How to Help Someone Who is Suicidal

Kelly Brogan, MD, ABIHM
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We have been conditioned to look upon the tender topic of suicide with horror. Perhaps because it represents a failure of our varied systems of control. Perhaps because we are, collectively, far from being at peace with the complexities of death as a part of the human experience. Perhaps because we have to pretend that we have never personally felt anything like suicidality in order to maintain the illusion that the experience of suicidality is pathological.

Suicidality is not one thing. It is not a symptom of genetic illness. It is not rare. And it is not simply a desire to end one’s life.

In college at MIT, I worked a volunteer suicide hotline called Nightline and spent many nights on the phone with people on the brink.

I learned that suicidal thoughts can be a desire to disappear. To not be instead of being. They can be a crisis of faith and a perception that everything is terminally wrong. They can be a deep grappling with whether the universe is fundamentally a benevolent or a hostile place. They can be the stuck belief that things will always be exactly as they are now.

I believe suicidality to be a nearly requisite expression of urgency for change that must be met with the promise of such change being possible. These feelings express the need for deep transformation that feels like a rebirth, replete with the labor pains and expressions of anguish and overwhelm. They are a scream that says, “This way of being, of living, cannot go on one second longer!!!”

Suicidality as a symptom of awakening

I know that you have helped a lot of people, but I just can’t do it. I’m done. I have nothing, my life has been struggle and suffering and I need this to be over.

And she meant it. Sonia was six months past her last dose of Effexor—a medication she had been on since she was 15. She is now 42.

At any given time, about 30% of my practice is actively suicidal. They know that I am comfortable with this. They know that I never have called 911. Never put them on a patronizing suicide watch. Never have drawn up some promissory note-type contract. I have never implied for one second that they don’t have what it takes to move through this.

They know that I am not scared of them or their feelings.

Rather, I perceive that something in them needs to die in order for them to be reborn and that this is their raising of the white flag. This surrender is the end of the end and the beginning of the beginning, if only we let the pain come up, come out, and leave. And it does. It moves. It changes. And often, what comes in its wake is exactly the kind of shift that could never have been prescribed, taught, or suggested. It’s deep spiritual growth.

In my taper process with patients, I aim for a strong, resilient physical foundation, first through a one-month commitment to self-care. I tell them that I am here to help support their body’s stress resilience and to offer them a taper process as free as possible from rashes, hair loss, menstrual abnormalities, electric shocks, body pain, and the myriad bodily signs of psychotropic withdrawal. But I am not here to make it easy or even tolerable on a psycho-emotional level. This is because I know that transformation is a necessary part of the alchemy of a successful taper. The part of them that believed in medication needs to be shed. But that part rarely goes quietly.

Transformation requires the death of an old self. Of old beliefs. Of old forms of security and identity. Transformation is disorienting and even terrifying.

Psych med-induced suicidality

The transformation process reflects a conscious grappling with suicidal feelings. These patients interact with the most existential of questions—to be or not to be. But psychotropics can also induce impulsive violence against self. Anytime I hear of a completed suicide in the media, my first thought is, “What were they on?” As in the case of Kim Witzack’s husband, Woody, who never felt suicidal a day in his life and was found hanging in their garage five weeks after initiating Zoloft, psychiatric medications have a poorly understood capacity to induce a dissociation from the soul. In fact, many of those who commit suicide in the setting of akathisia-induced impulsivity describe a sense of disconnection from their body and go on to hang themselves.

It is my belief that psychotropics can marry impulsivity and agitation with a mysterious rupture in consciousness, such that these acts of self-extermination make sense and are often completed.

In their description of psychiatric drugs as substances of chemical influence, Moncrieff and Cohen state: “…psychiatric drugs are, first and foremost, psychoactive drugs. They induce complex, varied, often unpredictable physical and mental states that patients typically experience as global, rather than distinct therapeutic effects and side effects.”1

How to help in the moment of crisis

1. Show what’s possible.

As Biggie would say, “If you don’t know, now you know.” It is particularly important to represent the possibility of medication-free recovery to those who are on meds and suicidal (or are recently initiated on them). Share these videos of radical healing, many of which depict histories of suicidality. Make sure those struggling know that suicidality can be an integral part of the experience of self-healing, and that moving through the portal of change can lead to something so grand and so much more incredible than their scared mind can show them in this moment.

2. Have no fear.

Check your own baggage at the door, please. Worry and concern are my least favorite words, you know why? Because when you worry about someone, you are dumping your unmetabolized fear into their already full lap. When we are in crisis, we need to be held in the light of possibility. We need to be reflected two things: “It’s going to be ok” and “You’ve got this”; not “I’m worried about you” and “I’m gonna call the police.” Fear-based escalation of this delicate situation is not going to help your loved one. Neither are more medications, the inevitable outcome of professional intervention.

