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“A failed product of ‘prevention'”

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This week’s post is by activist and writer Laura Delano, who first published this in a longer version last fall at Mad in America and gave us permission to post it here.

First, two links: JD Schramm, whose TED Talk on being an attempt survivor opened an important public conversation, posted his “real advice” this month on recovering from an attempt. And this petition by attempt survivor and activist Sandra Kiume, or @unsuicide, asks the American Foundation for Suicide Prevention to address the confusion around the term “suicide survivor.” Here’s Laura:

I am alive today in the most intense, sometimes painful, always beautiful of ways, and one of the many reasons I credit for my life is this: I am a failed product of “Suicide Prevention.”

For this, I am eternally grateful. While this statement may sound like a confusing paradox, I’d like to explain what I mean.

My long relationship to suicide began after I met Psychiatry as a 14-year old and ended when I found liberation 13 years later, in 2010. My suicidal experiences and I shared something akin to a passionate, painful love affair that grew stronger over time. It was a relationship that I both yearned for and loathed, relied on and desperately tried to pull myself away from, but because I was convinced that the roots of my suicidal urges rested in bad brain chemistry, I felt powerless to do anything about them.

Indeed, after a while, I simply accepted my “chronic suicidality” as part of what it meant to be “mentally ill.” I also accepted and eventually embraced that it was only a matter of time before I took my own life; that this was the inevitable conclusion of being “treatment-resistant bipolar.” I remember reading a write-up of some Rorschach test results which declared I had a “death wish” and was a “high risk” for suicide; I nodded in grim acknowledgement that this was my fate and that even the best treatment wouldn’t stop me from meeting it.

For many years, my thoughts of suicide kept me living. I always have my death, I used to say to myself. I can live another day knowing this. Life passed this way for a long time. After years of receiving elaborate and extensive psychiatric intervention, I determined that I was a lost cause. On a cold November morning in 2008, at the age of 25, I made the calm, rational, peaceful decision to end my terminally “ill” life, and I acted on it.

I feel a deep, human obligation to talk openly about my attempted suicide and the years of suicidal thoughts that led me to, and subsequently followed, that decision, because I see my once-profound urge to die as a crucial step towards the profound realization of how much I actually yearned to live. Leading up to my suicide attempt were years of shame, guilt, and secrecy; of fake smiles and sparkless eyes; of believing so deeply that I had no agency over my “illness” that each day would just be a fight against myself; of feeling hopelessly dependent on my doctors and therapists and parents and the hospitals I kept checking myself into; of feeling completely disconnected from myself and from the world; of finding peace of mind only after fantasizing about my death.

At night, when my suicidal thoughts seemed to demand action, I did what I was told and called my psychiatrist so that she could prevent the crisis from escalating. (On more than one occasion, the advice was to “Take extra Seroquel,” and I remember feeling beyond lucky that she’d stay on the phone with me until I passed out into drugged sleep, scared as I was of having to lie there alone, trapped in my head.)

There’s no denying that my relationship to The System was a complicated one because of how deeply I came to believe in Psychiatry’s tenets. It’s not an easy thing to write this, for the values and principles I live by today go firmly against the institutionalization of a human being, especially a human being who’s suffering, hopeless, and questioning the meaning of life. It’s not easy to write this because I see, as I continue to heal from the physical, cognitive, and emotional trauma of over 10 years of daily psychiatric drug consumption, how deadened, numbed, detached, and destabilized I was.

In the end, psychiatric intervention and “treatment” did nothing to quiet my suicidal thoughts, nor did it play any role in cultivating the unquenchable inner fire to live and thrive that I feel today. What my relationship to Psychiatry did for me — and I am truly grateful to it for this — was establish a life not worth living, and lead me as far down its path as I was capable of dragging myself. It was a life of accumulating hospital scrubs and rubber-soled socks and DSM diagnoses and pill bottles, medical records and outpatient programs and locked wards and “treatment team” members. But it was also a life that led me to my awakening — whether determined by luck or destiny, I’m still not sure — which began when I found myself face-to-face with Robert Whitaker’s “Anatomy of an Epidemic” in a Vermont bookstore in May 2010. The rest is history, so they say.

