A phone call at three in the morning comes as a siren, especially when you work at a crisis hotline. I was alone. Newly awakened, lying in a pull-down Murphy bed in the university counseling center, I pressed the phone against my ear.
“I have a bottle of pills, and I want to take them now. I want to die.” Sobs punctuated the caller’s words.
“You must really be hurting,” I said. “Can you tell me more about what’s going on?”
The caller was a graduate student in a counseling field. After struggling with depression for months, she condemned her goal of becoming a therapist as absurd. How could she help others who had mental health problems when she suffered so many herself?
The pain she felt now could be a gift later, once she was a therapist, I told her. It could help her understand, empathize, and be fully present with clients who want to die.
More sobs. More snuffling into the phone. “You really believe that?”
As a graduate student in social work, I had to believe it. Only a year earlier, in 1996, I’d also wept in my apartment late at night, tormented by the thoughts drumming inside my head: People would be better off without me. Things will never get better. Nobody could ever love me like this.
This was a most interesting article, and thank you for relating your own experiences. It’s an interesting point that you raise about stigma. It used to be the case that suicide was stigmatised as the ultimate act of selfishness. However, that stigma has made way for one that is arguably even more pernicious: the stigma that suicidal people are too mentally defective to be able to make decisions concerning their own welfare. That they deserve to be relegated to the legal status of children by being denied access to the means by which they may enact their will (given that if one’s will is to commit suicide, it is always to be regarded as inauthentic and a symptom of a ‘disease’ which impairs rational thinking). Suicide prevention doesn’t say ‘let’s slow down the process of making the decision to commit suicide in order to make sure that it’s a considered decision made over a period of time, rather than an impulsive response to an acute state of crisis’, it says, ‘let’s rule out suicide now and forever, no matter how consistent the person’s will is or how unyielding their suffering’.
If admitting to being suicidal meant that you were going to be judged as someone who was so mentally unstable that they were to be deemed permanently incompetent to make reasoned judgements concerning their own welfare; then it’s no wonder that you did not wish to vouchsafe your own history of suicide to your colleagues.
However it seems that, by being one of the leading advocates of ‘suicide prevention at all costs to personal autonomy’ today, you’re reinforcing the same stigma that you once worried would hamper your career hopes. My question is, how do you reconcile that in your mind?
I would like to comment on the following statement from your article:
“I see parallels to LGBTQ+ people coming out of the closet.”
While I agree that there is a parallel, it seems to be limited to what people will think of you – principally your colleagues. This is , of course, understandable;
but as you stated, your job was secure, so it really boiled down to anticipating potentially negative responses from others. I am not downplaying this in any way, as it can cause formidable psychological harm in and of itself, but merely pointing out that the coming out process for LGBTQ individuals is much more complex than that.
I can only speak from my experience: I agree that the anticipation of response from others, i.e. colleagues, co-workers, strangers, and (especially) family was sheer hell; the anxiety this produces is nigh-unbearable at times. The problem , for me, is that it did not get better upon revealing my truth, and I came to regret it for a long period of time.
As someone who is both LGBTQ and suffers from anxiety and depression with suicidal ideation I would like to revisit some of my experiences as a kind of compare and contrast exercise:
1) Family – when my family became aware of my anxiety/depression issues (and they became aware due to a “forced” hospitalization, there’s no hiding it after that), nothing really changed. Business as usual, with an acceptable explanation for my moodiness. In contrast, when I came out of the closet, everything changed – one (important) member, upon being told, got a look of what can only be described as horror upon their face, turned and went into another room, slamming the door practically in my face. We did not speak for some time after that. Ultimately, the family dynamics fractured, with some members not speaking or having contact with others for 20+ years.
2) Home – I met someone, who eventually became my husband (of course, we had to wait until 9 strangers on a court deemed it acceptable to society that we be allowed the right to marry; a right that most people take for granted) and we bought a home together (another step in the coming out process). 2 men living together were pretty obviously a gay couple, and one day upon arriving home from work, I was greeted by a neighbor with “Fa**ot” shouted quite loudly. Shortly thereafter, my vehicle was vandalized, with all the evidence indicative of the vandalism originating from said neighbors property (things were thrown).
