Showing posts with label Conroy. Show all posts
Showing posts with label Conroy. Show all posts

Real Suicide Prevention or Self-Satisfied Nonsense?

It's Suicide Prevention Month/Week/Whatever again. Those of us who are or have been suicidal know suicide prevention as a year-round, full time job. Those of us who are or have been suicidal have a whole lot of experience at preventing suicide. Is anyone interested to hear from us? Some of the following came from an earlier post. It bears repeating, 'cuz evidently even some bright people have some strange ideas. Like:





Suicide is not a choice

The way people talk, you'd think we sit down and make a list, pros and cons of suicide. Then based on our calculations, we make some kind of decision. She chose to end her life. Or, How could he have been so selfish.

This is called the volitional theory of suicide, suicide as an act of will. The suicide prevention approach that addresses it is to weigh in on that list of pros and cons, like Jennifer Michael Hecht's book, Stay.

You know -- Suicide is a permanent solution to a temporary problem. Or, Think of what you'll miss out on. Or, whatever. In other words, how dumb or short-sighted or irresponsible or selfish you must be to decide to kill yourself.

Between Stimulus and Response

I went searching for a Viktor Frankl quote. Mental health pro-tip: When desperate, Google "Viktor Frankl quotes." I mean, how does even the most desperate, darkest depression argue with a Holocaust survivor?

Here is what I found:


Okay, I confess, when you put an inspirational quote on top of a beautiful peaceful scene, it loses its inspirational value for me. That's just the way my brain works.

So I'd make my own image if I were inclined to that sort of thing, like if I were having a hypomanic episode. It would be three boxes, left to right.

On the left would be a screenshot of a webpage saying something like, Cannot open page because search timed out. Maybe, Cannot find printer. I saw those images on my laptop a lot last week.

Misconceptions about Suicidal Thoughts

My publicist seems to think people have a lot of misconceptions about mental illness (she's right), because many of her questions go there. You are very open about discussing your own struggles with suicidal thoughts. What do you think are the biggest misconceptions about people going through similar experiences? So today's post will focus on suicidal thoughts or suicidality.

Suicide is not a choice


The way people talk, you'd think we sit down and make a list, pros and cons of suicide. Then based on our calculations, we make some kind of decision. She chose to end her life. Or, How could he have been so selfish.

This is called the volitional theory of suicide, suicide as an act of will. The suicide prevention approach that addresses it is to weigh in on that list of pros and cons, like Jennifer Michael Hecht's book, Stay.

You know -- Suicide is a permanent solution to a temporary problem. Or, Think of what you'll miss out on. Or, whatever. In other words, how dumb or short-sighted or irresponsible or selfish you must be to decide to kill yourself.

Passive Suicidal Ideation and Suicide Prevention Awareness Month

Anna Borges speaks truth about suicidal ideation. In the midst of Suicide Prevention Awareness Month, with its lists of warning signs and gearing us up for the crisis, Anna brings to light the sometimes everyday-ness of suicidal ideation.

I am not always very attached to being alive, she wrote in at article for The Outline, an online magazine. It's not about being in crisis, not about having a "plan," not about needing an intervention. It's more like an indifference to life that sometimes surges into something more serious and then falls back. Like the waves of an ocean.



At 27, I’ve settled into a comfortable coexistence with my suicidality. We’ve made peace, or at least a temporary accord negotiated by therapy and medication. It’s still hard sometimes, but not as hard as you might think. What makes it harder is being unable to talk about it freely: the weightiness of the confession, the impossibility of explaining that it both is and isn’t as serious as it sounds. I don’t always want to be alive. Yes, I mean it. No, you shouldn’t be afraid for me. No, I’m not in danger of killing myself right now. Yes, I really mean it.

Flip the Script on Suicide Prevention Week

National Suicide Prevention Week starts next week (September 8-14) and I am trying to gear up for it. I can’t remember which I am supposed to watch for, the risk factors or the warning signs. I guess somebody will tell me again.

