You didn’t mention it in this post, but I think it’s interesting that we both ended up in Christianity. My story has a lot of similarities to yours. I am also not suicidal anymore, but when I was, inpatient psych invariably made things worse. I really don’t think many clinicians understand why suicidal people do reach out for help. They assume suicidal people don’t really want to die, but want to be prevented from acting on irrational feelings, which would subside if given time on a ward or the correct meds. But that was never true for me—my life felt intolerable for concrete reasons and I kept asking for help with how to imagine a future that felt livable to me. No therapist EVER was able to help me do that. Eventually, I’d give up.
It turns out the problem was in most therapy the goal is to achieve some level of satisfaction with your life and your capacities. Therapists have no idea what to do when you actually can’t do that due to disabilities that are never going to go away. Christianity gave me a reason to feel like life is worth living even if I know I will always be sad about my life and it will always, on some level, feel intolerable. It also gives me the motivation to feel grateful for the good things I do have. I’m not saying Christianity is the only good answer, but I sure didn’t find any good answers in psychotherapy.
Appreciate this essay tremendously. It’s a gift to all of us readers, not to be taken for granted, that Sorbie made it through by— chance or grace— to this point where we can learn from her reflections.
One lesson learn from stories like hers, which I find incredibly useful: that suicidal thoughts and actions are meaningful, point to real and excruciating pain, immense loneliness or psychological isolation, and a deep relational/spiritual void where love and connection is needed. These are not to be ignored, glossed over, or medicalized.
I didn’t read the post through, but what I read was terrific and useful. The way American medicine and psychiatry deal with suicidal risk is arbitrary and has more to do with our legal system and psychiatry’s role in medicine than any evidence-based intervention. I have appreciated a slight improvement from the beginning of my career 25 years ago, to now. But only slight. Private out-patient psychiatry allows me to almost entirely isolate myself from larger psychiatry’s approach to suicide and I am a more helpful clinician for it.
Sometimes I wonder if suicidalty became taboo because of the legal ramifications of it. Therapists, teachers, doctors, and police must report you and you will be removed from your life in a way that may destroy your hopes of ever getting back on your feet. Forced commitment, even voluntary commitment, is very hard to recover from economically, socially, and in terms of your record. Try getting life insurance, for example. Try getting taken seriously by any doctor, for any reason, with that on your record. It's like everyone is trying to avoid culpability if you off yourself and very few people are trying to get down in the trenches with you, making it a lonely place and therefore a more dangerous place than it needs to be. We're not doing this right and I don't see how we can build a culture that includes management of suicidality from where we are standing now.
Irvin Yalom, in his book Existential Psychotherapy, talks about lot about death anxiety and notes how many leading theorists before him (he’s writing in the 1980s) leave death anxiety (and the importance of facing mortality) out of their theories and treatments. They’d rather focus on something more manageable like neurosis. I think as other people have said, the worries about legal liability are the biggest contributing factor, but I’d say the second runner up is people’s own discomfort with death, mortality, things we can’t control, and things we can’t make better. Sometimes, therapists really can’t make it better—and that’s a hard pill for them/us to swallow. I think the best we can do in those cases, like Bryan Stevenson says in working with prisoners on death row, is to “get proximate”
Maybe another factor is the insistence that therapy, like education, should only conduct activities that have "measurable outcomes." Hence, focus on things that are "manageable."
do you think a libertarian euthanasia program is the best solution? i increasingly think so. only screen for coercion, otherwise, if someone wants to die, just provide reliable, painless means, non-paternalistic screening and a long self-directed final verification process.
I don't think we can screen for coercion. It's rarely measurable and human judgement is too frail to do it right, and eventually a bureaucracy, which is a goal-oriented thing, will come to understand that suicide is profitable and efficient and it will begin to promote it. It's inevitable, or at least so likely that we can't allow the procedure at all, in my opinion. We can't sanction it. This is actually part of why I favor the second amendment. If you are really serious, if it really is intolerable, you can act outside the system in a way that isn't messy. But the system cannot be allowed to condone it, I don't think.
