Survivors of suicide. Emerging counseling strategies

1. Effective intervention with survivors of suicide requires knowledge of the diverse sequelae of response including blame, anger, guilt, shame, search for why, and feelings of stigmatization. 2. Fearing blame and stigmatization, survivors of suicide may be reluctant to contact helping professionals. 3. Duration and intensity of bereavement is mediated by the survivors' nature of the relationship with the deceased and their perception of the preventability of the death. 4. Group counseling is an effective intervention because it addresses the issue of disenfranchised grief.     

The internal death of Japanoise

Japanese noise music (Japanoise) has strong associations with death. In the early stages of Japanoise’s development, practitioners would often make reference to eroticism, violence and death in their performances and album artwork to help visualise the “excess” of their sound. The discourse of Japanoise also draws on these associations, through concepts such as disembodiment, to help frame this transgressive enterprise. Death becomes a way of visualising and conceptualising a subversive style of music that attempts to leave the world of limits and meaning. Paul Hegarty and Eugene Thacker both account for Japanoise in these terms. Although death is only implicit in their writing, it will be argued that this understanding of death is essential to what Hegarty means by failure and what Thacker means by disembodiment. This paper will show how, for both theorists, death names a paradoxical yet extreme form of possibility that enables Japanoise to test limits. However, the problem with this understanding is that it holds Japanoise to a limited framework. It essentialises the concepts of negativity and subversion to the economy of Japanoise. This paper will argue that Japanoise cannot be limited to these concepts if it hopes to be more than an oppositional form of music and a tired form of transgression. This requires that its relationship with death not be reduced to a form of production or act of will. By arguing that Hegarty and Thacker’s accounts of noise can be read as Heideggerian, this essay will critique this understanding by drawing on Maurice Blanchot’s account of death. This critique will show how a different understanding of death enables a more nuanced understanding of Japanoise.     

Maintaining an Illusion: Abuse, Somatization, and the Elaboration of Meaning

Many clinicians who have treated adult survivors of abuse have known for some time what is now confirmed by the empirical literature: these clients often suffer from a host of physical complaints for which their doctors tell them there is no physical cause. The symptoms as well as the response of the doctors are frequently quite disturbing to the client. Both aspects of the clients' experiences are also very difficult to treat. Relational theory may provide a perspective that will enhance the understanding of somatization in survivors of abuse. The resulting thesis is that somatization may be the result of deficits in meaning, which are in turn due to conflicts between distinct levels of meaning. This theory weds two previously opposed perspectives: the deficit and conflict models of psychopathology. While the hypothesis may be interesting on the level of pure theory, the ultimate aim of the paper is to apply the theory to the treatment of somatic symptoms among adult survivors of abuse, expanding upon existing interventions. First, the clinician must assess for deficits in the levels of meaning, then utilize interventions appropriate to specific levels. To safeguard that no new conflicts arise, the clinician must ensure that the meanings elaborated in treatment support an integration of meaning on all three levels. To this end, he or she must target interpretations to the client's zone of proximal meaning. These principles are illustrated in a case example.     

An autopsy-based evaluation of deaths of homeless unknown persons (HUPs)

Background: India is a significant host to homeless unknown persons (HUPs) and subsequently to their untimely deaths due to various reasons. The autopsy-based evaluation has been always important in knowing the exact reasons behind it. Objective: To know about the epidemiological mortality profile such as magnitude, cause and manner of death, seasonality, and year-wise distribution of their untimely and unattended deaths. Materials and Methods: A retrospective autopsy-based evaluation of unnatural deaths among HUPs was done at LHMC, New Delhi for a total duration of 5 years (January 2006 to December 2010). Results: Out of 749 cases in the study group in this duration, 536 deaths have been caused due to some natural events and 213 due to some unnatural events. Among the natural deaths, the pulmonary pathology did contribute for 509 cases. Conclusion: The study population is a vulnerable segment of the society which often suffers the extreme adversity of natural and unnatural events in the form of their deaths. It is a significant host to the pulmonary infections that often spread to the other segments of the society at the point of contact. Thereby it deserves an urgent public health intervention and a policy response for the same for the well-being of HUPs and the general public at large.     

