June 27, 2018

Guest Column: Suicide is not inevitable

Gigi Colombini

Gigi Colombini

By Gigi Colombini, Special to Digital First Media

http://www.theoaklandpress.com/opinion/20180622/guest-column-suicide-is-not-inevitable

POSTED: 06/22/18, 5:19 PM EDT
When iconic individuals like Kate Spade or Anthony Bourdain end their own lives, we have to believe there was something so profoundly unhelpable about their situations that they believed suicide was the tragic only option.

As a clinical social worker with an expertise in suicide prevention, I can assure you, there is nothing inevitable about suicide. The biggest problem we face is a lack of education and understanding, even in the medical community, of what this 10th leading cause of death in America is really all about. This leaves almost everyone afraid to step in and turn the tide.

Family medicine physicians, who prescribe about 80 percent of psychiatric medications, undergo less than a day of suicide prevention training. Emergency Room docs are not required to have any. More people die by suicide than homicide. More people die by suicide than in auto accidents. The national suicide rate is 13.9 for 100,000, and recent studies show that 54 percent of those who die by suicide did not have a diagnosed mental illness.

But this is not a story of despair. If anything, we need to rewrite the story on suicide to one of hope because suicide is not inevitable.

Of the 14 people out of 100,000 who die by suicide, 999,986 find a way to endure painful struggles.

Somehow, we have come to believe that if someone is really suicidal, there is nothing anyone can do about it.

Shame often prevents people from sharing feelings, from telling someone, I’m thinking about ending it all. When we experience a spate of suicides in close proximity like we did recently, we feel powerless about the possibility of preventing these untimely deaths.

The Interpersonal Theory of Suicide suggests that the likelihood of suicide increases if three things are present in someone’s life: feeling as if they are a burden to others, social isolation or not belonging to a community, and an ability to make it happen. (More than half of all suicides are completed with a firearm!)

Having someone to literally talk you off the ledge helps immensely. A person who is suicidal does not really want to die; they just want the pain they are experiencing to stop.

The pain is so intense it makes it difficult to see solutions to their problems. Talking about it can help them see the possibility of enduring pain with the support of loved ones, community and connections.

In the U.S., the highest rate of suicide occurs among white men. During the economic downturn, we saw this happen because so many men became powerless to support their families. Unaccustomed to sharing feelings, many felt isolated and alone. We think suicide happens when you’re so despondent, you can’t leave the house. Suicide can occur from one pivotal situation that leads to despair.

I don’t know what Anthony Bourdain’s circumstances were, but I remember how devastating it was when we lost Robin Williams because people of all ages loved him. Sometimes, when men grow older, they feel a loss of quality of life; often they no longer feel valued after leaving the workplace.

Women are different. While our work is important to us, we are often connected to family and friends, and we talk about feelings.

When a famous person dies by suicide, people are doubly perplexed, thinking, they had everything; how could they do this? But rich and famous does not equal happy.

Happiness comes from connection, purpose, doing what you love. There is truth to the notion that it’s lonely at the top; achieving fame, fortune and renown can leave a person feeling alone and misunderstood.

We must change our conversation about suicide to one of hopefulness, where we all get involved in turning the tide. Even the language must change — a person does not “commit” suicide like they “commit” a crime or a sin. They die, tragically, and preventably.

When someone is grieving or struggling, be the one to start the conversation. Ask, “have you had thoughts of suicide?” And if they say, “Not really,” know that answer may actually mean “yes.” These simple conversations can save many lives.

Suicide is not inevitable. Even when someone thinks it is the answer, there is time to redirect thoughts. We simply have to care. We mustn’t shy away from getting involved.

As our society grows increasingly distant, we must double-down on connection and concern. We must “meddle” in order to make people believe they matter. Talking is the path to help.

Suicide is highly preventable. We must arm health care practitioners, educators, and community members with the tools to spot real risk, and then provide effective treatment to heal it.

Gigi Colombini, LMSW, is a psychotherapist and suicidologist with the Institute for Hope and Human Flourishing in Birmingham.

The Voice, The View, The Actions

By Robert Cooper

There is couple of ways of communicating based on our view of the future. Be it that the view is one of gloom and doom or the more upbeat I’ll rescue you, it’s pervasive throughout cultures , and the American culture is no different. These views and the actions that come out of those views affect our leadership style, our relationship to money, and our relationship to each other – everything.

My concern began as a complaint about the manner my wife, Sam, speaks to me to have me take some action she wants me to take. The manner of speaking caught my attention because I thought I had to figure out that she wasn’t just reporting or complaining, she wanted me to take action and do something about the situation, though the speaking never sounded, to me, like a request or command. Even when the speaking sounded like a question – did you put this here—it wasn’t a question seeking a yes or no answer or information. It sounded like a complaint or upset to be avoided.

Whenever I said anything about the manner of speaking and ask what do you want me to do, instantly my wife would be upset. The response would be along the lines of “you want me to talk the way you want me to talk” ”I’ll just shut up.” Begrudgingly, I’d take responsibility for the upset and restore our relationship.

I am fascinated with language and language use. It’s like a toy for me. My accepting responsibility for the interaction didn’t take away my puzzling over the stable, consistent and predictable manner that my wife spoke , and me wondering to myself why do I have to translate what she’s saying.

If she were speaking Japanese, I could easily accept the problem of understanding, translating, and taking the requested action. However, we were speaking English and my wife often wondered out loud “why don’t you understand me.”

I had several assumptions about why I didn’t understand her or didn’t, from her manner of speaking, get what action was being called for. I grew up in a cultural context where that type of unclear speaking could result in a heated I didn’t tell you to do that or I didn’t say that on one end and on the other result in a life or death situation.

Clearly the interactions between my wife and I do not provoke a life or death situation. Yet, all the other responses apply. Sam and I can be the only two people in the house for weeks at a time. Then I’d hear, “Are these your shoes sitting here?” “Who left the door open [unlocked]?” “Who ate my piece of fish?” “I’m gonna break my neck on these shoes.”

To bring levity to some of the questions, reports like your socks are on the table, I created a roommate early in our marriage. The roommate is The Ghost. To some of the questions and reports I’d answer The Ghost did it or I don’t know. I know I didn’t do whatever it was, and since Sam was asking she didn’t do it. I had to be the Ghost.

I’m southern and Sam’s dad is southern. So I gave the speaking manner a southern interpretation. Sometimes I attributed the manner of “don’t be direct”, “ don’t ask for anything”, “don’t show your intention”, “don’t give a direct command” as a carryover from the south, where the hiding of intentions, hiding of thought, the hiding of knowing, and the removal of self when speaking was thought to provide intergroup safety.

Lately, my interpretation has changed. Whenever Sam says something like “I’m gonna break my neck on this bag sitting here”, I respond you are being apocalyptic.

I got it. Whenever Sam forecasted the danger she was in, someone, but not her, was supposed to do something about it. I wanted to stop turning the issue over to The Ghost. I became curious and began to look for where I might have the same manner of speaking that I have been focused on with Sam. I looked at my piles of books and papers on the floor, on the dinging and kitchen tables and coffee table. Now that’s something I could create gloom and gloom about and I don’t.

Well, if Sam says a friend is dropping by, then I want to get into action and have the house look nice for the visitor. From the same west Asian and western traditions that I borrowed apocalyptic as the way of speaking for Sam, I borrowed messianic for myself.

Messianic and apocalyptic are most often used in religious contexts. The intention of this reflection, inquiry and writing is not to be religious, though for some it may be. I’m creating a mirror, a lens, and a set of practices to see ourselves not only individually, but also collectively at a cultural level.

To be Continued