PD Dr. Reinhard Lindner
Interview of September 28, 2010 with Astrid Söthe-Röck
What is suicidality? Can you give a short description?
Suicidality covers all conscious and unconscious emotions, thoughts and actions that are oriented on the self-induced death. Suicidal persons are often hopeless and in despair about themselves, their life and its perspectives. They experience their situation as hopeless. It often exists a tremendous fear of loss, loss of other people as well as of aspects of themselves. Causes are foremost interpersonal conflicts, separations or death of a significant other, insults, job-related problems, the experience of illness as well as loneliness and loss of self-esteem.
You claim “ Suicidality bears the handwriting of old age”. What do you mean by that?
Every second woman that commits suicide in Germany is above 60. The suicide rate of older men exceeds the middle suicide rate of the population, with aging it rises up to five times.
What about suicide in old age? What is the difference between suicidal thoughts of adolescences and people of old age?
Older people commit suicide faster, meaning they try less suicide attempts before the actual suicide and use more effective suicide methods. Even though statistically, the highest suicide rate is found in the group of older, alone and lonely men with alcohol problems, the interpersonal problems in long marriages or with grown children are in many cases a trigger for suicide in old age. Furthermore, the body gains a increasingly important role in the suicide event in older age: The questions on how do deal with limitations, what influence bodily changes –whether they are due to age or sickness- have on the self-feeling, self esteem and the identity, are more often connected to suicidal fantasies.
How is suicidality in old age recognized in society?
Suicide and suicidality are commonly societal tabooed. Especially with older people it is assumed faster, that to depart life in this way is “understandable” and to be tolerated.
Is it not understandable, that after a fulfilling life, an older person expresses the wish to end his life with his own strength? As a physician, can and are you allowed to think like that?
As I already said, this thought is widely spread and has its source in the tabooing of the emotions of anxiety, desperation and the hopeless life situation behind the suicidal act. A person hardly commits suicide after a “fulfilling life”, because the fulfilment, the commitments and relationships are keeping him alive. That’s why it is always useful to ask about the suffering that is behind the suicide intention. On the other hand, it is extremely important, also as a physician, not to try to “save” a person by all means, but to search for the triggers and reasons for suicidal experiences with respect for the individuality of the patient.
When we notice, that a good friend or relative for example, indicates to end his life, how do we deal with that?
The most important thing is to recognize it at all, and take it serious when a person close to you talks about not wanting to live anymore, wants to commit suicide, to rather be dead. In this situation, talking about it, listening and taking in the background, but also the condition of that person, is especially important. More important than a fast solution, a calming or an active measure. Nevertheless, it should be conveyed to the suicidal older person, that there is professional help and you wish, he or her would accept such help.
Interview with PD Dr. Reinhard Lindner, head of the Center for Therapy and Studies of Suicidal Behaviour (TZS) at the University clinic Hamburg-Eppendorf. Specialist physician in neurology and psychiatry, specialist physician in psychiatry and psychotherapy as well as in psychosomatic medicine and psychotherapy. Furthermore, he works at the medical-geriatric Albertinen- Hospital within the framework of a scholarship of the research program Geriatrics from the Robert Bosch Foundation.