WHEN A CHILD KILLS HIMSELF
- Boris Cyrulnik -
Attachment and societies
Extracts from Report submitted to Mrs. Jeannette Bougrab
French Secretary of State in charge of Youth and Associative Life
(In France Éditions Odile Jacob - ISBN 978-2-7381-2688-7)
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Thinking the unthinkable, Understanding the incomprehensible, these could have been the titles of this groundbreaking study on child suicide. Our contemporary societies are just beginning to catch a glimpse of the dark tragedy that has been unfolding before our eyes for several years now. It could not be otherwise, for how can we imagine, how can we conceive, how can we even begin to think or to sketch out a theory about this self-homicide, this self-assassination in little ones only 7, 8 or 9 years old? These children have, by definition, their whole lives ahead of them. And yet, they decide to end their lives.
A taboo is just beginning to fall. How can we fail to remember that suicide, this scourge that insidiously settles in the psychic life of individuals, is the second cause of mortality of 16-25 year olds, just after traffic accidents? But until now, no one had dared to address, or even touch this sad reality of children's suicide, often preferring to deny it by hiding it behind so-called dangerous games like the scarf game. Yes, suicide also affects the youngest, the children, the pre-adolescents.
Through his work, his books, Boris Cyrulnik was the ideal person to address what is nothing but pain, to try to prevent this catastrophe and to heal the families who have experienced such a drama.
The idea of publishing a report commissioned by the Minister of Youth, with a very wide distribution, was a deliberate and strong will to say that we can all be one day an actor of suicide prevention if we know how to read and translate the indicators, the signs of evil that our children let us see.
I am convinced that this work was vital in order to act to prevent the suffering of children who, out of desperation, because they are not heard by adults, act in risky ways (dangerous games, running across the street...) until the predictable fatal accident. Because if there are less than fifty suicides of children per year, this raw data does not reveal the malaise of children. Statistics and scientific knowledge are often partial. Suicide attempts, suicidal thoughts and suicidal behaviour, for example, are not counted, even though they are very numerous. Forty percent of children think about death because they are so anxious and unhappy.
Boris Cyrulnik's groundbreaking work, using a multidisciplinary approach combining neurobiology, biochemistry, psychology, sociology and other disciplines, sheds light on the fact that the factors of fragility are determined very early on, from the last weeks of pregnancy. The audacity of the method is found in the solutions proposed to overcome the suffering of children, which often has a traumatic origin dating back to early childhood, even in utero.
The richly layered proposals formulated here by Boris Cyrulnik give us hope. The tracks envisaged concern the quality of early childhood training as well as the creation of listening places and the return to a culture of clubs in the neighborhoods... All these measures are feasible in the short and medium term. Far from requiring considerable financial means, they depend on our sole will to look at a terrifying reality in a systemic way. We can therefore, all of us, from now on, be actors in the prevention of child suicide. Love, affection, family ties, and listening to adults can also constitute effective and scientifically proven protections against suicide.
- Extract from the preface by Jeannette Bougrab
Secretary of State in charge of Youth and Associative Life (2011)
HOW TO KNOW?
When a child kills himself, is it suicide?
Self-murder is not easy to think about. Each era, each culture has interpreted this fact in a different way: tolerated by Plato, condemned by Aristotle, valued by Roman antiquity, strongly stigmatized by Christianity and other monotheisms, a major sin for the Church, which supplicated the bodies of the suicides, and wisdom according to Erasmus, in those who kill themselves out of disgust with life.
It is only during the Enlightenment that suicide became a subject of debate. Jean Jacques Rousseau defends the right to be delivered from life, while the priests apply themselves to make it a taboo (Batt-Moillo A., A. Jourdain, "Le suicide et sa prévention" Rennes, Éditions de l'École Nationale de la Santé Publique, 2005). Of course, it was Emile Durkheim, the founder of sociology, who put the problem in contemporary terms: "Suicide is solely a social problem" (Durkheim E. (1897) Le suicide, Paris, PUF, 1999), which, for a psychologist, is not false, but it is not sufficient.
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When a pre-teenager kills himself, what does he give himself? Does he opt for an irremediable end of life or self-destructive violence, like those children who hit their foreheads on the ground, bite or scratch their faces? Does he simply want to hurt those around him? Is he suffering from an impulsive desire to relieve himself of an unbearable emotional tension? All these different emotions come together. The fact remains that, for an adult, it is difficult to think about the unthinkable, to understand this irremediable act.
We are not going to look for the cause that explains every suicide: a biological determinant or, on the contrary, a social cause, a psychological weakness, a mental illness or a family disorder. Instead, we will try to reason in a systemic way, giving the floor to researchers and practitioners with different backgrounds.
After this multifactorial investigation, we will propose a strategy to fight against suicide. Then, we will explain that a tendency is not a destiny and that no history is a fatality.
EPIDEMIOLOGY
These works collect information that allows us to identify the frequency of suicides, their distribution according to social groups and their evolution according to cultures or political decisions that reduce or increase risk factors.
"Fantasies, terror, fascination, taboos, secrets, models, images, real or invented memories between life and death, pleasure and desire, between force and right, drive and reason," (Legay D. "Which campaigns of prevention against suicide? in A. Batt-Moillo, A. Jourdain. Le suicide et sa prévention, op. cit. p.95) our thinking is so entangled that the suicide of a child is unbelievable and unbearable.
Suicide rates are low among preadolescents. However, since they are increasing in many countries, they are probably an indicator of disorganized conditions for a child's development.
Completed suicides are rare. On the other hand, children are increasingly considering killing themselves! Before the age of 13, 16% of children think that death could be a solution to their problems with family, school or friends.
The idea of taking one's own life is not uncommon among children, but the realization of suicide is quite difficult, especially for girls. Lack of technique? Impulsivity that prevents the planning of the act?
Among adolescents, we can see a gradation in the approach to death: first, during a moment of aggressive tension or extreme distress, death seems like a flash. Then 16% of them think about it regularly, they plan and organize its coming.
This progression is not seen in the little ones. They play, laugh, respond nicely and jump out of the window. To kill himself, a child looks around for the tools that could give him death: getting hit by a car, leaning out of the window, running across the street, jumping off a speeding bus, diving into the swirling stream that fascinates him. Many child suicides are masked by everyday behaviors that lead to death. The accident is not accidental when a conduct makes it probable.
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Trapped in a preoccupation, the child shows cognitive disorders. He is so absorbed by his inner world that he cannot process external information. Sometimes he talks to an adult, telling him that he feels bad, that his stomach is not right or that he has a headache. The adult reassures him and soothes him with a loving pat. The child thinks the man is nice and leaves with his problem deep in his soul. The adult calms him down by denying that this cute child has thought about death. Unthinkable at this age!
The suicide of a child represents the absolute scandal and the impossible mourning for those around him. How to cry, how to talk, how to say that he was brave "all his life", that he fought against the disease, that he was a good student? He had barely been born, he had no time to create a story.
Invisible suicides exist at all ages: the old man who no longer takes his medication, the elderly woman who refuses to drink even though she is dehydrated, the adult who rushes into danger, the teenager who takes ill-considered risks or the "distracted" child who runs across the street invite death. No one is talking about suicide!
To assess suicides, we must take into account the thoughts that evoke death and the behaviors that provoke them.
As a child, his family and friends often say that his emotionality was intense, inhibited and then explosive, or that his impulsiveness was difficult to control. Such an emotional disorder is neither an illness nor a depression. However, when there is a relationship difficulty, the distant or overly attached child reveals a developmental flaw. (Conner K. R., Duberstein P. R., Conwell Y., "Psychological vulnerability to complete suicide: A review of empirical studies", Suicide Life Threat Behavior 2001, 31 (4) p.367-385) An environmental, superficial or momentary failure is enough to trigger self-centered violence on an organism still unable to master it (Shafit M., Carrigan S., Whittinghill J. R., Derrick A., "Psychological autopsy of completed suicide in children and adolescents", American Journal of Psychiatry, 1985, 142 (9), p. 1061-1063)
A child who kills himself does not necessarily kill himself.
SUICIDE BY GENDER
Why do boys commit suicide more than girls?
... It has been argued that men kill themselves more than women because they destroy themselves with firearms, while women, before swallowing their pills, put on a nice nightgown. This argument does not hold for little boys who do not know how to use a gun.
Why do girls in some countries commit suicide more than boys?
Why do white boys kill themselves more than colored boys? It is not the pigment of their skin that protects African boys, but rather the place that boys are given in their family and their culture.
Perhaps white boys commit suicide because they are less responsible than colored boys. Responsibility, which is a burden for the young person, gives him at the same time a framework, a self-esteem, a project of existence.
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impoverishment. Perhaps a right should be added to the Convention on the Rights of the Child: in order to strengthen the little ones and give them a daily project, they should be given the right to give (Cyrulnik B. in C. Brisset, Children's Ombudsman, Rights of the Child, 2007).
The hypothesis of a decrease in self-esteem as a result of disempowerment is defensible, since surveys tell us that young mothers practically no longer attempt suicide (Pfeffer C. R. "Assessing suicidal behavior in children and adolescents", in R. A. King, A. Apter (eds), Suicide in Children and Adolescents, Cambridge University Press 2003, p.211-216). The most effective weapon against suicide would then consist in giving meaning to existence, which changes the way of perceiving reality. The affective connotation even modifies the perception of physical pain or existential suffering (Borod J. C., The Neuropsychology of Emotion, Oxford University Press, 2000).
When "suffering is worth it," we don't think about death. The problem is that the meaning, that is to say the significance and direction we give to events comes from our history and our context. It is the other imprinted in our memory that gives meaning to things, energizes our dreams and changes the emotional connotation of the reality we perceive.
... Difficulty does not lead to suicide when the family and the culture learn to overcome evil by giving meaning to suffering. When a boy is disempowered, any pain becomes unbearable for him because he does not know for whom he suffers. It is not the pain that leads to despair, it is the meaninglessness of the pain. Disengagement, for a boy, is the equivalent of emotional isolation. When you have no one to work for, when you have no dreams to fulfill, living is not worth it.
Girls are very sensitive to meaning. They are able to metamorphose the memory of the pain of childbirth.
... A generation or two ago, all children were engaged in work on the farm, at home, at school. ... We suffered, but it was not enough to think about death.
Today, children under 13 suffer less materially, but think more about death. The idea of death appears earlier, and the age of the first attempt is lower with the better physical and psychic maturation of children (Wasserman D., Cheng Q., Jiang G. X. "Global suicide rates among young people aged 15-19", "World Psychiatry", 2005, p.114-120)
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When suffering has no meaning, when family or cultural disengagement impoverishes the emotional environment to the point of sensory isolation, the idea of killing oneself comes more easily to girls (12%) than to boys (6%). Why do they worry about death more than boys? Are they more vulnerable, more aware of the difficulties that await them or do they need more commitment?
We know that little girls develop more quickly than boys. They speak earlier, they access before them the representation of the non-reversible, the irremediable, at a time when their early psychic autonomy is not associated with their social independence (Anawait B. D., "Male reproductive endocrinology", The Merck Manual, online Medical Library for Health Professionals, 2007). They feel a sense of injustice and repression because they have intellectual control over their representations, but do not yet have the freedom to express them socially. Intelligent and dependent, they are exasperated and try to control everything.
