Man Jumps, News at…?


A few weeks ago, at approximately 9:30 a.m., a young man jumped to his death from a bridge in downtown Asheville. He was not alone.

This young man, dressed neatly in Monday morning work attire, said his last goodbye and committed suicide surrounded by police officers, firemen, first responders, emergency personnel, school activity buses and hundreds of morning commuters snarled in the traffic jamb created by this very public emotional crisis.

Despite fervent attempts on the part of police officers, and to the horror of those in close proximity, he held his breath and jumped… into seemingly thin air.

I first heard about this young man’s unfolding crisis at a planning meeting for our Family Dens, our organization’s family mental health support groups. Our development director was late for our meeting and arrived in great distress. She had been stuck in traffic and saw this young man’s anguished face as he turned toward her and the police officer just a few feet away trying to negotiate with him.

“He looked just like you or I,” she shared, tears streaming down her face. “He was so handsome, and he looked, well, normal.”

We assured her he would be okay with so many people on the scene to help (not fully thinking through how completely terrifying all those lights, sirens, bull horns, and stopped cars must have been).

We finished our meeting and went home, each of us going straight to our computers to check on this young man and to reassure ourselves everything was okay.

It wasn’t.

This “unnamed man” had, in fact, jumped — a horrific act neatly described in exactly 150 words in only one local news source.

Contrast this coverage with what happened just a few hours later as reports of the Boston Marathon bombing quickly flooded local and national airwaves, news sources, social media and every conceivable conversation.

I learned about the Boston bombings from a feature writer I was talking to about our local suicide just a few hours before.

“This is not a good day,” she said and mentioned she was frantically trying to get in touch with her friend in Boston. I was puzzled until I checked the news and was confronted with images of the chaos in Boston.

Man jumps, news at ….?

It would not be until almost a week later that the second (and last) news story would appear regarding our local suicide, an act of desperation witnessed by hundreds of Ashevillians.

This time, “the unidentified man” got 165 words. And he hasn’t been heard from since.

Curious, this lack of news coverage, given the public nature of this suicide and the reality that more people die each year from suicide than from car accidents, averaging just over a 100 suicides a day, according to the Centers for Disease Control and Prevention.

This silence on the subject is curiouser still in our age of trauma-informed care where we are, theoretically, enlightened enough to recognize the importance of community support and collective healing around public tragedies. And the importance of supporting those who are left behind in trauma’s wake. And the importance of taking collective action to ensure future crises are prevented.

Yesterday, I noticed my local bank proudly displaying a window sticker proclaiming We Are Number 1 with Boston. (And yes, we are).

Meanwhile, our county has the fourth highest suicide rate in the state with five times as many suicides as homicides in 2010. When it comes to these tragedies, we aren’t number 1, we’re number 4.

But we’re not talking about it.

I called my children’s elementary school to see if Mother Bear could come in and do a presentation on mental health with the kids. A couple of classes were on an activity bus  caught in the traffic jam caused by the suicide event.

“Frankly, we’re afraid to talk about it with the kids,” whispered a well-meaning teacher who answered the phone.

As far as I know, they still haven’t.

Last month, Will Hall published an excellent blog here on Mad in America in which he suggested it was time for a new understanding of suicidal feelings.

“We need to speak openly about our suicidal feelings without fear of institutional reaction,” Will asserts.

Speaking openly about those we have lost, and how we are impacted in the aftermath, would be a good place to start. Even learning their names would be some progress.

Many of those lost to suicide remain lost and nameless because of the stigma surrounding taking one’s own life. Family grief, guilt and shame are only made worse in the deadening silence that is created when we can’t find our collective voice and then turn our backs on the suffering of the dead and those they leave behind.

It is time for a new understanding of suicidal feelings and actions.

Perhaps a more open dialogue, without fear of sirens and police and involuntary hospitalizations, would have made a difference for one young man here in Asheville last month. Perhaps more public local conversation would have saved some of the 45 lives we lost here in Buncombe County in 2010. Perhaps a more public and safe national conversation would have saved some of the 22 veterans who died from suicide every day in 2010.

And, lest we worry about what to say, an exploration of the many factors that contribute to suicidal feelings and acts would give us endless fodder for discussion. From poverty and trauma to individual and institutional abuse to existential crises and our “insane” pace of life to lethal side effects of psychiatric over- or mis-medication to lack of compassionate care.

There is so much we could talk about.

Perhaps all that talk might motivate us to actually do something to address our suicide epidemic. It might inspire us to reach out to someone who is hurting or to reach out when we ourselves are hurting. It might even stop us, as a society, from doing things that perpetuate the hurting.

We do have some examples of what can be accomplished when someone dares to talk about these matters.

MIA blogger and mother Maria Bradshaw’s wonderful organization, CASPER, has done much good work in New Zealand and beyond to support an open and healthy dialogue about the rapid rise in suicides and what we can do to prevent more of them. We are grateful to be able to refer families to CASPER when they have lost their loved ones to suicide or have concerns about suicide risks, particularly with regard to children and medications.

But we need more organizations like CASPER and many, many more conversations.

Unlike the one that started far too late and ended far too early on the morning of April 15 at approximately 9:30 a.m.


    • Duane, thank you for sharing John Donne’s beautiful line. We are all diminished by these losses.

      And thank you for inspiring our work at Mother Bear. We adopted you into our clan long ago, brother bear! Thank you also for saving lives by promoting possibilities for discovery (love this!), transformation and recovery.

      Gratefully, Jen

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  1. Thank you for introducing a tough subject.

    I believe that distressful experiences cause a painful lack of wellbeing and that extremely distressful experiences cause an excruciatingly painful lack of wellbeing. Unfortunately, if there is no expectation of relief, some people stop the pain through suicide.

    We need a more caring, supportive, civil society.

    Best wishes, Steve

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    • Thank you, Steve. I agree that excruciating emotional and physical pain (often a whole body experience) coupled with loss of hope and isolation are soul killing and often lead to predictable tragedies.

      It is not hard to understand why someone would want to end unbearable pain that they have no hope of relieving. Not hard to understand, but there is so much we can do to restore the spark of hope. Pain is such much more bearable when it is shared with others who genuinely care about our wellbeing, who can help us hold this pain without adding their own fear, who can remind us dark nights of the soul are universal and normal, who can simply be with our pain until we can find our way out or at least imagine the possibility of a way out.

      I would love to hear your thoughts about ways we can become more caring, supportive and civil around suffering.

      Warm well wishes to you too, Jen

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      • I believe that we should teach children the value of cooperation (as well as competitiveness); civics/ethics classes should be taught in schools, as well as an intolerance to bullying.

        I believe that we each can encourage civility in our daily interactions with the conviction that it is an admirable human trait. Class consciousness is in poor taste and should be mocked; it is ludicrous that Republicans successfully argue that rich people should pay a lower tax rate.

        Personally, I advocate a new paradigm of biological psychology that explains our common humanity and the significant value of a more supportive social environment.

        Best regards, Steve

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        • Class consciousness is in poor taste and should be mocked; it is ludicrous that Republicans successfully argue that rich people should pay a lower tax rate.

          That’s happening here too, and its been suggested disabled people should consider working for less than the minimum wage [because of being lesser value].

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        • Steve, thank you for sharing your insights. As a mother of two school-aged children, I couldn’t agree with your recommendations more. In fact, our family mental health organization (Mother Bear: Families for Mental Health) has been going into middle schools to discuss and interact with children around labeling and bullying and the impact of “creating others” on the human spirit. It is not surprising that everyone has felt the sting and weight of a label, and has contributed to and been the victim of bullying. If mental health doesn’t start here, it certainly checks in…

          I also appreciate your call to civility. I’m not sure we fully appreciate how much this is tied to our collective wellbeing. I really got a sense of this more deeply after recently completing a workshop with Parker Palmer, a Quaker educator, philosopher and author.

          I would like to share five “habits of the heart” that Parker shared are vital for making true democracy possible. They are adapted from his excellent book, “Healing the Heart of Democracy: The Courage to Create a Politics Worthy of the Human Spirit”

          I hope you will find them as resonant as I did.

          1. An understanding that we are all in this together
          2. An appreciation of the value of “otherness”
          3. An ability to hold tension in life-giving ways
          4. A sense of personal voice and agency
          5. A capacity to create community

          Interestingly, Parker has himself experienced three bouts with deep depression, which we writes eloquently about in his book, “Let Your Life Speak.”

          It is a recognition of our common humanity and the supportive social environment that you advocate for, Steve, that were crucial for his healing among other things.

          Thank you for your sharing your wisdom and heart. It has broadened the lens on this topic.


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  2. Thanks Jennifer. This is also a topic near and dear to me. The fear of death that permeates our culture in general becomes also a dangerous problem in facing the issue of suicide.

    I’ve collected several articles that look to opening dialogue as well. Perhaps some will find it helpful. See: Conversations about Suicidal Feelings

    All the pieces in that collection reframe the issue. We truly need to not fear talking about it…and more importantly not fear those who are feeling suicidal impulses. Meeting people calmly without terror at these times is the most loving, gentle and healing thing that can be done to help them through such times.

    I hadn’t heard about this man you speak of in this piece. It’s really sad that the school did not welcome you in to speak. (did you know I live in Asheville too?)

    thanks again Jennifer.

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    • Dear Monica, thank you. I look forward to reading your blog on this topic. I love your blog but had missed this one.

      Thank you for speaking to the need for supporters who can bring calm loving presence, not fear, to the vigil. I agree, this is vital. In fact, it was probably what was most absent that hour on the bridge before the jump. Our collective fear. The lack of news coverage and general silence speak to our ever present and deeply entrenched fear of death.

      As a young meditator, I was horrified at the instruction to meditate on my own death. After 20 years and the loss of so many friends and loved ones, I think I finally get it. Perhaps we all need to meditate on this and then speak openly and often about what it means to be human and vulnerable and to suffer.

      Monica, we have some lovely friends in common, so I have been aware we are neighbors, and I would love to join you in your garden when that feels good. I’ll send you a note with my contact info via Beyond Meds.

