Abstract
Reasons for Living (RFL) are reasons that persons identify for staying alive when otherwise considering suicide, including elements of life such as beliefs and values, interpersonal relationships, and socio-cultural and religious/spiritual concerns. Hence, they are specifically linked to the concept of resilience to suicidality. Aims of this chapter are (1) to provide a broad overview of the link between RFL and suicidal thoughts and behaviors, focusing on the different scales developed for assessing RFL; and (2) to describe specific therapeutic strategies for suicide prevention connected to RFL enhancement.
A literature web search was performed to identify studies focusing on the link between RFL and suicidal thoughts and behaviors from 1983 until June 2017. Since our aim was not to perform a systematic review, the most representative studies have been included.
Eight scales have been described and compared: the Reasons for Living Inventory (RFLI), the Reasons for Living inventory for Adolescents (RFL-A), the College Student Reasons for Living Inventory (CS-RFLI), the Reasons for Living inventory for Young Adults (RFL-YA), the Reasons for Living for Older Adults scale (RFL-OA), the Chinese-language Motivations for Living Inventory (CMLI), the Protective Reasons against Suicide Inventory (PRSI), and the Reasons for Living versus Reasons for Dying Assessment developed in the context of the Collaborative Assessment and Management of Suicidality (CAMS). Most historical evidence was attributed to the most studied measure, the RFLI: overall, a high total score was found to be potentially protective against both suicidal ideation and suicide attempts in clinical and non-clinical samples. Promising treatments specifically focusing on RFL enhancement include Dialectical Behavior Therapy (DBT) and CAMS, as well as Mindfulness Based Cognitive Therapies (MBCT), Positive Psychology (PP), Acceptance and Commitment Therapy (ACT), and problem-solving therapies.
Further investigation of RFL differences among different cultures and ages is warranted and should also account for major social changes occurring since the development of the first instruments. Moreover, our suggestion is that a focus on RFL has the potential to be integrated into every therapeutic intervention aiming at suicide prevention.
Ada:
“What a death!
What a chance!
What a surprise!
My will has chosen life!
Still it has had me spooked and many others besides!”
(Campion, 1993)
Contributors: Raffaella Calati wrote the chapter. Emilie Olié and Déborah Ducasse contributed to the section “Preventive and therapeutic interventions.” Philippe Courtet supervised the writing.
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Notes
- 1.
Wilfred R. Bion (1897–1979) was a British psychoanalyst. According to him, truth is essential for the existence and growth of the mind and for psychic health (Bion, 1984).
Abbreviations
- ACT:
-
Acceptance and Commitment Therapy
- CAMS:
-
Collaborative Assessment and Management of Suicidality
- CB:
-
Coping beliefs
- CC:
-
Child-related Concerns
- CFC:
-
College and Future-Related Concerns
- CMLI:
-
Chinese-language Motivations for Living Inventory
- CS-RFLI:
-
College Student Reasons for Living Inventory
- DBT:
-
Dialectical Behavior Therapy
- EMIL:
-
Experienced Meaning in Life scale
- FA:
-
Family Alliance
- FD:
-
Fear of Death
- FE:
-
Future Expectations
- FMS:
-
Family Member Support
- F/O:
-
Family/Others
- FO:
-
Future Optimism
- FR:
-
Family Relations
- FrS:
-
Friend Support
- FS:
-
Fear of Suicide
- FSD:
-
Fear of Social Disapproval
- HF:
-
Hope for the Future
- LS:
-
Life Satisfaction
- MBCT:
-
Mindfulness Based Cognitive Therapies
- MIL:
-
Meaning in Life
- MO:
-
Moral Objections
- MRO:
-
Moral/Religious Objections
- NIFM:
-
Negative Impact on Family Members
- NSSI:
-
Non-Suicidal Self-Injury
- PAS:
-
Peer-Acceptance and Support
- PASTOR:
-
Positive Appraisal Style Theory of Resilience
- PP:
-
Positive Psychology
- PR:
-
Peer Relations
- PRSI:
-
Protective Reasons against Suicide Inventory
- PSE:
-
Positive Self-Evaluation
- RB:
-
Religious Beliefs
- RF:
-
Responsibility to Family
- RFD:
-
Reasons for Dying
- RFF:
-
Responsibility to Friends and Family
- RFL:
-
Reasons for Living
- RFL-A:
-
Reasons for Living Inventory for Adolescents
- RFLI:
-
Reasons for Living Inventory
- RFL-OA:
-
Reasons for Living for Older Adults scale
- RFL-YA:
-
Reasons for Living Inventory for Young Adults
- SA:
-
Suicide Attempt
- SelfA:
-
Self-Acceptance
- SD:
-
Suicide Death
- SCB:
-
Survival and Coping Beliefs
- SI:
-
Suicidal Ideation
- SRC:
-
Suicide-Related Concerns
- TMBI:
-
Teachable Moment Brief Intervention
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Acknowledgments
Raffaella Calati: Thanks to P.G.M., who has represented one of my reasons for living. Dr. Raffaella Calati received a grant from FondaMental Foundation, Créteil, France (2015–2016). Dr. Emilie Olié received research grants from AstraZeneca, Servier, Institut UPSA de la Douleur and fees for presentations at congresses from Janssen, Lundbeck, Otsuka, Servier. Prof. Philippe Courtet received research grants from Servier, and fees for presentations at congresses or participation in scientific boards from Janssen, Lundbeck, Otsuka, Servier.
Conflicts of interest: None.
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Calati, R., Olié, E., Ducasse, D., Courtet, P. (2018). Reasons for Living. In: Hirsch, J., Chang, E., Kelliher Rabon, J. (eds) A Positive Psychological Approach to Suicide . Advances in Mental Health and Addiction. Springer, Cham. https://doi.org/10.1007/978-3-030-03225-8_4
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