Talking with Alicia Raimundo

So let’s talk about the idea of attempt survivors as superheros. Alicia Raimundo stood up at the end of this month’s national conference of the Canadian Association for Suicide Prevention and told a little of her story. We spoke this week, and she’s all for openness on the topic. And some playfulness as well. “Part of me wants to make people feel uncomfortable around me because I’m challenging their beliefs,” she says. “I’m not the media representation of the mentally ill.”

Here she talks about speaking up for a younger generation of attempt survivors, what effect it has on her dating life and how dealing with suicidal thinking shouldn’t be seen as all that different and scary. “If you take a normal person and put them in a suicidal situation, their coping mechanisms in that extreme emotional situation, they would fail too,” she says. “Just like we celebrate cancer survivors for beating cancer, we should celebrate people for beating schizophrenia or bipolar.”

Where would you start your story?

I think I would start by explaining that one of the first things you learn to do is cry, to get attention, to take the pain away, to help you get through something. And as you get older, you put Band-Aids on cuts, call the doctor. But no one tells you how to deal with pain you can’t see. No one tells you how to even start that conversation. To the point that I didn’t even realize I was sick until I was 12, 13. I thought everyone walked around extremely nervous and miserable. I struggled to find the right things to say in grades 7 and 8, and I realized this was a problem not common and unique to me. My classmates were a lot better getting people to talk and like them. That’s when it hit its hard point. And so I tried reaching out to a couple of people but didn’t know how to articulate it. One final reachout was to a teacher helping teach my grade 8 class. At this time, I was kind of known as a problem kid, the one who would not talk to anybody. That sometimes can come off as egotistical. I thought everybody was rejecting me, so I preemptively rejected others. She wasn’t too happy about me asking for help. When I went to meet her, I overheard her say, “I have to go meet this crazy girl,” and I kind of shut down: “I’m not gonna get better.” Everybody misunderstood: “She’s just acting out.” When she amplified that, I kind of just, you know, decided, “This is it. I’m done with this, being miserable every day, waiting for my mom’s car to come and to cry in the car. I’m done.” I made a plan to take my own life. It didn’t succeed, thankfully. At this point, I felt this struggling, like waiting for the next chance for it to come. It’s like just getting enough air to breathe and most days not getting that much.

One time life changed was when I was trying to get treatment on my own. I came across this woman in a treatment center. I was young, a teenager, and I looked like I didn’t care about anything. The woman says, “From one crazy person to another, you’ll need this,” and she gave me a necklace with the word “hope” on it. The ironic part of the story is, the woman was also a client, suffering from a manic stage, and her daughter came up to me seconds later: “I’m sorry, can I have that back?” To me, it was the idea that we can have small things to hope for. For me, it was watching my sister graduate from high school, which happened two years ago. The hope to see things. After that initial hope, my living was not so hard anymore. There are days where I don’t have a good day with it, but I’m a lot stronger. I don’t wish mental illness on anyone, but it’s a blessing in disguise because I had to know myself a lot better than others. I had to know what worked and what didn’t. For me, not knowing is lethal. And so at a certain point, I started getting better and better and wanted to give back.

I got frustrated sharing my story like Spider-Man, anonymously, on blogs here and there, hiding. It was really stupid. I wanted to be like Ironman, in front of a crowd. “Fuck this.” I wanted to do this, go there, start the conversations. I’m super. And from that point on, I share that story with people. You can be that person, sharing in the open. You get this overwhelming support. There’s a stupid comment here and there, but it’s mostly support. I created this peer group who supports me through bad days. I work for a large corporation in Canada, and I was on a large TV morning show here. I took the morning off from work. When I came back, they were really interested. I said this had nothing to do with work, but they wanted to see. One person just said to the other, “If you knew she was suicidal, why did you hire her?” You hear the horror stories, you know this happens. You hear this on trains, buses, people saying, “I can’t hire this person, they have gaps in their resume.” They’re not realizing people can get better. I was hearing this negative feedback nine years after I tried to take my own life, so it was really an unjust comment. Sometimes sick people should be stepping away from work to invest in themselves. If they need to take time off to get better, do it. But me, I was treated with a ridiculous amount of bias.
I was in a meeting with the CEO and a bunch of others. I went up to him after the meeting and said “You’re really concerned about brain injury. There’s a lot of employees concerned about mental health issues.” I told him my story, and he said, “My wife has bipolar. I would not stand for this in a million years.” He put the two gentlemen in touch with HR. I urged not to fire them because they’d get more angry and take it out on others. They started putting this into HR training. One guy came to a talk of mine a few weeks ago and apologized.

It has a strong impact. I share my story and have people telling the life stories they never shared before. Like my train story. I was on suburban rail in Ontario. I’m sitting, talking to a friend about suicide prevention. A gentleman followed me off the train and I thought, “This is kind of creepy.” Then he’s talking to me and seems normal. He says, “I’ve never heard anyone talk so openly about suicide prevention.” I said, “I’m passionate about it.” He’s telling me he felt suicidal for a really long time: “I’m glad people talk openly.” I asked if he had resources. He said, “Yeah, a lot of really great people.” I remember standing outside the station and my dad’s car comes up. “It was nice talking to you.” He says, “I want to thank you.” Why? He says, “If not for you, I was going to jump in front of the train.”

So the power of these conversations, it’s so uncomfortable and scary putting yourself out there, but the good effect is amazing. You just feel this connection with people. People come up to you in tears: “I was planning on ending my life next week, but I’m going to get help.” Sometimes you have to remember the most ignorant voice in the room is sometimes the loudest, the first to say, “That doesn’t happen” or “Your statistic is wrong!” And everyone else is waiting for someone else to say, “Me too.” My dream is showing them if you’re living with mental illness, you’re more than normal. You’re so strong. You have to know that helping yourself can be a full-time job. Help people to not beat up themselves if they’re not so productive at work. The strength of wanting to help people is amazing. [At Canada’s national conference for suicide prevention] I recounted the story of the woman [doing the mental health awareness walk] on the Brooklyn Bridge. She started feeling sick and collapsed in the medical tent. I went in and her husband said, “She has to finish for our son.” Just the power of making any choice, any difference.

I think one of most important messages is, it’s just as simple as asking what you can do for that person. Or giving a list of things you’re comfortable doing. I think there’s so much that needs to happen. It’s great to see these movements, these discussions around suicide moving from every time something horrible happens to a more constant dialogue. Just sharing stories of hope and change, saying people can get better. Because people always look at me. I’m a quirky individual, and they associate that with my mental illness. I’m like, “No, the reason I have a personality is I found a way to live with my mental illness.” My quirkiness is kind of just like … People, when someone knows you’re ill, they look for aspects of your personality they don’t like and think you’re still ill. It’s kind of like doing self-confirming bias, to make it look like I’m always sick. I do have remnants, but one reason I can have a personality is I feel a lot better now. I think it’s just one of those things that strikes me as kind of funny.

At the conference, you also told a story about following a guy around because he was scared of you …

The first time I was ever asked to speak, I was at the University of Waterloo. The guy basically looked at me, and hilariously enough, it was at our campus peer educator group. He was in charge of making information about suicide. He asked in a condescending voice, “Why are you talking about suicide? I said I was suicidal. It was not the most mature thing to do. I just was like, “Yeah, I’m going to prove I’m not contagious and follow you around.” His reaction was so unreal. I just wanted to show them I could sit next to them, have conversations, be a productive member of their team. I’m not going to, you know, snap and decide that I’m going to attack them all. I don’t really understand what goes through their mind. I was just trying to prove the point, it’s not something to be scared of. Most people with mental illness are not going to hurt you. They’ll probably hurt themselves. A lot of times when people do negative things, it’s a time for a conversation: “Why do you think that’s OK?”

And I think it’s been an interesting journey. Talking to people, sometimes they don’t realize what they’re saying is really wrong. They’ve never been told that before. They’ve not been told it’s offensive. And I do that. At the same time, I will stay in situations, and part of me wants to make people feel uncomfortable around me because I’m challenging their beliefs. I’m not the media representation of the mentally ill. The media don’t do the best job of showing it. And people don’t like feeling wrong. This is just something they believed. And one thing I’ve done for a couple of friends I lost by suicide is go to their Facebook page, and when people ask, “How did this person die?” I go in a private message and tell them they died by suicide. They suffered from mental health issues and were very sick. And there’s no type of person that does that. Like you can lose a person to cancer, you can lose them to suicide.

I think the more we can have these awkward conversations with people, make people laugh … When someone reacts weirdly to me now, I say, “Don’t worry, I’m not throwing cats at you” just to lighten the mood. Sometimes suicide and mental health can be really heavy, and making people laugh, showing we can laugh and are pretty unique people ourselves, sort of starts to change the discrimination. It can help change stigma. I’ve seen minds be changed. People come around to it. Sometimes people are not exactly where I want them to be, but it’s a journey. They went up a fair bit, even if it’s not to the level everybody wants it to be at. It just shows the power. When you realize the perception they have of someone else, it’s kind of fun to have fun with them. Make them face their own discrimination. “I thought this person was cool, then she said one word, and now I think she’s crazy”? I tell people I get one of three reactions, bad reactions: Running away, telling me they don’t believe me or never leaving me alone. That’s why I always say, ask people what they want. If they tell you they’re feeling better now, just ask them what they want to share. I don’t go into certain aspects of my journey because there’s nothing positive to pull out of them. I don’t focus on the negative.

Like what parts?

I had many bad experiences with therapists and with treatment in a treatment center setting. I grew up with parents who struggle to understand how I feel. They’ve grown a lot, but sometimes they still say, “Everything will be better if you pray” or, if I stay one day alone in my house, everybody starts calling me, telling me I’m depressed. I know there’s a lot of amazing parents out there understanding or trying their best. It’s just one of those things. I tell parents, bring your kid in! One way to summarize a bad experience: The person trying to help me is trying to treat the illnesses through me, without involving me. Like my parents, and the icon of depression is behind me, and they’re trying to throw things through me to get to it. Instead of asking, “What kind of treatment do you want?” And especially since I was young, no one thought to do that. It’s like fighting the thing within them, not engaging them. I like to tell people to go to as many evidence-based practices as possible. But I also tell service providers to make the treatment fit the person, not the person fit the treatment. It’s so much easier to fight what’s hiding in the dark shadows when you ask them to turn and look at it and not throw things through them. It’s like people trying to throw meds at you because there’s no time to talk with you. The medicine works when you believe in it and when you take it on an accurate schedule. I didn’t believe in it, and I didn’t take it long enough. But nobody ever talked with me to realize that was my personal stance. For some things, you need the meds. For me, somebody should have asked me. That’s why kids come up to me, say, on 15 different medications. For side effects, etc. I’m like, “OK, at a certain point you have so much medications you don’t know what’s working anymore.” I’m not anti-medication, but I advocate health care professionals talking to their patients about how they want to get better. And talking to peer mentors, showing them how to get up the mountains. And not everyone will benefit from a psychiatrist. And so it’s one of those things that’s a good message for people. There’s many ways of getting better. If it’s working for you, great. Be careful not to give advice to other people. I’ve had a few people go off their meds the next day: “I’m going to be like you.” I’m like, “No.” Believe in your journey. And there’s not an exact science behind this yet.

And I think one thing too is, I’ve had years and months where it’s been worse and better, where it comes back but not to the same extent. I try to show people that we are mental health superheroes, fighting our own bad guys. Nobody kills the bad guy the first time they fight them. They scare them away. And every time that you seek treatment, you have more sidekicks fighting with you. Some times are bad, but I’ve learned to pull happiness from my journey. I’m helped by that. By sharing my story, I keep myself on the straight and narrow. I have to get help. I can’t be a hypocrite, right? And yeah, sometimes I do have some bad days, but I’m kind with myself, and the reason I don’t normally share is that I don’t want people to think it’s horrible every single time or that it never goes away. I’m probably one of the more happy people you’ll meet. One message I like to give is, if you’re stuck in a place where they’re trying to diagnose you but it’s not helping, just say, “I don’t care what’s wrong with me, I just want to get better. These labels don’t make me better.” People think if you know what’s wrong, you’ll feel better. That’s not always the case. You can feel a sense of doom. Not everyone fits into these little charts.

You talk a lot about superheros. What’s with that? Are you a fan?

I’m a superhero fan, but I really wanted a new way of framing it. I wanted to show people they are strong, and they need to celebrate their strength and celebrate how awesome it is they’ve come this far and not get sucked into comparing themselves with people who don’t go through this. I joke that I used to call myself a mental health superhero in training. I also talk about intentional superheros. When you know someone is part of a stigmatized group and you be a friend to them, that’s how you change people’s minds about racism, sexism. I’m just going to treat you like a normal human being. You’re putting intention behind it, becoming a kind of superhero, becoming someone who will help them through their journey. And yeah, I’m kind of a nerd, whatever. Just taking off that mask and fighting the demons without your mask on and still showing you’re strong. All humans at some time wear a mask of some sort, but being able to show “This is me, I’m suffering with this” in the same way that people say, “I can’t come out today, I’m sick.” Creating the same situation: “I can’t come out today, I don’t feel so good.” Being a superhero shows people they’re strong. You’re dealing with something so much more than the average experience. You should be celebrating that, not thinking something’s wrong with you because you can’t deal with normal life. If you take a normal person and put them in a suicidal situation, their coping mechanisms in that extreme emotional situation, they would fail too. Just like we celebrate cancer survivors for beating cancer, we should celebrate people for beating schizophrenia or bipolar.

How did you start speaking out? And what were the reactions?

