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Comment by tokenadult | Hacker News Reader

You are working on something important, and I was glad to read (and upvote) a lot of the other comments you received, and especially the offers for pro-bono help. One comment below suggested that you read the literature (I presume that means the literature about suicide prevention) and I would second that advice. To expand that advice a bit, I'll note that Martin E. P. Seligman and some other psychologists who have studied depression and suicide think that the "self esteem" movement that took over United States schools after I graduated from high school may have actually INCREASED risk of suicide in the United States--certainly the rates of both attempted and completed suicide, and the rate of diagnosed youth depression, went up over the years when those school programs were put in place. In other words, don't just rely on intuition about what would be helpful, but look into actual research. Seligman's books Learned Optimism[1] and The Optimistic Child[2] are both helpful, although there should be some even newer research out by now. Reading those books may help you deal with the challenges of working on this interesting project while keeping up with your school work. Best wishes.

[1] http://www.amazon.com/Learned-Optimism-Change-Your-Mind/dp/1...

[2] http://www.amazon.com/The-Optimistic-Child-Depression-Resili...

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"the "self esteem" movement that took over United States schools after I graduated from high school may have actually INCREASED risk of suicide in the United States"

Yes, "self esteem" is again putting the individual up directly in front of themselves to examine and focus on which only brings existing problems into sharp center-focus. Depression and Pride both have a common denominator in too much self-absorption.

This is one of the most common misconceptions in my opinion of depression. Depression is not caused by self absorption. Depression is not vanity, imagine someone who has been rejected by a loved one. A depressed person might think, "I was never good enough for them," while a person who is not depressed might think, "I learned a lot and will do better next time." Viewing them as selfish or self absorbed is completely wrong. Do you think the depressed person wants to feel like they are not good enough? Is non depressed person self absorbed for their thinking?

> "I was never good enough for them."

> "I learned a lot and will do better next time."

Both of those are pretty self-absorbed (which is not the same as vane). In both scenarios you are seen as the person responsible, even though the rejection came from someone else.

What if our theoretical person is responsible? Everyone is going to view any event like this with some sort of "self-absorbed" (I disagree with your definition of self absorbed here, but lets continue) response because they had some part in it (by your definition). The difference between a Depressed person and a non depressed person's response is the self deprecating thoughts. "Self Absorbed" has nothing to do with it.

I'm curious as to what you are saying here. Poor self esteem is healthier? People shouldn't have self esteem, positive or negative? Or they should, but we should ignore it?

I think he's saying that falsely implanted self-esteen, a la "everyones a unique special winner!", is a problem. When everyone is told over and over again while growing up that they are great and their self-esteem is artificially inflated, they inevitably experience some amount of cognitive dissonance and maybe even depression at the realization somewhere down the road that they're probably not as unique, special, talented, or great as they were told they were as a kid.

This could set someone up for any number of positive or negative effects, emotions, or actions, from long term depression or suicidal feelings to a burning desire to really improve themselves to actually become that unique and talented person they were told they are.

> I think he's saying that falsely implanted self-esteen, a la "everyones a unique special winner!", is a problem.

I certainly hated that growing up. It was years before I could believe I had done anything right, because people would say the same things either way.

But I think tokenadult was actually proposing something else: not focusing on oneself so much. Much like CS Lewis's concept of humility: "could create the greatest cathedral in the world, know it is the best, and rejoice in the fact that it is the most wondrous of all cathedrals; without being any more or less glad that he created it than he would be if someone else had created the cathedral."

Or to take another CS Lewis quote: "And every state of mind, left to itself, every shutting up of the creature within the dungeon of its own mind - is, in the end, Hell. But Heaven is not a state of mind. Heaven is reality itself." Focusing on self-esteem instead of the goal or substance at hand is shutting a creature within the dungeon of its own mind. That really is a great phrase for it.

I don't really have a response to this other than to say that I like what you wrote and what CS Lewis wrote. Thanks for telling us about it. It is truly or relevant to the obsession over self-esteem today.

