Sunday, June 17, 2018

Think We're Alone

I wrote my thoughts about the Bourdain/Spade suicide in my essay, Suicide is not Painless. I chose not to share my struggle with the issue in 2012 when coming out of a Traumatic Brain Injury suicidal ideation is very much a symptom of the injury, so I understood that,  but also add PTSD  that was the result from realizing how I sustained said injury.  And that realization, rage and fear  was truly the driver of that car, as in between understanding TBI, PTSD, date rape drugs, medical malpractice, my down time  was spent debating and researching methods and ways in which to accomplish the end so it would be final and I would be found. I had decided on drowning and as I lived within walking distance to Lake Washington I would spend hours going to the very shore I used to walk my beloved dog along planning how and when I would do it. Clearly I never acted upon it and I would love to say I found a great therapist but alas that was not the case.

Here is the rundown of the therapists I encountered in this phase of my life: I was a member of Group Health and the first was a woman therapist who was fired shortly after our first and single encounter where she was convinced I was a pathological liar, never examined my medical records confirming TBI and noted this on my medical records (which are normally kept separate)  as she enabled me to sign off of this. Did I mention that I had amnesia during this encounter and have no recollection of this session?  Amnesia too is a symptom of brain injury and Harborview Hospital dismissed me days earlier without failing to treat me accordingly with relation to my injury.

**This has largely to do whn women or anyone does not have an advocate to defend and discuss patient care, I had insurance and sufficient credit so imagine those who do not.  But hey someone in full blown brain injury should not be responsible or trusted with their care and Harborview could give a fuck less and I sued them alone.. so if you think suicide was not on my mind think again.  I got the whole Bourdain rage when he discussed how he cleaned up without help or support.  There is a rage there that can never be assauged.**

When I finally tracked her down in private practice a year or so later and showed her my complete records and info on this disorder she apologized and admitted she knew none of it. When I asked why she "left" Group Health she lied of course as that would never change. She had a history of misdiagnosing and stepping on boundaries. How did I know this?  The second therapist at Group Health I visited following this encounter, where he showed me my "meeting" with her and in turn noted that I was again a liar and drunk despite my desperate pleas for help in finding out what happened to me that night.  It was later he began to believe me but by then it was too late.   His counsel was so idiotic that I spent most of the time doing just what he thought, lying, rather than getting the help I needed. I made up stories about my family, my ex husband and others just to kill time as I was not paying for these sessions so I saw no point of doing anything to get well.

Michael was so bad that an acquaintance had already called to speak to him about my depression and to get to some understanding, so she made an appointment as a patient to seek counsel as a method of at least seeking some professional counsel as a way to assist in helping me. She was so horrified about what an idiot he was she came clean with all this where I too confessed to my bullshit. And from that we agreed to end as it was at least of waste of time and I proved the point already. 

Then we have the last Therapist that I went to as a promise to her to find someone to help. He was a nice man but two sessions in with him demanding me to learn how to forgive myself I realized it was not I who needed to forgive I needed to understand something in which he could not provide. He also realized I just wanted to rant which frankly is correct but guess what that would have exactly been what I needed and he wanted no part of it. That I was paying for so I turned to writing and massive exercise, a Tarot Card reader and ultimately I realized I was never going to get the answers I sought. So I moved on literally to Nashville.

Why I chose Nashville is for my reasons alone and they were in fact what I needed and wanted. Once those were taken care of and the dental treatments the other reason begun I started to focus on those things extrinsic versus intrinsic. Laughing at the people here may be unkind but I find it quite healing. I still feel very alone, very angry and at times depressed but mostly because I am nearly done with why I came here and I want to leave. All in good time and all on my terms.

But again Suicide is not a universal answer to life's problems it is just one of many. But it is the most significant and substantive.  It is the final solution.  This essay poses many of the same issues and concepts I have said in many posts and in turn offers another form of insight into why some act upon that impulse and others fail or simply do not.

I recall after my rant in Vanderbilt's Dental Office that day and I recall how I was in Michael's at Group Health, it was full of bullshit, manipulative and yes one of anger.  I had come all this way and just wanted teeth, I wanted a treatment plan with costs so I could plan accordingly.  To get a wrong plan with incorrect information I just lost it.  I had dealt with the shock of the public schools, moved across the country and was closing out my legal bullshit from the accident in 2012 and was simply exhausted. I had only been here six months and all of them horrific as I tried to adapt to a place I did not truly belong but came again for reasons I chose to keep to myself as I knew that no one wants to hear any one's history, their truth, their pain.  And hence I rant, I lie and manipulate as a coping strategy and it was now finally biting me in the ass and when the Cops showed up at my door a week later my first thought:  The gig was up.  And in turn it lead me to still be angry but be isolated and I am fine with it as when I have subsequent encounters with others they remind me of that Patient Coordinator - stupid.  And stupid is as stupid does. So I now laugh at them and sometimes with but I just want to leave and when I go somewhere else it is to run to not away and that is the key difference.  No expectations, no needs, just be anywhere but here.  That may be why many do commit Suicide.  

