Suicide: Shhhhhh

Editor’s Note: The following essay offers a candid discussion of the writer’s suicide attempt and ongoing recovery. We are publishing it because we believe it offers insight on suicidality and the need to remove taboos around discussing this topic.

Suicide rates in the United States increased by 35% between 1999 and 2016. We do not speak of it. In 2018, nearly 50,000 Americans died by suicide. We do not speak of it. What we hear even less about are the 1.4 million people who did not complete their suicide attempt. I am one of these statistics. What follows are my reasons for wanting to end my life and my journey through the system that “handled” me, and finally the responses of family and friends.

Ideation

As I was nearing my 79th birthday (December 31, 2019), suicidal ideation began to permeate my thoughts. I was certain that I did not want to be here for number 79.

I have always had difficulty accepting care. I was and wanted to be independent. For 38 years, I took care of others as a Licensed Clinical Social Worker. Then, on my birthday in 2018, I gave up my private practice and went into retirement.  In addition, I held a large estate sale, selling all of my collectibles and emptying my house of thousands of memories. Also, for 31 years I had been in a relationship with Jim, who had been a wonderful life’s companion but had many major physical challenges throughout our time together. Jim was about to turn 90 and I wanted to exit before he did.

Because I have had extensive therapy myself, I was aware of my deeper reasons for wanting to leave life. At the age of seven, I was sent away from my home and family in Budapest on a dangerous journey to escape Communism. My mother, stepfather, and two-year-old half-sister followed. But we were separated for over two years, years in which strangers took care of me first in Europe. During these formative years, I learned to be independent and self-reliant. I learned not to expect to be cared for in ways that a young child needs to be cared for because people were either too busy or too preoccupied with the aftermath of surviving World War II. It was only through the goodness of their hearts that they had something left over for a bewildered, confused, frightened, unhappy little girl like me.

As I was approaching my next birthday, I felt a decline in my energy; my life’s purpose had left when I closed my practice. I saw my future as one of having to need care eventually – care to live and care to die—and this felt unacceptable. I saw no way around it. I did not want to be warehoused into a nursing home and I did not want to go to what I consider a summer camp, those assisted-living places. My family is very small.

I do have a strong spiritual life and received a Doctorate in Divinity in my 60s. I relate most to Buddhism. I have wonderful meditation room in which I keep a holographic picture of Christ welcoming a weary soul. I held this picture in my hand as I was making my attempt to leave this earth. I’ve had this picture for many years and each time I look at it, it brings me to tears. It’s the way I picture myself being welcomed, taken into the arms of Christ who understands the plight of the weary traveler.

Preparation

The Sunday before my suicide attempt Jim and I attended the Bat mitzvah of our friend’s granddaughter. On the outside, all seemed normal. On the inside, I was actually anticipating Tuesday, when I’d planned to end my life’s journey. Meanwhile, Jim awaited the arrival of his oldest daughter from California on Tuesday. She is a very strong person with whom I have had great difficulty but who I knew would somehow help her father get through what was to come.

I had written everyone letters long in advance. I wanted to try to make sure that no one was left with feelings of guilt. In the letters, I left the name and number of the funeral home to call with instructions for my cremation. (I later found out that Jim, understandably, destroyed all of these letters except for the one to him, which remains in my computer.) In the letter, I talk about my difficulty deciding from where to leave and explain why my final choice was from our home. It said, in part:

For me, it has so much to do with my difficulty feeling a sense of belonging. I have throughout my lifetime had a terribly strong need to belong. That need was satisfied twice in my life. Once by the Hammonds, who really made me a part of their big family, and then later by Florence and her family who also brought me in. And of course, I have talked to you a great deal about how strongly I have been impacted by your claiming and making me believe/know that I belonged to you.

It never happened with your family and now, after you leave, that’s all that I’ll be left with. I definitely want to leave before you do. Maybe that’s extremely selfish. It probably is, but I’m so very afraid of being left. I just want to make sure that I leave first.

…. Please know that your love, for now over thirty years, has poured over me, protected me, encouraged me, supported me, and helped me stay alive.

… My biggest worry right now is that I get it right and that I really manage to leave the way that I am planning to. Because, really, no matter how much I love you, I worry about you. I just can’t take another day.

Jim goes to bed at 10:00 every night and takes strong sleeping pills. He then sleeps soundly through the night. So I was quite sure that he would sleep till morning, when his daughter was due to arrive.

At 11:00 pm, I went upstairs. I had my favorite pajamas on, navy blue with “Follow your Dreams” on the front. I made the physical preparations that I knew would soon kill me, and by 11:15 I was lying on the couch ready to go, holding the picture of the welcoming Christ. I did not feel regret, fear, anxiety, or sadness. I just wanted to exit. I began feeling some heaving in my abdomen. It was bearable. And then I heard our little dog barking at the bottom of the stairs. The barking was annoying and distracting so I went downstairs and let him up. The barking stopped and I went back to the couch. The heaving continued.  That’s all I remember.

