The end of ambivalence. A narrative perspective on ambivalence in the suicidal process.

Abstract

Suicidal ambivalence is a recognized phenomenon in suicidology, yet not much is known about it in the context of progression from suicidal ideation to action. The current study addresses this gap. We explore narrative dynamics of suicidal ambivalence in stories about transition from suicidal ideation to action. We employ an experiential qualitative approach to gain in-depth understanding of narrated experience of suicidal ambivalence. We conducted semi-structured interviews with 22 patients hospitalized after a suicide attempt. For a detailed analysis, we selected 11 interviews in which the interviewees' accounts spontaneously referred to their ambivalence about attempting suicide. We used a text-oriented version of Critical Discourse Studies (CDS) to analyze the semantics and syntax, as well as the functions of what was said within the local context, and the social actions thus accomplished. Our study shows primarily that ambivalence is not resolved. Rather, it is set aside and removed from the narrative and replaced by an action-focused narrative with no references to mental activities. We propose that ambivalence recedes and gives way to action and that qualitative research provides a useful evidence base for conceptualizing and understanding the role of ambivalence in transition from suicidal ideation to action.