... Boys, whose development is slower, approach the world like little males: more relaxed, more sure of themselves, they like confrontations and competitions where they discover what they are worth.
The appearance of the idea of death as a possible solution to a human problem depends on the sex, the level of development of the little person and the socio-cultural structures in which the children grow up. The lowering of the age of the young suicides testifies to the combined influences of puberty, which is increasingly early for girls, and of adolescence, which is prolonged by the need to study in order to learn a trade.
The social construction of gender plays a major role in the internalization of gender roles. Perhaps this is the reason why minority sexualities commit suicide so much in adolescence? Since they are less assaulted by culture, these minorities commit suicide less (Rutter P. A., Soucar E., "Youth suicide risk and sexual orientation", Adolescence, 2002)
WHAT IS IT LIKE TO BE DEAD?
The idea of giving oneself death is not the same according to age, sex and cultural conditions.
... For a 7 year old child, death is an elsewhere, strange and reversible. One can die to join his grandfather on a cloud and wait with him to return to earth. (Lonetto R., "Dis, c'est quoi quand on est mort?" 1988) .
The idea of death is a process that is gradually built in the soul of a child. ... The neuropsychological development of the little one makes him live in a contextual and immediate world. He cannot yet represent a distant elsewhere in time and space.
... The word "death" becomes "adult" between the ages of 6 and 9, depending on the family and cultural context. Only then does it take on the same meaning for a child and an adult.
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Before the age of 8, death is only a cessation, a separation, a temporary absence, reversible. (Ferrari P., "Concept de Mort chez l'enfant", 2000) After this level of development, the term "death" designates an irreversible event, a universal phenomenon, linked to the living.
... The meaning that the child attributes to death results from a
The meaning that the child attributes to death results from a transaction between the way in which he has developed and the theater of death staged by his culture.
This progression of the representation of time gives the word "suicide" a particular meaning for the child. Premeditation is difficult. Most of the time it is an impulse that, with maturation, takes the form of a game. The distinction between obvious and masked suicide is difficult.
... It is not uncommon for death to strike around the child. Five percent of minors under the age of 18 have already lost one or both parents. Such a confrontation with an early mourning provokes in the child a surprising gravity. The reality of death accelerates and brutalizes the path towards the idea of death, as can be observed in countries at war.
... Finally, we can say that the idea of death is not a concept that falls from the sky. It is a slow process that results from incessant transactions between what the child is and what is around him.
However, the idea of death is not necessarily associated with the idea of killing oneself. It is another path.
GENETICS OF SUICIDE
In all the people who have shown suicidal behavior, a biological dysfunction has been noted, which does not mean that this disorder is the cause of the suicide.
... The discovery of serotonin, a neurotransmitter that passes through synapses from one neuron to another, plays an important role in the regulation of mood and sheds new light on how we react to life events (Caspi A., Sogden K., Moffitt T. et al. E. et al. "Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene", Science, 2003).
In frequently verified assays, the brains of suicide victims have been found to concentrate significantly less serotonin in the prefrontal cortex and brainstem than in those who have died of another cause (Arango Y., Undwood M. D, Mann J. J., "Post-mortem findings in suicide victims. Implications for in vivo imaging studies", Annals, Academy of Sciences, 1997)
... The discovery of serotonin, a neurotransmitter that passes through synapses from one neuron to another, plays an important role in the regulation of mood and sheds new light on how we react to life events (Caspi A., Sogden K., Moffitt T. et al. E. et al. "Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene", Science, 2003).
In frequently verified assays, the brains of suicide victims have been found to concentrate significantly less serotonin in the prefrontal cortex and brainstem than in those who have died of another cause (Arango Y., Undwood M. D, Mann J. J., "Post-mortem findings in suicide victims. Implications for in vivo imaging studies", Annals, Academy of Sciences, 1997)
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... Why is there so little serotonin in the prefrontal lobe of suicide victims? The answer comes from neuroimaging, which shows pictures and films of prefrontal cortices collecting little serotonin. In almost all cases, the subject was isolated as an infant. A sensory isolation, during the first months of life, did not stimulate enough the synaptization of the prefrontal lobes (Evrard P., "Stimulation and development of the nervous system", in J. Cohen-Solal, B. Golse, "At the beginning of the psychic life", 1999).
When the sensory environment of a newborn child is impoverished by the burden of parents made unhappy by a tragedy of existence, the brain of the child, not sufficiently stimulated, develops badly. The death of a parent, a maternal depression, a marital conflict that freezes the relationship or even a social precariousness that brings down the parents impoverish the affective niche of the child. The child's atrophied brain does not capture serotonin, a soothing substance. The child has just acquired a biological vulnerability because his parents have suffered around him.
EPIGENESE
... Emotional vulnerability is thus acquired during early interactions by an association between a genetic aptitude and an environmental structure. The "serotonin-prefontal lobes" system has not acquired the calming function that allows to control the impulses. When a danger arises in his world, the limbic circuit that processes emotions (on the inner side of the hemispheres) "fires up" and consumes a lot of energy. Since inhibition, this brake coming from the prefrontal lobes, has not been put in place during the first months, the subject remains subjected to his emotions which he cannot control. If, later on, he has not learned to speak properly or if his culture has not inculcated in him the rituals that code interactions, acting out, the physical explosion becomes his only possibility of appeasement.
.. Repeated experiments in a very large number of mammals show that when a youngster is isolated, i.e. deprived of the presence of another person during its early interactions, not only do its prefrontal neurons not start to function, but, in addition, it does not learn to feel secure in contact with another person. The only external object is himself, his own body: he experiences any information as an emotional alert, an aggression to which he responds by self-aggression (Higley J. P., Linnola M. "Low central nervous system serotoninergic activity is trait like and correlates with impulsive behavior. A non-human primate model investigating genetic and enviromental influences on neurotransmission" Annals, Academy of Sciences, 1997)
... Any event traumatizes an infant when it tears his bonds. For a baby who has lost his anchorage in the world, everything that happens around him becomes an alarm. He panics at the slightest piece of information and the biology of stress (cortisol, catecholamines) not only alters certain brain cells of the limbic system (memory, emotions) but also increases the methylation of the feeder cells that surround the neurons. Not only is the expression of genes modified, but also, when an early traumatized person reaches the age of procreation, he or she transmits to his or her children genetic sequences modified by the trauma and this, over several generations. (Bustany P., Ardix Seminar, Paris, February 1st 2011).
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The structure of the early environment is a powerful organizer of
gene expression. ... Epigenesis explains that a blatant trauma, such as violent abuse, or an invisible trauma, such as emotional neglect, tears the bonds and makes the child live in a frightening world. All of the child's metabolisms are modified: stress substances increase, but the soothing serotonin and dopamine that facilitate action, emotion and intellectual vivacity collapse. It is indeed the early relationship that has modified brain function and caused the acquisition of vulnerability.
Children do not react in the same way to the same structure of environment. ... What is mistreatment for one is not for the other.
... What is important in order to understand the acquisition of a factor of vulnerability or, on the contrary, of a factor of resilience, is to analyze the transaction between the biological structure of an individual and the psychocultural structure of his environment. When this articulation has been impregnated in the subject's biological memory, it is with this "way of being" that he or she embarks on his or her life path.
... Children who have learned to live in an affective and social restriction when they were small, still feel alone in adolescence, even when they are surrounded. If a suicidal idea comes into their head, no security base can make it disappear: the act becomes possible. (Rudatsikira E., Muula A. S., YZiya S., Twa-Twa S. "Suicidal ideation and associated factors among school-going adolescents in rural Uganda", BMC Psychiatry, 2007).
... The word, when it has a calming effect, or the interaction rites proposed by the culture are reassuring factors of environmental origin.
... The affective stability of the parents thus allows hypersensitive children to acquire a control of their impulses, even when they happen to be unhappy. Emotional vulnerability does not lead to compulsory suffering or to psychiatric pathology.
... The affective stability of the parents thus allows hypersensitive children to acquire a control of their impulses, even when they happen to be unhappy. Emotional vulnerability does not lead to compulsory suffering or to psychiatric pathology.
HORMONES AND SUICIDES
One may wonder why puberty causes some people to have a surge of suicidal thoughts. This has to do with self-image. The representation of oneself is built in our soul under the double pressure of our history and our context. We engage in existence according to this self-image. If the memory of the teenager is nourished of failures, abuse and shame, when the desire sharpened by the hormones arises, the representation of oneself will say: "How do you want that a girl accepts a bum like you?" Desperation, frustration and maybe even rage are associated with desire.
Hormones are not secreted at the same time in girls and boys; the proportions are not the same and the effects on the body are different.
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[...] The development of children is different according to their sex. [...] When young people reach the age where they have to take the two greatest risks of their lives, that is, sexual and social adventure, they sometimes collapse. Each one reacts according to his or her gender when "a specific vulnerability to suicidal behaviour has been established" (Franc N., Purper-Ouakil D., "Particularités des enfants et des adolescents", in P. Courtet, Suicides and suicide attempts). Girls, who are more verbal and relational, attempt suicide without damaging their bodies. Whereas insecure boys, without confidants, with little experience of intimate relationships (Dulac G., "Aider les hommes ... aussi", Montreal, ULB, 2001), but whose violence is valued in difficult cultures, do not hesitate to break themselves.
When hormones prepare the body for sexual change, it will be different again for boys and girls. The morphology of boys will follow the same process. They will grow taller, wider, deeper in voice and will feel this evolution as a promotion, an entry into manhood. Whereas the anatomy of the girls will be metamorphosed and will become carrying sexual signals: the breasts inflate, the size is marked, the hips become heavier.
[...] The construction of sexual identity is a difficult ordeal. Most girls are happy with the metamorphosis of their bodies that attracts boys. Most boys thrive on continuity; they get bigger, stronger, to seduce girls. But, when one is desperate to belong to the sex one hates or when one has the anguish of sexualizing oneself, it happens that the young person thinks of disappearing to solve his suffering. Then, the way in which he plans to kill himself depends on the way his gender has been constructed.
ATTACHMENTS AND DEATH WISH
When an elderly person takes his own life after mature and painful reflection, the gesture does not have the same meaning as when a child attempts death and loses his life. Very often, he or she has already experienced death.
They may be precocious orphans who have lost one or both parents in their early years. When an emotional substitute was quickly offered to them, the feeling of having had parents is imprinted in their memory, they feel less orphaned and their disappearance leaves fewer traces. On the contrary, when the death of the parents tears the affective niche that surrounds the child, when the family and society do not offer the child a substitute envelope, the child acquires an ability to perceive the void, a chasm that later, in case of affective loss, can evoke death (Mishara B. L., Toussignant M. "Comprendre le suicide", Les Presses de l'Université de Montréal, 2004).
The threat of death that a child perceives around him plays a significant role in his self-image. When he thinks that his father is going to kill his mother during a violent argument, when a member of the family is hospitalized for a suicide attempt, when someone suffers the death of a close relative or when there are whispers that he has attempted to kill himself, when war or social precariousness force one to think of death every day, when films or the news give a mortifying representation of the human condition, the child becomes familiar with the idea of death.
[...] When he is small, a threat of abandonment is for him an equivalent of killing. Even if he does not give to the word "death" the same meaning as an adult, the representation of the abandonment provokes in him, the sensation of an empty world, of an abyss where one cannot live. It is a sensation of imminent death, of intractable urgency, of cognitive panic that carries the child away.
