“Killing as an Option”

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Much energy, attention, and money has been focused on trying to understand—and end—the dramatic rise in suicide within the military.  And while this attention has resulted in the development of many efforts and programs, many of which have improved the overall well being of the force, the increase in suicides among those who serve our country continues.

Preventing suicide is a challenging endeavor, regardless of the target population. Mental health professionals recognize this: many civilian organizations, advocacy groups, and individuals work tirelessly to identify those most vulnerable and provide treatment to those at risk. Clearly our military leadership is dedicated to addressing this issue. But perhaps we have overlooked one aspect of the current military experience that is contributing to this crisis.

Our military has been at war for over a decade. And our service members are required to kill our enemies. Even those who themselves are not on the front lines are immersed in a culture that must accept killing as an option, as a component of the overall mission of the force. The taboo on taking a life has been lifted in order for our service members to defend our country, protect their battle buddies, and achieve critical goals. Killing becomes a viable option for solving a problem.

In the July 23 cover story for Time, Mark Thompson and Nancy Gibbs outline possible triggers for suicide among soldiers. They note that while triggers are unique to each individual, certain stressors contribute to the choice including the “the constant presence of pain and death.”

Perhaps we can take this line of thinking one psychological step further. Perhaps lifting the taboo on the taking of another life makes it that much easier to take one’s own. In addition, two-thirds of service members who commit suicide do so by gunshot. So not only is killing an option but the means by which to exercise the option are readily available to those seeking an escape from their emotional pain.

We can look to survivors of suicide in the civilian community to further illustrate the point. Family members of those who commit suicide are at increased risk for committing suicide themselves. Why? While it is true that they may have a family history of depression and, therefore, may be more prone to depression themselves, they have also seen that killing one’s self is an option—an option that they might never have considered before their loved one made that choice.

We have seen many examples of the effect of removing a taboo on societal behavior. Individuals will engage in horrific and brutal acts if they believe that such behavior is necessary or acceptable (consider the Los Angeles riots of 1992 ). And while many religions view suicide as a sin, it is unclear whether that belief serves as a protective factor for this generation of service members.

If lifting the taboo on killing has contributed to the increase in suicide within the military, what are we to do?

We must begin to address this directly within the services; we must begin to change the current climate so that those who serve do not confuse the necessity to kill with the possibility of killing as way to end emotional distress. Researchers at the National Center for Veterans Studies at the University of Utah asked 72 soldiers at Fort Carson why they tried to kill themselves. Among the reasons they had to choose from, all of the soldiers included one in particular: a desire to end intense emotional distress. They didn’t necessarily want to die; they wanted to stop the pain. These researchers also report that new approaches aimed at teaching soldiers skills to quiet or manage emotional pain may be far more effective in preventing suicide than approaches that treat underlying issues such as depression or post-traumatic stress.

It is unlikely that we will find one answer or one approach that works for all of those at risk. But, we can—and must—continue to identify the cultural, individual, and treatment elements that contribute to the choice to commit suicide. We must continue to develop strategies to assist those who are blinded to other options. And we must continue to engage the larger community about these issues, to ensure that services wrap around those who are too vulnerable, too exhausted, or too overwhelmed to continue to ask for help.

Barbara Van Dahlen is a Washington, D.C.-area psychologist who founded Give An Hour, a private non-profit group that pairs volunteer mental-health professionals with U.S. military personnel back from war.