When I went to university, I had control of my life for the first time. I could do things and not justify them to anyone. So I started openly telling my new friends what I had went through. When I wanted to get involved with the health community, I was so comfortable with telling friends and family that I just told my mental health mentor at the university, and she said, “We need a speaker.” I gave the speech and was nervous as all heck. I got off there and people gave me big hugs: “If you need anything, let me know.” After that, I reached out to regional suicide prevention things. I would always mention I have lived experience too. When they heard me speak, they just recommended me to be on national TV, and when they needed a speaker, they’d bring me along. It was really just people empowering me, really believing in me. I went on MTV Canada, our national breakfast TV show, and after that I decided I wanted to give back to the community. I was working in research to the front line. I was involved with TED and said I wanted to give back. I tried to nominate someone else, but they said, “Why don’t you do it?” I put in an application and got a phone call two months later: “Can you speak?”

Some people want to have this journey. I’m lucky that people believe in me. I’ve had speaking engagements where no one shows, but I always have had a standing ovation at TEDtalk. I give off positive energy, and people want positive energy, too. It was the scariest thing of my life, but I had so many people share stories with me after that. Then I became a “face of mental illness” in Canada after that, for people with lived experience and who give back. We get to be in a national campaign, meet politicians, work with Bell, which is donating a lot to mental health. It’s been soaring since last year, really. There’s a lot of benefit in putting yourself out there, not only sharing your story but being involved in the community. Some speakers, all they do is speak. Others act out the message. I want to share my story but also want to influence a good message.

The message for other people is, when you start sharing your story, you will find people supportive to you. Allow yourself to build up, and when you’re ready to jump into big things, jump. But don’t jump into big things first. Your experience, for the audience, may be triggering. You don’t have to be 45, 50 years old before your journey with this is done. And show young people we don’t have to be at the mercy of our parents, psychologists, psychiatrists. We can stand up for ourselves. Because we are the only ones knowing our experiences in our heads. If we don’t feed into the dialogue, we will not be as effective as we could be. And young people deserve the best people just like anyone else. If you don’t like your therapist, don’t be afraid to fire them. Don’t be afraid to do what you need to do to get better, as long as it will help you live in the future.

Have your parents seen you speak?

Nope. Well, a that’s a little bit of a lie. They tried to see my TEDtalk, but they don’t know tech very well, so they didn’t get a live stream. They watched the video. My dad’s Portuguese, and he doesn’t understand how he can give me everything and how I’m not super-happy. I own my own journey. My journey is me. Sometimes people say, “We want you to bring your parents,” and I say, “No, this is about me.” I’ve had journalists say, “I want to talk to your parents,” and I say, “I don’t know what they’ll be able to tell you, I was so good at hiding it.” I think one day I’ll invite my parents to talk, but the journey is mine, and I want to stand as an independent woman. I did it alone. Because I assumed that people would reject me, and I want to show if people want to do it alone, they can do it alone. I do have parents who are very supportive of whatever I want to do in life, but with this journey, I shut them out and I’ve only let them in recently. I’ll let them see me speak, but they had no idea what was going on. My journey is something that I own. People try to share their coping mechanisms, parents do that, but that tends to not work for me.

You didn’t really mention the details of your attempt earlier. Do you choose not to?

I choose not to. I say I attempted, but … There is some evidence of contagion, and I don’t want to give people the method because, “Oh, look at her, she’s getting all of this attention now, I’m going to do this half-assed attempt and get this attention too!” Also, out of respect for my family and my parents. But yeah, it’s something that I do. I briefly talk about it because at the same time it’s hard for me to go there. I was somebody who, after being suicidal, it was only a couple years after that I started cutting. Not enough to get really deep scars that friends have, but I have one on my wrist. What we basically are doing is creating external pain to distract from internal pain. I’ve done things I’m not proud of, and I want to focus on the positives. I want to know there’s a possibility of living life for you again.

Are there other possible drawbacks?

It will affect your dating life, I will tell you that right now. I’ll be honest, I’m on a dating site because I’m a busy person. And I talk about being a public speaker. I guarantee nine of 10 people say, “Let me see it,” I send it and they never speak to me again. And you know, it’s painful. Whether people don’t want to get close to a person who they think is going to take their own life … You don’t want to be with people who don’t understand you. If they’re judging you based on one talk, I probably don’t want anything to do with them anyway. And your friends, you deal with a lot of weird initial reactions. I had one say I was faking it because I didn’t go into the details of my attempt, or because I’m better now. Just one of those things where you sit down and prepare an answer to those reactions. Just having a way of having a nice, canned answer for them. “Oh, you’re faking it” or “Oh, you’re scary.” Well, I’m sorry, but if you ever want to have a conversation, I’m here to help you out. And the faking one, I understand, because people are really good at hiding it, and I was too. But it took a lot of effort to get here. This is genuinely me. I do want you to understand you can get better. The first time I got that, it was really funny. Why on earth would anyone want to fake this?

Are you making good money or something in speeches?

Sometimes I get paid when I talk about how to create a discrimination-free workplace or school or whatever. I just think any time someone says something bad, they are scared at the notion it could happen to them, too.

Has any reaction caught you off guard?

My mother. The first time she watched me on national TV, she called me. Up to that point, she had been uncomfortable. I had been bracing myself, but she actually called me in tears and said, “You are my warrior. I thought I had something wrong. I wanted to take this pain away from you but didn’t know how.” My mom was the best surprise to me. I have had weird comments or advice. One person said to get rid of depression, walk on hot coals.

You didn’t try it?

No, I didn’t try. Maybe one day. It was just one of those ones that I just kind of went, “Huh?”

What if everyone just started talking openly? Are we ready?

I don’t know if people themselves are ready. Whatever journey you want to take, be it two or 2,000 people, it’s a personal choice. It’s up to you. It should be based on what you want to do with that message. It’s not based on stigma. With some people, five people know they went through cancer, and for some, 5,000 know. I want a world where people feel OK saying, “I went through that, too.” But as a society, we’re not ready for people to say, “I’m going through that, too.” Because the resources are not enough. People seek help, but they might have to wait a year and a half. So I feel like I’m dangling a carrot sometimes. I’m scared for that “I’m going through that now, help me.” We don’t have a good system to rely on yet. There’s not enough people to help them navigate the system.

You really think there are not enough resources to deal with everyone?

In Canada, there’s a six-month waiting period for psychiatrists and stuff, they probably agree with me for that. I think what we have to deal with more is, you know, having all the organizations work together to rally behind people and help them, but sometimes they all compete for the same funding and don’t want to work together. I remember filling out an application for To Write Love on Her Arms on my campus, but they said they can’t come if we have Active Minds on campus. I’ve seen lots groups working against each other. There’s two therapy offices in the town there I used to live. One deals with family violence, the other doesn’t. If someone comes in and says they’re being beaten by their husband , they would rather send to their partner office in the next town than the one two streets over. The petty competition needs to stop.

Well, I assume that’s a lot different than in the U.S.

Well, here people pay for it with tax dollars. In the U.S., it’s more private. It’s a problem in itself. Everybody deserves to get better. One good response is the surge in online communities in sharing mental health issues. All these people are rallying to help people get treatment. One of my best friends from Philadelphia, she reached out to me on Facebook after the American Foundation for Suicide Prevention posted a story of mine. Just the power of social media, having this community that’s not there face-to-face for a hug but can rally and give a support network when you feel you don’t have one. So people stay in treatment longer or fight for themselves more. I work with Your Life Counts, and they do an e-mail service. They say, “We give you an e-mail back in an hour and give you thought-out answers, so you have one person out there who believes in you.” It’s a great thing that’s happened. It’s really creating stronger people to go out and show people that mental health is something we can talk about. And empowering them to believe in themselves.

Do you know of any support groups online?

I think this a problem. I, with a gentleman in England, started one in the summer of 2011, I believe. But because it’s really hard to get people to talk about these things, we had to close it down. But I think the things you can do is, there are a lot of online communities out there. There’s a Twitter called The Buddy Scheme. You can say, “I need somebody.” And you can message them, you can ask them to find an attempt survivor to speak with over Twitter. Those things are going to come. It sucks sometimes to have to find an attempt survivor who’s a speaker and then e-mail with them, because there should be forums out there with everybody talking to everybody else. It has to come to that. Just knowing you have that person in your corner is a good thing. I have a couple of people in my corner who are attempt survivors.

(I ask about the common fear about attempt survivors sharing information.)

It’s misguided a fair bit. I think it’s very important to have a facilitator to create positive conversations. Make sure the mentor is really stable. There is a genuine danger of someone sinking, and it will be like trying help someone drowning. If you don’t have the proper life jacket, they can pull you down with them. There are times people are straddling the line between OK and not OK and don’t need more triggers. But these groups are good, like Skills for Safer Living. Teach them skills on how to live. We need to see that more often. You know, I have about 15 friends who are suicide attempt survivors. We can get together, laugh, watch movies, we are normal people. There definitely is that fear, but there’s a one in 10 chance this happens. That “We’re not trying this at all” makes no sense to me. Because yeah, especially youth, we definitely need to talk to people who have been where we are because we have built-in BS sensors. If someone is telling us what we know isn’t true, we can lose trust so fast. You know how Judy talks about a survivors conference and not feeling welcome. You have the BS sensor. Even if I’ve been through the same disorder, my experience is very different from others. But we will see more and more people talk about what they’ve gone through. There’s always the issue of stigma. You want to start support groups, but you can’t because there’s not enough people showing up. I tried to do a youth bereaved by suicide group, but no one showed up. Because no one wanted to be part of that, you know? I think, too, the more you can educate people in a fun, light way, the better. I work with Mind Your Mind, and they work with games and celebrities. You can learn about it and have a fun time doing it. One way to break down stigma is not have a lot of super-duper heavy conversation with a lot of anger.

Some people say you can’t laugh at this topic.

If you’re able to laugh at jokes that are well-meaning … Some people say you can’t laugh at this, it’s horrible, but I bet that at some point when a person’s back is turned, they laugh at them being crazy. But laughing with us is great. We’re human, just like anybody else. And sometimes humor and light atmosphere allows to ask questions. One of my big criticisms about the mental health field is it’s so somber. Have you ever watched “The Bridge”? My god. It’s like, “This is the most depressing hour and a half of my life.” It’s all about the balance.

Is there anything else you really want to share?

The way I like to end is, if anyone’s looking at this and suffering, just know you’re worth it, worth living for, you have a beautiful mind, and the world wants to hear what you have to say, though it might not feel like it sometimes. There’s a life to live, and there are supports to help you live that way. You’re strong, and you’re fighting for yourself. Just don’t try to do it alone. Reach out and realize you are deserving of the best possible help you can find.

Who else are you?

I love photography, bad cop shows, hilariously even though they make fun of mental health. I love laughter, pulling pranks, being like, you know, the bad mom jokes, bad dad jokes. I love helping people, even if it’s not mental health. I’m a recent psychology grad from the University of Waterloo. Just quirky little me, who loves a lot of things. And I’m not defined by mental health, mental illness, but I’m looking forward to beating stigma in our lifetime. It’s actually funny, I have a therapist I see every couple of months, and that’s what she asked me: “What else are you? It’s like it’s consumed your life!” Yes, but in the best way. I have time to go out with friends, joke around, be completely like girly girls, complete idiots, jumping into shopping carts in malls and stuff. I’m still a youth, so I do things youth do.

Talking with Laura Carbonell

I didn’t expect to come across someone’s story of their suicide attempt on a blog dedicated to Latina moms, but there it was. Laura Carbonell was moved to write about her teenage attempt, one she had nearly forgotten, after a friend from high school recently reached out for help on Facebook. “It all came back,” Laura says. “I understood how she must feel. Abandoned, alone and helpless. I believe it was a call for help, but I too understand people wanting out.”

Laura offered to answer questions by e-mail:

Who are you? Please introduce yourself.

I’m 47 years old. I was born in Scranton, Pennsylvania. My father, who is Spanish,
was teaching philosophy at Duquesne University, where he met my mother,
who is American. Two years after I was born, my mom decided to leave my dad
and take us with her and her new boyfriend, but my dad resisted the idea. My
mom was 22 and very irresponsible and an alcoholic. My dad took us to Spain to
start over, my sister and I. My sister is two years older. We landed in Madrid,
Spain, where we were raised by my grandmother, who was going through her own
breakup and depression.

I barely recall my mother. I never missed her, I think, but I am sure many of my
problems are rooted in the abandonment and rejection I constantly felt. At the age
of 5, I already felt like an outcast and had difficulty making friends. I already
had questions about life, what it was about and why we were here. This I felt I
couldn’t communicate to other 5- or 6-year-olds.

I had a rough time at school because, as I now know, I have ADHD and was also
very shy. By 13, I was already drinking. I drank my way out of my shyness and felt I could
relate to other people, be fun and forget my self-consciousness.

I practiced all the self-hatred possible for years. Drinking, burning my hands with
cigarettes, and I believe all of this was to control what I felt and to numb my
feeling. I just couldn’t seem to be able to be normal or carefree. Whatever that
means! However, nobody had a clue, or would have a clue, because I am a very joyful
person when I am with people. I am a Spanish teacher, and I love what I do.
Nobody would think I have had social phobia, which now I am overcoming, at long
last! Outside the class and when I was/am alone, all the demons, insecurities and
fears seem/ed to come back.

I finally went to a psychiatrist when I was 24. My family didn’t know how to
help me and my destructive nature. I went happily on my own but kept drinking.
This man suggested I go to a hospital to get sober, and I did. But I didn’t like
the place. I did know I had a drinking problem, but I just couldn’t relate to these
people at the mental institution. Plus, they had me on megadoses of Valium. I lasted a week and a half, when the program was a month. I left and tried going it
alone. This was the first time since 13 that I had nothing to drink and had to face
life without the crutches of a drink. Oh boy! All my fears, insecurities were there,
every minute. A black cloud seemed to cover everything. One day I came back
home absolutely depressed. It wasn’t planned, I just walked into my room and got
three bottles of Valium (I was in Spain, and I could get most of what I wanted) and
had them all. I was in a daze and don’t remember very well what happened. I just
have images. It seems I called a lady friend of my dad’s who had recommended
the psychiatrist, and they rushed me to the hospital, where I had the Valium pumped
out. I do recall asking the nurse if I was going to make it and she said, “We don’t

The next thing that I recall was getting up at 6 a.m. and heading to teach my classes.
I taught at companies and worked for my dad at his language school. I wanted
to get back to life. Many of my friends agree my job kept me alive. Because
that was a confident me, not the me after the classes were over. Everyone, even
my psychiatrist, was amazed I went to work the next day. And I did go back to
drinking. I couldn’t face life without my crutches.

