The role of magical thinking in suicide risk assessment

This diagram shows that all adults have two systems or types of possible thought

A1 thinking Jpeg

When we are born we only have one system, the A1 type of thinking. The A2 does not develop until later in life. As we grow we develop more of the capacity for A2 type of thinking. However the A1 type of thinking does not go away. A 30 year old woman is just as capable of thinking in an A1 type of way as an A2 type of way. In most circumstances she will use the A2 type of thinking to solve problems and communicate but she is also quite capable of doing A1 magical thinking.

Some examples of A1 magical thinking are:

Egocentrism

Egocentrism is the inability to differentiate one’s cognitive perspective from that of others. The child mistakenly believes that its thoughts and beliefs are also held by others around it.

Phenomenism

The child makes causal connections between events that just happen to occur together when there is no causal relationship.

The child sees a red object floating and says that it floats because it is red.

“When I was angry, mummy looked sad, I can control (am responsible for) mummy’s feelings”.

Girls

As fully grown adults we are all quite capable of having A1 magical thinking

 

Finalism

Things happen because they are supposed to. There is always a reason for things occurring as they do

“Bad dreams happen to punish me because I am bad.”

Artificialism

There are two parts to this. First the child believes grownups are omnipotent, so the child feels defined by what they say. A child spills milk and mother says, “You always do these bad things to me”. Child then believes, “I am bad so things would be better if I was not here”.

Second, the child identifies with these omnipotent beings and believes she is omnipotent as well. This can result in grandiose thinking. Watching an angry father the child may think, “You could kill (obliterate) me. I can kill (obliterate) you.”

Animism

Child believes the world and nature are alive and has consciousness like it does.

“A stone is alive because it moves”.

“It gets dark at night so I can go to sleep.”

This graph shows how the A1 and A2 influence the thinking and decision making in the person over the life span. The very young child has only A1 thinking and no A2 thinking. As it grows into late childhood the A1 slowly decreases as the A2 slowly develops and becomes more influential itself as the executive in the personality.

Life span A1 thinking

When adolescence arrives there is again an increase in A1 type of thinking. Of course they are able to do A2 type of thinking but for various reasons they develop a sense of qualities like these

egocentricity

feeling omnipotent and indestructible

being narcissistic

believe they have special abilities

These mistaken (magical) beliefs assume greater influence in their decision making and become more powerful as the executive in the personality during the teenage years. Over time these taper off as well when the person moves into adulthood.

However we all are quite capable of doing magical thinking all our lives and we indeed do. The more we are put under stress the greater influence the A1 will have in our decision making and this is where it becomes crucial in suicide risk assessment. For the sake of simplicity we can say

A2 is the prefrontal cortex

A1 is the amygdala

Brain copy

 

In my book – Working with suicidal individuals – I make this comment

“This is supported by research in neuro-psychology as cited by Johnston (2009). When people are placed under stress they are less able to access the pre-frontal cortex of the brain which is associated with the more developed functions like problem solving, decision making and stress management (The Adult ego state). Instead people tend to access the more primitive part of the brain in the amygdala (The Child ego state).”

People who are considering suicide are usually under a great deal of stress which means their A2 lacks influence in their decision making and the A1 assumes greater importance. This is not a good thing for obvious reasons. Also from my book here are some quotes from others in the literature on suicidology

“My impression is that the suicidal patient does not, on the Child level, really conceive of his death as terminal”

“He notes that the suicidal person expects and understands that his body will die (Adult ego state) but the person can imagine there is another part of himself that can continue to live in a conscious body-less state that is unaffected by the physical death of the body (Child ego state).”

“suicidal people have transformation fantasies and are prone to magical thinking, like children and psychotics”.

These writers have also noticed that magical thinking can go on with people who are suicidal and have articulated in these ways.

Obviously if one is doing a suicide risk assessment they need to assess how much A1 thinking is going on for the person and how influential it is as the executive of the personality. The more it is the higher the imminent risk of suicide.

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