3. Listen.

Do you know how healing it can be to feel seen and heard? Many who are suicidal struggle with a sense of existential invisibility at best and deep shame at worst. They feel wrong inside, perhaps permanently. They feel like exceptions, aliens, freaks of the human experience who simply can’t hack it. An unexpected antidote to that feeling is having their reality received. Quietly and completely. This is empowering because, through you, they can have a lived experience of the possibility that their ugliest truth is not too much. It’s not grotesque. They can see that you can handle it, receive it, and reflect back to them that you’ve really listened and heard them. Leave room for pauses, reach out a hand if that feels right, and if they are open to an “exercise,” set a timer for three minutes and just try to hold each other’s locked eye gaze. It sounds strange, but it’s the fastest way I know to drop into the heart and out of the mind. Within even one minute, they are likely to have an emotional release of some kind from this simple experience.

4. Normalize and contextualize the experience.

So far, you may have noticed that I haven’t recommended a lot of talking, advice, or guidance. In fact, when someone is in this kind of a fear state, their childself wounds are likely hemorrhaging all over the place. They don’t have access to their “rational” prefrontal cortex, the managerial capacity of the brain, because they are in their reptilian limbic system. Use simple phrases, the way you would speak to and soothe a child (without being patronizing). It can also be helpful to speak in visuals. Symbols are powerful, so normalize this inflection point in their lives with the invocation of a metamorphosis image. Refer to the way a caterpillar must feel, all gooey and disoriented in the dark before it has to squeeze out of the tight hole in a chrysalis to be reborn.

I tell my tapering patients: this is what it’s supposed to feel like. Change is confusing, overwhelming, and often terrifying. Your ego hates change and it is likely freaking out because it knows that a part of it may be about to slough off. It almost has to feel this way in order to lay down new tracks for a radically expanded experience.

5. Find meaning.

If you know this person well, you might invoke the power of meaning-making. I have observed that suffering ends where meaning begins. And that beyond normalizing the archetypal nature of self-initiation and transformation that feelings of suicidality can attend, the meaning of this particular juncture in their life can bring great organization and solace to the emotional chaos.

What do you know about them that they need to let go of? What’s not working? Can you reflect that they can handle this and that they are ready to move through the tight part of the birth canal? What programs, beliefs, and voices are criticizing them? Can you encourage them to turn toward the pain and personify it as their childself, or even just a small same-gendered child that is terrified and confused?

Often the suicidal “part” of someone is the internalized critic/parental voice admonishing them with shame-inducing epithets. When we individuate from our parents (energetically), when we try to reclaim our power and look at old programs that no longer serve, often this punishing voice rages… simply because it knows it may be silenced for good.

6. Remind them that they are simply feeling.

As a nation, we have very little experience with feeling. In fact, it terrifies us to encounter the raw power of unbridled emotions like anger, grief, and shame. The lengths we go to in order to avoid feeling subtend and define our modern day addictive lifestyles. But what if someone who is feeling that they can’t go on another day is simply a sentinel of a new kind of humanity? What if they are leading us all into a new way of courageously relating to the shadow, to our dark parts, and holding that in witness consciousness and love? It’s possible that the pain they feel is all of our pain… and the rest of us are simply numbed out.

Remind them, though, that they are simply feeling a feeling; probably an ancient feeling that they were told wasn’t safe to feel early on in their lives. Feelings are energy and they, by definition, transform and change.

Encourage them to reflect on the last time they felt crushing soul pain. Did it transform? Of course it did. And once it does, we have that lived experience to draw on the next time life brings us to our knees, so it will never quite feel this blinding again. It’s the experience that a naturally birthing woman has—almost every naturally birthing woman: that she wants to give up the moment the baby’s head is crowning and about to emerge. And then the baby is born.

Part of really feeling is acknowledging that we are not in control. To truly feel a feeling, we must surrender to it. The moment we do, it releases. But if you lock horns with it, the limbo state of resistance can generate a kind of ongoing misery that would naturally lead someone to want to opt out. So encourage this person to say “Yes, ok,” to the feeling as a starting point.

7. Move into service.

This may not appeal to all types, but it certainly has helped me in my darker moments. When I’ve been at the brink, I’ve taken great solace in the fact that the simple experiencing of my own pain will help me to help others in the future. This is because there is no shortcut to empathy. You can’t take a class on it, you can’t watch someone else experience it. You have to get in the muck and see what being that dirty actually feels like. And then, as a lasting gift, you are forever deeply connected to others who visit that place you were in. You become the wounded healer.

