Survivors of Suicide Attempts
Are Speaking Up

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The New York Times reports that survivors of suicide attempts, who vastly outnumber the numbers of completed suicides, are beginning to be heard. “We as researchers haven’t yet tapped the potential of working with suicide attempt survivors,” said Matthew K. Nock, a professor of psychology at Harvard. “There’s the potential to learn from them not only more about the experience itself, but about treatments, and where there are gaps in our understanding.” Leah Harris, of the National Empowerment Center, adds in the article, “Even in treatment settings, all the interventions are brought down on you if you even mention it. So you just learn to shut up.”

Suicide Prevention Sheds a Longstanding Taboo: Talking About Attempts (NY Times)

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

21 COMMENTS

  1. There was no value whatever in going through the multiple interrogations by literally dozens of staff at a hospital in NYC on “what brought me here” – it was so painful (despite continuing to hold out certain events)…and for what…

    So that a bunch of zealots who don’t know me at all, can push it all to one side, and tell me that all of what I’d been going through, and why, was irrelevant, as actually the *real* reason is because I have a chemical imbalance in my brain…which must be treated by medication “for the long term if not the rest of (my) life.”

    Certainly within inpatient contexts, I simply don’t know why they bothered asking me to repeat what had happened ad nauseam. They apparently, were just waiting for me to stop talking, so that they can just get started on telling me what I’m wrong, and that they know better.

    • I think that people should stop treating suicidal individuals like criminals. I know that the mantra of the psych system is “we’re trying to prevent the tragedy” but the reality is that admitting to having suicidal thoughts (not mentioning ever trying it) make you an outlaw – in fact in some countries it is considered a crime. Even if that is not the case many people still think that you should not have the right to end your life and if you do feel like it, you’re crazy and should be “protected from yourself”.
      Such an attitude is counterproductive and one more reason why people with serious life problems don’t want to seek help, not only from professionals but even friends or family as they never know when an ambulance will arrive to take you to a locked ward. It’s a disrespect for someone’s freedom and autonomy.

  2. I’m sorry for your experience, Anonime, and am glad that you’re alive to tell the story.

    I’ve never been suicidal, but have spent time with three people who were expressly suicidal outside of a mental ward. I know two of them didn’t attempt it for at least a year after we talked. It seemed to me like suicide is always an option and that when someone is thinking about that option, it’s important to not be afraid of what they’re talking about, to not be afraid of them, to listen intently, and to remind them that circumstances change, even when it feels like you’re feelings are permanent, you can count on things changing. Which means, staying relaxed and fully present while being with them.

    The third person was an elderly woman who insisted that I let her give me a ride. She looked desperate so I accepted. She said her brother was expressing suicidal wishes and asked me what I would tell him. I told her, and just before I got out of her car she said that I “just may have saved a life today.” I hope very much that that was the case.

    In my one involuntary stay in a mental ward the paranoia over the possibility of suicide was palpable and overwrought. I get it that it would be traumatic for them to lose a patient to suicide, what I don’t get is how they let themselves maintain such a nerve-wracked environment. People who are emotionally overwhelmed have a tendency to be really sensitive to the emotional energies of people around them. When the people who are supposed to be in charge appear to be out of control, it doesn’t engender the trust they keep telling you you should feel toward them.

    That there is just now a movement to learn about suicide from people who have attempted it is evidence that the institutions of psychiatry and psychology have been neurotic and in denial about it to the degree that they fear that patients who are suicidal are objects who are suicidal by nature yet infectious. Bio-psychiatry embraces that reductionist thinking, but the problem of suicide for psychiatrists is much older than the DSM-III or IV. A primitive fear? A personal fear? Let’s hope that a lot of people learn from these formerly suicidal people who are sharing their experiences or suicidal feelings and of the treatment they got in response.

    • It’s all about removing symptoms. If you can take someone’s ability to feel and will to act you take the risk they’re going to do something undesirable. But calling it help is misplaced, it’s no more help as tying someone to the bed (which they of course also do with suicidal people).
      The psychiatry’s idea of treating people is to take away their choices, emotions, thoughts and replace them with the “normal” or “healthy” substitutes. Because the substitution is not really possible so they are down to taking these things away, often by force, and left with a drugged zombie. How is that better than just letting this person kill themselves?
      If you don’t want someone to commit suicide all you have to give them is hope and sadly enough not everyone will be able to see this hope. You can’t really prevent people from committing suicide – there are plenty of opportunities even in closed and monitored wards – the fact that it does not happen often is because most “suicidal” people don’t really want to die: they simply want someone to help them through the difficult time and show them a way out and that is the most desperate way of asking for that help. You don’t do that with drugs. In some cases you prevent that with drugs.

    • On the great help one receives in these institutions: in an attempt of “preventing” me from hurting myself they have abused me so much that was the first and last time I had a real suicide attempt. I was trying to hang myself but was to drugged to do it properly and ended up passing out. Funnily enough they staff didn’t even notice that. What a bunch of pathetic morons.

      • One could argue that you didn’t kill yourself because you were too drugged to do so, and so it was a net good. I would argue that that’s glib and insufficient justification for policy.

