What Can Life Stories Teach us About Suicide Attempters Among Indigenous People?

Context: The author works as a psychiatrist for the public health district that serves the five Indigenous Nations of Maine. Within that context, he conducts life story interviews as part of his intake assessment process for all clients.

Objective: To determine what is common among the life stories of indigenous people who have recently attempted suicide. I sought to understand their worldview.

Study Design and Analysis: Life stories were reviewed of recent suicide attempters. Constructivist grounded theory as developed by Charmaz was used in an iterative manner to identify the predominant findings that emerged from the review of these life stories. The life stories were compared to stories collected from people judged to be reasonably adjusted and happy.

Setting or Dataset: Five indigenous communities and an Urban Indian Health Center in Maine.

Population Studied: Indigenous Maine suicide attempters

Intervention/Instrument: The Maine Life Story Interview

Outcome Measures: Categories as developed from qualitative analysis

Results: The life stories of clients who attempted suicide were shorter than the comparison stories. The vignettes told were also less complex and well-constructed. Suicide attempters had no future stories. Within the arena of religious and spiritual beliefs, suicide attempters appeared alienated from the people around them and the context of their lives. The comparison group of indigenous people spoke frequently of their connectedness to family, other community members, their nation, and the land. The average ACE score of the suicide attempters was 7.4. Most dramatic was the sense of aloneness and isolation and the idea of death as having the potential to erase all suffering and pain.

Conclusions: Indigenous suicide attempts make sense with Rosa’s concept of alienation, which can result from intergenerational trauma, historical trauma, and childhood abuse. The suicide attempters did not feel connected to their community and had entered into a Eurocentric notion of the isolated, individual self, which differed from the comparison group. Suicide makes more sense within the Eurocentric idea of the self as contained within the body and isolated from others and from nature/more-than-humans/other-than-humans. Intact cultural concepts provide a buffer against suicidal ideation by maintaining a continual connectedness with context and others and a sense of self as existing beyond the body within the relationships one has with others.