It can’t be a coincidence or an accident that so many of those who fully recover from psychiatry go on to serve others as healers. I had to create a peer support arm of Vital Mind Reset simply because these individuals wanted to pay it forward, and recognized the diamonds they had collected from their own coal mines. Those who can transform suicidality into service are some of the most powerful sources of healing on this planet.

8. Offer gentle support.

Language is powerful. That’s why we have been so careful with it up until this point. If you succeed in offering this person a glimpse of ok-ness, you might want to give them something to take them through the following hours. A simple mantra like “I can do this,” or “I’m ok,” or “It’s going to feel different soon,” repeated hundreds of times an hour can help to create the conditions for a shift in perspective. Similarly, encourage them to visualize themselves free of this pain—whole, healed, strong—to invoke the power of a seeing-it-into-being potential. A tapping exercise for suicidal thoughts, a meditation for crisis, and/or flower remedies for the dark night can also be a secondary line of support after you have established a connection.

Let’s evolve the conversation on suicide

Even if you don’t have someone near you struggling with this, open yourself to a new perspective on suicidal feelings. We must, as a collective, reorient around the crisis of self if we are ever to mature beyond our dysfunctional habits of unconsciousness. Together, we can hold individuals who are plumbing the depths of their pain and help them to transform it. We can show them that there is another, med-free way to accept themselves and that there is precedent for what it looks like to break free from psychiatry, its labels, and consciousness-warping chemicals. We need to turn toward this elephant in our sociocultural room and make room for dark feelings to be felt without reflexively freaking out, maligning, or pathologizing. When feelings are truly felt and accepted, they lose the capacity to translate into violence.

“The wound is the place where the Light enters you”. – Rumi

Show 1 footnote

  1.  https://www.bmj.com/content/338/bmj.b1963

33 COMMENTS

  1. “At any given time, about 30% of my practice is actively suicidal. They know that I am comfortable with this. They know that I never have called 911. Never put them on a patronizing suicide watch. Never have drawn up some promissory note-type contract. I have never implied for one second that they don’t have what it takes to move through this.”

    Some of your other points resonated as well, but this is the most important piece of this article that every mental health treatment provider (and concerned family member) needs to grasp. I was so used to being instantly (and reactively) locked up for ever bringing up suicidal thoughts, that it was shocking when my therapist allowed me to talk about this subject in therapy and be honest about how much I was struggling with the desire to die (and active urges and thoughts of how to do so). Ultimately, his decision to allow me to be the one in control of whether or not I kept living gave me the strength to keep living even when I could hardly see through the pain and fog of drug withdrawal.

    Nearly a year after I was off all meds, when I said I’m moving in a few months so I’d like to set an end date for therapy, he said you don’t need to keep coming anymore. But I said I wanted to come for three more months, he agreed to let me set a specific end date to work up to. He also agreed to let me see him long distance if things went south for me after my move. About 8 months after I moved, I called up and asked to see him and he said I hear you say you’re struggling but you sound pretty good and I don’t think you really need to see me. He was right. I liken this to a parent telling a kid to get back on the bike after they’ve fallen off. They may have a banged up their knees and bruised their ego but they aren’t injured. This gentle encouragement to get back on track was such a refreshing change to the normal psycho-go-round that is so ordinary in mental health treatment. No control on his part, just a simple willingness to sit with me in my pain, acknowledge that pain without taking the privilege of action away, and then gently encourage me to take the next step, and the next and so on until I realized I truly didn’t need him anymore. I wish everyone who was in crisis could experience this kind of assistance. I would not have moved beyond that chronic suicidality that I felt for so many years with the heavy hand that ordinary psychiatry and psychotherapy wield.

    Of course, I have still the existential angst that seems typical of these times. When there are so many things to worry about: constant threat of war, political division, social media madness, 24 negative news cycle, climate change, it can all feel pretty pointless. We’re all going to die after all. But that is different from active suicidality.

    Thank you for being one of the “good guys”, for being willing to take this risk professionally, for your clients and not just covering your a**. I always thought those ridiculous safety contracts were the biggest waste of my time and served mostly to absolve the treatment provider of any responsibility to actually help.

      • I’m glad to see this, Shaun. It’s hard though, isn’t it? Took me so long to wake up and take these steps for myself.

        Do you ever see your client in a toxic situation and they don’t see it and as a result, they can’t make the changes they desire to make and can’t see the double-binds? I find this to be such tricky territory. People defend their abusers/gaslighters all the time, which I understand how that works and why that would occur, but it feels like a Gordian knot. Any thoughts on this?

