İntihar Girişimi Sonrası Yaşam Deneyimleri: Toplumsal Cinsiyet Bağlamında Fenomenolojik Bir Çalışma

Öz

Bu çalışma, intihar girişimi sonrasında kadın ve erkeklerin yaşam deneyimlerini toplumsal cinsiyet ve eko-sistem yaklaşımı bağlamında anlamayı amaçlamaktadır. Yorumlayıcı/sosyal yapılandırmacı paradigma içinde fenomenolojik desende yürütülen araştırma, bir üniversite hastanesinin Ruh Sağlığı ve Hastalıkları Anabilim Dalı’nda gerçekleştirilmiştir. Maksimum çeşitlilik örneklemesiyle seçilen 16–44 yaş aralığındaki 20 katılımcıyla (16 kadın, 4 erkek) yarı yapılandırılmış derinlemesine görüşmeler yapılmıştır. Veriler tematik analiz yöntemiyle çözümlenmiştir. Bulgular, “Derin Sulardan Yüzeye Çıkmak” ana teması altında; intihar girişimine bakışta ambivalansın, kendini damgalama ve pişmanlık deneyimlerinin öne çıktığını; aile ve yakın çevre tepkilerinin şok, korku, üzüntü, suçlama ve öfke ekseninde değiştiğini ortaya koymaktadır. Bulgular ayrıca, bazı katılımcılar için ilişkilerin onarıldığını ve destekleyici bağların güçlendiğini, bazı katılımcılar için ise değişmeyen baskı örüntülerinin kırılganlığı sürdürdüğünü göstermektedir. Sonuçlar, intihar girişimi sonrası dönemin hem iyileşme ve güçlenme hem de yeniden risk üretme potansiyeli taşıdığını; izleme temelli, aileyi kapsayan psikososyal desteklerin ve toplumsal cinsiyete duyarlı müdahalelerin kritik önemini vurgulamaktadır.

Anahtar Kelimeler

• İntihar girişimi
• intihar sonrası
• toplumsal cinsiyet
• yaşam deneyimleri
• nitel araştırma

Life Experiences after Suicide Attempts: A Phenomenological Study in the Context of Gender

Öz

This study was aimed at understanding the life experiences of women and men after they attempted suicide within the context of gender and ecosystem approaches. The study in which a phenomenological design and an interpretive/social constructivist paradigm were employed was carried out in the Department of Psychiatry at a university hospital. Semi-structured in-depth interviews were conducted with 20 participants selected using the maximum diversity sampling method. Of them, 16 were women, 4 were men. They were in the age group of 16–44 years. Data were analyzed using thematic analysis. The results obtained in the main theme of "Rising from the Deep Waters" revealed that ambivalence, self-stigma, and regret were prominent in perspectives on suicide attempts; and that reactions of people in the family and immediate circle varied along the axes of shock, fear, sadness, blame, and anger. The results also demonstrated that while relationships were repaired and supportive bonds were strengthened in some of the participants, unchanging patterns of pressure remained fragile in the others. The results not only revealed that the period after the suicide attempt (post-suicide attempt period) had the potential both for recovery and for empowerment, but also emphasized that follow-up-based, family-inclusive psychosocial support and gender-sensitive interventions were of critical importance.

Anahtar Kelimeler

• Suicide attempt
• after suicide
• gender
• life experiences
• qualitative study