Sadly, I think this is very true. If it can be monetized, it will. If there was a way that we could avoid that, and avoid some of the legal ramifications that are, more often than not, geared toward increasing profitability, that would be great.
I've often wanted to donate my entire body to someone who is happy and values their life, but has some kind of physical sickness or disability that I don't have. Go on, take it! I have no need for this meat sack anymore!
well yeah that first premise is the big question. i don't know that we can't. but even if we can't, i think i'm still inclined to support it. i am pretty sure that disvalue from false positive kills would be far less than disvalue from selling alcohol, while being a step towards existential compassion & a stand against mainstream existence-bias and associated authoritarian tendencies.
The first thing I did because of multiple attempts starting at age 3 and heavy self harm to the current day at age 46, was to get a DNR notarized on my 18th birthday. After I got it done I was so happy I jumped with joy. Killll me !!! Killtard!!! Gas the psycho!!!!
I wanted to emigrate back to China for 40 years but I can't because of multiple involuntary admits. It is what it is. It's because I was born in America and not in China. I am also permbanned from Tsa Precheck. I headsmash everyday and am wananarexic.
Relatable! I've wanted to die since I was 16. Actually, I never thought I would make it past high school graduation, so after I graduated college I was a little dumbstruck about what to do with myself and have been winging it ever since. Intermittently, I have routine suicidality. Most of it became passive as I got older. These days, I'm just counting down the days until it's time to go. I joke, but not really, that I only have about 50 years to go. Can't wait to die! I will tell people. Maybe 30 if my schizophrenia diagnosis prognosis ends up carrying out its notorious fate. Who knows. But you're right, people need to talk about suicide more. When I was talking about it ten years ago, I was posting Facebook statuses like it was casual, as jokes, really, but then people would report me and then I would get locked out of my account. They had me watch these really awful videos with smiling people and sunshine coming from the window. It was really lame. I just wanted to make jokes! Let me be suicidal in peace. I won't kill myself for God's sake, I can't do that to people who love me, but I do wish there were some happy place where I could safely wish to die with humor.
re: ''talking too openly about my desire to die'' - I've found it to be hugely frustrating that even though I find it very hard to tell a friend or a loved one that I often think of ending my life, talking about it with a therapist is generally far more difficult. It feels like the proverbial minefield.
It shouldn't feel that way. I know what I can safely say and what I cannot say without crossing a line. I always have the discussion with them anyway, just so that I know for certain how they interpret the rules. This ought to be more than sufficient, but it isn't.
A few weeks ago, my therapist was reviewing her cases with her supervisor, and the supervisor felt it was necessary to ask the police to make a home wellness check. My therapist and I had an understanding, and we'd agreed that unless something changed, there was no need for this sort of thing. The supervisor, who has never met me or spoken to me, overruled my therapist.
I agree, I think the legalization of suicide risk has had a very negative impact on clinical encounters and turned discussions of suicidality into the minefield you describe. Furthermore, every clinician has their own threshold and comfort level with suicidality, which makes things very confusing and difficult for patients.
I have a lot of Goth friends because I cut, choose to eat in disordered ways and am interested in suicide with a first attempt 43 years ago. This is despite the fact that I listen to Pop, Dance R&B music and vote Republican. Gothic and Metalhead people are more open to it.
“But because she still shows up in the neighborhood, I am reminded how diligent I have to be in maintaining love, light, and connection to the divine. I don’t want to be tempted to follow her ever again.”
So this. Thank you for putting such beautiful words to it 💗
This is a magnificent essay, Sorbie. As a child and relative of people who have attempted suicide or taken their own lives, it resonates strongly—the knowledge that what follows the attempt is punishment rather than listening, in a context where it feels to the person like punishment is all there is. I often feel that The Haunting of Hill House is the story of my family. Your essay is also a reminder for parents about the importance of listening instead of objectifying. This is great writing.