Hospitalization

My next memory is of Jim and policemen. I remember grabbing onto the rail, walking down the stairs, being placed into an ambulance, and taken to the hospital. I don’t remember the ride in the ambulance, but they whisked me off to a nearby hospital, where I lay for over 12 hours with three different guards on shift duty.  I felt like I was being treated like nothing short of a criminal, without even being read my Miranda Rights!

I was contained in a small, very cold, dimly lit room in the basement. No food or drink. No one to ask for a blanket. I was able to see some movement of staff behind a glass window, but no one came out to talk to me. No one told me what to expect or what the next step would look like in my imprisonment. I saw a camera in the room that was aimed directly onto the bed that I was lying on, so there was absolutely no way for me to have continued with my suicide attempt. There wasn’t anything in the room that resembled either a rope or any sort of sharp object, so what was this costly security really all about?

I have since spoken to others who have survived a suicide attempt and learned that treatment such as this is pretty much standard.

Late in the evening, someone came to tell me that I would be transported to a psychiatric hospital in another town almost an hour from my home. I asked if there was a hospital closer because I had a 90-year-old husband who would not be able to make the trip. The answer was firm. NO. Finally, at 11:00 p.m., I was strapped onto a stretcher and in the dark, pouring rain, taken to the psychiatric hospital.

When I began to realize what had happened. I felt rejected by God. I was not wanted in whatever place might exist after death. I wasn’t angry. More confused and very much without a future plan.

I’d arrived at the psychiatric hospital around midnight and was asked to sit in a chair. Fifteen minutes later, a nurse told me that she needed to take a picture of me. I yielded because I had no choice. Then she asked me to follow her into a private room where she said that I needed to strip so that she could look at my skin. She said that she was checking for bruises, tattoos, etc. I am the daughter of Holocaust survivors and the stripping brought flashbacks. However, at that point, I was too numb to really care what they would do to me.   After this, she gave me a uniform, navy blue pants, and a shirt of questionable material. It was close to 1:00 a.m. when she gave me a little blank book and a pen with which I couldn’t stab myself. They couldn’t give me anything to sleep because, they said, they can’t dispense medication after 12. It didn’t seem possible to get any sleep there; it was incredibly noisy, with lots of patients sleeping in the hallways. When I asked the nurse why she said that people preferred that. Later I had four vials of blood drawn and met my roommate.

The patients could make phone calls out. And I did, every day. I called Jim. I told him how awful the place was, and he very wisely told me that this was my penalty for doing what I did. Somehow, his saying this made a real difference to me—and a difference in my attitude toward my confinement. It made sense that I did, indeed, have to suffer the consequences of my actions.

Psychiatric Treatment

I absolutely could not stand the psychiatrist. Somehow, she reminded me of a black widow spider, interesting but deadly. In our first meeting, she asked if I was glad that I was alive. At this point, I didn’t know what the answer should have been and gave the wrong one, the honest one. No. How could I be glad when I put so much effort into killing myself? She gave me a dubious look and said that she would see me the next day.

The atmosphere in the wards was very disturbing at night—lots of noise.  My roommate slept in the hallway but every night someone brought her to bed at around 1:30 a.m. with much talk and commotion. My phone, of course, had been confiscated. All of my phone numbers were in the phone, so even if I wanted to—and I didn’t— I couldn’t call anyone.

Today when I told the psychiatrist that I felt like I was in the film One Flew Over the Cuckoo’s Nest, she took serious umbrage.  She then put me on medication, saying that I was suffering from Major Depressive Disorder. She assured me that I would be with her for at least 10 days and after that she might send me someplace else. That’s when I understood the enormous power she had, and I made myself into a model patient. No more Cuckoo’s Nest!

My daily meetings with the psychiatrist changed. I began giving her the “right” answers. Yes, I was really glad to be alive. I am finding a purpose. And what is it? It’s to appreciate how much I mean to others. The medication is helping. That last one was possibly the only bit of truth. She’d put me on Effexor, plus Remeron for sleep. I was not sure how much the meds were helping, but I didn’t think they were hurting.

I watched the psychiatrist and I know she was watching me. She didn’t trust me. With good reason. I didn’t trust her either, also with good reason. She came into the common room daily and for a few minutes visited every patient. Except me, whom she called into her office for a few minutes. I wondered how these “visits” would translate for insurance purposes.

Life on the Wards

Throughout the day there was group therapy. The groups were all centered on Behavioral Cognitive Therapy, teaching people how to understand and control unhealthy thoughts and behaviors. I diligently attended every group because attendance was taken, and participation observed and recorded. And, I am certain, relayed to the psychiatrist.

