Wednesday, July 15, 2015

The Suicide Spectrum

The Jumper ~ R Noelle
"The friend who holds your hand and says the wrong thing is made of dearer stuff than the one who stays away." ~ Barbara Kingsolver, quoted in The Sun, February 2007

Somewhere between taking one’s own life when everything seems completely without hope – call that “hopeless suicide” – and “assisted suicide” there is a conversation waiting to happen.  This post is meant to spark that conversation.
So many Veterans appear to choose suicide from the perspective of having nothing left to live for – no meaning in life and too many issues, whether physical or emotional or practical – so ending it all appears as the best option. Non-Veterans also face this choice, including my grandfather (whom I never knew) and my best friend (whom I knew well) and me. This is “hopeless suicide.”
It’s also a fact that there’s growing awareness and advocacy for “assisted suicide” as a humane way to end one’s life when reasonable expectations for recovery simply don’t exist.
There’s some crossover, too: “officer-assisted suicide” is, ironically, a fairly reasonable way for some people to end their lives. These days, all one has to do is show up in a public place acting crazy and brandishing a toy gun and the police will take you out.
And what about the protest suicides that are popular in Asian countries? Monks have set themselves on fire for a long time to call awareness to conditions they abhor and can’t change. That’s considered honorable.
Finally, what if suicide is a better alternative in the moment of crisis? The Jumper (hat tip to R Noelle for the image shown above) depicts one person's choice to leap from the World Trade Center rather than die during its collapse.
Which of these forms of suicide does society want to prevent? It’s fine to pass laws to add more behavioral healthcare professionals to the rolls of caring professionals, or pass laws to permit more assisted suicides, but laws alone aren’t going to resolve the questions that reside along the suicide spectrum.

Hopeless Suicide

Let’s start with the big one: unless you are the one contemplating taking your own life, you are an outsider. Even as close as my friends and family were to me when I was thinking seriously about killing myself, none of them – and I mean NONE of them – knew what was really going on with me, and I made sure to keep it that way. Yes: I was in therapy, and I even told my therapist what I was thinking, but that wasn’t the reason I didn’t take my own life. I didn’t share that reason with anyone, and at the decision point, it wasn’t about reasons anyway. Something else takes over at that moment, and that something has nothing to do with reason and sanity.
So who are “we” (the outsiders) to say we know best about some random suicidal person’s wellbeing? Doesn’t matter if we are parents, close friends, spouses or co-workers of one who’s suicidal – what right do we have to interfere? For most practical purposes, by the time I was at my decision point, it was too late for outside intervention. I suspect that’s the case for many others, too.
I’ve been through a couple of trainings that help non-clinical non-professional folks like me know how to recognize suicidal tendencies in others and begin the process of intervention to stop a potential suicide from becoming a real one. Both programs were good, but as good as they were, I believe both programs operate at a point that’s too late to do much. Prolonging the act is really all we can hope for when a person is obviously suicidal; much more work is required to turn a suicidal individual into a non-suicidal individual. I choose life every day, but that consistent choice to live came hard to me.
The time to intervene in someone else’s suicide comes way before they are ready to take their own life, perhaps even before they consider it as an option.
Think about this: do you have any authentic human relationships? The kind that battle buddies have in military combat. The kind where you would give your own life to save your friend’s life without a moment’s hesitation. If you have THAT kind of friendship with one or more people, you are blessed. I believe this is the kind of authentic human connection that saves lives, too.
Are you a good mentor? Have you ever volunteered to truly put someone else’s success ahead of your own, stand beside them as they struggle, encourage and coach when necessary, answer the phone in the middle of the night, be the big sister or big brother they never had, allow them to reach their full potential? If not, try it. If you achieve success as a mentor, you will have done two important things: 1) you will have modeled an authentic friendship, and 2) you will have empowered one more person to do the same and become a friend or mentor for someone else in turn. Pay it forward.
We must guard against the complacency of assuming that another law, or another program, or another donation to a humanitarian cause, or another Sunday in church is making the difference for folks thinking about suicide. It’s not. What DOES make the difference is authentic human connection, whether that’s the in form of a real friendship, or being a mentor, or being an authentic spouse or authentic partner. We can’t make the mistake of assuming our relationships are OK just being on cruise control; if we do that, it’s too late to intervene when suicide becomes an option.
There’s research that indicates an authentic relationship is the best intervention for hopeless suicide. If you really want to prevent hopeless suicide, work on the relationships in your life. Make certain they are authentic. Those relationships might save YOUR life some day.