Artificial concern for people in pain won’t stop suicide. Radical empathy might.
Our language about suffering is suffused with cliches, and they don’t help.

by Richard Morgan The Washington Post June 15
Richard Morgan, a freelance writer in New York, is the author of “Born in Bedlam,” a memoir.

You’ve heard my suicide story before. I contemplated killing myself because of heartbreak, or being beaten by my father, or job woes, or being gay, or being raped, or the come-down after a bender. I took pills once in grad school, vomited them up and stared at the mess. It’s a particularly strange blow to the ego, that slop of having failed even at death. My most recent suicide plan, several years ago, was to jump off the Golden Gate Bridge. Only an intervention of friends, partnering with my estranged mother, set me on a better path. All of that thinking is alien to me today. Now I don’t even joke about wanting to die.

I could perform charisma and humor, but I had what felt like zero affect. I just didn’t care about anything anymore, even myself, and I could entertain these dark thoughts with alarming detachment. That’s the suicide we all know and loathe. It’s a demonic, simplistic creature, a cartoon supervillain, a composite of expectations and tired tropes. It’s a cliche. And for discouraging other people’s suicides, the cliche is a problem.

Part of how I escaped my tedious trap was by drafting suicide notes. I would write one, wait a day, read it and then see if it still felt true. Here’s one: “How bruised does fruit have to be to become not just unwanted but also inedible? And what, then, is inedible fruit? Its purpose is gone. It is a waste. That’s how I feel: I’m a waste. A waste of intelligence. A waste of personality. A waste of talent. A waste of words. A waste of love. I cannot be this man anymore. I am weary of the performance of it — wary of it, too. When I think of ending my life, I don’t mourn the loss. I never knew that guy. He was a feedback loop of habits and obligations. He never made me laugh without feeling insecure about the laughter, and never made me cry without feeling aimless about the tears. People might miss the person they thought I was. But nobody will miss the me I was in the dark. My tears were the loneliest thing about me. Nobody ever touched them.”

Another: “Would anyone I know be proud of my life? I have been blessed with many friends and colleagues — even strangers — who are supportive and encouraging. But I am very aware of the simple truth that, at the end of the day, they are glad they don’t have my life: the anxiety, the depression, the rejections, the loneliness, the poverty, the itinerant vagrancy. In one word, the brokenness. . . . It’s not a life anyone should have. I have lived wrongly. Certainly I have had moments of life the way it was supposed to be felt. Falling in friendship at first laugh, or a lover’s caress reverberating through the decades, or seeing my byline — my idea, my mind, my way of seeing the world — solidified in ink in the world’s best newspapers and magazines. But there are so few such moments. I can count them. They were not enough. And so, by extension, I was not enough. . . . I have been gone a long time already. I am proud that I realized this in time.”

Except, when I returned the next day to read these notes, they felt like they’d been written by someone else. In the elapsed time, I had grown not content but maybe restless — the kind of restlessness that reveals a faint awareness of hope, of faith in hope. Who was this strange man who had my voice but could not tether it to my soul? Reading my notes turned me into a one-man empathy machine. I was able to hold myself, steady myself, hear myself, know myself and love myself. They gave me ideas for how to cauterize my wounds: I’d visit a Korean spa to get a body scrub, gaze at the heaps of discarded skin and think, “The old me is on a tile floor now, being washed down a drain.” These rituals worked. I can’t imagine killing myself anymore — and I have a pretty ambitious imagination. Suicide notes saved my life.

With Kate Spade, Anthony Bourdain and the untold thousands who commit suicide without international attention, we seem surprised to learn that plenty of people do not, as a Kate Spade slogan went, “live colorfully” — without blacks, whites or grays. Apparently life should be a sumptuous confection, a millefeuille of giddy Oprah-resonant adjectives like “blessed” and “glamorous” and “inspired” and “ready.” Apparently we’re supposed to be a woke-up-like-this BeyoncĂ© of flawlessness, even as we step out of an elevator having just watched our sister claw and kick our husband. There is no “perfect life.” No dream job. But we refuse to believe that; confronted with suicide, we understandably say things like Andy Spade, Kate’s husband, did: “It clearly wasn’t her.” He had to dissociate the act from the actor, its own kind of cliche.