There are a bunch of 'positive thinking'-style things that claim to 'increase self esteem', but actually intentionally cause unrealistic expectations - and when those expectations aren't met, then the larger the gap/mismatch between expectations and reality, the greater damage to self esteem.

I think that sometimes increasing your self-esteem depends on factors totally outside of your control. However, a lot of self-esteem programs seem to think that change depends entirely on the individual. Depression comes from the difference between reality and what you think it should be.

Goals aren't results. A movement with the stated goal of "increasing self esteem" is not guaranteed to actually increase self-esteem, nor is there any guarantee that the only effect of the movement will be on self-esteem. Further, the stated reasons the movement had for increasing self-esteem are themselves goals of the movement, which are also not results; nothing guarantees that increased self-esteem will actually have the results those who were in the movement believe, nor that those would be the only results.

(This is one of those things that when I say it, it sounds trivial, but I observe that there is a very pervasive cognitive bias to assume that stated goals === results, in a wide variety of contexts.)

I second the advice to familiarize yourself with the literature, and would like to add a strong word of caution at the same time.

A disclaimer: I speak out of personal experience with this topic, and I did not read most of the comments that you've already received (sorry, wish I had the time).

So here's my word of caution:

You must be aware that you are intentionally brainwashing yourself into a biased worldview by reading all of these books on suicide prevention.

Every book on suicide prevention has the premise that suicide is "bad", after all, that is why the author wrote it, and that is what they are trying to prevent.

It does not matter a lick how scientific their "data points are", if the premise that they are starting out with is based on a biased point of view.

You will join their ranks if you don't keep this in mind.

Therefore, in addition to all of the literature on suicide prevention that you read, I strongly recommend reading literature that supports suicide.

Books that support suicide use a different word, but it is the same thing. These books employ the same linguistic trick that books attempting to prevent suicide use: they use words.

Words have unspoken meaning associated with them, that only exists ephemerally in the culture in which they are used. You may or may not find this hidden meaning in dictionaries.

These two words have in fact the exact same meaning, when it comes to the end act. Their meaning only slightly diverges when you take the cultural connotation and circumstances surrounding their use. Nevertheless, they really should be treated (by you) as synonyms, because the reasons that the people you are trying to prevent from killing themselves are usually the same in each case.

Word #1: Suicide

    - the action of killing oneself intentionally:
    - a course of action that is disastrously damaging to oneself
      or one's own interests

Word #2: Euthanasia

    - the painless killing of a patient suffering from an incurable
      and painful disease or in an irreversible coma. The practice
      is illegal in most countries.

For your project, I will throw a devil's advocate accusation at you, and call you, and anyone in this thread who supports your cause, a terrorist and/or sadist. I will accuse you of in fact not helping people, but misguidedly (due to complete and utter ignorance on your part) torturing people by encouraging them to experience more suffering.

Further, I will claim that unless you can see this point of view, your project will be an utter failure, and will not achieve any success beyond what existing measures have achieved.

To understand suicide, you have to understand wanting to kill yourself, and you cannot understand this intellectually, you have to have experienced it yourself (or have a great "emotional imagination", aka ability to empathize). How can you help anyone with a concept that you have no understanding of yourself? That is the road to failure.

Suicide is a very rational reaction to life. I've seen people call those who want to kill themselves "selfish", when it's clear that it is the other person who is selfish, and wants the person to stick around and suffer, only to spare themselves suffering.

So, to start you off, you may want to compliment your reading by familiarizing yourself with real suicide notes, before you even think about writing a single line of code. Here are some I found via some googling (I cannot vouch for their authenticity though):

http://theholydark.wordpress.com/2012/08/28/some-painfully-e... (references this page that is no longer online: https://web.archive.org/web/20130112214925/http://www.well.c... )

I'll play devil's advocate to your devil's advocate, then. You are a callous human being who encourages countless needless deaths to justify your personal experiences, especially deaths of teenagers.

