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Cited by 48Suicide and Self-Harm StudiesGrief, Bereavement, and Mental HealthPsychiatric care and mental health services

Surviving moment to moment: the experience of living in a state of ambivalence for those with recurrent suicide attempts

Bergmans, Yvonne, Gordon, Evelyn, Eynan, Rahel·2017·Psychology and Psychotherapy Theory Research and Practice
DOI 10.1111/papt.12130
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Abstract

OBJECTIVE: This qualitative study aimed to capture the experience of living in the ambivalent space between life and death for adults with recurrent suicide attempts (RSA). It sought to expand upon an earlier study that explored the processes involved in transitioning away from RSA among adults, which revealed that occupying this ambivalent space is a crucial part of this process. DESIGN: Interpretive phenomenological analysis (IPA) was used. This methodology was designed to explore the lived experiences and meaning making and enabled interpretation of the multidimensional subjective experiences of RSA participants. METHODS: In-depth semi-structured interviews were conducted with eight adult women with a history of RSA who had participated in a therapeutic intervention at the research site (Skills for Safer Living: A Psychosocial/Psychoeducational Intervention for People with Recurrent Suicide Attempts [SfSL/PISA]). The six stages of IPA were followed to analyse the interview data. RESULTS: Analysis revealed the superordinate theme, 'surviving moment to moment', which refers to a precarious state of making decisions about one's life and destiny on a moment-to-moment basis without clear commitment to either life or death. Two subordinate themes were identified: 'deciding not to die in the moment' when the participants were more invested in dying than living and 'deciding to live in the moment' when they were more invested in living than dying. CONCLUSION: The study illuminated the complex process of making decisions about ones' destiny on a moment-to-moment basis. It revealed the torment experienced when occupying this state, while paradoxically, also revealing how indecision about life and death provided a lifeline opportunity for those with RSA. Clinicians who recognize the subtle distinctions associated with this in-between state can tailor their interventions accordingly. PRACTITIONER POINTS: Surviving moment to moment is characterized by a state of emotional flux and uncertainty about one's destiny, where the person has not fully committed to either life or death. Within this state, there are two interlinked subprocesses, whereby the person is leaning more towards death or life. A critical feature in working with this client group is to recognize their ambiguity and the fragility and temporality of their decisions about their destiny. The practitioner has an opportunity to be a catalyst in the momentum towards life by demonstrating understanding of this survival struggle and tailoring intervention to fit with the nuanced processes within this state.

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  • Ambivalence about suicide can also be protective against suicide attempts, since an awareness of goals which would be negatively impacted on by suicide may deter individuals from attempting suicide.

    “However, ambivalence about suicide can also be protective against suicide attempts (Bergmans et al., 2017), since an awareness of goals which would be negatively impacted on by suicide may deter individuals from attempting suicide (Tarrier et al., 2013).”

    From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Bergmans et al., 2017

  • Ambivalence towards suicide plays a crucial role, on an ongoing basis, for multiple suicide attempters, both causing them distress and keeping them alive.

    “Furthermore, ambivalence towards suicide plays a crucial role, on an ongoing basis, for multiple suicide attempters, both causing them distress and keeping them alive (Bergmans et al., 2017).”

    From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Bergmans et al., 2017

  • Our theoretical account is consistent with findings that ambivalence can be both distressing and protective in suicidal individuals.

    “Our theoretical account is consistent with findings that ambivalence can be both distressing and protective in suicidal individuals (Bergmans et al., 2017).”

    From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Bergmans et al., 2017

  • It does not explain fluctuations in individuals' ambivalence about attempting suicide.

    “Furthermore, it does not explain fluctuations in individuals’ ambivalence about attempting suicide (Bryan et al., 2016; Bergmans et al., 2017).”

    From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Bergmans et al., 2017

  • Ambivalence about suicide can be distressing.

    “Ambivalence about suicide can be distressing (Bergmans et al., 2017)”

    From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Bergmans et al., 2017

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Authors
Bergmans, Y., Gordon, E., & Eynan, R.
Affiliations
  • St. Michael's Hospital (CA)
  • Dublin City University (IE)
  • Western University (CA)
Corresponding author
Bergmans, Yvonne
ORCID
Venue
Psychology and Psychotherapy Theory Research and Practice
Publisher
Wiley
Published
2017-05-12
Volume
90
Issue
4
Pages
633-648
ISSN
  • 1476-0835 (ISSN-L)
  • 2044-8341
DOI
10.1111/papt.12130
OpenAlex
W2614097172
Cited by
48
References
47
Citations by year
2026: 12 · 2025: 2 · 2024: 9 · 2023: 2 · 2022: 8 · 2021: 4 · 2020: 6 · 2019: 2 · 2018: 2
FWCI
3.38
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Psychology and Psychotherapy Theory Research and Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
ambivalence, life and death decisions, indecision, lived experience, psychosocial interventions, suicide prevention, women
MeSH terms
Adult, Attitude to Death, Female, Humans, Male, Suicide, Attempted, Survivors, Qualitative Research, Young Adult

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