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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Courage

“The original definition of courage when it first came into the English language, from the Latin word ‘cor’, meaning ‘heart’, was to tell the story of who you are with your whole heart.”  – Brené Brown, TED Lecture, 2010

Some years ago I did what looked like a crazy thing.  Over a three year period, as I traveled the United States for my work as a trainer of therapists, I put out the word that I wanted to interview people who had attempted suicide, and specifically, people who, through their own hard work, and the assiduous care of others, reclaimed the qualities of balance, perspective, connectedness and happiness in their lives.  People who came back to life, literally from death’s door.

Partly, it came from my training as a researcher.  I was taught that if you wanted to understand a deep part of human experience, in this case psychological and emotional healing, it was essential to listen to and chronicle the stories of those who had truly been there; who had powerfully experienced it's entire arc. This is called participatory research and it’s less about statistics and more about “stepping into someone else’s shoes” in order to derive a true sense of what it’s like.

And, partly, it came from a quirky optimism I seem to have, that arose both in working with others, but also in my own life; a recognition that when we are pushed to the edge, up against the wall…really challenged by significant life issues, that that wall represents the edge of the box we are trapped in; the box we rummage around in that generates a lot of suffering for ourselves, and most often, for our loved ones.  So, bad news-good news.  The bad news is that we suffer, often caught in this box of limited perspective and constricted narratives.  The good news, is that when we are up against the edge, the inside wall, we are only a hairs-breath away from jumping out of the box altogether!

So, I traveled the country, sitting with people, in their homes or in nature, often for three, four, or five hours at a time, listening to and recording their stories, sometimes harrowing and unflinching in detail. But listening particularly to the parts of the story that detailed how people began to embrace life again, and humbly, little by little, came to believe again – in possibility, in others, and, blessedly, in themselves.   I discovered that these deeply personal stories, were also universal stories.  I learned that in listening without prejudice or fear, these stories shed much light on precisely how all of us can bring ourselves back to life…not only from the brink of life and death; not just in a suicidal context, but with regard to the dizzying array of other challenges all of us face in our lives.  Those I interviewed told their stories, with a full and open heart, both to help others, and so that one day, others wouldn’t have a story like that of their own to tell.  I was blown away by their courage. Still am.

A final note:  In writing Waking Up, Alive, it was not my intention to create another trend or another series of identities through which people can define themselves. In fact, it is my fervent hope that as we move further into the 21st Century, people will define themselves in terms of their strengths and their potential rather than their wounds. I have undertaken this work in order to break the silence to which so many—be they survivors of suicide attempts or the enormous number of people who secretly contemplate the act—have sentenced themselves, and to open communication between those who have attempted and those who haven’t. Ultimately, this book was written for everyone, for each person bears his or her share of pain, and everyone has felt stuck at one point or another in his or her life. I chose to write  Waking Up, Alive so that we may remember that there always exists a “yes” after what seems to be the final “no.”

I hope that in some small measure these words may alleviate suffering in the mysterious world in which we live.

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Ed - The Heart of the Attempt

“What I really wanted was a part of me to die. [All of] life didn’t stink, but that situation did, and it was a huge bruise that I had to heal and couldn’t. I didn't want to throw away the whole thing, but I did not know how to heal the bruise at the time. The only way I knew was to throw away the whole apple.”

Ed’s is a cautionary tale about our cultural heroes and who we need them to be. No one is uni-dimensional, but attempting to be so, can be life threatening. And, in itself, being gay is not a cause of suicide, but because of ignorance and societal pressures, the façade that one must create to hide in plain site, can be. Ed's is also a story of tremendous heart and courage as he returns to life, becomes a public figure and inspires others, but before that, we can see how lost he became in what I call the 'suicidal trance', and how deeply he plummeted.

"When John Lennon was murdered in 1980, it sounds strange, but that inspired me to…[realize] that maybe I have a talent. I thought, ‘If I can do one one-thousandth of what Lennon did, maybe I can accomplish something in this world.’ To my thinking, then, it seemed all the great ones—Lennon, Martin Luther King, Kennedy—they go out with a boom. Something about that turned me on. Something about how they went out and how they were loved afterwards. Maybe one day I’ll spring a hit on everyone and they’ll look back and realize that Gallagher just didn’t play football and physical things—that he had some kind of brain."