I think mental health services really want to be seen to be ‘doing’ something, and perhaps there is more justification for a passive kind of holding in these moments of crisis, acknowledging it’s not immediately fixable. Not panicking or overreacting but also not jumping in and assuming we can do anything particularly helpful.
One of the downsides of the de-stigmatising of mental health conditions is maybe that it’s compared to breaking a leg, when really it’s not. People aren’t going to be able to be successfully treated with a cast and some painkillers in the vast majority of cases.
I think the word you're looking for here is "liability." The mental health system wants to be seen as "doing something" as a CYA. I don't think it's actually because they acknowledge these complex life situations as "not immediately fixable," I think they absolutely do approach these situations as though they ARE immediately fixable by flattening them into something two-dimensional and treatable by drugs & confinement. It's cheaper, less time-consuming, and more convenient this way. It's not because it helps the patient/person in distress.
it's tough because whatever caused me to get better is as mysterious as the things that made me sick in the first place. I have things I can point to in both cases; I have a narrative I can offer. But because it (the whole "being alive""having the human experience" thing) is such a dynamic process, it's tough to give a bulleted list of things that helped me. I used to lack a lot of relational and emotional skills/fortitude, and now I have more. I learned those things from having good relationships, but something changed inside me before I could start trying to have those, and I deeply do not know what that thing was. Part of it was literally just getting older, I think; but it's not like I simply "grew out of it" exactly. Sorry if this is unsatisfying! Sometimes honesty is!
Thank you! That’s a thoughtful answer. It’s always hard to say: what is the thing that changes that allows someone to get better? Do we control that process almost at all?
for me, becoming less suicidal took a few things. they involve coming to believe and feel things, which can only be a result of an indescribable intrinsic experience over time involving a lot of trust, faith, and sustained hope:
finally believing in the privilege it is to be alive, to age, to be “free”. this world is inundated with people who have their lives ripped from them by cruel cowards.
being trans, since my teens, i have witnessed so many trans lives across the globe be stolen, including those pushed to suicide. i lost a friend in 2022 in the transphobic/homophobic mass shooting in colorado springs. he deserved to live, even when living would have meant witnessing the continued violent transphobic wave that picked up that year (which his death and the other victims’ were treated as catalysts for hatred).
in the US we are surrounded by people who are kidnapped into prisons which, in the US, are concentration camps. it is not lost on me that millions of people are functionally enslaved in squalor to labor and/or die out of the public eye. anyone without immunity granted by fascists in the US can be considered a criminal and forced into those conditions, and it means something mighty to be on the outside of that
i finally believed that my hard life is worth living.
people lead hard lives all the time and i never used to understand why people would keep going after so much tragedy. but i finally believed that my hard life shaped by mental illness and poverty was still worth getting the most out of it that i can, including on days that don’t “look like much”.
when feeling like my hard life, and my “freedom” (quotations because it’s conditional) are a privilege and honor, it is much easier to feel a lust for life. to be curious and have fun, which are literally crucial to enjoying any of this living! to actually feel gratitude when i look around me. i can marvel at my proximity to neutral, innocent nature like bugs, foliage, creeks. i can be deeply grateful for the few close friendships i have, and show up to maintain them because i want to.
hope this helps :) it’s still super mind boggling to me to not be a suicide risk after being one for 14 years of my life
There’s some really good points in here. Thank you for taking the time to write it all. And I’m happy to hear that you’ve been able to put so much difficulty behind you!
Oh man. So much to say, thank you for this one Sorbie (especially because, as you say, such depictions and investigations are rare and it is quite something to mine your own Being for the cause).
I may write a piece speaking to the challenges of working with suicidality within the system as a practitioner and link to what you've written here ... because (imo) as you say it's so important for a therapist not to be crushed by the fear of suicidality or try to 'get rid' of it. But there's also a secondary fear of what the system demands and what it will extract if you get it "wrong".
What happens when we are consistently forced to choose between protecting ourselves, and doing something likely to be "safe" but inhumane and potentially traumatising?