I never talked about it with my dad, or any family member. We didn’t discuss
anything personal. I know my dad has always lived in fear that I would pull it again. But it has never been discussed.

Eventually, at 27, I quit drinking with the help of NA. This helped me in so many
ways, building confidence and finding out that I wasn’t alone. Drinking, smoking and overeating, I believe, are also smaller forms of slow suicide. This should be emphasized.

How did you decide to talk and write openly about your experience?

I had almost forgotten about it until I started writing for VOXXI and Mamiverse.
A high school friend posted on Facebook that she wanted out with her kid. Her
parents had also committed suicide years ago. We alerted Facebook and the cops, and it
seems we got her help.

Throughout the process, I got discouraged because many people who actually
lived near her were not responding. I live in San Francisco, I haven’t seen her for years, and nobody close was responding! I finally wrote to my friends, and it all came back.
I understood how she must feel. Abandoned, alone and helpless. I believe it was a
call for help, but I too understand people wanting out.

I came across the video I linked to the [Mamiverse] blog and found it so honest. I understood the guy so well. I also read and wrote about Bob Bergeron. A happy man
who killed himself. Sometimes I believe there are no clues. Our rivers run so deep.
Even having it all doesn’t mean we are doing so well.

It is true I am attracted to suicide. I find it interesting and something people should
be more open about, with discretion, of course. We don’t want to say it’s OK, but
we do have to acknowledge that it happens. What scares me the most is that, as with myself, it wasn’t planned, it seemed like the thing to do. There is depression and sadness, but clinical depression can drive you to do things without much thought.

What kinds of responses have you received to the blog?

It has come as a surprise to many, because I am a very happy-looking person. I
genuinely am. Again, only when I am alone do the demons try to pry their way in.
A student-friend of mine did thank me for my story and honesty.
Some have come to me with their own stories or other personal stories. They felt
they could confide in me, and I could understand were they were coming from.

How can more people be encouraged to speak out, or to not freak out when
someone mentions a suicide attempt or suicidal thinking? Or are there benefits to
keeping all of this quiet?

I believe that it is trickling out. Slowly it is being more talked about, as with
the bullying which has driven teens to commit suicide. I think parents should
encourage more openness with their kids, more conversations, even if they might
feel it uncomfortable. Kids need to feel comfortable about communicating their
feelings. And only parents can encourage this.

Once it has happened, I think people should reach out and get the conversation out
of the way. Once out, people can understand and forget about it and see it as an
anecdote. When people have all the information, they feel more at ease. No more
big elephant in the room kind of thing.

Ignoring it might work for some, though. I haven’t talked about it. Ever. Just now,
because I now feel strong enough to do so.

Is it easier to get past a suicide attempt if it happened earlier in life, for teens or
young adults as opposed to older people?

Yes, maybe it is easier when you are younger. Time heals most wounds, as they
say. And you learn from experience. However, adults may have a harder time.
More baggage, more fears of being accepted and seeming loony. There is too
much pressure as an adult to keep appearances.

If a person has had a suicide attempt and would like to be open about it, how
should they balance that with the possibility of negative reactions in their career,
social life, etc.?

Being an alcoholic, even a recovering alcoholic, years ago was seen as a weakness,
an embarrassment, etc. However, now people look up to some of these people and
praise their strength. There is more understanding. Same would go with suicide if it
were more openly talked about.

I now have this belief _ finally! _ that the people who can’t handle how or who you are
need not be in your life. Being you, accepting yourself, will make you stronger.
Fear of what people think will hold you back.

I often include a question about assisted suicide. Is that a completely different
issue, or should there be a different approach for people near the end of their lives who say they want control over it?

Death is a taboo, when actually it is as natural as being born. I believe people should
have a choice of how and when to die. I must say that I joke about it and always tell my family and friends to unplug me ASAP! For one, I want a dignified exit for myself and others. On the other hand, I don’t want my relatives or friends to go broke to give me a couple of more suffering-filled days!

If you wanted to add another angle or approach to suicide prevention to reach out
to attempt survivors, what would you do?

As I said before, we should get closer to people. I am a teacher,
and I get real close to my students. They tell me things they wouldn’t tell other
people. I bond because I ask personal questions. I used to think that people didn’t
want to talk about their losses, as in the death of a loved one. Now I understand
that people do, want to and need to. Same as in suicide attempts or any other real-life matters.

The problem is that I understand too well wanting to exit. Life is hard, and we live
two lives, our inner lives and outer lives. We all have our demons, and some are
harder to overcome.

Oh! And last year, when I felt depression start to come over me, I immediately
sought help. I was afraid of falling into that deep hole again. I am sincerely doing
very well, and that is why I can talk about who I am.

Who else are you?

I am a language teacher who has found a home in San Francisco. The city of outcasts, where I feel normal because they are not afraid to blurt out their most
personal stories. Because here, there is real acceptance.

More from Canada, part 2: Listening to Wendy Matthews

One of the several attempt survivors I met last week at Canada’s national conference for suicide prevention was Wendy Matthews, who gave an open, engaging presentation about her experience. “I have finally been able to recover my life, and my illness finally turned into just that. An illness,” she told the audience. “It is no longer who I am. It is something that I have.”

She agreed to let me post her speech here:

Good afternoon, my name is Wendy Matthews. And I thought I would start with a little bit about who I am.

On Dec. 26, I will be married for 25 years to the same wonderful man.

I am a proud mom of an 21-year-old son.

I am a college graduate.

I am a board member of a local not-for-profit agency.

I am a public speaker for the Canadian Mental Health Association of Niagara, United Way of St. Catharines and for my own company. I own three businesses: Happy Being ME, Button Me Happy and Wendy Speaks Up.

My life sounds pretty typical, don’t you think?

What I haven’t told you is that I have a mental illness. I have been ill for over 30 years and was properly diagnosed only 13 years ago. For over 10 years, I was totally unable to do any type of work. My diagnosis is bipolar-schizoaffective disorder. This means that I suffer from deep, dark pits of depression for long periods of time and sometimes for years. Depression for me is like a wet, thick, dark blanket that is thrown over my head. I can’t breathe, I can’t see past the darkness and I can’t lift myself up because of the weight of the blanket.

I also spring over to the other extreme, to the mountainous highs of mania. In this part of my illness, it is the exact opposite. I am light as a feather and as free as a bird. I know I could fly if I just take that leap. During these times, I do not sleep or eat for days on end. I commit myself to everything and anything people ask of me, and I have put myself into unsafe and at times dangerous situations. Mania for me can last for days or weeks at a time.

I also suffer from schizophrenia, which for me includes hallucinations and delusions. Some voices tell me horrible things. Other voices are just my friends, and we chat. Other times, it is just a lot of unrecognizable talk, kind of like being between radio stations, hearing the static and voices but not being able to understand what they are saying. I see dark figures and forms that live in the corners of rooms, behind things and in the ceilings. My delusional thoughts are harder to describe. The best way I know how to describe it is like being awake in a dream or nightmare. Well, more like a nightmare. I think, feel and see life, but no one else is going through the same things. I feel confused, terrified and angry during these episodes. These feelings only intensify when someone challenges me on what is going on.

My illness started back when I was 12, with a deep depression and my first of many suicide attempts. One day after school, I swallowed a bottle of pills that was in the medicine cabinet and left home. I was young and had no idea about how medications worked. I thought I would walk for a while and drop dead in my steps and everyone would be so much better off without me. After walking for a while, I started to feel ill and was getting tired, so I headed home to go to bed and die. I came home, and my parents were there waiting for me. They yelled at me because I had left and not told anyone where I was going.

I was grounded. I listened to them lecture and kept thinking in the back of my head that they wouldn’t have to worry about me anymore. I went to bed and awoke the next morning very disappointed that I couldn’t even get a suicide right. I had survived and no one knew what I had done, and I was still grounded.

By the time I reached high school, I was drinking to cope with school and life. I needed to drink to go to school, to be at home and to go out with my friends.

During my time in high school, I had a few more suicide attempts, and still no one knew. I would overdose and go to sleep. Sometimes I would get sick, but mostly I would lie down and expect to die but always wake up the next morning feeling that same disappointment that I felt years ago. Still, I never told anyone. I didn’t want to admit there was anything wrong with me. I thought other people felt the way that I did, only they were able to cope with life better than me.

So, after five intoxicated years in high school, I left without graduating. After high school, I worked at a bunch of different jobs, dated a bunch of different guys, and finally I met and married my husband. We moved to Nova Scotia, and a few years later we welcomed home a beautiful baby boy. All during this time, I still hid everything, my depression, my suicide attempts and my drinking, which was no longer working for me and had now turned into cutting myself as a way of dealing with everything.

My family didn’t know what I was doing or how I felt. Not even my husband knew. I kept everything from everyone. I was becoming the world’s greatest actress.

When my son was nine months old and I was 26, once again I tried to kill myself with an overdose. However, this time, if no one had found me I would have got it right. I was taken away unconscious in an ambulance in front of all our friends and neighbours.

My secret that I had hidden for 16 years was finally out in the open.

I was hospitalized for a few weeks and was diagnosed as bipolar, even though I was hearing things that were not really there. I was told that the reason for the voices was because I was tired and overwhelmed from being a new mom. So I went home from the hospital. But I needed help and support to look after my son as well as myself. My husband was in the Navy and had to quit his job, and we all moved back to St. Catharines. Back here, my husband found another job and my parents helped care for my son while I attended a day program at the hospital.

Over the next few years, that was how our lives carried on. I had lost contact with my friends from Nova Scotia, and my friends back here slowly dropped off because of my illness. I was not the party girl that they remembered.

Over those years, I had been put on dozens of different medications or combinations of them. Getting on the correct medication was the first thing to help me move forward. Medication doesn’t fix everything, but it helps you with a kind of kick-start to the brain. Even though my medications were working, I, like many others with my illness, have gone off my medications more than a few times, only to disastrous results. My medication does not take away all my symptoms, but it is a good balance between side effects and symptoms.

Finally, at the age of 30, I received my correct diagnosis but was also told that I would never be able to work again. This was hard to hear, but on the other hand, I was almost relieved. I had not worked for a long period of time and knew that I couldn’t. It was validating for me to hear a professional say this. So I went home and settled for the life that was given to me, but only for a while. I wanted a better life. I wanted to care for my family. I wanted friends. And I wanted things to be normal, like I thought other peoples’ lives were. So, never being one to be told what to do, I went back to school. Six months after starting back at school, I finally received my grade 12 diploma.

I then decided that I wanted to work. I started with one day a week. This was hard. It was harder than school. I had not worked in over 10 years, and the medication I was on made me soooo tired. But I figured I could do this one day a week and rest for the other six. Kind of like God, but backwards.

Over the next few years, I was finally able to work full time as well as go to night school. I graduated with a certificate in business management. Work was going pretty good for a few years, but as life would have it, things always happen, and for the first time since I had been back to work I had to go off sick due to my illness.

I felt sooooooo defeated, and I was very hard on myself, but after hiding out with my head buried under the covers for a while, I started to think of what I should do now. During this time of self-discovery, I was also able to finally come to terms with my illness. I no longer was asking my doctor that forever unanswered question of “When will I be better?” It just didn’t matter anymore. My illness wasn’t who I was. It was just a part of me, sometimes big, sometimes small. But I was more than that. My illness does not define who I am.

I had started opening up to people outside of my family, who to this point were the only ones other than a few professionals who knew about my illness. I had worked very hard all these years to hide it from everyone. I was so afraid that someone would find out and treat me differently, or more importantly, my family. I was especially worried that my husband and son would be affected by the reactions of others because of the stigma attached to this illness. But I could not go on hiding who I was any longer. It was exhausting, and it was time to tell my story. So in the summer of 2007, I started speaking publicly about my life. I must say it was quite empowering.

Another thing also happened that summer. I was awoken from my sleep with the fact that I was finally Happy Being ME. Me, the person who had wished myself dead for so many years, was finally happy. These powerful words and feelings would not leave my head. The more it went through my mind, the more I wanted everyone else to feel this way.  To be proud of who they are, no matter what their challenges.

Since this thought was not going to leave my head, I got up and sat at my computer and started a business plan. By the next morning, my business was born. Happy Being ME, offering happy, eco-friendly T’s and accessories, all sporting the Happy Being ME message as well as a fun character from our family, for babies to adults. I wanted everyone to be able to express themselves in this positive way.

The next day, I told my husband my idea, and to my surprise, he said, “Great idea, let’s get started.” But you should have been there for the conversation with my parents. There I sat telling them that their 40-something-year-old daughter who currently was off sick from work due to her mental illness was going to start an eco-friendly T-shirt business with printed stick figures and the words “Happy Being ME” on them. They smiled. You know that smile a parent gives their child when they’re thinking, “What the heck is she doing? But we’re going to support her anyway because we love her.”

I tell you about my business not only to shamelessly plug it _ that’s, and our store is located at 4 Second Dr., St. Catharines _ but I tell you because my business is a very important part of my recovery.

People always ask me what helped me the most, but before I tell you that, I just want to touch on a couple of things that have held me back over the years.

Number one, stigma. I believe that the stigma surrounding mental illness is a direct result of the lack of education. Stigma is probably the most significant thing that has held me back. Stigma was not just pushed upon me by others and society, it was also my own self-stigma that created problems.

