What will people think of you?
What will people say about you?
Some people asked me these questions when I told them I was publishing an essay in the New York Times (“A Suicide Therapist’s Secret Past”) about a very dark time in my life when I made a suicide attempt. I can’t really blame them. I myself had the same fears.
It’s stigma. If I had been pummeled by a tornado and almost died, or survived breast cancer, or been robbed at gunpoint, no one would question my decision to tell others of my experience. However unfairly, suicide and mental illness are treated differently. They are, to many people, unspeakable.
The meaning of stigma is “a mark of disgrace associated with a particular circumstance, quality, or person.” I refuse to abide by the notion that people with suicidal thoughts, depression, and other mental health problems deserve a mark of disgrace.
Depression and suicidality are things that happen to people, like cancer or bad weather. It’s not our fault, and it’s not something that taints us.
And so the fear I felt in coming out paradoxically fueled my motivation to do it.
A Long-Held Secret
For 22 years, I kept secret from almost everyone that I had made a suicide attempt in my first year of graduate school in Austin. Personally, it felt deeply private to me, even tender, a source of shame and failure regardless of whether that shame was deserved. Professionally, it seemed too much of a liability for people to know.
Of all people, some mental health professionals hold very stigmatizing attitudes toward people with mental illness. In my master’s program and beyond, I heard some colleagues’ disparaging remarks: “People who attempt suicide just want attention.” “She’s being manipulative.” “He’s so sick.”
Many physicians and nurses are openly hostile to people who have attempted suicide. When I worked as an emergency room social worker, more than once a physician came to me and said of a patient who had attempted suicide, “Could you please tell them how to do it right next time?”
Stigma exists even among researchers who devote themselves to helping prevent suicide. Early in my doctoral studies, I heard a suicide researcher complain that some people who worked in their research lab had a history of suicidal thoughts or behavior. The researcher wanted to know how to “weed out” these people before unknowingly hiring more people with a suicidal past.
From these experiences and more like them, I got the message loud and clear: Don’t tell anyone your past if you want to get a job, be respected and cared about, and succeed. Hide. Be quiet.
So that’s what I did – for more than 20 years.
Liberating Truth
I never lied. When people asked me why I was so interested in suicide prevention, I told them a friend of mine had died by suicide in high school, and the experience had filled me with questions about how to help suicidal people. I give this same explanation in my essay Why I Study Suicide.
It’s true. But it’s not the whole truth.
The whole truth is much bigger than a 1,400-word essay in the New York Times can capture. Maybe one day I will write a far longer piece about my experiences with depression and suicidality, maybe even a book. But for now, I wanted to at least come out of the closet.
Suicide prevention activists and researchers like to say that we need to lift the taboo about suicide. Talk about it. Diminish stigma. If enough people from diverse walks of life share their stories about mental illness and suicide, then stigma will buckle under the weight of enlightenment, education, and compassion.
As I explain in the New York Times piece, the longer I hid that I myself had been intensely suicidal, the more hypocritical I felt. I needed to do my part.
Some people cannot take the risk of revealing their mental illness, suicidality, or other vulnerabilities. They might be fired, or discriminated against, or hurt in other ways. Though I wish it were not so, the risk is real.
I could afford to tell my story. As an associate professor at the University of Denver Graduate School of Social Work, I have tenure. I’m not going to get fired for revealing my past.
It also helps that I recently finished writing a book, Helping the Suicidal Person: Tips and Techniques for Professionals. This gave me a huge sense of accomplishment and pride. I feel more confident now, not only professionally, but personally, too.
What Do People Think?
So let’s go back to the questions that came before the essay was published: What will people think of you? What will people say?
I’m happy to say that almost all of the responses have been positive. In the New York Times comments section, on my personal Facebook page, and in emails, phone calls, and handwritten notes, people convey their support. There are no doubt some people who think less of me, or judge me, or are aghast because I suffer from depression and I attempted suicide. I am not likely to receive emails from them.
Perhaps most gratifying to me are the emails from other people with mental illness and suicidality, many of whom are also mental health professionals. They tell me that my story helps them to feel less alone, less afraid, and more hopeful.
I love knowing that my essay is, in its own small way, spreading hope to others. But my motives in publishing it weren’t entirely selfless.
In sharing my experience with suicide, I also hoped to help myself. My suicidal past was a big secret to carry, especially as someone working in the suicide prevention field. I felt like an impostor, hiding in a dark closet of secrecy.
In coming out of the closet, I have stepped into the light.
Copyright 2017 Stacey Freedenthal, PhD, LCSW. All Rights Reserved. Written for Speaking of Suicide. All photos purchased from Fotolia.com.