      I am not surprised you didn’t know about the suicide. Most of the practitioners in our local mental health community are still unaware. Another irony. Susan Reinhardt ran a Sunday feature on it a week later but she ended up focusing more on Mother Bear. We can’t seem to stay present with the pain…

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  3. In the UK ‘suicide prevention strategies’ fail to address many of the socio-political factors which lead to suicide, as well as the obvious lack of availability of meaningful and chosen support, and how health services can directly and indirectly lead to suicide.
    This week a woman died by suicide because of being unable to pay her rent, this is because we have a national shortage of social housing and our governments answer to that is to reduce the housing benefit assistance people receive. This is available to people both in work and out of work, with the majority being in [poorly paid] work. There have also been suggestions from politicians that disabled people [sorry if the word disabed offends anyone] including psychiatric survivors should accept less than the minimum wage [being of lesser value]. This woman made it clear in her letter that her death was as a direct result of housing policy but politicians refused to admit this and explained away her death as being nothing to do with their policies, and insisted she must have had mental health problems. There is also official denial of other welfare suicides [by people who DO have recorded histories of mental distress] even though the documentation they left clearly stated that as the prime reason for their suicide. The desperation our mental health service users feel can denied in the press, people can be told they are not allowed to speak of it when it directly relates to government policy, i.e. cuts to services, benefits, housing, employment support. Or else they told they are selfish or lazy.
    Research now shows that claimants are now regarded as a separate ‘out group’, a distinct social group different to others, not properly human, not even possessing the same emotional range as others.
    Suicide as a direct result of health services action or inaction is also neatly covered up. I helped supervise some research which yielded shocking results, where psych services who specifically work in physical health services [called ‘liaison psychiatry] told A&E [Emergency Room] staff ‘yeah we know her she’ll probably kill herself but don’t worry you’ve got all your notes in order’.
    When psych services decide a person is ‘terminal’ there is no ‘palliative care’ and some are even told of the expectation of their death – which comes with no support.

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    • Joanna, this is unconscionable. Thank goodness you are there to speak out. Are there any advocacy groups in the UK that are working to redress these issues? Any avenues outside the system for support? I had heard there was a movement to create a healing center there called Chy-Sawel (sp?) but I”m not sure this lifted off the ground.

      Does the Hearing Voices Network there do advocacy around these issues?

      I would love to hear you have support and a platform for your concerns. It sounds like you are shouting into the wind…

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      • Sigh Jen, not a straight forward answer..there are self-harm survivor-led groups but they are less politicised than they used to be. There is one especially good service despite cuts to funding, they offer one of the very few non-medical [non-residential] sanctuary;
        In terms of advocacy, our advocacy services have been decimated for a number of reasons, I’ve always carried the fantasy of an advocacy service specific to A&E [ER], there was even professional support for this, but funders are fixated on cessation as an outcome measure, not helping people to seek emergency medical treatment without all the associated humiliation and crap.
        As for suicide being caused by current government policies, I’m ashamed to say that British psych survivor groups [including HV] are not really addressing this, it’s physical disability activists who are way ahead of us in this respect.

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  4. Dear Joanna,

    Thank you for bringing up the connection between socio-economic conditions and suicidality and emotional distress.

    We all need safe and reliable housing, food, clothing and healthy human connection, not only for our mental health, but for our very survival as a species. There is no doubt that a lack in any of these areas can create despair and hopelessness that can manifest in all sorts of tragedies, including suicide.

    I would love to see more non-medical sanctuaries such as you suggest, where people who are suffering can be nurtured with respect, dignity and compassion and free from fear.

    Even more so, I would love to see us all be able to reach out and talk openly about these feelings and impulses without fear of involuntary treatment or hospitalization so that we can get support without necessarily needing a sanctuary, or perhaps by making sanctuaries in our homes, places of worship and other safe places where people gather to connect and share that can help normalize the experience and the experiencer.

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    • I say socio-political and not socio-economic because where our housing is concerned it’s ideology not economics. We have a form of ethnic cleansing happening here.

      Non-medical residential and non-residential sanctuaries [and helplines] are something survivor groups have been pushing for decades but we haven’t made much headway, we have very little. Even with what we do have, it’s doesn’t matter how much evidence there is that it helps and is what people want, they have to peddle twice as hard as statutory services to hold onto any funding.

      I get the impression that any expression of suicidal feelings gets hospitalised relatively easily in the US?
      Here’s it’s the opposite, you’re more likely to end up with no support, more so those with certain diagnoses.

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    • In the first psych hospital where I was held, because I’d tried three times to kill myself, I was point blank told that I shouldn’t be talking about my suicidal feelings! The staff thought it was improper and would make all the other patients “get ideas that they shouldn’t have.” At least one quarter of all the patients on the unit at the time were being held there because they’d attempted suicide; one young man tried to kill himself by drinking cleaning solvent. But we weren’t supposed to talk about it. I piped up and asked them where I was supposed to talk about it if not there in the psych hospital?!! All I got were dirty looks from the staff, and from some of the patients. We “suicidals” formed a special group of our own that met each and every day so that we could talk among ourselves about what caused us to try to kill ourselves. It was the best group that took place in the unit! It was true peer support!

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      • Stephen, I’m so glad you insisted on talking about it! There is no small irony in your situation.

        Joanna, it is not uncommon for any therapist or doctor in the US to follow this drill when working with a client who is very depressed and expresses any self harming ideas…. “Do you have a plan? Do you have the means?” If the answer is yes, involuntary hospitalizations often follow.

        Unfortunately, or fortunately as the case may be, many people are aware of this possibility and thus do not disclose this information to care providers.

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        • Jen I think there is a distinct difference for sure, and absolutely if you know that’s on the menu of course you won’t disclose it.

          How is it for self-harm without clear or expressed suicidal intent?
          Here it’s very easy to fall through the psych net even if attending A&E regularly with injuries which require surgical repair. The only difference now is we’re forced to undergo an “assessment”. I use that word loosely because it invariably means a 3 question 5 min interview which is purely backside covering. This is forced as in you cannot access medical treatment until you do this, or hospital security can restrain you until they arrive and before you leave. It’s known to be meaningless, an assessment which is a means to no end. People admitted for an OD are treated differently they are medically assessed and treated before this takes place.

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          • Joanna, I”m not sure about self harm. That is a good question. Whether or not one is admitted to or evaluated in the ER, and how helpful that is, is another good question. As others have shared, this can lead to more trauma. No easy answers here.

            Our systems are broken in many ways. Which is why community-based, non-medical care is so attractive to so many reformers. We may need to create the care we need and not wait for lumbering, well-lobbied and misguided bureaucracies to create it for us.

            We certainly can’t have too many options.

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  5. “…more people die each year from suicide than from car accidents, averaging just over a 100 suicides a day, according to the Centers for Disease Control and Prevention.”


    I do appreciate your having drawn a connection between these various, tragic events, which occurred suddenly, on the same day; that must have been quite a moving day for all involved; and, yes, some suicides (such as the one you’ve referenced) can be terribly tragic.

    Yet, I wonder if our society isn’t quite confused by the frequent merging of suicide and murder, in the news. There is a big difference between killing oneself and killing another (or, others). Of course, suicide can be a serious problem – but not so serious as murder, I think; and, I wonder if suicide — generally speaking — is quite exactly the problem, in our society, that many (and, perhaps, even yourself??) are making it out to be?

    Of course, suicide is most often quite devastating for the family members and other loved ones, of the deceased; so, you do well to speak of, “the importance of taking collective action to ensure future crises are prevented,” concluding, “we need more organizations like CASPER…”

    But, as some of the commenters on this page have already pointed out (and you have agreed), we must not panic around this topic – and prospect – of suicide. Our medical establishment (and, especially, psychiatry) has taught us to *fear* it; and, that’s to our great detriment, I believe.

    More than two decades ago, I was repeatedly “hospitalized” against my will, being *falsely* accused of presenting “a danger” to myself. (Please excuse me, if you’ve already read this, about me; I’ve pointed out the following personal experiences elsewhere, in my comments, on this site.) The resulting *unwanted* ‘medical (psychiatric) treatment’ I received led me, after a couple of years, to become suicidal. Never, before those “involuntary hospitalizations” was I suicidal; nor, since extracting myself from the “mental health system” have I ever been suicidal. I.e., the “mental health” system, in and of itself, was driving me toward suicide — via ‘treatment’ meted out, by medical-coercive psychiatry; and, that began with a psychiatrist calling me, “a danger to himself.”

    From what little I know of CASPER, it looks like a great organization; its founder is apparently properly skeptical of the ‘mental health’ system. Yet, I wonder whether CASPER can be duplicated here, in the U.S. — as its success seems to be the inspiration of one truly *uniquely* driven and capable person living in New Zealand; and, New Zealand is quite different, culturally, from most of the U.S, is it not? [A side-note: one can’t access CASPER’s suicide prevention strategy without paying a fee (albeit a small fee, just $15 ); while, of course, every non-profit needs a way to raise revenue, doesn’t that document represent precisely the sort of information that should be simply given away?!?] Based on what little I know of it, I would welcome CASPER in my community, and I am all for initiating discussion regarding suicide, in any event; but, for me, that discussion would need begin with my asking: do we actually have a suicide crisis in the U.S.? (I suspect that, probably, there is such a crisis in some of the most economically ‘depressed’ communities – but not all of them.)