The second thing is recovery, or what I thought recovery meant. I look back and remember talking to a support worker and them talking about recovery. I looked at her as though she had two heads. You see, to this point, I had been ill for so long, had problems just getting out of bed in the morning or off the couch during the day. I had already being given that mental health life sentence from my doctor, which I mentioned before. What I didn’t understand about recovery was that I may always have my illness, but I have finally been able to recover my life, and my illness finally turned into just that. An illness. It is no longer who I am. It is something that I have.

So, as promised, I want to share with you some of the things that have helped me in the retaking of my life:

Forgiveness. Give the gift of forgiveness, and start with yourself. I thought that my illness was a character flaw. I had to come to terms with my illness and myself. When I finally realized that the things I had done, felt, or experienced was my illness, it was much easier to forgive myself. Next was to forgive those around me who could not understand my illness. I was angry at people around me, and a lot of that anger was directed at my husband. I was angry at him for not understanding what I was going through or how I felt. I carried this anger with me for many years, but when I started to look at it differently, I finally came to this realization: He was not able to understand my illness. Not everyone is capable of empathy. This was not his fault. It was who he was. But he has stuck with me through all of my years of illness because of his love for me.

Do something new, as often as you can. Say yes. It was much easier for me to stay in the depression, stay in my bed, stay in my cocoon that I had created. It was an awful place, but it was what I knew. But this was not what I wanted for myself or my family. At the suggestion of a professional, I started to add things to my life. I started to do one thing different at a time. Sometimes I would keep moving forward, and at other times I would fall back into the old routine. But I kept remembering that quote by Thomas Edison: “I have not failed, I’ve just found 10,000 ways that won’t work.”

Accept help. I took the help offered to me from family and professionals. There were groups and programs out there to help me, whatever I needed help with. This does not mean that they did everything for me. I was the one who had to do the hard work, and with their encouragement I was able to start living a functional life with my illness.

And finally, fake it ’til you make it. This phrase was told to me many years ago, and I have used it many times. I faked a good life, I faked smiles and I faked happiness to the outside world until they actually became my world.

You know, I look at the statistics of mental illness. One in five will suffer from a mental illness in their lifetime. One in 100 will have schizophrenia, 8 percent will suffer a major depression, 1 percent will experience bipolar, and so on and so on. And I look at those odds, and I fall into so many of them. I think my number just keeps coming up. I’ve hit the lottery. Unfortunately, it’s the mental health lottery, but as funny as that is, many more people will hit the mental health lottery. This is why I tell my story to complete strangers. My goal is to educate, to reduce and eliminate stigma that surrounds mental illness. I also hope to inspire anyone who is suffering from, or cares for someone with, a mental illness to move forward, to get help, forgive and believe that recovery is possible. But most important, I want people to finally be able to say that I am Happy Being ME.

Thanks for allowing me tell my story.

More from Canada: Talking with Judy James

I met Judy James this week at Canada’s national conference for suicide prevention. A few hours later, we had the following conversation upstairs in her hotel room, with the window open on a beautiful view of Niagara Falls.

Judy’s direct, and she was just one of a half-dozen or more people at the conference who spoke openly about their suicide attempt experience. “I think that this is a natural part of life, as natural as any catastrophic event can be,” she says.

She speaks about how she pushed for years for attempt survivors to be recognized at the conference, and about how professional hockey players helped lead to a breakthrough in Canada’s public conversation on suicide over the past year.

“All you’re doing is having a conversation,” Judy says. “And honest, heartfelt conversations don’t kill. Ignorance and stereotypes and silence, those things do kill. So let’s start the conversation and keep it going until it’s as common a conversation as anything else. I don’t think I’m saying anything profound here. This to me makes common sense. But what do I know?”

Who are you?

Oh god. Well, right now, let’s see. I’m a 54-year-old supportive housing worker in Toronto, so my clientele are people who have been diagnosed with serious mental health problems, also have had issues with the criminal justice system. My job is to try to get them into housing and try to keep them housed. That’s where I’m at now. It’s a really far journey from where I started out, which was in … Well, if you were to look on a map, you could not find where my house was. Rural northern Ontario. So I grew up in a small town, excelled in school, skipped grade four, you do all the things that everybody expects of you to do. I was on the Reach for the Top team, like a TV quiz show for high school students. I was president of the student council. I had a weekend job as a reporter for the Sault Ste. Marie Star. I was doing that at 14. Again, to help support my family. My parents were both very abusive alcoholics. I found my escape in doing a lot of stuff in school. I found it was actually quite dangerous to be at home and safe to be at school and excelling there. So of course I had all kinds of aspirations. I wasn’t going to be like my parents, not have their very narrow thoughts on the world, which bordered on what I’d call backward thinking.

So I was out of the house and into a full-time job at 18, married at 20, was working on becoming a graphic artist, and then my marriage fell apart. And then I started drinking. And then I started driving. And one of those nights I just decided to just keep driving until I hit a rock cut. Fortunately, I came to my senses and realized I could kill someone else, not just myself. So I went back to work, but it caught up to me again. I was first diagnosed at age 23 with major depressive stuff, episodes. I got through that, went back to work, life carried on. I had another major episode a few years later, then carried on through work. TV Guide [where she was working] was scheduled to close in 1997, and so I applied for and got a job in Toronto, was going to be project production manager for a magazine. I came to Toronto, looked up somebody I thought was going to be a friend. I was almost raped on that first date. That was the start of a real tailspin. I started to experience symptoms again. When I told my boss I might have to take a few days off because of depression, she said, “I don’t care if you die, just make sure the next edition comes out.” So I checked into a hospital and said “Let’s forget about this.” So I stayed there a while. I was fired from my hospital bed. And then it just went from bad to worse. I was out of a job, in a strange city, I didn’t have any friends, my prospects were looking very bleak. By that point, I had lost contact with my family. So it was just getting bad to worse. I was going to lose my housing. I was down to eating a bag of apples a week, all I could afford once the rent was paid. I had to go on welfare, so I lost all my savings. And of course, I still couldn’t get a job.

This went on until late 1999. I went to see my doctor, and she said, “I think you need ECT.” I said, “ECT, like, that’s gotta be the worst, right? That’s the last-ditch intervention? Isn’t that kind of like using an axe to fix a hangnail?” She said, “In your case, you need an atom bomb.” I had been in and out of the hospital, in and out of a variety of talk therapies from ’97 to ’99 and had become so treatment-resistant. So I went in for ECT. I started to have psychotic symptoms, which I had never experienced before. I thought, “This can’t be getting me better.” I didn’t tell anyone because I thought I was already at the end of my rope at that point. So when ECT didn’t work, I went back and said, “What’s going on?” I was told I would never work again, I might as well get used to being … better give up my apartment, get used to a life that was going to be living on assistance, never having a job, never even getting close to the lifestyle I used to have. So at that point, I just went home and started making a plan. And within a couple of weeks I had amassed enough medication. I went to the most beautiful spot that reminded me of home, and there I decided to end my life. I won’t get into a whole lot of methodology, for obvious … I said that once to a reporter and they went into gory detail, so forgive me if I don’t go there. Anyway, I woke up, and all I was was sick. I think I threw up for about eight hours. But I felt even worse. I thought as low as you could feel to kill yourself, but when you fail in the attempt, you somehow reach even lower. Yeah. So I went back, asked all the questions, people still did not have answers. So I made another attempt. It probably was the best thing I ever did, because once you made a second attempt … I know this sounds silly, but by making a second attempt, it qualified me for Yvonne‘s group. You needed multiple attempts.

So this bouncy lady shows up in my hospital room, this is 12 years ago, and she was like, “How are you today?” I was feeling lower than a snake’s rear end in a wagon rut. She’s telling me how she was going to hold hope for me. I just told her to fuck off. She said, “Anger. I could work with that.” I thought she was some religious zealot coming from the airport. This was prevalent in hospitals at the time. Anyone could come in, people were coming in asking you to come to services out near the airport in a grab for money. That’s what I thought Yvonne was. So she kind of took off, and another doctor showed up. He was an older guy but was doing his residency in psychiatry. For some reason, his name has just escaped me. I can see his face right now. At any rate, he said, “What’s going on? We want you to come back into St Mike’s for more ECT.” I said, “No way I’m going back there because of what happened at the other hospital.” We talked about it. It was all about how I didn’t have a voice. I had always looked upon the doctors as people in places of authority, didn’t question them, they knew me better than I did. and so I left it at that. And after ECT, the way I was feeling before my attempts, I was scared, terrified. I didn’t want anything more to happen if I was going to live. And he saw this disconnect and said, “Why can’t you talk to the doctors?” I told him. He said, “How would you feel if I moderated that discussion and gave you some tools on how to have that discussion?” I thought, “This is weird.” And we did. It was horrible. I was in tears, just a quivering, blubbering mass of goo. But I had that conversation with my attending physician and changed the treatment. It was so empowering. I thought, “Wow, this is cool.”

He said, “How would you feel about going into a group?” I went, “What? You’re going to take a group intervention with me? I’ve been in group interventions, and no doctor has done that.” That was the PISA group. So we did that. I met Yvonne, again. It was like, “You’re not that bouncy religious zealot. You work here. OK.” So we went through this 20-week program. In that program, which borrowed from all kinds of different things, it looks at DBT, CBT, it borrows from all sorts of different models, all over the map. The neatest part is, she actually talks to the people: “What has worked for you? What has kept you safe before? How would you design this?” We had a hand in our own intervention. We became teachers for them. It turned the whole medical process on its ear for me. Yvonne, I love this woman, she’s setting the medical component on its head by making medical students take this program, getting nurses, students, some of us involved in this program. Some of us are becoming facilitators. I went through the group, learned so much. I learned about basic human rights, stuff I didn’t have a clue about. I grew up where the nearest neighbors were a bear and a moose. I didn’t know I had a right to say no, to be respected. I could have conversations with professionals and be treated on a different level. I learned about physical systems, mental systems, gaining autonomy with medication. I learned about relationships, how to change toxic relationships. I learned how to work on a scale of intensity, to identify where I was on my own map of illness, which interventions worked. Oh, wow. There were so many lessons there. I think everybody should take this thing. I think everybody could use this on a daily basis. I learned the physical parts, that it was not just all in my head. I learned about internal dialogues, self-talk, how to turn off a lot of self, the expectations of others, what is expected of me in different roles in my life, that I don’t have to be perfect all the time, the world will not end.

Yeah, so I got through the first 20 weeks, and I thought I really had it sussed. Things were looking up. I still didn’t have anything really going on. Then my best friend died by suicide. It sent me into a bit of a tailspin. Yvonne said, “You’re not ready.” I said, “You’re not kidding.” She said, “Do you want to do the group all over again?” I said, “Yeah.” That’s unheard of in other programs. After that, I then became a group facilitator. At the same time, she let me come into the studies unit, where she worked, and I got a lot of old skills back. How to do research. How to feel good in an office setting again. How to work on deadlines. How to work with other people. At the time I lost my job in publishing, it was the time computers were becoming prevalent, as opposed to typesetting. I had lost the ability to work in that field during the time I was ill. So in 2002, I went back to school. The work they were doing at the suicide studies unit was fascinating. They let me work on just about anything. I was quite happy: “OK, this is cool.” I went back to school, thought maybe I’d get my masters in social work. I still didn’t have a job, money. I got into the social services program, wherein you could major in addictions, mental health or criminal justice. I majored in mental health with a minor in addictions. It was eye-opening. Because then it was forcing me back from the world that was a safe space at the hospital, around people I felt safe with, and putting me back into the general public. At this point, I had all these new skills: “I am woman, hear me roar. I am a consumer survivor, hear me roar. I’m going into the field to help people, to help them navigate a system that is just so wrong.” My own fellow students couldn’t have a conversation with me. They had come from the education system and decided they wanted a career in mental health. They couldn’t relate. At some point, we were sitting in the lecture theater, and one professor asked someone to volunteer as a psych patient being brought into the ward for the first time. I was sitting with a hockey jersey, pants with a belt and running shoes. I immediately thought, “OK,” so I pulled out my laces and took off my belt. So I’m doing what’s common on the ward. People were literally moving away from me in their seats. Why? Because they thought there was some kind of contagion happening. They might catch mental illness. On the day we graduated, we were all going out for a beer and somebody came up to me and said, “I hope someday I can work with someone with a mental illness.” I thought, “People are all around you!”

So yeah. I’ve been out since 2002 quite publicly. And I’ve been advocating for people with mental health issues but also people who have made suicide attempts to be seen as people. Because it’s one thing to have a mental illness, there are all kinds of causes. But with suicide, it’s still kind of a no man’s land. People are afraid to come out because they think automatically they’ll lose their job. I know there are places where, if you disclose, they will covertly not hire you, though they advertise for consumer survivors. Back in the early ’60s, we had a problem with cancer. No one wanted to say the “c” word. People have likened a lot of mental health issues to diabetes: If you have medication, it’s under control. I’m not sure if I like that analogy, because this can be so different. But why are we so scared about this? And why are we so scared of people who have attempted suicide? One myth is that people will always be somehow damaged. I mean, I finally found a place where I can work now that values recovery in mental health. And I want to see more people take back their voices. Because so many of those voices are silenced because of the stigma, financial constraints, all the different taboos, cultural taboos. I think that this is a natural part of life, as natural as any catastrophic event can be. People have illnesses and die every day. Why is it so hush-hush when it comes to those of us who have felt trapped and isolated and scared and worthless and hopeless and that we try to either alleviate the pain or the human condition we think we’ve got or genuinely feel?

How’s that for the start?

You’ve mentioned that it hasn’t been easy taking part in this conference. Why?

