- Education and Science»
- Psychology & Psychiatry
Suicide: experiencing it, working with it, being with it.
Suicide as a choice
Suicide is a choice that some people make but it is an option that many consider. It is, at some basic level, one of the most fundamental choices that all of us make. It seems that there is a perception that the dominant choice is to live, and therefore an implicit assumption that the choice not to live, is somehow abnnormal.
However, as the saying goes: death is the only sure thing in life; so if death is inevitable, what is unusual or abnormal about taking control of that...making choices about it?
Perhaps we are all making this choice, all of the time?
Choices, choices, choices...
The London Marathon 2016
Risk and reward
Many of us enjoy and grow from those experiences that bring risk into our lives. Many of us also enjoy spectating at events where others take risks - such as sport and physical challenges.
When we do things that bring us close to our own mortality we are invigorated and empowered - the most profound experience of this, in my opinion, is giving birth, for both the mother and birthing partner. We feel we have overcome something and achieved something.
When we observe others expending huge effort or taking risks, we are often prepared to pay, or to contribute, either directly or to charity. And it is at times moving to see how people are prepared to exert themselves and push the bounaries of what they previously thought possible for themselves to raise money or awareness for others and their needs.
People often talk at such events of feeling proud of themselves, or impressed and respectful of others, and often take the time to thank those who have supported them, who have made their achievement possible or inspired them to begin the journey that has culminated in this experience.
Although there is huge variation between groups and individuals, I think it would be fair to say that many of us in the West have a serious problem with death. Much money and time has been invested in prolonging life and prolonging the 'quality' of life.
Both the state and religious institutions (some not all) have contributed to this problem, and now there is a huge machine of people and processes that convince us that being young and youthful is the primary aim. It was not always so.
It is true that in the '1st world' many old people live alone, are ridiculed, taken advantage of, and excluded from many sectors of society - most notably the workplace.
Somehow, we have trodden the unhelpful path towards a fear of death, and in some cases into a neurotic avoidance. Into the bargain we have developed an intricate and revered practice of examining the detail of life that we call science. This has become one of the most important and dominant models of our time. And the fact that we cannot interrogate death in the same way, leaves a glaring discrepancy of 'knowledge'. This only inceases the fear. And drives another neurosis: that of which we do not know or are uncertain.
Responsibility...who'se is it?
Alongside this is the development of an idea that someone always has to pay, that accidents should result in an investigation of some sort and that following this, someone should be held accountable. Whilst at some level this is true and that it can be a helpful process to enter into, this kind of interaction (often presided over by lawyers and the insurance industry) is dependent on the presentation of the available facts and the representation of these facts by individudals with competing agendas. Often what results is a lengthy process in which some people charge and make a great deal of money, without any resolution to the problem.
Many years ago now I was involved in a bad car crash. I was travelling in broad daylight along a straight road. I was T-boned by another car that pulled out into me past a stop sign. He hit me half way along my car so it was clear that he pulled out as I was passing. There were no witnesses, but my car was written off and I was badly injured. I recall the other driver commenting as I was removed from the car "don't worry love I've crashed every car I've ever owned" and this was witnessed by the paramedics and ambulance crew that removed me from my vehicle. Given the facts it is indesputable that he was "at fault" and that there was something that caused him to pull out into my car and cause damage and injury. After many months with much tooing and frooing between lawyers and insurance companies, he was let off on a technicality (something to do with the road, the details of which are too lengthy to explain). He was not held responsible for what he had done and he didn't apologise. If what he said was true about crashing all previous vehicles, it suggests that he had a problem with decision-making in his car at the very least and yet nothing was done about it. I felt aggrieved and insulted...and unsafe. It took me some time to recover physically and also to regain my confidence in a car.
So how is this related to working with suicide?
Well, that experience sticks in my mind, particularly when I make a bad decision in a car - when I prioritise changing the track on my iPod, speed, attend to my child or otherwise allow myself to be distracted. I know that at times I make a split-second decision that takes my attention away from what I am doing in the car and could result in a collision, with all that that means. It shocks me and I chide myself, but from time to time it happens. I know what it is like to be left feeling hurt by that kind of thoughtlessness.
