I hate suicide.

I know this isn’t particularly the most unique or insightful observation, but it’s true. Ask any mental health professional and they’ll tell you the same.

There is this thing that got bandied about in my graduate school program and I would assume other psychology programs, as well. I have no idea the statistical validity of it, but it had the kind of ring of truth to it that none of us ever felt the need to research the science behind it. It goes something like this,

“Within the first five years, if you are doing direct care with clients, you will lose one of your clients to suicide.”

They tell us that partially to scare us to make sure we truly want this job. They also tell us it is partially to make sure we take suicidal ideation as seriously as possible. But the biggest reason they tell us is the prepare us. Even if the five years stat is wrong, suicide is the enemy of all therapists.

It is the proverbial boogeyman that we always need to be on guard for.

SUICIDE: Anthony Bourdain
Anthony Bourdain was found dead in a hotel room in France of an apparent suicide on June 8. He was 61 years old. (Courtesy of Page Six)

My First Professional Experience of Suicide

I experienced my first client ending his life before I went to grad school. At the time, I worked as a caseworker for an in-patient program for veterans with co-occurring disorders — typically PTSD and some kind of substance addiction. The program rules stated that if a resident ever tested positive for drugs or alcohol — after returning from a pass or during a random screening — they had to be immediately discharged. It was a zero-tolerance policy.

During my first week, I drew “the perform the random screening” straw. Dutifully, I sought out the resident, breathalyzed him, monitoring him peeing into a cup, and tested his urine with a special strip. He tested positive and I did what the rules said. I discharged him. Days later, in the parking lot, security found him dead in his car.

An overdose. There exists a chance that it happened accidentally. That he only meant to get high, not to end his own life. However, given proximity, timing, and method, that seems unlikely. At least, that has always been the conclusion I reached. I do not blame myself. Not really. He knew the rules, he signed the contract.

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I had just started and it was only my second mental health job. I was green and, even if I wanted to, had no means to object to the policy or to keep him on campus. The moment he left without allowing me to even find him a shelter for the night if not the next few nights, logically, he stopped being my responsibility.

All true. And yet, I still remember what he looked like, what the testing strip looked like, and how the night felt when I found out he had ended his life.

My Classmate

However, my first true encounter with what we refer to — with something of dark irony — as “successful suicide” happened when I was still in high school. My — well I want to call him my friend but I always worry that will read as me setting myself up as chief mourner. There were certainly people closer to him than me. But we ate lunch together most days, we had several classes together, I was friendly with him, I was friendly with his older sister… I don’t know. I’ll call him my classmate to be safe.

He ended his life. I remember the funeral took place just before Thanksgiving. It was a grey but mild day in November when I and several other 14 to 18-year-olds streamed in and out of a funeral home a town over to pay our respects. Signing a book, pinning the black ribbons we had worn all day to a photo album next to the open coffin. He had shut himself but somehow the morticians had managed to “fix” him. I can still remember the way a bit of makeup caked up in the corner of his near his nose and the strange impulse I had to clear it away.

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No Tools

In a lot of ways, it was a motivating factor to become a therapist. For a while people had told me I listened well, I was supportive and helpful. But my classmate… I didn’t have the tools to help him when he needed it. So I went after them in college and grad school. See, a week or so before, he, several other classmates, and I went to a young leadership training program at the National Guard. My classmate had dyed his hair green, he had a pierced tongue that he like to tangle his chain link keychain from.

We knew him, we accepted him. He was fun, he was hilarious, but the other schools did not know that. He was a target of mocking those few days. One night, as we drank terrible barracks coffee, I found him alone and asked him what was up, if he was ok. He insisted he was and not to worry. The next day, heading home, he thanked me for checking in on him, said no one else seemed to actually care. I waved him off, told him it was no big deal.

I was happy to ask.

Before the month was out he was dead. Because I knew to ask, but I didn’t have a clue what else to do to help him. I didn’t think him thanking him was another opportunity so I let it pass. Again, not my fault, but those are the moments that stick with you. I didn’t have the tool then so I pursued the tools. I became a therapist.

SUICIDE: Kate Spade
Kate Spade was found dead in her apartment on June 5 of an apparent suicide. She was 55 years old. (Courtesy of NBC News)

Close Calls

I stopped suicides after that. At my first mental health job, a resident of the group, a client with schizophrenia, ended up with a sharp, a steak knife. He began to cut his own throat in the kitchen of the home. Thankfully, it turns out cutting one’s own throat is a painful experience, especially with a fairly dull steak knife.

Thus, although he knicked the first artery, he almost immediately dropped the knife. I held a compress on his neck until the ambulance arrived and they saved his life. He never tried again for the rest of the time I worked with that company. I hope he never tried again.

It is never fun though. It never feels good. Because even if you stop a suicide, you have the knowledge that someone felt so desperate, so alone, that they could conceive of no other way to stop their pain. It is important to remember this: suicide is not the acts of cowards, it is the acts of the desperate, of the isolated, of the emotionally devastated.

Even if the person is amongst the VERY FEW who didn’t really want to do or did it as a “cry for help,” imagine the pain, the torment, the terror that had to go into that moment they crossed the line.

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Two Lives Lost

What has me thinking of all this is the twin suicides of Kate Spade and Anthony Bourdain.