I always knew I had advocates somewhere. The first to introduce me to CASP was Yvonne. But I know there were still some hurdles. The first was them asking me way back when to identify as a survivor, but as a survivor in the traditional context of bereavement. And when I said, “I’m here because of my own attempts,” everything just went kind of silent. I’ve been to workshops where there was name-calling. I’ve been to workshops where we were told right off the bat that we weren’t really welcome. So again I’ve advocated and we’ve had different workshops about the language of suicide, what it is to “commit” suicide, to be a “survivor,” to be “successful” or a “failed attempt” or a “successful attempt.” There’s such a weighty language all around suicide. I don’t consider myself a failure. I don’t consider myself … There’s a guilt factor in the broader population are putting on it, almost as if, if you didn’t die by suicide, somehow you weren’t really trying. So in that context, we’re all looking for something, some soapbox to get some sort of unmet need met. And I just look at them and just, “No, I’m just trying to have a conversation so it’s not about us, it’s about everybody trying to see the point that we’re all in this together.” Last year, when I went with Jenn Ward, the survivor chair for CASP, she saw that happen, where I was told that I really didn’t have a place. And she made it her mission this year to make sure I had a place. So this year is all about celebrating having that place. And it has been a huge, huge weight off my shoulders to have that happen this year. I was told it was gonna happen last year, and it didn’t. This year, it did. I couldn’t be happier. I just hope it continues.

What happened this year? You had mentioned you put together a list of everything that happened for attempt survivors.

Wow, this year. I don’t know if there was some cosmic shift or what. This year, it seemed like people got it. I guess for me, last year about this time we were doing this conference, and it was all about teaching people that attempters could still be valuable assets in the community. We had such a great response to that. Some of the people you met today, Cathy and Allan, spoke as well. And then we had CASP. And despite what happened to me at CASP, I met a lot of people who were very positive. At the same time as CASP, we had the national strategy for suicide prevention, we had people asking for Canada to have a national suicide prevention strategy established and have government funding to it. So we at CASP raised a glass to that. At the same time, there was a firestorm in the media. Over the summer, two hockey players had died by suicide. And the media got ahold of it and raised questions. A couple of former NHL enforcers got up and talked about the hardships of that role. When they did, the media again took a proactive stance. CTV, Bell Canada, which owns CTV, announced a mental health intervention where they were going to make substantial donations. CTV ran with it, ran its own thing on suicide. And there was this hockey … Can I say shitstorm? Where a couple of players came out in support of these tough guys. And then Don Cherry, like a national icon up here, he called these guys several derogatory names. The backlash from that went around the world. There was so much support for people who had mental health issues, who had attempted, who had died by suicide in the sports world. That set up a new conversation with their fans. It also allowed a lot of other celebrities to come forward and start conversations. In 2010, the “Do it for Daron” project had started, a youth initiative named for Daron Richardson, an Ottawa teen who died. That has been going like crazy. So all of a sudden, we’re seeing all these support things happen for people with mental illness and specifically around people who have attempted suicide. Not only are we coming out of the closet, as it were, people are not calling us weak and crazy and “Maybe you should have died,” really rude comments. All of a sudden, it’s taken a 180-degree shift.

So everything’s OK? Or what more needs to be done?

So like I say. I don’t know if this is just a blip. I hope not. I’ve found my voice now. I’m thick-skinned. I’m 54. I see every day as a gift now. I worry about the kids and how meanness can be over the Internet, some of the technology they don’t know how to control, and we don’t either. I hope the attitudes are changing and we don’t see a rollback position. There’s too much energy wasted on the bad feelings and the name-callings. Folks like us who have to feel nervous: Do we belong? Are we in the right place? When we enter a room, are we gonna feel welcome?

So you’re seeing the same people at the conference who were rude?

I’m not seeing the same people. Different people come. It’s quite a smaller group this year, I’ll be honest. But I think the core group is here. Because CASP moves around, in a different major city across Canada each year. Last year, it was Vancouver. Before, it was Halifax. All over the country. And so far this year, I have only heard good things. I’m also meeting new people this year who are very much behind what I’m saying. And people like you aren’t afraid to come up and talk to me, either. Because that used to be a thing, too. “Can we talk to her? Is it safe?”

Again, fear of contagion? Or they thought it would set you off?

Just a fear of the unknown. They didn’t know if I would say anything really controversial. I think a lot of it is, “Is she safe to talk to? She’s a person with mental illness, who tried to kill herself. After we talk to her, is she going to jump out a window?” Well, we’re sitting here, you’re typing, the window’s open, and I’m not jumping. We get it. What are some of the things they’ve done to you?

(I talk about my experiences, none of them that severe, and Judy continues.)

I’m coming out there because I want other people to come out and be a spokesperson and do this. It’s not like I have money or fame, anything to gain. I’m coming here on my own dime. Because this is my way to give back. I don’t want others to go through what I had to go through. I want people to have the conversation that needs to happen and not feel scared about it. It’s a conversation like any other one.

I feel like I ask this question of everyone. How to break down the stigma, the silence?

Well, you have a running shoe company in the States with a pretty good slogan: Just do it. Don’t be afraid. Just do it. It’s not like opening the can of worms means you have to go into a whole four-hour intervention with somebody. All you’re doing is having a conversation. And honest, heartfelt conversations don’t kill. Ignorance and stereotypes and silence, those things do kill. So let’s start the conversation and keep it going until it’s as common a conversation as anything else. I don’t think I’m saying anything profound here. This to me makes common sense. But what do I know? The conversation becomes how to make it easier for people to come out. For a lot of us, our voices have been taken over by professionals. These conferences are attended largely by doctors and those in the medical profession. Talking about us.

A lot has to do with the same social determinants as anything. A lot of people can’t afford to be here. A lot with suicide in their past are living with mental illness, living under some sort of subsidy, so to come to a three-day conference … We talked about this on the panel yesterday. It would have been impossible for Richard to be on the panel unless somebody subsidized his being here. It would be impossible for most to pay three nights’ accommodation, food. One of these junkets can easily cost over $1,000. I’ve made friends with a number of researchers, This is kind of our junket. We lecture, take a bit of time off. This is our vacation. We come as individuals, then hang out together.

How many people at a conference like this aren’t “out”?

Good question. Talk about the 4,000 who die each year in Canada. So the guesstimates are, for every 4,000 who die, another 10 for each person are affected. So, extrapolate to coworkers and friends. Now, when you consider the other 10 times the number for the people who attempt this year, 40,000, you tend to see how the numbers are skewed in terms of who’s at risk, who will be at risk in the future. I heard one doctor today come out. I thought that was cool. It was at a seminar I hadn’t planned on going to. And Dan this morning. So the professionals are starting to come out.

How did it go with the doctor?

Usually, the survivor panel happens on the third day of the conference. This year, it was right at the beginning, so we got all the baggage out and aired. Yesterday, I didn’t hear one negative comment. Nobody said anything. That’s a first. We heard a lot of positive stuff. I’ve met a lot of people since then who’ve said, “Right on.” I presented in Rome in 2010. Of the audience that we had, there were only two I didn’t know. Which is to say that nobody was interested in our topic. And at that point, this was the first international conference where they had attempt survivors, as such, presenting.

Which conference?

The 13th European Symposium on Suicide and Suicidal Behaviour. Anyway. Yvonne, I and another PISA graduate were going to present on the journey we had taken away from suicide. We had Yvonne’s group from Ireland watching. The Canadian delegation. And these two Belgian folks who actually wanted to hear the presentation.

That’s it?

That was it.

So it will take a while.

It will take a while. But I’m encouraged.

Go back to the doctor. Was it a moment? Were there murmurs?

It was actually part of his presentation. He told us what he did. He had it up in the PowerPoint. The methodology. How he was saved by his wife. Right on! We’re human!

And the reaction in the crowd?

No. Given that Dammy was there, Tim was there … These are past presidents of CASP. There wouldn’t have been any hooplah, I think.

Tomorrow, there’s an unusual session on euthanasia, assisted suicide, assisted dying and how they fit into CASP. What do you think about that?

I was at the session in Vancouver where it was pitched. I don’t know how it will go over. I think it’s gonna be controversial. We’ve just had a fairly recent example of where a woman was allowed to, she hasn’t died yet, but has permission from the government to end her life when she chooses. I can’t remember her name now.

So this is a national issue now.

Yup. CASP doesn’t shy away from being controversial.

But do you believe these issues come together?

Could. There’s still a lot of people of the belief that you and I would be aberrations because we have messed with God’s plan. I’m saying that with heavy-duty quotation marks. And a lot of that comes from a few of the bereaved survivors. I think we’d be kind of foolhardy not to look at it. And I think, I’ve looked at this issue myself, and I don’t know how I would be. Who knows in another 20 years. I already have some mobility issues. Where would I be if I were in excrutiating pain? Where will I be if I can’t make a contribution to the world, where I can’t clothe, eat, feed myself, look after myself? Those are all the things we have to look at. How to make a decision? Those are the questions I’m sure we looked at when we were facing suicide before: What was our life worth? I see you nodding your head, yeah. I don’t know where I’m gonna be 20 years from now. Am I gonna want to advocate for suicide prevention then? I don’t know. As long as people feel they can make a contribution, where society can help. I mean, we don’t live in a society anymore where it’s survival of the fittest. We’re here to take care of each other. We have programs in place, where the value of life is sacred. I don’t want the attitudes of, like, my parents to be around, where if you don’t pull your weight you have no worth.

So, where are we now?

I was waiting for you to pull out the perfect answer.

You think I’ve got one of those?

What have I not asked?

This is a totally different conversation than I’ve had. You and I don’t need to have this conversation. You get it. I had this conversation with a reporter from The Ottawa Citizen, who said, “I don’t know if I can have this conversation, because I am a Catholic.” Which was cool, because he put his biases out there: ‘”To me, you’re a mortal sinner.” I said, “OK, at least I know where you’re starting from.”

How did the conversation go?

I don’t know. It was long. It was good! He won all sorts of awards for that article. It was candid.

I’d like to read it.

Well, it would have been October 2003. Yvonne still has that thing hanging up on her wall. It won something like 13 awards. It was part of a series. But they were so nervous talking to me because they were afraid I was going to get triggered and they would get lawsuits.

What kind of questions did he ask?

Well, the whole thing was startling for him because he never considered asking before. I wasn’t sure how to talk about stuff, either. He said, “Off the record, tell me what you did.” I thought he would withhold it, but he didn’t. He went into great detail. I don’t know, I haven’t taken any courses in how to deal with the media.

How does the media up here deal with suicide?

Were you here yesterday? We had a reporter from The Globe & Mail for the plenary. He went on about how suicide contagion is not something the media should be responsible for. But we’ve seen where they report on methods, suicide styles, and all of a sudden there are clusters happening. Again, I felt bad. I hope nobody read what happened in the Ottawa thing and then … Yeah. I mean, that’s haunted me. I mean, it’s nine years later and I’m still thinking about it. The hardest part for me is how I’m coming across in the media. Do I sound like a crazy person? Do I sound like I have my head screwed on sideways? Thankfully, you haven’t asked dumb questions like, “How’s your medication?” because I’m not on any.

And you haven’t asked the follow-up question, “So why aren’t you on any?”

I’m still typing!

Good answer. No, I think the media has a responsible place to be in all of this. I don’t like the use of the word “commit.” It’s not a crime to be so low that you want to die. It’s criminal to have to be in that space in this day and age. It’s not anything criminal against the person. So yeah, the word “commit” is big. And then they go into the whole lexicon I have feelings about. What’s a “completed” suicide? “Successful”? “Failed”?

What are the terms you prefer?

Call it what it is. Suicide.

What if you’re still alive?

Then it was an attempt. I attempted to die. I mean, I have a whole problem with the word “suicide.” It gets lumped in with “regicide,” “homicide,” “infanticide” … You know.

You didn’t like the idea of the media talking about methods.

Just the contagion thing. And some people get hung up on how sensational it can be.

Maybe this is just me, but I worry that so many people go into their attempts not really knowing whether what they’re doing will kill them: “Maybe this will work.” I’ve spoken to people who are blind because of their attempts, or who are in a wheelchair. And I worry that others who never really meant to go that far ended up dying.

Then there are the people who thought they had chosen the ultimate _ jumping in front of train, out of a building _ and are still here, breathing through tubes or in a wheelchair. Part of that is what saved me. My ignorance. And maybe that’s not so bad. I don’t know if I messed up my head a little bit with my methods. People have thought jumping over the falls was pretty foolproof. We heard the mayor of Niagara Falls talking about people who jumped and lived. You could hear how nervous he was talking to this crowd yesterday. Again, I think it’s about normalizing the words. We do the same thing with funeral announcements. They say “died suddenly,” “died tragically.” They died! Leave it! And start talking about it at funerals and stuff, so again it’s a conversation. I’m not just a survivor of my own attempts. I told you about my best friend. I’ve also lost two clients, and this year I lost a colleague at my workplace. And courageously, the wife of my colleague at the service talked about suicide. And you heard a couple of audible gasps. But once they got over that, we had some conversations. And again, it brought it out of the darkness. That’s the conference theme this year. So let’s give it a voice, take it out of the closet. Call it what it is and get rid of all the crap around it.

I’ve asked my main questions. Sometimes I ask whether it’s actually better to never talk, to pretend it never happened.

No. Because nobody’s talking about it. It’s become a big part of my life. Hopefully in the days, months, years to follow, I’m just going to become Judy again. Not the “Judy, the crazy woman who loves to talk about suicide attempts because nobody else will.” Because it’s gonna become commonplace.

Oh, Canada: Exploring attitudes up north

Two big surprises came up when I went to Canada this week for its national conference on suicide prevention. One was the number of attempt survivors who addressed the conference, with humor at times and a welcome lack of nervousness from the crowd. The other was a difficult, sometimes emotional session on what role the Canadian Association for Suicide Prevention should play in the growing issue of assisted suicide. I’ll write this in two parts below.

Part one: I’ve been to two national conferences in the U.S., and they seem more somber and less intrepid now. One example: When the American Association of Suicidology had its first-ever plenary session on attempt survivors in 2010, with just one attempt survivor addressing the full conference, the mood was deeply serious and careful. That’s not wrong, and it was a historic move after decades of AAS conferences, but sometimes deeply serious and careful can be a barrier to faster change.