Not to be snarky – I do appreciate this annual effort to get people to pay attention. You’d think so, given my personal stake in preventing suicide, as in, my own. But I have to confess, these campaigns leave me feeling a bit disconnected from myself. How ironic is that?

I figured it out. The problem is that I pay any attention at all to suicide prevention campaigns. But they are not addressed to me. They are addressed to professionals, friends, and loved ones. They are about me and others who are at risk.

But here’s the thing. Professionals, friends, and loved ones are bit players in the suicide prevention business. The ones who do the heavy lifting are the ones in danger ourselves. So we read the literature, always looking for another trick to try, only to discover that we are eavesdropping on somebody else’s conversation.

Honestly, we don’t need to know the warning signs. Honestly, when we are in late stages of planning, we read those lists to make sure we don’t slip up and give the game away.

The Heavy Lifters for Suicide Prevention

God and Suicide

Eight years ago I wrote "I don't believe in God anymore." It was the title of a book chapter, a book reflecting on suicide from a Christian perspective, though probably not the Christian perspective that you think about when I say that. More like what goes through the mind of a Christian who is suicidal and is bringing what is left of her theology to the experience and desperately trying to tell the truth about it. The truth. Not what we want the truth to be. Just the truth. It wasn't exactly a suicide note, though it might have been taken that way if that's the way it turned out.

It didn't turn out that way. I recovered. "I don't believe in God anymore" anticipated that I would recover, but that wouldn't make the problem go away. Relapse was statistically probable. I might be in that darkest of places again. This chapter dealt with the problem of suffering. Oh, how tidily that phrase expresses the chaos of a believer's brain when looking into the abyss. But I wouldn't let the tidy answers stand, and I still won't. While I am not so bitter anymore about this remitting, recurring condition of mine, as far as God goes, well, I just don't know as much about God as I used to.

Here is a piece of that chapter:

Although my own soul is a dry desert, I have deep wells from which to draw. While I do not believe in God, so I cannot say the creed, I cannot set my heart on the One who has broken it, I still believe in the communion of saints. As a Christian, I have a big family, across space and time. For now, I ask the rest of my family to do my believing for me.

The lament psalms persist in worship, and worship is how I persist. I listen to Gospel music. I sing along with those whose music it is. I do not have their faith. But I cannot dispute their testimony, what God has done for them, and the power they find in God to get through. I believe in them. I believe in the Brooklyn Tabernacle Choir.


Those whose ancestors survived the Middle Passage, survived slavery, survived Jim Crow, survived the Klan, who still survive today, I don't know how they survive. But they assure me, and I listen to them tell me over and over:


             Everything He said in His word,

               He will do it for you.
               Every prophecy he gave, every promise He made,
               He will do it for you.

Eight years later, I am in remission, not depressed, not even a shadow for the last six months. An eternity! I have challenges. I manage my condition every single day. And my life is good. I work toward a publication date of September 2020. There will be something that comes out of that old hellhole, a book, a different book that offers help and hope to others who have been misdiagnosed and inappropriately treated as I was. And I am very proud of it, Prozac Monologues, the book.


I am not saying it was worth the price. I am not saying that my God issues have been resolved, that some promise was kept, and it's all okay because there was a happy ending. You can say that if you want. But it's a slippery slope, hanging your faith on the happy ending.


David Conroy wrote, Suicide is not chosen. It happens when pain exceeds resources for coping with pain. There is some truth for you. I have been blessed by enormous resources, and they have kept me alive through enormous pain. One of those resources is an unshakable experience of the communion of saints, those who have been there for me across the centuries, from Jeremiah to John of the Cross to the friend who said my prayers for me when I confessed I couldn't pray anymore to the Brooklyn Tabernacle Choir.

