It takes an extraordinary effort not to act on intense suicidal feelings when they occur. Sort of like fighting a strong desire to sleep, except this is not just a sleepy state but one where you can’t help it at all. It’s like having to pull over to take a short nap just to stay safe on the road. When I start experiencing that sleepiness and realize that there is no way to pull over and I have to keep on driving, that’s when it resembles fighting the suicidal impulse.
Here it comes again: the pull, the force, the total invasion of intense suicidal feelings. It’s an obsession. I obsess about how I am going to take the car keys when everyone is sound asleep, and how I am going to drive into a wall. Then I obsess about how I am not a good driver and how it’s not going to work because I’ll just end up disfigured and injured from the accident. But I continue to go about my day, except the time dimension changes drastically. When I feel that extreme sleepiness I also experience time as passing painfully slowly. I have to push myself to get through the day, to take care of my kids, to respond, even to drive. But I know that soon I’ll have a nap and afterwards I’ll be normal, or that night is coming in a few hours. However, when I am that sleepy at least I can say out loud that “I am very sleepy, I can’t function normally” and there is a huge relief in just being able to say it. Even if only to myself.
It makes it bearable because it’s not a silent suffering anymore, once you name it. Not unlike other humans, I’m as inept at silent suffering as I am at devising ways to kill myself… Here, for me, the time is both painfully slow and awfully silent. It’s like moving through some thick cotton wool that I have to push aside just to take the next step. But I can’t share the feeling with anybody, and friends and family keep saying the usual phrases like “see you tomorrow” or “I’ll talk to you Monday” and it’s so agonizing to hear that. Agonizing because I am trying to make it to tomorrow, but at the same time I don’t really want to make it to tomorrow. Yes, the famous ambivalence of the suicidal person. And Monday is an eternity away when I am intensely suicidal.
People have the misconception that suicidal intent grows stronger and stronger and then at some point it reaches a “point of no return.” In my experience, there is definitely such a point but it happens surprisingly close to the actual suicide attempt. The ambivalence and the fighting of the impulse can go on for me for a very long time. Months, if the feelings are constant. Or if the feelings come and go, the obsession can come and go, together with the ambivalence.
And at any point during this ambivalence I am open to the “right” contact. Some contact is very painful and can make my intent worse, but some could make the pull, the invasion, less intense — it can halt me. No, it won’t stop my ambivalence, it won’t “change my mind” right away, but it could take the pressure off a little bit. It would make it easier to move through that cotton wool ball because I’ll be more “on this side” (the side of life).
While stuck in the cotton wool a person could still attend a psychotherapy session and a few hours later make a suicide attempt. I did.
Just because I didn’t really want to fall asleep, I just wanted to stop feeling sleepy, that’s all. I desperately wanted that “right” contact, and as much as I felt the therapist was useless to me I was willing to give her another chance. Moreover, when I was seriously contemplating taking the tons of psychotropic pills that I had in my house at the time, I picked up a phone call from an unknown number. Yes, I was alone in the house with the kids sleeping and I picked up a call from a total stranger… simply because any contact is potentially the “right” contact. And nothing is worse than silent suffering.
So, moving through the cotton wool, being inside the cotton wool ball of suicidal feelings… the thickness of it is about fighting the instinct, the force that keeps us alive. This fighting force is immensely strong, even when the suicidal feelings are unbearably intense. It’s the force that makes people turn away from bridge rails and roof ledges; it’s the pull that pulled me away once when looking down at the street from an open high-rise window.
Yes, it’s scary, it’s unnatural and it feels wrong to obsess about choosing to die, and so comes the ambivalence. And not because my kids need a mother and my husband will go crazy without me — this idea doesn’t work for me when I am intensely suicidal. I know others have written that being reminded of their loved ones has helped them, but for me it only works when the feelings are just starting to build up. Once I am inside that ball only “I” exist and so any reminder about my commitments is beside the point. It’s like trying to guilt me into staying alive when I am so desperate for relief from pain, there is no more space for “the Other.”
But the ambivalence is between the longing for relief from the pain of existence and the pull of life force that is inside. And the “point of no return” is when this life force doesn’t exist, doesn’t matter anymore, when pain is all there is. And so to end the pain is all there is.
Like when you can’t stay awake, you know you are falling asleep but can’t help it.