The depressed, suicidal, or blackmailer parent is no longer a security
base for the the depressed, suicidal, or blackmailing parent is no longer a basis of security for the child, but becomes a kind of panic teacher. When the child comes home from school, he rushes to his mother's room to see if she is already dead. He learns the horror.
This reaction is very different from that of a child who is told of a fatal illness: he often calms down and shows a hyperattachment that moves adults. Their calmness is a sign of resignation and loss of the urge to live, and their gentle attachment reveals their search for a secure base. The tender and upset relatives provide her with love in a state of painful happiness. "I am happy to have soothed her torment. The last year of his life was a wonderful time of love," says the mother desperate for the loss of her son and yet happy to have accompanied him well.
[...] When he is small, a threat of abandonment is for him an equivalent of killing. Even if he does not give to the word "death" the same meaning as an adult, the representation of the abandonment provokes in him, the sensation of an empty world, of an abyss where one cannot live. It is a sensation of imminent death, of intractable urgency, of cognitive panic that carries the child away.
The depressed, suicidal, or blackmailer parent is no longer a security
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This reaction is very different from that of a child who is told of a fatal illness: he often calms down and shows a hyperattachment that moves adults. Their calmness is a sign of resignation and loss of the urge to live, and their gentle attachment reveals their search for a secure base. The tender and upset relatives provide her with love in a state of painful happiness. "I am happy to have soothed her torment. The last year of his life was a wonderful time of love," says the mother desperate for the loss of her son and yet happy to have accompanied him well.
It is the opposite that happens in the soul of a child whose parents have become bases of insecurity. Their own misfortune imbues the child's memory with a feeling of imminent death that remains impossible to calm. Having acquired this mode of emotional reaction, the slightest event awakens in him a mortal panic: a bad mark at school, the loss of a friendship triggers the impulse traced in his biological memory. Not only do these children think about death for no reason, but this acquired impulse becomes for them a possible way to solve their problems. The mortal solution arises in their mind and imposes itself, without possible appeasement. [...] The child cannot count on anyone, since the threat of death comes from his parents from whom he expects protection. He can then commit suicide without wanting to die, as one jumps out of the window to avoid the flames of the house.
Almost all preteens who express suicidal ideation belong to the borderline group, those personalities who have so much trouble building themselves. Their moods change abruptly for a trivial cause, they get angry when they were smiling, their ambivalent attachment leads them to attack those they love and then regret it, they make surface friends but desire the intimacy they fear, they don't know how to live alone, but their incessant conflicts isolate them. This difficult relationship style is the result of poorly formed attachments due to early trauma from family misfortune (Patrick M., Hobson R. P., Castle D., Howard R. Maugham B., "Personality disorder and the mental representation of early social experience", Development and Psychopathology, 1994). Since the trauma of the first months, poorly identified because it is often an affective neglect difficult to observe, poorly supported by lack of affective substitute, poorly elaborated in an environment where little is said, the child struggles to meet a tutor of resilience. Preoccupied by the emotional fickleness that alters his relationships, he deprives himself of the affective stability that would have allowed him to develop harmoniously.
The account that these borderline personalities give of their life as a child is hardly coherent: they combine in the same sentence the love and hatred of their parents, describe a cruel mother whom they want to protect, and claim the affection that they flee as soon as it is given to them.
When a small child loses its mother, it cannot be said that it mourns (Hanus M. "La Résilience: à quel prix? Survivre et rebondir", Paris, Maloine, 2001). But we can say that the affective niche which made him secure is suddenly impoverished. If he is badly surrounded, badly stimulated, the developments of the child are disorganized. He sends distress signals that no stable structure around him can soothe. What is inscribed in his memory is a learning of distress. And this is how he learns to respond to the inevitable frustrations of daily life.
When an early emotional substitute soothes the child and helps him to resume a new development, a particular personality is established. The body calms down, some pleasant relationships are organized, but the biological trace of the loss of the first months, buried under the resumption of the developments, is not completely erased.
When a small child loses its mother, it cannot be said that it mourns (Hanus M. "La Résilience: à quel prix? Survivre et rebondir", Paris, Maloine, 2001). But we can say that the affective niche which made him secure is suddenly impoverished. If he is badly surrounded, badly stimulated, the developments of the child are disorganized. He sends distress signals that no stable structure around him can soothe. What is inscribed in his memory is a learning of distress. And this is how he learns to respond to the inevitable frustrations of daily life.
When an early emotional substitute soothes the child and helps him to resume a new development, a particular personality is established. The body calms down, some pleasant relationships are organized, but the biological trace of the loss of the first months, buried under the resumption of the developments, is not completely erased.
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In adolescence, when one has to appeal to the image that one forms of oneself to try the sexual adventure and to the confidence of oneself to try the social enterprise, this acquired vulnerability can wake up and provoke the collapse.
In addition to the biological traces of the loss, there is the feeling of not being like the others: when one has no parents, when they are abusive, sick or in prison, this representation, which depends on the cultural narratives, amplifies the biological vulnerability. Suicidal thinking results from the convergence of all these heterogeneous causes (Bunch J., Baraclouch B; "Suicide following death of parents", Social Psychiatry, 1971).
The psychosocial commitment of an adolescent is therefore linked to the attachment style that he or she acquired at an early age. When an early misfortune fascinates the mental world of a child, he has a high probability of collapse in adolescence. (Allen J. P., Moore C., Kuperminc G. P., Bell K. L. "Attachment and adolescent psychosocial functionning", Child Development, 1998). The potential for suicide in adolescence is strongly correlated with the preoccupied affective style that causes relationship difficulties.
A child who is mistreated before the age of 4 learns to distrust others. He reacts to any encounter by withdrawing (Guedeney N., Guedeney A., "L'Attachement. Concepts and applications", Paris, Masson, 2006). This isolation or rather this affective distance slows down his learning. He speaks less, becomes peripheralized and self-centered. He feels attacked, he shouts, he avoids, he runs away, he attacks to defend himself and isolates himself to suffer less. By defending himself in this way, he slows down the development of his empathy. He does not train himself to represent the mental world of his loved ones, which alters intersubjectivity.
Emotional neglect, which is increasingly frequent due to the modification of family structures by modern living conditions, impoverishes the sensory niche of the first months. This leads to intimate insecurity, relational withdrawal at school and a feeling of incompetence (Cooper M. L., Shaver P. R., Collins N. L. "Attachment styles, emotion regulation, and adjustment in adolescence" Journal of Personality and Social Psychology, 1998). The child who has acquired a "worthless self" sometimes gives himself the illusion of revaluing himself by becoming delinquent. He triumphs over his fear and finally provokes the admiration of his gang mates. This immediate benefit comes at an exorbitant price, since it sets the child on a desocializing trajectory.
Fortunately, this trend is not inevitable. A single structuring relationship with another parent, a friend, or an encounter with a significant adult is enough to straighten out the situation and correct the orientation. (Born M., "Pour qu'ils s'en sortir. Les leviers de l'intervention auprès de jeunes délinquants", Brussels, De Boeck, 2011). It should be noted that adolescents who have acquired a secure attachment in their early childhood are those who most readily accept being put back on the "right track."
Emotional neglect, which is increasingly frequent due to the modification of family structures by modern living conditions, impoverishes the sensory niche of the first months. This leads to intimate insecurity, relational withdrawal at school and a feeling of incompetence (Cooper M. L., Shaver P. R., Collins N. L. "Attachment styles, emotion regulation, and adjustment in adolescence" Journal of Personality and Social Psychology, 1998). The child who has acquired a "worthless self" sometimes gives himself the illusion of revaluing himself by becoming delinquent. He triumphs over his fear and finally provokes the admiration of his gang mates. This immediate benefit comes at an exorbitant price, since it sets the child on a desocializing trajectory.
Fortunately, this trend is not inevitable. A single structuring relationship with another parent, a friend, or an encounter with a significant adult is enough to straighten out the situation and correct the orientation. (Born M., "Pour qu'ils s'en sortir. Les leviers de l'intervention auprès de jeunes délinquants", Brussels, De Boeck, 2011). It should be noted that adolescents who have acquired a secure attachment in their early childhood are those who most readily accept being put back on the "right track."
These "secure" children make up only 15-20% of suicidal
depressions, and even then they know how to seek help. The insecure, who make up 80-85% of the suicidal population, have ways of suffering that are characteristic of their attachment style. Avoiders mask their suffering, isolate themselves, pretend they don't need help, and when invited to talk, they respond, "I don't remember ... I don't know..." which of course is not true. The ambivalent ones call for help, but when we run to them, they attack us or run away and blame us for abandoning them. The confused are the most difficult children to understand and help.
On the whole, poor sharing of distress because one does not know how to express it or because those around one do not want to hear it allows the child to drift into self-centered mentalizations that eventually become depressive ruminations (Nolen-Hoeckesemas S., Parker L. E., Larson L. J., "Ruminative coping with depressed mood following loss", Journal of Personality and Social Psychology, 1994)
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On the whole, poor sharing of distress because one does not know how to express it or because those around one do not want to hear it allows the child to drift into self-centered mentalizations that eventually become depressive ruminations (Nolen-Hoeckesemas S., Parker L. E., Larson L. J., "Ruminative coping with depressed mood following loss", Journal of Personality and Social Psychology, 1994)
A young person's self-aggression is often directed at someone for whom he or she claims affection (Shaffer D., "Suicide in childhood and early adolescence", Journal of Child Psychology and Psychiatry, 1974). This does not mean that these children were not loved. Their subjective affective deficiency often comes from an early impoverishment of the sensory niche, due to an organic disease, a family misfortune or a social disorganization. All of these heterogeneous causes converge in the child's sensory environment, impoverishing the niche and imprinting an affective style in the child's memory that can lead to a subjective affective deficiency. The child feels unloved, even though he or she was surrounded by affectionate parents.
Secure children have parents who can move away and try their social adventure without the child feeling abandoned. The sensory distance is great, but it does not alter the emotional closeness that is well established in the soul of a secure child.
Secure children have parents who can move away and try their social adventure without the child feeling abandoned. The sensory distance is great, but it does not alter the emotional closeness that is well established in the soul of a secure child.
THE MENTAL WORLD OF THE SUICIDAL
The distress of a child is often difficult to perceive because he lives in an immediate time. Intensely unhappy at 10 o'clock, on the verge of acting out, they can become intensely happy at a quarter past ten because someone has spoken kindly to them. Prediction is not easy when time is running so fast.
A teenager, on the other hand, lives in a longer representation of time: "She has left me, I can never be happy again. My life has no meaning without her." Death in such a representation of time appears as a relief.
The distress of 12-15% of our teenagers is heartbreaking. Depressed, pallid, with dark circles in their eyes, without movement or mimicry, they can suddenly explode against others or against themselves.
Between these two opposing pictures, these older children often express presuicidal statements, semantic behaviors: a very good student becomes bad, a girl surrounded by friends isolates herself in her room, a smiling boy becomes morose and withdrawn. They express confused somatic complaints. "Stomach ache ... headache ..." means "I feel bad, I don't know why". The doctor consulted declares that everything is fine, and the young person's stagnation continues. In France, 17% of students think that death could be a relief. Some of them will take action, a small number will succeed (Pommereau X. "L'adolescent suicidaire", Paris, Dunod, 2001). Young people do not know that the death drive is not always a desire for death. They will understand this later, when a new way of living will lead them to think: "Fortunately, it didn't work. Fascinated by my suffering, I didn't understand that there were other solutions".
