suicide

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Dead kids and Mother’s Day 


To all the surviving mothers who celebrated this recent Mother’s Day without their children, lost to mental illness, we dedicate this post.  To the mom’s who have outlived their babies. To the mothers who have watched their boys and girls deteriorate slowly with piece meal pincing bites that brain illness has taken from them until they were gone. To the mommy’s of those who left them fast, at the end of a rope, under a car, at the point of a needle, or in the many bits of brain that a gun blows apart. 

I’m dedicating this post to the mothers who continue to live. Who remember more than the moment of their child’s death. Who celebrated on Mother’s Day the individual of her child that was more than his or her behaviors and emotions. 

This post is for the mothers who remain for us, we who need them still. We need you. Thank you for telling us your story and living with us, among us. For fighting for brain health, for freedom, we thank you. 

To the mothers who survive(d) the death of their children to mental illness, happy belated Mother’s Day. You are amazing to us. 

Today’s question is more of a request: Tell us your story please. 

Or, those of you who know these courageous women, and want to share, please do. We are listening. 

Self care tip: You tell me. How do you (they) do it?

Keep on. 

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Why do I Keep Living? – Chronically Suicidal.

trainwrecklife

Carl D’Agostino is a retired high school history teacher. His interests include woodcarving and blogging. Cartoon blog at carldagostino.wordpress.com.   Cartoons published in book, “I know I Made You Smile, Volume I.”

Marvin lived hard for years, used up his bank, his talents used up like putting a flame to his wick.  He was wired to live in the moment. Living that way, when he had gifts galore freely given, living was different than when those gifts were used, diminished, and broken. Marvin was smart enough to rationalize his way into a chronic suicidality thereafter.

What is the point of living, after all? Marvin asked this question, answered it, and asked it again, to the point that it separated itself from Time and place. It is a question that is infinite anyhow.

Sometimes Marvin, with this infinite question, this question that occupies the time of God, kings, and beggars, Marvin would sit in my office with this infinite question in his nicotine-stained and inked fingers, and he would in this bring together the infinite with the finite. I remembered that the whole point, the meaning of the infinite and finite, is increased in value by the other. Marvin, living in the moment, even now years after his coin was thus reduced, was living in the infinite.

Why do I have to keep living? I just need someone to tell me it’s going to be ok if I die.

Marvin, If you are looking for a doctor to help you die, you need to go somewhere else. I will always choose life.

(It seemed like that “FYI” was in order.)

“We” made a plan …that Marvin wasn’t entirely in agreement with. I told him he could not come back to my clinic if he wasn’t engaged in that plan.

Marvin, we are just going to do what the data tells us will work. We don’t have to feel it or even believe it. We have the data at least.

Every time I have ever seen Marvin, I took a hard look, memorized him, knowing this may be the last time. Setting boundaries with him was freaky. It felt like trying to hold broken glass. Would Marvin be back? If not, I knew I’d be hurt.

The patient-doctor relationship is unique to each patient. It is unique to each doctor. For me, in my patient-doctor relationships, if it wasn’t for the hard grip I keep on the seat of my chair, I’d have too many of my patients in a big, but likely awkward, (and my Academy tells me, “Inappropriate”) hug.

This flashed through my mind in fair warning again. I compromised, saying instead,

You matter to me, Marvin.

I think Marvin’s lip actually curled and his canines grew. And I quote,

How can you say that? I just don’t get it.

This was a moment of road’s diverging, 31 Flavors, coins in your hand in front of a mother-loaded vending machine. I could see philosophers, all over the now and then of the ages, slobbering like they were at a nudie bar.

Once, when I called 911 on behalf of a patient who needed to go into the hospital for safety, the police person looked like that, bouncey even, on her toes. I had to check her feet to see if she was actually standing on a pedestal, she sermonized my poor patient so thoroughly. I think she was even eating a candy bar as she left my office, satisfied, (without my patient, by the way. Apparently she thought her tonic words had medicinal powers.)

Marvin was fishing me. There were so many ways to lose with that question. He was hoping I’d flop around with straining gills sucking air for hours while he tugged on the hook.

I’ve done that often enough, and will do it many more times. We can count on mistakes. What took me by surprise was, this time I did not.

