Week Eight Flashcards
prevalence of committed suicide
1 in 71 people in us
Luoma’s approach to suicide treatment
not treat it as a symptom of a diagnosis and assume that it will resole if the diagnostic condition is treated, rather address suicidality directly as a primary target of concern.
What is experiential avoidance? (Luoma)
the tendency to escape or avoid unwanted thoughts, emotions, memories, and sensations, even when doing so is futile or causes harm. May be common process for suicide
Increasing clients mindfulness of psychological events can reduce experiential avoidance and alternative to suicidal behavior.
mindfulness as a psychological process
views mindfulness as a generic concept that overlaps with four psychological processes that have been described in Acceptance and Commitment Therapy (ACT):
- Contact with Present moment
- psychological acceptance
- Cognitive diffusion
- Self as context
Contact with the present: (luoma - first step of mindfulness with suicide)
- We spend so much time living within mental constructions of the future and past that we begin to lose access to our non-conceptual, direct, and current experience.
- Suicidal individuals may ruminate for long periods of time about past failures or anxiously worry about the future.
- Mindfulness promotes ongoing, nonjudgmental contact with psychological and environmental events as they occur
- Therefore one can describe and note events without getting caught up in unhelpful comparisons, evaluations, or get stuck in the future or past
Psychological Acceptance: (luoma - second step of mindfulness with suicide)
- There is no situation or circumstance where we can completely escape psychological pain.
- Mindfulness promotes psychological acceptance, the active and intentional embrace of the psychological events occasioned by one’s history, without unnecessary attempts to alter or remove them
- Acceptance of one’s own history and current thoughts and feelings allows the freedom and flexibility to move toward a valued, meaningful life even in the presence of hardship
Cognitive Diffusion: (luoma - third step of mindfulness with suicide)
- Suicidal thinking tends to be relatively rigid and dichotomous with a predominance of right/wrong and good/bad evaluation, fatalistic and passive, waiting for change to occur or relying on change to be instigated by others.
- The goal of cognitive diffusion is to disrupt the problematic functions of thinking through creating nonliteral contexts in which a person observes the active ongoing process of thinking, rather than merely experiencing the world as structured through thought.
- Suggests that rigid thinking is not something to be eliminated, but rather that suicidal individuals spend too much time in their thoughts or looking from their thoughts rather than simply observing the process of thinking and returning to their experience in the present moment.
- This loosens the thought-action relationship = more flexible responding to current contingencies
Self as Context:(luoma - fourth step of mindfulness with suicide)
- Suicidal individuals conceptualize selves as often very negative, seeing themselves as broken, damaged, or hopeless.
- Mindfulness techniques tend to generate contact with a transcendent sense of self that is distinct from the content of one’s experience.
- Rather than directly challenging content of a person’s life story or self concept, helps clients experience a sense of self that is larger than their story and more like a psychological perspective or conscious location from which all events are experienced.
- Reduce attachment to a conceptualized self, opening up new avenues of living that are different than those in the past
Mindfulness Meditation as the Prototype: (luoma)
- Illustrates the application of all four of these processes. Involves contacting the present moment
- Emotions, sensations, thoughts, urges, and memories are allowed to come and go without resistance.
- Mindfulness meditation instructions describe how to respond to thoughts that arise
- Instructions typically foster diffusion: dispassionately observing thinking, seeing thoughts as thoughts, rather than what they say they are, and simply allowing thoughts to come and go without holding onto them.
- Clients adopt a stance of an observer of their experience that allows contact with an experience of being a conscious, boundaryless, person that is distinct from the content of experience – self as context.
Mindfulness and valued action (luoma)
• Focus on helping clients to articulate their values and take action toward longer-term life goals
How mindfulness might mitigate suicidal behavior: (luoma)
• Two treatments that use mindfulness for suicidal behavior: DBT and Mindfulness Based Cognitive Therapy
Over general Memory and Suicidal Behavior: (luoma)
- Over general memory = experience difficulty recalling specific episodes and details from their autobiographical memory.
- The inability to recall specific life events in turn contributes to the poor problem-solving abilities of suicidal individuals that have been repeatedly demonstrated in the literature
- Over general memory happens because of a habitual tendency to avoid or suppress specific autobiographical memories due to associated negative affect
- Mindfulness will help with this
Thought suppression and suicidal behavior: (luoma)
• Mindfulness will help with the ability to observe the process of thinking rather than be entangled in cognitive activity and reduce the need to suppress such thoughts.
Self Critical Brooding and Escape from Self-Awareness: (luoma)
- Mindfulness will reduce suicidal behavior motivated by escape from aversive self awareness
- Fosters the observation of the process of mental activity, such that self-critical and judgmental thoughts are observed more as passing mental events, rather than indicating something enduring about the self that demands a response.
Focus of Sullivan Article
work of an inpatient service in an acute care safety net hospital in the prevention of suicide on its inpatient services, and during high-risk period post discharge