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We could describe the process that, starting from the suicidal idea, leads to the act in these terms:
- I feel bad and I don't know why.
- I can't find a solution. The idea of death, like a flash of lightning, offers me a possible way out.
- With each trial, this idea comes back to me, more and more easily.
- It's all I can think about now because I feel so bad.
- I foresee, I plan the gesture which will relieve me of the existence.
- From now on, it only takes a little to launch me into death. (Séguin M., "Le suicide", Montréal, Éditions Logiques, 1991).
Each stage is reversible (except, of course, for completed suicide), but in pre-adolescents, this pathway telescopes: a child feels bad, becomes cheerful again, and suddenly acts out. This progression can take place in bursts of despair but, as the representation of time is brief in children, it is better to speak of "suicidal crises" which can be resolved when the friendly, family or cultural context is changed.
When he thinks of killing himself, the teenager suffers, the adult sinks, the elderly person has already sunk and the child gives in to an instantaneous impulse. However, not all children experience the emotion that drives them to the act. Approximately 10% of suicidal children belong to a family where there are many suicides. (Dervic K., Brend D.A., Oquendo M. A., "Completed suicide in childhood Psychiatric Clinics, North America", 2008). The genetic determinant of serotonin plays a role in emotion, much more so than in the idea of death. The epigenetic shaping of the brain in the first few months hollows out the prefrontal lobes, which can no longer restrain the amygdala, the neurological center of emotions. However, as soon as the oedipal child registers in his lineage, he identifies himself with a suicidal parent whose family stories have spoken in a low voice. During the inevitable trials of life, this model comes to mind, impossible to appease because of the way his brain was precociously kneaded. These children had previously shown some semantic behaviors: those around them were surprised by their emotional intensity and the frequency of their self-centered, sometimes self-aggressive behaviors (Beautrais A. L., "Child and young adolescent suicide in New Zealand", Australia NZJ Psychiatry, 2001). In this convergence of determinants, it was also noted that the family was isolated, routine, without friends or external events.
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In such a family system, a hypersensitive child can only attach to an emotional adult.
Only attach to an emotional adult. He has no choice. This intense child, difficult to curb, develops in an intense, closed affective niche from which he cannot escape. Such a family system, where influences of different origins converge (neurological intensity, intensity of the closed home, identification with a model of the suicide victim), constitutes the most reliable predictive index of child suicides (Pfeffer C.R., Klerman G. L., Hurt S. W., "Suicide children grow up rates and psychosocial risk factors for suicide attemps during flow-up", Journal American Academic child Adolescence Psychiatry, 1993). One third of suicidal children have experienced such developmental conditions. When some were removed from their homes and placed in soothing foster care, they did not commit suicide, but they did exhibit the emotional disorders of borderline personalities (Brent D. A., Baugher M., Bridje J. "Age and sex-related risk factors for adolescent suicides", Journal American Academic Child Adolescent Psychiatry, 1999).
[...] This emotional disorder is not necessarily a psychiatric disorder, but it does create relationship problems, frequent conflicts and painful socialization that can lead to depression. When we ask the relatives of a teenager who has committed suicide, they often answer that he or she was a difficult young person, but when we ask the relatives of a child who has committed suicide, we hear the shock, the unthinkable forecast. Adults describe a precocious, intelligent and impulsive child. His particular character was noticed, as in many children, but to think of death, that never!
PAINFUL DEVELOPMENT
It is mostly borderline children who commit suicide (Black D., Blum N., Pfohl B., "Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction and prevention", Journal of Personality Disorder, 2004). The painful development of their personality diminishes with age and learning about relationships. [...] Borderline personalities experience a chaotic development of conflict, disruption and emotional and social failure. There are so many trials in their history that 70 to 90% of them think about suicide and 10% end up doing so: a huge number!
Many depressed children are anxious, unhappy and withdrawn, as relationships hurt them so much. Daily life is a suffering and yet they do not necessarily think about suicide. [...] Their adaptation to reality is good, but the pain of relationships causes developmental chaos. They alternate the impulse towards others and the conflict, the inhibition and the explosion, the despair and the euphoria.
In this type of self-construction disorder, there are a few constants.
- There has been a cascade of traumas during early interactions: illness, death of a parent or conjugal violence. There is probably a genetic determinant since, in the same situation, all children do not react in the same way: some isolate themselves, withdraw into themselves and seek indifference to suffer less. Others fight, explode, call for help and attack those who help them.
- These children go through a terrible adolescence: they discover drugs, get into fights, are attracted to delinquent or marginal gangs.
- The girls have sexual relations from the age of 12, many partners in love, sexual diseases and early pregnancies.
- The damage is enormous in this population: suicides, delinquency, self-mutilation, psychosocial handicaps, but for those who pass through these catastrophes the evolution is favorable. Between the ages of 30 and 40, these young people calm down, learn a trade, start a family and have friends with whom they establish pleasant relationships. 70% of them will become balanced.
- There has been a cascade of traumas during early interactions: illness, death of a parent or conjugal violence. There is probably a genetic determinant since, in the same situation, all children do not react in the same way: some isolate themselves, withdraw into themselves and seek indifference to suffer less. Others fight, explode, call for help and attack those who help them.
- These children go through a terrible adolescence: they discover drugs, get into fights, are attracted to delinquent or marginal gangs.
- The girls have sexual relations from the age of 12, many partners in love, sexual diseases and early pregnancies.
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- The damage is enormous in this population: suicides, delinquency, self-mutilation, psychosocial handicaps, but for those who pass through these catastrophes the evolution is favorable. Between the ages of 30 and 40, these young people calm down, learn a trade, start a family and have friends with whom they establish pleasant relationships. 70% of them will become balanced.
One has the impression that, in this picture of serious developmental disorders, certain critical periods have not been secured. The child misses certain turns (language, school, relationships) because the framework has failed at that moment. The integration of impulses is only possible if they are contained, ordered by affective and meaning-producing boundaries: parental stability, school, art, writing and sport provide some of these structuring boundaries. "The traumatic conditions of childhood prevent the early establishment of solid narcissistic foundations" (Ladame F., Ottino J., Wagner P., "Adolescents suicidaires, adolescents suicidants", Paris, Massons, 1995). However, as soon as such a subject finds his or her framework, the progression of his or her personality becomes harmonized. This does not mean that everything is settled and that the past is erased. Despite the traumas of childhood, two out of three injured children resume a resilient development. A third of them give a population of adults in difficulty. But all of them admit that as children they thought about killing themselves (Herba C. M., Ferdinand R. F., Van der Ende J., Verhulst F. C., "Long-term association of childhood suicide ideation." Journal of American Academy of Childhood and Adolescent Psychiatry", 2007).
COMMITMENT PREVENTS SUICIDE
[...Whenever families are together on Sundays, vacations, ritual and religious, secular, artistic, or athletic activities, the number of suicides decreases significantly. "Multiple attachment family systems are clearly the most protective for children. (Bowlby J. "Maternal care and mental health", Geneva, World Health Organization).
When women engage in motherhood, they are less likely to commit suicide. "They are protected by domesticity" (Baudelot C., Establet R. "Sociological reading of suicide"). [...] Men are also protected by their commitment to work and family, but it is the technological context that structures their way of commitment.
The so-called "progress", the technical evolution, the improvement of the satisfaction of the needs (food, comforts, leisure, care), diminishes the need of solidarity. Until the incredible expansion of the tertiary sector in the last decades, social protection came from the couple. Each relied on the other.
In high-tech cultures, the presence of the other becomes a hindrance but, in case of misfortune, the personalities, although flourishing, find themselves alone and without support, subjected to their impulses and ruminations. In rich countries, it is the isolated poor who commit suicide the most when they have neither work nor solidarity nor emotional or social commitment.
When women engage in motherhood, they are less likely to commit suicide. "They are protected by domesticity" (Baudelot C., Establet R. "Sociological reading of suicide"). [...] Men are also protected by their commitment to work and family, but it is the technological context that structures their way of commitment.
The so-called "progress", the technical evolution, the improvement of the satisfaction of the needs (food, comforts, leisure, care), diminishes the need of solidarity. Until the incredible expansion of the tertiary sector in the last decades, social protection came from the couple. Each relied on the other.
In high-tech cultures, the presence of the other becomes a hindrance but, in case of misfortune, the personalities, although flourishing, find themselves alone and without support, subjected to their impulses and ruminations. In rich countries, it is the isolated poor who commit suicide the most when they have neither work nor solidarity nor emotional or social commitment.
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energizes a child is structured by the affective field composed of the parents' history and their sentimental agreement.
The development of the child is improved by our hygienic, nutritional and educational progress. In the XXth century, under the impulse of psychoanalysts, we understood that it was necessary to talk to children and to give them the word in order to weave secure links. However, this same context of technical progress diluted the niche of family systems. While the development of the body and intellect of children is greatly enhanced, the soul is less secure because the guardians are distanced in the space of technical culture. Children whose development is accelerated become anxious and, in case of misfortune, no environmental structure can soothe their ruminations. When there is no other, the child remains subject to his intimate world. In case of distress, he can annihilate himself, run away through the window, join his dead grandmother on her cloud, hurt himself, self-aggression or scarify himself to expose his wounds and feel himself finally existing under the gaze of others (Le Breton C. "Anthropology of pain", 1995).
All changes in the environment create sensitive periods that can awaken the traces of vulnerability acquired at an early age. Any family change (death, depression, illness, stormy or icy conflict), by impoverishing the reassuring envelope, abandons the child to his or her painful and impulsive intimate world. Social crises, by modifying the family structures or by weakening the home, create periods where suicide is more common.
[...] Suicide in Western children increasingly speaks of a failure of self-realization: "I don't live up to my dreams ... I will disappoint my mother ... "
[...] Suicide in Western children increasingly speaks of a failure of self-realization: "I don't live up to my dreams ... I will disappoint my mother ... "
EROTICIZATION OF DEATH
[... ] The abandonment of welcoming rituals no longer allows for the integration of older children, thus depriving them of the possibility of acquiring a sense of belonging to the culture of their elders. The transmission of values is poor and the child, badly identified, does not have the opportunity to discover what he is worth. A large number of young people who are not part of a family line inflict traumas on themselves in order to identify themselves, to prove their courage and to create frightening events that they must overcome. But these ordeals are invented by children who have not yet had the opportunity to acculturate. This is why they rediscover the archaic processes of initiation ... by putting their lives at stake!
The "scarf game" probably constitutes a secret test, outside the eyes of adults. It is the failure of the game which reveals the tragedy when the child dies auto-étranglé (Cochet F., "Jeux du foulard et autres jeux d'évanouissement, Paris, L'Harmattan, 2010).
Almost all children play at not breathing when they understand how tenuous the thread of life is. Just put your head under water in the bathtub, stop breathing for a few minutes, life is so small! So they block their breathing to ward off the spell "If I can manage not to breathe for two minutes, I'll get a good grade in math". Usually, they can't help but catch their breath, so there is no damage. This is not the case with the scarf, which continues to strangle them when the lack of oxygen has made them lose consciousness.