Thank you, Sorbie. Very well put and I do love Harold and Maude despite odd looks when I explain the plot to others. I think it’s fair to say that we make up/live in stories that are fantasies all the time - and unfortunately treatment as it is commonly structured typically is only interested in the story of the identified patient/person and not in the fantasies of the larger community. One of the essential stories in the US has always been ‘when in doubt do something!’ as compared to some other cultures’ ‘when in doubt wait and see what happens’. As I’m writing this I also am recognizing that it is just plain hard and awkward as a ‘professional’ in the field to own my/our side of these conversations - how difficult and hard it is to sit and listen to your level of pain without wanting to prematurely make it better, to worry about what my peers/medical board will say if I haven’t ‘done something’, to recognize how connecting to the person sitting across from me also makes me vulnerable and can make it hard to sleep at night … we claim we (culture/health systems/experts) know things but at the most intimate and close levels when in a true partnership with someone else that knowing protects none of us reliably from pain. Much easier to execute a 5150/invol hold and go home with less potentially painful attachments. My apologies to you from the ‘healthcare professional’ side for maybe pretending just a little bit - that it was entirely out of concern for you that the treatments and nostrums I/we insisted you take or submit yourself to - and not done to assuage my/our own fears and worries. Thanks again and please keep writing!
Thank you for sharing. I feel less alone having read your story. I also started talking about suicide around nine years old, and felt something akin to a dark cloud over my head even earlier in preschool. I wonder how much of that early emotional instability comes down to nature vs. nurture. In any case, thanks again. It’s good to feel seen, especially in such dark subject matter that’s difficult to communicate to others.
You didn’t mention it in this post, but I think it’s interesting that we both ended up in Christianity. My story has a lot of similarities to yours. I am also not suicidal anymore, but when I was, inpatient psych invariably made things worse. I really don’t think many clinicians understand why suicidal people do reach out for help. They assume suicidal people don’t really want to die, but want to be prevented from acting on irrational feelings, which would subside if given time on a ward or the correct meds. But that was never true for me—my life felt intolerable for concrete reasons and I kept asking for help with how to imagine a future that felt livable to me. No therapist EVER was able to help me do that. Eventually, I’d give up.
It turns out the problem was in most therapy the goal is to achieve some level of satisfaction with your life and your capacities. Therapists have no idea what to do when you actually can’t do that due to disabilities that are never going to go away. Christianity gave me a reason to feel like life is worth living even if I know I will always be sad about my life and it will always, on some level, feel intolerable. It also gives me the motivation to feel grateful for the good things I do have. I’m not saying Christianity is the only good answer, but I sure didn’t find any good answers in psychotherapy.
Appreciate this essay tremendously. It’s a gift to all of us readers, not to be taken for granted, that Sorbie made it through by— chance or grace— to this point where we can learn from her reflections.
One lesson learn from stories like hers, which I find incredibly useful: that suicidal thoughts and actions are meaningful, point to real and excruciating pain, immense loneliness or psychological isolation, and a deep relational/spiritual void where love and connection is needed. These are not to be ignored, glossed over, or medicalized.
I didn’t read the post through, but what I read was terrific and useful. The way American medicine and psychiatry deal with suicidal risk is arbitrary and has more to do with our legal system and psychiatry’s role in medicine than any evidence-based intervention. I have appreciated a slight improvement from the beginning of my career 25 years ago, to now. But only slight. Private out-patient psychiatry allows me to almost entirely isolate myself from larger psychiatry’s approach to suicide and I am a more helpful clinician for it.
Sometimes I wonder if suicidalty became taboo because of the legal ramifications of it. Therapists, teachers, doctors, and police must report you and you will be removed from your life in a way that may destroy your hopes of ever getting back on your feet. Forced commitment, even voluntary commitment, is very hard to recover from economically, socially, and in terms of your record. Try getting life insurance, for example. Try getting taken seriously by any doctor, for any reason, with that on your record. It's like everyone is trying to avoid culpability if you off yourself and very few people are trying to get down in the trenches with you, making it a lonely place and therefore a more dangerous place than it needs to be. We're not doing this right and I don't see how we can build a culture that includes management of suicidality from where we are standing now.
