Chris - The First Steps (Part Two)

"In the profile of every recovery from attempted suicide, there is a moment on which one’s entire fate balances." R. A. Heckler, PhD

*        *        *

-I know your little girl. She’s the most beautiful creature I’ve ever met.  You know your husband.  Do you really want him to raise her?-

(Continued from March 26th Blog)

‘I don’t even want you to tell me [how you feel] right now, [said the attending physician]. Then he said, ‘and I’m gonna tell you a secret. You see, in this state, it’s illegal to attempt suicide, and they send you to the state hospital for a month if you try, plus you have to pay a fine. You have to handle all the legal ramifications and it’s nasty. So I admitted you under a diagnosis of food poisoning, and you should know that my career’s on the line and you are holding it in your hands’—and he squeezed my hand. [He said] ‘I’m gonna have to trust you that you’re gonna act differently than I expect you want to right now.’

In minutes, the years of isolation that surrounded Chris were gently pierced.

As he’s talking, I realize that my actions are going to affect him. He says, ‘I don’t expect you to want to live for a while. I know how you are feeling, but I also know your husband and your little girl. She’s the most beautiful creature I’ve ever met. He lets that sink in a little, and then he says, “You know your husband. Do you really want him to raise her?” The question had never entered my mind! I knew this was the voice of reason.

Patient and gentle, her admitting physician seemed to be the very archetype of the Good Doctor. Skillfully, undemonstratively, he empathized with her dilemma while challenging her to poke through her suffering and grasp a wider perspective.

The doctor was right. I still felt I wanted to die. I knew I still wanted to die, but I was also angry. I realized there was no way in hell that I wanted my husband to raise my daughter. I didn’t want her to feel as powerless and abandoned as I felt. It felt like he was giving me a task I could accomplish even though I felt so bad.

I knew nothing about psychological innards at that point, but two things had happened all of a sudden that were new. First of all, he didn’t put me down for wanting to leave my husband. Most everyone else seemed to think I was a bad person for wanting to leave him. And then, even though I still felt real dead inside, there was this other thing out here, separate from myself, which was a task worth trying to accomplish.

In the profile of every recovery from attempted suicide, there is a moment on which one’s entire fate balances. It is the first step, a hesitant and humble, but palpable beginning. First steps are critically important, because they reflect the birth of a nascent feeling that life can somehow unfold in a new and different way.

I still felt like ‘I don’t want to live’” but at the same time, I thought, ‘if I’m gonna raise my daughter, I’m gonna have to live. That means I’m gonna have to get through these feelings.’ It was so early, though, and I didn’t trust my thoughts, and I didn’t trust myself being alone. So I did the hardest thing of all.

In such a small town, there was only one place where she felt she might get through the day. Chris was nervous how she’d be received, but there was no alternative. Years later, she could still feel how fearful she had been.

There was this hardware store in the center of town where everybody came. It had a potbelly stove and tables, you know, and you could go in and have tea. That’s where I’d hang out a lot of the time, and so did everybody else. Everyone would come in, have lunch together, and talk. I knew everybody in that town and I knew that everyone heard what I had done the night before. But in spite of that, I knew that I had to have people around me if I was going to make it through that day, and so I took my daughter with me. God, I can feel the fear as I talk about it.

I went into the store and I talked to the woman who owned it. I told her I needed to hang out all day. 'Could I do that? Will that be okay?'

She said, ‘Yes.’ And then she said, ‘And if anybody says anything, I’ll kick them out!’

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Chris - The First Steps

"We can do no great things, only small things with great love.”

                                                                            Mother Teresa.

"The doctor was right. I still felt I wanted to die. I knew I still wanted to die, but I was also angry. I realized there was no way in hell that I wanted my husband to raise my daughter. I didn’t want her to feel as powerless and abandoned as I felt. It felt like he was giving me a task I could accomplish even though I felt so bad."

Chris, now a therapist herself, met me in her office. It was summer in Santa Rosa, California, dry and hot. The indoors provided a welcomed relief from the sun. We sat down, registering our initial impressions, and I was immediately intrigued. Chris is a large woman, big-boned and a little heavy. Her arms were muscular, her hands veined and rough-hewn. Her story took place some years before, in a small town in rural southern Oregon. Chris is a woman who has worked the land, canned her own food, found a way to make things work in difficult times. She is not afraid to be physical. She isn’t averse to hard work. She has a ready smile and a hearty laugh.  When she speaks about her life, and her first days in the hospital after her suicide attempt, she is straightforward and candid.  
 
I just felt really hopeless, like just not wanting to live. I had no idea what was happening to me. I was very angry. I was simmering underneath. The doctor came in. He was clearly very tired from being on all night.
 
Chris had been braced for condescension and reproach, and stiffened when the attending physician walked in.  She was surprised what happened next.
 
He sat down and took my hand in his: he just picked up my hand and held it! He seemed very loving. I was dumbfounded! He held my hand and brushed the hair from my face and said, “I’m not even gonna ask you how you feel. I know you feel miserable.