        • Have you tried helping them literally map it all out by introducing them to genograms? (I did one of my own life, looks like a freaking highway system, LOL.) I had one older lady I was working with who was essentially trying to make sense of her life. She had several chronic health conditions that were getting more severe and didn’t think she would live much longer. She *loved* the idea of a genogram and found the process so helpful in understanding some of the things that had happened in her family and how those had impacted her life. Such clarity! I saw her making shifts in her relationships, even though these folks were long gone and she was relating to them through memory. Helped her put her wounds into a larger context, of what was going on in the larger constellation of her family at the time and what preceded. And that helped her to take things less personally, because she could see a lot of the intergenerational traumas that had been in play.

          I wonder what it could do for somebody who has more time to re-vamp their life?

          • That’s so interesting, LavenderSage, I do believe that we carry ancestor energy and looking at this can bring to light so many of our present time patterns, and then we can make desired shifts. That would release sooo much past time energy and clear our space a great deal. Kind of gets it outside of ourselves, like a connect-the-dots picture, and then we can feel the truth of it within. I can see how this would bring clarity.

            So much of my work is with family contracts, seems to have the deepest impact on any individual, how could it not? It’s our first human blueprint to fall on our spiritual nature.

            So you do genograms? I’m not familiar with this process and how to read it, never done it before. Although I do know of my roots and I’ve integrated as much family information and dynamics as I know how into my healing, so I have done that work exhaustively, always fascinating. But if you actually do these, I’d be interested to know more because I could see myself referring people to you for this. Plus I might be interested in learning this.

            I’m in the process of gathering healers at this very time, we’re creating a healing network in the new paradigm. Do you still have my email? If so, please feel free to write me if you’d like to discuss this further.

            Thank you for sharing!

        • Hi Alex,

          Thanks for the question. What I tend to see often with clients is that they tell me they don’t believe they have the ability to leave or deserve a better situation. They also say that they also don’t have any other good options, which is frankly true when you live in poverty and you don’t have a social safety net. Many of my clients make choices with their safety because they are trying to get other basic needs met, like food and shelter.

          The DV cycle is a very nasty one. Many DV survivors know on some level that they don’t deserve to be mistreated, but they defend the other person because “I love him/her”. Love is often a justification for staying. Also, abusers are well adept at manipulation, so survivors genuinely believe that they “deserve” the poor treatment, and they hold onto the brief “good times,” hoping they’ll have more positive experiences with the person. Many abusers know that to keep their partner, they need to at least show some remorse and say “I’ll never do that again”, even though many of them don’t have the wiliness or skills to do otherwise.

          I try to be patient with my clients in these situations. I can tell them “get the hell away from this abusive person!” but that doesn’t help. I sit with them and their struggles, and try and help them to see their own worthiness and deserving to be happy. We examine safety and I provide information for DV shelters and the like. I gently encourage them to consider how the relationship is impacting their health, their goals, their relationships, etc. This process can take a long while, and sometimes people never make it out of these scary relationships. Getting out of these relationships is one of the scariest and most difficult things anybody will do. Also, it is a very common dynamic. At one time or another most women end up with someone who is at least mildly abusive. While men tend to be the abusers, that is not always the case.

          Additionally, often people who find themselves in toxic adult relationships grew up in households with poor boundaries, so these individuals are also confused about what healthy love looks like. They sometimes think being hit shows you are loved, or being yelled at shows their partner cares. I’ve had other clients who get parentiefied at an early age, where as a pre-teen or younger they were in the role of taking care of siblings or even parents. This is very damaging to a child, because they need to know adults are in charge. And when the adults are out of control, lacking skills, clueless, it is very confusing to a child’s sense of safety and security.

          Then in adulthood these same people end up often in relationships where they are going to be abandoned (not have their needs met) either emotionally, physically, or both. I think Adult Children of Alcoholics literature does a good job of explaining this dynamic and how it causes toxicity in adult relationships. We ultimately have to love ourselves in order to be in a healthy relationship, and if we weren’t shown genuine, healthy love as children, this becomes a very difficult task. When don’t trust our decision-making, our choices, or our experiences being in relationships becomes very challenging.

          I think DV situations are another symptom of a larger social problem–because feel powerless, scared, hopeless, frustrated, and so on because of the toxic and difficult world we live in. Human systems are flawed, like capitalism and governments, and this trickles down to all of us in one way or another. We feel the stress and sometimes lash out at others due to feeling powerless. This is why perpetrators of DV need support as well, in order to break the cycle of violence and manipulation. They need to be taught that it’s wrong to treat people this way, and that there’s a better way to interact with others.