Sexual Facts and Values

It is important for psychoanalysts to educate themselves about variant forms of sexual expression, such as the fact that heterosexual cross-dressers virtually never give up their preference because of psychotherapy. A more realistic therapeutic aim is to help the couple negotiate a workable relationship. Infidelity, too, has many possible definitions that can be negotiated by the couple. In some instances, the wish for extramarital contact may be motivated less by sexual desire than by other psychological needs, such as the fear of death and the wish for immortality. The sustenance of sexual passion in a long-term relationship is a phenomenon that requires greater understanding. Variation in lifestyle, as well as modifications in characterological ruts, can often help revive passion.     

Persistence of close personal ties over a 12-year period

Using data on 60 intentional communities from the Urban Communes Data Set, we examine factors related to the persistence of ties 12 years later, when nearly all members had left the groups. We find strong evidence of triadic effects—people are more likely to remain in contact with others when they share patterns of contact with third parties. Such triadic effects retain importance even when we use alternative measures of contact, and when we control for individual-, dyadic-, and group-level effects including geographic separation. When we examine friendship as opposed to contact, we find that the triadic effects can be decomposed into some effects pertaining to hierarchy and other effects pertaining to reciprocation, giving us a sense of how networks structure themselves over time.     

Violent Death

ABSTRACT

Approximately 1 in 3 Americans have a loved one die in a sudden violent manner in their lifetime. This article examines the postevent experiences of three groups of survivors: survivors of victims of motor vehicle fatalities, suicide, and homicide. The article takes the position that experiences vary, in part, because each group faces different challenges created by the mode of death. Challenges are classified as trauma reactions, negative social responses, and efforts to make or finding meaning in the tragedy. The manifestations of these challenges are delineated for each group. Obstacles to survivors' movement are described followed by interventions specific to containing or reducing trauma-based reactions, activating social support to buffer and alleviate the effects of negative social attitudes, and creating the possibility for meaning-making through the intense pursuit of what matters now. These interventions increase the probability that survivors can continue to grow and even thrive in spite of and quite often because of their history.     

The experience of quality of life among older people

Although quality of life has been in the focus of attention for over a decade there are few studies available investigating, how the old and the oldest old experience their quality of life or what quality of life actually means for them? To illuminate this, eleven in-depth interviews were conducted with six women and five men (80+) living in their home. An interpretative hermeneutic phenomenological analysis revealed that quality of life in old age meant a preserved self and meaning in existence. Maintained self-image meant that the older people experienced a coherent life with an intact meaning. How quality of life was valued depended on the meaning the old people attached to the areas of importance as well as how they were evaluated. Additionally, areas not generally included when measuring quality of life became discernible. The meaning of home, how life was viewed, thoughts about death and dying, and telling ones story proved to be areas of importance for their perception of quality of life. Thus, indicating that older people's view of quality of life is more complex than some of today's most commonly used quality of life instruments capture and that quality of life assessment tools needs to measure beyond pure health indices. For nursing care the use of life review in everyday care, and an open way towards existential topics as well as a family oriented care along with preventive work helping people to remain in their own homes may enhance their experience of quality of life.     

Notes on the Death Penalty in the Context of the September 11 Attacks

As of September 11, 2001, a rogue and criminal entity has sentenced us to death. The sentence makes no distinction between the innocent and the guilty. Its authors proceed as self-declared sovereigns exacting limitless retribution. The terrorizing extremity of their program reveals some of the malignant determinants in the pursuit of both sovereignty and retribution. Some of those determinants, also operative in judicially sanctioned executions, are as the focus of this paper.

Proponents of the death penalty want something from it. For them, having the State kill the convicted party seems to promise the kind of relief not available from any other form of punishment. This essay, using cultural and clinical material, addresses some of what might be wanted from the death penalty and some of what it seems to promise. The pursuit of such promise can be undertaken only as an exercise in sovereignty. Such pursuit depends on the unquestionable belief in one's absolute right to the imaginary fruits of retribution. This puts into question some of the determinants of that belief and that right.     