    After reading your blog, I’ve been studying this Wikipedia “list of countries, by suicide rate”: If you follow that link, you’ll see that, numerically speaking, the U.S. does *not* seem to have an extraordinary problem, of suicide, as compared with many other countries — 12 suicides per 100,000 (in 2009). And, the U.K. apparently has a similar rate to the U.S.. (I offer that last point, as I know there are a good number of MIA readers from the U.K..) But, admittedly, such stats can be misleading in various ways; they are highly depersonalizing; and, hence, my point, as follows…

    Stats can be manipulated to create fear of suicide – as can focusing exclusively on certain, individual instances of suicide. Each suicide must be evaluated on its own, subjectively – before it can be judged tragic; after all, suicide needn’t *always* be considered a bad thing. Consider people suffering the final stages of painful and irreversible, degenerative physical diseases; is it not obvious that their suicides can be justifiable – and even a clearly *good* thing? This should be considered a vital part of the discussion of suicide, I feel: Some people commit suicide for reasons that are, arguably, quite reasonable, but suicide, generally speaking, is broadly condemned by the powers-that-be, in most societies; and/or, quite simply, it’s *medicalized* – viewed as a form of psychopathology, to be turned over to psychiatrists, such that most people wind up associating it, directly, with the concepts of “mental disorder” and “mental illness,” especially, here in the U.S.. Psychiatrists and other “mental health professionals” are, by law, expected to captivate and ‘treat’ people who are, supposedly, both, (A) ‘mentally disordered/ill’ *and* (B) ‘a danger to others or themselves.’ The *medicalization* of ostensibly ‘suicidal’ people, in our “mental health system,” has become standard protocol in this country – virtually codified by precedent-setting U.S. Supreme Court cases, which refer to “dangerousness” that is supposedly directed at oneself or others.

    But, really, the medicalization of suicide is very nearly a *worldwide* phenomena. WHO completed a global study, in 2006, which concluded 90% of all investigated suicide attempts wind up in hospitalization. I’m guessing a significant number of those ‘patients’ require a *physician’s* treatment for self-inflicted injuries, so their hospitalizations may, in fact, be genuinely needed; but, simultaneously, ‘medical’ *containment* of such ‘suicidal’ people suggests suicide is a disease — or a function of disease.

    From this point of view, I hope that the conclusions of the U.S. government’s Centers for Disease Control and Prevention view of suicide will be seriously *questioned* by those who choose to discuss these matters. [I doubt the U.S. C.D.C. will be compelled to *cease* counting suicides, but, perhaps, that counting could be done, as well, by some other, more appropriate/understanding — ideally, non-governmental — organization(s) — realizing that suicide is *not* a disease, it is a choice — and realizing, indeed, not all suicides are problematic.] Surely, it is psychiatrists, mainly, who study suicide, within the C.D.C. Of course, most psychiatrists – being physicians – are inclined to medicalize people; they make up countless ‘diseases’ out of seemingly ‘unacceptable’ behaviors. (No matter how long I’ve known this, it never ceases to disturb me, given not only my own memories of having been forcibly medicalized – but recalling, also, many others who have been treated similarly.) It’s purely a travesty.

    Realizing that I’ve gone on here, at lengthe (probably too long), I close now – with a brief passage from Thomas Szasz, who addressed these issues, in his own way, quite well…

    “Laws that enable some persons to lock up some others persons whose behavior they find upsetting have nothing to do with health, medicine, or treatment: They are a system of extralegal social controls without the due-process safeguards of the criminal justice system. Calling the arrangement “suicide prevention” is deception and self-deception. The coercive prevention of death may, depending on circumstances, be a noble end. The coercive prohibition of it is, a priori, ignoble and unworthy of modern people in secular societies.” (Suicide Prohibition: The Shame of Medicine, 2011, p. xiii)

    Thank you for your thoughtful blogging…



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  6. Dear Jonah, I really appreciate you bringing up this point. I have also been thinking about the clear parallels with movements such as the right to die with dignity and assisted suicide for terminally or chronically ill and severley disabled (and/or in pain) individuals.

    This is a really, really important point and I would hope that we could be fearless in including it in our conversations as well.

    Is suicide a choice? Is is a right? Can it be chemically induced? Can it be a response to ongoing trauma and abuse such as the repeated involuntary hospitalizations and treatments you recount (for which I wish you hadn’t experienced)? Can it be an act of passionate impulse? A long planned choice?

    I’m guessing, if we’re honest, we could answer Yes. No. Or Sometimes in each case. But it would be nice to find out. And to then talk about what we do with those answers and insights, how they related to individual freedoms, and if we should do anything, and when, and how? All things that are probably best decided by those involved not top-down, depersonalized systems.

    Thank you for asking us all to think about when suicides are tragedies and when they might be something else. A very good question. I, for one, would like to prevent the tragedies. Life is so precious and fleeting, if hope can be restored, I’m all for it. (At least, that’s what I’d want you to remind me if I find myself in that dark place again…)

    Warmest regards to you,

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    • “Is suicide a choice?”


      I briefly address my view of that question at the end of this commment; I offer my opinion. (Though, I doubt you were actually calling for it.)

      But, first, I thank you for your very generously warm and well-considered response. In fact, reading each of your comments, to everyone on this page (that includes your responses below, from this morning), I am touched; for, you are an unusually thoughtful/feeling and articulate, community-oriented person, genuinely warm and wise — well-gifted for moderating discussions such as this.

      So, about this question, “Is suicide a choice?”

      My humble opinion: Of course, it is — absolutely.

      After all, look at the definition of “suicide”; e.g., Google these two words, “define suicide,” and see what comes up…

      “su·i·cide /ˈso͞oiˌsīd/ Noun The action of killing oneself intentionally…”

      (That’s just a beginning, but it forms the core of all related definitions of the word; i.e., *intentionality* is key to the act of suicide.)

      Anything that one does intentionally is a *choice”.

      If anyone is in doubt about that, then, let’s Google these words, “define choice.”

      Here’s what appears,

      “choice /CHois/ Noun An act of selecting or making a decision when faced with two or more possibilities…”

      Of course, regarding a suicide, some may argue, “But, maybe s/he had no other choice!”

      In reply, to them, I’d say: Perhaps, s/he *thought* or *felt* that s/he had no other choice; yet, in fact, there is always, at least, one alternative choice — which is that, of doing nothing.

      The Taoists often encourage, “Wei wu wei” — which is to say, ‘doing not doing.’

      In truth, it implies removing ones own ego from ones own choices; and, yet, it can mean doing nothing, literally speaking.

      And, in many instances, doing *nothing* is the wisest, most compassionate ‘action’ (e.g., in many instances, those who are faced with suicidal thoughts and impulses who are well-encouraged to very deliberately *choose* to do *nothing* will see, indeed, those thoughts and feelings soon pass).

      Finally, I quite agree with you when you say, “Life is so precious and fleeting, if hope can be restored, I’m all for it.”



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        • I have to agree with Jonah here (Jonah, it seems we have been on the same page a lot lately :D).

          Those who have killed themselves under the conditions you describe fit 100% the bill of what Jonah calls “it implies removing ones own ego from ones own choices; and, yet, it can mean doing nothing, literally speaking.”

          If everything else fails, you can be homeless. At least in the Western world -even in the US with a combination of both private and public programs such as Food stamps/SSI/Medicaid-, there is a large enough social net to take care of anybody’s basic needs.

          Sorry, I don’t buy the excuse of a “suicide epidemic” caused by the Big Banks that is very popular in some corners. I am not excusing Big Banks for what they did (in fact, I am of the opinion that the corruption at the high levels prevented many from going to jail for their crimes) but people do have choices. You cannot have it both ways: being free to make your own choices (which is legally a given) and “my mortgage pushed me to kill myself”.

          This is the type of “mythical/surreal” scenarios that psychiatry loves to exploit to justify itself.

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          • I haven’t stated there is an ‘epidemic’ caused by big banks, the situation in the UK is more complex than you have knowledge of. It’s easy to say oh well be homeless or there’s a safety net, it’s not as simple as that, these things are not black & white.
            There is distress and suicide which is preventable, I can’t be that cold, and some of these issues are not directly attributable to psychiatry – it doesn’t exist in a vacuum

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        • Joanna Care writes, “sometimes it isn’t a choice that people truly desire, but a lack of options to continue living.”

          @ Joanna Care,

          If I wander my city (or any similarly large city, in any similarly, relatively ‘free’ society) on any given weekday, and I survey people about the work that they’re doing, how many shall honestly tell me that it’s the work they truly desire to do? (Probably, not many.)

          Countless ‘working people’ in the largest, post-industrial ‘free’ societies are palpably dissatisfied with their jobs.

          Yet, their jobs are the jobs that they *choose* to work, are they not? (Of course, they are.) If they wanted to, they could choose to actively seek other kinds of work. Maybe, then, they would find better jobs — or find interesting ways to employ themselves; maybe they wouldn’t be successful in such searching; but, failure would be the risk they’d take; and, too, they could, perhaps, not work and all, at least for a while — and see what happened…

          Instead, they choose to work in jobs that they don’t truly desire — i.e., jobs that they only *half* desire to work.

          Most people make countless choices (including many highly impactful choices) during the course of their lifetimes, that are half-hearted; but, no one can reasonably argue that such aren’t the *choices* that they make. They do make such choices.

          That’s my point.

          Similarly, many people make half-hearted attempts at suicide; many of them ‘fail’ to kill themselves in the process; some of them ‘succeed’ at killing themselves.

          Your statement, above, seems to me as though your way of making ‘apologies’ or ‘excuses’ for people who ‘successfully’ kill themselves.

          RE your saying, “Those who have killed themselves because of losing their homes/incomes wanted to live.”

          On the the contrary…

          They wanted to live in their homes (no doubt);
          they *chose* not to live — because they were losing their homes.

          My point is that they *chose* not to live…

          By my saying so, I don’t mean to sound insensitive to their plight (I do not favor having people thrown out of their homes); that is why here, at last, I emphasize: in my opinion, such people could have well used an element of CBT (cognitive behavioral therapy) — that which could teach them to avoid painting their fate as catastrophic.

          Commenter Nijinsky referred to this, just moments ago, in another thread.

          He remarked on, “CBT’s basic concepts that we bring fear into our lives and allow this to create unrealistic images, which is called catastrophising, I think this is truly insightful.”

          I agree with him on that point.

          (E.g., I think of Romeo and Juliet.)