A few dozen children die each year from this game. Its meaning is sometimes conjurative (I would have a good grade), most often it is a search for extreme sensations or a simple exploratory test, "to see".
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One can rarely explain this action by depression or by a developmental disorder of the personality, but one can ask why one child out of 7 to 12 years needs to inflict such an ordeal on himself.
A beginning of answer is possible: these children develop well, in a family environment which protects them, but in their childish soul, an environment without ordeal brings an existence without event. How can they feel alive if nothing happens?
[...] Most of the time, there is no sign of tragedy in a child with no problems who simply wants to spice up his or her life, which has been made bland by his or her balance and good development in a caring family. Our educational culture has certainly underestimated the extent to which our children need to identify with events on the verge of trauma. It is up to the culture to propose them in order to control them.
It is not a question of aggressing children to harden them. On the contrary, it is about surrounding them in order to teach them to overcome a sensible ordeal. When the culture does not prepare a child to face a danger, he will seek a flirtation with death in order to give himself the pleasure of escaping it. Death and pleasure can thus mate to create the immense emotion of a secret event, an archaic initiation into a routine life.
What is eroticized in this flirtation with death, it is the pleasure to have known how to escape it, to have feigned it whereas it brushed us, to have thus converted an extreme anguish into euphoria of victory.
The resolution of fear brings an enormous relational benefit: we become attached to those who reassure us, we admire those who allow us to become stronger.
[...] Every living being, during its development, experiences the pleasure of exploring the unknown. Without a basis of security, novelty frightens him. The slightest event has the effect of an alarm.
[...] In our children, we find this pleasure of discovering the
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unknown which frightens them, provided that they associate it with the pleasure of attaching themselves to the one who makes them feel secure. When educational conditions protect children from all danger, they deprive them at the same time of the pleasure of attaching themselves to those who defend them.
A world without fear would demotivate them, deprive them of the pleasure of learning and loving. It would prevent the acquisition of self pride. Fear overcome is a reinforcer of the self. A world without fear would be bland, uneventful and uneventful, until the young person discovered the risk of dying.
Perhaps this is why most children flirt with danger. By eroticizing risk, they form their identity, but when they run into danger without adult or cultural control, the behaviors become suicidal equivalents, without a true death wish. They run across the street, climb on almost smooth walls, lean out of windows, tumble down stairs, without controlling their limits.
[...] When the flirtations with death are not controlled by the narratives, the advices, the prohibitions of the adults and by the cultural rituals, the erotic game is transformed into mortal risk. The desperate adult speaks of a play accident, whereas it was a cultural failure to confront the danger.
[...] Initiation rituals provide a way to welcome young people and give them the opportunity to develop a sense of pride, as long as adults provide a safe and meaningful framework.
SUICIDES AT SCHOOL
[...] The school, a tool of happiness for a good number of children, is for others the place of unhappiness.
[...] The school's mission is to be a social machine condemned to produce and reproduce the social relationships in which the great currents of inclusion-exclusion emerge. (Mannoni M. "Education impossible", Paris, Le Seuil, 1973).
The social or intellectual precariousness of the environment is a more powerful source of suffering than immigration, where, on the contrary, many parents over-invest in the school so that their children "get by". Everything that pushes children into exclusion causes their suffering: family abuse, social abuse, skin color, obesity, "mama's boy", or the beginnings of a minority sexuality. Visible differences cause daily wounds that end up flaying the child. Other differences are invisible, but when some children learn at home that their classmate is Jewish or diabetic, they respond to the representations acquired in their family and manage to let out verbal or mimic aggressions that end up tearing the targeted little friends apart.
In these groups of different children, pushed towards exclusion, not protected by their families or teachers, there is a very high rate of suicidal thoughts.
The sources of unhappiness are heterogeneous: when a family is poor but structured and cultivated, it does not transmit emotional or intellectual misery.
[...] The harassed, the "bougnoules", the redheads, the "bouboules", the "bananias" and even the good students who break out of the normalizing routine, make up a group in adolescence where we find four times more suicide than in the general population.
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When school is only a place of instruction excluding time for meetings, games and interventions, it becomes a form of harassment. In elementary school, the number of suicidal behaviors is estimated at 12%. In high school, this morbid temptation rises to 35%. In university, 40% of suicidal ideations are found and, in certain classes that prepare students for the competitive entrance exams of the grandes écoles, even more are noted! The more violent the intellectual harassment, the more it can give rise to the idea of killing oneself. Is the desire to succeed keeping young people from the pleasure of living?
Of course, the suicide curve rises with age when the emergence of sexuality and the need for independence mix fear and desire. These figures invite us to think that a school which would be only a place of instruction neglecting the blooming of the personality would push our children to the moroseness and, in case there would be an early sensory deficiency, would provoke an anguish of death.
It is indeed at the age when we go to school that in case of exclusion, the impulse of death can come to mind to solve this emotional problem. In case of misfortune, we suffer but we don't necessarily think about death. On the other hand, when it is a case of rejection due to emotional loss or social exclusion, the idea of death comes into the minds of 12 to 20% of children.
Of course, the suicide curve rises with age when the emergence of sexuality and the need for independence mix fear and desire. These figures invite us to think that a school which would be only a place of instruction neglecting the blooming of the personality would push our children to the moroseness and, in case there would be an early sensory deficiency, would provoke an anguish of death.
It is indeed at the age when we go to school that in case of exclusion, the impulse of death can come to mind to solve this emotional problem. In case of misfortune, we suffer but we don't necessarily think about death. On the other hand, when it is a case of rejection due to emotional loss or social exclusion, the idea of death comes into the minds of 12 to 20% of children.
SENSORY DEFICIENCIES AND SELF-AGGRESSION
Neurodevelopmental studies propose a strong hypothesis: babies who have suffered a sensory deficiency at a sensitive period of their development have acquired a disorder of cerebral functioning that leads them to react to emotions by increasing their self-centered activities.
When an accident deprives them of otherness, they acquire an ability to react to stress by focusing on themselves. If there is an other around them, they learn to turn to that attachment figure for security. But when early circumstances deprived them of an external sensory object, they learned to orient themselves to the only object they had: their body.
Their rocking, spinning, and self-contacting provided alternative
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stimuli. This is why it is commonly observed that abandoned, isolated or affection deprived children manifest these self-centered activities and, when the emotion is too strong for them, they violently self-aggress. At the slightest internal tension, they bite their nails, suck their thumbs, wring their hands and, when the alarm is too strong, bite themselves, scratch their face or bang their head against the bars of their little bed. Any encounter becomes an alarm for them, awakening the memory trace of the loss. They only know how to appease the immense anguish of lack by violent self-aggression. It is indeed a violence against themselves that appeases them.
[...] Self-centered behaviors disappear when a new, soothing sensory niche is created around the children. However, the trace of lack does not always disappear. If the environment is stable, it may never be expressed again, or it may be reawakened by a trivial event, such as a bad grade, an argument with a classmate or the momentary absence of his mother. An emotional deprivation, harmless for a child who has acquired a secure attachment, takes on the effect of a dizzying emptiness for a deficient child that only a violent self-aggression can calm. Taking one's own life suddenly appears to be the only possible solution to relieve an unbearable sense of loss. Such self-aggression is not a cry for help. It is the only way to suffer less from the terrible anguish of emptiness.
SUICIDES AND MIGRATIONS
People are driven out of their country by war, torture, famine or drought. One is sometimes sacrificed by one's own family, which has remained in the country of origin. You are very poor, attacked, looted, swindled during the journey. One survives alone, without family, controlled, parked and often exploited by the host country.
[...] There will soon be in Europe a population of seventy million migrants in great psychosocial difficulty. [...] In this incredibly heterogeneous population, all the markers of ill-being are in the red (Lindert J., Schouler-Ocak M., Heinz A., Priebe S., "Mental Health, health care utilisation of migrants in Europe", European Psychiatry, 2008): poor health, physical exhaustion, infections, depression, irritability, income barely allowing for survival, substandard housing. In such conditions, the education of children is difficult: "accidental" morbidity-mortality is high and suicides are not rare.
Faced with these population movements, the worst strategies are: cohabitation and marginalization.
In cohabitation, two groups share the same territory. When the social context is peaceful, they live together and ignore each other. But at the first economic or eventual difficulty, each group attributes to the other the cause of its malaise: violent conflicts ensue.
The marginalization of migrants is the one that causes the greatest unrest. In the marginalized group, an archaic socialization process is immediately established: the law of the strongest.
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[.. ]The problem is posed in terms of a political choice: assimilation or integration? When the arriving group melts and disappears into the host culture, we speak of assimilation. When a foreigner respects the laws of the host country and acquires the values of his new culture to the point of becoming a social actor, he is considered integrated.
The fate of these populations differs according to the acculturation strategies. When we study the fate of these groups, we easily discover the appearance of some indicators of well-being: improvement of health, reduction of depression and anti-social behavior, protection and education of children.
When assimilation is forced, the parents, in their desire to save their family, accept this contract. They keep silent, never talking about their origins or the reasons why they emigrated. Their social adaptation is through submission and silence. This silent suffering forms a strange basis of security for the children of immigrants. This explains the "paradox of the second generation". The child becomes attached to a parent whom he or she loves and who nevertheless anguishes him or her. [...] The history of the parents constitutes a chapter of the history of the children. When parents remain silent, they alter the identification process of their children.
Forced assimilation (by politics or by circumstances) destroys the roots thus disturbing the identification of children who develop along parents who have become bases of insecurity [...] The absence of traditions, the lack of transmission of values, the language of the origins itself which has become a language of mystery, of shame and of secrets that the children must not hear, disturb their development.
Forced assimilation causes a kind of family tear between what can be said and what must be hidden. The policy of assimilation extinguishes the migrants who, curiously, do not commit suicide. [...] In this process of assimilation, it is the second generation that explodes.
[...] In spite of their birth in the host country, in spite of social assistance, in spite of their academic success, which for some groups is better than that of the children of the host population, they have the impression that they are rejected like their submissive parents, sidelined, belittled. This leads to a feeling of bitterness or even hostility towards the host culture. The second generation gets depressed, takes drugs and sometimes commits suicide because they have been deprived of the family security base. The parents, unhappy and silent, have not been able to offer their children self-confidence because the policy of assimilation has deprived them of the pride of their origins that transmits values.
[...] Migrants are a fragile population that makes their children vulnerable. When, before leaving, some individuals were already ill, the cascade of traumas breaks them or reveals a vulnerability that would not be expressed in a stable environment.
[...] When the first generation of migrants assimilates without a word, their insecure children, ashamed of their origins, protest against the host culture and idealize the culture of origin as a lost paradise. When circumstances isolate the newcomers and make them suffer even more, they become frightened-scary parents for their children, altering the second generation. The markers of malaise are even more obvious (Veling W. Susser E., Van Os J., "Ethnic density of neighborhood and incidence of psychotic disorder among immigrants" American Journal of Psychiatry, 2008). These include psychotic dissociation, depression, school failure, medical and psychiatric consumption, antisocial behavior, and numerous suicide attempts.