          • Shaun, thanks for the thorough response. Like I said, I do get how these mechanisms work and how co-dependence can blind us to our own needs and deservedness. And, indeed, in a society where emotional abuse (which is what I’m really talking about here) is such the norm and at this point, seems to be woven into the fabric of everyday living, it can be really hard to spot and identify. Calling it out can be dangerous, which is exactly why I call it toxic. No boundaries, coming or going, can be ever so challenging!

            And indeed, I agree that social and political norms have created an epidemic feeling of powerlessness. That is the nature of oppression, and how it succeeds.

            So thinking about it now, I’d say it’s about knowing exactly where our power is at all times. I do believe we carry this with us inside, but trauma can separate us from this. Gaslighting, especially, can cause complete disorientation of sense of self, because there is so much vagueness and trickery involved, conscious deceit for the purpose of feeling the illusion of “power.”

            And I call it an illusion in this case because not only is it contingent upon lying and purposeful misrepresentation, but also it is based on having power over another person, rather than power in one’s own life, to make their desires manifest.

            This is where I say a lot of people don’t realize that someone in their vicinity is purposely trying to make them feel unworthy and value-less, to inhibit their confidence by always calling into question their personal reality. That will keep a person tethered and dependent for a long time.

            The idea is to not believe what others say about you while fostering positive self-beliefs, which is a core shift, to my mind, where the true healing lies. Once we heal unworthiness and realize our true worth, then our spirits heal and can take over from there. We are, after all, our own healers and guides, each one of us. Support is wonderful, but healing is done by our spirits. That is my belief, in any event.

            Thank you, Shaun, I appreciate the dialogue. My greatest hope for others is that they find their freedom and get away from chronic negativity, naysaying, and cynicism. Inevitably, it only serves to sabotage anyone in the vicinity. But I do feel folks need to wake up on their own, no one can do it for another.

          • Alex, well said. I would say that we can learn to “wake up” with the assistance of others. I do believe, for example, that MIA has helped me to shift my thinking in ways that would have seemed impossible to me a decade ago. I do challenge the DSM and “medication management” in ways I wouldn’t have done in the past.

          • That’s awesome, Shaun. Indeed, flexibility in thinking is a very helpful trait to embody.

            Well, I think inevitably we awaken thanks to others, for I believe we all play a role with each other in this regard, whether we know it or not. Often it is unconscious, I believe. Sometimes, it is by inadvertently triggering another with our truth, that’s always a golden opportunity for more clarity and shifting. In my practice, I call these “spiritual contracts,” which always have a purpose. Fascinating stuff!

          • Thanks Alex. While uncomfortable, I believe change is necessary to evolve my thinking. Anyway, we are all changing all the time whether we realize it or not!

  2. Thank you for reminding me that there are those in the healing professions who see what psychiatry is doing is the opposite of what is helpful, and who truly care about their patients. I do agree, withdrawal from the psychiatric drugs does result in an awakening, a spiritual journey, and a rebirth.

    Denial of the spiritual, and even the Holy Spirit itself, by the material world only believing, hypocritical medical professionals, and even some within the clergy, was a tremendous disappointment to me. Although, their disbelief and blasphemy, did not take away my belief in God.

    It just meant I had irreconcilable differences with those who only believe in the material world, like all the “mental health professionals” with whom I had the misfortune of dealing, so I had to walk away. It is a shame the United States has a profession that feels defaming, poisoning, and attempting to murder the “insightful” Christians for belief in the Holy Spirit is acceptable human behavior, however.

    I know lots of people dealing with a spiritual emergency that have been greatly harmed by today’s psychiatric industry, an industry which has overstepped their boundaries. But when a society gives an industry the right to murder any one they want, for any reason they please, outside the law. You will end up with an industry full of “professionals” who have lost their minds due to their unchecked, albeit undeserved, power.

    And absolute power, does indeed, corrupt absolutely. The number one actual function of today’s psychiatric industry is turning child abuse victims into the “mentally ill” with the psychiatric drugs, how sick can psychiatry get? But I do believe “A society will be judged on the basis of how it treats its weakest members.” And I wish I lived in a more civilized and mutually respectful society.

  3. I would tell them you have to keep your thoughts secret unless you want to be jailed.

    I remember when in hospital-jail, a co-patient woman was so upset she lost her privileges when she said (out-loud) that she was thinking suicidal. ” I am just expressing my feelings, what do you want me to do? Isn’t it healthy to talk about my feelings?”

  4. Thank you for your community service; you provide some great advice on comforting the afflicted in the community.

    However, you address mental distress as an existential problem rather than a social welfare problem, and discount the authenticity of emotions (“Remind them, though, that they are simply feeling a feeling; probably an ancient feeling that they were told wasn’t safe to feel early on in their lives.”). In contrast, I contend that all emotions are real, natural responses to distressful experiences and are important to confront and desensitize.

