title: Shame reactions after suicide attempt.
abstract: Shame reactions were spontaneously described by 13 of 18 patients interviewed in a qualitative study investigating experiences of care following a suicide attempt. The shame data from the interview study were extracted, analysed separately, and are reported in this article. The shame reactions often occurred in conjunction with the suicide attempt. Feelings of shame were accompanied by impulses to hide or flee, i.e., fear of seeking help or impulses to leave the hospital. The attempted suicide patients often experienced the initial encounter at the hospital as difficult. Having attempted suicide and survived was often perceived as yet another failure, in addition to the problems leading to the attempt. The attempted suicide patients were sensitive to the attitudes and behaviours of the personnel. Experiencing the personnel as kind, respectful, and nonjudgemental seemed to contribute to a relief from shame for some patients. Some respondents expressed that a tolerant and flexible atmosphere in the psychiatric ward, with low demands on the attempted suicide patient, helped them accept treatment and made them feel less ashamed for not living up to the expectations of everyday life. On the other hand, feeling too exposed to others or experiencing negative attitudes from the personnel seemed to contribute to an exacerbation of shame for some patients. Being aware of possible shame reactions after a suicide attempt might help caring personnel to understand and interact with attempted suicide patients in a way that could make it easier for these patients to accept and benefit from psychiatric care after a suicide attempt.
authors.affiliation: Psychiatry Section, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. maria.wiklander@nvso.sll.se
authors.forename: Maria
authors.initials: M
authors.lastname: Wiklander
authors.forename: Mats
authors.initials: M
authors.lastname: Samuelsson
authors.forename: Marie
authors.initials: M
authors.lastname: Asberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001362:Avoidance Learning; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D008875:Middle Aged; D009341:Negativism; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology; D011369:Professional-Patient Relations; D011568:Psychiatric Nursing / Q000379:methods; D036301:Qualitative Research; D012752:Shame; D013406:Suicide, Attempted / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013548:Sweden