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Half in love with easeful death

In the same issue of Human Life Review that I mentioned here there is a valuable article by Mary Meehan called "Outfoxing the Grim Reaper." It's about suicide prevention. Meehan discusses new techniques in suicide prevention--she calls them "tricks," with no pejorative intention. They include what sound to me like good ideas such as asking the suicidal person to imagine himself years later, having gotten through the present crisis, giving advice to his present self.

Meehan also chronicles the disturbing aspect of some suicide prevention groups which, bizarrely enough, try to hold on to the "absolute non-judgmentalism" notion of counseling to such an extent that they consider it wrong to tell people that they shouldn't commit suicide! It's difficult to see exactly how one can be passionately committed to preventing suicide while at the same time refusing to advise people against committing suicide, while believing that any choice the client makes must be affirmed--in other words, while accepting the relativistic claptrap of modern counseling "standards." (See here.) It's unfortunate that anyone is trying to do so.

One thing that Meehan does not discuss, which surprised me, was the connection between suicide prevention and the suicidal person's perception that others are depending on him.

Here I may be over-emphasizing personal experience, and it is possible that those who work with a wide range of depressed and suicidal people will not be able to bear this out, but it seems to me intuitively that the notion that you will harm or abandon others by suicide is a very powerful deterrent and may reach a person even when nothing else will.

My personal experience itself is limited: Some years ago after the birth of one of my children I struggled with fairly severe postpartum depression. Anyone who has been depressed knows that thoughts of death and self-harm do intrude. I doubt that there is such a thing as severe depression without them. And under that stress, it is a tremendously powerful pull back into life to feel that suicide is simply not an option because other people need you. It isn't even always a welcome pull. Like a shock of cold water that awakens a sleeper, the realization that you are a grownup, that you have responsibilities, and that living is a must can be somewhat annoying. But it is effective.

Now, it may be that a given person with whom a counselor is working has no family members immediately dependent upon him. But it would seem to me that even that could be gotten over to some degree. The counselor himself, if really involved in trying to prevent suicide, can present himself honestly as someone who will be hurt and disappointed and who will feel that he has failed if the person commits suicide. No doubt this would be said to be manipulative, but would it be wrong? If you have befriended someone, it seems to me that it could be perfectly legitimate to tell him that he is not an island, anymore than anyone else, and that whatever he may think to the contrary, there is at least one friend who will be hurt and grieved if he kills himself. Not, probably, as effective a link to life as a baby or a spouse, but better than nothing.

It strikes me, too, that if I'm right, and if the argument that others need you and will be harmed by your death is particularly effective at preventing suicide and banishing suicidal thoughts, the Devil is especially clever in targeting the elderly and the ill with the lure of medical suicide. (Meehan calls assisted suicide the "elephant in the room" in suicide prevention literature.) These are the very people most vulnerable to the claims of the monster Despair: "Nobody needs you. Nobody wants you. It will be better for others if you die now before you become a burden."

I do not know the pragmatic answer to this. It may be very difficult to convince such a person that he is wrong and that someone else needs him, partly because it may be true that others do not need him in the ordinary ways, perhaps not even in the ordinary emotional ways, if all of his near loved ones have died or, even worse, want him dead.

I am reminded here of a striking scene in a mystery novel by Agatha Christie, Ordeal by Innocence. A man has been rescued after trying to commit suicide. (He got caught in a bush when he jumped off a cliff.) In the hospital, he tells the nurse that he would be better off dead and rails against those who rescued him. He tells her that no one needs him. The nurse fingers a cross around her neck and tells him that God may need him. He laughs a bit, though he doesn't want to hurt her feelings, and asks her what God could possibly need him for. She says she doesn't know, but it may just be by being somewhere, just by walking down a road, that he accomplishes God's purposes. Of course, in the story, this turns out to be what happens, and he later saves an innocent life by being in the right place at the right time. Can you imagine that conversation's taking place now? I can't. Who knows whether a nurse who had such a conversation would be punished for "unprofessionally" bringing in religion.

But I think a suicide prevention counselor must be free to bring in religion: You are alive. You are precious. Your life is not meaningless, whatever you may think and however old you are. God has a purpose for you. You are needed.