      • Upon reconsideration, I believe that existential problems are social welfare problems about interpreting the environment, and agree that typical social welfare problems can cause existential problems. However, I do not believe that existential problems are as common as other types of mental distress. I believe that poor nutrition and poor sleep habits cause far more mental distress than existential problems. More importantly, I believe that the reality of distressful experiences or distressful life circumstances (a hostile environment) is the predominate cause of mental distress. The article seems to imply that mental distress is predominately a problem of interpreting the environment; I consider it predominately a problem caused by hostile environments.

        More to my point is my contention that all emotions are real (natural reflections of personal experience) and should never be discounted.

        • I’d say all emotions FEEL real at the time, but that doesn’t mean that they are fitting the facts of the situation. The feeling of rage, for instance, could be distorted if someone gets violent with an innocent person. Domestic violence comes to mind. Anger about injustice, on the other hand, is appropriate and justified.

          I think mental distress is impacted by both the environment and existential realities of living. Hostile environments are triggering and scary, and questions like, what’s the meaning of life?; why am I hear?; and what is real? all can cause distress and confusion.

  5. The problem with society is that its fixation over the easiest Apollonian ego archetype destroys the brutal rest of psyche, including the realm of the death IN THE CENTER OF THE PSYCHE. That’s why we have psychiatry, because psyche and death is seen as invader in anti psychological spiritual society. The problem is that psyche is just psyche, but authoritarians use apollonian ego to terrorize psyche, using ideologies like theology, science, pseudo medicine/pseudo rationalism to destroy the rest of the psychic reality, like dionisian, Hades traits. We must remember that Zeus was god of the psychic reality, Zeus OR Hades, there was no Apollo there. And all the gods represents the REAL traits of the character, but in authoritarian reality, legal is only one of them – Apollo and Apollo is the the least psychological, and is the farthest from the death..No, go for help.

    The problem with the state is that, there is no human state. Because, the law, science,theology are anti psychological, they represents only their own interests – NOT THE INTERESTS OF THE HUMANITY, and religion represents the interests of the church. Human psyche is banned, and when human psyche is banned, what kind of human are we?

    And what kind of help can find someone whose psychological reality collides with death, if the society reject the death, death is seen as evil, psyche is seen as evil and Jesus overcome death…with alive people in the closed coffin.
    No one who thinks logical, will be searching for help from the todays inquisition which exists ONLY to destroy the traits that he represents. Psychiatrists represents Apollonian ego traits and apollonian ego hegemony (BUSINESS,LACK OF EMPATHY, APOLLO IS PSYCHOPATIC), they are not HUMAN psyche defenders and they reject the death in the psyche -its heart.

    If you search for stupidity in the psychic reality, go to Apollonians. Hades and Dionisus has got no time for kids. Authoritarian reality is not the same as psychological reality, and in my opinion psyche it is worth thousands times more. There’s no amount of paper money by which you can buy anything in psychological Hades. Money means nothing in the realms of death/psyche. The problem is not the death, the problem is the arrogance/MATERIALISM/nihilism/theology-transcendence of the authoritarian NORMAL EGO APOLLONIANS reality and their claims towards the REST of the psychological archetypes. Psyche means nothing. But it will be everything and when the psyche will means everything, Apollonian inquisition apparatus will say goodbye to DSM power, and THEOLOGIANS will say goodbye to illusion of spiritualism and the hegemony of the spiritualism over the HUMAN psychic reality.We must remember that psychiatry has got its own interests, and there are not the interests of human psyche, and that theology has got its own interests, and those interests are THE interests of the theologians, not human psyche. Humanity does not exists without phenomenology of the psyche and without the death. There’s only interests of the ideologies alien to human psyche.

    Of course that spiritualists and representants of the ego DICTATORSHIP feel extremely good in THEIR hell made for everyone else. but not for them, not for “normal”. Definition of the state. James Hillman was the only defender AND NOT THE ANOTHER SLAYER, of human psyche.The only worth war today is to bring back phenomenology of the psyche in the place of ANTI – HUMAN brutal primitive power of DSM, and this is the greatest of war. There’s no other war, and all the others means nothing. Don’t fight with the death, fight with those who want to destroy death,misery and then build an utopia of immortality ruled by brainless/soulless people and their money.