I went to church on Sunday with a CD by The Brooklyn Tabernacle Choir. It reminded me of that chapter. And I thought it was time to say thanks. They carried me through.





photo of candle by anonymous, used under Creative Commons license

On Surviving - I Wish Robin Williams Had

Nearly a week's worth of reporting on Robin Williams' death, some of it heartfelt, some of it educational, some of it ignorant bloviating -- even if you have been living under a rock and not heard any coverage at all, you can name the bloviators, can't you.  By now, my readers surely wonder, What is the Prozac Monologues take on his untimely death?

I have written reams on suicide and suicide prevention.  Click on those two links and take your pick.  But skip the Suicide Monologue, at least for another week.  It is inappropriate for another week.  And if you do go there, then mind the humor alert.  I am serious -- about the humor alert, that is.  Some of you won't find it funny. It wasn't written for you.

But before we abandon the suicide conversation in favor of the next thing, let's expand the frame.  Here's the deal.  Of all the people alive on the planet today, 50,000,000 will, at some point in their lifetimes, struggle with suicide.

I can't say we will think about suicide.  Those of you who think about it in passing seem to think that the seriously suicidal think.  There is lots going on inside our burning brains.  But thinking doesn't really describe it.

The Suicide Monologue

Suicide Humor

They asked for a trigger alert. This is a humor alert. Oh, well.

I realize some people do not find suicide humor humorous. I get that. I respect this opinion and honor the feelings and experiences behind it.

If you have not read Prozac Monologues before, you need to know that it has always aspired to a bent sort of humor. And in honor of the World Health Organization's World Suicide Prevention Day, today's post, a long time coming, is The Suicide Monologue. Watch me while I attempt humor. You don't have to read it. Just know, it is what it is.

Recovery In Progress -- My First NAMI Convention

Dr. Ken Duckworth's job at the Ask A Doctor about PTSD session was to make some opening remarks and then let people ask their questions. He rattled off a list of treatments and said, The good news about PTSD is, we know what causes it -- trauma that was not able to be processed adequately. The bad news is, the treatments just don't work so well.

Short and to the point. Actually, I am not so negative (right this very minute, anyway) about treatment as Dr. Duckworth, because I am not looking for the magic med anymore. I know about recovery.

Recovery is about collecting tools and pulling them out when the occasion requires. I will illustrate. But first the setting...

Last week I attended my first NAMI (National Alliance on Mental Illness) Convention in Chicago -- 2300+ people who have mental illnesses, family members, advocates, volunteers and caregivers, with a few scientists thrown in for good measure. As a friend said to prepare me, A NAMI Convention has a certain kind of energy. Yes, it does.

I have been to big conventions before, used to be a legislator (called Deputy) for the Episcopal Church, which gathers 8-10,000 or so Deputies, Bishops, exhibitors, visitors, volunteers and the like every three years. I stopped doing that when I figured out that every three years General Convention tripped my hypomania and was followed hard on by a depressive episode.

So this was my largest gathering in some time, with plenaries, workshops, symposia, networking and ask-a-doctor sessions, drumming, theater, yoga and talent show, internet cafe and peer counselors, exhibitors, book sales and an information booth which was the best hidden spot of the whole damn Chicago Hilton.

You can expect a number of blogposts out of this event, including dueling comments between me and fellow blogger John McManamy. Now that we have finally shared a beer, does that make us blogmates?  I began writing this piece in the hotel room, late after the last gasp, the rawest of my posts to come.

I knew it was a mistake to make Ask-The-Doctor-About-PTSD the last thing I attended. It's just, that was the schedule. Most helpful take-away: The brain is simply not designed to metabolize certain experiences. PTSD is the result of incompletely metabolized traumas. Bottom line, it is a normal response to an abnormal event or series of events.

The brain keeps trying to metabolize these unprocessed events/memories/emotions/bodily sensations. They lurk beneath the surface, waiting for the next opportunity to emerge, when triggered by some reminder.


Oh, I was triggered, alright. The last question of the day was about a particular symptom I don't talk about and religiously avoid. I left the room reliving it, dizzy and disconnected.