In times of crisis, simple acts of caring are often pushed aside in favor of intricate technical interventions, both medical and psychological. For those who spoke about early moments in the hospital after their attempt, however, it was the simple acts of kindness and the desire to understand that were most treasured. Sometimes they proved powerful enough to ignite the first spark of life, the first steps, after years of courting death. The night before, Chris had to endure the disdain of her new hospital roommates.
 
I was in a room with two other women. I could overhear them: it wasn’t hard; they were talking pretty loud. They were very angry that I was put in “their” room.
 
Chris suffered not only a profound loss of privacy, but also reproach for what she had done. This time, it didn’t come from the hospital staff, but from the patients, as if there was a hierarchy of illnesses, an unspoken caste, with suicide at the bottom. Somehow, her story quickly became public knowledge and she was exposed to derisive and malicious commentary. Hours after the attempt, Chris lay awake in her hospital bed, separated from her fellow patients by only a curtain. Both hyped from the drugs and exhausted by her ordeal, she could see their silhouettes as they spoke.
 
They seemed to know why I was there, and thought I was horrible for wanting to kill myself. I remember them saying, ‘She should be ashamed of herself, when she has everything to live for,’ and ‘Why did the doctor put her in here?’
 
Understandably, the following morning, Chris expected the worst when the attending physician walked in, haggard from a long shift.  What happened next was unexpected and startling.

(End of Part One. Read Part Two, tomorrow.)

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Myths

Don’t Talk About It!

Here is one of the big myths.  I’d say one of the top two. It goes like this:

If you think someone may be suicidal, do not talk to him or her about it!  It will propel them into attempting suicide.

What’s this myth all about?

There is no getting around it. The possibility of suicide is frightening - even to experts; even to experienced psychotherapists.   Someone attempting to take his or her own life is a harrowing thing to contemplate, and because of that, most people feel intimidated by the topic and believe they are ill equipped to offer even simple help to someone who may be stuck and suffering. Because of this, the entire subject has spawned myths that leave everyone unnecessarily hesitant and fearful.  From time to time, I’ll blog about the most prevalent ones, and this is the perfect fallacy with which to begin.

Where do we start? First, is with your expertise.  Truth is, you don’t have to have any.  You don’t need a Ph.D or a Master’s in Social Work to help someone who is suicidal.    You don’t need to do dream analysis or fashion some fancy interpretation that has to do with someone’s childhood. You don’t have to be a therapist to be a friend.

So, what kind of tools are needed?  Simple, your own humanity.  Just yourself, unadorned.  Maybe another way of saying it, is that you need heart and a pair of feet.

The Heart Part:

This has to do with vulnerability…ours!  One of the most popular TED lectures this past year, and recent New York Times Bestselling book, is Brené Brown’s, The Power of Vulnerability. In it, Brené acknowledges that so much of our world is ambiguous and unpredictable, just by its nature, that the most authentic, and useful response, is to allow ourselves to be vulnerable.  She writes:

Vulnerability is the birthplace of innovation, creativity and change. It is the birthplace of love, belonging, joy, courage, empathy; the source of hope, and authenticity. If we want greater clarity in our purpose … vulnerability is the path.
 

What does that mean?

It means, keeping the conversation open, despite the fear. Much of the conditioning one receives in western culture teaches us to keep a tight lid on our emotions and not show much; to gather a cloak of protection around us in the face of what we don’t know or what we can’t control. Helping someone who may be suicidal, or in any kind of emotional pain involves the opposite.  People who are caught in suicide’s horrible sway still share their most salient qualities with everyone else – they are people who have emotions, who, most often, have very good minds that have become caught in a deep trough.  Their thoughts, which tend towards worry, loop over and over, predicting defeat or loneliness.  And, most often, they have great hearts, often very big and empathic hearts, that have constricted in fear.  Sound familiar?  Is there anyone for whom this hasn’t been true at some time or another?  True, their loop is tighter and the gravitational pull towards the negative can be much, much greater. But it’s all still very much human.

So, what can I do?  It’s simpler than one thinks.  You don’t have to take on the whole of someone’s problems.  And, you don’t have to fix anything.  You just have to help them, get help.  If you sense that someone you know or love may be suicidal, tell them. Let them know your sense of them, your guess that maybe they have been thinking of suicide and you are concerned and want to help.  That’s pretty much it for the ‘heart part’.

Again, our fear is that someone will run away screaming, tearing their hair and clothes.  Usually, there is quiet acknowledgement, maybe even relief, some conversation…and then the next part…the feet.

The most skillful thing we can do is tell people we will help them find help…usually in the form of:

•         a suicide hotline (800-273-8255, National Suicide Hotline)
•         the name & number of a therapist,
•         and a simple plan to be safe until then.

It may go something like this:  I know you’ve been thinking about this, and I’m concerned for you.  Can I help connect you with someone?  I’ll stay with you as you make the call.  I’ll drive you to your new therapist.  I'd like to check in with you on the hour for awhile, until you feel safe. Who else can we include in this to make sure you are safe for now?

