and Loss (second edition) US: Basic Books

Bowlby. J and Robertson. J (1952) Responses of Young Children to Separation from Their Mothers.  France: Courier Centre International L’Enfance

Schaffer, H.R. and Emerson P.E. 1964. The development of social attachments in infancy, Monographs of Social Research in Child Development 29: no. 94.

Levinson.D.J (1978) The Seasons of Man. (first edition) UK: Ballantine BooksSteinberg.L, Bornstein.M.H, Vandell.D.L  and Rook.K.S (2010) Lifespan development : Infancy through to adulthood (first edition) UK:Cengage

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