  6. Well, all I know is that sometimes when you really want something that’s not there, the simply inordinate inability to let go of wanting it is torture in itself. Sort of like wanting to flip an egg and attach it to the floppy drive as attachment (for E-mail of course), and finding you need a translator……

    I’ll read the whole article later, it’s rather conspect (conspicuous and circumspect) here. Lots of…

  7. As soon as I saw: “Worry and concern are my least favorite words”, I realized you \know. I am grateful (and very impressed, if I may use an ego-stroking word) that you have been able to comprehend this. So few people who have never been through psychiatric imprisonment get this.

    Expressions of ”’worry”’, and, still worse, ””’concern””’ (which adds a cold, bureaucratic tinge to panic) can be the tipping points into crisis. Why can people not understand this? Panicking is a deadly and contagious thing to do on the decks of the Titanic; it is still worse in times of internal distress. The incipient patient who knows in his solar plexus how much the legal deck is stacked against him, and how easily the psychopaths in his life can deal him a mortal blow while feigning ””’concern””’, instantly realizes his life is about to be dismantled, and becomes from that moment a hunted animal. The panic of others is internalized, so that the prophecy becomes self-fulfilling. In such cases—-it is very hard to sleep than while you are on the run, metaphorically or physically: I have read of ordinary people becoming ‘ ‘psychotic’ ‘ while in hiding or in flight—-suicide can seem like the only way out, especially in our era of “”Assisted Outpatient Treatment””, which threatens a lifetime of something possibly worse than physical imprisonment.

    One thing I would like to know is: what words \do work? What can we tell our surrounding ego-bound hand-wringers to say? All I can think of is: “I love you, and you are free to do as you wish.” And if they want to express their difficulties with your behavior to simply say: “This is too much for me, right now.” But somebody must know something better….

    One thing Dr. Brogan omits because possibly she has never experienced it for herself is the need for compassionate \looking. Eyes can destroy you, and eyes can also heal. The conventional psychiatric gaze is especially punishing, only a few notches down from the infamous sociopath stare.

    (I am unable to find an alternative for the word ‘sociopath’, even though I try to avoid any term from psychiatry whatsoever; the concept it refers to is for all its medicalismo simply too useful. When you are in a hospital that will not turn off the lights in your bedroom, and also forbids sleeping masks but allows pens and toothbrushes, you realize there are sociopaths somewhere in management. I feel like sociopathy and narcissism are the authorized mental “disorders” of our time. They call the shots, and they are especially hateful of what they call depression, mania, and schizophrenia. And they can be found everywhere power concentrates, and will emerge from the woodwork as soon as the smell of awakening is in the air.

    I have sympathy for sociopaths and narcissists: they need healing as much as anyone else. But for their own sake and for ours they need to be kept away from power. It is time for our society to realize that leadership, and credentials like the MD, are not lifetime entitlements. The history of sociopathy in psychiatry would make for an interesting read; Hannibal Lecter is a cultural touchstone for a good reason, alas.

    Dr. Brogan, writing like yours is almost enough to redeem that discipline.)

  8. Dr Brogan,
    your work is so important! thank you for giving we psychiatric/psychosis survivors a language of credible science to dispute with our psychiatrists in! I cant wait to bring your book to my Dr., Daniel Suzuki of Las Encinas Hospital in Pasadena (And San Marino Psychiatric Associates of South Pasadena). I hope now that I can explain to Dr. Suzuki in a biomedical, scientific language he can understand, we may perhaps be able to connect on a level where I can actually begin to express my so-called psychotic experiences, which no medical professional has every actually bothered to inquire of me about! Perhaps now my spiritual insights will not be misinterpreted by the people around me as grandiose bipolar mania, delusions, etc., and the empiricism of actually listening to a person’s experience, will prevail! Thank God for you Kelly Brogan! God bless!

  9. Thank you so much for this article. It absolutely spoke to me. I’ve been suicidal myself and experienced all the horror and shame-upon-shame that goes with it, from professionals and family. I also know at a very deep level that my suicidal times were exactly as you say here – a response to seeing and feeling the shadow. These times in my life have indeed proved to be transformational. I now run creative writing workshops, often with ‘shadow’ themes, and I also love Leonard Cohen’s ‘There’s a crack in everything, that’s how the light gets in’ – and this poem by Michael Leunig…

    WHEN THE HEART
    When the heart
    Is cut or cracked or broken,
    Do not clutch it;
    Let the wound lie open.
    Let the wind
    From the good old sea blow in
    To bathe the wound with salt,
    And let it sting.
    Let a stray dog lick it,
    Let a bird lean in the hole and sing
    A simple song like a tiny bell,
    And let it ring.

  10. This article resonates with me. Also, I agree with Alex about “toxic environments” even though I don’t use the word “toxic” as social metaphor. I choose not to because I fear it is too offensive to some people who have been called “toxic” themselves (i.e. “You are mentally ill,” which is really what is under that statement).

