Ouf...I've been on the other side, the professional side, a few times. I've sat with clients who were deep in despair wishing they were dead. This time, instead of getting a call on my work phone informing me that a client had attempted to end their life, I was getting a text message on my personal cell from a loved one, informing me that someone I love was in the hospital after a serious suicide attempt.
This was my first time on the non-professional side. The side of watching a low budget hospital poorly handle someone I love who was deeply emotionally wounded. The side of knowing that someone I love, someone I valued, was so hurt that they'd rather be dead. The side of wondering if I should have called more often, if I did enough to show that I loved and valued them. The side of talking to my other loved ones while juggling the very complex task of maintaining personal boundaries while inherently thinking like a therapist and not being able to turn off that thought process.
As a professional, I can usually keep a level head and manage all the personalities in the room. When I'm acting as a therapist, I'm able to focus on the facts and be more direct with the support team of the person who attempted to end their life. Holy shit was this different. This post is coming from that in-between space. That very narrow gray area of being a psychologist who specializes in mood disorders while having many loved ones who have mood disorders, and now one who attempted suicide. As a therapist, it's harder for me to say this in such a crass manner...but as the loved one of a suicide attempt survivor, now I'm a little less interested in respectability when it comes to suicide prevention.
Unless you've ever stared down the barrel of darkness, it's very possible that you just don't get it
If I hear one more person tell someone with depression or suicidal ideation to "look on the bright side," I may have to start a movement to make that phrase illegal. Before you reconnect with someone who's attempted suicide, take a good long look at what you're thinking and feeling about that person. Does their sadness feel foreign or uncomfortable to you? Do you think to yourself "why don't they just snap out of it?" or "we all feel sad, I can just get over it." Is this you??? If it is, please take a seat. Take several seats. And put off seeing this person until you can come from a place of compassion. Radical compassion. It takes time, but it can potentially save a life. If you've never felt deep, heavy, stubborn depression before, you have to know that you run the risk of being insensitive to someone who is at their lowest low.
The "choose happy" phenomenon started off with the right intentions. In large part, our thoughts, feelings, and behaviors do a very intimate dance with each other, and reframing our thoughts can help ease uncomfortable feelings or get us unstuck. The problem arises when people focus on positivity to the point of becoming toxic. To the point of inadvertently signaling to sad people that they are broken for being so sad for too long. I'm still too raw to find a polite way to tell toxically positive people to STFU, so I'll refer to psychologist Susan David's Ted Talk:
"Normal, natural emotions are now seen as good or bad. And being positive has become a new form of moral correctness. People with cancer are automatically told to just stay positive. Women, to stop being so angry. And the list goes on. It's a tyranny. It's a tyranny of positivity. And it's cruel. Unkind. And ineffective. And we do it to ourselves, and we do it to others."
Bring your Mr. Rogers energy
"Dr. Stephanie, you just called bullshit on toxic positivity, wtf do you mean by Mr. Rogers energy?!"
Ah, I'm so glad you asked! Mr. Rogers did more than just ask kids to be his neighbor. If you check out the 2018 documentary "Won't you be my neighbor?" you'll find that Mr. Rogers was big on radical love, radical acceptance, and radical compassion. I told my loved ones they should watch this documentary to really delve into this message. The loved one who attempted suicide was not a small child, but I still felt the message was relevant: "I love you, and I like you just the way you are."
Another important gem from Mr. Rogers is that "feelings are mentionable and manageable." During a time when TV shows for children focused on shallow silliness and distraction from emotions, Mr. Rogers focused on empathy and emotional exploration. Bringing your Mr. Rogers energy means you're less interested in distracting a depressed person from their sadness, and more interested in reminding them of your deep love and acceptance of who they are. In doing so, the heavy emotions become mentionable and manageable.
Put on your own oxygen mask first
The first thing I did when I learned of my loved one's suicide attempt was call out sick at work. I did this even though I live in another state and had no intention of travelling to see my loved one (because we're still in the middle of a pandemic). So why'd I take the day off? We all know that cliche, overused but so very true phrase: "put on your own oxygen mask before assisting others." We hear it on airplanes during the safety demonstration. The idea is both literally and metaphorically true. Taking the day off allowed me to put on my own oxygen mask. And doing so gave me the stamina I needed to act as "ground control" while my loved ones figured out next steps.
What did putting on my own oxygen mask look like? The first thing I did was ask my therapist if there was any way to see me before our scheduled appointment. This was really important. This gave me the space to process my own shock, sadness, and guilt while thinking about my role as the person who is in the family...and a therapist...but not the family therapist. That role sucks sometimes. My therapist helped me think about how I'd take care of myself that day to help soothe my shock and think more clearly about the days ahead. This was essential to staying on my feet and in helping my loved ones think about how to support this person once they were to be released from the hospital.
By putting on my own oxygen mask, I was able to remind my loved ones to do the same. Some of them witnessed the attempt and were traumatized by the experience. No one was reminding them to breathe, sleep, hydrate. These basic functions become so easily forgettable when we've just watched someone we love attempt something so tragic. Putting on my own oxygen mask first also gave me the patience I needed to redirect people's anger and misguided shame.
Keep it simple
I'll wrap up with a reminder to keep it simple when supporting a suicide attempt survivor. There may be several logistical hurdles, such as medication management, finding a therapist, assigning people to watch over the attempt survivor. Slow down as you do this. Remember the most important aspect of healing: love. Never underestimate the power of accepting someone and providing empathy so that they feel less alone in their sadness. Some might be wondering if the first order of business should be a large gathering, "intervention" style. In most cases, I'm going to discourage that. Keep your interactions simple: "I love you, and I'm so glad you're okay."