Kaynakça

1. Ağılkaya, Z. (2014). İntihar ve din: İntihar girişiminde bulunanlar üzerine empirik bir araştırma. Marmara Üniversitesi İlahiyat Fakültesi Dergisi, (38), 173-202. https://doi.org/10.15370/muifd.86904.
2. Alves, A. C., Silva, A. C., and Vedana, K. G. G. (2020). An attempted suicide from an adult’s perspective. SMAD, Revista Eletrônica Saúde Mental Álcool e Drogas, 16(4), 49-57. http://dx.doi.org/10.11606/issn.1806- 6976.smad.2020.168837.
3. Apaydın, H., Özdemir, Ş., ve Zoroğlu Ünal, A. (2016). İntihar girişiminde bulunan bireylerde bazı değişkenlerle intihar girişimi ilişkisi. Amasya Üniversitesi İlahiyat Fakültesi Dergisi, (6), 7–46. https://doi.org/10.18498/amauifd.251527.
4. Asare-Doku, W., Osafo, J., and Akotia, C. S. (2017). The experiences of attempt survivor families and how they cope after a suicide attempt in Ghana: A qualitative study. BMC Psychiatry, 17(1), 1-10. https://doi.org/10.1186/s12888-017-1336-9
5. Avcil, C., Bulut, H., ve Sayar, G. H. (2016). Psikiyatrik hastalıklar ve damgalama. Üsküdar Üniversitesi Sosyal Bilimler Dergisi, (2), 175-202. https://doi.org/10.32739/uskudarsbd.2.2.4
6. Azizpour, M., Taghizadeh, Z., Mohammadi, N., and Vedadhir, A. (2018). Fear of stigma: The lived experiences of Iranian women after suicide attempt. Perspectives in Psychiatric Care, 54(2), 293–299.
7. Buus, N., Caspersen, J., Hansen, R., Stenager, E., and Fleischer, E. (2014). Experiences of parents whose sons or daughters have (had) attempted suicide. Journal of Advanced Nursing, 70(4), 823–832. https://doi.org/10.1111/jan.12243.
8. Canetto, S. S. (2015). Suicide: Why are rates higher in men than in women? Social Science ve Medicine, 126, 1–8.