CULTURAL DILUTION AND SUICIDAL IDEATION
The greater the cultural dilution, the greater the risk of suicide for individuals in the group concerned (Kral M. J., Arnakaq M., Ekho M., "Suicide in Nunavut: Strories from Inuit Elders", in J. Oakes, R. Rievwe, S. Koolage, L. Simpson, N. Schuster (eds.), Aboriginal Health, Identy and Rescue, Winnipeg, MB, Studies Press, 2000). When culture is diluted (few encounters, few rituals, few reasons to help each other), the emotional niche that surrounds a child is no longer a secure base. The child cannot gain self-confidence, no effort has any meaning if it is not addressed to an attachment figure, the slightest event can then become precipitating towards suicide. In the United States, African, Asian and Hispanic minorities constitute groups where the markers of well-being are lowered: poor physical and psychological health, few diplomas, low income, little travel, little reading, little leisure, high delinquency. [...]
[.. ] In groups in difficulty, the two most protective factors are the solidarity of the migrant group and its transactions with the host culture. There are hardly any supports below the poverty line.
[...]The paradox of the second generation can be found in the same group [...]. The children of immigrants have had fewer hardships to overcome, and yet they suffer more from the demeaning image of their parents. Those who emigrated suffered severe real hardships: fatigue, stress, poor hygiene, substandard housing, and exhausting jobs, but in their psychic world they were living a honeymoon: the American dream would make them happy, rich, and free, and allow their children to flourish.
The second generation experienced better material conditions, but
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had to identify with exhausted, exploited, and often poorly integrated parents. After the euphoria of the American dream of the first generation, the descent was painful for the children. [...] The generation of children of emigrants was in great difficulty. There were many depressive states, with suicidal ideation. Obesity was impressive with asthma and physiological disorders. The school dropouts had let the children drift towards drugs and delinquency. The absence of a reception policy did not allow the parents to choose their mode of acculturation. Neither assimilated nor integrated, they had constituted a marginalized group, managed by the law of the strongest and the runaway. It is in such an environment that children have developed without cultural rituals or transmission of family values.
Assimilation requires migrant parents to renounce their culture of origin, which turns them into a base of insecurity. They lose their calming effect and their power to enunciate the forbidden. Brutal assimilation does not give migrants time to acquire the rituals and values of the host culture. For several decades, anguish floats through these families. The children must then make an agonizing choice. Feeling excluded from the host culture, they idealize the culture of their origins, where they are not better accepted. When, on the contrary, they reject the culture of origin in order to better acquire the values of the host culture, this creates a feeling of betrayal in the parents that causes a family tear.
[...] The process of integration, where pride in one's origins is combined with the pleasure of learning the
pleasure of learning the host culture, leads to an assimilation without violence. [...]
It should be emphasized that it is not the long term that promotes assimilation, it is the cultural politics of integration (Ponizovski A. M., Ritsner M. S., "Patterns of loneliness is an immigrant population", Comprehensive psychiatry, 2004). When the second generation has not been surrounded by peri-familial cultural structures, cultural isolates are formed. Some unintegrated minorities, ashamed of their origins and hating the host culture that demeans them, organize themselves into hostile and desperate groups. [...]
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The identity crisis of the children of the second generation is very
painful. [...]
In all countries, migrants, regardless of their origins, religions and initial cultures, have voted in favor of cultural integration policies (Eyou M., Adair V., Dixon R., "Cultural identity and psychological adjustment of adolescent Chinese immigrant in New Zeland", Journal of Adolescence, 2000) which propose to combine pride in one's origins with the pleasure of acquiring a new way of life. Their children benefited from two cultures as one learns two languages. Everyone benefited.
It must be recognized that the rapid modernization of recent years does not favor this process, because the children must, in addition to the work of integration, endure the "clash of civilizations." [...]
Everything that creates a bond has the effect of a reassuring constraint. The attachment is neither an impediment, nor a ban. It is a biological, affective and social agreement which guards our developments, but not in any direction. Once we are attached, we can develop, but we can no longer allow ourselves to do anything.
Everything that dilutes the bond facilitates the passage to the suicidal act. Affectionate, family and cultural commitment constitute the most effective protection against the desire to die, provided that society organizes the institutions and meeting places where the links are woven (Mishara B. L., Tousignant M., "Comprendre le suicide", Les Presses de l'Université de Montréal, 2004).
Intergenerational transmission is a constraint to secure identification, provided that the narratives offer a representation of the culture of the elders, through novels, films, essays and testimonies.
The absence of constraint is often experienced as an abandonment, a rambling that dilutes meaning and allows anxiety to emerge. Loneliness is a loss of freedom when, not having another to orient us, we let ourselves be carried along where the wind blows.
Everything that dilutes the bond facilitates the passage to the suicidal act. Affectionate, family and cultural commitment constitute the most effective protection against the desire to die, provided that society organizes the institutions and meeting places where the links are woven (Mishara B. L., Tousignant M., "Comprendre le suicide", Les Presses de l'Université de Montréal, 2004).
Intergenerational transmission is a constraint to secure identification, provided that the narratives offer a representation of the culture of the elders, through novels, films, essays and testimonies.
The absence of constraint is often experienced as an abandonment, a rambling that dilutes meaning and allows anxiety to emerge. Loneliness is a loss of freedom when, not having another to orient us, we let ourselves be carried along where the wind blows.
PREVENTIONS
To prevent is to take measures that prevent the suicidal act. Once we understand what pushes us to death, we must intervene at each step of this process in order to reverse it and push us towards life, which is not always easy.
There are countless decisions to be made to reduce the number of suicides. [...]
To understand this phenomenon today, we tend not to fragment the knowledge, but on the contrary to integrate biological, emotional, psychological, sociological and cultural information.
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and repeated misfortunes (loss of job, domestic difficulties, divorces, psychological disorders, stress diseases) favors despair and lets death come. But how can we understand that leisure culture plays a major role in the prevention of suicides? [...]
In all the countries where a prevention policy has been implemented, the suicide rate has clearly decreased (Scandinavia, Hungary, Canada).
The only 100% reliable data is that if we do nothing, we will let everything that leads to death happen. But if we take medical, family, educational, school and cultural decisions, we will have a return on investment that has already been evaluated: the earlier we invest, the more beneficial the results (Heckman J. J., "Skill and the economies of investing in disadvantaged children", Science, 2006).
This prevention policy should focus on :
- on the development of the person: genetics, pregnancy conditions, structure of the affective niche of the first months, family identification models, siblings.
- on the surrounding structures: family functioning, neighborhood culture, school, peri-family activities, leisure.
Cultural narratives have an important function: myths, prejudices and stigmatizations can cause suicide epidemics, whereas explanations or valorizing narratives prevent them.
PREVENTION AROUND BIRTH
[...] There is still no program for toddlers, although recent data from neurosciences prove that early childhood is a determining moment, not for suicide, but for the acquisition of an emotional vulnerability. Depending on the conditions of the context (family, school or cultural), this neurological trace can facilitate the passage to the act.
It is not easy to control for family history, a family of suicides, small serotonin carriers or intergenerational violence, but they can be identified in order to determine what type of environment would be appropriate to tutor resilient neodevelopment.
[..] Prevention can be organized in three stages.
Primary prevention
It prevents the acquisition of the most decisive vulnerability factors in child suicide: impulsivity, the impossibility of not acting out. When the parental niche, during daily care, stimulates the prefrontal neurons that inhibit the impulse, when the facial mimics and postures of the caregivers structure the affectivity that teaches a baby to interact, when the words explain the situation to the child and when the culture gives him the possibility to express himself, all the control processes are put in place.
Conversely, when an unfortunate event alters parental emotions, the impoverished affective niche no longer provides security for the child.
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In France, primary social prevention is good: [...] Protection Maternelle Infantile (PMI), crèches and nursery schools. However, the training of early childhood professions is very disparate (nursery nurses, kindergarten teachers, psychologists, nurses, educators, auxiliaries, etc.). It would be advisable to institute a university of early childhood where the theory of attachment, by integrating biological, emotional, psychological and social data, would give early childhood professionals an educational coherence and a sharing of knowledge. [...]
European countries are trying to organize a support network around the newborn (Wahlbert K., Makinen M., "Prevention of Depression and Suicide", Luxembourg, European Communities, 2008). The sensory environment begins at the end of pregnancy, since it is at this time that the baby begins to inscribe in its memory the maternal emotions that it perceives. Epigenesis, the environmental pressures that lead the brain into a type of functioning, can be organized by political decisions: protection of pregnant women, emotional stability, maternity and paternity leave, help for parents in difficulty. It is a real network made up of parents, their history and their family that should be associated with professionals, carers and educators, and, in clinical research and if necessary, with psychiatrists and psychologists whose clinical and scientific research supports early childhood practitioners. (WAIMH (World Association Infant Mental Health, Hôpital St Vincent de Paul, Paris).
Secondary prevention
It consists in taking charge of the problem at the very beginning of the appearance of the disorder, which can thus be stopped (Dugnat M., "Troubles relationnels père-mère/bébé : quels soins ?", Ramonville-Saint-Agne, Erès, 1996). Many institutions and associations are already working very well: PMI (Protection Maternelle Infantile), REAAP (Réseau d'Ecoute, d'Appui et d'Accompagnement des parents). Many associations help children and parents in difficulty. It will be enough to make them better known because many young parents are unaware of their existence.
Tertiary prevention
It seeks to repair existing disorders: emotional withdrawal, isolation, dropping out of school, self-aggression.
All early traumas imprint traces of vulnerability in the biological
memory of the toddler. The fact that the infant is shaken by exasperated parents sometimes tears his meninges. The violence around the child, the screams and threats panic him and prevent him from acquiring the secure attachment that, in case of misfortune, could protect him. Direct mistreatment, beatings on the child's body or sexual abuse cause serious developmental problems. But, it is the affective neglect, the sensory isolation
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memory of the toddler. The fact that the infant is shaken by exasperated parents sometimes tears his meninges. The violence around the child, the screams and threats panic him and prevent him from acquiring the secure attachment that, in case of misfortune, could protect him. Direct mistreatment, beatings on the child's body or sexual abuse cause serious developmental problems. But, it is the affective neglect, the sensory isolation
But it is emotional neglect, sensory isolation or an overly dehumanized technical environment that permanently alters the development of the nervous system and the learning of interaction rituals that allow us to live together. In our civilization, where the culture of sprinting and the improvement of technology allow us to work at a distance, the family conditions distance the parents and impoverish the affective niche. If we want to preserve the benefits that technology brings us and fight against the side effects of the dilution of links, it is necessary to organize a new affective niche by integrating the parents, but also the energy family. And if we want to fight against gender disparities, we need to develop the early childhood professions by giving a shorter and more coherent training.
In children, psychotropic drugs are rarely useful. On the contrary, in adolescents and adults, the answer is clear: a group of suicidal people who take antidepressants has far fewer suicides than another group who refused them (Isacsson G., Holmgren P., David P., Bergman V., "The utilisation of antidepressants - a key in the prevention of suicide: An analysis of 5.281 suicides in Sweden during the period 1992-1994"; Acta Psychiatry Scandinavia, 1997). Suicidal impulses induced by drugs are rare in practice. [...] However, in children, it is not medication that can prevent suicide; it is the reliable establishment of an affective and educational niche, within and outside the family.
PREVENTION AROUND THE FAMILY
[...] Some children take their own lives when they have no desire to die. They are making a mistake, they want their life to change, not to stop.
[...] Child suicides are rare. [...] In large families, suicides are practically non-existent (Durkheim E., "Le suicide"). This finding reinforces the idea that families with multiple attachments are the most protective of children. (Bowlby J., "Maternal Care and Mental Health").