        Seeing the frantic checking of rooms and tossing of patient’s personal effects for contraband caffeine (as if it contributed to suicide) was bad enough. I can’t even imagine being strapped into restraints for long periods of time, but figure if I were suicidal, it would make me want to hurt them more than myself.

        It’s understandable that the staff doesn’t have time to give very personal care to every patient in a ward, but they could rectify that to some degree by not keeping people who are not a threat to themselves or others and who want to go home. Keeping people until they agree with the psychiatrist or vocally express a willingness to go along for the sake of going along and getting out is not necessary. They could be a lot more choosy about who they keep in their wards and for how long, by using sensible triage for the sake of the patients.

        • How about I wouldn’t have tried if they didn’t put me through that shit in the first place for no reason? They had an incredible talent to take a person in distress and then take their misery to a whole new level. I think the only way it could possibly work is that you realise that your life was not that shitty afterall – they just made it even more hell than you ever felt was possible. But hey, if you got PTSD from that it’s not their fault, it’s because you left this wonderful facility at the earliest convenience instead of sticking around for more treatment. Seriously, if my family didn’t pull me out of there it would probably end up in murder/suicide scenario, especially with they drugs they gave me.

          • Having someone to speak up on your behalf is very important.

            The one thing that I found helpful about my involuntary stay was visiting with other patients and being fed good food. The rest was ridiculous, but I did manage to find time every day to contemplate my psychotic episode, the content of it, and what that meant to me. I still had to work at it for about four months after I got out, but in the end, I became more content than ever. I’m not free of the PTSD and must watch carefully for triggers, but I really managed to get off my own back about it after feeling the horror of it so vividly. Of course it makes me sick sometimes— it was a very powerful trauma that is too big for anyone to make sense of, and it’s o.k. that it has knocked me down as much as it has. I’ve done alright. I’m not a failure, I’m a survivor and a strong person, and I’m happy with where I’m at and who I am.

            My voluntary stay in the V.A. ward did not involve condescension and being treated like a child, I think, because it isn’t safe for them to treat veterans of war like children. They also make it very clear that you can decline meds and don’t push once you’ve declined. The food wasn’t as good, but it was also nice to be fed and not to worry about taking care of anyone but myself. And to visit with other veterans in an environment where being disturbed and wanting to heal is normal is a unique comfort.

          • Can’t reply to your answer directly wileywitch, so I just add the answer here.
            It’s good to hear that at least in some places they treat you like a human being – the VA services get such a bad press now, which make it sound like they are not any better if not worse than the standard psych institutions. But I guess trying to treat people with military training the way they treat “normal” people would be a disastrous idea, so good for you.
            Unfortunately I don’t have a single good thing to say about the place where I was held (the food was so disgusting that I still feel sick even remembering the smell f it – the colorless pulp made of the cheapest ingredients. But I also know I had the misfortune to end up in the worst shithole in the area – I did a bit of research after that and found out numerous reports in press about abuse, people dying in restraints, ex-staff members telling horror stories – of course everything “properly investigated” to conclude no wrongdoing so they just continue with business as usual.

  3. I have talked to hundreds of suicidal people (used to supervise volunteers on a suicide crisis line), and have not found one who didn’t have good reasons to feel like ending his/her life. Validating their emotions and experience while helping them come up with alternative approaches was almost always a simple and effective approach. But it required a fearless willingness to allow the person to feel suicidal if s/he wanted to. It seems the current paradigm does the opposite of what I found helpful. It invalidates the very real reasons behind the suicidal feelings, blames the victim, and offers one and only one option, which is literally forced down the client’s throat if s/he resists. I think the main purpose of this, and the main reason they don’t want their clients talking about it, is because they, the providers, really don’t know what to do about it and are terrified. It brings up their own vulnerability and humanity, and many have spent their careers trying to “be professional” by distancing themselves from their feelings, and ergo, from their clients.

    There is nothing helpful about the current paradigm. It exists to protect the clinician, and when it fails to help, it provides a ready justification for blaming the client instead of looking at their own behavior as the key element in the failure to help.

    —- Steve

  4. “There is nothing helpful about the current paradigm. It exists to protect the clinician, and when it fails to help, it provides a ready justification for blaming the client instead of looking at their own behavior as the key element in the failure to help.”
    Honestly, I think that is the main reason. I’ve seen so little actual caring in the institutional setting (it looks a bit different in private practices) that it is hard for me to imagine that the whole process has anything to it other than avoiding possible responsibility at all costs. I think it’s another fallout of the coercive system: when you have a power to force someone to follow your “treatment” and you don’t do it and something happens you’re immediately responsible. Giving the power back to people who are affected would change this dynamics.

