Friday, April 27, 2012

Suicide as an Escape

Yesterday, I had the opportunity to speak with local pastors and chaplains at Good Shepherd Hospital in Barrington, IL about suicide prevention. I have worked with many clients who struggle with suicidal thoughts in community mental health centers and now in private practice. Many people have a hard time understanding why someone would even consider taking their own life. In my experience, suicidal thoughts are almost always motivated by the fantasy of escape.

1) Some people believe that suicide will deliver them from pain they are currently experiencing. This pain can be emotional, physical, or even spiritual. When suicidal thoughts come to mind, a person may be trying to escape feelings of being deeply depressed, alone, abandoned, betrayed, or ashamed. Sometimes, the intensity of this pain is heightened by the existence of Major Depressive Disorder or Bipolar Disorder.

2) Some people believe that suicide will help them escape an impossible situation. Common situations I have observed that place people at risk are the following:

  • The person has experience a significant loss, such as the loss of a person to death (esp. suicide), a divorce or break-up, loss of a home, or loss of a job.
  • The person has recently been arrested or publicly exposed for something s/he experiences as humiliating, financially crippling, or career damaging. 
  • The person experiences distress over his/her sexual identity due to personal beliefs, bullying, fears about implications for current spouse and children, or perceived rejection or potential rejection by family members.
If you or someone you know is experiencing suicidal thoughts, you are not alone. If you are struggling personally, it is really important that you reach out to someone, especially a mental health professional. If you are worried about someone, do not be afraid to talk to them about suicide and encourage them to seek help. It is a myth that asking someone about whether they are suicidal makes them suicidal. Most people who are suicidal feel extremely alone and benefit from someone noticing their pain and caring enough to ask.

Wednesday, March 28, 2012

Letting Go

Many people who come to see me in psychotherapy have experienced significant losses. Sometimes they have lost someone to death, but just as commonly they are experiencing the loss of someone they love due to a divorce, a break-up, or a significant interpersonal conflict. Losses are especially difficult when you feel like it is your fault. This is why losing someone to suicide or to death following a significant argument is especially devastating. Even if you know intellectually you did not cause the loss, the heart is not so easily convinced.

Sometimes, we do not actually lose a person in our lives but experience the loss of ideals, dreams and hopes. For example, most parents dream of conceiving a healthy child and so experience grief when they cannot conceive or when their child is born with  medical or developmental problems. Life is not infinitely long. It is not unusual for people to seek therapy in their 40s or 50s when they realize that their personal or professional dreams are no longer possible.

In the face of loss, most of us want to hold on. We don't want to believe the person we love or a beloved dream is truly gone. We can't believe it and we may refuse to believe it.  It is not unusual for me to meet with someone who is sure that a past romantic relationship is not over, despite much evidence to the contrary. The "Parent Trap" may be an old movie, but the hope of divorced parents reuniting is ever new. One of the more difficult parts of my job is informing parents that their child has a significant mental illness. Almost always, the immediate reaction is for the parents to deny or minimize the problem. And I get it. No wants wants to experience loss.

Time of loss can be times of fluctuation or even deepening in the realm of faith and spirituality. For believers in God, It is not unusual to feel abandoned or punished in the wake of a significant loss. Nicholas Wolterstorff, in Lament of a Son and C.S. Lewis in A Grief Observed have chronicled their personal spiritual walks as Christians through significant personal losses. 

How then do we go on? Where does hope come from? I wish it were easy. The truth is that walking authentically through your pain and coming eventually to accept the loss is the only way forward. Grieving is especially intense when you have no one to talk to or feel that no one understands. Sometimes, as a therapist, my most important job is simply to be there when someone is telling the story of their loss. Support groups can also be helpful. For example, one group I have especially appreciated for adult survivors of suicide is LOSS. In the northern suburbs of Chicago, Willow House offers many groups for grieving children.  

If you are experiencing a significant loss right now, I am truly sorry. Blessings and peace to you in your journey.