3) Protection – early in our relationship, my partner and I had a talk (maybe the talk) about what to do in the event of an aggressor and/or outright assault. I told him that he is to run, to get away and try to get help, but he said he would stay. I replied that that could get us both hurt or killed; I will fight, and hold them off as long as I can, but I need to not be worrying about you at the same time, so run. This is not a conversation I ever thought I’d have to have, but this something out sexual minorities have to think about and should prepare for.
4) Religion – simply put, due to enormous religious intolerance, I feel like I’ve lost my religion, and I’m not sure what I believe or not believe anymore. This didn’t happen when dealing with anxiety and depression prior to coming out, but the aftermath of the process just completely destroyed organized religion for me, leaving me to question what is left, if anything. I still don’t know.
As you can see, I touched upon 4 aspects of my life, 2 (Family & Religion) with comparisons between being out with mental health issues and being out as LGBTQ and 2 without (Home & Protection). The 2 without comparisons are because being out with anxiety/depression had no major impact on those particular areas of my life, while being out as a gay man did. The point here is that while there is a parallel, it is a limited one at best. Just to give one more example, I was not forced into the hospital because of my sexuality, but because of my depression. It can be argued that one precipitated the other, but they are ultimately separate and distinct parts of being. One cannot be hospitalized for being gay, but can for serious enough depression.
On a side note, Harvey Milk was wrong: the more people come out as, well, any minority, really, the more prejudice and violence and othering seem to come to the surface in response. The last few years have been a prime example – minority assaults are, and have been, on the increase for some time now.
Please excuse this if it reads as some disjointed ramblings, I wasn’t going to post again, but I am home sick from work and bored and well, you get the idea.
I thought it was very enlightening. Thank you for writing it.
Dear Stacey,
Thank you for being so honest, and I hope this helps many people. So many people seem to assume that the world is divided into suicidal people who want to die (with the implication that this is a permanent, unchanging part of someone’s personality, like sexual orientation), and non-suicidal people who are intolerant fascists for trying to encourage them to live. You, and many of us who have had suicidal thoughts, know that life isn’t that simple, and that our feelings can change from one day or hour to the next.
As someone with mental health problems who has tried training as a mental health nurse and gave up because I couldn’t cope with the stress, tried working in a care home and gave it up because I couldn’t cope with the stress, and since then have been turned down even for voluntary work, I am impressed that you have managed to keep on with your work and helped many other people.
However, as a patient (and as an autistic person who sometimes tends to think in exaggerated, black-and-white terms), I must admit that I sometimes find the concept of the Wounded Healer – in distinction to the Scarred Healer – rather alarming. If I look to therapists to be role models who can say, ‘I’ve felt the way you do, but I’ve managed to recover and find hope, and so can you,’ then I’m frightened by the idea that their real message might be, ‘Nobody ever gets better, I still hate myself and want to die, but I’m forcing myself to stay pointlessly alive, and so can you.’ I’m sure this ISN’T meant to be the message, but it is how it sometimes sounds. Recently, I considered getting in touch with a therapist and author who lives locally and who had written an autobiography about her teenage struggles with anorexia and obsessive thinking, but I was frightened off by the way that her autobiography frequently repeated the mantra ‘life hurts’. I thought, ‘If it isn’t that problems hurt and we need to find ways to overcome them, but that being alive is always, inescapably, constantly painful, then does her being still alive mean she’s a masochist? Does her being a doctor and keeping other people alive mean she’s also a sadist?’