In Canada, the attempt survivors loosened up their session by passing out chocolates. That’s what they do in support groups when things get emotionally intense, they explained. The woman behind the original groups for attempt survivors is Yvonne Bergmans, who spoke with me months ago about the work she’s doing. During the session, she was blunt and informal, just like everyone else. “Quite frankly, if you don’t want to work with this kind of clientele, then don’t,” she said of fellow therapists and others. She shared feedback from professionals who work with attempt survivors who have gone through the support groups: “The conversations are very different. The conversations are no longer, ‘I want to die.’ It’s now, ‘I don’t feel safe.’ When you tell professionals you want to end your life, it scares the shit out of them. They panic and run. We try to change the language so you will be heard.”

Most of the attempt survivors in the session have worked with the support groups as peer facilitators. “I sit on both sides of the desk,” said Allan Strong, who leads the Skills for Safer Living support groups in a community about an hour’s drive from Toronto. “Oftentimes we look at the lived experience and clinical experience as separate silos. Our intent is, it’s not an either-or, its and and-both. One can give voice to the other. I could easily have been a member of the group as a facilitator.” The average number of attempts that group members have is seven, he said, with a high of 25. The groups’ approach is not talking about methods and focusing on keeping people safe.

“All of us are really open talking about it,” he added. “We schmooze our buns off.”

Cathy Read-Wilson, who also spoke with me earlier this year, gave a lively presentation of her own suicide attempts and her work as a peer. “I never anticipated that a suicide attempt would get me a job!” she began. She read feedback from one formerly skeptical member of a support group: “When my psychiatrist referred me to this group, I thought, ‘Great, another group to tell me to think of my kids, my husband, think happy thoughts, endless useless suggestions. BUT I WAS WRONG.'”

Cathy later ended a description of one suicide attempt by saying, “The cops found me, and I like to add that they were damn good-looking. The ambulance attendant was even better!” The audience fell apart laughing. “I joke because it’s the sense of humor that gets me through,” she said. “We need that. We need that reality in life.” At the end of her story, she returned to her role as the session’s moderator, turning to the next speaker and asking, “Do you need a PowerPoint?”

Attempt survivors spoke at sessions scattered throughout the conference, and listeners didn’t shrink away. At the closing session, a young woman, Alicia Raimundo, stood up and introduced herself as an attempt survivor. She also told the audience about meeting a woman in a psychiatric ward who told her, “You’re gonna need this” and gave her a necklace with the word “Hope.” What she didn’t realize, Alicia said, was that the woman was in a manic state and was giving away all her possessions. Finally the woman’s sister came over and asked, “Can I get this back?” It was, the audience agreed, pretty funny.

(I later watched her earlier TED Talk online, where she explained the anecdote fully, and it turns out that moment became a turning point in her recovery and her decision to be open.)

Part two: It seems the issues of suicide and assisted suicide are usually treated as separate worlds. The Canada conference included a fascinating session that tried to bridge them. A recent court case in Vancouver that struck down the country’s ban on physician-assisted suicide was the cause.

“We’ve ducked these issues for a long time, and for a good reason,” Adrian Hill, a former president of Canada’s association for suicide prevention, said to open the session. “Maybe our hands were full already.” But he argued that the association now needs to have a voice. “We no longer have the luxury of leaving the discussion of assisted death to others.”

His argument was personal. His mother had been in a wheelchair since her 50s. “My mom was terrified of ending up in an institution where she couldn’t kill herself,” he said. “She wanted to die before she was institutionalized, and she did. She sent my father out of town so he would not be charged. She researched on the Internet the best way to kill herself with a firearm. And she did. And my father came home and found her.” Later, he realized that if his mother had been in a place with assisted suicide, she would have lived longer. “She would not have to secretly have this pact with my father, for this act that scarred us.”

He pointed to a recent survey in heavily Catholic Quebec, where a majority of people said they wanted a right-to-die option. “If Canada is on this road, with this right to die, I think we damn well better be on that bus,” he said. “And if we don’t, it will look like we don’t care. We’ll look like we don’t know. Like it isn’t important to us. Like a turf war with people who won’t share what we know.”

The association’s current president was in the audience. A panel of ethicists and clinicians began the discussion, and they were open about saying this is a difficult issue. When people say, “I want to be able to control my death,” what does that mean? Isn’t suicide the same? How do we tell the difference between a death that can be prevented and one that can’t? What does it mean if assisted suicide is OK but the suicide prevention community says, “These cases are never good!” Who should be part of the decision-making process? How could an option that shortens life be a better option than one that prolongs it? Does someone want to die, or do they not want to suffer unbearably? Can you imagine something worse than death for yourself?

“Certainly in both cases, somebody’s dead. And we always grieve people dying,” philosophy professor Michael Stingl said. “But we can say in those situations (of assisted death) we’ve done the best we can. … In suicide, we can’t. That person died in isolation.”

He continued, “There may still be difficult cases in the middle. And they need to prompt discussion of whether we need to put in one camp or the other. But we classify most cases in one camp or the other. And if we succeed in doing that, we’ve made some headway. And we can pursue suicide prevention in good conscience.”

Dr. Anne Woods, a palliative care expert, ended the discussion with a comment from one patient. “One woman said, autonomy is naming the limits of her own suffering.”

And the Q & A session began. One woman in the audience said she had had one friend die by suicide and another die by ALS. The friend with ALS had plenty of conversations with friends about suicide, with no shame attached, she said. It was a very rational discussion. She then choked up when she turned to the friend who died by suicide. “We didn’t know she was suffering. It was stigma and shame. We are an emotion-phobic, death-phobic, mental illness-phobic society.”

I stood up and asked: If we are told that mental illness should be seen and even treated as any physical illness, that there should be no stigma, why is assisted suicide closed to people with mental illness? Can they not name the limits of their own suffering? I told them I was a suicide attempt survivor and that I had asked experts this question in the past. Again, the audience murmured.

“This has haunted me for years, this question,” Hill said.

“It’s actually the central question,” Woods said. “We don’t know about suffering … not sure how to quantify it.”

The questions continued: Why did a veterinarian deal with a family’s decision over a terminally ill cat so much better than doctors did over the fate of a mother with dementia and physical complications? If a parent with dementia says in a rare moment of clarity, “I don’t want to be here,” where does that fit in? Again, there were no clear answers.

“Right now, physicians and nurses are asking the question, how do we keep being human?” Woods said.

And Hill said, “One of my enormous regrets is that my mother died alone. I’ll be damned if someone else will.”

Talking with Cheryl Sharp

I came across Cheryl Sharp when I read her firsthand story of her several suicide attempts in the National Council magazine, whose latest issue focuses on suicide. She writes that her first attempt was in seventh grade, when she tried to kill herself with aspirin: “I had heard that this would kill you.” She told a teacher. Her parents weren’t told. There was no hospital visit and no counseling. She didn’t see a therapist for more than a year. Her attempts continued, and people told Cheryl or her parents that she was just seeking attention. “Yes, I screaming at the top of my lungs for attention, but I also was screaming that I wanted ‘out’!” Cheryl writes. She credits a “very tough and direct psychiatrist” for steering her into taking responsibility for her own life after her last attempt at age 24.

Cheryl started talking publicly about her experiences soon after that. She’s now 55, which means she’s been at this for three decades. When we spoke last week, she warned that people who are interested in talking publicly about their experience should be prepared to be judged or pitied. She added, “I don’t think you have to have your act totally together to speak out about it. After all, does anyone?”

Who are you? Please introduce yourself.

That could be a three-day conversation! I’m Cheryl Sharp, special advisor for trauma-informed services for the National Council. And I’m a wife, a mother, a grandmother, a friend, a sailor, and I’m a suicide survivor of multiple attempts. And I have been living well for many years now.

Why did you come out about your attempts?

I’ve always been out and about about my story. It’s basically who I am, and there’s so much shame and stigma about mental illness, so much guilt many of us carry. I hope that you’ll get this webinar I did on depression and listen to that. And so I started my recovery journey in 1982. I had had a long bout and was kind of at the end of the really pronounced suicide attempts. I started in 1982 and always have been public about my story; I spoke nationally and internationally through a 12-step recovery program. I just made the decision I was not going to hide who I was, not be ashamed of who I was, not be ashamed of what happened to me. I’m sure there were people who judged me along the way, but it’s their loss. I wish that I had had someone who could talk to me. I wish there had been someone I could have identified with when I was so desperate to want to take my own life. There was no one, so if not me, then who?

Has that improved? Are there a lot more people out there now talking about their experiences?

There are some. I am a professional person, and there’s even more stigma surrounding professionals who speak publicly about their own struggle. But I don’t think there are enough people. It’s a hard conversation to have. I have a much larger audience now than I have had in the past due to my affiliation with the National Council. Kevin Hines is the only other person I’ve spent time with who’s been really vocal about the experience. I think many more of us need to speak up. There’s no shame in having had the thoughts and the feelings. To me, I feel like I’m showing compassion to other people who struggle. I would’ve wanted to have had that compassion.

You work in the mental health field, and I’ve noticed that several people I’ve spoken with work in that field. I thought the mental health profession would be a more understanding profession for someone speaking out.

Not necessarily. People will often share their struggles privately when I give presentations. They will often say, “I’ve never told anyone at work that I have had these problems. It’s not safe.” One of the things we do know, many people do go into the helping profession trying to figure out their own stuff. I went back to school based on a desire to help others like myself or my mother. I didn’t go back to school until I was in my 30s and graduated with my masters in my early 40s. I had figured out a lot by that time, understood a lot more about myself by that time. I was an older student, and it was obvious that many people in my graduate program were there because of problems they or a family member had. I was open, and that made them uncomfortable: “You can’t be a professional and talk about that stuff!” Oh yes I can. There’s nothing in my code of ethics that says I can’t. It’s just important to remember why you are sharing. Is it for your own benefit or in the best interest of the person you are supporting?

Did you win your classmates over?

It’s not my job to try to persuade people about anything. I can really only share my experience. I won’t stop talking about it. It’s not unethical. I’m someone who’s here to live my own life. I do not work as a therapist any longer but as a public educator and advocate. There is a difference. I also think there is a respectful and responsible way for a clinician to speak from experience. Knowing how and when to share is important.

You speak publicly, but what about in your personal life? Does it come up?

It depends on the setting. My husband and I were competitive sailboat racers. In the sailing community, it’s not a community in which I have that conversation unless someone shares their own struggle. When people asked me what I do, I’d say I’m an educator and work in the mental health field. My husband and I have been together eight years. When we met, I don’t know, maybe by the second or third date, I knew I liked him very, very much, and he liked me a lot. But why bother trying to move forward in the relationship if he doesn’t know the truth about who I am? He was a little taken aback at first: “I’ve never known anybody with mental illness.” I said, “You have four kids in your family. Statistically, one has a mental illness.” The bottom line is, my neighbors don’t know my story. Some relationships are superficial. I don’t really care who knows. I do not have “suicide survivor,” “trauma survivor” or “person who was diagnosed with a severe mental illness” tattooed across my forehead. Some of my lack of concern of others’ opinions may be that I’m almost 55, and what people think doesn’t matter much anymore.  It’s much more important what I think and feel about myself.

Is it easier to talk about it if you’re far removed from the attempts, time-wise?

I don’t think it matters how much time has passed.  I still have tremendous compassion for the teenager and young woman who was in so much pain. I think of those people out there that are feeling now what I felt then. I was telling my story in a public way when I was 24, 25, 26. When the situation calls for it, I can. Who am I living my life for? I think it caused some discomfort with my parents. My father is still alive. I don’t know if he would be real thrilled. So much I do in the mental health realm, he doesn’t know. If he did know, it would be fine. He does know I was called to do the work that I do.

You’re not suicidal anymore?

I haven’t been suicidal in years. Do I get down? Yes.

If you would still find yourself slipping into that bad place, would you be as open?

Yeah. I’m very open now, when things get hard. I don’t know what next year’s gonna bring, or next month. My husband is physically very ill. I don’t know how I’ll respond if something happens to him. It would be a very difficult time for me. I don’t know what my response will be. I know what I put in place in my life to support myself when things get really hard. I don’t want to ever be this person who’s put on a pedestal: “She’s fixed, it’s all done.” Believe me. I have worked and continue to work on being as mentally well as possible.  Through all of this time I have become so much stronger, so much more resilient. I have tools to use when life gets overwhelming. No one can take care of me except me. I know that was so much of my frustration and despair, I desperately wanted someone else to take care of my pain, to help me, to fix me. No one is the master or mistress of another’s soul.  We are each independently the only ones who can quiet our inner demons.

How does a person decide when it’s the right time to talk about their suicide experience?

If a person wants to go public with their story, number one, please know how to tell your story, how to speak publicly. It’s important to also be prepared to be judged or pitied. If someone is still actively suicidal, I don’t know if I would speak publicly about it. For one, you could end up in the hospital if people take it the wrong way. However, I don’t think you have to have your act totally together to speak out about it. After all, does anyone?  I’m almost 55, and I still have a lot of mistakes to make, still a lot of learning to do.

In your story for the National Council magazine, you say you were helped by a tough, direct therapist who said you needed to take responsibility for yourself. Do you think there should be more toughness and directness in suicide prevention messaging? What more should be said?

I am not sure “tough” is the right word. She was very kind, very understanding, but she didn’t mince words. She told me her truth and asked me to look for my own.

