Acta Psychopathologica Open Access

In one way or another, everything around us has to do with communication. Human beings have the capacity to communicate not only by means of what they say and do, but also by means of what they do not say and do not do. Not always what people say is what they really mean, and not always what they do is what they really want to do. Sometimes what people say is denied by their behavior. So, the first topic to be dealt with in this book is related to the ways used by adolescents to express their suicidal purposes, that is, the different manifestations of suicidal communications at different stages of life.

Adolescents express their suicidal intentions through changes in their behavior. They may appear isolated, despaired, irritable, or they may complain of loss of appetite or insomnia. They may show interest in the topic of death or dying, or express overtly their intentions to kill themselves: “I want to kill myself”; “I will hang myself”.

Suicidal threats, which are verbal expressions of a wish to die by the individual’s own hand, are chosen very often by adolescents to communicate their suicidal intentions, and that something is about to happen (a suicidal act) to people who are attached to them affectively.

A suicidal gesture is another way adolescents use to communicate their self-destructive intentions. Suicidal gestures consist on threats to commit suicide using any available means but not actually taking action, or simply carrying out an attempt without any serious physical harm, as for instance, superficial wounds on the forearm which do not require medical or surgical care (suture or blood transfusion, etc.)

Suicidal threats and gestures are usually underestimated, devalued, and even ignored by significant others who are supposed to be the addressees of the subject’s message communicating his psychic pain. So significant others do not realize that these are manifestations of suicidal communications which, very often, are prodromic clues announcing a completed suicide.

Suicide attempts are very often an expression of suicidal communication in adolescence. It is considered that the suicide attempt-completed suicide rate can be up to 300 attempts per completed suicide, taking into account that, as an average, there are from 15 to 20 suicide attempts per completed suicide.

Repeaters, that is, individuals who have made two suicide attempts, abound among adolescents; as well as great repeaters, that is, subjects who have tried to take their lives three or more times. Some adolescents continue with their reiterative suicidal behavior during their adulthood and it becomes part of an unhealthy life style. This kind of life style is carried on in their old age—when it tends to become less intensive—if they do not die as a result of one of the earlier attempts.

As it has been said before, accidental suicides are common among adolescents. An accidental suicide can be defined as the suicide of a subject who did not want to die, but dies accidentally due to the high lethality or a complication of the method used. As a rule, the victims of an accidental suicide never have in mind to die, instead their suicide attempt is aimed at causing distress, frightening, or showing the magnitude of their problems to attract the attention of their dear ones or manipulate them.

Farewell notes or suicidal notes are frequently used by adolescents and they often express the circumstances that impelled them to make such a decision.

Other times adolescents show their suicidal intentions in cartoon stories and drawings that they create as part of their school assignments in which the main character ends his life by suicide. For that reason, teachers should be on the alert for these tragic stories that may be omens of what is going to happen. Some therapists consider that these are real projective tests that reflect the adolescent’s suicidal intentions in disguise.

Using the Internet to make suicidal pacts is a new type of suicidal communication frequently used by adolescents and young people familiarized with this technology.

Adolescents can also make videos of their own death in which they often tell part of their personal history, their mood at the moment, and the reasons that led them to make the decision of taking their own lives. Sometimes these videos are not only an evidence of an individual’s suicidal intentions, but also a warning about his homicidal intentions against his schoolmates before taking his life.

Some other times adolescents express their suicidal thoughts via Internet chat. This provides an opportunity for other cybernauts either to try to neutralize these thoughts, to encourage the suicidal adolescent to commit suicide, or to join a suicidal pact which involves other adolescents who share similar ideas.

The electronic mail can be a suitable means for adolescents who have access to technology to communicate their suicidal intentions. They can contact sites or professionals concerned with mental health services, and they can even have a virtual consultation, which has several advantages over a real consultation: it is less expensive; it is easier to discuss personal problems with a computer than with a human being; the family is kept out of the virtual therapeutic relationship. And above all, they engage in the virtual relationship on voluntary basis, they are not forced to get involved against their will, as often happens with most real therapeutic relationships.