          My saying so is not to promote CBT — but to emphasize that, I suspect the majority of people who ‘successfully’ kill themselves are catastrophising yet fail to realize that they are catastrophising.



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          • I wasn’t aware people needed to be ‘excused’ for killing themselves.
            Some physically sick/disabled/mentally distress/unemployed people ARE being thrown out of their homes because of welfare/housing policies and don’t have the choice, ‘epidemic’ no, but one entirely preventable death is too much for me.
            ‘Catastrophising’? It IS a catastrophy if you’re unemployed or cannot work but policies and impossible faceless systems have conspired to take away the practical ability to live. In those circumstances people don’t need CBT, they need food and a roof. The ‘safety net’ isn’t always there because various rules and conditions can mean months of no payment.

            I know you can technically argue any act is a choice, but it isn’t an academic exercise when it comes to real life.

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          • Joanna Care writes, “I wasn’t aware people needed to be ‘excused’ for killing themselves.”

            @ Joanna Care,

            I didn’t say that people needed to be excused for killing themselves.

            (In fact, my first comment on this page, above, points out and emphasizes my deep conviction, that there should be no prohibition against suicide; no excuse should be necessary; the choice of killing oneself — tragic as it may be, in most instances — should be entirely ones own, a universally given right, of every adult.)

            You’re now responding to my first comment to you, wherein I wrote of your response to me, “Your statement, above, seems to me as though your way of making ‘apologies’ or ‘excuses’ for people who ‘successfully’ kill themselves.”

            I said that because, more than once, in recent days, on this site, I’ve seen you insist that people have no choice but to commit suicide when being thrown out of their homes.

            In my view, that’s unreasonable of you.

            Such suicides are tragic — and entirely unnecessary.

            I see your repeated insistence that those people had no choice but to commit suicide as your *catastrophising* their housing situation; in my view, the prospect of facing homelessness (scary as that may be) does *not* warrant committing suicide, logically speaking; therefore, you are making a poor ‘excuse’ or an ‘apology’ for their behavior, I believe.



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      • Dear Jonah,

        I most certainly welcome your opinion regarding choice! And what beautiful insights arose from your response. Thank you for being vulnerable and stretching further into this space.

        I can see the importance of not stripping the dignity of someone for whom suicide is the most powerful choice they believe they can make. And, as we’ve acknowledged, we seem to be able to hold this respectful stance when we look at end-of-life issues where someone is ravaged by physical disease.

        I know I just opened myself up here by bringing the D word in, but I mean only to make the point that we are better able to accept and honor end-of-life choices when we can “see” the pain in the form of some crippling physical deformity and/or severe functional limitation.

        Lest we begin celebrating every suicidal act, I appreciate your equally important point that doing nothing, “wei wu wei,” is one of the most powerful ways we can support each other. I would add “wei wu wei *with*” (not sure how you Lao Tzu would say “being with friends of your choice”). Doing nothing when someone is in despair *and* isolation may not improve matters. Though it may still resolve these feelings as time alone can be a wonderful healer. But not always.

        Essentially, when I was in my darkest despair, my friend did nothing but be with me. No more, no less. But no leaving. No turning away from my pain. This was and is a life-changing memory.

        Thank you for bring what feels like very important medicine to this topic.

        It is the very thing that was not given to several beautiful souls who have shared their experiences (or their friends’) here. I can’t imagine how many millions each day fail to receive this loving “doing by not doing” presence.

        I am also grateful that you brought up CBT and catastrophizing in your response below.

        I am not unfamiliar with this process and the flight-or-flight limbic responses that can accompany it. My grandmother’s death and my subsequent deep grieving process was a crash course in catatstrophizing, in fact.

        I worked with a Mindfulness CBT practitioner to learn to recognize and work through this way of responding to overwhelming stress and fear.

        Again, having a calm friend during these times was very helpful. Not to argue or contradict my perhaps unrealistic fears and predictions, but to hold a safe space until I can wend my way back from a future I can’t really know or predict without more information (and, even then, not really).

        Jonah, you have enriched this discussion, I am grateful for your thoughtful and vocal presence. Jen

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        • I also want to acknowledge the inherent challenges in knowing when choice is truly choice.

          As you and many others have shared, involuntary treatment, hospitalization and various forms of institutional neglect and abuse can engender and intensify suicidal feelings and desires and lead to completed acts. Under these circumstances, we may still be looking at a choice, but I would argue it is a forced one created by choices made on behalf of someone in distress that severely limits other choices.

          So many of our psychiatric medications carry the risk of suicidality, and we have NO idea how much this risk is intensified in the drug cocktails that are so commonly prescribed to and taken by those in distress. And the suicidality risk that accompanies sudden or rapid withdrawal from psychiatric and other medications, withdrawal choices that are often attempts to reduce other life-diminishing side effects. Talk about a black box warning (that we are not heeding).

          Catastrophizing limits our range of choices, sudden displacement from homes and jobs, trauma, abuse, death of a significant other, and other life-changing events may contribute to catastrophizing and limited or faulty choice making.

          This issue of choice and free will is so important. Perhaps the best we can do is to always make as many life-giving choices available as possible, to encourage each of us to make our own choices with as much information, support and time as we can muster.

          And to do our best, collectively and for the greatest good, to dismantle systems that rob us of our birthright to choose and determine the quality of our lives without robbing others of this same precious right.

          I am grateful to be learning from all of you in how to accomplish this important work…

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          • “I also want to acknowledge the inherent challenges in knowing when choice is truly choice”.

            Thank you, that’s all at the heart of it I was arguing for, regarding the preventable deaths, where people’s circumstances have been toppled by systems and policies leaving them in unnecessary dire positions. The plight of low paid part-time workers reliant on tax credits which are now threatened is an example of where choice is limited – unable to secure or do more work but being sanctioned regardless. It’s not ‘catastrophising’, the choices really have been curtailed for them.
            ssenrch on the CBT blog writes really well on the issue of catastrophising, I’d recommend taking a look.

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  7. Our suicide rates are down for inpatients and up for community patients, this is because admissions are now pretty short and there is so little support available in the community. Right now because of housing/welfare/service cuts with a negative media actively demonising all sick and disabled people [which includes people defined as mentally ill], alongside unemployed and welfare recipients I’m seeing something very worrying. I’ve never listened to as many survivors with active plans for their deaths at the point of where they could lose their welfare and homes in addition to their support as I am right now. For them it wouldn’t be a choice.
    In terms of when do services decide to intervene, it’s quite arbitrary here, we’ve had high profile cases where one woman’s advance directive was respected after she drank antifreeze, whereas another went to the high court and was denied her desire to cease endless refeeding.
    It’s ironic that those who want to live feel they are might reach a position where they can’t and others don’t want them to because they’re not economically productive enough. Then those who truly do want out are allowed or denied their wishes according to – luck.
    I believe in physician assisted death for people whose conditions are terminal, degenerative, and intolerable to them. It’s just terrible to see quadriplegic people denied the right to end their own lives. Some people can afford to go to Dignitas [it takes about £10,000 because your body has to be flown back]but they won’t consider mental distress as a just cause for ending life – actually I think they should.
    Equally, there are times when being detained has saved lives and people have been grateful for that afterwards. I’m not adverse to a short period of detainment being used sometimes to put a ‘pause’ into what’s happening for a person, what I am opposed to would be any forced treatment within that

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  8. I am so grateful to those who have shared their experiences with suicidal feelings and actions in response to this blog. I was hopeful this might be an opportunity for a healing dialogue as well as to share what has been most helpful during these times in our lives.

    While I have never tried to commit suicide, nor entertained or developed specific plans to end my life, there have been a few very painful times in my life where I have gone to bed wishing I would never wake up and have awakened for days on end regretting I that had (awakened), with no will to live much less get out of bed.

    I can remember how vaguely disconcerting it was to realize I had lost the will to live, which felt decidedly different than the “please just make the pain stop whatever it takes” place I had occupied just prior, a place that although charged with destructive energy, still had some life in it.

    I entered this soul-dead place for several months in my late 30s, about 6 months after my grandmother died (and 8 months after my mother-in-law passed on after losing a painful battle with cancer).

    I had spent my first year of life with my grandmother, and she had always been my spiritual guide, my living archetype for unconditional love and my number one supporter regardless of what I thought of or did to myself. My grief over her loss was profound; however, since it did not hit me with its full force until 6 months later, it was labeled and treated as depression.

    Inappropriately prescribed mood-destabilizing medications, grief, the stress of motherhood and community service landed me in bed, literally, unable and unwilling to get up. My life had become unbearable. And there I lay in the grey half-light, curtains tightly drawn, for several weeks.

    Here is what helped during that time when almost nothing helped:

    • Friends and family that came by and whisked my girls off on adventures that gave them the chance to access joy and normalcy when it was in short supply at home.

    • My husband who let me rest. While it didn’t feel good or healthy at the time and worried many, perhaps, in the end, all that sleep wasn’t all bad either.

    • My physician friends who knew what would happen if they took me to the hospital, and so, they didn’t, and made house calls instead.

    And, perhaps most importantly, one dear friend who called every day just to check in, who didn’t require me to talk or to listen. Just to answer the phone. The same friend who sat on the edge of my bed on more than one occasion, in my darkened room, who just listened and sat vigil while I cried.

    She did not try to tell me life would get better (though it did), or that the pain would recede (though it has waxed and waned), or that time would heal all wounds (though it has certainly helped).

    She just sat with me. And had faith in me. And didn’t run away from my pain. Until I could be brave enough not to run away from my pain either.

    I wish that kind of friend for us all. And I am grateful for my friends and family who helped hold it safe for me until I was able to hold it again.

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  9. • My husband who let me rest. While it didn’t feel good or healthy at the time, and worried many, perhaps, in the end, all that sleep wasn’t all bad either.

    I have a name for that – duvet surfing!
    Yes it’s something professionals and friends can get most worried about but sometimes it’s really neccessary. I always remember something Pat Deegan wrote about staring at the walls for long periods of time [months/years] and how that WAS doing something

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  10. I can relate very much to this from both sides of the fence. My brother committed suicide when he was 33 years old, I was devastated but the response from others was essentially that of silence so I not only learned yet another hard lesson about people and life but I also had to once more deny and bury my feelings.

