An afternoon with Alternatives to Suicide

Yesterday marked a week since I found out about my cousin’s suicide. The day before, a friend of mine forwarded a flyer she had received, which she thought I may be interested in: an introduction to a new way of facilitating support groups for people who are contemplating suicide, are depressed, suffer from anxiety, eating disorders, engage in self-injury, etc. In other words, the “mentally ill.” I suppose most people may be too scared to attend a 3 hour presentation on suicide and “related conditions” when they are immersed in grief and shock and all the other stuff that happens when someone you love decides to leave the world abruptly.

There was certainly a part of me that wondered if this was the best idea for me, given my own emotional state (volatile). But out of curiosity, a desire to learn more, to perhaps understand Mona more, and to hopefully learn something that may help others, I cleared my schedule and went. I had no idea what to expect but it certainly wasn’t what I got.

Before I share this with you, I ask that you keep these very important points in mind: 1. I am not a mental health professional. I do not claim to have any training in mental illness, so my impressions are purely based on a layperson’s experience and (lack of?) knowledge. In all areas of life that I may appear to be knowledgeable, I humbly offer that I know just enough to be dangerous. This is certainly one of those areas. 2. What I am sharing with you here I share with the intent to help me organize my thoughts and feelings and perhaps in the process, help you see a perspective you perhaps may not have had the opportunity to consider before.

For three hours, I was in a room with a small group of women who shared openly, what it is like to live with depression. Some of them had tried suicide several times. Some had lived with depression and suicidal thoughts their entire adult lives, some since childhood (one since she was . Some had experienced drug and/or alcohol addiction. Some have children. All are currently professionally employed. And they all think of suicide every day.

I sat there listening to them. I was fascinated. I was so very sad. But I was also comforted. Hopeful. Now I think you’re probably wondering if the craziness has rubbed off on me – how could I be hopeful in this arena? Trust me, that thought has crossed my mind too. I think that’s one of the reasons that as a society we are so medieval in our handling of the “mentally ill.” It is impossible for most of us to encounter the subject without immediately threatening our ego – our set of beliefs, of self-beliefs, our loved ones that we hold so tightly, the stories we tell ourselves that help us define our lives and those around us.

“A genuine relationship is one that is not dominated by the ego with its image-making and self-seeking. In a genuine relationship, there is an outward flow of open, alert attention toward the other person in which there is no wanting whatsoever.” – Eckhart Tolle

The group I was in was about Alternatives to Suicide, which is a support group format started in 2008 by the Western Massachusetts Recovery Learning Community. I have never been to a suicide support group so I have nothing to compare it to, but from what the facilitators said, it is indeed a revolutionary way to conduct a support group. We were a small group so our introduction was, I think, very much in spirit the way the support group actually is conducted. There was ZERO judgment. There was 100% AUTHENTICITY. Brené Brown would have been jumping for joy at the lack of shame in the room.

This is what I learned. Please keep in mind that these were MY impressions, with the filters that I carry today. Some of my points may indeed make you wonder if I am losing it, but I am willing to take that risk because what I experienced yesterday was extremely powerful and eye-opening. I sat there, sometimes asking questions, sometimes sharing my own experiences with depression (about 8 years ago and as a teenager), suicidal thoughts (when I was a teenager), always with an open mind and heart. I let their words and feelings flow through me and I let my gut take the lead.

1. People that we categorize as being mentally ill are, like you and me (ie those of us who really don’t even consider suicide or any of that other “stuff” an option, or it doesn’t even occur to us at all), although it may not seem that way to those of us who are not in the same state of awareness, doing their best. They are not defective. We are all struggling through life in one way or another. This is their struggle. For those suffering from deep depression (not situational depression), this may be a part of their daily existence. It just is. Does it affect and impact the rest of us? ABSOLUTELY. Because we are all in this together, and everything we do and say impacts everyone around us. This is why it is so natural and automatic to shift into fear mode when we hear of suicidal thoughts or attempts, we learn of a child’s self-injury behavior, or we find out that our child has ADHD. It doesn’t help that the media sensationalizes the “warning signs” that preceded a person’s tragic or violent acts, which “in hindsight should have been acted on.” It is so easy to lump “mental illness” and its ramifications into the same group, but this is as limiting and dangerous as saying that all Puerto Ricans are low-life thieves (I’m married to one – a Puerto Rican that is – and he and his family are anything but). Engaging in certain behaviors or thought processes does not necessarily predict future behaviors or thought processes. Your signing up for a 5k today does not mean that in two years you will be doing a marathon. That may happen, but it is not necessarily your journey. No more than cutting herself today means that a girl is going to end up killing herself in a couple of years.