Is it foolproof?  No, nothing is, even for therapists.  Does is have the capacity to break through layers of protection and cloaking (see, my last blog, The Mask)? Yes. Surprisingly and powerfully so.  All that’s needed is for friends and loved ones to lean in a bit, push past the fear that arises in everyone about suicide, and try to connect with the person in pain. You don’t even have to be good at it.  The heart part - the authentic intention to connect and engage - will outweigh any skill that you do or don’t have.

In the coming weeks, I’ll be blogging about people who began their turnaround, their road back to life with the simple, humble overture from others. It’s extraordinary sometimes, how little, has accomplished so much.

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The Mask

There will be time, there will be time, to prepare a face to meet the faces that you meet. -    T.S. Eliot

“Nobody could tell that anything was going on. The [suicide] notes gave me something to focus on [at my desk] so that I could do my job without thinking about it and be really occupied with it. I was able to do [my job] by rote, going through my role but not being there…” - Deborah

With the news of the probable suicide of L’Wren Scott, noted fashion designer and partner to The Rolling Stone’s, Mick Jagger, we read messages from around the world attesting both to understandable sadness and shock.  Quite often, we hear smart, caring, well-intentioned people say, “I had no idea, he seemed so happy”, or “Her life seemed so together…”

 
How does this happen?
 
As someone withdraws into the idea of suicide, what I’ve termed the suicidal trance, he or she becomes increasingly trapped within a closed system of corrosive thoughts and emotions.  It prevents others from seeing their anguish and one misses the opportunity to receive much needed understanding and compassion. Ones inner turmoil, and in large measure his or her humanity, becomes concealed. As the withdrawal continues, a pernicious belief encamps within them – that no one will understand the dilemma they are in or even if they did, would not be able to help.
 
As a result, people create a façade, designed to mask their pain, and that mask is often nearly impenetrable. So much so, that when others don’t recognize the façade, isn’t an indication of their lack of attention or love, but a testament to how powerfully someone who is suicidal can withdraw into a tight spiral of emotional pain and hide it.
 
What happens inside this closed system?  People who descend into suicide become their own judges and juries. They privately decide that their concerns are either:
 

•     pathological
•     impossible to grasp
•     impossible to remedy, or
•     not worthy of another’s attention.

 
They pull further away from genuine interpersonal exchange and, over time, lose a sense of who or what could be helpful. It is as if someone has become lost in the forest and finds a cave for shelter. The territory is foreign and the sounds, alien. Every rustle of leaves or crack of a twig is interpreted as a sign that something alive and dangerous is drawing nearer, and one pulls back into the cave, withdrawing deeper and deeper. The further he or she retreats from the cave’s mouth, the less the possibility of distinguishing fact from fear, help from danger.
 
 Some forms the façade can take:
 

“…everybody thought I was happy and normal and well-adjusted and I got straight A’s. I was a good person, you know? I was just trying to pass for normal."  - Mattie

 
As inner turmoil remains unaddressed, the chasm widens between one’s silent suffering and the image one projects.  Emotional pain – most often fear– continues unabated and the perceived need for the façade increases. Unfortunately and frighteningly, people can mask themselves so skillfully, it fools friends and loved ones alike.  Some forms of the façade may include:
 

•      extroverted – happy and smiling; life of the party and friend to all.
•      robotic – cloaked in plain sight, methodically going through one’s day
•      hostile – combative, defiant but underneath, terrified.

 
 
Here are some examples…

Extroverted:

In the roughest times, Mattie could always call on her wit, her joie de vivre, and her considerable intelligence. People naturally gravitated to her, as she was attractive, genuinely caring, and unpretentious. Her most frequent complaint was that she didn’t have enough time for all her friends. No one knew the self-loathing she carried, or that she was bulimic and often contemplated suicide.

“There was something inside me that [felt] just horrible or bad or needy or painful, and  it didn’t match the outside, because I’d always been so extroverted.”
 

Methodical and Robotic:

"Nobody seemed to notice, except one. When I came back from lunch, one woman asked me if I’d been crying. I went to the bathroom and washed my face and I did not talk to anyone again the rest of the day. No one bothered me!"
 

Deborah is a medical secretary who lives in Colorado Springs. She spent the day of her suicide attempt calmly and unobtrusively sitting at her desk in the office, writing suicide notes. The mask she wore was virtually impenetrable.
 

Defiant & Hostile:

"James Dean was one of my biggest heroes—Rebel Without a Cause, The Outsiders, Indiana Jones, Fonzie. I grew up on Rambo films and Playboy. Tough guys were my idols.  Smokin’ cigarettes, stealing shit, comin’ in the next morning all hung over. Living on the streets, sleeping in newspaper bins—these were my battle scars.
I started realizing how much pain there is in the world, how much loneliness, and although I don’t want to kill myself anymore, it still frustrates me how many kids feel like shit. – Jason, 19
 

Withdrawn:

"I acted out for years—didn’t communicate with my parents, hung around the university bars uptown, and sexually acted out a lot too. I was pretty promiscuous and I drank a lot. I didn’t talk to anyone. No one. I got into the blues and listened to Billie Holiday records." - Cynthia
 

Next Blog:  What Can Someone Do?

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