In rural civilizations, a child, even away from the eyes of his or her parents, is always supervised by an adult. African cultures have a slogan to express this: "it takes a whole village to raise a child." Any adult has the power to intervene to rescue or scold a child. As in a large family, the little one is always surrounded by attachment figures with whom he establishes different affective styles: secure and affectionate with one, insecure and conflicting with the other. The child, in his affective constellation, can orient himself towards the developmental tutor that suits him best.
[Whether the family is traditional, village or modern, it is always a moment of isolation that makes the child vulnerable: a contextual desert when the parents are overwhelmed, a past desert when a developmental disorder has left a trace in the memory that prevents the control of the impulse.
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A child can commit suicide without being suicidal. This is why the warning signs are difficult to see and understand. The little one expresses badly a diffuse uneasiness that the adults do not even imagine. How can you expect them not to be stunned, dazed, flabbergasted by a child's suicide? Unthinkable!
The predictive clues are barely perceptible and unreliable. [Most of the time, the child at risk expresses only one or two barely significant clues. They are not noticed when they are punished, when they declare themselves guilty of a fault they did not commit, when they play with cars, when they run across the street, when they bite their lips, when they scratch their face in mild frustration, or when they get off the bus. The frightened adult gets angry because he or she was scared, but no one understands that these disorders reveal a cognitive failure, a consequence of a child's emotional disengagement from life.
Prevention consists of establishing a trusting relationship, creating a secure bond, enrolling the child in a sports club, a music class or simply sending postcards. All of these are necessary ingredients to create the bond of attachment which is fundamental.
The prevention strategies can be summarized as follows:
Professional prevention
In adolescents, adults and the elderly, doctors are often consulted, which does not mean that the patient expresses the temptation to commit suicide. He or she tells a story of suffering that is acceptable: "My stomach hurts ... I'm tired ... I'm fed up." This expression serves as a mask for what the suicidal person is unable to say.
In the child, it is even more difficult. When they are depressed, we can see that they are morose, isolate themselves, are afraid of school, get angry, play less and have morbid preoccupations. But when they are not depressed, how do we spot an impending impulse?
Yet, when physicians, during their continuing education, train themselves to understand what suicidal ideation can be, they detect a significant number of cases.
Non-occupational prevention (Eagles J.M., Carson R.P., Begg A., "Suicide prevention: A study of patient's view", British Journal of Psychiatry, 2003)
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at the beginning of his or her life, if he or she has suffered repeated emotional ruptures, if there are psychological disorders in the parents, if he or she is immersed in a violent family environment or if the parents' way of life is a series of catastrophes.
In this case, everything that manages to weave affection is a protection: a phone call, a postcard, a chat, a banal event for a fulfilled person takes for a suicidal person the effect of a rescue. [...]
Prevention for the general public
Probably the most protective message is to bring the idea of "suicide crisis" into the collective narratives. "You want to kill yourself, this is a terrible time in your life. It's a crisis that you're going to have to find a way out of. The stereotypes of previous decades were that suicidal people were crazy, insane or weak-minded. Desperate people became even more isolated, which added to the despondency and seemed to confirm that there was no way out except death.
PREVENTION AROUND THE SCHOOL
Acquired vulnerability is not enough to explain suicidal ideation and the act of suicide. It is also necessary that cultural circumstances provide the child with a damaged emotional environment that reveals this flaw.
The precipitating factor comes from the group that surrounds the child, but it cannot be the cause of the suicidal act. It takes a convergence of individual, family and cultural risks for an event to trigger lethal self-aggression.
It is at the age when one goes to school that the impulse to commit suicide can arise. The primordial prevention that should have circulated the prefrontal neurons and allowed the inhibition of the action could not be put in place because of an unexpected sensory isolation. The child was not able to acquire emotional stability because his parents were themselves in marital difficulty (violence, relational ice) or social difficulty (unemployment, professional exhaustion). The child developed in an environment where he was rarely spoken to, which did not allow him to discover the calming effect of speech. It is with this explosive charge that he entered school.
On the first day of school, two out of three children have already established this neurological, emotional and verbal system that gives them confidence. It is a game for them to discover the little companions. It is a pleasure to make the intellectual effort that gives access to abstract knowledge.
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One child out of three has not had the opportunity to build this mastery of the impulse which is a form of freedom since it allows not to submit to an all-powerful emotional determinism.
It is at school that this fault in the construction of oneself is expressed. However, the institution can only solve a part of the early affective failure. It is impossible to say that the teacher is responsible for a child's suicide because she scolded him or gave him a bad mark. It was necessary that beforehand, a whole ontogeny (development of an individual since its conception) had prepared it for this excessive reaction. The evolution of this little person has been articulated with a school situation which, for her, because of her particular development, takes on an extreme meaning and triggers an emotion that she does not have the means to control.
Thirty percent of children are insecure, which does not mean suicidal. By establishing distant, ambivalent or confused relationships, they demonstrate an emotional style that disturbs their daily relationships and puts them at risk for poor learning in school, poor speech, and submission to their own emotions. Some children aggress against those they love, which makes them difficult to help. And other children who are illegible, confused, incoherent disorient the teacher who cannot establish a stable, secure and educational relationship with them.
Ten percent of school children have thought of committing suicide! [...] Suffering at school and suicidal ideation are frequent. [...] When, in addition to the physical immobility required at school, emotional isolation and difficulty in mentalizing are added, the child remains a prisoner of a devalued self-representation. Boredom subjects the child to these traces inscribed in his or her memory that keep coming back, like an obsession.
Twelve percent of children are very unhappy at school and 18% do not like it there (International Observatory on Violence in Schools, Unicef, Debarbieux, 2011), which corresponds to about a third of insecure children who have a stomach ache every morning at the thought of going to school.
Insecure children who are insulted and pushed around at school (which happens to more than half of school children) are able to overcome the ordeal. Insecure children feel harassed and traumatized and are among the population of children who think about suicide.
The school is a space, an institution, where one undergoes emotional
imprints as much as one receives instruction. Grading, exacerbated by our culture of competition, does not take into account the emotional shaping that continues in school. The neurological trace that facilitates impulsivity can be reinforced by isolation or bullying. This same trace can be extinguished when the child bonds with secure companions or teachers who, believing they are only giving instructions, unwittingly serve as the child's identifying model.
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imprints as much as one receives instruction. Grading, exacerbated by our culture of competition, does not take into account the emotional shaping that continues in school. The neurological trace that facilitates impulsivity can be reinforced by isolation or bullying. This same trace can be extinguished when the child bonds with secure companions or teachers who, believing they are only giving instructions, unwittingly serve as the child's identifying model.
Some children who are unhappy at home improve at school. They say they are calmed by the meeting with a teacher who does not always realize it. It is during an extracurricular activity, such as theater, a philosophical workshop, a cultural or naturalist expedition, that the first knot of a new and reassuring bond is woven.
[...] anything that causes the dilution of bonds in a family or school group (emotional neglect or boredom) allows the traces of vulnerability acquired early on to emerge. When circumstances put a child "out of touch" by exclusion or humiliation, this flaw can emerge. Conversely, it can be controlled, buried or relativized when the child finds a family substitute or when the school offers educational activities in addition to the necessary instruction.
Suicide prevention at school is therefore possible (www.refusechecscolaire.org). It will not cure the family difficulties, but it will prevent the child from suffering at school, from being harassed to the point of suicidal ideation. The teachers' commitment is effective. [...]
We could schematize extracurricular prevention at school as follows: action, affection, mentalization.
- Action is an excellent tranquilizer. [...]
- Affection, by creating bonds of familiarity, makes the child secure and gives him the pleasure of making the effort to explore the mental world of others and to acquire abstract knowledge (Bretherton I., Munholland K. A., "Internal working models in attachment and relationships" in J. Cassidy P.R. Shaver (Eds) Handbook of Attachment). When emotional security facilitates intellectual performance, children learn to express themselves. In the event of misfortune, he will know how to seek out the resilience tutor who can support him. Any encounter in and around the school that facilitates the creation of a bond decreases the probability of expression of an impulsive fault acquired at an early age.
- The mentalization, by putting a sensation in the form of images and words, allows the elaboration and the sharing of emotions (Rimé B. "Le partage social des émotions", Paris, PUF, 2005). The child does not feel alone in the world when he has a place to express himself and a familiar person to hear him.
Children kept by machines (Internet, television, cell phone, video games) strongly increase their risk of depression when they spend four hours a day in front of the screens. This culture of communication alters the culture of relationships. [...]
The teacher cannot do everything. He has been trained to educate, that is his contract with society. However, we can surround him with educational extracurricular structures where the child can learn to move, to love and to engage in his life path.
SUICIDE PREVENTION
We never commit suicide alone. When we rush into the act because of an emotional or social slackening and when death takes us away, it tears away a part of the soul of those who are close to us. Those who discover the child's body are seriously shocked. Those who witness the distress of the family, the confusion of the companions, the despair of the teachers, the clumsiness of the neighbors are affected by his death.
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How to announce to the children that a little friend of class has just killed himself? [...] Faced with this huge crash, in the old days (not so old as that) we acted as if nothing had happened. The children were prevented from seeing the body, they were even prevented from talking about it so that they would not be traumatized. The children continued to live, with an enormous hole in their self-representation: "So we can die, like that, for nothing and nothing in the souls of those around us. As if we had never lived!" This way of preventing empathy, by arranging for children not to represent the suffering of others, is a training for perversion: "Only my well-being counts. The death of others must not alter me."
[...] The evolution of the suffering of the bereaved person is different according to his or her personality and family and cultural support (Seguin M., Castelli-Dransart D.A., "Le deuil suite à un suicide : symptomatologie et choix d'intervention", Encyclopédie médico-chirurgicale, Paris, Elsevier, "Psychiatrie et pédopsychiatrie", 2006).
At first, it is the psychic agony, the stupefaction, the intense denial, almost delirious so much the reality is unthinkable. "It is not possible, he cannot be dead, he cannot have done that."
The pain comes with the awareness, the acceptance of the real: "What did I do to make him kill himself?". Shame: "I didn't see anything, I didn't understand anything, I'm pathetic." Anger: "He had gone to see a doctor because he had a stomach ache, this doctor did nothing ... It is the teacher who is the cause of his death..."
The immediate support must be emotional before being psychological: "We are close to you, we cry with you. We loved him too..." Psychological intervention, by raising too many questions, can worsen the suffering of the bereaved (Shear M., Frank F., Foa E., "Traumatic grief: A pilot study," American Journal of Psychiatry, 2001). The family, of course, the siblings and even the neighborhood are invited to support with effectiveness and some awkwardness. The bereaved think that no one can understand such a tragedy. So they join associations of parents of dead or suicidal children, and there they feel less bad and can, in spite of everything, attempt to mourn (Paré C., "Le rôle du center de prévention du suicide de Québec, auprès des écoles", in P. Ghyslain, D. Rhéaume, "La prévention du suicide à l'école", Montréal, Presses universitaires du Québec, 2004).
Cultural belonging gives form to this support, to this recognition of the right to suffer. [...] The different cultural expressions all have a common issue: to support the bereaved, to give dignity to the dead and to allow a work of mourning.