So when depression or apathy emerges, we race to theorize about toxic secrets or “personal demons,” as Spade’s husband put it. We call it a “stupid thing, this selfish thing,” as Bourdain himself once described it. That’s a suicide we can absorb. The predictable one: the internal wrestling match. The Kurt Cobains and Marilyn Monroes. These people lost a “battle,” or their dark side “finally overtook ” them. Their soul was in a kind of car accident. They lost control of the steering wheel.

But suicide is more subtle than that. Suicide is a kind of fatal exhaustion. It knocks on your door not as a monster but as a healer making a house call. We have to invite it in. Spade held that red scarf in her hands, Bourdain held that bathrobe belt in his, and both thought, “This will do nicely.” The coroners’ reports will not bother to note if their cheeks were tear-stained, but I think not.

What we need to do is make that knock at the door less appealing. Give it less space to be heard. That’s the obvious takeaway from the Centers for Disease Control and Prevention report about an across-the-board surge in suicides from 1999 to 2016. In 2015, there were 18,000 homicides and 44,000 suicides in America. Suicide is 250 percent more common than murder. There is something missing in our understanding, and it is this: Empathy is not a pro-forma answer to some social problem, to be dispensed in the appropriate dose but otherwise withheld. Amid all those permeating cliches of joy and woe, empathy is too discrete, too intentional. We perform empathy like a child learning to box-step for a school dance, one-two-three, one-two-three. It’s a performance we don’t really care about.

That’s the message we send when we blurt out phone numbers for suicide prevention hotlines, as TV anchors, pundits and social media users did in recent days. I’ve called those numbers. Sometimes, they’re helpful. Often, they’re just another detached bureaucracy; it’s easy to feel processed, shunted through the protocols and scripts. It can be empty empathy. What else do we expect of emotional labor we have outsourced? (Also, repeating those phone numbers assumes they’re easy to call, that they’re not triggering, as if feeling indifferent to or incapable of calling a number isn’t just one more nudge toward suicide.)

When we search for answers to our pain and the pain of loved ones, we see empathy through the lens of danger and disease. We yell, You are not alone! Telling that to a person who feels suicidally alone is the same as asking, “Have you tried not being sad?” We are alone, all of us. Nobody will ever share in the experience of being me. I will never share in the experience of being inside any of my loved ones’ minds or hearts or souls. Empathy is not a cure for loneliness. It is merely a commitment to assert that other people’s loneliness matters, that it is seen and heard and felt as much as possible.

Empathy is about undermining loneliness by flooding it with engagement. Because sometimes, even with a face-to-face human, even with a doctor — you can check yourself into, say, San Francisco General Hospital for depression, have your medical history taken — you may still receive callous and confusing care. Seeking help or offering help is not the same as helping.

Suicide is the third leading cause of death among 10-to-14-year-olds in America and the second leading cause of death among 15-to-34-year-olds. More than 9 million American adults — 4 percent of us — have reported having suicidal thoughts in the past year. For context, 4 percent of Americans is roughly the population of Boston, Chicago, Washington, Los Angeles, Miami and Seattle. It’s not just about our broken mental health system; based on data from the National Violent Death Reporting System — which, jeez, is something we have — 23.8 percent of people who take their lives are on antidepressants. Pills and doctors won’t fix this epidemic. We need the meta-medicine of a better citizenry.

In American high schools, the CDC reports, almost one-fourth of girls have seriously considered suicide, and one-tenth have attempted it. Almost one-fifth of all students have seriously considered it. And yet where are the fights for arts and language and music programs that might channel these anxious and expressive impulses? Instead, the goal of governments and school districts in charge of high schoolers is to pass the buck onto college deans, who are broadly derelict in their duty. Of the largest 100 public colleges in the United States, only 46 bother to track suicides. Arizona State University, for instance, doesn’t tally suicides even though at least two students committed suicide there last year, but its administration can tell you the three-decimal-point GPA of every student athlete. That’s what we care about.

In the end, empathy should be a way of life and love; it should be our other oxygen. It’s not about saying, “I’m always here if you need me.” There is no if. We need each other desperately all the time. That’s what society means. That’s what civilization is. It should be the core of more than just our personal, private conversations. It should be the animating concept behind public policy, taxes, civic duty. There are obvious calls, like throwing the book at a woman who texted her suicidal boyfriend: “You just need to do it.” But what if we paid more to make homeless shelters havens instead of out-of-sight, out-of-mind hellscapes? What if we invested as much in Puerto Rico as we do in Afghanistan? What if we stopped nickel-and-diming our ride-share drivers literally to death? What if we made learning Spanish as necessary to a high school diploma as learning algebra? What if we made “How are you?” real? That’s how you end the cliche.

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