When we suffer physical illness or injury, we expect that, most of the time, we will get better (sometimes with the aid of medication or surgery, sometimes without), or that, if we have a permanent illness or disability, there are often ways of managing it (for example, I have epilepsy, but am on a medication that works, and haven’t had a seizure for the past thirteen years; I am also slightly short-sighted, and see the world much more clearly when I wear glasses). Part of the reason that mental suffering is harder to escape from is that it becomes part of the way that other people define us (as with the prejudice you described in your article), but I suspect that another part of the problem is that it sometimes becomes part of the way we define ourselves. It wouldn’t be rational for me to tell myself, ‘Having seizures is what I do, therefore offering me anticonvulsants is a conspiracy to force me to conform to society’s norms,’ or, ‘The world looks blurred without my glasses, therefore it IS blurred, and glasses are a lie.’ My mother and my uncle have both undergone treatment for cancer in the last few years, and it would have been very irresponsible for their doctors just to say, ‘Cancer is part of you, it’s what makes you yourself, and you need to learn to love and accept it,’ instead of explaining options like chemotherapy and surgery. But when I suffer depression, I feel that it must be true that I am worthless and evil and God hates me, and when I talk to counsellors about delusional beliefs or feelings of self-hatred and self-destruction, all too often the counsellors have said, ‘Well, if that’s what you believe, then it’s right for you,’ or, ‘Well, these feelings of self-hatred and self-destruction are part of you, and in time you’ll learn to love them.’
So yes, we need people, including therapists, to be able to be open about their own problems. But patients like me also need a reason for hope, as well as empathy. I was struck by the line you quoted, ‘As we are liberated from our own fear, our presence automatically liberates others.’ I got the impression that you were talking primarily about fear of speaking openly about depression, but I think the same applies to being liberated from fear of living.
Temple,
You make so many good points that I’m not sure where to begin.
First, let me say thank you for your kind words. It took me many years to be so honest. I’ve seen such honesty help others, as I note in the article, and it also helps me to be able to live more authentically.
I also appreciate how you depicted the false dichotomy among suicide prevention critics as people who unchangeably want to die and “non-suicidal people who are intolerant fascists for trying to encourage them to live.” Naively, I was stunned at first when people viewed me so negatively because of my work in suicide prevention. You’re right that these categorizations are overly simple and rigid.
What most stands out for me is your observation about wounded vs. scarred healers. This is a very important distinction, and I wish I’d thought to make it in my essay. I obviously believe that lived experience of suicidality can deepen empathy and understanding in others, but if the helper isn’t able to tap into their own healing and hope, then they risk doing harm to someone who is suffering. I hope I didn’t say anything in my essay to indicate “Nobody ever gets better, I still hate myself and want to die, but I’m forcing myself to stay pointlessly alive, and so can you.” I don’t think that was your takeaway, especially since you said that’s not the message overall, but perhaps I could’ve paid more attention to recovery and hope.
It hurts me to read that when you’ve shared with counselors your depression’s edicts that you are worthless and evil, they’ve responded with “Well, if that’s what you believe, then it’s right for you,” or, “Well, these feelings of self-hatred and self-destruction are part of you, and in time you’ll learn to love them.” Those aren’t constructive messages!
My hope for you is that you’ll either be able to challenge those thoughts – talk back to them and assert your innate goodness – or, if you’re not able to change them, then to observe them without buying into them. For example, it helps some people to say, “That’s my depression talking, that’s not truth” or “There go those negative thoughts again.” I know, this sounds both overly simple and easier said than done, but with practice, it can help disarm the depressive thoughts of their power. In acceptance and commitment therapy, this is considered “cognitive defusion.” Acceptance in this context doesn’t mean giving up trying to feel better or loving what causes you pain. Rather, it means to stop trying to get rid of thoughts and feelings and, instead, to relate differently, and less painfully, to them.
If you’re interested, a good book for trying to talk back to and change such thoughts is The Suicidal Thoughts Workbook, by Kathryn Gordon. To learn and practice skills around observing and detaching from thoughts, I recommend the ACT book Get Out of Your Mind and Into Your Life, by Steven Hayes.
Thank you for sharing, here and elsewhere on the site!