Well, I’d guess it has something to do with me and something to do with you.

Yup. It surprised me. The surprise brought a wave of gratitude. “Thank you God.”

And if you aren’t as surprised or grateful by that liner, I can only explain that it was right at the time. Marvin lost his handlebar lip curl. I lost my grip on the chair. Marvin’s still alive, (I know everyone’s worried about the “for now” part of that.) And our universe cares, finitely and infinitely.

To the Marvin’s of the world, the wasted, the used, and the squandered, work your programs.

To the lonely and distorted, to the ones who have tried to die, to you who don’t know why you keep living, follow what the data offers by way of direction.

To you who may not get the same freely given gifts in this life that are now gone, you have good things coming.

We choose to live with you, than without. We choose you again. We choose, every time, what Love will bring. Keep on.

Questions: Have you ever asked yourself and/or others, “Why do I keep living?” What has your answer been? What is your answer now? For yourself. What would you tell your own Me?

Self-care tip: …I think I waxed on and off enough already with that – smile.

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Nurse tells her experience – Suicide

Guest Post

by, Leslie Oneil, RN

Nurse extraordinaire! Person to know. More.

Nurse extraordinaire! Person to know. More.

In The Ring

I sat at a table in a large meeting room watching Dr. as she stood in front of the room. She stood in front of us with poise…armored with stories, analogies, statistics, and invisible red boxing gloves to match her red dress. She was ready to defend mental illness, and fight for its proper place in medicine and in the spot light where it belongs…right next to the heavy hitters: cancer, heart disease, diabetes.

Dr. delivered the statistics….”1 in 5 people suffer from depression.” She counts the room, “1, 2, 3, 4, depressed. 1, 2, 3, 4, depression.” She continued, “Put all of the depressed people in a room, and look around. 1 in 15 of those suffering from depression will go on to commit suicide.” It’s dramatic. The room was silent. It usually is. I am not comfortable with the topic anymore than I was the first time, but I am getting used to hearing the same phrases, the same statistics, and responding to the same questions from the audience. I am now familiar with the language of mental illness.

Last Friday, as I stood in the middle of the PACU, our eyes met. It felt intense. it was an emergency, and an emergency in behavioral health means…

Then I heard Michael Buffer, the master of ceremonies, in my head. He introduced the statistic to the ring. Dramatic music played, and before I had the chance to raise my gloves, the statistic nailed me…First with a left hook, then went below the belt. I was knocked out. Speechless with my face in my hands. Gloves were off.

 

Your patient committed suicide.

 

No amount of training prepares you. No power point presentation. No book. No doctor.

TKO.

I never even imagined how I would handle the news. I was weak in the knees and shook.

The patient was starting electroconvulsive therapy in 3 days. The patient had just called me. The patient denied any suicidal thoughts. The patient…….It doesn’t stop.

The gravity of what I do hit me. It hit me hard.

As I drove home I thought, “Have I entered a losing battle? I’ve wanted to be a nurse to comfort people, advocate for them, care for them, and try to help improve their quality of life if possible.” If possible are the key words.

Am I okay with, “We did everything we could. Stop. Time of death….”

 

My question to you: “Do you find gratification with the result or with the process?”

You think you know the answer…until you’re in the ring.

 

Leslie Oneil, RN, is a ECT specialist nurse.  She writes at a blog worth following, A Very LOshow.

 

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Cut Here

Walking the crowded streets of Los Angeles today, I was smiling. My heart was open up, grateful for life and the privileges of sharing great company. And then, without armor, vulnerable because that is what happiness does to us, I saw what I think sodom and gamora might have been burned for,

20130820-102724.jpg

Glamorizing suicide or whatever this was glamorizing, I felt it against my soft underbelly, sheez! Snap click and up went my professional safety measures.
Back at my room, I googled “him” and got little more than his name is Trevor and,

“the famous tattoo of “CUT HERE” with the dotted line going across his neck.”

Famous.
I have never been that cool. I have never heard of Trevor or his “cut here” tattoo. You?