    I made a vow to myself many years before to avoid like the plague the ‘Mental Health’ profession and not just psychiatrists. I innately knew from a very young age (14) that there was something very wrong about the way the whole set up operated after my experience (among others) of being in their clutches when I could no longer cope with being bullied at school (long story that I could say so much about).

    After making somewhat of a comeback from all this, my life again took a nosedive in later years when my marriage deteriorated. Due to the particular troubles I found myself homeless for a short time and this led to me being temporarily placed in a women’s shelter. It was all very stressful for me, I was far away from home, I missed my son and I knew nobody. I was then transferred for 6 months to a women’s refuge. During this time I tried to get a grip but inwardly I was very insecure and frightened. I then had thoughts that I would be better off dead and knowing my brother committed suicide, this actually made it a little bit easier to think that way. I stupidly shared my thoughts with the lady in charge who I sometimes had conversations with. Well, that just prompted her to say it was ‘her duty to inform authorities’ and I couldn’t talk her out of it. I was then taken to hospital. I was kept in the emergency room section where the staff kept an eye on me, There was no one really to talk to as the emergency room staff were busy doing other things so they hardly said anything to me except that I could not leave and that I had to wait for the next day to see someone. I felt awkward and frustrated and didn’t know what to do with myself all night.

    The whole thing was so contrived and once again I had to deny and bury my real feelings. I knew also that I had to play the game, act ‘normal’ etc otherwise I may not get out of there the next day. All it did was further cement my feelings toward this bankrupt system that suppresses and punishes rather than liberates through genuine care and understanding which is all I was ever really after – a need so simple yet so seemingly impossible to feed.

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    • Cathy, I am so sorry to hear of the silence surrounding your brother’s death, what sounds like the may have been institutional even if unintentional bullying from the mental health system when you spoke up about being bullied, and the reactions you received when you did have the courage to reach out and share your extreme distress in the women’s shelter, distress which, by the sounds of it, was an understandable response to a very challenging and chaotic time in your life.

      I wonder how your healing would have unfolded if you had been met, each step of the way, with the genuine caring and understanding that you were seeking.

      I think you are right, It really is that simple. But we need to support each other in giving and receiving this kind of care. And being fearless about it. I think the more of us speak up and out, the more space we create for this kind of heartfelt support and witnessing.

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  11. I think it’s good to focus on “the importance of taking collective action to ensure future crises are prevented.” Peter Levine’s book, Waking the Tiger: Healing Trauma, discusses how healing occurs when the focus on trauma is counterbalanced by the focus on its opposite – peace, joy, strength. Healing occurs when a focus on an uplifting purpose prevails.

    It’s possible to measure whether people experience harmony or disharmony (in their brain waves and heart rhythms) when experiencing talk of suicide. This can determine when the discussion is progressing in a way that increases health for its participants. This kind of proof could help schools welcome healthy discussions. I’m posting a related comment on MIA’s facebook page.

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    • Irene, I always treasure your insights! Peter Levine’s Somatic Experiencing work is invaluable, and it was what I had in mind when I made the statement you quoted.

      In fact, in our local Family Den support meetings, we are looking at the various ways distress can be understood and defined (or explored). We are looking at trauma as one of the ways to understand distress, and we have invited an SE Practitioner and Trauma Resource Institute master trainer to share practical ways individuals and families can resource and support ourselves in healing our individual and collective distress. Accessing our strengths and safety in community are great ways to do this.

      Thank you for sharing this excellent resource.

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      • I’m wondering how talk of suicide could be most healthfully integrated into the experiences people are already having in school or other places. I hear highly integrated experiences are mentally healthy, whereas switching back and forth between highly unrelated topics is mentally destructive. ( ) If the topic of suicide blindsides people rather suddenly, dropping like a dark thunk into the pits of their stomachs, how can words better transition them into a healthy discussion? How can the healthiest rhythms be woven into the underlying tone?

        I thought the article you cited, “Time for a new Understanding of Suicidal Feelings” somehow flowed in a much more comforting and hopeful way than I’d experienced with many writings on suicide. Even the title includes many words which can open and relax people’s perspectives, “time,” “new,” “understanding,” and “feelings.” I wonder if it’s possible to assess how such “thought markers” could indicate how healthy and inviting a discussion is likely to be.

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        • Irene, this is an excellent point. I think ideally we learn to have conversations about overwhelming and hopeless feelings, and good ways to support ourselves and others during those discussions (like breathing, pausing, grounding, resourcing, for those who can do these things).

          When someone is at the point that ending their life is what is “up” for them, then gentle languaging like you suggest does sound helpful. It may be that validating the rawness and intensity of these desires may be helpful too. And the normalcy of them.

          You are bringing up a good point, if I’m understanding you, about the vicarious trauma that people may experience when they talk about suicidal feelings or acts, especially if the person experiencing them is known to them.

          I wonder if much could be learned by looking at cultures where death is a more open topic of discussion and is less encumbered by fear.

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          • There’s lots of evidence my mi

            When I read the words you wrote “breathing, pausing, grounding, resourcing,” I feel relaxation flowing through my being. (There’s evidence my mind and body are highly coordinated.) This is why I love that technology can now prove, in real-time, whether experiences are creating more harmonious brainwaves, or not.

            You hit it exactly with “vicarious trauma.” I think the practical, effective approach is to move as quickly as possible to the language that relaxes people. When relaxed, more signals can move seamlessly through their minds, so they can conceive of more options to make needed changes. That brings hope.

            I wonder how many suicidal people are victims of predators? How many feel hopeless because they lack support for what happened to them? They may not be able to face what happened, nor their family/friends. Intelligent predators may have included psychiatric approaches in the abuse. Some predators say “bad boy” when they abuse. Others can say, “Crazy! [any diagnosis]!” They know when the traumatized victim seeks treatment, that psychiatric approach will re-trigger the trauma they instilled. So the victim will be considered more disordered (less able to trust/bond with authority), and their memories/perceptions will thus be considered less credible.

            Brainwave technology can bring them hope, as it can prove who has brainwave patterns like predators. ( ) This is a big boon for victims whose predators have cozied up to authorities by claiming “I care about her. She needs help. She’s disordered.” When really, the predator’s mental states is by far the much bigger problem. When psychiatrists don’t treat victims like they realize that, it can seem hopeless. Technology can also prove when psychiatrists have less balanced brainwaves than many “patients” they’ve been locking up. It further offers hope, as victims can turn in their abusers (sometimes family members), yet still be effectively caring for them, because predators’ brainwaves can also undergo balancing.

            I’m sure all your caring attention to these issues gives many people hope, Jen! Thanks for being so focused and involved.

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          • Technology could prove death is less encumbered by fear (or involves less brainwave disharmony), in cultures which focus on spirituality or eternal life. Yet, people don’t want to be seen as “pushing” spirituality on suicidal people who are already entangled in highly complex situations. So, technology can prove focusing on harmony in more secular terms – peace, joy and happiness – involves less brainwave disharmony.

            A culture that focuses on happiness pretty much has no worry of suicide. An anthropologist found a tribe in the Amazon to be “relentlessly happy.” When he told them how his stepmother’s suicide had a spiritual impact on him, they burst out laughing. They were so devoted to happiness, they couldn’t conceive of ever wanting to kill themselves.

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          • It can go beyond “vicarious trauma” to actually involving people in the trauma. Highly conscientious people can start feeling and thinking about how they can do their part to help enable people to make needed changes in their lives. Feelings can be aggregated physical sensations, or rational information reporters on the situation people are in. Traumatic feelings are relieved when the problem is resolved — when they conceive of how to make healthier treatments, approaches and situations more accessible. I’d assess whether a communication primarily focuses on how people can effectively enable hopeful options. Does it feel more like “light” than “dark” (though both may be involved)?

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  12. Dear Jen, thank you for so honestly sharing your moving experience of intense grief over losing your dear grandmother. Yes, often all it takes is the kindness of one friend to sit and listen and simply “be” with you in those moments/days/months of intense pain.

    I am so sorry for the grief in your Asheville community over the suicide of that young man and the quiet shame surrounding his death. Of course, suicide needs to be talked about. I know Sean Donovan here in western MA runs a wonderful group focused on suicide. He also has a blog here on MIA.

    Thank you again for sharing your personal story. It always helps to know that you are not alone.

    Love, Dorothy

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  13. Dear Dorothy, thank you for sharing Sean’s wonderful work and for connecting us. I look forward to learning from him and sharing with our local community and also our Mother Bear network of families. Western Mass RLC is such an amazing resource!

    Much love to you too, always.

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  14. Hi Jen,

    Thank you for the courage to bring this “shadowy” topic into the light, and for doing so in such a powerful and thought-provoking manner.

    When we stop to really think about it, it’s not difficult to recognize that it’s actually a very natural response to consider suicide when we feel profound hopelessness and powerlessness in the face of tremendous pain–hopeless that this intense suffering will ever pass, and powerless to do anything about it. And yet, what is the socially accepted response (and a legally mandated response for some of us)to someone in such a painful place? To lock them up against their will and either coerce of force them to take spirit-dampening drugs, and typically try to convince them that they need to “have insight” into the fact that they have a lifelong brain disease. In other words, here’s someone struggling with overwhelming hopelessness and powerlessness, and our response is to strip away any remaining wisps of hope and power. Wow. Really?

    This topic is near and dear to my own heart because one of my closest friends–one of the only people who supported me in my own time of overwhelming distress, and a fellow lover of the sky (a hang glider pilot like myself)–committed suicide inside a psychiatric hospital.