    Either way, for me, therapy was that toxicity. My therapist was manipulative, gaslighted me, threatened me, kicked me out of her practice and then, begged for me to come back, used sectioning power to scare me, accused me of things I never did, and made me play with stuffed animals. She regularly accused me of lying when I wasn’t. All this made me feel like I was very stuck. Stuck until I realized…THIS IS ABUSE! And I got out.

    Withdrawing from her narcissistic abuse was absolute hell. This was six and a half years ago. That was when I was actively suicidal for about a month. Then, a year later I had anorexia really bad, and I know her abuse (and other people’s failure to hear what I had to say about it) definitely was the cause. (Anorexia and suicide are not the same thing, please do not confuse. You die of it, but you die of a lot of terrible things out there.)

    Then, slowly, I got better. I got over her.Yes, getting away was the answer! I wish I didn’t have to nearly die to find out. But I am grateful and I have a decent life now. Really good.

  11. Kelly,
    What you have written here is SO IMPORTANT. This advice to other practitioners is incredibly valuable; I do hope you offer it in book form to your colleagues someday, if you have not already done so. I am a long-time veteran of bio-psychiatry and talk therapy as I have had Recurrent Major Depressive Disorder since I was 16. I am now 59, and have been through many, many horrible, deep, dark, suicidal depressions. It’s truly a miracle I’m still here. The fact that you, as a therapist, encourage your patients to feel and share their feelings is so very important. I have always said this. In order to move through “the black hole”, as I call it, you must first face it and fully acknowledge it. Don’t be ashamed of what you are feeling. Your feelings are your own…you are allowed. Too many therapists avoid this topic, making therapy an entire farce. If a patient cannot discuss their pain, what is the point? So the patient goes into each session and lies, telling the therapist they do not feel suicidal for fear of “getting locked up again”. I’ve been there, done that many times as I’m sure others have and still do. So essentially, you are still isolated, alone and conflicted with all your horrible feelings and therapy is meaningless. We, as a society, desperately need to “get out of the dark ages” of both psychiatry (God knows) and therapy. Until there is such honesty and authenticity, I’m afraid the alarming suicide rate in this country will continue to skyrocket. I also wanted to mention that I see no harm in making contracts with patients. I recently worked for a private mental health practice (as secretary/biller) and the counselors there did make contractual agreements for various reasons, including suicide, very rarely, but they did do it on occassion. I see no harm in having a person sign a contract although I wonder how effective they might be while someone is in a deep suicidal depression. I didn’t care about anyone or anything when I was suffering, so I’m not sure signing a piece of paper would have mattered much. Then again, perhaps it would make a difference for some people.

    • I never used a contract per se. I simply asked the person how long they believed they could go without going through with suicide. I’d then invite them to contact me again at that point and we could talk some more. It was more an acknowledgement of their own capabilities. I don’t know if it helped or not.|

      Having been suicidal myself, I agree 100% that dealing with the strong emotions attached to that urge was the MOST important aspect of any kind of therapy or helpful assistance I ever received. Along with that, validation that it is OK for me to feel that way and in some sense a NORMAL experience given my history was also extremely helpful.

      I used to work at a crisis line, and we got calls all the time from people who felt suicidal but could not tell their therapists for fear of being locked up. Same with people who cut themselves. I often thought that having therapy with someone you couldn’t talk to about how you’re feeling must be worse than useless, actually kind of re-traumatizing.

      Thanks for your insightful post!

      • Steve it got that way with me, too. In 2012 I told no one, and then, did not follow through. That was June/July. By September I was totally fine, no help from “them.”

        After that, a year later, to be falsely accused of suicidality and theatened with long-term lockup while I was in kidney failure was scary, upsetting, and deeply traumatizing. Nothing I could say or do would get them to listen. What a bunch of arse-holes. No, assholes. I said it.

        • Oh, you’re getting ANGRY again! We can’t have ANGRY patients around here – you’re supposed to be HAPPY because you’re getting such wonderful help. (But not TOO happy, of course – that would be manic!)

          Good for you for saying it. There are plenty of rank assholes out there, and some to whom far worse terminology applies.

  12. Actually suicide is only painful for those left behind. It is a way out. A self approached euthanasia. I think it is entirely an individual’s choice.

    If there is nothing after death then that is fine. If there is life after death then that is fine also. If there is life after death then I am afraid we are all going to die and travel over anyway.

    It seems that mankind is so hell bent on saving lives. Yes I believe in life but I also accept that death is a part of life. If we didn’t have mankind constantly interfering with death then maybe it would be a better world.