9. Chapman, A. L., and Dixon-Gordon, K. L. (2007). Emotional antecedents and consequences of deliberate self-harm and suicide attempts. Suicide and Life-Threatening Behavior, 37(5), 543–552. https://doi.org/10.1521/suli.2007.37.5.543.
10. Courtenay, W. H. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science ve Medicine, 50(10), 1385–1401. https://doi.org/10.1016/S0277-9536(99)00390-1.
11. Creswell J. W. (2013). Nitel araştırma yöntemleri. Ankara: Siyasal Kitabevi.
12. Dahlgren KG. (1977). Attempted suicides-35 years afterward. Suicide and Life- Threatening Behavior, 7(2), 75-79. https://doi.org/10.1111/j.1943- 278X.1977.tb00420.x.
13. Durkheim, E. (2011). İntihar (Ö. Ozankaya, Çev.). Cem Yayınevi.
14. Favazza, A. R. (1998). The coming of age of self-mutilation. The Journal of Nervous and Mental Disease, 186(5), 259–268. https://doi.org/10.1097/00005053-199805000-00001.
15. Fogarty, A. S., Spurrier, M., Player, M. J., Wilhelm, K., Whittle, E. L., Shand, F., Christensen, H., and Proudfoot, J. (2018). Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy, 21(1), 261–269. https://doi.org/10.1111/hex.12611.
16. Goñi-Sarriés, A., Yárnoz-Goñi, N., and López-Goñi, J. J. (2022). Psychiatric Hospitalization for Attempted Suicide and Reattempt at the One-Year Follow- Up. Psicothema, 34(3), 375–382. https://doi.org/10.7334/psicothema2021.455
17. Groholt, B., Ekeberg, O., and Harlodsen, T. (2006). Adolescentsuicide attempters: What predicts future suicidal acts? Suicide and Life-Threatening Behavior, 36(6), 238-250. https://doi.org/10.1521/suli.2006.36.6.638
18. Henriques, G., Wenzel, A., Brown, G. K., and Beck, A. T. (2005). Suicide attempters' reaction to survival as a risk factor for eventual suicide. The American Journal of Psychiatry, 162(11), 2180–2182. https://doi.org/10.1176/appi.ajp.162.11.2180
19. Henriques, G., Wenzel, A., Brown, G. K., and Beck, A. T. (2005). Suicide attempters’ reaction to survival as a risk factor for eventual suicide. The American Journal of Psychiatry, 162(11), 2180–2182. https://doi.org/10.1176/appi.ajp.162.11.2180.
20. Joiner, T. E. (2002). The trajectory of suicidal behavior over time. Suicide and Life-Threatening Behavior, 32(1), 33–41. https://doi.org/10.1521/suli.32.1.33.22187.
21. Khan, A. R., Ratele, K.,and Arendse, N. (2021). Men’s reflections on postsuicide attempt episode in Bangladesh. OMEGA-Journal of Death and Dying, 84(2), 582-595. https://doi.org/10.1177/0030222820904878.
22. Lakeman, R., and FitzGerald, M. (2008). How people live with or get over being suicidal: A review of qualitative studies. Journal of Advanced Nursing, 64(2), 114-126. https://doi.org/10.1111/j.1365-2648.2008.04773.x
23. Leon, A. C., Friedman, R. A., Sweeney, J. A., Brown, R. P.,and Mann, J. J. (1990). Statistical issues in the identification of risk factors for suicidal behavior: the application of survival analysis. Psychiatry Research, 31(1), 99-108. https://doi.org/10.1016/0165-1781(90)90112-i
24. Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., Hegerl, U., Lonnqvist, J., Malone, K., Marusic, A., Mehlum, L., Patton, G., Phillips, M., Rutz, W., Rihmer, Z., Schmidtke, A., Shaffer, D., Silverman, M., Takahashi, Y., Varnik, A., ... Hendin, H. (2005). Suicide prevention strategies: A systematic review. JAMA, 294(16), 2064–2074. https://doi.org/10.1001/jama.294.16.2064
25. Maple, M., Frey, L. M., McKay, K., Coker, S., and Grey, S. (2020). “Nobody hears a silent cry for help”: Suicide attempt survivors’ experiences of disclosing during and after a crisis. Archives of Suicide Research, 24(4), 498–516. https://doi.org/10.1080/13811118.2019.1658671.
26. Meissner, B. L., and Bantjes, J. (2017). Disconnection, reconnection and autonomy: four young south African men’s experience of attempting suicide. Journal of Youth Studies, 20(7), 781-797. https://doi.org/10.1080/13676261.2016.1273512.
27. Osafo, J., Asare-Doku, W., and Akotia, C. S. (2023). Exploring the role of religion in the recovery experiences of suicide attempt survivors in Ghana. BMC Psychiatry, 23, Article 219. https://doi.org/10.1186/s12888-023-04674-3.
28. Pirkis, J., Spittal, M. J., Keogh, L., Mousaferiadis, T., and Currier, D. (2017). Masculinity and suicidal thinking. Social Psychiatry and Psychiatric Epidemiology, 52(3), 319–327.
29. Player, M. J., Proudfoot, J., Fogarty, A., Whittle, E., Spurrier, M., Shand, F., Christensen, H., Hadzi-Pavlovic, D., and Wilhelm, K. (2015). What Interrupts Suicide Attempts in Men: A Qualitative Study. PloS one,10(6), e0128180. https://doi.org/10.1371/journal.pone.0128180.
30. Reynders, A., Kerkhof, A. J., Molenberghs, G., and Van Audenhove, C. (2014). Attitudes and stigma in relation to help-seeking intentions for psychological problems in low and high suicide rate regions. Social Psychiatry and Psychiatric Epidemiology, 49, 231-239. https://doi.org/10.1007/s00127-013-0745-4
31. Scocco, P., Corinto, B., and Pavan, L. (2008). The aftermath of a suicide attempt: The emotional impact on patient and psychiatrist. Clinical Neuropsychiatry, 5, 240–244.
32. Shamsaei, F., Yaghmaei, S., and Haghighi, M. (2020). Exploring the lived experiences of the suicide attempt survivors: a phenomenological approach. International Journal of Qualitative Studies on Health and Well-being,15(1). https://doi.org/10.1080%2F17482631.2020.1745478
33. Spillane, A., Matvienko-Sikar, K., Larkin, C., Corcoran, P., and Arensman, E. (2018). What are the physical and psychological health effects of suicide bereavement on family members? BMJ Open, 8(1), e019472. https://doi.org/10.1136/bmjopen-2017-019472.
34. Sultana, A., ve Altay, S. (2019). Ataerkillik ve kadının ikincilliği: Kuramsal bir analiz. E-Şarkiyat İlmi Araştırmalar Dergisi, 11(1), 417–427.
35. Tentama, F., and Riskiyana, E. R. (2020). The role of social support and self-regulation on work readiness. International Journal of Evaluation and Research in Education, 9(4), 826–832.
36. Uslu, R. (1993). Çocuk ve ergenlerin intihar davranışına yönelik bütünleyici bir tedavi yaklaşımı. Kriz Dergisi, 1(2), https://doi.org/10.1501/Kriz_0000000025.
37. Wiklander, M., Samuelsson, M., and Åsberg, M. (2003). Shame reactions after suicide attempt. Scandinavian Journal of Caring Sciences, 17(3), 293-300. http://dx.doi.org/10.1046/j.1471-6712.2003.00227.x
38. World Health Organization. (2023). Mental health: Suicide. https://www.who.int/health-topics/suicide. Yıldırım, A., Şimşek, H. (2013). Sosyal Bilimlerde Nitel Araştırma Yöntemleri. Seçkin Yayıncılık, Ankara.