DIMENSIONAL PERSONOLOGICAL PERSPECTIVE ON SUICIDAL BEHAVIOUR
Existența ființei umane este delimitată de cele două extreme - naștere și de moarte. Atitudinea individului față de moarte este întotdeauna istoric și cultural condiționată. Acesta pendulează între un echilibru și, respectiv, o anumită teamă sau sensibilitate. În prezent, moartea este acceptată sau respinsă în conformitate cu semnificațiile sale. Ființele umane integrează temperament, caracter, biografie, componente arhetipale, dar, de asemenea, abilități auto-reflexive. Aceste abilitati duc la conștiința de sine a individului și la o înțelegere a sensurilor vieții care favorizează realizarea de sine și a bunăstării subiective. Ideația și comportamente suicidare sunt expresia supremă a pierderii sensurilor existențiale. Trăsăturile de personalitate sunt printre factorii personali care au implicații majore asupra comportamentului suicidar. Având o perspectivă dimensională pe aceste trăsături - inclusiv luarea în considerare a fațetelor dimensionale ale personalității - duce la o înțelegere mai nuanțată a fenomenului suicidar, precum și elaborarea unor strategii de prevenire și intervenție timpurie.
Individual existence is delimitated by two extremes – birth and death. The dynamics of the individual’s ages after birth – including childhood, adolescence, adulthood and aging – confirms the cyclical continuity between life’s beginning and end. At a certain stage in its history, psychoanalysis even hypothesized the existence of two fundamental instincts – of life and of death, respectively of Eros and Thanatos (1). The last would represent the inherent tendency of organic life returning to a preceding state, the inorganic state of existence.
An individual’s attitude towards death has always been historically and culturally conditioned. In an animated universe – according to the concept of animism – fear of death began as a fear of the dead since it was believed that they could harm the living (2). On the other hand – and in a later period – death was considered „happy” according to its significances and to the individual’s situation at that moment. That is why the Vikings were striving to die with the sword in their hand so that they could enter Wahalla. The manner in which human beings view death depends on their preservation instinct, but also on the stage of life they are going through, so that, for example, at an advanced age death could be looked at in a detached manner, like a fatality. On the whole, the individual’s attitude towards death swings between a serene balance – cultivated by the ancient Greeks – and a particular fear or sensibility. (3).
The contemporary individual refuses or accepts death depending on its meanings. Fear of death represents in the first place fear of the unknown and the irreversible. Because of social mores death has become an external „show” for the individual – frightening most of the time – not the intimate act it should have stayed. Napoleon said „priests and physicians made death painful”. On the other hand, not only death but also life is often accompanied by suffering, and the fear of death should not be stronger than the fear of life. Moreover, taking into account the „birth trauma”, death has been compared with birth, „sleep” and „oblivion” being the dominants (Barbarin quoted by 3).
In general, the way an individual relates to life’s roles and values influences in an obvious manner the attitude towards death (4). Thus, pragmatic individuals who are involved in different activities and roles, with pro- social aptitudes, and have a social support network which is well represented quantitatively and qualitatively, ignore the idea of death which is overwhelmed and diluted by the intensity with which they live their life. In their case
„memento mori” is actually a reference to „carpe diem”. Death may also be ignored, and by those for whom life represents a mean to achieve a value ideal, a goal, who enjoy a supra-personal respect and appreciation. The achievement of such a goal brings about great existential satisfaction and may lead to a reconciliation with death which can often be manifested by an attitude of detachment and courage.
It may be considered that living intensely one’s own life – in a pragmatic or idealistic way – protects the individual when confronting the eternity of death. On the other hand, the scarcity of interpersonal relationships and existential motivations and values, as well as the dysfunction in various roles of life, disadvantage the human being before death which appears with all the negative connotations that may be attributed to it.
It is a known fact that human beings are products of self-determination and self-becoming. Biographical experiences, archetypes and self-reflexive abilities are progressively integrated throughout a person’s life so that in adulthood one becomes self-aware and aware of one’s relationships with others. Dominant personality traits are both inherited and acquired through interaction with other people and with the natural world (5).
Individual self-awareness means implicitly knowing one’s own qualities and flaws, but also being able to reflect upon the resemblance with people around you, as well as the challenge of accessing common existential values. It allows the creation of a feeling of self-realization and the „access” to personal happiness. This not only means the harmony between physical, mental and spiritual well-being, but a certain subjective well-being which may result from this harmony and especially from the understanding of life’s meanings.
The approach to life of the mature person must harmonize the attitude towards himself with the attitude towards others seen in their own existential context. Hence, one might learn that life should not be lived as if it were eternal, and might be able to find and give meaning to its end.
The contemporary social culture has a particular dynamics dominated by the phenomena of technological advancements, urbanization and population migrations. The abundance and growing diversity of material goods and services, life models and lifestyles are often assault the individual’s adaptive expectations and capacities. Old community traditions and customs are ignored or presented distortedly, as are spiritual and religious values and ideals (5).
These incessantly altering socio-cultural conditions have a negative influence on content and duration of the individual’s developmental stages and may facilitate the development of dominant individualistic type traits. People who live for themselves prevail numerically over those dedicated to certain meta-personal goals.
The individual’s attitude towards himself is dominated by narcissistic and egocentric arguments and as a result is fragile and becomes vulnerable in relation to the diversity and incisiveness of existential stimuli. In its extreme version it may take a dramatic turn – that of the suicidal behavior. Suicide is an act of an extreme severity of the individual towards himself with multiple psychological, social, legal and moral meanings (3). Thus, suicide may mean the cessation of any possibility to ever again have a conscious experience that precedes the gesture followed by physical death, it may be a „crime”, a „sin” or an expression of the subject’s isolation from the surrounding world or his marginalization.