Irvin Yalom, in his book Existential Psychotherapy, talks about lot about death anxiety and notes how many leading theorists before him (he’s writing in the 1980s) leave death anxiety (and the importance of facing mortality) out of their theories and treatments. They’d rather focus on something more manageable like neurosis. I think as other people have said, the worries about legal liability are the biggest contributing factor, but I’d say the second runner up is people’s own discomfort with death, mortality, things we can’t control, and things we can’t make better. Sometimes, therapists really can’t make it better—and that’s a hard pill for them/us to swallow. I think the best we can do in those cases, like Bryan Stevenson says in working with prisoners on death row, is to “get proximate”
Maybe another factor is the insistence that therapy, like education, should only conduct activities that have "measurable outcomes." Hence, focus on things that are "manageable."
I like "get proximate."
do you think a libertarian euthanasia program is the best solution? i increasingly think so. only screen for coercion, otherwise, if someone wants to die, just provide reliable, painless means, non-paternalistic screening and a long self-directed final verification process.
I don't think we can screen for coercion. It's rarely measurable and human judgement is too frail to do it right, and eventually a bureaucracy, which is a goal-oriented thing, will come to understand that suicide is profitable and efficient and it will begin to promote it. It's inevitable, or at least so likely that we can't allow the procedure at all, in my opinion. We can't sanction it. This is actually part of why I favor the second amendment. If you are really serious, if it really is intolerable, you can act outside the system in a way that isn't messy. But the system cannot be allowed to condone it, I don't think.
Sadly, I think this is very true. If it can be monetized, it will. If there was a way that we could avoid that, and avoid some of the legal ramifications that are, more often than not, geared toward increasing profitability, that would be great.
I've often wanted to donate my entire body to someone who is happy and values their life, but has some kind of physical sickness or disability that I don't have. Go on, take it! I have no need for this meat sack anymore!
I understand.
well yeah that first premise is the big question. i don't know that we can't. but even if we can't, i think i'm still inclined to support it. i am pretty sure that disvalue from false positive kills would be far less than disvalue from selling alcohol, while being a step towards existential compassion & a stand against mainstream existence-bias and associated authoritarian tendencies.
I want to feel as much pain as possible though and damage my body slowly. I want to be a Liveleak splat. Not a The Giver type case.
The first thing I did because of multiple attempts starting at age 3 and heavy self harm to the current day at age 46, was to get a DNR notarized on my 18th birthday. After I got it done I was so happy I jumped with joy. Killll me !!! Killtard!!! Gas the psycho!!!!
I wanted to emigrate back to China for 40 years but I can't because of multiple involuntary admits. It is what it is. It's because I was born in America and not in China. I am also permbanned from Tsa Precheck. I headsmash everyday and am wananarexic.
Relatable! I've wanted to die since I was 16. Actually, I never thought I would make it past high school graduation, so after I graduated college I was a little dumbstruck about what to do with myself and have been winging it ever since. Intermittently, I have routine suicidality. Most of it became passive as I got older. These days, I'm just counting down the days until it's time to go. I joke, but not really, that I only have about 50 years to go. Can't wait to die! I will tell people. Maybe 30 if my schizophrenia diagnosis prognosis ends up carrying out its notorious fate. Who knows. But you're right, people need to talk about suicide more. When I was talking about it ten years ago, I was posting Facebook statuses like it was casual, as jokes, really, but then people would report me and then I would get locked out of my account. They had me watch these really awful videos with smiling people and sunshine coming from the window. It was really lame. I just wanted to make jokes! Let me be suicidal in peace. I won't kill myself for God's sake, I can't do that to people who love me, but I do wish there were some happy place where I could safely wish to die with humor.
Humor could help a lot.
Thanks king
re: ''talking too openly about my desire to die'' - I've found it to be hugely frustrating that even though I find it very hard to tell a friend or a loved one that I often think of ending my life, talking about it with a therapist is generally far more difficult. It feels like the proverbial minefield.