The Importance of Form in Skinner’s Analysis of Verbal Behavior and a Further Step

A series of quotes from B. F. Skinner illustrates the importance of form in his analysis of verbal behavior. In that analysis, form plays an important part in contingency control. Form and function complement each other. Function, the array of variables that control a verbal utterance, dictates the meaning of a specified form; form, as stipulated by a verbal community, indicates that meaning. The mediational actions that shape verbal utterances do not necessarily encounter their controlling variables. These are inferred from the form of the verbal utterance. Form carries the burden of implied meaning and underscores the importance of the verbal community in the expression of all the forms of language. Skinner''s analysis of verbal behavior and the importance of form within that analysis provides the foundation by which to investigate language. But a further step needs to be undertaken to examine and to explain the abstractions of language as an outcome of action at an aggregate level.     

“I Felt Like I Was Being Abused All Over Again”: How Survivors of Child Sexual Abuse Make Sense of the Perinatal Period Through Their Narratives

ABSTRACT

Sequelae following child sexual abuse pervade the lives of adult survivors, significantly impacting on pregnancy and childbirth. Symptoms of this distress are recognized, but meanings for women are less understood. This research aimed to examine the meaning for women themselves of the impact of child sexual abuse on experiences of pregnancy, childbirth, and the postnatal period. Taking a critical feminist perspective, three open-ended interviews with three survivors enabled women’s narratives of pregnancy and childbirth to be heard, explored the structure of these narratives, including how experiences were connected, and identified key themes and how selves and others were positioned. Women themselves contributed to the analysis of their own narratives. The different struggles of each woman occurred within three domains of experience: identity, embodiment, and parenting. They were underpinned by a fluctuation between empowerment and disempowerment. These findings, although based on detailed analysis of the experiences of only three women, dovetail with, integrate, and extend the existent literature, offering a framework for understanding the complexity of meaning making for women. Further research might develop this. The framework may facilitate clinicians’ understandings of what it is like for some women having children who have experienced child sexual abuse.     

Improving quality of life after breast cancer: prevention of other diseases

Many women with breast cancer will be diagnosed at an early stage through screening programmes. Furthermore, most women affected by breast cancer will not die from it but from other diseases, owing to recent improvements in treatment. This article assesses whether breast cancer survivors suffer more frequently from other diseases. Specifically, it examines whether they have a higher incidence of other cancers, cardiovascular events and osteoporotic fractures. Women with breast cancer and three or more co-morbid conditions have a 20-fold higher rate of mortality from causes other than breast cancer and a 4-fold higher rate of all-cause mortality when compared with patients who have none. Breast cancer survivors are at increased risk of other cancers, such as stomach, colorectal and lung. Radiotherapy, trastuzumab and aromatase inhibitors increase the risk of cardiovascular disease. However, tamoxifen does not, although it is associated with an increased risk of venous thromboembolism. Aromatase inhibitors, but not tamoxifen, increase the risk of osteoporotoic fracture and bisphosphonate therapy should be considered.     

An Interpretive Phenomenological Inquiry of Family and Friend Reactions to Suicide Disclosure

Suicide attempt survivors’ interpretations of reactions to attempts are understudied, yet could inform prevention efforts concerning subsequent attempts. Interviews with 40 attempt survivors about family and friend reactions were analyzed using interpretive phenomenological techniques. Three distinct patterns emerged as follows: (a) Stigmatizing statements and emphasis on reactor's feelings were interpreted as signs that attempt survivors were a burden to others, (b) avoidant reactions and excessive monitoring were interpreted as cues that suicidal behavior must remain hidden to not be a burden, and (c) asking questions and projecting strength were interpreted as signs that attempt survivors belonged and were not a burden. These findings highlight the importance of working with family and friends to encourage reactions that reduce the risk of future attempts.     

Sudden death in infancy

SUMMARY. Sudden death in infancy is now one of the commonest cause of death in young children in the United Kingdom affecting two to three per 1,000 livebirths. A number of background factors are associated with an increased risk of sudden death and the aetiology is likely to be multifactional. Some of these background factors are reviewed together with possible causes. The relationship with child abuse is discussed. While the aetiology and therefore methods of prevention remain uncertain, it is clear that families who suffer this form of bereavemem need support and counselling. The response of one health authority to the challenge of cot death is described.     