The people on the ward were divided into sides by age– I was on the side of the elderly. There was very little talk on the old people’s side. But there was a great deal of noise, complaining, screaming, and yelling. However, because my mind was still intact, I had the privilege to go across the hall to visit the younger group. Some of the younger ones there completely distanced themselves from those of us who came over from the other side. Also, in order to get there, I had to ask one of the busy people at the desk to buzz me in. They didn’t like to be disturbed like that.

There was no eye contact at all in that place. The patients didn’t look at one another. The staff, too, did not make eye contact. They were either too busy, too tired, or too burned out. Therefore, if you needed some kind of attention, you had to advocate for yourself.

I have had a lot of work with great expense done on my teeth and at home, I am required to use the water pick in addition to flossing and using a tiny broom-like cleaning contraption that goes in between the teeth. Since my handbag was confiscated and under lock and key with the “instruments” in my bag, I was unable to access these innocuous dental aids. Finally, on day six, I spoke up, and very begrudgingly, my locker was opened, and I was handed my little wand. The staff person had to follow me into the bathroom to make sure I wasn’t in there trying to stab myself.

The staff was definitely overworked. Twelve-hour shifts! From their vacuous, tired eyes, it was hard to tell the staff from the patients. I doubt there were anything close to staff meetings where there might be some support for them and some debriefing, some talk of coping strategies. The staff seemed as uncared-for and as isolated as the patients, except they got to leave.

Transition

While in lockdown I had to meet with a social worker. The meeting with her gave me a bit of hope because she said that she knew my therapist and mentor with whom I had worked for over 14 years. When I met with her one on one, she was personable, available, open, helpful, and real. However, near the end of my confinement when I had to attend a group meeting for my final evaluation, she acted as if she had never seen me before. She was on automatic pilot, behaving mechanically and throwing printed-out questionnaires at me to make sure that I was not still suicidal. She was clearly caught in the system.

It was this social worker’s task to secure an outpatient program for me. Consequently, I found myself at a university behavioral health center one week after coming home. Ironically, I had worked as a clinician for that same center during the 1980s. This was hardly the full circle that I would have envisioned.  The program was three times weekly for eight weeks. I was also to check in for half an hour each week with a very nice L.C.S.W. whose goal, it seemed, was to ascertain that I no longer had suicidal ideation. I assured her, truthfully, that I did not.

At the center, I was placed into a group called IOP (Intensive Outpatient Program.) The group was facilitated by a competent, gentle social worker who made a heroic attempt in meeting the needs of a diverse group of us. A 55-year-old woman’s issue was that she wanted the program to help her get out of a nursing home in which she felt she did not belong. A young man with ongoing suicidal ideations sat mostly in silence. An extremely verbal man of 78 dominated the group. He was a retired bus driver and was left without a purpose. We had that in common. Not much else, but it turns out that he gave me the most to think about when, in his many musings, he proposed that people who were suicidal were fearful. I thought about that a lot and, for me, that’s absolutely true. I was fearful of becoming dependent, fearful of losing my autonomy, fearful of becoming a burden to others.

Aftermath

The reason for my coming out and sharing this experience is the incredible silence I’ve experienced around it. Not one person has mentioned my suicide attempt to me. Recently, I visited family members who obviously know about what happened. I caught their 28-year-old staring at me. My more-than-likely accurate guess is that he was wondering what was going on with me then, and what is going on with me now. I know that he, too, has had some mental health issues. The next time that I saw his mother and dad I brought up their son and told them that I felt that he might have some questions for me and that I would be glad to talk to him about it. I was assured that their son was all right and that it would be best to leave it alone.

And when I have opened up about it, there’s been more silence. When I told one of my good friends, a clinician herself, why I had been missing for 11 days, she said: “You’re crazy.” I know she didn’t mean to insult me; she just is not able to go there. She is unable to get it. She herself has a tremendously strong urge to live, and my guess is that when we have that, it must be very difficult to understand another person’s wish not to live. No one has been willing or able to go there with me.

This silence has left me very much alone. Alone is also one of the reasons I wanted to leave. Alone is probably one of the many reasons why people choose to leave. Something needs to change. Will it? I don’t know. I hope so.

My thinking really hasn’t changed all that much since the attempt. I still don’t like the idea of the journey ahead, in which I will have to face more of my vulnerability and fragility. Truthfully, I would be terrified of a second failure. And I do believe I have to learn the hard lesson of allowing others to care for me when I need it. I carry with me one of the prompts given to me at OIP: ASK FOR HELP. I’m going to call my friend Margie today and ask her to give me a lift to the supermarket! It’s a start.