It shouldn't feel that way. I know what I can safely say and what I cannot say without crossing a line. I always have the discussion with them anyway, just so that I know for certain how they interpret the rules. This ought to be more than sufficient, but it isn't.
A few weeks ago, my therapist was reviewing her cases with her supervisor, and the supervisor felt it was necessary to ask the police to make a home wellness check. My therapist and I had an understanding, and we'd agreed that unless something changed, there was no need for this sort of thing. The supervisor, who has never met me or spoken to me, overruled my therapist.
I agree, I think the legalization of suicide risk has had a very negative impact on clinical encounters and turned discussions of suicidality into the minefield you describe. Furthermore, every clinician has their own threshold and comfort level with suicidality, which makes things very confusing and difficult for patients.
Indeed.
I have a lot of Goth friends because I cut, choose to eat in disordered ways and am interested in suicide with a first attempt 43 years ago. This is despite the fact that I listen to Pop, Dance R&B music and vote Republican. Gothic and Metalhead people are more open to it.
“But because she still shows up in the neighborhood, I am reminded how diligent I have to be in maintaining love, light, and connection to the divine. I don’t want to be tempted to follow her ever again.”
So this. Thank you for putting such beautiful words to it 💗
This is a magnificent essay, Sorbie. As a child and relative of people who have attempted suicide or taken their own lives, it resonates strongly—the knowledge that what follows the attempt is punishment rather than listening, in a context where it feels to the person like punishment is all there is. I often feel that The Haunting of Hill House is the story of my family. Your essay is also a reminder for parents about the importance of listening instead of objectifying. This is great writing.
I’m so glad you could find some resonance in the essay. Thanks for your kind words :)
Each Sorbie guest post is > 1 year of psychiatric residency.
Hear hear! 😃
I think mental health services really want to be seen to be ‘doing’ something, and perhaps there is more justification for a passive kind of holding in these moments of crisis, acknowledging it’s not immediately fixable. Not panicking or overreacting but also not jumping in and assuming we can do anything particularly helpful.
One of the downsides of the de-stigmatising of mental health conditions is maybe that it’s compared to breaking a leg, when really it’s not. People aren’t going to be able to be successfully treated with a cast and some painkillers in the vast majority of cases.
I found this article very interesting, thank you.
I think the word you're looking for here is "liability." The mental health system wants to be seen as "doing something" as a CYA. I don't think it's actually because they acknowledge these complex life situations as "not immediately fixable," I think they absolutely do approach these situations as though they ARE immediately fixable by flattening them into something two-dimensional and treatable by drugs & confinement. It's cheaper, less time-consuming, and more convenient this way. It's not because it helps the patient/person in distress.
I’d love to read more about what got you out of this spot! The love and meaning that sustains you now, and how you somehow got there
it's tough because whatever caused me to get better is as mysterious as the things that made me sick in the first place. I have things I can point to in both cases; I have a narrative I can offer. But because it (the whole "being alive""having the human experience" thing) is such a dynamic process, it's tough to give a bulleted list of things that helped me. I used to lack a lot of relational and emotional skills/fortitude, and now I have more. I learned those things from having good relationships, but something changed inside me before I could start trying to have those, and I deeply do not know what that thing was. Part of it was literally just getting older, I think; but it's not like I simply "grew out of it" exactly. Sorry if this is unsatisfying! Sometimes honesty is!
Thank you! That’s a thoughtful answer. It’s always hard to say: what is the thing that changes that allows someone to get better? Do we control that process almost at all?
i have no idea hahahahhhhaaa! If I did I wouldn't be a blogger/pancake cook, I'd be Psychiatry Genius Emperor or something!!