Kate Spade, unfortunately, I know very little about. I knew her as a fashion designer, certainly. However, my wife has never been much into fashion and I don’t wear women’s clothing so it has been a distant association. Nonetheless, given her relatively young age, her obvious talent, and the fact that she was a person just like you or me, I do take the time to mourn her loss.

Anthony Bourdain is a different story. I did not know Bourdain as a person, but he paid a significant role in my life without his knowledge. When my daughter was born, she didn’t sleep unless she was being held. So we worked out a system where my wife would go to bed and I would stay awake holding Hope til around four in the morning.

Janelle would then take over and I would sleep. Later, when that became untenable, we bought a wickedly firm mattress and a bed rail. Janelle would go to bed with our daughter at seven at night they’d sleep through the night. This was our life for over a year. The problem with both is the amount of time I was awake and alone. Isolated.

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Separated from friends, from family, from my very wife and child. So television, during those wee hours in the morning and those evening hours after the chores were done, became a lifeline. There always seemed to be some kind of marathon — KITCHEN NIGHTMARES, RESTAURANT IMPOSSIBLE, whatever. My favorite of them, NO RESERVATIONS with Bourdain hosting, provided an escape.

He had this energy and this love of high and low cuisine that seemed so cool to me.

“A Lifesaver”

I know he has come in for some criticism in the past few years, some of it certainly earned. But he remained someone very interesting to me. He was a former addict who beat that monkey on his back. Despite being where his addiction gained full bloom, he continued to work as a chef and do an incredible joke doing so after he got sober. He was a parent and a good one from what I understand. Even as he aged and mellowed, he remained true to himself.

As a man alone in a quiet house wondering if this was it, if this was all there was going to be from now on, he and his show was a tremendous outlet. He is not a friend because I never met and we certainly never had a singled conversation. However, he was something of a lifesaver.

I know that sounds hyperbolic and, in some ways, it probably is. Still, I cannot deny that things probably would have been worse for me during that hard year plus if he was not a dependable presence on my TV and my DVR. So this morning when I read he had ended his life, alone, in a hotel room, in a foreign country, by his own hand, the sadness was sudden and real. It hit me harder than the death of a stranger should, harder than I had any real right to be hit by it. I suspect it was because, in part, he was not really a stranger to me.

SUICIDE: 13 Reasons Why
Promotional material for Season 2 of 13 REASONS WHY (Courtesy of Netflix)

13 Reasons Why

This also led me to think about 13 REASONS WHY the blockbuster Netflix series that just recently rolled out its second season.

REASONS is a challenging pop culture item for people in the mental health field. I see it both ways.

On the one hand, in school, we learned that we should never hesitate to ask a client if they had experienced recent or current suicidality. Our teachers and supervisors assured us that asking and talking about it could not make someone act on their impulses. If anything, not asking could be far more dangerous to the client.

So I understand and appreciate when the makers of the show claim that they want the show to spark discussion. Taboos brought into the light become less dangerous and, often, less attractive. At least, so we hope.

On the other hand, we also learn in school that suicide contagion — the idea that one suicide can spark a trend — exists and can be particularly dangerous for teenagers. So when we deal with suicide we do all we can to not make it — for lack of any better way to put it — sexy.

By this measure, REASONS is something of a nightmare. They depict the suicide in graphic detail. I believe in their hearts they meant it as a demonstration of how scary and painful attempting suicide can be. However, film something well with interesting angles and a good soundtrack and, inevitably, someone will find it stylish, perhaps even sexy.

Moreover, despite her having committed suicide, the actress Katherine Langford continues to exist as a character in the present. She has power, enacts revenge, and gains a legendary status of sorts. All of these would appeal to those contemplating suicide. People remembering you, mourning you, and you getting to best those that tormented you in life.

In the End…

I don’t know the right answer. For every person we catch, it feels inevitable we miss several too. On days like this, it is hard to unravel it all. People have ended their lives and I’ve been unable to help them. People have come to me to tell me they have been thinking about ending their lives or are scared they might. I’ve been able to help them find hope or put them in touch with other people to support them. But it never feels like enough.

I do truly believe that my work and the work of other therapists have the capacity to save lives. On the other hand, there exists the undeniable reality that there are people walking around feeling that way every day. In pain. Depressed. Lonely. Hopeless. I hate suicide. I’m tired of it. And I plan to spend the rest of my life trying to prevent it.

It may be a fools’ errand. There will always be suicide just as there will always be sadness, pain, isolation. Just as there will always be joy, hope, love. So what else can I do? What else can any of us do?

To paraphrase a cliché, every life lost diminishes us. And I believe every life saved enriches us. If you are thinking about self-harm or suicide, if you are scared you might try it, please reach out. A friend, a neighbor, a family member…whoever. People will help. People want to help.

If you are someone who is not feeling suicidal but see someone you think might be, reach out. Depression can get so thick sometimes, it can make it impossible for the affected to see through it. Don’t make them. Meet them halfway. We can all help in some small way.

National Suicide Prevention Hotline: 1-800-273-8255

One Comment

  1. Joe Marino

    June 21, 2018 at 5:15 pm

    Thanks for this really wonderful article. I hope you’ve reached people the world wide with this.

    Reply

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