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From a Fellow Commentor – Her Friend Suicided

Anxiety Always

Anxiety Always (Photo credit: Wikipedia)

i woke up this morning to find out that my friend shot herself last night. she texted me, said she hoped i had a good night and said goodbye. she then walked outside and shot herself in the head.  
there are so many emotions i can’t even sort them out.  i don’t know what to feel, i can’t even cry.  why haven’t I cried?  I didn’t hear her stupid text, I didn’t know… I knew she had her demons we all do, but they convinced her to end it.  it’s so finial, so F-ing stupid!!!!!
is this how it ends for us that are so f**ked up in the head?  she wasn’t on meds, would that have even helped?  I don’t know what to think sana. last month i got a phone call from my friend who lives in Fallbrook and she had been dealing with anxiety couldn’t take it anymore, said she didn’t want to feel the anxiety anymore and tried to kill herself.  she was admitted and stayed for 4 weeks.  she’s on so many meds that she’s speaks in a monotone voice.  it’s has really scared me.  
is this how it’s going to be for all of us that deal with fear, anxiety and panic? I need to go for a walk, i feel numb. i feel so pissed off and feel bad that I’m mad. 
i’m scared
didn’t know who else to share this with that would understand
Questions:  Do you?  What do you understand?  Is this how it’s going to be for all of us?  Please tell us your story.  We need to hear.
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If You Want To Die, Tell Others.

McCulloch Electric Chainsaw. Photo by Eric Bea...

Image via Wikipedia

Have you been having any thoughts about wanting to die?

You folks know about these questions I must ask. Some people are offended by them. Many people are grateful. Trisha was guarded.

Yes.

I asked,

Did you have a plan in mind on how you would kill yourself?

There was a black pause and then,

I’m not sure I want to tell you that.

I could understand your reluctance Trisha but telling me is a good thing. It helps the ideas lose some of their power. It’s no longer as much of an option when you tell someone than it would be if you kept it a secret, I said.

Ok.

Another black pause and then,

I wanted to use a chain saw.

When it comes to ways of suicide, this one sounded pretty painful.

Ouch! I said to Trisha.

Her response, well, I didn’t expect it.

I hadn’t thought about that! The pain from that would have been nothing compared to the pain I was going through!

Trisha’s words schooled me. I don’t care how many times we talk about the darkness, the hopeless horror and the suffering of some brain illnesses, somehow, I know that I really don’t want to have full knowledge. When having your neck sawed off by your own hands with a chain saw seems like it would feel better than the full body despair, not many others will understand. Trisha wasn’t processing well, true. But the point isn’t her poverty of suicide options. What is the point here. Well, there is one major point to take home and there is a minor. Starting with the minor point – We can’t presume much about others. Moving on…. Major point – Tell people when having thoughts about wanting to die and what those thoughts are. Why? Because it’s friendly to Me. Telling someone isn’t as much about what they’ll do for Me, although once in a while someone may do something right on our behalf. Rather, telling someone is about what the telling process and knowledge of the telling does for Me. It lets us know that we are not alone. We lose some of the magical quality to the suicide plan. It dilutes our conviction to self-harm as a solution.

Question: What else do you think telling someone about thoughts of suicide does for Me? Please tell us your story.

Self-Care Tip: If you have thoughts of wanting to die, tell others.

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What does it say about who God is?

Hello. Your missing psychiatrist at hand. Missing you. Thank you for your presence despite the quiet.

Today I heard from a woman that anyone who has God in them could never kill themselves. Aside from all the obvious reasons that was so ignorant, she didn’t know what she was saying about who she believed God to be.
I wondered if you would tell me your opinion of what it says about who God is when we suicide?
If that’s not an important part of being a friend to Me, …
Be a friend to yourself.

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Want Life despite the freakishly terrible. It’s really That Good.

Hope

Hope (Photo credit: bitzcelt)

So many of us don’t get much to speak of as a chance at life until we are older.  Raped with penetration by age five and following, traded for favors, fear and more fear, isolated, escaping from one to other places of objectification.  We don’t like closets.  We avoid reminders but since there is no place we don’t remember our traumas, we are, we know, not hidden well enough.

And then one day, Hope gets through the diseased surface of our primitive defense and delivers her message.  The message comes again, as Hope is unchangingly drawn to us.  Hope has been here before, but this time for what ever reason, it might be our age, finally seventeen or twenty-eight or fifty-four, it might be a nosey teacher or a fatal car crash involving one of our victimizers or our home is moved, but this time that Hope comes, we have the fortune of being pierced through.

