You’re Not…Are You?

“You’re not feeling suicidal…are you?” During the week after the suicide of Robin Williams, the question came to me three times from three people close to me. That’s exactly how it was phrased, too. Something about seeing a well-known person who shared my condition die made it feel more real to them, I suppose; they wanted reassurance that I wasn’t in that kind of danger. Understandable–but what’s the right thing to say to them?

They want to hear that I never think about harming myself. But I can’t tell them that with honesty. The reassurances I can give them feel second-best, and are hard for them to understand. It’s hard to understand that I can be doing “well” and still not live too far from a dark voice that sends thoughts and images without being asked to. It’s hard to accept that there is no support they can give to eliminate that voice completely. No guarantees, no cure, no ticket to the land of my-loved-one-is-now-safe.

My studies in counseling are useful to me in observing the ebb and flow of this aspect of my condition. We were taught about a “continuum” of suicidal ideation and taught to assess someone based on this. We learned the difference between thoughts, intrusive thoughts and images, intentions, general plans and specific plans. We became less fearful of the subject and more accepting–and that’s important, because it’s not good for a client to believe they must keep their mouth shut about their darker thoughts to prevent their counselor from freaking out.

So, when someone anxiously asks whether I have any suicidal thoughts, I can’t tell them no, but I can tell them where on the continuum I’ve been lately. I can give them a lot of good news: I haven’t crossed into the realm of intentions, even vague ones, in a very long time. But they aren’t made happy by this, because they are distressed that I’m still on the continuum at all.

Intrusive thoughts and images. That’s the area of the continuum where I spend the most time, and the “intrusive” part means that they come to me without being actively invited. Their frequency and intensity varies, and is diagnostic. The details are also diagnostic, as are the frequency and intensity of ruminations about death in general.

How can I claim to fight for life, creativity, hope when I coexist with these thoughts? Shouldn’t I be trying to eradicate them? Is it unhealthy for me to admit I have them? Is this dialogue of mine a sick fancy? I don’t know. To me, my thoughts are what they are, and I have enough shame to fight without judging them too.

Years ago, at a psychiatric program, I witnessed a well-meaning but unfortunate clinical choice: a lady was hospitalized due to a suicide attempt, and professed her determination to try again. The counselors tried to engage her at a group level in questioning this choice logically, only to find themselves floundering and trying to keep this woman’s charisma from affecting others. Basically, it turned out that this woman believed wholly in a wonderful, healing afterlife, felt done with her Earth suffering and was anxious to get to the good stuff. A logical debate was completely counterproductive, as was judging her.

When it comes to my own beliefs, I do have some about the undesirability of departing early, but that doesn’t change the fact that suicidal ideation having to do with mental illness is not always logical and cannot be vanquished by logic.

So what, exactly, do I say to family and friends when they want to know? How can I ease their fears without lying, and how do I be at peace with the fact that they might never understand? Should I try to devise a system of describing the contents of my head, or stick to mild/medium/high?

I have, as usual, no concrete answers. Those I love know that I have a commitment to working my ass off to stay here until it’s my fated time to go, but false promises aren’t my thing. Accepting me as I am means accepting the sometimes dark path I walk, and I’m privileged to have a few people in my life who are trying to learn how.

5 responses to “You’re Not…Are You?

  1. I was just talking to my psychiatrist about this very thing. She asked me if I was having suicidal thoughts and I said “thoughts of me dying but not by my own hand.” She said there is a big difference.

  2. Also the thoughts and images come uninvited, so I know what you mean there too. They often take me by surprise.

  3. Thank you for intelligently articulating your experience with suicidal ideation. While in crisis, at 18 years of age, I found countering my thoughts using cognitive restructuring helpful for it enabled me to establish some distance between myself and the thoughts. Later trained in psychodynamic theory and receiving psychodynamic psychotherapy, I understood my suicidal thoughts as internalized anger and would stop myself and ask, “With whom am I angry?” Finally with medication, supportive psychotherapy, and eventually a diagnosis of bipolar disorder type II, I found additional relief, adding to my arsenal. Still, the illness lurks, the thoughts at times persist. We develop tools to cope with our illness, to minimize symptoms, but our brains remain different in ways others may never fully understand.

  4. I saw a Psychologist for nine years. It helped me bring some of my demons to the surface and process them. I certainly have no regrets about that.

    However, I continued to live the painful existence of a dry drunk. The booze was long gone. Everything that took me down the addiction path was still there.

    Then a great mentor came into my life. He told me that psychology is the study of human behavior . The goal is to get you to change your thinking. He told me that AA is the study of your behavior. We act our way into better thinking by taking action. The three A’s, Awareness, Acceptance and Action. That has made all the difference for me.

  5. I think is great that you share this type of things, probably helps other who are in the same situation and those who are not to understand the people that are in that situation and what to look out for.

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