Stacey, I’m just dropping in to say I continue to appreciate your work here on Speaking of Suicide.
I love Mary Elizabeth’s comment (below) – ” . . . what I love about you, Dr. Freedenthal, Stacey, one-of-us. You see us, and in your vision and sage advice, you see us – not just our dress and makeup – but you see all of us. You see all of us because you see yourself in us.”
Its a fitting tribute to your body of heart-work.
What a lovely message, Tamara. Thank you so much. Have I told you LATELY how much I appreciate your support and friendship?
Hi Stacey, I stumbled across a post you wrote. (not this one) And found my way to this post. I’ve not been honest with my family or friends about my thoughts. I can’t even type it yet.
When I decided to “test the waters” the other day with my Mother, who I’m very close with, and jokingly said, that I’ve considered it. I was not too surprised by her reaction. It was of shock and almost annoyance by what I said. I apologized and told her not to worry I was only joking and wouldn’t say it again.
I have A friend, but she’s fair weathered sad to say. I have some acquaintances, but they are very religious and when I tried to explain how I was doing they told me “to pray and that God would take care of me”. With all due respect, I’m spiritual and everything but, it’s been 2 months now and these thoughts are getting worse not better.
I went to my Dr., she added a new anti-depressant to the one that I apparently am at the max dose on, it’s not doing much of anything, but I’m told to give it more time. I talked to my therapist a little bit about it, but he tells me that I’ll “pull through it”.
I need to find a new therapist specialist who deals with this, but here in NH. there are none. So, I’m lost and feeling more alone then ever. I go to bed each night hoping I don’t wake up. And each morning, wishing it was night. I’m tired of feeling this way. Could you point me in the right direction to find a new therapist who might specialize in this in the Southern NH. area?
Rebekah,
I’m sorry you’re dealing with this and feeling so alone, all the while. Suicide freaks many people out, and unfortunately many people can’t manage hearing others say they’re having suicidal thoughts. I hope you will connect with someone soon. You can also try to national lifeline at 800.273.8255 (TALK) or the text line at 741741.
As for referrals, please email me at stacey@staceyfreedenthal.com (or you can use the comment box and I will receive the comment but not publish it) so that I can learn more about your location in NH, preferences, etc. and respond to you privately. Thank you.
Thank you for your blog. I wish my therapist knew the information that you do. It’s just a tragedy that mental health professionals do not get training in therapy for suicide in graduate school. Not many professionals seek out the additional training on suicide. In my experience, a therapist can be great at cognitive behavioral therapy on every topic except suicide. As soon as the client brings up suicide, it’s like they forget all of their knowledge in how to perform cognitive therapy. And this includes therapists that specialize in cognitive behavioral therapy for pain management who say that virtually all of their clients with severe, chronic physical pain have suicidal thoughts or make one or more suicide attempts!
I’m shocked that you don’t address chronic, severe physical pain in your blog other than just a cursory mention. Are your clients suicidal because of emotional suffering or mental illness? Do you have any comments specific to chronic, severe physical pain? Perhaps you could do a future blog post about it.
It’s no surprise why severe, chronic physical pain makes people suicidal. The pain is usually undertreated , especially if the patient needs opioid medication, and as a result, the physical pain radically reduces the patient’s quality of life.
In fact, chronic, severe pain causes many of the conditions associated with an increased risk of suicide: relationship problems, loss of health, loss of job, home, money, status, self-esteem , and depression. Chronic, severe physical pain also causes many of the emotional and behavioral changes associated with suicide : overwhelming pain, hopelessness, powerlessness, feelings of worthlessness, declining performance in school and work , social isolation , insomnia and loss of appetite. All of these things can be caused by severe, uncontrolled physical pain. This information is from the book Out of the Nightmare: Recovery from depression and Suicidal Pain by David L Conroy PhD, pages 253 and 254.
It’s also such a shame that you do not accept insurance. The very people who need you cannot afford you.
Becky,
You are absolutely right – chronic physical pain is a big issue, and it definitely increases suicide risk. I do intend to write about the relationship between chronic pain and suicide at some point in the future (though the list of topics on that to-do list is formidably long right now).
I agree with you that more therapists need training in suicide risk assessment and intervention. I wrote about this problem in an earlier blog post.
Thank you for adding to the conversation here. I think a lot of people will learn from what you wrote.
(As for insurance, that’s a very complex topic and maybe I will write about it, too, in a future post.)
Thank you for your honesty and persistence.
(and thanks for this site. It, along with the other sites you link to, have given me much to think about).
Thank you