Comments (20)

Nicely written.

All depression imagines a future denied, which, carried to its extreme of despair takes one right out of the possibility of even imagining that one could be in a Heaven. Being needed by even one person connects the depressed person with a future, even if it is not his own.

The saddest thing is that many people, today, are being taught from youth to value people because of utilitarian worth instead of their intrisic worth. The whole concept of love comes with a price tag for more and more people. I really fear for the elderly in coming years. Watch for the emergence of a class of hope peddlers who are really merchants of death in disguise.

Humor is intimately connected with tragedy and depression. You needn't be suprised that understaning the one gives insight into the other. Just as modern humor has become less engaged in the worth of people, so will people begin to distance themselves from engaging in the tragedies of others. It is only an appreciation of the Cross that can make our joys and sorrows human. I fear for the loss of the sense of the Cross in modern society more than anything else. Ave Crux, spes unica.

The Chicken

Lydia, your experience parallels mine and others that I'm aware of. I suffer from chronic depression, and the one thing that kept me alive for several years was the simple fact that *someone* had to fix breakfast for the kids . . . and get them dressed . . . and change the diapers . . . and then fix lunch . . . and get them bathed . . . Later, it was my responsibility to work as well -- my administrators and students depended on me to do the job I'd been hired to do . . . my husband was not capable of bringing in income to feed and clothe the kids, so I had to do it . . .

Even now, when those suicidal thoughts occur (as they do still so frequently), and even though I've put to rest the possibility of acting on them, it's the connection to others that helps me to ignore them, to walk past them to the other side of the depressive episode. I would not be here now if it had not been for Christ affirming my need to live in responsibility to others, even though for a long time I did not know it was He who was saving me.

MC, you are so right about the need to recognize that people have intrinsic value. My dad was so active, and when that was taken from him, a regular refrain became "I'm no good; I'm no use." It was hard to work against that constantly -- not to tell him and show him that as much as humanly possible, that was easy -- but to get through to him that we meant it, that he was just as valuable to us as he ever had been. He toughed it out, and he never suggested suicide, but it was so hard. If we had been deceived ourselves as to what makes a human being worthy, it could well have ended in earlier death for him. And so many today are thus deceived. God have mercy.

Beth, thanks, that's kind of what I thought. And the feeling that one has to do these things isn't at all warm and fuzzy, either. As your comment indicates, it's matter-of-fact. I think it gets one past the, if I can put it this way, adolescent stage of suicidal thinking--anything like, "Everyone will feel sorry for me when I'm dead," any of that self-pity and selfishness--it goes away when one realizes that it isn't an option to be that self-centered, adolescent person.

I want to look up a quotation for responding to your comment about your father, but I don't have it here right now. Later tonight or tomorrow I'll try to find it. (It's in a paper book!)

So true, Lydia -- nothing warm and fuzzy about responsibility! I agree there's a selfish aspect to some suicidal thoughts -- a "they'll be sorry" mentality that taking responsibility does tend to mitigate. There's also another type -- "they'll be better off without me"; "I'm no good to anyone": this is not so much childishly selfish as simply despairing; and common, in my experience, with chronic depression. But it also is mitigated by taking responsibility -- I may feel like I'm worthless, but I'm actually doing something necessary for others, and eventually that truth makes its way into my thick skull . . .

"Nobody needs you. Nobody wants you. It will be better for others if you die now before you become a burden."

This is a demonic appeal to ethics, which proves the need for a counselor to offer an ethical counter-proposal.

People in severe distress or temptation have all sorts of thoughts going through their head. The ethical appeal should be another tool in the suicide prevention toolkit.

I agree, Beth. Another thing I think Satan tries is, "I'm so bad that everyone will be better off without me."

Good way of putting it, Kevin: a tool in the toolkit.

Here I may be over-emphasizing personal experience, and it is possible that those who work with a wide range of depressed and suicidal people will not be able to bear this out, but it seems to me intuitively that the notion that you will harm or abandon others by suicide is a very powerful deterrent and may reach a person even when nothing else will.
I think this is spot-on.