I also know what it is like to contemplate suicide and I know what it is like to be bereaved by suicide. It is not a thoughtless act, it is not an accident, suicide is the result of a series of events and decisions, often at the end of a hard and difficult path.
For me, it was something that seemed like an opportunity to end the suffering, my suffering. It was a selfish thought and would have been a selfish act. It was about my feelings, my experiences and my needs. It wasn't to do with helping or hindering anyone else. It was also borne of desperation and deep pain, it was an exit from something I felt, at the time, was insurmountable. It came out of a long period of ambivalence and confusion, and when it arrived in my mind I felt a huge sense of relief and a clarity of purpose. There were many people around me and I doubt if any of them had any idea that this was in my mind. That was the way that I wanted it. My privacy was what kept me from acting on the thought. My need to keep it secret overrode my need to exit the pain and thus I am here writing about it all these years later. If I had done it many people would have been held responsible as I was still at school. And yet, I don't believe it could have been their "fault" as I did everything I could to hide it.
Being bereaved by suicide was a totally different experience. I felt anger, confusion, terror, hopelessness. It stopped me thinking - there was none of the clarity or distance that I felt I needed to make decisions about how to respond. It was disorientating, and debilitating. There was no way to negotiate with it or the person who was gone, no place to take my questions, no one to turn to. Even others I knew who had experienced suicide seemed far away from me. I felt alone.
Working with Suicide
For many years, my work has involved working with people who express suicidal thoughts and feelings and for whom it sometimes results in taking decisions to act in ways that will end their life. I feel deeply honoured to do this work as I know, for me, that it would have taken huge courage and vulnerability to share this with someone and to ask for help. I also know that it comes from a place of pain and hurt and that it is not something that arrives in a happy and content mind, and so I also feel respectful for what those people that I work with, live with and bear on a daily basis.
One thing I do not feel is responsible. I state this explicity and I am clear about how I feel about the work. I talk with people about their choices and how they see different solutions. I don't force choices on them and don't try and take away their responsibility for managing life in their own way. But I know that the organisation that I work for, would hold me responsible at the point at which any of the people that I work with did take their own life. This has happened and the manager who spoke to me about it didn't ask me how I was or what the impact was on me. The conversation was about the organisational need to address the incident and the capacity that I had to defend my practice, and about the managers need to change processes - as far as I could make out this manager had stopped thinking in the face of this tragic incident.
So you see, suicide has powerful effects on the mind - sometimes it seems to clarify and clear it, and sometimes it seems to disrupt it and disturb it. And it does powerful things to relationships too, particularly if you take responsibiity for keeping someone else alive. In many instances it is not possible to know the state of mind of the person who took their life, nor is it always possible to know what would have altered the course of events.
So working with suicide is both a privelidge and heavy load to carry. It invovles wrestling with things that are hard to articulate, that are in flux, that are serious and damaging, and that sometimes mean that my need to recognise the choices that the people that I work with make, put me in a vulnerable position with the organisation that I work for. Taking that professional and personal risk (for who couldn't be damaged by authentically relating to suicide) is the offering that I know I can give the people that I work with. And that goes some way to match the huge risk that they take in coming to do the work we do together.
And what of the man in the car who pulled out into me? I saw by chance in the press that he had committed suicide in his car. I don't know whether he was distracted him that day that he hit me or what choices he was making, but there is certainly more to the story than I will ever know.
What to do if you are suicidal or know of someon who is considering ending their life
If you feel you are at risk, I can only say that I respect that you are struggling with it. And that whilst you are alive you can be supported, loved and participating, even if you still make the choice to end your life. ASIST is a suicide first aid approach that is very valuing of choice. If you see this image or one like it, it means that the person is qualified to hear your story and help you keep "safe for now". It is not about stopping you or taking things away from you and I can highly recommend it. If you are reading this and wondering about what help you can get, it is ok to reach out and as for it. There are many practitioners and counsellors that want to listen and be alongside you and you deserve to have that. You can use online services if that helps keep your situation private and can access survivors of suicide projects and groups or suicide support groups. Look for what is available in your area. These also often offer support to relatives, bosses, teachers, friends and colleagues, so don't feel that your need is not great enough. We should all shoulder some of this and help those who are thinking and feeling touched by suicide, it is better for us all.