2. The women yesterday spoke of being diagnosed. How for some people, receiving a diagnosis is a relief. Now you have an answer, an explanation for your feelings. You are prescribed a plan which may or may not include medication and medical intervention, so you have a possible solution. For many this is a relief. But for many this is limiting, it is scary, it is overwhelming. Again, back to the label.

"The quicker you are in attaching verbal or mental labels to things, people, or situations, the more shallow and lifeless your reality becomes, and the more deadened you become to reality." – Eckhart Tolle

Imagine being told that you need to be fixed. That you need to take medication, probably for the rest of your life, medication that probably has really uncomfortable side effects ranging from a deadened sense of reality and self to weight gain. Some people feel empowered and more in control when they are diagnosed and prescribed, while others feel a loss of control, an increased helplessness. For a moment, imagine what that feels like.

3. We each live in our own reality. I am often surprised by the different way that we each interpret the very same movie, conversation, essay, Facebook status. Our reality is shaped by the experiences we have lived up to this very moment, by our childhood, our biological make-up, the relationships we have experienced, the values we carry, where we live. Someone on the “mentally ill” spectrum is no different. Just like someone who is in a leadership role, or in the public spotlight, is also no different. But we immediately label them as “crazy” or “a role model” or “successful” and again, back to the labels, we load on the expectations. We impose our own reality on theirs, and this is where stigma and discrimination and judgment and fear erupt. In my reality, today, in my current life, getting in my car and driving away and never looking back is not an option. In fact it’s not even appealing. But was it a recurring thought several years ago when I was in a very dark time in my life? Yes.

As I heard these women speak yesterday of their realities, I felt no judgment from or toward them. No fear. I didn’t want to sneak out of the room and dial 911 and call the loony bin police. These women were just sharing their realities, and I realized that in this type of group, you are free to have a voice, you can be as politically incorrect as you want, expressing your thoughts and feelings has absolutely no repercussion besides creating a connection with others.  You are not in a counseling setting where you may feel like you're being treated.  You are not speaking with your family, who is well-intentioned as they want to keep you alive and well, but they don't have the foggiest idea on how to do it (how could they?) and they think you're crazy so they don't want to/can't hear what you have to say.  This group is a safe, validating space.

We are all, I think, in parallel universes. When these universes or realities feel threatened, they collide – resulting in tragedy, in violence. When they are allowed to exist in a way that feels supportive, acknowledged, respected, and loved, then they just continue to exist. Sometimes maybe getting a little closer and bumping up against each other, but not with a need to intersect, to influence, to FIX.

4. Like the rest of us, people with “mental illness” really want to be heard. They want a voice. When we rush to diagnose, to prescribe, to FIX, we often forget to listen. We are afraid to hear what our loved ones are feeling and thinking. Trust me, I get that, it is terrifying. It threatens everything we know and love and dream of when someone we care about doesn’t see what is so very clear to us – that eating well, exercising regularly, having goals, trusting God, caring for our children, being grateful for all that we have, hanging out with positive people, taking the medicine, following the 12 steps – all this stuff really works! We know that and I do believe that on some level, depending of course on where they are on the spectrum, most of our “mentally ill” peers know that too. But perhaps, what they really need, is to be heard. To be listened to without judgment, without an agenda. Without the instant panic that we naturally give in to when we hear the word “suicide.”

5. Something I heard yesterday was that while suicide is part of their daily thought process and inner dialogue, it is sort of like a safety blanket. An option. It gives some people a sense of control, that even though my life sucks, I am totally miserable and don’t know how the hell I am going to function, at least I have a plan for a way out. I am not without options. There is a sense of safety and security for some people in this. It doesn’t mean they are going to do it. And this is when I think it is really important for those with suicidal thoughts etc to find a mental health professional that really honors them and allows them to speak and share, someone with whom they feel a rapport, someone who treats them with dignity. They get enough of the “fix it” from the people in their lives, and just like I can’t fix someone who is overweight by shoving a plate of kale at them and throwing them onto my dreadmill, when we try to talk our loved ones off a ledge without allowing them to (whether with us or a therapist or in a group) share what is going on inside of them, in an honorable, dignified way, we aren’t helping them or ourselves.