Hopeful approaches. One thing I always say is, “Suicide is a permanent solution to a temporary problem.” I wish it was printed on suicide prevention cards everywhere. It’s very direct. The other thing is, it took a long time for me to learn that everything changes. When I thought there was no hope, the one thing I’ve learned is if you stick around long enough, something’s gonna change, the universe is gonna shift, life will be different. When I get really down, like with my husband’s illness, I get scared. I don’t want to live alone. Financially, it’s scary. It would be a horrible thing. So when I get down, one thing I tell myself is, “OK, you can be down today, so go to bed and tomorrow will be different.” And when I look back, it is. I don’t feel as devastated today as yesterday. It’s part of when I do speak out, for people who are trying to hold me up as this wonderful paragon of being “beyond it,” I speak clearly about how I am struggling now and the direction I’m trying to go in. I’m a person who’s becoming, not a person who’s done.

Are there other approaches in suicide prevention that are worth exploring and not shushing up?

One of the things that was powerful to me was my mentor. I called her feeling very suicidal many years ago. We lived a long distance from each other, and one thing she said to me was, “Cheryl, I love you, I have seen you struggle so hard and so long, and it’s very hard to watch you struggle. I can’t do anything for you 2,000 miles away, but I want you to know if I woke up tomorrow and you were gone, I would be devastated. I would be so very sad.” That had a profound impact on me. What was so helpful was, she took it out of judging me or fixing me and just was very real with me. She could have said, “Oh, your parents would be so upset!” She didn’t do that. She just talked very plainly about how hard it would be for her. That was huge. That was the last time I had serious thoughts of suicide.

The other thing is, you cannot underestimate hope, other people holding hope for you. I’ve had other people say to me, “If you don’t have hope for yourself, I will hold it for you.” That’s also helpful.

How to make this topic more comfortable for everyone to talk about?

More people being willing to speak out. Are you familiar with Mental Health First Aid? It’s a National Council program. It educates lay people on how to support those struggling with various mental illness issues. Suicide prevention is one of the key ones we address. It’s part of what we talk about. It’s being able to have the conversations. We’ve trained over 70,000 people to have conversations they’re really comfortable with.

When “coming out,” is it better to talk to someone a bit more distant than a loved one? For example, my dad knows my background, but when I mentioned to him this interview and other suicide-related work I was doing today, he changed the subject immediately. If someone comes out to a loved one and the reaction is uncomfortable, would that keep the person from speaking to anyone else?

Your dad loves you. For him it’s not just uncomfortable, it’s painful. One of my big memories is my taking a massive overdose of my mother’s medication and my father finding me, making me drink hot salt water to make me throw up and walking me around the neighborhood but never having that conversation with me. Ever.


Ever. The last time I was hospitalized, my mother finally understood my struggle; the final time, I almost took the life of my son. I couldn’t leave him behind, so I had to take him with me. “Oh my god, if I’m thinking this, I need to go somewhere.” My family came. My father couldn’t tolerate it. I don’t love him any less for it. My mother even followed him out into the hallway and said, “You WILL come back to this group.” But I felt really sad that it was so painful for him.

How did the relationship develop with your mother from then on?

My mother was very ill. She had schizophrenia. She died of a medical doctor overdosing her on psych medication. But for a very brief period of time, she was having a good year. We were close, we managed to heal the relationship. Her understanding was very, very helpful.

If someone is out there saying, “Who do I talk to?’ what would be the best answer in general?

Someone who is wise, centered. What are the qualities of a good peer supporter? Someone who had similar experiences, who struggled to overcome difficulty. Someone nonjudgmental. Someone who listens, not preaches. Having an opportunity to think it through: “OK, who are the people in my life who might be OK to listen to this?”

Because we didn’t get the chance to talk about the circumstances around her attempts during our conversation, I e-mailed Cheryl a few more questions afterward:

What drove you to keep wanting to kill yourself?

I am not sure I would say I was driven to wanting to kill myself.  I think more than anything the level of desperation I felt in being unable to live without emotional pain is what drove me to try to kill myself. “Wanting” to die was not the way I felt. It was “not wanting” to live with the pain I experienced that led me to try.

Did you really think the methods you were using would kill you, and where did you get the idea that they would?

My first attempt was over 40 years ago, so I can’t remember how I came to know that they would kill me. This was during the time when the world was exploding with anti-drug messages, that drugs were terribly dangerous. I suppose in my adolescent mind I might have thought that any drug you overdosed on would kill you. When I look at all of the attempts, I usually only include the ones where I there was a consequence for the behavior. I do not include all of the times that I took my car over 100 miles per hour.

Should suicide prevention messaging include warnings that it’s very hard to kill yourself and that you could end up living with serious, permanent physical damage?

I am not sure what others would hear if this was the messaging. In some ways, the message feels a little bit like guilt-tripping. Those of us who are in that place could hear the message as a taunt and respond by thinking/feeling, “I’ll make darn sure I get this right” and amp up their efforts to do just that.

Watching JD Schramm

Sometimes I put items like this straight onto the Resources page without comment, but I wanted to point out this TED talk by attempt survivor JD Schramm, which the TED website says has been watched more than 360,000 times on that site alone. I suggest reading through the comments as well, which are just as striking for the number of people who talk openly, and apparently under their real names, about their own attempts.

It’s a good debate. Some comments argue not only for being more open about suicide but for being more respectful of the people who contemplate it. As surprised as many people might be by such comments as “If we don’t push ourselves to see those in danger of suicide as at least potentially rational equals worthy of our respect, we push them toward the choice to go” and “If we have the right to extend our lives, as we’ve so aggressively asserted with our medical advancements, then we must as well recognize the right of medicine to provide us with an alternative” and “If we really want to help them, why not make it safer and easier?” such sentiments are still part of the public conversation about suicide that’s been waiting so long to happen.

Being no longer ashamed to talk about it means being no longer ashamed to talk about all of it. With the number of suicides not trending down and the even larger number of suicide attempts not even fully known, more exploring of different points of view could lead us to new approaches. “Nothing has ever driven me crazier than being terrified that my feelings _ over which we have no control _ were the wrong sort of feelings to have,” another commenter says.

Schramm says his TED talk is the first time he’s spoken so publicly about his attempt, and I like the way he describes it as coming out of a “totally different kind of closet.” The door is open. How will society treat the people who come through it?

Talking with Paul Quinnett

It took me far too long to come across “Suicide: The Forever Decision,” a book that psychologist and author Paul Quinnett allowed to be posted online. This is the first time I’ve ever seen a suicide prevention effort that includes a strong warning about the physical dangers of a suicide attempt. As the chapter title puts it, “What if You Don’t Succeed?”

“I had a long debate with myself about whether or not to write this chapter,” writes Quinnett, who has worked with hundreds of attempt survivors.

On the one hand, what I have to say to you here is both unpleasant and, some might argue, unnecessary. On the other hand, I promised you an honest book. Since most people who attempt suicide do not succeed, I feel I would be cheating you if I didn’t share what I know about what can happen if you try to kill yourself and fail to get the job done. So, I will keep my promise.

He gives more than a half-dozen examples of people who survived with serious physical problems and says he could give more. And he’s smart enough to know that some people reading his book will dismiss the warning as a scare tactic. He adds:

I know it is not enough just to warn people who want to kill themselves that, if they try, they may not succeed and some terrible unanticipated consequence may follow. But because I know that once you are in that terrible and lonely place and in the midst of that awful crisis of whether to live or die, you may convince yourself that the solution you seek will be neat and clean and tidy and final. This is part of the logic of suicide: that death will be quick and easy. But I will quote Murphy’s Law, “If a thing can go wrong, it will.” And Murphy’s Law, I’m afraid, applies just as well to suicide attempts as anything else.

I spoke with Quinnett last week about how his book came about, including its  conversational style and direct approach. (Other chapters include “Don’t I Have a Right to Die?” and “They Won’t Love You When You’re Gone, Either.”) Overall, the book is a refreshing, personal approach after the careful messaging of most suicide prevention efforts.

In our conversation, he also shares the results of a study he did on the health care costs of suicide attempts. It would be fascinating to see this done on a much larger scale, especially as so many attempts are classified as accidents instead, because of stigma or otherwise.

First, please introduce yourself. Who are you?

I’m Paul Quinnett, a clinical psychologist, professor, at least part time, and president and CEO of QPR Institute, an educational institute dedicated to suicide prevention education and saving lives.

It took me a long time to come across your book, and I’ve done a lot of Googling on this subject. How come it’s not more easily found out there?

Writing is easy, publishing is easy, marketing is hard. I’ve written seven books and a lot of magazine writing, and I’ve written outdoors and travel articles, fishing stories. I used to write for Audubon Magazine, a lot of fly-fishing magazines. I lead two lives, one as psychologist and another as outdoor writer. By the way, I just published all of my books on Kindle. So “The Forever Decision” book, the one you’re talking about, will soon be available for all e-readers. It’s available in several languages and is free from the QPR web site.
I think it’s $3 on Kindle. We just last month published Spanish translations of two of my books, including “The Forever Decision.”

I was very interested in your chapter about what happens if a suicide attempt doesn’t succeed, the possible injury involved. Why isn’t that message used more in suicide prevention?

I think people are terrified of the subject, first of all. To back up a little bit, the book was actually written to a patient of mine, an attempt survivor who had made three attempts. For years she was “on the edge.” I was working with her with a psychiatrist colleague. She had poor care from another psychiatrist who abused her sexually. It’s a long, complicated story. After her third overdose, she came to our mental health center and entered treatment. It took a while, including suing this psychiatrist and seeing to the removal of his medical license, but justice was finally served. In my view, injustice drives a lot of suicidal thinking. I call her Ann. When I was treating Ann, I realized there are lots of Anns out there. I really wrote the book to her, you know, in the second person, as if we were sitting across from one another in my office.

After the book was published, I met lots and lots of Anns because we had opened a conversation that had not happened before, at least not in that way. My work began to focus on suicidal folks, and I began to see more and more people who had made attempts. In my limited private practice I became known as the “suicide guy,” and other professionals began to refer their suicidal patients to me. I had a very exciting practice where I actually learned how, as near as I can understand, it feels to be suicidal. I think I had a mild mood disorder in my early 20s, but I never had an episode where I recall being actively suicidal. But I think I can begin to understand the psychological pain that drives that suicidal thinking. So the book was written to someone who had made several attempts, and who is now a successful grandmother. I saw her later at a Costco, and she looked great. The problem is, nobody feels they can talk about this. Some of the most important things I learned were from my patients. I didn’t get it from books. You have to get into the conversation and be willing to tolerate some pretty frightening stuff.

Why don’t more people talk like that, use your approach?

Thinking about suicide is one thing. Actually doing it, that final physical action, requires a great deal of courage and fearlessness. I’ve talked to hundreds of people who’ve attempted suicide. They don’t always die, obviously. The state of mind sometimes changes after an attempt, but sometimes it doesn’t. I had a patient, a brilliant young fellow with late-stage AIDS, homebound, basically dying. His physician agreed that he could get enough medication to kill himself. I worked with this fellow and couldn’t say to him, “You’ve got to stay alive and die painfully.” I wanted to go as far with him on the journey as I could, but not aid or abet his final decision. He took a massive overdose, and he didn’t die. He was revived at a hospital, and he went back to his apartment. I visited him, and he said, “I guess Jesus didn’t want me, and I was too much competition for the devil.” He went on to die naturally some months later.

I think a non-fatal attempt often reveals to suicidal people things they didn’t appreciate before making the attempt. There are people who survived the jump from the Golden Gate Bridge and who are happy to be among the living. I have a saying I sometimes used with my attempt survivor patients, usually toward the end of a first session: “You can learn so much from wanting to die, so perhaps a suicidal crisis is a terrible thing to waste.” So many people have gone through this moment of darkness and found the light on the other side. I recommend people read Shenk’s “Lincoln’s Melancholy” to see how close our greatest president came to ending his own life. I think all of this needs more discussion. I’m working with a filmmaker now who wants to make a documentary on this whole business to open up more conversations.

On which part?

I’m not sure, I’ve not seen the outline. Her father-in-law died by suicide. We have story after story. Bruce Springsteen just came out and talked about his attempt. [Note: The article mentions suicidal thoughts but not an attempt.] This is starting to happen. Where we have less information, and from whom we could learn a great deal, is from attempt survivors, because this conversation has been so taboo. And yet, people who are considering ending their lives need to hear these stories. Maybe these stories are told in therapists’ offices and confessionals, but the public can’t benefit from these discussions since they are all private.

Why isn’t it more open?

My theory, and we’re about to launch a national research study, is fear. Some colleagues and I put together a survey to determine how much fear is felt by health care providers when encountering a suicidal patient and, perhaps, what impact this fear has on the healing relationship. I see it all the time. Therapists cannot talk about this. They’re not educated; they’re fearful. A suicidal person goes in to talk about wanting to die and the therapist can’t even listen quietly. They fold their arms, look out the window and send all kinds of off-putting messages. If clinicians don’t deal with this fear, perhaps we are contributing to this continuing loss of life, even among the very people we are sworn to help. Years ago, I did a little study in my own clinic, trained my clinicians in how to do a suicide risk assessment and talk calmly about ideation and past attempts. Rather than ask the clinicians what they thought about the interview, I asked the patients. Did they feel comfortable? Did they feel more hopeful at the end of an interview? Talking about sex is easy, talking about suicide is hard. But just like a prostate exam, it’s potentially embarrassing and even a bit painful, but it’s needed and saves lives.

Why is there not more research on injuries caused by suicide attempts? Or have I just not found the studies?

I think it’s an excellent question. I’ve seen very few studies on the cost of nonfatal suicide attempts. And I think this is because of a couple of reasons. One is, many of the seriously injured people after, say, a single-car crash which was ruled an accident by the officers on the scene, will never been screened in an emergency department and asked, “Did you crash your car intentionally?” The result is that the medical costs associated with these frequent intentional suicidal self-injuries are considered accidents and, thus, not attributed to suicidal behaviors. I had a consult from a Montana hospital where a farmer had rolled a tractor on himself, and it cost $50,000 to $60,000, probably more, to put him back together again. The hospital staff called a psychiatrist friend of mine on staff and asked him to ask the farmer if he was suicidal. “Why don’t you ask him?” my friend asked. They said, “No, that’s a specialty question.” My guess is that hundreds, if not thousands, of falls, overdoses, car crashes and such are coded as accidents, not intentional injuries, and so we don’t have solid cost figures.