The factors involved in the preparation and course of the suicidal act may be sub-divided into personal and extra-personal (6). In the first category a first rank position is occupied by the individual’s personality structure with its dominant traits. The presence of certain pronounced or disharmonic personality traits – may favor the attempts with both a high survival risk and those with a low survival risk. But suicidal behavior – in the diversity of its versions – may also often be encountered in harmoniously structured personalities, being caused by non-personal factors.
Both from a categorical and qualitative perspective, the most common factors involved in the suicidal act are, in a descendant order, the borderline type pathological traits, and the antisocial, hysterical, avoidant, dependant and obsessive-compulsive types. Cluster A disharmonic traits favor the so called „no prior history” suicides. Different personality types disadvantage the differentiation between real suicide attempts and those with a low risk of death. And so a categorical type of personality prone to suicide cannot be pointed out.
When looking at personality traits, the dominants in cluster A and C pathological personalities seem to be the suicidal ideation, ruminations and representations related to the preparation of the act itself due to a detachment from the practical, and to the triad of perfectionism, rigidity and pride. In the case of cluster B traits, actual suicidal behavior, with high or low survival risk, is favored by the instability of one’s self-image, one’s affective instability, as well as by one’s impulsive- aggressive potential.
The dimensional or quantitative perspective allows the establishment of more complex correlations between normal personality, pathological personality and Axis I diseases by facilitating comparative comments. It ensures a significantly increased accuracy of the diagnosis and a more nuanced comprehension of the psycho- behavioral anomalies (7). The most known and used dimensional models are the 5 factors model – the ‘Big- Five’ and Cloninger’s 7 factors model – the psycho- biological model.
In case of the 5 factors model, each trait has six corresponding facets which allow a much finer dimensional validation of the diagnosis. Thus, among the facets of neuroticism – that is of the dimension corresponding to the affective stability – fear, pessimism, attitudinal fragility and shyness may favor suicidal ideation and behavior. By the same token, the facets of either extroversion, activism and spirit of adventure or solitude, resignation, passivity and anhedonia – inability to enjoy, may also play an enhancing role in suicidal ideation and behavior.
With respect to the conscientiousness or perseverance dimension, its extreme components such as perfectionism, sense of order and duty, reflexivity, respectively negligence, carelessness, unpredictability, lack of personal purposes and hedonism – which express low levels related to it – may all favor self- suppressive behavior.
Agreeableness or charm through components such as optimism, honesty, altruism, modesty or empathy lower the risk of and preoccupation with suicidal acts. The facets of spiritual openness such as fantasy, esthetic sense, curiosity, sensations seeking, openness to novelty and faith may be other factors non-conducive to suicidal ideation and acts.
Overall, suicidal behavior is enhanced by high levels of neuroticism and low levels of extroversion, and also by extreme values – increased respectively diminished – of conscientiousness. It is disadvantaged by high values of agreeableness and spiritual openness. It is a confirmed fact that the high level of impulsiveness, aggressiveness and affective lability as well as of perfectionism and rigorousness may favor suicidal behavior. These traits corresponds to antisocial, borderline and obsessive-compulsive type personalities.
When relating dimensional personality reference points to demographic factors one sees that the pathological dimensions which favor the suicidal act such as impulsiveness and affective-attitudinal instability prevail at a young age, while perfectionism and rigorousness have the same influence at a more advanced age. In males, high-mortality risk suicide attempts are prevalent, while in females the risk of mortality is diminished.
From a dimensional perspective of the psycho- biological model of the seven factors – four of temperament and three of character – the suicidal behavior may be favored by the high values of dominant inherited dimensions – novelty seeking, harm avoidance, reward dependence and persistence. High values of character dimensions such as self-directedness, cooperativeness and self-transcendence – are a protective factor as to the suicidal phenomenon. This particularly complex personological model may allow a correlations with genetic and biological factors by means of the integrated neuromediators – dopamine, serotonin, noradrenalin and gamma aminobutyric acid.
It can be stated that ideation and suicidal attempts are disadvantaged by the structuring quality of the Self regarded as an individual strategic pole and by the complexity of interpersonal relationships, so by the relational social pole of the individual. The spiritual dimension or pole of the person has the same role, particularly through the ability for self-transcendence.
Any attempt at comprehending the suicidal phenomenon and of elaborating prevention strategies must integrate a dimensional assessment of the personality
– inclusively according to its facets – that may offer data of a particular value.
We cannot forget that the human being is the only one who knows he is here on Earth just in passing, and that is why he must – while seeking happiness and not the end of life – dare, hope and believe. The individual can accomplish this by cultivating self-esteem, inner harmony, with the surrounding people, nature and the cosmos.
1.Freud S. La psychopatologie de la vie quotidienne. Paris: Payrot, 1924.
2.Eliade M. Fragmentarium. Bucharest: Ed.Vremea, 1939.
3.Athanasiu A. Elemente de psihologie medicală. Ed.Medicală, Bucharest, 1983.
4.Baumgarten F. Der weltgelbundene und der lebensgebunkkiene Typus. Arbeit und Leistung 1966;20(7-8): 119.
5.Lăzărescu M, Nireștean A. Tulburarea de personalitate. Iași: Ed.Polirom, 2007.
6.Cosman D. Compendiu de suicidologie. Cluj Napoca: Ed.Casa Cărții de Știință, 2006.
7.Dehelean P, Dehelean M, Dehelean L. O problemă controversată: modelul categorial versus dimensional al tulburărilor de personalitate. Perspectiva categorială și cea dimensională în cadrul tulburărilor de personalitate. In: Nireștean A (eds.) Personalitatea între anormalități biologice și interpretări culturale. Tg.Mureș: Ed.University Press, 2005, 43-72.