Sorbie also discusses what she thinks helped her heal in Rich Girl Rehab: https://www.psychiatrymargins.com/p/rich-girl-rehab
for me, becoming less suicidal took a few things. they involve coming to believe and feel things, which can only be a result of an indescribable intrinsic experience over time involving a lot of trust, faith, and sustained hope:
finally believing in the privilege it is to be alive, to age, to be “free”. this world is inundated with people who have their lives ripped from them by cruel cowards.
being trans, since my teens, i have witnessed so many trans lives across the globe be stolen, including those pushed to suicide. i lost a friend in 2022 in the transphobic/homophobic mass shooting in colorado springs. he deserved to live, even when living would have meant witnessing the continued violent transphobic wave that picked up that year (which his death and the other victims’ were treated as catalysts for hatred).
in the US we are surrounded by people who are kidnapped into prisons which, in the US, are concentration camps. it is not lost on me that millions of people are functionally enslaved in squalor to labor and/or die out of the public eye. anyone without immunity granted by fascists in the US can be considered a criminal and forced into those conditions, and it means something mighty to be on the outside of that
i finally believed that my hard life is worth living.
people lead hard lives all the time and i never used to understand why people would keep going after so much tragedy. but i finally believed that my hard life shaped by mental illness and poverty was still worth getting the most out of it that i can, including on days that don’t “look like much”.
when feeling like my hard life, and my “freedom” (quotations because it’s conditional) are a privilege and honor, it is much easier to feel a lust for life. to be curious and have fun, which are literally crucial to enjoying any of this living! to actually feel gratitude when i look around me. i can marvel at my proximity to neutral, innocent nature like bugs, foliage, creeks. i can be deeply grateful for the few close friendships i have, and show up to maintain them because i want to.
hope this helps :) it’s still super mind boggling to me to not be a suicide risk after being one for 14 years of my life
There’s some really good points in here. Thank you for taking the time to write it all. And I’m happy to hear that you’ve been able to put so much difficulty behind you!
instant entry into my top 10 favorite substack posts
<3
Oh man. So much to say, thank you for this one Sorbie (especially because, as you say, such depictions and investigations are rare and it is quite something to mine your own Being for the cause).
I may write a piece speaking to the challenges of working with suicidality within the system as a practitioner and link to what you've written here ... because (imo) as you say it's so important for a therapist not to be crushed by the fear of suicidality or try to 'get rid' of it. But there's also a secondary fear of what the system demands and what it will extract if you get it "wrong".
What happens when we are consistently forced to choose between protecting ourselves, and doing something likely to be "safe" but inhumane and potentially traumatising?
Thank you, Sorbie. Very well put and I do love Harold and Maude despite odd looks when I explain the plot to others. I think it’s fair to say that we make up/live in stories that are fantasies all the time - and unfortunately treatment as it is commonly structured typically is only interested in the story of the identified patient/person and not in the fantasies of the larger community. One of the essential stories in the US has always been ‘when in doubt do something!’ as compared to some other cultures’ ‘when in doubt wait and see what happens’. As I’m writing this I also am recognizing that it is just plain hard and awkward as a ‘professional’ in the field to own my/our side of these conversations - how difficult and hard it is to sit and listen to your level of pain without wanting to prematurely make it better, to worry about what my peers/medical board will say if I haven’t ‘done something’, to recognize how connecting to the person sitting across from me also makes me vulnerable and can make it hard to sleep at night … we claim we (culture/health systems/experts) know things but at the most intimate and close levels when in a true partnership with someone else that knowing protects none of us reliably from pain. Much easier to execute a 5150/invol hold and go home with less potentially painful attachments. My apologies to you from the ‘healthcare professional’ side for maybe pretending just a little bit - that it was entirely out of concern for you that the treatments and nostrums I/we insisted you take or submit yourself to - and not done to assuage my/our own fears and worries. Thanks again and please keep writing!
Thank you for sharing. I feel less alone having read your story. I also started talking about suicide around nine years old, and felt something akin to a dark cloud over my head even earlier in preschool. I wonder how much of that early emotional instability comes down to nature vs. nurture. In any case, thanks again. It’s good to feel seen, especially in such dark subject matter that’s difficult to communicate to others.
<3
Beautiful, beautiful writing. Thank you 💕