Tony White

Escape hatches and the suicidal

As far as I know the term “Escape hatch” and its relationship to the suicidal was coined by a man called Bill Holloway who wrote a number of unpublished monographs in the early 1970s. These were on a variety of topics one being the area of suicide and its management. After that a man called Harry Boyd picked up the term and wrote more about it in the late 1970s. I have not seen the term ‘escape hatch’ and the suicidal being used since that time.



The term escape hatch is an intersting one and a very apt choice by Holloway. An escape hatch is usually a good thing. It provides a way to get away from danger or bad things. Most people would like to have an escape hatch as it would make them feel safer and more comforatbale and indeed better able to deal with any current dificulties. The individual can think,”As I have an escape hatch that means I can always get away and cannot get cornered”. If they know this then they will deal better with what they are currently involved with day to day.

However the way it is used by Boyd and Holloway is in a negative frame of reference. They see it as necessary to close the suicide escape hatch. They acknowledge that suicide can be seen as an escape hatch that alows one to escape from very undesirable stress, feelings of depression and so forth. Of course they see suicide as a very poor method of escape. They would suggest other means by which the person escape from the emotional pain. A commonly held view I think it is safe to say.



Suicide as a solution.
Inherent in the concept of suicide as an escape hatch is the idea that suicide is a solution to a problem. There are some who don’t like this idea at all and will argue vehemently that suicide is not a solution. They may argue that suicide does not solve problems because the person is dead and therefore has no knowledge of the problem being solved.

If suicide is seen as an escape hatch then that implies that the person is escaping from something such as their problems. This is a view that I agree with in part and that suicide does solve problems in the sense that if the person is faced with divorce, then dies, thus he does not have to face it. So in this sense the problem is solved.

Those who work with the suicidal would most often see closing the suicide escape hatch as a worthwhile thing. I would suggest that this is so as well but needs to be considered in another light as well. It is not as simple as it seems. It also shows another dimension or factor that must be taken into account when working with the suicidal patient.

As I mentioned above most people would see an escape hatch as a positive thing. Below are two examples of the suicidal escape hatch and one way in which it can be a positive psychological function.



Louise in discussing the option of killing herself:

“Having the option there in the back of my head actually serves to help me. It doesn't help once the danger is more immediate. When it starts making messes. But on a day to day basis it is nice.”

“It helps with the more minor bad things like 'yes this situation is bad, but it's not quite bad enough to kill myself over, which if it does get worse is an option.'

Most of the time I have a method picked out. I'm very protective of the method of the moment. I feel like sharing it corrupts it.
There have been times where I felt my method had been corrupted or somehow made unusable. And it immediately has pushed me into a depression, often times making me want to die more. I've had times where I became suicidal because I felt my option to kill myself was ruined. Feeling that option is taken away from me makes everything feel like it is crumbling around me.
It's such a strongheld belief that I will kill myself eventually, I just don't know when. It might be at 90. It might be at 25. A threat to that belief I have trouble handling

I visualize the method in my head a lot though during times of stress. It's soothing”
(end quote)


Soothing? One of the most basic tasks of the developing child. Learning how to self soothe.




Marissa in describing what she does at home sometimes:

Sits in a chair in her lounge room and can see the drawer in her kitchen that has many pills in it. It gives her a sense of security or relief somehow. She reports that the pills give her a sense of security for whenever everything just gets too bad.

She imagines putting the pills into little piles and taking one and then two and so forth. She has created a ritualised suicidal fantasy that gives her a sense of solace and relief because it reminds her that she has an escape hatch should she require it one day.

Marissa states:
“The pills are a comfort because they give me a sense of choice when I am in that place.”

“What happens when those pills beckon me?
When my eyes go back to the drawer time after time
What do I imagine when I'm staring at it
Thinking about the pills inside
And the oblivion they could bring to my mind”
(end quote)

Clinical implications
First one needs to be clinically aware that closing the suicide escape hatch can in fact make the situation worse. In such circumstances the client needs to be able to see other ways of easing the pain (alternative escape hatches) before the therapist suggests closing the suicide escape hatch. If one is using the closing escape hatch approach as suggested by Harry Boyd one would need to monitor closely the client’s reaction to that over the next week or two.

If one is suggesting a no suicide contract then the therapist must be clear to the client that the NSC is not closing an escape hatch, all it does is delay the person taking the escape hatch for a certain period of time. It may in fact be a good way of monitoring how much the individual sees alternative escape hatches as viable options.



Secondly, as the case examples show the suicide escape hatch can provide some positive feelings to the Child ego state. This means that if a therapist is working with a suicidal client so they no longer have suicide as an option then they are taking away something that feels good to the Child. Hence we end up with a Parent contract. So the therapist has to deal with a Parent ego state contract contained within the treatment plan for the client to cease being suicidal.

Graffiti

References:

Holloway, W.H.
“Shut the Escape Hatch” in The mongraph series. 1973. Midwest Institute: Ohio.

Boyd, H.S. & Cowles-Boyd, L.
“blocking tragic scripts”. Transactional Analysis Journal, 1980, 10(3), 227 - 229.