Walking out, I heard the voice of my therapist, who once ended a session saying, The things we have talked about today probably have triggered your past traumas, and you will be dealing with the effects after you leave. So how are you going to take care of yourself today?

Time to pull out that toolbox.

The Ask-A-Doctor doctor listed half a dozen treatment modalities for PTSD: meds, support groups, EMDR (Eye Movement Desensitization and Reprocessing), sleep regulation and aerobic exercise. He mentioned Prazocin for nightmares.

First off, pop my anti-anxiety rescue med, put on my walking shoes and go get some aerobic exercise. Work off that negative energy.

Just outside the door was Grant Park. An art exhibit diverted me from my aerobics. But art is good, very good. Change the channel -- that's Cognitive Behavioral Therapy 101.


I stood still and drank in paintings inspired by water. Not this painting, actually, which is exhibited just down the street. But I thought of it.

Water is good. It evens out the emotional turmoil. -- So says my other therapist, the one who does eastern-based energy work. You see, when even the doctors acknowledge that western treatments (they don't call them western, because they don't speak of there being any other treatments) work poorly, I am not going to limit my tool box to only half the planet, especially not the more rigid half.

I spoke with the artist about perspective. He paints on a flat surface, so doesn't think it matters which side is up. I breathed into the here and now. Thich Nhat Hanh taught me here and now. But here and now is my worst subject. And somebody interrupted to talk about showings and art business. There were too many people -- had to reduce stimulation.


My energy therapist would recommend grounding. I headed back to the gardens, flowers, trees, dirt, all good, all grounding. Eating is good for grounding, too. Maybe I should eat something.

From Alcoholics Anonymous: HALT = pay attention to when you are Hungry/Anxious/Lonely/Tired. No, a martini is not in the recovery toolbox.

So I bought my inner child a strawberry ice cream -- a drippy cone instead of my usual adult cup. Sugar isn't really the best choice, but it was red and a gift to my inner child. Then I head off to find some meat. Meat feeds the first chakra. First chakra is about safety. PTSD is about the amygdala is about safety is about the first chakra.

Still I was struggling. I don't just have my own pain; I suck up the pain of every person with whom I have spent the last three days. All those stories -- how can there be such a world? How can I live in such a world?

I picked up my whole personal Book of Traumas, the traumas that never got resolved, that get retriggered today when I try to resolve them in therapy, the distrust I try to pretend does not exist toward the people who try to help me but they end up retriggering the traumas I can't resolve because they never seem to address that they are retriggering them and my retriggered shame prevents me from telling them and I truly believe the result will be retrauma anyway.

There are exceptions to that negative thought. List the exceptions -- Cognitive Behavioral Therapy 102. But how do I know who is for real...?

So I head back to the convention, walk over the train tracks. And there is another trigger, another overpass, another trip to Chicago, another episode, another long time ago. How quickly is that train traveling?  How far away?  How fast does a body fall that far?  How to time the collision of the two?  Velocity problems were the one thing that defeated me in high school math.

But I am not in the right spot anyway. Geometry I got. I need to be right -- there -- where -- a woman is pushing a baby stroller.

Oh. Okay. Not tonight. I have an Iron Rule. In a world filled with trauma, to the extent that it lies within my power, I will not cause trauma. A two-year-old is sitting where my demon would call me. The two-year-old wins.

God bless the internet that led me to David Conroy some years ago. The first sentence of his book Out of the Nightmare brought sense out of the chaos that compounded the pain of my suicidal symptoms. Suicide is not chosen; it happens when pain exceeds resources for coping with pain.

Tonight my pain was painful. But I have survived worse, much worse. And tonight my resources are many. Tonight the thought was more than a mosquito, but it wasn't a tiger. I do not underestimate the lethality of this disease. One in five people with bipolar II do not survive it. Tonight, I am still of the four.

I know people freak out over the suicidal ideation part of mental illnesses. I apologize to my friends for causing them pain by bringing up the subject -- even though my need to protect you from this pain adds to my own. I try not to bring it up, except with people who know what I am talking about. But this is one of the tools in the Recovery Toolbox. Those who do know what I am talking about need this tool. And this post is for us.