    Tragically, this all happened while I was living on the other side of the planet (staying in Buddhist monasteries with only infrequent access to email), and so I didn’t even know that she was going through all of this. Fortunately, another close friend of ours remained in contact with her during her final days, and so he was able to share with me his understanding of what had occurred:

    After a traumatic childhood, she continued to struggle with ongoing social and emotional difficulties, including occasional bouts of severe hopelessness several times prior to this incident. She feared that this time she might really try to take the ultimate “exit strategy.” She didn’t know where else to turn for help, so naturally she went to a psychiatric hospital. She apparently made it very clear to the staff that she didn’t want any drugs, as they had only made things worse for her in the past, and that what she really needed was someone to talk to and to keep an eye on her–to make sure she didn’t do anything impulsive (i.e., attempt to take her life). The staff failed horribly on all counts. As soon as she checked in, they forced her to take drugs (I don’t know which kind), refused to allow her to leave, AND failed to provide her with genuine human support and compassionate watchfulness–the only things that she had asked for. Several days into her stay, she walked out onto the hospital grounds, climbed to the top of the tallest tree, and dove headfirst to her death.

    As you can imagine, upon hearing about all of this, I was grief-stricken and enraged. Really??? This is the kind of “support” that we can expect to receive in our greatest time of need? Perhaps the one good thing that came from this was that it represented one of the last straws that led to my own resolve to commit to working towards a more empowering, humanistic, and compassionate health care system.

    And meeting people like you, Jen, and others on this forum keep the hope alive in me that such change is a very real possibility,

    In support,
    Paris Williams

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    • Paris,

      Your friend’s story is so incomprehensibly sad. It is as if everything conspired to fail your friend in her greatest time of need. That it left no doubt in your mind what your life’s work would and should be does seem to be her parting gift to you.

      That you have hope and resolve in spite of this personal loss inspires me as well. I am imagining you scooping her up, mid-leap, and jumping off a different cliff, this time, with a hang glider and your fearless piloting. Bless you in your work.

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    • Oh, Paris, I am so sorry about your dear friend’s suicide. And especially sad since she was completely let down and disrespected by the hospital. It is so often the case (myself included) that the death of a close friend in the system inspires us to activism.
      Love, Dorothy

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  15. Is having more reports about suicide in the news, the way that you can pretty much assume it will be reported, is this going to help prevent suicides; or will it go the same route as everything else that’s reported and turned into a means to get people riled up, scared and perpetuate the problem? I’m sure they would start talking about the drugs that are supposed to help that have only been proven to cause suicide. I’m sure they will get everyone so alarmed that they would fail to see that a person on the brink of suicide is also highly alarmed and doesn’t need more alarming contributions, as well meaning as they are. And I’m sure all the money and attention will go into organizations (and have) which would talk about escalating numbers of suicides; while they monopolize on everyone’s alarm to make them think their measures are helping, although this wouldn’t be the case. The same with cancer “drives,” the same with the war on “terror,” and the same with religions teaching people that being terrified of going to hell brings you to the gates of heaven; the same with governments waging wars to alleviate the “bad guy” while in doing so they create a pattern of misunderstanding between cultures rather than the peace they say that needs to be maintained by the wars, and never has.

    Is it really wise to have the focus on why wasn’t this more in the news, rather than don’t buy into all of this alarm and you will be to relate to the person whose life you are trying to save?

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  16. Dear Nijinsky,

    I am grateful for your questions and contributions here (and on so many blogs). I want to highlight a few of your comments for response because I find them so valuable..

    A person on the brink of suicide is also highly alarmed and doesn’t need more alarming contributions,

    This is incredibly important. And a point I was trying to make, but which may have been missed. Adding fear to fear results in predictable tragedies. As well-intentioned as the first responders were in this local suicide, I can’t imagine a worse response to someone in crisis. I can imagine an emotional seismograph registering mass fear in that situation (amplified by all those who were channeling it).

    Similarly, sensational news accounts can and often do make matters worse. When I got my journalism degree, it was common knowledge “if it bleeds, it leads.” No bias there.

    For my family’s own mental health, we long ago stopped watching the nightly news and taking the daily paper. I had to give up my daily dose of All Things Considered when the economy tanked.

    Points well taken. Our media is biased (on the left and right) if for nothing else, commercial interest and to keep their own viability (as noted by magazines and newspapers folding left and right). Alarm sells. So do advertisers. And the ones taking out the biggest ads are often pharmaceutical companies…

    Is it really wise to have the focus on why wasn’t this more in the news, rather than don’t buy into all of this alarm and you will be to relate to the person whose life you are trying to save?

    Definitely not. The wildly disparate news coverage on that day was just an interesting (and sad) metaphor about what we will talk about as a society, ad nauseum, and what we won’t.

    My concern was that there were so many people in our community who were personally witness to and connected to this tragedy. School children, hundreds of commuters, dozens of first responders and their families, not to mention the family and friends who now have a gaping hole left by this young man’s departure.

    The lack of news coverage correlated with a lack of local community support. Everyone was left to “deal with it” (or not) on their own, in silence.

    I have the opportunity to work with many local therapists and many were completely unaware that this ever happened.

    I can also contrast this with a sudden death that occurred last year. My daughter’s piano teacher and my friend, Paul, died suddenly and unexpectedly. He was in his mid 40s. He ran our local music school. My daughter and I were in shock, and so were many other children and families. The community snapped into action, while there wasn’t a whole ton of press for Paul either, we had bereavement teams at the music school, trauma specialists volunteered their services, counseling centers offered to make sure people had support regardless of ability to pay, meal and visit calendars were created that fed and held Paul’s grieving partner for months.

    At his funeral, the large church was filled to overflowing. My daughter and I attended on her birthday (Paul’s strange gift to us). And we celebrated a life well lived and much missed, out in the open, in the light of day.

    The profound silence surrounding this suicide (a silence I believe to be common in many communities across the country) robs communities of the chance to grieve and heal together, to celebrate a human life together, to acknowledge every life has meaning, no matter how short, and to look at ways we might better relate to each other in that very personal, safe and compassionate way I think you are advocating.

    I’m not sure we can move beyond alarm and fear if we can’t begin talking about death, and life, and suffering more openly without institutional overreaction. I do appreciate your suggestion that media coverage can most certainly be part of this overreaction.

    Thank you for expanding the dialogue. Warmly, Jen

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    • When I’m on a train or tube and there’s a ‘fatality on the line’ and we all know what it means it feels like glass in my eyes when I listen to people around me tutting because they will be late, and how “selfish” is this person.
      I want to scream out SOMEONE HAS LOST THEIR LIFE, this person was someone’s mum, dad, brother, sister, grandmother, grandfather, partner, husband, wife. We’ve had newspaper articles berating people who die by suicide on a train line.

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    • I a friend of mine, actually the one person who pretty much introduced me to the mental health system she was in, something I didn’t know about beforehand; she committed suicide October 25 2007.
      I was maybe the one person she could completely confide in about some things. And as all her “friends” were acting like an urban assault team having her institutionalized against her will, she had already told me that it’s the great depression that comes after having been institutionalized that had caused her to try suicide in the past. After she had committed suicide a local spiritual medium/channel in the area happened to have shared what she called a message from my friend in the after life, saying that suicide didn’t help her depression. Just to add that her for anyone having the same thoughts. But after she was institutionalized, she had already ripped her Achilles tendon trying to get away from these people terrorizing her about forced commitment; in the asylum they never even recognized she needed medical treatment for that, called it a sprain (although her leg was swollen up to the knee) and consequently her ankle was ruined for the rest of her life in a “medical” asylum where they refused to look at what really needed medical help. And they drugged her up so badly and had so little concern for anything emotional going on with her that she somehow convinced them she was OK to leave, and all the pressure of having to behave in a way controlled by others rather than relating to herself caused her to become very careless, she hung around with the wrong people, got raped, and then after she had been put in the asylum again (where they at first didn’t believe she had been raped, and was actually strapped to a gurney and medicated for “being to provocative”), she told me later a doctor actually threatened her with either she take a whole combination of drugs or she wouldn’t get out. She couldn’t even sit still because of these drugs, when I talked to her having gotten out. Then she started saying she was having emotional swings, was up and then down a lot. And then, to everyone’s surprise who had forced all of this “treatment” on her, she had committed suicide. This wasn’t in the news (something I don’t follow anyhow, either), but it of course got around and many people were talking about it. So, I had to deal with the same friends and family who had her institutionalized although I had vigorously already told them that the treatment she would receive in the asylum hasn’t been statistically or scientifically proven to help. They would start coming up to me and expecting me to take part in all their sorrow while they completely negated their contribution and would do the same thing all over again, for all I knew. and they had treated me so harshly while this was going on, as if I was the stupidest most ignorant disruptive and unhelpful person they could imagine. And I had warned them that I was concerned they would lose her, that she would get so depressed after being committed that she would commit suicide. After this went on for years, I had to finally inform them that they needed to leave me alone and their behavior was highly inappropriate, after what had happened.

      You of course wouldn’t hear about any of the true contributing factors in the news. And even, I am told, the alternative news outlets such as Democracynow won’t take information from anyone who has what they call a persistent mental illness, as if this is a statement about the person rather than a degrading humiliating prejudice, much like a person in a war zone is called an enemy, just because they are of a different culture.

      Freespeech television, although they had a really good show called chemical angels also run shows that try to maintain that we need more health care money to maintain the vehicles that do almost nothing but drug people up and is a major cause for the epidemic they are trying to heal.

      And there are millions of stories like this, that aren’t told. People whose lives are completely misrepresented.

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      • Oh Nijinsky,

        Your story has pierced my heart. Again. This. has. got. to. stop.

        Even if we have the grace to acknowledge that perhaps all of these harms are done with the best of intentions, that systems and bureaucracies don’t need evil intention to commit evil, we are all complicit in crimes against humanity as long as we don’t speak up and out against them.

        It sounds like your words have been strong and tireless but have fell on deaf ears. For your dear friend, I am so sorry that your words were not heard in time to save her life.

        Perhaps it is some comfort that your precious friend heard them? Even in her time of intense suffering, to have you validate her life and rights? I hope so, Nijinsky. I do believe our words and hearts have the ability to heal beyond this lifetime. I hope I am right.

