Tag Archives: Suicidal

What reinforces Suicidal Behaviour?

Suicidal behaviour doesn’t just mean the attempt or act of killing oneself, but also includes talking about it, thinking about it, threatening others about it, imagining it and even fantasising about it.

Here are some common reinforcers of suicidal behaviour:

  • relief from pain (even just thinking about it can lead to some instant relief from pain)
  • overt avoidance (can stay away from situations that one doesn’t want to be in)
  • diminished responsibility (people expect less from the person)
  • attention
  • forgiveness
  • identification with hero or idol
  • distraction from other issues
  • revenge (I wrote about this before here)
  • prevent abandonment (“if you leave me, I’m going to kill myself”)
  • escape punishment


Maybe you want to read about this too: Euthanasia

Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145

Life Line Association Malaysia
03-4265 7995

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800

Suicide Survivor Support Group

Due to my attempts of organising support groups in Klang Valley (more details here), I have encountered people who are searching for support groups for all sort of things.

I just happened to come across this from Befrienders. Please go get in touch with Kenny at 03-7957 1306 or admin@befrienders.org.my if you or someone you know might be interested to attend.


Suicide with a Hostile Intent

In the past, whenever we talk about suicidal clients, it’s normally due to depression, they feel hopeless about the future and see themselves as a burden to the family and society, and see that ending their lives as the only solution to their problems.

But things changed. Today I’m not writing about suicide bombing or attacks, but suicide with a hostile intent, on a personal level.

So recently I’m seeing more and more young people who are suicidal, who have self-harm issues, or who have attempted suicide. Or, there are also some who have done any self-harm, but they are always telling others that they don’t want to live no more.

It’s not just me. When I was teaching suicide risk assessment in Beijing, many of the students (who are teachers/psychotherapists/counsellors themselves) express the same concerns. They are seeing more and more students and young people like that. They don’t quite seem to be depressed, but they are expressing suicidal thoughts, seem to be as a mean to obtain something, usually from their parents.

It’s difficult. Because you can’t really provoke these youngsters, by telling them that “stop seeking attention! You don’t really want to die! You say it to manipulate your parents” etc. Some of them are willing to “sacrifice” their lives, to make you regret and feel guilty all your lives, just because you don’t give them what they want. Sometimes I feel they don’t appreciate and love lives as much as the previous generations (Why?!).

It’s difficult. Because any expression of suicidal ideation is important and worth our attention, we can’t simply make assumptions and then ignore it. (But do you realise, it’s also because of this, we are reinforcing their behaviour… So they get what they want, they can continue to threaten or blackmail us etc.)

We can help them as much as we can, by being more emphatic and having more compassion. But I’m just wondering, what happens to our society, parenting and education systems, why are more and more entitled children growing up, who are fairly self-centered and do not care much about how others feel?


N.B. I don’t mean to discount the importance of helping anyone with suicidal ideation. Here I’m only talking about a small group of people who use suicide to blackmail or manipulate around, but there are definitely plenty of people out there who are really suicidal and in need of attention and help.

Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145

Life Line Association Malaysia
03-4265 7995

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800


This is the first time I came across this word. Euthanasia.

It’s also called “mercy killing”, or “painless death.” This is the definition from google “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.”

I searched about it after hearing a patient telling me about “legalised suicide” in some countries. She isn’t depressed, but she was for quite a period of time. When she was thinking about ending her life and making plans about it, she came across this idea – that it’s legal in some countries and even some with the assistance of a physician. (You may read more about it on google, especially the Belgium’s “Euthanasia Act”).

She asked me, “isn’t that nice? So it wouldn’t be so painful. And less trial and error. Maybe it’s just a pill and it’s done”

I’m aware of quite a number of patients of high risk suicidal, yet they are still around because they are scared to do it or scared of pain. I’m thanking god that they are scared of pain and hence they are still around, and hence I still get to help them.

I asked her, “Joey, do you still want to end your life now?”

“No, but back then yes. I didn’t do it because I was scared, but it would be good if it’s legal and I can die painlessly” (N.B. even if it’s legal it’s under certain kind-of-strict conditions, it’s definitely not that simple)

“So now you are ok to live on?” “Yes”

“That’s the thing.” I explained to her, “Joey back then wanted to die. That was Joey with depression wanted to commit suicide. But does Joey (without depression) want to die?”

“Ehmm I guess no” (She’s no longer depressed now)

Actually that’s all I want to say today. You feel like there’s no purpose to live on, you want to die, you might even feel like a burden to your family, or it’s such a suffer living… But it’s you with depression (or other mental/physical problems) who are thinking so. It’s not you. It’s like when you’re enraged (very, very angry) you shout that you want a break up or a divorce, but you don’t mean it at all. You regret it later on. So when your emotion is not like the usual you, you can’t make the decision to take away your own life, it’s not (the original) you, yes it might feel so real, but no, you don’t mean it. So don’t do this. Please seek help. It can be treated, and you can be like many of my patients, who are grateful that they didn’t/couldn’t make that move.


Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145

Life Line Association Malaysia
03-4265 7995

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800

Related read (in Chinese): 识别自杀的预警信号

<心理追兇Mind Hunter>男主角马国明是精神分裂吗?



不交代剧中的内容和角色。只是昨晚因为家人还在看,提起主角Dr Chong(心理学家钟泰然博士 — 是的他不是医生,他不能开药,他被称为Dr 是因为 PhD博士学位,不是medical doctor),说他是精神分裂症(schizophrenia),有幻觉(hallucination),可以看到听到他已故女友。我想了一下,他总是在点起烟的时候对方才出现,看起来真的有点像是刺激物引致的幻觉(有些药物和毒品确实可能引起幻觉,可能但不一定引致精神分裂症)。

说真的,看这部电视剧的过程中,我从没想过他可能有精神分裂。虽然我满怀期待最后编剧导演给我一个交代,一个诊断,这名心理学家患有的是什么心理问题(可是没有。No, 我不认同他是反社会人格障碍 antisocial personality disorder!)。对我而言,他的表现是grieving,悲悼(因为失去所爱的人的悲伤),长久下去,可能形成抑郁(depression)。当然,就像我常和病人说的,接受这些悲伤,你刚失去生命中这么重要的人/感情,你要是不悲伤不难过不哭泣,我才要担心才想治疗你。所以抑郁也是正常的。或许大部分人会说,悼念五年,也太久了。可是以陪伴丧亲者的角度来说,悲悼其实没有期限,有些人要几个月,有些人几年,周围的人能做的,就是陪伴。

回到主题,最后Dr Chung不再和其他人联络/接触,情绪崩溃,独自走上末路(其实他有没有死,结局没有交代)。这其实对我而言,或多或少地确认了我的判断,他是悲悼过度而抑郁。如果你只是悲悼,一般不那么抗拒周围的人,你还是可以继续生活、工作或学习等,并接受其他人的陪伴,但是哀悼与抑郁的一线之差(really just a fine line!),在于你开始抗拒其他人,开始封闭自己(有一幕他的警擦朋友和社工朋友说已经很久没有看到他了,另一精神科医生好朋友也已经反目成仇)。


最后还是有一点相当欣赏这部剧的地方,在于催眠那段,社工朋友童月因为过度惊吓,出现暂时性失忆,Dr Chung说催眠可以看到平时看不到的事,原本太远的距离太小的事物,在催眠中可以变近放大,当时我的心里在说“放屁!为什么误导观众”,很开心最后发现那只是他的手段,用来骗童日。只是这个操作(manipulation),真的很难让人不觉得他是反社会人格…. 不过!从剧中很多地方不难发现,他其实很在意别人的感受,也尊重别人的权益,反社会人格,是不会在他30-40岁突然出现的…



  • 过去自杀企图(Previous suicidal attempts):包括家庭成员的自杀史,将显示对方可能熟悉把自杀当成解决问题的方式。(10分)
  • 家庭精神问题史,或目前有精神问题的诊断(包括人格障碍,含或不含自残行为)。(9分)
  • 毒品或物质滥用史(毒品和酒精可以使一个人失去理性,也可以被用来压抑情绪)。(8分)
  • 抑郁,对未来感到绝望、无助。(7分)
  • 童年遭受虐待或严重创伤。(6分)
  • 孤立自己、疏远其他人,与家人没有建立良好关系、没有联系。(5分)
  • 最近经历丧生或丧失,分离、离婚、失恋。(4分)
  • 患有危及生命的疾病或慢性身体疾病(如,癌症、艾滋、老人痴呆症等)。(3分)
  • 经济问题。(2分)
  • 失业。(1分)



  • 很多人把“讨论自杀”视为禁忌,但是问对方“你是否有自杀念头”并不会使对方更想自杀。相反的,坦诚真心地一起讨论反而会使对方觉得自己被理解、自己其实并不孤独。
  • 可以用一些比较开放式的问题,比如“你对未来有什么想法?”,对方可能比较间接地说“我希望我可以这一觉睡下去再也不会醒来”,或直接地“我想死”。
  • 注意对方对未来或目前的情况(尤其困境)的无助感、绝望感、悲观想法。
  • 注意一些非言语的信号,比如把个人财物托付给别人,或安排身后事。
  • 无论任何时候,只要对方提起自杀,都请认真对待。
  • 自杀的念头与自杀的计划并不同。很多人在一生当中都会想过“自杀”,但是并不打算付诸行动。同样地,可以问对方,“你是否有计划怎么去进行?”,一旦发现对方有了计划(比如,想好了以什么形式比较快捷不疼痛,或把孩子送去妈妈家后独处时容易怎么做等),务必着手处理(必要时报警、送院让他留院接受治疗)。
  • 如果对方曾经企图自杀,这会是显示他将来可能再做出类似行为的最重要信号。



心灵扶助协会 (The Befrienders)
热线:03-7956 8144/ 03-7956 8145

马来西亚生命线协会 (Life Line Association Malaysia)
热线 :03-4265 7995

马来西亚博爱辅导中心 (Agape Counselling Center Malaysia)
热线: 03-7785 5955 / 03-7781 0800