When the context does not provide these rituals, persecutory interpretations are added to the pain of the loss: "Why the silence? Did the doctor do something wrong? Did my husband drive him to suicide? When I see my wife, I think of the death of our child." The divorces that often follow the death of a child add pain to pain.
When bereaved friends understand what death is, they are shocked and need the same support as adults. If we don't talk to them about it, they will talk to each other and the rumors and fantasies will not be stopped.
Those who are too small to understand death suffer from the suffering of the adults around them.
They become mute, dark, silent and show less pleasure in going to school.
[...] "The associations have responded to the problem of suicide
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before the implementation of measures by the authorities." (Amadeo S., "What role for associations in suicide prevention", in P. Courtet, "Suicides and suicide attempts"). Volunteers, mourners, suicidal people, academics and researchers come together to combine their experiences and thoughts. This mode of knowledge produces original and practical ideas. In these groups, there is much talk of postvention and resilience, as bereaved parents convert their own suffering into prevention for others.
Currently, networking between different associative organizations provides ample evidence of its effectiveness and organizes an annual suicide prevention day. The UNPS (Union Nationale Pour la Prévention du Suicide - in France-) groups together thirty-eight experienced associations that raise awareness among the general public with the help of ministries. [...]
The aftermath of the suicide of a surviving child is not easy. When the act has been committed, it is inscribed in everyone's memory, and it forces the family to reorganize its functioning. Family members must become more reassuring, without exasperating the child by watching him too much. This new supervision can be done in daily life and allow to reconnect with the family and friends by setting up a shared project (Terra J.L., "La souffrance psychique : le suicide", in F. Bourdillon, G. Brücker, D. Tabuteau (eds), Traité de santé publique, Paris, Flammarion, "Médecine-Sciences", 2004), but making the post-crisis period a new life project is not always easy.
The associations have a crucial role in the prevention of suicide, by explaining the phenomenon, by giving addresses and by fighting against preconceived ideas.
The "Werther effect" shows that the simple fact of learning that one can kill oneself by losing one's love serves as a model and causes an epidemic of suicide. So why not organize an "anti-Werther effect"? Since life stories teach us that a little word is sometimes enough to prevent the act, why not ask the media to do stories that explain that suicide is not inevitable (Taylor S.E., "Health behavior and Primary Prevention in Health Psychology", New York, McGrawHill, 1999). Why not organize protection networks? Newspaper articles could also explain that the impulse is controllable when we create a bond that makes us feel secure. This simple information would counteract the "there's nothing to be done about suicide" curse.
This new vision of suicide allows us to stop looking for a scapegoat (the mother, the teacher or society) through whom the misfortune arrives. It is a constellation of determinants that pushes the child to the act. The fight against preconceived ideas is already a protective factor. To prevent is not to trivialize.
Bringing the notion of "suicidal crisis" into the public eye makes it possible to say that "it is a terrifying and dangerous moment", but, after the crisis, one starts to live again, as the little suicidal ones hope.
To detect these moments, teachers are on the front line. It is not a question of brutally asking children: "Do you want to kill yourself? Sententious lectures only serve to numb students. On the other hand, on the occasion of an educational activity, one can give the floor to the children, in the form of tales (Tychey C. de, Test des contes et clinique infantile, Paris, In Press, 2010). If they are small, they are asked to comment on "L'ourson pas pareil", "Le sexe préféré" or "L'oisillon tombé du nid", which creates the opportunity to talk about the feeling of rejection, the difficulty of choosing a gender or the anguish of being abandoned. For "grown-ups", the commentary on a film, a novel or an essay allows the same psychological work.
This type of primary prevention in schools has made it possible to spot some warning signs and to alert the people around them and the professionals.
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These ways of giving voice do not always have an effect on suicidal ideation, but they do let the child know that support is available and is often enough to overcome the crisis. Numerical evaluation is imprecise, but there is no shortage of testimonials from children who have been saved.
Awareness programs for the very young in schools have been controversial. Some believe that these talks trivialize suicide and suggest that taking one's own life is a possible solution. "Many children come out of these meetings extremely distressed." (Velting D. M., Gould M. S., "Suicide contagion," in R. w. Maris, M. M. Silverman, M. S. Gould (eds.), Review of Suicidology (New York: The Guilford Press, 1997). It appears that this effect is more a function of the adult's style. Children are very sensitive to rhetoric. The way of saying things sometimes counts more than the content of the speech. If the adult is an imprecator, the child may be frightened by his talk of doom. When, on the other hand, the adult explains that the chick that has fallen out of the nest will be reunited with its parents, who have come to its rescue, the child will receive a message of a helping hand and not of inexorable misfortune.
There are, however, dangerous preventions. When school programs heroize the death of children, as we see in war-torn countries. In the Middle East, many boys begin to love death. When a movie or singing idol commits suicide and the front page of the newspapers and television news make this death a tragic and beautiful representation, the emphasis can provoke a feeling of suicidal ecstasy, as we see in the collective hypnosis of cults.
An increase in suicides was noted after the death of Marilyn Monroe or when such a tragedy made the front page of the newspapers (Kahn J.P., Cohen R., "Impact es médias sur le suicide, comment transformer l'"effet Werther" en prévention du suicide ? " in P. Courtet, Suicides et tentatives de suicide).
The Internet and blogs also play a role as a super-media that may have encouraged some suicides by giving recipes or exhortations. Fortunately, it has also discouraged many by explaining what a "suicidal crisis" is and by giving telephone numbers.
CONCLUSION
Suicide is a public health problem. [...]
Suicidal people, prisoners of their suffering, think that it is a last freedom, whereas clinical and scientific studies show that it is a path towards a fatal outcome... when culture does nothing!
At the time when knowledge was compartmentalized, we submitted to this fatality. We said: "It's genetic... it's biological... it's familial... it's cultural." We obeyed these representations, thus confirming the fatality. Since research has been integrating data, it is admitted that multiple causes exert their pressure at each stage of development, until a precipitating event pushes it into action. We then discover that we can intervene at every stage.
Genetics has its say. It speaks of hyperemotivity which does not lead to suicide, but makes one sensitive to any event.
Epigenesis intervenes from the end of pregnancy and modifies the expression of genes by impregnating biological, behavioral and emotional habits.
The articulation between biology and environment is powerful during a sensitive moment when the sensory niche that surrounds a baby marks its imprint in the nascent psyche. [...] An emotional vulnerability can thus be acquired early, engraved in the child's brain by parental suffering, whatever the cause: early orphanage, physical or sexual abuse, violence, alcohol, psychiatric illness, emotional neglect, conflictual divorce, professional exhaustion, social disorganization or deculturation.
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Traumas are not rare in the human adventure. [...]
Only those who :
- before the trauma, are attacked by a force outside the family (natural disaster, aggression by a stranger);
- after the trauma, can benefit from family and socio-cultural support (soothing affection, social assistance, explanatory and revaluing stories).
When "these repeated traumas occur very early in life, the alteration of symbolic references is much more profound (incest, relationship with the other sex, barbarism, etc.) (Vaiva G., Ducrocq F., "Syndrome du stress post-traumatique et risque suicidaire en France. Prévalences croisées dans l'enquête SMPE", Stress et trauma, 2007).
Children whose development and history are just beginning are sometimes subjected to blatant traumas (physical or sexual violence, abandonment), but they are much more damaged by repeated deprivations, difficult to identify, where the affective, social and cultural structures impoverish the sensory niche that envelops the child, thus causing him to lose his supporting power. When the deprivations are insidious and repeated at a sensitive period of development, they are inscribed in the biological and historical memory of the child, strongly altering the representation of the self. "I have no value because I am taken and thrown away. My death has no importance."
Acute traumas, those best understood, are probably less deleterious than adverse conditions during a sensitive period (Stix G., "The neuroscience of true git," Scientific American, March 2011) of child development.
Finally :
- what best protects a child is a "village."
- what best weaves his attachment is the appeasement of his anxieties and not the satisfaction of his needs;
- what allows the transaction between the culture of this village and the development of the children who live there, is the solidarity that structures the daily rituals and gives meaning to existence.
Very little work has been done on child suicide because it was thought that the phenomenon was so rare that it could be lumped together with adolescent suicide. However, the mental worlds of these young suicide victims are totally different.
The idea of death, which takes so long to sink in, is fed by three sources that escape adult educators: discussions between children, television films, and the suicide of someone close to them, about which their parents speak in hushed tones. Their downcast and murmuring behaviors are so modified that they draw the attention of the little protégé, underline the uneasiness and indicate non-verbally the place of the tragedy.
[...] Child suicide, a rare phenomenon, is an indicator of the emotional disorders caused by our socio-cultural changes.
Fortunately, epidemiologists, clinicians and associations who study this tragedy affirm that when prevention is put in place, the evolution is often favorable.
FOUR PROPOSALS
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- Stabilize early interactions :
- At the end of pregnancy
- During the first months of life.
- To support the parental couple
- Maternal leave
- Paternal leave
- Fight against repeated emotional breakdowns.
- To give coherence to early childhood professions:
- creation of an early childhood university
- The theory of attachment, which integrates biological, emotional, psychoanalytical and socio-cultural data, allows practitioners and volunteers to participate in research and evaluate proposals.
- Providing common continuing education for physicians, nurses, psychologists, educators, teachers and volunteers is a valuable prevention factor.
- Encourage studies of siblings. The shaping power of children among themselves has been underestimated.
- The precociousness of children, valued by our culture, is not a protective factor. It improves school results at the cost of anxiety and relational problems.
2 - AROUND THE SCHOOL
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- Develop the "hyphen" structure between teachers and the family.
- Encourage research on implicit education when emotional encounters are added to school programs.
- Adapt school rhythms to the biological rhythms of learning.
- Offer emotional and intellectual support to children in difficulty.
- Create spaces for discussion during artistic activities: films to comment on, stories to complete, suicide prevention kits, sharing natural and cultural activities with educational tutors.
- Delay stigmatizing grading.
- Reinventing school rituals of welcome and promotion.
- Fight against harassment at school which is a very serious factor of vulnerability.
- Combat the depressive effects of physical immobility, lack of connection and weak mentalization.
- Promote studies on co-education.
- Follow the fate of adopted children or those born of MAP.
- In case of misfortune, organize discussion groups between adults and groups between children who refer to an adult.
3 - AROUND THE FAMILY
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- Favour the protective and educational "village" that opens up closed families.
- Strengthen neighborhood cultures: associations, children's involvement in sports, social and meaningful activities such as scouting, francas or patronage, adapted to the values of our new society.
- Give children the right to give by engaging them in children's responsibilities.
- Publish a directory to make known the telephone listening networks, the places of meetings and immediate help.
- Invite non-professionals to ongoing training. Motivated volunteers have proven to be effective.
- In case of misfortune, let people know that "postvention" exists.
- Offer help without imposing it.
4 - IN THE CULTURE
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- Participate in debates on the philosophy of suicide.
- Bring the notion of "suicidal crisis" and not fatality into the collective narratives.
- Encourage artistic creations - films, novels, theater, essays - so that they have an "anti-Werther effect".
- Organize a village culture in the neighborhoods where shared leisure activities have a great preventive effect.
- Participate in Internet messages and blogs by controlling harmful advice and validating the valuable aids of these technological meetings.
- Defend the cultural policy of integration where each culture presents itself to the other and reinforces it.
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