The “Mental Health” industry — and American society as a whole, for it seems we’ve reached a point at which we look only to those with letters after their names to speak as “experts” on the causes of and solutions for the human urge to die — has infused suicide with a deep, oppressive fear. Much of The System’s fear is self-centered in origin: it is fear manifested as liability, risk and responsibility by those in positions of clinical power. “I just can’t let you leave the ER, I’m afraid, as you’re a safety risk.” Or, “My license is at stake if I allow you to go home after sharing what you did with me.”

Missing from this “Suicide Prevention” framework is acknowledgement of the agency of the person considering suicide; of the dignity of risk and choice; of the human legitimacy of thoughts about life and death, especially when life has lost its meaning; of the right to feel and believe what one desires, however dark and scary that may be to those around her.

Missing from this, most of all, is faith in the human condition and our capacity as human beings to survive and move through profound suffering and hopelessness. When an entire system of “care” is founded upon this lack of faith, as today’s system is, it makes it hard for those reaching out for help to have any, either. In fact, I believe that it’s this collective loss of faith and infiltration of fear that lies at the root of America’s rapidly increasing suicide rates.

Fear drowns out curiosity, faith, honesty, empathy and the opportunity to listen with open ears and hearts. Fear breeds control, and whether this control is welcomed or resisted, the clinician’s agency almost always trumps all. At the heart of it, fear of suicide strips away the humanity of life and death, leaving in its place a sterile, objectified “problem” or “symptom” that allows for only one course of action: prompt and effective intervention and prevention, usually via evaluations, diagnoses, locked wards, and prescription pads.

Never once was my urge to die seen as something meaningful, as something to be explored and faced. Never once was I presented the opportunity to take the time to listen to it, or to consider that if I did, I might discover that on the flipside of my urge to die was an urge to live, just in a very different way.

So what do you say about all those people out there who want to kill themselves right now, in this moment? Some of you might be asking, “Where should they go?”

My answer is that I don’t have the answer, nor do I pretend to. But where it starts, I believe, is in re-humanizing suicidal experiences, and in embracing them as important and meaningful messages that need listening to, not running away from. I’ve learned this along my own journey, and by listening to the wisdom of other suicide attempt survivors like David Webb. The answer to this question starts also in the creation of alternative spaces in which people can talk about their suicidal experiences without fear of incarceration, or silencing, or pathologizing. These kinds of spaces are developing here in Massachusetts, where the Western Mass RLC is running ‘Alternatives to Suicide’ groups and has a respite, Afiya, which offers non-pathologizing support.

The answer, for me, was to take my life back. In doing so, the urge to take my life from the world fell away.

3 Comments Join the Conversation

  1. While I don’t share Ms. Delano’s global criticism of psychiatry and maintain that psychiatric care is essential for people suffering with serious emotional problems, especially suicidal thoughts and plans, I do agree with her comments regarding the attitude many clinicians have about suicide. Cardiologists, oncologists, etc. expect that some of their patients will die and as long as they have done their best in accordance with appropriate medical standards, do not fear retribution, liability, criticism etc. In psychiatry, however, the practitioner is taught that a suicide will always be the doctor’s fault and therefore psychiatrists tend to see people with suicidal thoughts as dangerous and threatening. This obviously distorts their ability to help. I remember a professor declaring over and over again to us as residents “no patient of mine has ever attempted or committed suicide.” This made us believe that if we had a suicidal patient we must be doing a terrible job. Obviously, the psychiatrists’ goal is to help people not try to kill themselves and to feel better. A suicide is tragedy. But psychiatrists need to be trained to understand that suicide is an outcome of serious depression just like dying is the outcome of some forms of severe heart disease. With that attitude I believe that psychiatrist will be less afraid of suicidal patients, more willing to accept them as patients, and more able to be empathetic.

    Reply

  2. Enjoyed your article and made a variety of notes on thoughts it generated, thanks…

    Mental health, depression, suicide are as complex as are humans they can nest in. All discussion and attention brought brings an end to years of silence.

    Most do not understand the hurdle reaching out from fear and doubt can present at certain moments in one’s life. I agree with Jack’s analogy to normal ‘body’ health situations, depression can be like the flu and with proper treatment, clear up.

    Reply

  3. I am astounded to have read my story here. I’ll most likely wind up doing it in the end, but yours are the first words on “why to not kill yourself” that actually makes sense. So refreshing not to read the usual crap platitudes and schmaltz and self-delusions; I thank you for that. You have given me some things to think about. I don’t know you, but I love you for that. I hope life goes well for you. Bless you.

    Reply

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