So, now that we've got the hyperbole and name-calling out of the way: Many suicides are based on a misguided notion that the suffering is endless an interminable. I happen to actually support assisted suicide and "the right to death", but I'm painfully aware that the decision is rather irrevocable and requires strong safeguards.

If an app or a book convinces you to not commit suicide, the likelihood is high that what you're experiencing is strong emotional pain that is quite likely to subside. If your ideation is based on actual incurable physical pain, or merely the idea that you have lived a full life, a simple app or book will not convince you otherwise.

To the OP: Work with a suicide prevention organization. The Trevor organization is a great place to start. (Disclaimer - I've worked with them for a while, presenting to LGBT youth)

I'll play devil's advocate to your devil's advocate, then. You are a callous human being who encourages countless needless deaths to justify your personal experiences, especially deaths of teenagers.

Touché, I agree the hyperbole was unnecessary and over the top (probably got generated by some emotional trigger that I didn't do a good job of moderating). Just to clarify though, I _don't_ "encourage countless needless deaths".

If an app or a book convinces you to not commit suicide, the likelihood is high that what you're experiencing is strong emotional pain that is quite likely to subside.

I agree with this and the rest of your comment. :)

Obviously, you have strong opinions about this subject and I will try to tread carefully, but your comment reads like you are not in favor an app that attempts to assist in preventing suicide.

And on this point: > To understand suicide, you have to understand wanting to kill yourself, and you cannot understand this intellectually, you have to have experienced it yourself.

Not all people who attempt suicide have the same mindset. I know people who have attempted suicide (one guy's face is disfigured due to a self-inflicted gun shot) and they do not even remotely suggest that suicide could possibly be anything but bad.

> Not all people who attempt suicide have the same mindset. I know people who have attempted suicide (one guy's face is disfigured due to a self-inflicted gun shot) and they do not even remotely suggest that suicide could possibly be anything but bad.

Yes, that's a great point. There are a variety of viewpoints to consider, and it's important to understand the context in which they all occur.

I'm sure the person you're referring to did not have that opinion a few moments before pulling the trigger, otherwise he wouldn't have done it. The surviving individual cannot be said to be the same one who pulled the trigger, in spite of appearances. His life went on, and in a radically different direction.

> I'm sure the person you're referring to did not have that opinion a few moments before pulling the trigger, otherwise he wouldn't have done it

But I think that's exactly where suicide and euthanasia are different, where you claim they are synonyms. Euthanasia is for people that are suffering, in pain, and cannot get better. Suicide, in the context of depression and other mental illnesses, is for people that are suffering, in pain, and can get better.

Not to suggest that the suffering or pain is any different, but that the available treatments are very much different. I would argue that your points of view are more akin to terrorism and/or sadist, because you're peddling the kind of information that leads these people to truly believe that they can't get better.

And that's why a project, that the OP is attempting, is virtuous IMO. I agree with other commenters here that there are some very very important considerations though, and it should not just be released onto the world without very careful scrutiny, both legal and medical.

> But I think that's exactly where suicide and euthanasia are different, where you claim they are synonyms. Euthanasia is for people that are suffering, in pain, and cannot get better. Suicide, in the context of depression and other mental illnesses, is for people that are suffering, in pain, and can get better.

I'm sorry, but where did you find the Guidebook To Life that lays out the precise rules of what is and isn't an acceptable time for suicide? And what is the reason we should follow the advice in this book as opposed to some other book that says the exact opposite?

Regarding mental illness, that is in fact some of the worst type of illness you can get (I personally feel it is the worst type). You can carry on just fine without an arm or a leg (or no arms and no legs![1]), but mental illness is a monster that will truly crush the very core of your being and make life agony 24/7.

Now you come along and say, "But wait! It Gets Better™!"

Except that's not true.

What you mean to say is: "Wait, it might get better!"

Except, depending on the mental illness, the chances of it getting better in any meaningfully amount of time can be zero.

