Has anyone ever said to you, “What are you doing? You seem totally depressed. Can’t you see you’re just hurting yourself?” Maybe you’re in an abusive relationship; maybe you’re having indiscriminate sex; maybe you’re ravaging your body with drugs and alcohol; maybe you’re gambling away most of your paycheck and your spouse is ready to take a hike. One way or the other, you’re engaging in risky behavior. You are not overtly or genuinely trying to kill yourself, but you’re certainly leading a self-destructive life, and acting like you don’t care if you live or die. People with this ambivalent attitude often live a lifestyle that escalates into exposing themselves to more and more risky behaviors. Like an untreated sore that can become infected, what begins as moderate apathy – “If I die today what’s the big deal?” – becomes like a whirlpool that gradually sucks the victim into despair. Do you live “on the edge” of life, regularly engaging in risky actions? Do you show self-neglect and carelessness? Are your moods characterized by negativity, pessimism, and depressive thoughts? If so, you may be afflicted with what therapist Michael Church calls Subtle Suicide.
Dr. Church has found that clients who fit the Subtle Suicide profile are generally not helped by anti-depressant medications. Their problem appears to be rooted in avoidance actions they have learned over a long period of time. They work to avoid stress and confrontation and tend to “bottle up” emotions and not deal with them; they often show addictive behaviors like gambling, alcoholism, excessive drug use, and overeating; and, they develop symptoms of depression and anxiety. These actions and symptoms are often mistaken as their root problems, and both counseling and medication are geared to them, not to the subtle-suicidal ambivalence that underlies the symptoms.
Jack, the older of two children, was always a physically large, overweight boy, and the other kids typically made fun of him. Consequently, he never developed much self-confidence and had low self-esteem. His home life was lacking in warmth and love. In fact, the primary source of acceptance in Jack’s family seemed to be food. Whenever the kids came home from school, Mom was in the kitchen cooking, ready to welcome them with all sorts of treats. Jack’s father was domineering, cold, and harsh. We do not know if Jack’s father physically abused him. When asked, Jack was evasive.
In high school and college, Jack got acceptable grades and stayed out of trouble. He plugged along, avoiding challenge and confrontation. After graduation from college, he got a job, met a girl, got married, and began a family. Unfortunately, he continued to avoid facing the challenges of life. His wife, Brenda, ran the household and made most of the decisions, both domestic and financial. When children came along, Brenda became the disciplinarian and primary caretaker. Jack had no clear father model from his childhood, and he stayed in the background when it came to raising the kids.
After a couple of unsatisfactory jobs and a failed business venture, Jack eventually found a job that gave him some success and financial security. Over the years, however, his drinking increased significantly. He spent long hours away from home socializing and drinking while Brenda was home managing the kids and the home. When she confronted him about his need to take on more responsibility and be more involved, he got angry and refused to discuss the situation. Jack developed some health problems in his early forties, but he kept his symptoms to himself. He chose not to tell Brenda about his pains and not to get checked out by his physician. Eventually he developed open, bleeding sores on his skin, and he needed Brenda’s help in caring for them. Brenda pleaded with him to go to the doctor but he still stubbornly refused, even as his condition worsened. His denial and avoidance tendencies had now reached irrational levels. Brenda took extreme action and had him involuntarily committed to a medical facility for diagnosis and treatment. Her actions, unfortunately, came too late. The physicians said his cancer was too advanced and he died within a couple of months.
Beginning in childhood, Jack’s life was devoted to avoidance of conflict. His domineering father scared him so much he withdrew into a shell; his mother showed little warmth toward him except by cooking. Jack’s view of life became negative, based on a belief that people were untrustworthy and threatening. By adulthood he showed little compassion for himself or his family. He was self-absorbed, disconnected from others, and had no sense of purpose or life goals. He did not care about his own life and took no steps to help himself. Nothing seemed to matter to him except avoiding confrontation with others. His lifetime of avoidance and apathy showed an ambivalence toward living that is typical of the subtle suicide individual. His withdrawal strategy was doomed to fail because confronting and dealing with negative emotions and psychological pain are necessary if we are to become psychologically strong and healthy. Jack, however, refused to do so. His avoidance actions grew stronger and took him in a downward spiral from which he could not escape.
Psychology and Stress 