6. One woman spoke of her experience jumping in front of a train years ago. This was a powerful moment for me because that is what Mona did last week (under different circumstances but still, a train). Unlike Mona, this woman was saved by a friend who was with her. This woman described this experience as being one of the most incredible nights of her life. I won’t go into details only to say that she described the intensity of the experience – of the act itself and the hours that followed, with this friend. As she spoke I found myself - in my own parallel universe, because I just cannot even imagine tempting death in that way, I so love being on this side of it – I found myself on a very deep level knowing exactly what she was talking about. I looked back on certain periods of my life where I have engaged in self-destructive behavior, and I listened to her through that lens. I thought of Ironman triathlons. Of marathons. Of how much connection I have felt with my inner self, with others going through the same physical and mental challenges, of how when you are in that deep, dark place where you don’t want to talk to anyone because you are all alone, and you don’t want to or can’t reach out to someone else, you are on mile 21 of the marathon after having swam 2.4 miles and biked 112 miles and it is hot, and dark, and there is no one cheering for you on some dark stretches of that Ironman course. There are others around you in the same place and you may look at each other knowingly, but as you stumble alongside each other or pass each other, you don’t speak – but you know. It’s primal. It’s a rare occurrence in today’s life that is characterized by To Do lists and media bombardments and gadgets and societal expectations and self expectations and rules and laws and tests and autopilot settings. When you are in that place, it’s just you and your thoughts and God (or whatever you believe in), it is something extremely powerful and in many ways a gift. Addictive for many, which is one of the reasons I think those races sell out in minutes in spite of the cost – financial and otherwise. Why so many endurance athletes are recovering substance abusers.

I have compared this part of Ironman to childbirth. Not in the level of physical pain but in the way that we are stripped of all pretenses, barriers, inhibitions when we are engaged in that very primal act of pushing a precious little baby out into the world. The physical intensity (I didn’t have epidurals), the lack of inhibitions – I really didn’t care who saw my wuwu at that point – there are no shields to hide behind. How often do we get to feel that? No wonder so many people are doing Tough Mudders – their inner Braveheart gets to come out in a socially acceptable way.  

7. Mental health care SUCKS in our country and I suspect in most if not all of the developed and developing world. Maybe some tribal communities do a much better job (I suspect they do). I haven’t waded into the whole jungle of mental health reform, so I am definitely not knowledgeable on the current laws or those pending. But this is what I have heard, both from yesterday’s group and from people who have messaged me over the last week: if you want to have a bed in a facility you need to use certain buzz words because treatment is to a great degree not determined by physicians, but by health insurance companies.

There are mental health and judicial laws in existence and pending (such as House Bill 3717 ) that strip away the rights of those considered “mentally ill” and that could potentially cause far more harm than good, as they eliminate, for example, many initiatives that promote recovery and voluntary, peer-to-peer support. As I have pointed out before, it is very easy to focus on laws and rules and black-and-white “solutions.” The problem with this though is that as appears to be the case with 3717, it sounds a lot better than it actually is in practice. Remember how good the No Child Left Behind Act sounded? How popular it was, how easy it was to pass? I do not know a single educator or parent today who thinks it’s a good thing. In fact, I think most would say it has caused more harm than good. But this isn’t education we are talking about – this is mental health, this is human dignity. It is freedom. I completely understand and join in on the fear that leads to the desire to restrict access to or remove certain people from society, for the sake of public good. But I believe that when it comes to bills like 3717, we need to really understand the implications, try to put our emotions about Sandy Hook and Columbine and Cheshire, CT aside for a moment (because while absolutely horrible, these are extreme examples) and if we are going to address mental health from a legal and/or criminal perspective, we need to look at the long-term and widespread consequences of a bill. Let’s not jump into something and then ruin more lives and rip apart more families, the way the Three Strikes bill did in California (since reformed). If you want to learn more, here’s a start.

When I came out of this 3 hour meeting, I just sat in my car and did nothing. I just sat with all I had experienced. I realized after a bit that I had this new appreciation for, and understanding of, what Mona had probably been going through. Possibly at different times in her life and certainly during those last few months. I don’t know what it was like to live with her, I don’t know the details of her medical interventions during that time, I didn’t have a conversation with her. But I knew Mona. We were very similar on many levels. The way we didn’t/don't run with the herd. Our independent, adventurous spirits. I remember walking into my therapist’s office for the first time several years ago and declaring right off the bat,

“I know I need your help but I don’t want to be fixed. As messed up as I may be, I feel alive.”