        I am also glad you honored your boundaries. You are not the only one who has been in this exquisitely painful situation of foreseeing an outcome that you feel powerless to change, and trying to change it anyway. And having to say goodbye too soon. Unfortunately, so many on this website share this story. Too many.

        Thank you for telling your friend’s story here. It is welcome. And heard.

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  17. The reality is that if people seek “help” for suicidal ideation and psychache (unbearable psychological pain/distress), they will be subjected to any/all of the following: armed and dangerous police presence, public humiliation, incarceration/involuntary detainment, loss of civil rights, chemical and physical restraints, intrusive constant observation and no effective reduction of the causative distressors. The blog, Incompatible With Life (, chronicled this, investigated the research and clinical literature and proposed or endorsed treatment strategies and resources to reduce suicidality causes. The Reading List page of the blog contains references to suicidal theory, research and effective (evidence-based) treatment and care to reduce distress.

    It’s also salient to note that suicide/suicidality is not a psychiatric disorder, that there is no curriculum to teach any licensed professional about it, and there is no endorsed treatment for suicidality. Of course, the biggest risk factor for suicide is a previous suicide attempt. No one has studied the nature of this, but I’ll throw out a bone: an animal trainer once said that if you want a puppy to come to you again, you shouldn’t smack it on the nose when it does. Humiliating, degrading and imprisoning people who encounter “help for suicide” will fur darn sure make certain that they don’t willingly allow that to happen to themselves again.

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    • A fellow UK survivors observation;

      “I think that survivor support (survivor solidarity) is something we work with on a small scale rather than something the whole “movement” is going to adopt. Szasz’s type freedom crusade grew out of a different soil than the solidarity of people who have suffered and seek to understand one another. But for some survivors, Szasz’s perspective gives an orientation and meaning to their activities together – that is, they use it to support a solidarity i.e. “This is what we are about”. I think it gives some people a belief in autonomy and mutual respect for others (which is good) – but it then gets caught on the problems of real life and real distress where those who do not fit the model become those outside the fence”.

      Life is complex and messy and I try to find humanity and maintain humanity in amongst the painful mess.
      I can feel outside the fence when I see the line of sink or swim, how stupid is anyone to choose to take drugs [that’s sometimes a choice no matter how much we might not like it],use services, be in receipt of any welfare support which means using the given diagnosis [iatrogenic damage suddenly loses its validity], too linear.

      I can’t take a people die so tough shit line. I’m enraged by clearly preventable suicides where choice is not truly a choice, such as punitive welfare sanctions [for those in and out of work].
      Otherwise I respect anyone’s right to die but would obviously want to see society and anyone paid to support react quite differently to anyone suicidal coming to their attention i.e. no forced drugged incarceration, and access to non-medical sanctuary.

      In saying this, if a friend wanted to be hospitalised I’m going to help them [it does happen], just as if they wanted to escape I’d help them [I’d be happy to break any law].

      I’m not against suicide per se, I support assisted suicide [Dignitas] and feel they should see people for psychic/mental pain as well as physical [they currently don’t, few people would support me on this], because I’ve seen how grim failed suicide can be when it means living and body altering disabilities. If someone really needs to do it, then I don’t want them to suffer.

      I don’t want to see anyone degraded and imprisoned for being suicidal but I have seen a couple of people detained without any treatment forced to put a ‘pause’ into what was happening for them. I know this is rare, I’m just reporting it, to throw an idea for consideration, maybe as a stepping stone to forced treatment/sectioning/commitment laws being dropped.
      You may have to consider the shade of grey because the world may not shift to a Szazsian dream just like that.
      If you had the chance to secure something nearer to where you want to be rather than nothing would you take it? I would.

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    • aek, thank you for this link. It sounds like a rich set resources.

      It is seems so painfully obvious, as in your dog training example, that the only effective and “sane” responses to expressions of suicidal feelings and attempts are love, compassion, unconditional acceptance and support finding life-giving options.

      Honestly, does it take a PhD, an MD, and LCSW or an ER tech to figure this out? Does it take a whole branch of Sociology? Does it take death after death after death…?

      Apparently so, to our disgrace.

      Thank you for joining and enriching our conversation!

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  18. Jonah – I’m saying I understand why they feel they have little choice – compassion – I’ve never advocated a prohibition on suicide and yes they are unnecessary tragedies because if policies were not so punitive people wouldn’t be placed in the position of considering that. It’s not my catastrophy, it was theirs, you can pathologise my feelings if you choose that doesn’t bother me

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    • “you can pathologise my feelings if you choose that doesn’t bother me”

      Joanna Care,


      I am not pathologizing your feelings (nor anyone else’s feelings). I’m not even referring to your feelings. I am simply remarking on the fact that you have repeatedly indicated that people who are facing eviction from their homes have no choice but to kill themselves.

      I have now objected to your saying that, a couple of times.

      I have said that, in my view, that’s your *catastrophising* their housing situation.

      I.e., your saying that someone had to kill herself or himself because s/he was facing homelessness is your painting his/her situation ultimately catastrophic. (Indeed, you now say, “It’s not my catastrophy, it was theirs…”) You are painting their housing situation as catastrophic.

      My pointing this out has nothing to do with pathologizing; it is me pointing out and critiquing the narrative that *you* are placing on these instances, of people committing suicide because they face eviction.

      Now, I feel I have said all that’s needed — especially, as I’ve already said that, in my view, you’re making a poor ‘excuse’ or an ‘apology’ for their suicide.

      By the way, in your preceding comment to me, you stated (above, on May 18, 2013 at 3:19 pm) that, “I know you can technically argue any act is a choice, but it isn’t an academic exercise when it comes to real life.”

      I supposed it may be true that one can technically argue any act is a choice, but I don’t forward such a proposition.

      In my view, it’s reasonable to say that, in some (rare) instances, some people are faced with choice-less situations.

      Perhaps, we can speculate as to what those situations might look like; however, that may be another conversation — a philosophical one, which this is not, really; simply, being faced with homelessness presents various options — more than just suicide.

      Unless or until you can concede that point (i.e., that the suicides of people facing homelessness are their choice), I am done with this conversation.



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      • I have indeed stated they felt they had no other option, and that I can appreciate feeling that.
        I don’t use the language of CBT such as ‘catastrophising’ [just as we don’t use DSM diagnoses], so to me that is pathologising, whether you apply that to me or others.
        Yes I view their circumstances as having been catastrophic for them and a tragic loss – we all ‘paint’ our thoughts about others situations.

        “In my view, it’s reasonable to say that, in some (rare) instances, some people are faced with choice-less situations”

        Thank you, I think that’s all I needed acknowledged.

        “Unless or until you can concede that point (i.e., that the suicides of people facing homelessness are their choice), I am done with this conversation”

        It’s a “choice” but people can feel they have no other option, and not really want to do what they’re doing, but can’t face or do the remaining options.
        I’m saying it’s a choice that people can go into unwillingly

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        • “I’m saying it’s a choice that people can go into unwillingly”

          Joanna Care,

          I follow what you’re saying — until you offer your last phrase (in that last line which I’ve quoted, above) …at which point I throw up my hands — finding we’re back at square one.

          Note — Googling “oxymoron,” here’s what appears: “ox·y·mo·ron /ˌäksəˈmôrˌän/ Noun A figure of speech in which apparently contradictory terms appear in conjunction…”

          Seems to me that you’re offering a beautiful oxymoron, in that last line of yours (when you refer to, “a choice that people can go into unwillingly”); so, I think we should just agree to disagree…



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          • Note – Google “contradiction” A person, thing, or situation in which inconsistent elements are present.

            Life and actions can be a contradiction, can’t you grasp that?
            People can self-harm without suicidal intent whilst at exactly the same time not wanting to.

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    • Dear Joanna and Jonah,

      I want to offer support for what you are both saying. It seems to me that you actually are not so far apart, but that words are getting in the way of feeling that.

      You both have been so helpful in deepening my understanding around this topic. I hope that comes through with the sincerity that I feel.

      And Joanna, I had not seen your comment about catatrosphizing feeling pathologizing before I used that word choice in a response above.

      I can’t speak for Jonah (who does a much better job of speaking for himself ;-), but I can explain that what I mean by that term, based on my own experience of terror, is a feeling that the world is coming down around me, that my very survival is threatened at a basic level, that extinction seems a very real possibility (and not by my hand). It involves a somewhat involuntary (or at least irresistible pull) to play out any number of “what if” scenarios, none of which end well. And, interestingly, the ability to stack multifold disaster scenarios to “cover my bases.” If one disaster doesn’t pan out, then surely the next one will.

      The whole cognitive therapy behavioral approach, which does not have to be an approach or a therapist, simply a good friend or trusted advisor, is to untangle the “what if” knots, get out of the future, and breathe into and live in the present. It is all we have to work with anyway. I have found the only real choices I have are available in this present moment.

      This may or may not be what Jonah was trying to convey in the situation specific to homelessness, but I’d like to share a particular scenario that played out in the height (or depth) of my grief and accompanying anxiety. I would definitely call this a catastrophizing scenario as that rings true to my experience.

      Shortly after my grandmother died, I became convinced that I was going to lose all sources of income and ability to support myself.

      I did not lose my grandmother (who was my first mother), until I was nearly 40 years old, and it was my first intimate experience of death (a blessing and a curse I guess, not a lot of practice).

      My grandmother had occupied a large continent in my “the world is a safe place” cognitive map. With her death, there was a giant gaping hole in my world view.

      Looking back, I can see that in losing her, I also lost my safe footing in this world (I hadn’t done the work of providing safe footing for myself, content to let her hold that for me). In my grief, I conflated my income and my home with the safety I was desperately looking for outside myself (where it had never been, even in my dear grandmother’s arms).

      So, I would replay various scenarios of losing my livelihood, my house, my family, etc. There were many creative but disturbing ways that played out. I worked long and hard with a CBT practitioner to recognize how “unlikely” many of these scenarios were, however, the most helpful question, in the end, was this (and I’m not sure who asked it):

      “Let’s assume you do lose everything, what now?”