GENDER,MORTALITY, AND CORPOREAL INEQUALITY

Most previous empirical analyses of gender inequality have focused on modern economic indicators such as income. The advancement of theory on gender stratification requires detailed analysis of indicators with greater endurance and prevalence in world-historical terms. Sex mortality differentials are presented as cross-cultural indicators of corporeal gender inequality, defined as differential access to basic bodily resources for life and health. Indeed, mortality differentials represent a more fundamental form of gender inequality, in that women first must be alive before they may be denied access to other resources such as equal pay. Analysis of United Nations and World Bank data on developed and developing countries evidence the importance of ecological, economic, and familial explanations in determining corporeal gender inequality. Women's familial roles are found to be more important for gender inequalities in death at younger ages, and women's economic roles are more important for death at older ages. Implications of the results for mortality decline and gender stratification theory are discussed.     

Disrupted Bodies: Experiencing the Newly Limited Body in Stroke

This article explores the intersection of recovery and bodily practices among stroke survivors. Drawing on the extensive literature on the socially constructed body in general, on chronic illness, and on interactionist thought, we explore bodily experience as a mechanism that informs stroke survivors' understanding and practices of everyday life in recovery. We ask a central question: what practical mechanisms does the survivor employ to provide meaning to her or his newly disrupted body? Data gathered from in‐depth interviews with fifty‐one discharged stroke survivors show that they use three specific technologies of bodily management and meaning‐making. These are managing the body within a mind‐body dualism, testing the body in its everyday practices, and orienting to the body as a biographically informed phenomenon.     

Resilience among adult survivors of childhood neglect: A missing piece in the resilience literature

Despite the established long-term effect of childhood maltreatment, some proportion of adult individuals, who suffered childhood maltreatment, appear more resilient than others and continue to function well in life. We searched the databases of MEDLINE, PsycINFO and ERIC in order to identify relevant studies on resilience among adult survivors of child neglect, which constitutes the most common form of child maltreatment. We found that the vast majority of quantitative (n = 41) and qualitative (n = 45) studies on resilience among adult survivors focused on survivors of sexual and physical abuse rather than neglect. Only few studies examined neglect often along with other forms of child maltreatment. We reviewed the studies, identified gaps in the existing literature, and suggested directions for future research.     

knowing word in an effective way

Vocabulary acquisition study is the theory of how to enlarge vocabulary. In some countries, especially using English as second language, learners should learn words not only according to the sound, form, meaning, and other characteristics, but also selecting the appropriate teaching methods to strengthen the vocabulary learning interest and efficiency. In this paper, the appropriate teaching methods just refers to use prefixes and suffixes to illustrate words is an effective way and phrase via related prepositions, which provide learners with an effective way to enlarge their vocabulary. With the help of the methods, learners' learning interest can be excited; to some extent, their English level be improved.     

Carrying Capacity and the Death of a Culture: A Tale of Two Autopsies*

Issues associated with the phrase “sustainable development” are clarified by careful analysis of the meaning of carrying capacity. In their impressions of carrying capacity's effects, two explanations for the death of a memorable culture (Easter Island) differed fundamentally. One explanation was captive to a premature notion of a carrying capacity ceiling no population growth could ever penetrate. For the other, population was seen as having grown until it did exceed the maximum sustainable load, thus having inflicted environmental damage that reduced carrying capacity. The former view had to imagine a geological catastrophe to account for the culture's death. In the latter view, it was a case of excessive success proving fatal. A proponent of the latter view regarded Easter Island as a “preview in microcosm” of what may be happening globally. As such, the Easter Island experience would have important implications for industrial societies. Comparison of the two autopsies has implications for the social sciences.     

Support for Openness in Adoption Placements-What can we learn from New Zealand?

SUMMARY: The placement for adoption of older children and those with special needs brings into focus the practice of open adoption whereby there is some form of continuing contact, including face to face contact, between birth and adoptive families. This in turn raises issues about the support needed to maintain such links. The paper discusses the progress made in New Zealand towards open adoption. The views of social workers, birth and adoptive families on face to face contact are reported and arguments for and against post-adoption support for open adoption are examined.