Secretly, Ed began to romance death…as a means for his truer self to be seen. As the disparity between his inner and more public selves grew, Ed became both more clandestine and impulsive. Early one morning, about three A.M., he stole into New York City to hire a prostitute. He was afraid of what he felt inside. He desperately wanted to affirm that he wasn’t gay.

"I was glad afterward. I was thinking, 'Wow, I can really do this. Maybe I’m not gay. Maybe my friends won’t suspect I am.' I was still playing the jockish part of my nature in public. [Privately], I said to myself, “Let me write these songs in secret.”

Ed began to study songwriting formally and it bore unexpected side effects. As he received encouragement from his teachers, he stretched beyond the cloak of  'Big Ed'.  Combining visits to music classes with explorations in Manhattan, Ed ventured into Greenwich Village, specifically the West Village, where the gay community lived in high concentration. It was there he had his first encounter with the life he’d so surreptitiously fantasized about for over a decade.

"I was curious, but I acted disinterested. Very guarded, very intrigued. I’d start to hang out more frequently, still not even entering one of the gay bars—just walking past; looking in but acting nonchalant. I did that many times—eat by myself, walk past a bar, going to Washington Square. Finally one evening, I said, “Fuck, man, I’m twenty-seven years old! I can do what I want!” and after having a bite to eat, and getting a little bit tanked—not too much, but I feel good—I go into this bar—I won’t tell you the name of it—and I feel different. I can talk with guys and feel good about it. I can be myself ! I was gonna leave, but this guy asked me to his place. I’m thinking, “He’s really good looking, and I say to him, “I never really did this stuff before.” He said, “It’s okay, I’ll help you—I’ll show you.” He was coming on to me, I know, but he was also nice, not pushy. I’d never even kissed a guy, let alone done anything else. I felt so comfortable to be myself. I had a real nice time. It also helped I was a little tanked!"

That night, Ed embraced his longing for a man, and for a few precious hours he felt whole. Yet at some deeper level, the binary construction of his psyche, the sharp division of self that he’d been living with for so many years, became inflamed. Driving home the next day, Ed was consumed with fear.

"I started thinking, “Now what? You can’t go back to your old lifestyle! How can I look my friends in the eye, my friends who think I’m straight as an arrow? You never told anyone and then just because you walk down Greenwich Village, you get involved with someone!”

The intensity of his self-flagellation increased, and Ed, alone more than ever, grew frightened and more savage with himself.

"Then I started thinking of AIDS, of which I knew next to nothing. “Was I careful? Was I not? What did you do! You stepped into this new world and then you get AIDS! You’re gonna kill anybody you come near.” I remember going to work and not wanting to breathe near anyone.”

One might think that Ed’s first encounter caused his suicide attempt. It didn’t. One must look deeper.  The now longstanding pattern of hiding, secreting himself away with no support, no friend or mentor to offer perspective, created a fault-line so deep, that he couldn’t withstand the internal pressure.

“I never had an experience opening up to anyone and I couldn’t do it now.”

THE HEART OF THE ATTEMPT

What drives someone, in these final moments, to carry out his or her plan rather than interrupt it? What is the nature of the momentum that continues one forward, often despite consider- able obstacles? The answer to these questions lies in at least one of the following desires:

    • To escape a dilemma that feels inescapable

    • To gain control of uncontrollable confusion

    • To send a message when all others means of communication have failed

There’s a dam in upstate New York near the small town where Ed had been a high school all-star and hero. He drove to the top knowing that in its seventy year history, none of the forty people who jumped from it had survived. Ed couldn’t imagine living life as a gay man, nor could he endure one more day of the vicious and corrosive self-hatred which was consuming him. He paused for a half-hour or so, then tumbled.

Someone witnessed the fall…a medical student, taking a walk nearby.  When he reached Ed at the bottom, Ed asked:

“Did I do it?”

“Yes,” the young man replied.

“Am I gonna die?”

“I don’t think so,” he said.

“Shit.”

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