Ironically, the state of the art treatment for people who have a lot of suicidal ideation and behavior, people with a diagnosis of Borderline Personality Disorder, is Dialactical Behavioral Therapy, radical acceptance. Starting, not ending, but starting with acceptance even of that symptom that freaks out so many of you.

Yes, sometimes I have those thoughts. They are well-worn grooves in my neurological pathways. Any number of things will trip the cascade that leads there, including things you might not imagine, a cold sunny day, my doctor suggesting a new medication, an overpass. These are not reasons. Suicide is not about reasons. These are triggers of neurological pathways that have a current of their own.

It is what it is. Those five words sum up Dialectical Behavioral Therapy, an offshoot of CBT. They were the chorus sung by one of the players in the lunchtime drama troupe. Saturday night, I repeated them to myself. Often when that thought appears, somewhere between a mosquito and a tiger, I say, There it is again. That's all. Mindfulness. The thought doesn't have to freak me out, doesn't have to freak you out. It is what it is. Move on.


As I crossed the overpass, I felt a draw, a pull toward the hotel. It was an energy, a spiritual energy on the side of life, two thousand people in that building, rooting for me, for my life, for one another, for you. One of them even blowing a didgeridoo, accompanied by a flute, to be followed later by another who whistled Somewhere Over The Rainbow, all spiritual energy on the side of life.

The wisdom is ancient. Two are better than one, because they have a good reward for their toil. For if they fall, one will lift up the other; but woe to one who is alone and falls and does not have another to help. Again, if two lie together, they keep warm; but how can one keep warm alone?  nd though one might prevail against another, two will withstand one. A threefold cord is not quickly broken. [Ecclesiastes 4:9-12, New Revised Standard Version]

So that is my first report of my first NAMI Convention, the most confusing and most compassionate experience I have ever had with 2300 people.


(Find your local NAMI Chapter here.)

photo of toolbox by Per Erik Strandberg and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
General Convention Seal for the Episcopal Church in public domain
Olaus Magnus's Sea Orm, 1555 in public domain
Water Lilies by Claude Monet, 1906, in public domain
photo of Grant Park in Chicago by Alan Scott Walker and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
root chakra by Muladhara Chakra and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
photo of Chicago Orange Line by Daniel Schwen and used under the Creative Commons Attribution-Share Alike 2.5 Generic license
photo of Coal Creek Falls by Walter Siegmund and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
fresco at the Karlskirche in Vienna by Johann Michael Rottmayr, in public domain
book covers by amazon.com

Suicide Prevention for All of Us

I end this month's focus on suicide with what we can do. Remember, "Suicide is not chosen; it happens when pain exceeds resources for coping with pain." (David L. Conroy, Out of the Nightmare: Recovery from Depression and Suicidal Pain)

So the way out of the nightmare is laid before us: reduce pain and increase resources.   Somewhere below is something you can do for yourself, for those you love and for those whom you have been commanded to love, if you believe in that sort of thing.   These lists are from Conroy, pp. 300-302.  My remarks are in brackets.

Out of the Nightmare: Recovery from Depression and Suicidal Pain

Suicide is not chosen; it happens when pain exceeds resources for coping with pain. 

David L. Conroy had me at the opening sentence.  I read it first at Metanoia.org and knew it came from somebody who had been there.  I recommend the website for help and insight from the insider's perspectiveIf you are thinking about suicide, read this first. 

Fact of the Month -- Suicide

It's June, the month with the highest suicide rate for persons with major depressive disorder.  So my posts this month will be on the topic of suicide.  Note to friends: This is not a coded message.  I personally am okay right now.

Today's post introduces the "Fact of the Month" feature.  And today's fact comes from David L. Conroy, Out of the Nightmare, who gets his information from the Statistical Abstract, 1989. 


Statistics -- More Suicides Than Homocides

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