When there are holes, Light can enter.  When Light enters, Light takes chase to darkness and then, served on a moment-gilded-platter, we have it.

This may not be your story, but is for enough.  Even one, right?  Even one matters.  Things really are that sick in more “homes,” represented by the normally garbed, disguised at school, work, church, stores and behind their computer screens.  We are all invariably fooled.  All of us respond to these disguises with what is available from our biopsychosocial-selves.  We respond by naming them consciously and unconsciously with a name that serves the needs of our biopsychosocial-self.  We could say that the disguises are designed both by them and us.  It is what it is.  We are all fools, this way by different degrees.

But back to those pierced by Hope.  Being a friend to yourself may not occur to us for what seems forever along the line that Time determinably follows in our dimension.  Being a friend to Me finds us now where light enters.  Hope and Light can have their way on our damaged selves.

Hope ports to all new beginnings.  The judgment of what makes living, through such distances, worth it is not for anyone but the individual and God.  However our opinion, served from our biopsychosocial selves is that life is worth living even in the distance before Hope pierces us through.   See Post, Your Pain is Not Special. It Is Normal., to read more on this.

We who have gotten friendly with Me, want Life despite the freakishly terrible.  Either we are masochistic to continue through such horrors, to continue living, or it is true.  What comes with hope, with being a Friend to Yourself, with Love, when experienced cannot be qualified or quantified other than to say, that Love wins.

Questions:  Do you believe Love wins?  If not, why?  What do you say about being a friend to yourself to those who are in the midst of being victimized?  Please tell us your story.

Self-Care Tip:  Want Life despite the freakishly terrible.  It’s true.  It’s that worth it.  Be a friend to yourself.

Related articles
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Why Am I Worth Keeping Alive? A Tool To Fight Suicide.

Vulcan (Star Trek)

Lately I’ve enjoyed a variety of novels cast in some future in which the government uses statistics and the higher good of the masses to govern.  Each book maintains that catastrophes brought these supportive measures on, resources are few and self-accountability is through the roof.  We get to experience with the protagonist her blooming sense of self and human rights which fuel and protect her as she leads and achieves needed changes.

Some of the novels are better than others but I am finding they all have in common an expectation for their characters and readers.

We must know why we are worth preserving.

Why am I deserving of sharing space, air, water, life-sustaining resources and free-choice?  Why not keep those for my betters; for people with fewer diseases, more to offer and less to take.  Ouch.

In Star Trek II: The Wrath of Khan, Spock famously poisons himself while saving his ship and friends.

Spock: Don’t grieve, Admiral. It is logical. The needs of the many outweigh…
Kirk: …the needs of the few…
Spock: …Or the one.

We can’t help but ask ourselves, “Why am I worth keeping alive?”

Isn’t that question an interesting irony for those of us who suffer with morbid thoughts?  Those of us, who struggle with diseases that cause us to want death, might use this as a tool to hijack that suicidal thought into fighting to live because…

Even if we are not in that group of people who have or do or will fantasize about the “what ifs,” I can still think of a few good reasons to spend some time in the space of what is worth preserving about us.

Spock: I have been and always shall be your friend.

Question:  Why are you worth keeping alive?  Please tell us your story.

Self-Care Tip – Do not go gently into death.

Dylan Thomas wrote:

Do not go gentle into that good night,
Old age should burn and rage at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right, 
Because their words had forked no lightning they 
Do not go gentle into that good night.

Good men, the last wave by, crying how bright 
Their frail deeds might have danced in a green bay, 
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight, 
And learn, too late, they grieved it on its way, 
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight 
Blind eyes could blaze like meteors and be gay, 
Rage, rage against the dying of the light.

And you, my father, there on the sad height,
Curse, bless me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.

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Resist The Lure of Suicide

Dangerous Risk Adrenaline Suicide by Fear of F...

Image by epSos.de via Flickr

Sometimes I wonder, how come other people get to get away without having to deal with this?  Why can’t I get a break?