Assisted Suicide

The conversation about assisted suicide is easier for most of us. But think about this: if it was YOU with a chronic, painful health condition from which there was no prognosis of recovery, would you want to ride it out until your “natural” death, even if that meant great emotional and financial stress to those you love as well as your own suffering? I can understand the reasonableness behind choosing assisted suicide.
I can also understand the reasonableness behind officer-assisted suicide. Although perceptions are changing rapidly thanks to racial tensions in the United States, society has had less trouble with a peace officer taking out a crazy person brandishing a gun than society would have had with that same person taking their own life. Now that society is confronting the issue of killings by peace officers, perceptions are changing. Society is demanding a higher level of accountability from its peace officers, which seems to anticipate an expected drop in the numbers of officer-assisted suicides.
The bottom line, however, is that a reasonable, rational person in possession of their own faculties and “of sound mind” may still choose to end their own life, even with the cooperation and consent of those closest to them – their family and friends. Whether a person in that situation runs in front of a train or gets a lethal injection or threatens some police officer doesn’t really matter, does it? One way or another, someone who wants to die – maybe even needs to die – is going to figure out a way to do so, and there’s a poignant beauty in this paradox that states such as Oregon recognize by legally protecting a person’s right to assisted suicide. Isn’t this a humane treatment?

The Questions

The challenge for everyone who cares about the issue of suicide is to embrace the paradox of life and death. Both are necessary parts of being human.
In spite of the overwhelming evidence that all of us are going to die n our society, there’s an implication that death is somehow “bad” and life is “good.” What would happen if society could put aside its judgment on life and death for long enough to talk about it objectively? Could this provide an opening for a more enlightened conversation about the value of a good life and the value of a good death?
Are you aware of the resources available to a person who, facing his or her own death, seeks a transition that has great meaning and great authenticity? The resources are out there, and they range from religious counseling to psychological counseling to all sorts of New Age modalities for approaching one’s own end of life. It’s a very moving field of endeavor, and it seems that the people who engage in facilitating the mental and emotional transition from life to death have been given short shrift in the conversations about suicide. Perhaps they stay hidden because the perceptions of society in general are often hostile to these workers, especially regarding suicide.
That’s the big question of course. Society feels it is somehow necessarily humane to prolong life and anathema to assist death. “Thou shalt not kill” runs deep in American ethics. No matter what, suicide in any form is killing, and disconnecting from a deeply held belief in the sanctity of life is difficult work. But it is possible to put one’s beliefs on the shelf during discourse, hear the various points of view, and perhaps even evolve more effective policy without compromising one’s individual ethics. For example, isn’t “thou shalt not kill oneself” versus “thou shalt not kill anyone else” a reasonable distinction for dialogue? I’m not ready to pass laws that remove penalties for murder, for example, but I’d be willing to hear a wider discussion of permissible humane choices at end of life.
I’d also be willing to entertain a wider discussion of permissible choices at the end of hope. Many humanitarian organizations claim to serve people who have reached the end of hope, but taking a step out of homelessness and addiction, for example, is often a process that homeless addicts don’t survive without friends and mentors.
Perhaps these questions, if we could at least talk about them, might help bring society closer to preventing suicide. After all, isn’t it society that has failed the individuals who take their own life? Isn’t it incumbent on all of us to be the friend to a person who feels the death grip of hopelessness, for whatever reason? If we aren’t willing to live like we value life itself and act to preserve that value, what purpose do we have to live at all?

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