I imagine that when people were giving Mona diagnoses and prescriptions for medication that dulled her senses and made her foggy, this must have been extremely frustrating, increasing the sense of hopelessness. Not having a group like the Alternatives to Suicide group that I was introduced to yesterday was a big loss for her. It’s a big loss for others in her situation, who encounter fear, resistance, assumptions, dominance at every turn. When I think of my life and fitness coaching, I think of the many people I know who are in a situation that most would consider less than ideal. Perhaps they are overweight. Perhaps they are in a lousy marriage. Perhaps they could have better results at their annual physicals. They know what to do and how to do it but they don’t. On some level, that state of what others may consider mediocrity or worse, while it sucks for them, and it makes them feel lousy about themselves, it’s what they know. They find some sort of comfort in their routine, as much as it is a disservice to them. I could be totally wrong but my gut tells me that for some (many? most?) people who have been in a deep depression for a long time, or suffer from other “mental illness,” this is a way they may feel about their state. Rationally, they hate it. They don’t like the dread or the craziness in which they live every day. But it’s also a part of them, something they can count on. So when we “sane” people try to fix that part of them, I think that in a way it’s denying them a part of their identity. And when I think of someone denying something that’s a part of me, I get angry and frustrated. And hurt. I think that’s what happens with them. I also think that by accepting people where they are at, by respecting them and not trying to jump in and fix them, this actually gives them more of the acceptance and power that they have been lacking – and may actually be part of the journey toward wellness.

When we accept, and surrender our right to control, it feels like we are giving up. Or that we are saying fine, go dig a hole for yourself and go off and die. That would be the automatic way to interpret acceptance, I think. But my gut tells me that if someone who is deeply depressed, or suicidal, has a space in which to speak of what she is feeling, without fearing that someone will dial 911 – I think that’s where they begin to take their own finger off the eject button. They may still have the suicide plan in the drawer just in case, but they may, hopefully, begin to be open to developing other coping skills.

In June I am going to be trained to be a facilitator for such a group. Over the last several months I had been thinking about how we need an outlet for people who fall somewhere on the spectrum, but don’t quite fit into the 12 step groups. When Mona died, my need for something like this increased big time, as I did not want Mona’s death to be just another tragedy. Depression and other mental illness are rampant. This really became clear after Mona died and hundreds of people reached out to me after reading my blog, with their own stories of suffering personally from depression, etc or of being a survivor to suicide. Everyone knows someone who killed themselves. Everyone knows an addict. The problem with the 12 step groups is that they don’t fit the bill for a lot of people. I joked with a friend on Saturday that we should have a Life Sucks Anonymous or Strugglers Anonymous. Sitting in the group yesterday I realized that I had found it.  Check out this video about what these groups are all about.

Who knows where this will lead me but I’m not going to worry about that. I am just going to do what my intuition tells me that Mona, and others like her, would want me to do if I am going to in any way help them exist more peacefully in our world. When in doubt, I ask myself, what would Jesus do? And I know that Jesus would not force, or judge or condemn the weakest, most invisible group of people in our society. He would sit with them, listen to them, help them, speak for them. Teach them. I pray that in some small way, I may follow Jesus’ example.

Invisible (Hunter Hayes)

Crowded hallways are the loneliest places

For outcasts and rebels

Or anyone who just dares to be different

And you've been trying for so long

To find out where your place is

But in their narrow minds

There's no room for anyone who dares to do something different

Oh, but listen for a minute

Trust the one

Who's been where you are wishing all it was

Was sticks and stones

Those words cut deep but they don't mean you're all alone

And you're not invisible

Hear me out,

There's so much more to life than what you're feeling now

Someday you'll look back on all these days

And all this pain is gonna be invisible

Oh, invisible

So your confidence is quiet

To them quiet looks like weakness

But you don't have to fight it

'Cause you're strong enough to win without a war

Every heart has a rhythm

Let yours beat out so loudly

That everyone can hear it

Yeah, I promise you don't need to hide it anymore

Oh, and never be afraid of doing something different

Dare to be something more

Trust the one

Who's been where you are wishing all it was

Was sticks and stones

Yeah, the words cut deep but they don't mean you're all alone

And you're not invisible

Hear me out,

There's so much more of this life than what you're feeling now

And someday you'll look back on all these days

And all this pain is gonna be invisible

These labels that they give you

just 'cause they don't understand

If you look past this moment

You'll see you've got a friend

Waving a flag for who you are

And all you're gonna do

Yeah, so here's to you

And here's to anyone who's ever felt invisible

Yeah, and you're not invisible

Hear me out,

There's so much more to life than what you're feeling now

And someday you'll look back on all these days

And all this pain is gonna be invisible

It'll be invisible