    • I always say it would be really strange if your car mechanic failed to fix your car, but insisted on charging you anyway and claiming that you car has “repair-resistant fuel injectors,” but you should still come back next week for another expensive “treatment.” But if you don’t get better with whatever they prescribe, you have “treatment-resistant depression” and it’s not their fault, it’s yours. Why don’t they just admit when they can’t help? It is pitiful when clinicians lack the moral courage to simply be honest with their clients. Sometimes the most healing thing I did was to acknowledge, “Wow, that’s a really tough situation. I don’t know exactly what to do right here. I think depression is a pretty understandable response.” It can help for people to hear that it is NOT them, and that their circumstances ARE inherently depressing and would be for anybody, even if no one has a solution. Just to know it is not because you’re nuts can be a big relief. Unfortunately, psychiatry provides the opposite energy. No matter what happens, you’re supposed to buck up and be at least mildly cheerful, or else there is something wrong with YOU! It is sick and bizarre.

      —- Steve

      • A psychiatrist on a V.A. ward (I affectionately refer to as “the flight deck”) told me they couldn’t help me with an issue and I love him for it. How hard is it to say that something is over their heads and beyond their imaginations? It was like being given myself back. I was the arbiter of my trauma, not them. It doesn’t mean they can’t listen and try to understand, it’s not like a psychiatrist needs to explain something to a patient better than they can explain it to themselves in order to help.

        It’s the paternalism that is so quick to justify overwhelming force and psychological overpowering that claims superior knowledge and superior motivations of the psychiatrist over the contents of the patient’s mind and the patient’s values in their lives. When the psychiatrist is acting like a petulant child who is ready to punish you because you are not letting him have his way and are not becoming exactly what he says you are, then it’s kinda his problem.

        Who wouldn’t like to paid a good salary with benefits for that, while being absolutely convinced that they are the last and best hope, though? They’ve been trained to believe this.

        I’m not saying that psychiatrists never do good or that some psychiatrists don’t do a lot of good, just that the whole field is delusional and twisted with the psychology of dominance and force.

  5. You don’t find. No one is able to predict someone is going to commit suicide with any reasonable degree of confidence and even if they did it’s no reason to lock that person up and force drugs down his/her throat (or vein). If they asked me they might have realised I have a phobia against needles and injections (also iatrogenic from my childhood). Actually they did not have to ask, they could have spend like 2 minutes reading their own documents. Putting me intravenous drugs was the stupidest thing they could have done but of course me trying to pull the needle out was just another symptom of my disease, whatever it was that had to be treated with more needles. I never new you treat arachnophobia by throwing someone into a pit full of tarantulas. It such a pile of dung, one stupid idiotic thing done after another and in the end it’s your fault: the treatment was successful but the patient died…
    I really have a feeling that people who are the LEAST qualified to deal with people with “mental illness” are the so-called professionals.

  6. I keep forgetting the name of the “Rosenham” experiment, but fortunately for my drug induced memory, it keeps coming up on recovery forums. Every mental health professional should be reminded everyday to check themselves for confirmation bias and ask themselves if what they are seeing as symptoms of disease, may be what they’d consider a normal human reaction in other situations with other people, including themselves.

    I have heard that most suicide attempts are impulsive. If that’s true, then perhaps it makes sense to ask suicidal people if they’ve made plans and to ask them to have someone take away their weapon of choice or to give them up voluntarily. Until the passage of the ACA, it has been illegal for ER doctors to ask patients who are the victims of domestic violence if there is a gun in their house. It seems to me that if suicide is impulsive for most successful suicides than any intervention that slows down the suicidal person and asks them to focus on getting help with solving their problems would be preferable to seizing them and taking control away from them. If the person felt like they had the agency and resources to solve their problems, would they have been suicidal to begin with?

    I don’t think there’s one answer to that question, but I don’t see how overwhelming force would help a person feel like they have the strength to keep living.

    • I really don’t think taking a gun or knife away makes much sense. Having been suicidal myself I know that a person who has it on their mind can turn almost every object/situation into a opportunity. Unless you put someone in a padded cell there is really no way. I think the reason why most people don’t succeed is that they don’t really want to die – there are very few who actually get to the top of the building and jump and many of these people don’t even “show signs” to begin with. For most people it’s more of a cry for help but instead of getting help you just get more abuse, which really does not help.
      “If the person felt like they had the agency and resources to solve their problems, would they have been suicidal to begin with?”
      Sure not but maybe you should just ask them first what is their problem and if they have any idea what would have to happen to make things better. And sometimes just isn’t a solution. I remember what I really needed at the time was just to go away somewhere when I could be safe and did not have to worry about anything. The hospital was just not that place: it was awful, disgusting, boring (you were supposed to just walk up and down the corridor like a caged animal for most of the time), it created more problems for me than it solved (like contacting my boss, friends and my family without even asking me for opinion), the only answer to everything was to drug you, the treats, the restraints … I could go on. I had a pet in my house while they were keeping me there and I was scared that it will starve or something since I didn’t know when they would let me out – they didn’t care about that at all. If you ask me what they did wrong: everything.

      • Of course, anyone trying to intervene should listen. I’m so sorry for your experience, but glad you’re alive to tell the tale. I joke that I’ve never attempted suicide because it’s too much of an executive decision, but I’m not sure I’m joking.

        Do you have someone in your life who you can safely talk to about these feelings if you have them again? Someone you can stay with for a while? No one should ever be treated the way you were treated ever, much less at such a dark time. Let’s hope that the people conducting this study learn a lot and are able to influence care in the mental health institution.

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