Heidi wasn’t talking about fair or foul fortune in life.  She was talking about suicide.  Heidi found the suicide idea alluring and promising.  She found life unfair and death a form of equalization.  She reminded me that suicide contagion is a real effect.  I didn’t know this before.  I don’t know when it became an understanding for me, but it was after medical school and definitely after residency.

So much of what I know, came to me outside of those places of learning.  So much of what I know, came from my patients and a settling effect into my specialty of practice.  I have learned, in one way of consideration, too much about suicide.  In that way, I wish I didn’t.

There are good things too, of course.  Suicide is no more moral or amoral than another act in life, it is simply (if one could use such a word with this) and most objectively the last.  I remember commenter Mike J said on December 17, 2011,

Whenever I feel suicidal I remember that I’m going to be dead a long time. As bad as the pain is, I understand but, why rush to get there?  

Life is like pizza or sex, even when it’s bad it’s kinda good.

I know.  Who wants eat bad pizza?!  Sigh.  Each to his own 😉 but you get the meaning – clever man.

Mike J has used this to inoculate himself perhaps to build suicide resistance.  He and you might be interested to know that the CDC takes the risk of “catching” suicide so seriously that they have made formal recommendations for our protection.  In reading them, we find friendly ways to protect ourselves not only from suicide, but also from the contagion of other extreme thoughts that actions such as suicide cluster in; such as self-injury, catastrophizing, all-or-none thinking, and self-flagellation.

Suicide is contagious as a learned behavior, which is part of why it is so confusing for Western Cultures to conceptualize it in any way apart from morality.  Another reason we have a hard time not moralizing suicide is that we still struggle with where emotions and behaviors come from.  (But moralizing emotions and behaviors is for another discussion.)

When I heard Heidi say those words,

Sometimes I wonder…

despite the patients I have known who’ve died by suicide, despite the knowledge gained in clinical practice and despite the diagnosis I had already reported to her insurance carrier – I had an autonomic response.  My skin erupted in goose pimples, breathing sped up and I realized I was afraid.  Despite being a psychiatrist whom our community imagines thinks of who is going to commit suicide next all the time, I am not.  I am not that jaded.  I am affected and I am still taken off guard.  “Heidi,” I thought.  “No.”

Heidi had the “benefit” of media exposure to suicides, media who was promoting suicide contagion through learned behaviors but also as activating her already infirm brain to increase in degree of illness, producing more suicide-thought symptoms.  When I weighed Heidi’s risk of hurting herself knowing her medical condition, I had thought, “Ok.  She’ll make it. We’ll do this and she’ll heal.”  But when the knowledge of news-worthy suicides spread in her, I knew her medical risks might be catalyzed and I knew enough to be afraid.  “No Heidi.”  What to do?

The CDC tells us to turn the copycat-suicide risk upside down by using the  media, which the gypsy in me really likes.  Instead of being silent and afraid, we can describe the help and support available, explain how to find persons at high risk for suicide, and tell about risk factors for suicide.

Today is Christmas and you may be wondering why I am speaking about suicide today.  It is because I’m hoping that by going toward our fears and our places of pain, that they will lose power over us.  I am hoping that on Christmas, which is for some a positive time, that we have a knowledge that Christmas is for others much less.

Furthermore, I am hoping that we know that we and Heidi are up against our illnesses as well as media-poisons.  And most importantly, I hope that we also know that we have power.  We don’t have to be a victim and we are free to choose.  At every level, we are free.  In every paradigm, we are free.  We are free until we do not – AKA, die.

I’ll take it.  I hope Heidi and you do too.

I hope you will speak into the wind if it be windy.  I hope you will look into the flash if you must and I hope you will fight against your own destruction as long as you can choose.   I hope you know that you are free.

Questions:  How do you oppose the lure of suicide, even when you have to oppose it repetitively and against multiple forces?  Please tell us your story.

Self-Care Tip:  When others inappropriately describe suicide and when your thoughts tell you to die, be your own friend by speaking about suicide, even to yourself, with this knowledge.

Related articles
If You Want To Die, Tell Others.2011/10/17
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Find Hope When You Otherwise Must Die – Depression

Jane Eyre

Image by madelinetosh via Flickr

Briggs was crying again.  His wife, who came with him to our first appointment, looked like a peeled fruit beside him.  She was undefended, giving her last layer of self without knowing what would be left.  Briggs was one case of serious depression, but his wife; she was heartbreaking.  Both of them in their own ways would not last long.

