Childhood Trauma, Male Suicide Risk…

Mandelli L, Carli V, Roy A, Serretti A, & Sarchiapone M (2010). The influence of childhood trauma on the onset and repetition of suicidal behavior: An investigation in a high risk sample of male prisoners. Journal of psychiatric research PMID: 21115183

What is it about childhood trauma that increases the likelihood of suicidal ideation and suicide attempts across the lifespan?

As a child abuse survivor myself, I grew up with the constant threat of violence and a complete absence of safety. Instead of learning the lessons that every child should, lessons derived from love and care, nurturing and attachment, I had no one and nothing to comfort me in this world. Mine was a childhood of perpetual fear and danger, of anticipated trauma and unexpected terror, where every peaceful moment past became the dread that it would soon all shatter.

It did…

I was repeatedly subjected to or forced to bear witness to the most extraordinary acts of excruciating torment. Real, and yet surreal, I was caught up in a crash of explosive violence that could come from nowhere and end, for instance, with several burly police officers struggling to hold my father down to the ground. As he tired, his resistance subsided and his anger faded into mournful sobbing, like a child in desperate need of a parent.

I (too) was a child in desperate need of a parent, with none to be found…

For me, ‘surviving’ child abuse has meant many things. It has taught me to be idealistic, optimistic and given kindly to others. It has inspired me to rail against injustice, to stand up for human rights and in solidarity with the poor and oppressed. It has reminded me how fortunate I am to have a loving partner, dear friends, and trusted colleagues. It has challenged me to make my adulthood everything my childhood was not.

There are, of course, limitations imposed by surviving and for me, that has primarily been the tension that exists between the story of my life ‘as was’ and the story of my life as I want it to be. The narrative that characterised my entire childhood was that I was never supposed to be born, that my birth was a terrible mistake, and that my existence brought immense suffering to others. Distanced though I am now am from that shocking script, the tragic fact remains…

Knowing is not necessarily feeling…

In this brief article by Mandelli et al. (2010, n.pag.), they report on the causative links between childhood trauma and later suicidal behaviours among a cohort of 1553 male prisoners. Two hundred of those prisoners, or 12.9 per cent of the total, ‘had a lifetime history of making a suicide attempt’ (2010). The prisoners who had experienced child abuse were significantly more likely to have attempted suicide than those who had not experienced child abuse (2010).

Moreover, those prisoners who had been sexually abused as children were at ‘higher risk for repetition of suicidal’ behaviours (2010)…

The authors (2010) conjecture that ‘severe early stress and maltreatment produce a cascade of events that have the potential to alter brain development,’ without providing a detailed analysis for their argument. They conceptualise suicidal behaviours within a psychopathological framework and therefore presume that child abuse is but one type of a precipitative trigger to the subsequent onset of mental disorder (2010). Here, their argument is flawed for two main reasons, notably that…

1. Male suicide is a complex phenomenon involving multiple causative pathways. Trying to reduce this phenomenon to mere psychopathology is highly fraught. Further, drawing the dots between child abuse, the development of mental disorder and later suicidal behaviours in men, denies the existence of so many confounding variables like, for example, the immense shame so often associated with having been the victim of sexual assault or the paucity of therapeutic services to respond to men abused as children.
2. By their own admission, the authors (2010) concede that the Child Trauma Questionnaire (CTQ) used in their study does not accurately measure the presence or absence of childhood trauma, nor does it ‘provide information on the severity and duration of each type of trauma’. Those glaring omissions invoke foundational methodological issues in terms of what then might be claimed about any purported positive association between child abuse and male suicide beyond, perhaps, ‘maybe’…

I have no doubt that child abuse can cause considerable harm to its victims. I have lived that experience and know all too well, how persistent psychological and somatic effects linger on, even decades after the event. What I remain unconvinced about are attempts to construct a reductionist psychopathological box in which childhood trauma is a logical input and, as Mandelli et al. (2010) would have it, male suicide, a logical output…

Simplicity simply does not fit here…