Talking about suicide being a “selfish act” is not just judgmental, it’s plain inaccurate. In that space, when I’m falling asleep, there is no morality and no choice — it’s a physiological act. Once you can’t keep yourself from acting on your suicidal feelings, once that pain of being here is stronger than the life force, then you are just following through with your plan. If your plan is solid chances are it will work, like with men who are familiar with the use of firearms. Many times it won’t work because it’s damn complicated to end your own life. There are logistical challenges, and we’re not programmed to do that.
So the talk about “selfishness” could only relate to fighting the impulse to fall asleep, the actual process of moving inside the cotton ball of suicidal feelings. If only people in that state could take the perspective of their loved ones… if only. But they don’t seem to be able to, most of the time; at least I can’t. And the idea that kids who are suicide survivors are so much more likely to attempt it themselves because they see it as a legitimate way to end suffering does not help me either, even though it’s a fact.
I wish I could say that being deeply religious helps — if anything, it’s counterproductive for me. Religious people often write how they always knew they would be killing their soul, their afterlife, and how it makes them have this visceral reaction to their suicidal feelings, and that stops them right away. I once read that going ahead with this “plan B” is like dropping by on God uninvited, and I laughed at that and really loved that saying. And so when a thought of suicide just crosses my mind I think of that quote and it helps.
But when I am already inside the cotton wool ball of intense suicidal feelings, sayings like that don’t work at all. At that stage, I just obsess about the fact that God is the only one who truly understands and truly knows how much I am suffering and how impossible it is for me to keep on going. About how he would never judge me, and never punish me for doing it because he knows for real, he truly understands how desperate I am. I start imagining what a relief it would be to come to God and be away from any demands placed on me. And most importantly, what a relief it would be to just be free of pain. And to be loved, simply loved as I am.
I know my husband loves me like crazy but it doesn’t matter. It doesn’t matter because he doesn’t engage with me; he doesn’t want to understand me when I am inside that cotton ball. He is scared and he just wants me to get out, miraculously. And there is no miracle here; there is only one solution to getting me out of this cotton ball — to get my life force stronger than my pain. And I don’t know of a better way to do that than for others to get inside the cotton ball with me. Yes, to try to understand me “as is,” to understand how I feel about my pain and my suffering. And that desire to be “with me” is what feels like the most loving, most caring act ever. And if somebody is willing to talk with me and take my mental state seriously, that feels real, that empowers my life force, which keeps me “on this side.”
So, what feels like love when I am suicidal… is the same as what feels like being loved when I am living a regular day, struggling with being an immortal soul in a physical body. It might sound shockingly simple but it’s true. I need the same love that feels like love for us all, only it’s so much more intense, simply because it’s enormously exhausting to love somebody who is suicidal. Such a person is self-absorbed and self-centered since people in pain tend to think, feel and speak about their pain, so it’s one-sided. I need somebody who will push through that thick cotton wool ball with me until that moment when we can toss it away altogether. Someone who really tries to look at this world through the lens of my life, not theirs. And to do so they have to be so sincere, so intense, and so thoughtful. They can’t pretend that I matter to them as a unique person — that I matter, not just my absence. That it’s not about my function in this life, but about my soul, struggling to stay in this body, on this earth.
When I feel suicidal, that’s what’s in my mind’s eye — these feelings take my whole mental space and there is nothing else I would rather talk about. But I can’t. The common misconception is that people don’t talk about it because they don’t want to be stopped, but that’s not true. The reason I don’t talk about it is that I don’t want to be punished for my thoughts, for my feelings. I don’t want to be locked up, especially if I have had previous experience being locked up. But it goes deeper than that — it’s not just about being committed or being forced to take drugs I’d rather not take because of their detrimental effects on my body. It’s about being labeled as a “disorder with legs” as some would call it. It’s about my suffering being reduced to a psychiatric diagnosis. I desperately want somebody to see my identity and the narrative of my life behind my symptoms. And I definitely don’t want to be told I’m “calling attention to myself” or “can’t cope.” So it’s primarily about never being considered “trustworthy” again.
We have a term for this in English, the term “quitter”… we ostracize people who don’t want to persevere in the face of pain and adversity, and no wonder. It seems that preserving meaning in our lives does require significant measures of pain at times. So either I, the suicidal person, simply can’t go on, and then I am just sick, or I don’t want to, which signifies that I don’t share society’s commonly held belief in life being meaningful; don’t care to persevere with life’s struggles in order to maintain that meaning. Or else I am just too weak emotionally to persevere — a version of being sick, so back to the first explanation. It sounds like a computer algorithm, but from talking to many people I have come to believe that’s how people construct suicidal impulses in their minds. So what’s left is that if I am not sick, not ‘disabled’, then I am a rebel who doesn’t share the belief system of the “rest of us” who never seriously think of quitting “the whole thing.”