It is not unusual in a specialty clinic to work with people such as Briggs who have been around the treatment shops.  Then, finally, in Jane Eyre-style, they appear at my door in the company of death.  They have been through therapies, practitioners and churches, but disease resists treatment.  Everywhere they walk, it is as if Hades (or Neptune) were visiting.  Hope-blossoms wilt as they pass by and those of us who share space, feel like the ground is going to open up and suck us under.  It is not uncommon in specialty-care, to be told, “…I have no strength to go further.”  Like Jane Eyre, they plead, “I must die if….”  (By the way, Charlotte Bronte is the bomb.)

As the person on the other side of this exchange, I have worn down the rainbow of “specialty” options available to offer.  And what are they?

I’m going to write more about those options next, but my questions for you today are:

What has worked for you or your loved one?  Is there any treatment you think is too extreme to consider to get brain health?  Please tell me your story.

Self-Care Tip:  Find your specialty care.

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Your Pain is Not Special. It Is Normal.

Self-Care Tip #243 – See yourself as special rather than your pain and know that you will find your normal again.

What is your normal?

When we were kids, we all had a perspective of what normal was.  Let’s say it was “here.”  Let’s imagine we were lovely then, nurtured and emotionally bonded.  We struggled through peer conflicts, social anxiety and rivalry.  We wanted a bike.

Two Sisters

Image via Wikipedia

Then we got a little older.  Maybe our parents divorced.  Maybe, a sibling died.  Maybe we were abused or in an accident and damaged.  Damage changes normal.  What we never would have thought would be acceptable in our lives became acceptable.  We suffered.  We lived.  Life was indiscriminate and ignored our status.  We think there must be a mistake.

What is our normal at one point, filtered through remaining hopes, grew into regenerating fantasies, through real potential and it moved again.  We are older now and more suffering comes.

Where is our normal?  We survive our child, our own dear perfect boy, hanging from a tree.  Normal?  No dear God!  No!  And we continue to live.

Two years.  Two years are what it takes for our biology to catch up to the shock.  Two years are what it takes for us to begin to accept and realize that in this new normal we care again.  We choose it in fact.

People don’t remember his name or talk about him and we can’t remember his eyes.  We are ashamed and lose our breath from panic just trying to see them.  We want to bang our head because we know there is something wrong about feeling normal! Ever! Again! after that.  But we do.

Our normal mutates over financial ruin, abandonment and a growing healthy list of disfiguring illnesses.  We accept them and say yes please.  Live.  We want to live.  This is acceptable.  This is normal.  Our friends die.  Our memory.  We can’t find our teeth.  Our heart stops.  We die and the world finds normal.  The world chooses just like we did.

What we don’t think will ever be allowed to happen while we brush hair, clip our nails and microwave food, happens. We endure these changes.  We find normal again.

What is your normal?

My brother, Vance Johnson MD, is a physical medicine and rehabilitation specialist.  He said that during his residency, close to 100% of spinal cord injury paralysis survivors he worked with wanted to die after their injury.  Many of them would beg him to let them die.  They would cuss at him for keeping them alive.

I leaned very heavily on the studies and data during those times.  It was very hard.

Vance said that what kept him faithful to his task was knowing that close to 100% of them after two years would be glad they were kept alive.

Even the ones who were basically breathing through a straw and that’s all that moved on them; even they wanted to live.  These people found a new normal.

Where is our normal?  We will want it.  We will adapt.  Biology will catch up to our reality.

Remember that your pain is not special.  You are special.  Not your pain.  Pain is normal.

Question:  When this happened to you, how did normal find you despite the rubble?  How does this concept feel to you, that your pain is not special?  Does it make you angry or what?  Please tell me your story.

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Starting With Your Own Answers to The Big Questions Leads to Reducing Stigma In Others

Alexander Ostuzhev as Quasimodo, 1925.

Image via Wikipedia

Question:  How do you see the paradigm of spirituality intersecting with the paradigm of biology?

As a psychiatrist who blogs that behaviors come from the brain and not a theater script we voluntarily revise to perform, this is a good question.  As readers, and perhaps subscribers to this same belief, this is a good question.