It’s not just the cost of attempts I’m interested in, but the number of injuries from attempts, the percentages …

I have worked up some suicide-related costs here in Spokane County. We tracked people who came into four of our six hospitals with nonfatal suicide attempts. We tracked numbers of days in the hospital. We didn’t know long-term costs, but we did know the direct medicinal costs. The medical costs for nonfatal suicide attempts exceeded $20,000 in the majority of cases. The costs are covered directly our health care plans. I’m not aware of the ongoing cost for continuing care, disability and nursing home placement if needed. I’ve had patients who suffered very serious injuries. They were in long-term care facilities. Spinal cord injury, gunshot wound to the head. Very, very tragic outcomes that, most of us believe, are preventable. [Note: The study looked at 1,100 emergency room visits and hospitalizations for suicide attempts for the year 2008 in Spokane County, Wash. In that time, the number of completed suicides was 70.]

Why is this not mentioned in suicide prevention efforts?

I don’t really know. When I wrote that chapter in the book, I debated: “Am I talking with someone who’s clear-headed and thinking rationally before taking an action?” I think probably not. People experiencing a great deal of suffering don’t always make great decisions.  And many people who make a suicide attempt decided to act in 20 minutes or less. At that moment, and if they are reading my book, at least we are reading and not attempting suicide. For many depressed suicidal people, and especially if they are beat down, not sleeping, and tired, and worn out, I doubt they’re going to sit down and read that chapter in the book and it will somehow change their mind.  But it might buy them a little time. I’d be happy with that. Just put off a suicide attempt one day. In one day, things can begin to turn around.

What many experts are thinking now is to move further upstream, go to the school years, ask, “Where does the thought of suicide come from, anyway? Did you see it in a movie? Did your mother take her life?” “Are you being bullied or abused?” These are known risk factor-producing experiences, and if they can be mitigated early on in the developmental
years, there’s good evidence suicidal behavior can be prevented. I don’t think there’s anything frightening about thinking academically about suicide as a sort of harmless thought experience. According to the Centers for Disease Control, eight million people in America will seriously think about suicide in the next 12 months. Seriously going to think about it. If people are thinking about it, why can’t they learn more about it, realize what it means, what that first thought means? The first suicidal thought is like a bad cut on your finger. If it doesn’t close up on its own, it may need a stitch or two. What do we do with badly cut fingers? Unless we’re Rambo, we get some help. The persistent idea that death is a solution to suffering can occur once and pass on as a non-option, or it can begin to recur, to haunt us. What we need now is a way to help people understand what suicidal thinking is, what it might mean, and what practical things they can do to manage these thoughts and move beyond them. According to the CDC study, 4.7 % of adults in my state, Washington, think seriously about suicide in a 12-month period. In my county alone, that’s 17,000 folks, and almost a quarter of a million in my state.

You haven’t had a suicide attempt. But for therapists who’ve had their own experience, should they mention it?

That’s what’s called self-disclosure. Is it useful? Is there a point when it would make a positive difference with a client to say you had made a suicide attempt yourself? There are some ethical guidelines about self-disclosure. I think that in some times and cases it may be helpful; at other times it might not. I can’t tell a practitioner when it’s time to bring up this personal historical fact. In recovery work, with addictions, lots of addiction counselors are front and center with their own recovery, but I’ve also seen some of them disclose too soon and cause the client to back away.

Is it healthy for people, not just therapists, but anyone, to self-disclose anyway? Or is it better to keep the experience quiet?

A very good question. I think the day is coming where disclosure will not matter. I did a lot of work for law enforcement over the years. I did fitness-of-duty evaluations and pre-employment psychological evaluations. Once I was evaluating a woman, 26 or 27 years old. Police officers have one of the highest suicide rates by profession, second only to the military. I always tried to determine if the candidate was exposed to suicide in his or her family, if he or she had ever been suicidal or made an attempt. When she was 18, the candidate I was examining was drinking heavily and had just broken up with her boyfriend, and was sitting in the bathtub. She cut her wrist with a razor, a superficial full-circle cut around her left wrist. She showed me the scar. She wore a wide wristband watch. She made a full recovery for her abusive drinking, was active in AA for six years or more and had her life together. She was psychologically fit to work in law enforcement, based on my extensive testing and interviewing. I recommended her to be hired. When the chief saw the report and that she had made a suicide attempt, I got a call. He wondered if I had lost my mind recommending an attempt survivor. I said, “Let me put it this way. She cut herself while intoxicated, an alcohol-related risk factor. She’s been sober many years now, there has been no recurrence of suicidal ideation or behavior. Of all the officers on the force right now, I can assure you that at least this one is not alcoholic or drinking excessively.”  The chief laughed, and they hired her. She’s been a great cop and promoted several times.

Are people going to stop listening to Bruce Springsteen because he had an attempt in the past? I don’t think so. Is the arc of revelations about having been suicidal at one time in one’s life ramping up? Yes. I know a major airline that hired back a pilot who twice was suicidally depressed. But he was well and on medication. He flew me and my friends around the Northwest after being seriously suicidal. What is the FAA doing now? Allowing pilots to say they’re taking anti-depressants. Before, if a pilot reported he or she was depressed and on medication, they took away their flight status. I think the arc of greater communication is forward. Having made and survived a suicide attempt is a long way from being a badge of honor for courage, but the sooner it’s part of the normal human experience, the better it will be for those headed down that dark road. Most people get over those thoughts. If not, action needs to be taken.

Is there anything that can be done to speed that arc along?

The National Council just published a magazine on suicide prevention. In this publication are multiple stories of hope. I recommend others find it online and read it. Stories of people who had made attempts, seriously suicidal, and so forth, who found a way forward in recovery. As I’d like to be quoted when it comes to experiencing a mental illness, “If recovery is possible, suicide is preventable.” Too many people wrongly believe of others, “They made an attempt, they’re going to die someday.” That’s nonsense.

The subject of suicide prevention and the subject of assisted suicide and the right to die, is there any common ground between them? Are they completely separate issues?

Well, that’s a big, long discussion. The field has tried to deal with it. There was a vote taken many years ago, maybe 10 or 15, among the membership of the American Association of Suicidology on this issue, and about half of the suicide prevention people said they supported right to die under special circumstances, and half said such laws should never pass.

I’m not actually that close to this issue or that familiar with the laws in Oregon and Washington. My fundamental concern is that many people are older people, which I am now one, and late-life depression is common. One of the drivers for late-life suicide is identified by Tom Joiner: burdensomeness. We have the largest cohort of people going into late life that the country’s ever had, and questions are arising about how to take care of them, how to help them through their last years. The problem is, the risk of suicide for them goes up with every decade of life. The highest rates are among the oldest groups, particularly white males, but almost nothing is being done in suicide prevention to address late-life deaths by suicide. What’s the cultural message for those headed toward what will, for some, be a burdensome, precarious lifestyle? Most don’t have sufficient savings, many are going to end up in dire poverty. If they see themselves psychologically and financially as a burden on the entire country, let alone their families, how will they deal with this?

If death by suicide with physician assistance or passive easy access to lethal means becomes culturally acceptable, I’m alarmed. I don’t want people dying to relieve the cost burdens our political system has created. And I’m adamant that I don’t want to see suicide made more convenient because it’s easier for us as a nation to deal with our deficits. I’ve been following some of the reports coming out of Washington and Oregon, and I’m not exactly comfortable that the law requires two physicians _ not mental health professionals _ concur before a fatal prescription is written.  Remember, these are the same doctors who can’t even talk comfortably about suicide with their patients. Most people who are receiving care when they die by suicide had last contact with their primary care doctor, not a mental health professional. But physicians get almost no training in suicide risk
detection, assessment, treatment, prevention or management and, what’s more, they push back when asked to get such training. Assisting medically ill, terminal suicidal patients in their desire to die is at best dicey and at worse criminal.  I’m no expert in this area, but Dr. Herbert Hendin, a psychiatrist and suicide prevention expert, has
written widely on this, and I’d recommend interested persons Google him if they wish to learn more.

Would making suicide safer, regulating it somehow, reduce the number of suicides? If people had peace of mind in knowing there was a sure way to go?

Well, that was the Greek method. But we have no data on the policy’s impact. In ancient Greece, you could make the case to die before the Senate and, if you were successful, you’d be given a prescription for, I believe, hemlock. Once people are terminally ill and make an application for self-administered death with dignity, many are relieved they have a way out, the stress goes down, and they choose to die naturally. In Oregon, the actual number who die after the application is completed is smaller than the number who apply. The book “Final Exit” came out at the same time as my book, and I can tell you, Derek Humphry’s sales were a lot better than mine.

I think what we know from imitative behavior is that if the methods of suicide are widely publicized, they become more accessible and acceptable for people in desperate straits and who may be seeking the mark of approval. We try to reduce that kind of contagion by making access to means difficult. If the means are not readily available, lives are saved, and the data is in on this intervention. The ambivalence of that moment of final action is tremendous, and if the suicidal person is provided an opportunity to see a new way forward, in my experience they will choose to live. Like the scene in “It’s a Wonderful Life” when Jimmy Stewart is about to jump to his death into a raging river. He is rescued by the angel, who jumps in just ahead of him. His greater humanity to care for the lives of others is appealed to by the drowning angel, and he forgets about his suicide and saves the
other fellow. Saving others gives life a broader meaning. It’s very interesting to me that two of America’s most-loved films are “It’s a Wonderful Life” and “Dances With Wolves.” The plot line is that people who made suicide attempts and don’t die open up a whole new life for themselves. You haven’t seen it? “Dances with Wolves” is about a solider who suffers a wound in combat in the Civil War and decides to end his life by having some rebel across the field of combat shoot him. They miss, he lives, travels west, keeps a journal, meets a woman attempting suicide after a great loss, he saves her, they fall in love and the two attempt survivors experience an entirely new and wonderful life together.  I
teach this film to students because people don’t see the underlying motivations of the characters, or that life can be wonderful if you don’t die in your suicide attempt.

That leads me to ask about media portrayals of suicide.

That’s big question, too. There are media guidelines, but they are often not followed. There’s no doubt about a contagion effect, additional suicides that occur after a first suicide. If you publicize suicide in a way that glorifies the person without providing the background issues that drove their behavior, and you show the method used _ “Here’s how you do it” _ you’re appealing to those thousands of people out there thinking about suicide today. We humans are “Monkey see, monkey do” learners. It’s how we acquire
important life lessons without having to do everything ourselves to learn something new. We watch other people. If you see a suicide and 15 minutes of fame as the outcome, people see that what happened to that person “might work for me.” It’s a modeling effect. It’s what I did my dissertation on. Some years ago, I wrote a letter to Richard Masur, then
the president of the Screen Actors Guild, who had just asked all actors not to smoke on screen if they could avoid it. I wrote to ask him to ask actors not to kill themselves onscreen. I never got a response, but it was worth a letter anyway.

When it comes to print media, I’d like someone to invent a software app that causes the reporter’s computer to freeze when he or she enters the word “suicide,” after which a pop-up would ask, “Have you read the safe messaging guidelines about how to report on suicide?”  A click of a mouse, and they could access the guidelines. Doesn’t mean they would follow them, but if they knew how they write their stories is a possible risk factor for suicide, perhaps they would think twice.

I feel I haven’t asked enough about your experiences with attempt survivors. In talking with them, what else have you learned? What surprised you?

I remember one of my male patients I saw over his summer break, the son of a professor. He had these terrible mood storms and was clinically depressed. He told me, “I like you, you seem like a good guy.” I was trying to work out a safety plan with him before he left for school.  He said that a plan was fine and even though I had asked him to call me and
he had agreed to, he said, “You know, I tell you now I would call you, but once I start down that tunnel, I’m not calling anybody.” He made two attempts and didn’t die before he saw me. He said, “Once the trance begins, once I get into that space, I don’t think about rescue, I just think about moving down the road toward that final decision. There is a relief in it.”

I’ve done a lot of work with people in recovery. The decision doesn’t begin with the decision to drink again, it starts with the decision to get in a cab and go get a bottle. How do we go upstream, backing up to what triggers this first thought of suicide, and fix it right then? Like
maintaining your car, how do we maintain our mental health? You can’t recover from alcohol or drugs by sleeping in a crack house. And so what I think, and what I’ve heard from more than one attempt survivor, is that we should not ask them to call us, but we should ask them if we can call them. In my practice for many years, I told my suicidal patients it was important to me to know they were doing OK. And I would say on our last session,” Is it OK if I call you later?” Nobody said no. Then would say, “I’ll call you between three and six months. How’s that?” No one said no. And I called every single one of them. A few were surprised, but most welcomed the call. Studies now show that staying connected reduces future suicide attempts and completions. It’s one of the things that actually works. The call says, “Hey, I want you to be around.”

This little practice was one of the more rewarding things I ever did as a psychologist. Knock on wood, I never lost anybody to suicide, at least that I’m aware of. Sometimes people would come back in for counseling: “I think I need a tune-up.” But we established a kind of a lifelong connection. I said, “I’m not moving, I’ll be right here.” But the real job of the therapist is a guide, not a pal or friend. The real job is to bridge the person to other caring people and to stay connected with them until they are safe on the other side.

Do you still call people?

No, I let them all know that I was closing my practice. I don’t see patients anymore. I encourage people to do these simple follow-ups. It costs almost nothing and can save lives. Now military research is doing the same via e-mail. And imagine what the support feels like.

Is there anything else you’d like to mention, anything you expected me to bring up?

Not right now. Maybe we can do this again sometime when we have data in our research. We’re trying to help create a tipping point in this country where people everywhere are talking about it and taking action.