So if I can’t keep on living and persevering like the rest of society I am either “too bad” or “too sick” — in either case, I don’t belong among the rest of you. Not until I fix my “attitude.” And so I suffer in silence, so as not to be punished and “canceled” in society. Exactly because I am ambivalent, I still care about “this side” — I still do care to belong.
And while silently suffering I still know I “don’t really belong” because I’m experiencing such intense, uncommon feelings. Although the truth is we don’t know how actually uncommon these feelings are since there is a huge taboo about the subject… But think about it — what could make me feel more desperate than wanting to belong and knowing in my heart I just don’t?
What people don’t understand is that the more pain there is in one’s psyche, the less space is left there for any meaning. People do get it with regards to physical pain. Everyone who ever experienced severe physical pain, like migraines, knows that it takes over your whole being, that life becomes just all-consuming pain and nothing else. The same “all-consuming” quality goes for soul pain — it’s no different. When somebody is intensely depressed there is nothing besides the dark cloud of depression that presses them into the ground, which has been written about very eloquently in memoirs like Darkness Visible. So, there is no meaning — and therefore nothing to preserve, nothing to struggle for. The famous hopelessness of a suicidal person is about exactly the fact that this meaningless will never change. It doesn’t feel temporary when it’s happening to me. And once there is nothing to struggle for, suffering becomes pointless, and then there is no conflict between suffering and meaning, and so the thought of ending the suffering seems like the most natural conclusion.
So, a suicidal person wants relief from pain, obviously, but at that point there is no conflict, no meaning that makes life worth living. Only once there is less soul pain can meaning fill the freed-up space. And I feel less soul pain if somebody gets inside the cotton wool ball with me and is willing to share my pain. True understanding, true empathy is sharing. Practical help is also sharing. But most of all I need somebody to believe that I matter, that my life makes sense, that it has meaning. When I don’t believe myself that my life can be meaningful, I need somebody who does believe in it — who really believes in it. And so the only way to bring me “to this side” is to reduce pain in those three ways of sharing my life story — true understanding, practical help, and belief that my life has meaning. All three work first and foremost by breaking the isolation, which is why I call them “sharing.”
Once I feel more connected to people, even to only one person, I automatically feel more alive. The worst part of soul pain is being alone with your pain, simply because we are wired to feel connected. And once there is less pain I can find a way to connect more to people, even to reach out, risking rejection — this requires some life force. So it’s a circle where one reinforces the other. And once there is less pain, more connection and therefore, again, less pain, I can jump into life and find my place in it, and not feel so disconnected. Once there is this true, intense, sincere love, then my life force, the force that keeps me “on this side,” can take over and the suicidal feelings will abate or disappear. I don’t know of any other way. Well, there are psychotropic drugs. But they don’t work for everybody, and they can stop working even for someone for whom they had worked for years. For some, they can even make it worse.
Even a suicide watch in a hospital would not generally keep a person for more than a month. So instead of a physical 24/7 presence, you could do only one thing humanly possible to halt me from going down that path to attempt. And no, unlike a hospital suicide watch it’s not a guarantee, but the best thing you could do under the circumstances. It’s too big of a job for one person, although it often falls on one person’s shoulders. After all, if one of the main themes of suicidal feelings is isolation then it’s no wonder others are not interested in providing me with empathy. I need to trust somebody to be able to really share with them, and such trust only grows as a reaction to genuine interest. To be genuinely interested in somebody on the verge of falling from “this side” requires courage, and also requires risk-taking beyond belief. It’s scary to risk loving somebody who might be gone soon… Risking the tremendous anxiety of possible loss, possible abandonment.
No wonder that when I say that finally giving into suicide impulses is not “selfish” of me it goes against all that the suicide loss survivors experience. They feel angry, angry more so than anything else. They feel that because they were abandoned, in a sense, by their loved one. And if I were to suggest that suicide happens to people just like cancer or car accidents happen to people, that doesn’t quite sound right to many. We don’t like to assume the victims didn’t have any choice, that would be too deterministic — then loss survivors might blame themselves for not preventing the attempt. And some suicide loss survivors admit that it’s easier to be angry with the loved one who died by suicide than to accept any blame. Self-blame for the death of a loved one is obviously a terrible cross to bear. And so it’s easier to feel anger than grief. Grief means arriving at some closure, acceptance… And it’s hard to do with those themes that are as taboo of a subject as suicidality. Grief is a communal act, it can’t happen in silence.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.