In church, Bible study, or circle of any kind, there are fewer things that goad me more than listening to descriptions of the moral value in emotions and behaviors.  I have found myself visiting the lady’s room more often, carousing the fellowship hall-kitchen and fridge, or thrusting myself on a poor unsuspecting soul loitering by the door with my fervent uncomplimentary words.  I do this before I stand up and pull rank on the speaker.

(I know.  The words “pull rank” sound just as arrogant, and probably are, but they were said in the heat of the moment.  Please understand that the emotion behind them and including the words came from my brain.)

It wasn’t so long ago that suicides were thought to be the ultimate separation from God.  Oh wait.  That’s still happening isn’t it?  It wasn’t so long ago that anger and sadness were thought to be from separation from God.  Oh wait, they still are.  Ok.  I’ll stop.  This is childish.

The hunched figure of Notre Dame comes to me now, ringing his bell, gazing at Esmerelda – pure heaven in flesh.  He offers up his humble life force, begging to be near her despite his biology.  He is ugly.  He is different.  He is separated by his own beliefs that he is forgotten by God.  His answer to our question is his own isolation.

This pithy topic has no boundaries across the world but yet I reduce it down to Me, one apparently arrogant psychiatrist, kicking up dirt where I stand.  I realize that the best way to protect us from stigma, to help you (again arrogant me swaggers in), is to start with my answer to this marvelous question.  I have to answer it for myself.  I have to start with self-care, spiritual care, relationship care, physical care – I have to start right here with Me.

These kinds of imposed opinions have never been reduced quickly.  We can’t take care of everyone before we take care of ourselves.  We must be patient.  We have the privilege to answer thoughtfully.  It is our freedom.  It is our right.

Self-Care Tip #193 – Answer the big questions in life for yourself, deliberately, and see that a secondary benefit is that it will protect you from the prejudice of others as well as reduce their prejudice.

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When You Are Pushed Down, Push Back

A Push and a Shove

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Self-Care Tip #185 – When you are pushed down, deliberately push back with The Force in  you.  Be a friend to yourself.

So much in life pushes down on us.  I am amazed that we push back – considering how awful some of it is.  After 7 years of private practice in psychiatry, I still get caught off guard by some of the particularly horrible stories I am told.  Blinking my own stinging eyes, I look in amazement at the person in front of me.  What I see is this pushing-back Force.

Last week after diagnosing PTSD in Margie, a mother of a murdered son, I could hardly believe that she still chooses life.  She takes care of herself despite.  That’s how amazing she is.  And I’m her psychiatrist!  It’s such an honor.  And thinking about that straining towards life, that thread in us, all of us – I saw that it was the best description of the brilliance and power that is God.  True, sickness can mute our perception of this beautiful thing in us, whether it’s depression or liver disease.  But all of us have seen some of how hard the thrashing against that loss is.

In thinking on this amazing force, this thrashing about, this straining against the push of whatever is set at tipping us over, I named it God in us.  And I thought, for all the time I spend on the stuff pushing me around in bad ways, I’m going to more actively team up with the struggle to live.  I’m going to choose to strain and thrash about and move at that chink of space in the dark room as much as I can.  Hopefully I can be brave too, like that mother of a murdered son, Margie.

I can choose to ally myself, with what I want to live for.  I’m going to partner with that Force that keeps me thrashing against the push and be stronger, like you have readers.

After our post on suicide a couple days ago, many of you responded with your own stories about how you were pushed and pushed back.  Karal said,

Like all difficult experiences we face in life, there is the possibility of growth from the ashes.  It requires strength and a willingness to walk through that fire.  Unfortunately for survivors of suicide (i’m referring to those left behind) we’re often chastised into feeling that our grieving, our walking through the fire is both wrong, and  unnecessary.  I totally disagree.  Like you said, caring for people is a choice, and being a friend to yourself means making sense of, or at least peace with, what may never make sense.

Karal is allying herself with that Force to make as much sense of what will always be jumbled.  I’m not going to quote all the rest of the brilliant comments.  Please read them.  They were amazing demonstrations of pushing back in a collaborative way with The Force that makes their lives worth living.  This is active in us at times, and not deliberate at others.  Being better to ourselves, we could more deliberately choose when given the push.  We are not thrashing alone.  Push back.