I'm surprised that the nonjudgmental therapeutic approach is still popular. I thought it's been passe for quite a while. It was being challenged as far back as the 1970s. I remember reading some book years ago on some latest fad in psychotherapy: one technique was that when the patient talks about some self-destructive behavior he engages in, the therapist says in a strong, authoritative, parental voice, "Don't do it!" Supposedly, patients were often shocked to hear that from their therapist. I think this was a mainstream school at the time, too, maybe transactional analysis.

The "God needs you" technique seems strange to me. If someone's a believing Christian, Jew, or Muslim, which covers most religious people in America, wouldn't he already believe that God forbids suicide and that suicide might damn him to hell or some other bad afterlife? Doesn't that person already believe that if he takes sleeping pills to escape the pain, he might wake up in hellfire for all eternity? Or is this technique mostly for the people who believe in the nice, nonjudgmental God? And for those people, isn't an effective response something like, "God understands that I need to do this?"

Can a Christian be suicidal? Yes, of course. The human person is a strange animal, part mortal and part immortal. Depression negates the human half, but it doesn't realize that it is with the human half that one goes to God. In other words, the depressed person sees the divinity of Christ but can no longer see his humanity. Touching flesh, being needed, restores the sense of the mundane - depressed people are actors in a grand play, written by them, starring them, and directed by them, with an audience of one - them. It is important for them to realize that there is another person in the room. Taking care of others is a form of humility that counteracts the extreme self-focus that accompanies depression.

Depression wants to cross the finishline without running the race. Tripping over others is a way of being forced to acknowledge that there is still a course to run.

By the way, humor and mania overestimate the audience size of the "play" whereas tragedy and depression underestimates it. It is more subtle than that, but I'll save the analysis for the paper on the neurodynamics I've been meaning to write. Tom Cruse was wrong. There is a definite neurobiological process that occurs in depression. We have had only a muddy picture of it, but recent studies and theoretical models are slowly converging.

The Chicken

A practical note. If you ever happen to be in contact with a suicidal individual - say, you're on the phone with them - before you end the conversation get them to "contract" not to hurt themselves.

Have them make a commitment that they will call you back the next day at some designated time and if they make that agreement then you can be assured they will not kill themselves that night.

If they refuse to make that contract, call the cops.

Have them make a commitment that they will call you back the next day at some designated time and if they make that agreement then you can be assured they will not kill themselves that night.

It depends on how well you know the person. In my opinion, one would have to know them very well and even then, it depends on the level and cause of depression. For depression caused by some physical ailment, this might work, since one can always appeal to the argument that they survived it the night before and this particular night is nothing special. For depression caused by a chemical imbalance or other neurological conditions such as stroke, I think it is risky. If you don't know them that well, get someone over there, in person. They don't call it a suicide watch for nothing.

I have known quite a few people who have been clinically depressed. I have studied depression form a theoretical perspective as a part of my humor research for thirty years. Depression can be a tricky thing in some cases.

Can't someone post a fun topic this Christmas week? All I've seen is gloom and doom. I want hot chocolate and a roaring fire.

The Chicken

MC, I'd post some fun music by country Gospel groups, but I don't think anyone around here would thank me. :-) I save that for my personal blog.

Here was my most recent "lighten up" post. The song (which is neither country nor Gospel but more doo-whop) is "All I Want is You." Personally, I like the studio version a bit better, but that can't be embedded and is linked:

http://lydiaswebpage.blogspot.com/2010/12/to-help-you-lighten-up.html

Aaron, I don't know how much telling someone that God needs him would help, but I do think it would be much more emotionally relevant than telling him that God will punish him, even if one thinks that is true. I've certainly found that when depressed one is inclined to beat oneself over the head anyway. Believing that there is something you have to do in life is a wake-up call.

Dear Masked Chicken. As odd as it might first appear, the practice of contracting works with both friend and stranger.

I know. For a score of years I worked as a Psychiatric Social Worker in a Crisis Stabilisation program in the most populous County in the State of Maine and there was not one individual who was experiencing suicidal ideation that I ever contracted with who ended-up committing suicide.

Of course, I always followed-up the next day a.s.a.p. and offered an array of options to deal with the Crisis.