      The question I feared most, when asked out loud, was actually liberating. My mind was able to come up with lots of options and choices.

      Okay, well, I know there is a shelter on such and such street. Oh, yes, well, there is a women’s shelter that takes children too. I could get a minimum wage job. No one wants those. If I got one in food service, I might get some food as well. Well, there is Section 8 housing. And Homeward Bound. Maybe I’d qualify for services. Maybe I could help others in the shelter. Do some empowerment circles.

      Honestly, the creativity that question unleashed was shocking. All the sudden there were lots of options and choices. None of them what I would prefer, but, given a new reality, I could see that I could create new opportunities in the chaos. That was actually very empowering. And, because our system in the US stinks too, I used all those “what if’s” to create back up plans. Pretty good ones, I might add. Shelters gave way to living in tents in friends’ back yards. Looking for house sitting opportunities. etc.

      None of this is shared to diminish the real pain, hopelessness and despair of losing your home, job, family and other traumas. They are traumatic. Deeply so. And no doubt they have led to untold suicides. Here in the US, during the Great Depression, many literally lept to their death after the stock market crashed.

      But, perhaps, all hope is not lost when we lose these material things. And maybe we can share that with our friends (and a place to sleep and something to eat) if and when the unthinkable happens.

      Which is not to say that we should not fight, tooth and nail, to provide stable housing, food and compassionate care for all of our citizens.

      There is a Buddhist saying I once heard,

      “We cannot build our happiness on the suffering of another.”

      I believe this to be true.

      Thank you, Joanna, for living and advocating for our collective happiness.

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      • Yes Jen you have a point, language can get in the way, and perhaps the useful aspects of CBT are better when sought for oneself without a therapist in the equation!
        I accept how you used it, no problem with that, but I’m thinking of people who really have lost everything, or people whose circumstance and distress were far lesser than yours, we all vary in how we cope and in our resilience.

        You’re a gentle soul Jen, and I like that Buddhist quote but as Richard has ably just spoken of in the CBT blog we can’t ignore the material world and need to be biological psychiatry’s worst nightmare within it, because much of people’s distress, including distress which proves fatal is also rooted within the inherent damage all our political systems [not parties] do. That doesn’t remove all trauma but it changes a lot

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        • Amen, Joanna! We do need to address the roots of systemic abuse and neglect until we are all liberated. Every last one of us.

          There is another teaching that I resonate with in Buddhism, the Bodhisattva’s promise to return to this world again and again until all beings are relieved of suffering.

          I believe this concept is a part of every wisdom tradition and I feel it coursing through your veins. I am grateful for your warrior spirit!

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          • For something lighter Jan do check out my Fergeson’s Safety smock piece on ‘Difference..’ I didn’t like to post it here because I didn’t want to be disrespectful to the subject, but it’s a humorous piece ridiculing psychiatry’s utterly prosperous responses to people in suicidal distress

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  19. irenecardenas – when I’ve watched programme’s about tribes in the Amazon and elsewhere it’s very humbling. They build their homes from the materials around them, have to hunt and chop down their food. They live such a natural and better life in so many ways.

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  20. Hi all, earlier in the blog responses an interesting discussion has been bubbling about choice and when it is informed, free, and restricted. One issue that came up, among many, is psychiatric medications and their impacts and influence on suicidal feelings/impulses/actions.

    I mentioned that there is little information on the enhanced risk of suicidality with the medication “cocktails” that are frequently involved in those experiencing emotional distress.

    I would like to offer one of the few resources I know that can help decipher those risks, Dr. David Healy’s website. There is a link at the bottom of every MIA page, including on this blog page. There is a way to check side effect risks with multiple medications.

    Of course, focuses only to the medication risks (which are by no means insignificant).

    Logic and intuition would encourage consideration of the manyfold factors that, in combination with medications, can limit rational choice-making around suicide (for more on the idea of “freely chosen” suicide, please review the comments above).

    I would also like to encourage followers of this blog to at least skim through the comments (they are worthy of a full read, as many have contributed greatly to this discussion).

    There have been a number of resources regarding suicide awareness, support, causality, rights, and more that have been shared throughout the comments section that you may wish to explore further.

    We will try to incorporate many of them on our Mother Bear website,, in our resources section.

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  21. Since I was entangled with this discussion about CBT because of a post from another blog that was shared, I think I should say something, or try to say something.

    To begin with, I agree with both sides of the argument.

    Catastrophizing is an unfortunate term, or can become one. At the point when someone is told that they are catastrophizing, are unrealistic, are in need of treatment, or would be in need of being indoctrinated by someone else, this becomes intrusive. I didn’t come up with that term, I was repeating it.

    I originally posted about CBT because I felt there was something there that can teach a basic tenet that heals both sides of the problem. It’s often overlooked that perhaps the wallstreet bankers causing the game playing, causing the economic collapse, causing people to loss their homes and causing distress amongst people less privileged than them: they may be run by completely unrealistic addictions and scenarios of what they believe happiness is. You don’t know what kind of an environment of “you must play along with the game,” or “you have to be cool and be part of the cult,” and all the programmed fear, the ingrained insecurities, the pangs of loss towards completely unrealistic scenarios that go on in their head, keeping them from actually finding happiness while they think they are in a chase scene to catch something that will forever elude them the way they are going about it.

    That’s what I originally was trying to point out as being catastrophizing, not the very real trauma of losing your house because you were deceitfully conned into a mortgage in order to have your monthly mortgage payments raised to impossible level; and have this all used as capital in corrupt investments that are gambling material for wallstreet games. There’s a difference between real catastrophes and catastrophizing. However, this could conceivably help a person, to focus on how their mind, in its distraught state, might start building up scenarios that make life seem impossible and suicide the only solution; when it could hold onto hope instead, and allow a softer more patient route to emerge than the harshness of ending one’s own life. There are wonderful movements that have come from people holding onto hope instead. It is possible to catch the mind before it gets locked into seeing only one desperate solution. It is possible to gently steer it into another mode. But denying the very real trauma, anguish and despair of being conned into losing your house, have the government bail out the bankers causing such trouble rather than the actual people losing their houses; and then having it insinuated that you’re into hysterics when this all gets to you: this isn’t the best way to encourage a person to have a more positive outlook on life.

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  22. So many interesting posts here and thanks Jennifer for your reply to my earlier comment. On one level I get what some are saying about ‘choice’ and ‘catastrophising’ when used in a somewhat rarefied context. However when it comes to people’s lived experience this context can seem rather disingenuous. With both it appears that often no real consideration is given to actual perceptions/circumstances/driving factors. So with the former all that counts is what ‘choice’ is made and with the latter, ‘realism’ seeks to overwhelm perceived hysterical thinking.

    In relation to the former, perhaps in many situations it would be better to say they were reactions rather than genuine choices. Although I mentioned a few things before about my life it was of course a very incomplete picture. In my younger years I also developed panic attacks and agoraphobia which were quite disabling and lasted 8-9 years. Due to this experience I became acquainted with the catastrophising and choice dilemma. I can’t go into much detail about my experience as there are many aspects to it so I will just focus on the two mentioned. Although I understood the motive to use CBT, overall I had trouble accepting what seemed to me was a denial of and trivialization of the genuine distress and complex problems caused by recurring (and often severe) panic attacks/agoraphobia; especially if it took time to find out what the problem was and by then it could be well entrenched (which was my case). The reality for me was I had to quit my job, I lost all independence to the point where I couldn’t even go to the shop on my own and at 21 this to me was a catastrophe, I lost all confidence, self respect and so much more.

    Although theoretically there may have been ways to avoid/escape this problem, at the time I didn’t/couldn’t see it, it wasn’t available to me and that was the reality I lived – all I knew is what I was experiencing and from within myself I tried my best to overcome it. I don’t see quitting my job etc as being real choices – they were reactions to circumstances. As for making out that people catastrophize the effects of panic attacks etc (and therein lay the problem – wrong thinking) – well, let them experience this problem at full force and see how they go. I doubt anyone would become a virtual prisoner in their home against their will without good reason.

    I eventually overcame it mainly by being with people who were like me and by using my own inner resources (I used no drugs). The key thing was we truly respected and understood each other and didn’t trivialize the difficulties each was experiencing. One lady who I became close to had been through the mill of psychiatrists, drugs, ECT etc and was worse off for it. As difficult as it was I am glad I didn’t go down that path.

    I feel that in many instances of suicide maybe it is more a reaction rather than a genuine choice and I believe this was so in my brother’s case. That doesn’t mean the person was incompetent it just means they are acting from a (variously defined) inferior position which I think is the reality for a lot of people.

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  23. Cathy, thank you for adding another important layer to this discussion. I hear you, and know first hand, how debilitating a full-blown panic attack can be (and prolonged fight-or-flight anxiety).

    I can’t remember where I first heard this phrase, “Something that is perceived as real is real in its impacts.” Perception is everything isn’t it? And, I think it is so important to start with the perception of someone who is suffering and acknowledging their very real pain. As I write this, as a mom, I know I am guilty of overlooking this. I’m making a silent vow to do better…

    Thank you, thank you, for giving voice to this need we all have. To be validated in our pain (and celebrated in our joy and all the rest of the human experience).

    I’m not sure this has gotten as much attention in this thread, but one challenge with CBT could be that when we are in survival mode, our thinking mind can shut off. What may be most helpful is to work on the traumatic feelings coming up in the present moment.

    I hesitate to use the word “non rational” response, because when our body is is fight, flight, freeze or collapse, any number of extreme choices may “feel” entirely appropriate to our internal survival system (even anti-survival).

    I believe Nijinksy mentioned earlier that gentler approaches may help lead us to a more hopeful set of choices and responses. Perhaps mindful breathing with a friend or reaching out, with permission, to offer a steadying hand, could help us move out of fearful or despairing reactivity and into a more grounded place where truer/more choice(s) can be possible.

    We have to feel safe first.

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