Question:  How do you deliberately choose your alliances in your life for working against what pushed you down?  How do you define that Force in you that pushes back?  Please tell me your story.

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It Is My Choice to Take Care of Someone, Even in The Context of Suicide

Detail of The Death of Socrates. A disciple is...

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I was a teenager I think when a woman in our church suicided.  Dad pointed out the man sitting alone.

His wife just killed herself.

Dad asked me what I thought of suicide.  Imagine.  What a compliment really for a teen, to be asked her thoughts.  Being a “Feeler,” I oozed something empathic I’m sure, but still I only remember what Dad said,

I believe God has a special way of seeing these cases.

This was at a time when culturally most of the western world saw suicide as sin.  It was quite forward for Dad to say what he did again later to the grieving man in the pew.  I did not realize at the time, but now I see that people judged him and his wife for what she did.

Later in psychiatry training, my attending said,

Suicide is the most selfish act anyone can do.  It is the ultimate punishment aimed at those who still live.

I don’t know what you think, but I couldn’t help wondering.  I still do.  I think this may be true for some and not others.  I haven’t had a chance to ask them.  They’re dead.

Suicide is terrifying to a psychiatrist.  We all tremble at the thought.  Statistically we know women attempt it more than men, but men are more “successful” when they do try.  They use methods that are generally more lethal than women.  They don’t get a chance to realize that in a month or a day they will want life again.  Or an hour.  They could have lived.

In the intensive-care unit of a hospital, “unsuccessful” suicide attempts hover in life in a space where their self-injury placed them.  The nurses are kept running between medicines, treatments, physician orders and prayers for these lives that tried to die.  Sometimes, the “chronically suicidal” become familiar patients to this critical care ward and that has it’s effect on those who have spent themselves so heroically to save them.

A nurse once told me angrily about her patient who kept coming back.

I fought for that woman’s life!  I prayed over her!  I worked all night for several nights and didn’t know if she would live until much later.  And then she was transferred out to the step-down ward (to a floor where the patients aren’t in such a life-threatening condition), and that lady probably never knew what I went through to keep her alive.

Then later, she came back, and later again, almost dead but not dead.  She kept trying to kill herself!  Finally, when she was conscious again, I just told her how it is.  ‘Listen!  I fought hard for you!  You better go out there and live!  You better figure out what it is you want and go for it.  Stop trying to die!’

This lady-patient was hurting more than herself.  Suicidal thoughts and attempts are dangerous.

There was a patient who tried to use his bed-sheets as a noose before the nurse lifted his wet body from the door frame.  In the emergency room (ER) he was examined, x-rayed and determined fit to return to the ward.  Alive.  Talking to the ER physician, I learned that the reason most people die when they hang themselves isn’t because of suffocation.  It’s because they break their neck.  Done.  No more chances to choose life.  Even an hour.  My pulse was still beating on me to the rhythm of, “He could have died!  He could have died!”  This time, no broken neck.

Regardless of our culture, we are not the judges of these people who want to die.  Regardless of our emotions, their emotions before, any previous conflicts, regardless, we cannot measure their final act by degrees or intentions.

We fight together for their lives and they may or may not know about what that does to the rest of the world.  When we don’t want to fight for them any more, we should change jobs.  It is our choice, each of us.  Whether we are fighting as professionals or as a wife, brother, friend, volunteer or the hired tutor, we fight for their lives because we choose to.  If we cannot keep it up without judging, shaming, accusing the suicidal, we need to own that and take care of ourselves first.  “Can’t give what you don’t have.”

The truth is, suicidality is hard for everyone.  It is hard in ways and in people that aren’t talked about, such as the nurses or the x-ray tech who is the first to find the cervical fracture (broken neck) on film.  It is hard for the church parishioners, the person separated by seven-degrees or the grocer.  Suicidality is hard for all of us.  We give what we choose to give and remember to say, “I can’t control that,” when we can’t.  It is our choice.

Self-Care Tip #182 – Taking care of someone is your choice, even in the context of suicide.  Be a friend to yourself.

Question:  How has suicide touched your life?  Please tell me your story.

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