There are different levels of depression, for example, and many people who say they've been depressed haven't actually experienced depression at its worst. Depression is one of the worst "illnesses" that can happen to you (at its extreme), and it _will_ kill you if it's severe enough (by getting you to kill yourself).

The type of agony associated with such a disease is unimaginable to someone who hasn't experienced it, and isn't even necessarily recallable to someone who experienced it in the past, but it is real, and you'd better respect the person who tells you that they want to kill themselves.

In such situations, I believe that the "right answer" (if there is one), is the one the person chooses to make, whether it is to kill themselves, or not. The possibility of their situation improving is not in any way a justification for them to continue the very real and immediate torture that they're going through.

At that point it's up to them whether there is anything left that they want to continue staying alive for or not. That's a decision that they have to make, and I respect it, regardless of what they choose.

[1] https://www.google.com/search?q=nick+vujicic

I feel we're approaching this topic in very different directions. Let me rephrase both arguments, and let me know if I've rephrased correctly or not.

Your point is; how can you call suicide a bad or evil thing if it relieves pain and suffering in exactly the same way that the traditional definition of euthanasia does.

My point is; suicide prevention isn't just about demonising suicide, the act, but about helping people not get to the point where they feel/know that suicide is the only option.

Suicide/euthanasia is a tragedy. It means that we, as a society, have failed someone. Whether that is an inability to cure cancer, or cure depression.

I'm not qualified or experienced enough to really comment on the rest, so I'll leave it at that.

Your point is; how can you call suicide a bad or evil thing if it relieves pain and suffering in exactly the same way that the traditional definition of euthanasia does.

I very much appreciate you reaching out in such a way. It helps to know that we're working toward an understanding of perspectives, instead of arguing. Thank you.

That is not quite my point. I do accept the possibility of a "dishonorable" or "reckless" suicide, but I suspect such cases are the exception, rather than rule, given the significant taboo suicide carries today.

My point is; suicide prevention isn't just about demonising suicide, the act, but about helping people not get to the point where they feel/know that suicide is the only option.

Re: "isn't just about demonising suicide", the demonization of suicide is one of the key issues that I was getting at in my post. It hurts everyone involved. Family members wake up one day only to find their loved one dead all of a sudden. This happens because of said demonization. It wouldn't happen if suicide weren't illegal, if people weren't locked up against their will when they say they are suicidal, etc. A suicidal person should be free to talk about killing themselves with those close to them without fear of loss of liberty, social ostracization, and chemical rape. A son, father, daughter, mother, wife, husband, should be able to speak openly with their family about wanting out. Unfortunately, it seems our society is not mature enough for such conversation, and thus suicide becomes an agony for all involved. The person who killed themselves went through extra guilt and agony, and those surviving are also left feeling guilty, indignant, upset, angry, depressed, etc.

It doesn't have to be that way.

Re: "not get to the point where they feel/know that suicide is the only option", I can't comment on that without a concrete example. People get sideswiped and end up close to the edge. It can happen gradually, or very suddenly. Each situation is unique, and must be treated as such.

FFS, this is not an anti-euthanasia project. Euthanasia is distinct from suicide, and is usually treated as such by people campaigning or working in the area.

> For your project, I will throw a devil's advocate accusation at you, and call you, and anyone in this thread who supports your cause, a terrorist and/or sadist. I will accuse you of in fact not helping people, but misguidedly (due to complete and utter ignorance on your part) torturing people by encouraging them to experience more suffering.

How does this help discussion?

> FFS, this is not an anti-euthanasia project.

Indeed. I didn't say or think that it was.

> Euthanasia is distinct from suicide, and is usually treated as such by people campaigning or working in the area.

Yes, they treat it differently and invent various criteria and judgements on what is and isn't an acceptable reason to commit suicide.

Frankly, it's all a mis-mash of opinions and cultural beliefs. If you were in Japan a few centuries ago, you'd think it was perfectly rational and reasonable to gut yourself just because you shamed yourself (or your family/lord).