Our success rate was 100% in that score of years. Not one suicidal individual who we had contact with - whether the contact was generated by the suicidal individual himself, or the cops, or a landlord, or a family member, or a bartender, etc - ever committed suicide after making a contract.

VC, that's fascinating and useful. I've just skimmed the Meehan article and didn't find a mention of that technique.

Beth, I found that quotation. It's from a novel called The Rosemary Tree by Elizabeth Goudge. (There's a whole, strange story about how this novel was plagiarized after it had been forgotten after Goudge's death and how the plagiarism was caught.) Here's the quote:

She had become imprisoned in this uselessness almost overnight, it seemed, and now she must bear it as best she could. She told herself she could have put up with it better if John and Daphne had done as she had begged them and sent her to some institution, but they wouldn't do that. She had been nanny to John and his stepbrothers in the old manor house up on the hill a mile away, and his bleak childhood had been redeemed from disaster by her love. He said he could not face life without her. They all said they could not do without her. In the paradoxical nature of things if she could have believed them she would have been a much happier woman, but not the woman whom they could not do without.

Oh, that's a fascinating quote, Lydia. Thanks so much for sharing it. I'm familiar with Goudge's name, but I don't think I've read any of her work. Do you recommend her generally, or any specific books?

She's not a truly great novelist, but I think she has a lot to offer. I especially recommend The Dean's Watch of all her books. After that, probably a tie between The White Witch (for which the reader is asked to accept the reality of a certain amount of unusual supernatural stuff such as ESP and tarot card reading) and The Scent of Water.

Goudge has an enormous range of quality. Some of her books are really only so-so--The Middle Window, for example, and (ironically) her most famous, out of which a movie was made, Green Dolphin Street.

Her best-known children's book, The Little White Horse, is still in print and very charming for girls. I would have loved it as a child, and my girls have liked it. An amazingly Victorian-styled book, considering that Goudge herself was born as the Victorian Era was ending (1900).

Her Eliot family trilogy leans towards being preachy, but it's very good preaching, and I have enjoyed them quite a bit, especially the second and third--Pilgrim's Inn (also under the title The Herb of Grace) and The Heart of the Family.

Goudge had a lot of insight into human nature and is a convicting writer. She holds some of her characters to very high standards indeed--standards of charity and motive--and I've found it a useful devotional exercise to read her.

Mental illness is a repeated theme in her novels. Here is my 2008 post on Goudge:

http://www.whatswrongwiththeworld.net/2008/01/elizabeth_goudges_novels.html

Thanks, Lydia. Name on my used-bookstore list . . . :)

Vermont Crank,

I can see where a contract might work, since it restores a sense of the future, but again, it does depend on the person. Depression has an interesting neurodynamic which I could maybe explain, somewhere. The mathematics is really interesting and I will publish it, someday, Lord willing. According to the theoretical work I have been doing, There should be a specific oscillation in the pre-frontal cortex which is the smoking gun for depression, but MRI technology is not quite fast enough to see it, yet. I don't want to get too much into it, since it it the wrong forum, however.

The Chicken

Lydia,

Excellent post and an excellent comment from Beth.

At least when I'm depressed, my faith in God very much wavers. I lose conviction that love or friendship genuinely exist - my so-called friends are merely using me for the pleasure our conversion brings, or to borrow my knowledge, etc. If I went psychotic or fell into poverty, how far they would run away! As for family, sure, I have some debts to them - but not enough to keep me alive, as they have wronged me considerably. They don't love me, but an image of me in their heads, an idealized picture which I cannot realize. And if there is no love or friendship, there is certainly no Christian God. Six months of grief for them, tops; a lifetime of suffering for me; you do the math.

And suffer I shall, because my depression is biologically grounded, and worse - frequent anxiety, panic attacks, and worst of all persistent depersonalization. There is no light at the end of the tunnel, just a hurricane of pain and confusion. When I dream I dream of demonic faces and my body writhes in torture; no where am I safe.

Two things help. One is to reinforce my faith by looking at the saints - surely they love, even if the mass of men does not; grace does have effects. And if there is grace, there is Christ; if there is Christ, then as long as I live I have reason to live. The second is a vain desire to exercise my will. The more pain I consume, the more resilience I exert and in turn acquire - and I want to be resilient.

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