And frankly, you'd be just as right about that opinion as the folks working in Euthanasia are about theirs today.

>How does this help discussion?

The hyperbole doesn't help (I addressed this in another reply to someone else), but there was a point there that just wasn't stated very eloquently, and that is that our present culture (in the United States and many other places) does, many times, actually result in people suffering more than they otherwise should, were suicide/euthanasia a more normalized and talked about practice.

The problem with your argument is that you assume that attempts at suicide are being supported by some sort of logical reasoning that inevitably leads to the conclusion of killing oneself.

This is rarely the case, and is mostly seen in instances of euthanasia where the sufferer has no chance of life improvement due to an irreversible decline in health, and thus requests an assisted suicide.

Whereas those who are suicidal due to depression tend to take the irrational view that their mental anguish will never cease. This is bias towards extreme pessimism, not rationality.

The thought of suicide does not usually arise "rationally", but usually due to anxiety created by the context/environment/society. There is no rational argument that ends with "Therefore, die" just like there ain't any that says "Therefore, live". Rationally, living on and "fixing things" seems like a better way to alleviate the suffering, suicide is a very crude and dumb measure, eliminating any possibility of suffering and "non-suffering".

If it was a purely random or logical decision how can you explain the differences in suicide rates among different groups (e.g. males)?

> you have to understand wanting to kill yourself

I 'm willing to bet that everyone has had that thought at least once in their life.

Way to dump your own depressive tendencies on a 15 year old. Jesus.

But he has a good point. I don't think we can say that "suicide" is a universally Bad Thing, and I think it's fair to say that if you want to help prevent suicide, you could benefit from trying very hard to understand the mindset of a person who is contemplating suicide. Reading and understanding the arguments for suicide strike me as a very valuable tool in accomplishing that. You can't really understand suicide unless you yourself are feeling suicidal, but if you approach if from multiple directions / angles and kinda circle around it, you may be able to gain a better appreciation for it (without needing to become suicidal yourself).

All of this said, and saying this as someone who has contemplated suicide at least once in my life, I don't know much much any kind of app is really going to help. The times in my life that I've been depressed enough to think thoughts like that, I doubt I would have pulled up an app and consulted it.

Same deal with "Suicide prevention hotlines". My feeling is that many people who contemplate suicide don't want to be talked out of it, and won't call the hotline no matter how well publicized it is or whatever. When you're suicidal, you're in a totally different mental state where the normal rules just don't apply.

Which leads back to my saying that you can't really understand suicide, and why I think the GP post was valuable.

But reading "pro euthanasia" information is going to be very very different from reading "pro suicide" information.

> All of this said, and saying this as someone who has contemplated suicide at least once in my life, I don't know much much any kind of app is really going to help.

I gently agree. I hope it gets some research and oversight. And, if it works I hope it takes off.

> Same deal with "Suicide prevention hotlines". My feeling is that many people who contemplate suicide don't want to be talked out of it, and won't call the hotline

The Samaritans tend to say that they're not a "suicide prevention" hotline for that reason. They even say that they'll stay on the phone with you as you die if that's what you want. They say they just listen. This is for exactly the reason you mention - people don't want preachy "don't do it" advice, but they might want to just talk to someone.

> When you're suicidal, you're in a totally different mental state where the normal rules just don't apply.

Yes. And sometimes all that's needed is a small diversion, a bit of distraction, to allow the person to make it through the night without the attempted suicide, and to thus get help from doctors in the morning.

> Which leads back to my saying that you can't really understand suicide, and why I think the GP post was valuable.

I don't understand my own suicide attempts. I certainly don't understand the completed suicides of friends and acquaintances. I'd be foolish if I pretended to understand the completed or attempted of people in other nations (with different cultural expectations and so on). But GPs post (while it may have had a germ of useful information) is just weird and misleading.

Most people contemplating suicide are not in a position where euthanasia would be considered - they're suffering from some mental health problem. "Wanting to kill yourself" is not a rational reaction to life events. At least, not for most of the people who complete suicide. Some relatively minor interventions (a low interest loan of $4,000; some good debt advice; better lawyers and a decent legal system; housing advice; etc) would prevent many suicides. To suggest that suicide is a rational choice when the person is not capable of making a rational choice about life is cruel.

Way to dump your own depressive tendencies on a 15 year old. Jesus.

^-- A perfect example of the ignorance that I mentioned, thank you.

To Krish: remember, people who contemplate suicide are constantly faced with such ignorance, and so in the cultures where such attitudes are common, suicide happens unexpectedly (and this is most of the world). Then people "wish they could have said how much they loved them", etc. etc.

Ignorance? Oh my. Unfortunately, I satisfy your criteria required for understanding suicide, so I vehemently disagree with your assertion that "Suicide is a very rational reaction to life."

Especially when we're discussing teenagers, who haven't even lived one fifth of their expected lifespan.

> Especially when we're discussing teenagers,

...and who haven't finished cognitive development.

> Unfortunately, I satisfy your criteria required for understanding suicide, so I vehemently disagree with your assertion that "Suicide is a very rational reaction to life."

OK, you're certainly entitled to your opinion and to disagree with mine.

Especially when we're discussing teenagers, who haven't even lived one fifth of their expected lifespan.

It was only a short time ago that it was common in Europe and elsewhere for 15 year olds to be starting families.

Today, many 15 year olds (and younger), commit suicide.

What exactly are you seeking to accomplish by emphasizing his age and your arbitrary requirement on what the "right amount of life" is?

I understand your view point, and will keep it in mind while designing the app.

+1 :)

If you are suicidal and someone tells you that action 'X' will convince you to change your views and want to go on living, why would you 'take action X'?

The result 'want to go on living' is not a goal you want to reach.

(Where 'X' might be phoning a helpline, downloading an app, talking to a therapist, doing a thought experiment).

But that doesn't mean your desire to commit suicide is valid and coherent and respectable. We, the living, agree that living is better than non-living, that happiness is better than sadness, and that health is better than illness.

When someone is too ill to physically take care of themselves, we take over and act where possible "in their best interests" until they recover.

When someone is suicidal, they don't want to go on living, and offering help isn't enough because they won't reach out and take it. The only respectable act on our part is to consider them incapable and take over control of their life, assume their best interest is 'survival' and help them towards that.

anyone in this thread who supports your cause, a terrorist and/or sadist. I will accuse you of in fact not helping people, but misguidedly (due to complete and utter ignorance on your part) torturing people by encouraging them to experience more suffering.

Why would you assume that the goal would be to dump the person right into a life of suffering, instead of to help them out of the suffering as well? Current suicide prevention interventions don't always help as much as they could, but that's rather because they are implemented poorly than because they want people to suffer.

Empirically, most suicides have more to do with corrupted thinking processes than a negative total life value expectation. Often the corrupted thinking process can be directly observed without knowledge of the suicide attempt. Often, people who are prevented from suicide are later grateful in ways that are unlikely to be faked.

I don't see much that an anti-suicide app could do in the cases where it is a rational decision, whereas it probably could provide relevant information and perspective to people who need it. So that sounds like an overall good thing (so long as it doesn't invoke forced hospitalization or drug changes or other backfiring interventions).

http://slatestarcodex.com/2013/04/25/in-defense-of-psych-tre...

  Suicide is a very rational reaction to life.

Contemplating suicide can be a rational reaction to introspective inquiry into the state of 'being alive'. However, committing suicide is never a rational action. There is no logical argument that leads to the conclusion that suicide must be committed, because there is no set of purely objective premises from which the argument can start. There is always a premise that introduces someone's beliefs about the value of being alive and that premise cannot be defined in rational terms. In the end it is always a circular argument: I must commit suicide, because circumstances are such that I believe I should commit suicide.

By which I say absolutely nothing about the ethics of, or the validity of emotional arguments for, committing suicide.

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