Let’s Talk About Death – breaking the taboos that surround suicide

Trigger warning: This article is all about death and suicide. It may not be an easy read.

The first time I thought about suicide was when I was eight. Leeds Utd had just lost to Chelsea in the FA Cup Final and the shame of trying to beat up my big brother’s cocky friend and collapsing in tears was too much. I was in the garden afterwards trying to focus on the beautiful cloud of butterflies landing on the purple buddleia.

And then this quiet voice wafted over me, landed and drilled into my forehead: “Why bother?”.

This question has haunted me ever since. And it probably haunts you. But we are not allowed to ask it.

In 1990, in the thick of my six year long 24/7 obsessive anxiety state, I thought much more about dying than living. It was not a cry for help. It was a wanting to be free of pain. The fantasy of dying was an escape valve – I assume a little like self-harm is for some people, though I wouldn’t know.

 

The Dabbler

I dabbled with suicide. I took some over-doses. I remember sitting on a bed washing down half a dozen paracetamol with half a bottle of whisky and calculating how much more would do the job. But what scared me more was the double pain – the stomach pump and possible liver damage plus the shame of coming round in A&E with my mother frowning down. What if I did not succeed? Why bother? Oh, irony.

I also remember wandering up and down Union Street in High Barnet for hours burning with anxiety about living and dying and eventually wondering into the path of a white van that had turned into the side street. But it was only doing a max of 20mph. I think the police that came were chortling at my half-hearted attempt. And I had fucked up the nerves of the poor van driver. I had brought one more sorry soul into my sick circle. What a shit I was. This proved it.

And so then there was the shame of thinking I was not even decisive enough to kill myself properly. I was a dabbler who was fortunate to stay alive in hindsight.

 

The Decisive

Back on the ward, Steve went off and hung himself in his caravan. Larry stole one night to the reservoir and drowned. Decisive. That was the way to do it.

So, there is my first learning about suicide – that there are different types of folk. Even in the mists of pain and suffering, there are different ‘styles’ of suicidal behaviour. Is anyone studying this? Or are we stuck in our simplistic ‘suicide prevention’ models – the ‘let’s talk’ or ‘breaking stigma’ approaches that allow us all to be smug – that raise Twitter awareness – that conflate ‘hits’ on a website with true analytical thinking about what works and what doesn’t?

If we truly understood what’s going on with folk as they near the brink, maybe we could have more subtle approaches, based on involving users in that work. Maybe this sort of work is happening – I’d love to know about it.

 

The vulnerable time

Lesson two about suicide came later. I was ‘recovering’, with the volume, intensity and frequency of ‘intrusive’ thoughts receding. So much so that my psychiatrist wanted to prescribe pills to prevent me from being too high! He thought I might turn psychotic.

When he realised that this was a positive turn of events, he ‘discharged’ me. I spent a few weeks popping back into the day centre to sit amongst my semi-comatose, drugged up, fearful but lovely compatriots. Then I was ‘discharged’ from that limbo-land. I was in the ‘real’ world that I had spent six years away from.

In that vulnerable state, with fewer lifelines, I was ‘getting better’. I was doing more, but feeling still like shit. This gap between behaviour and feelings – where to ‘act as if’ precedes the nervous system re-wiring – is surely the most potentially risky in terms of suicide. This time I had the energy to do it. I was stronger in some ways, and more vulnerable in others.

I went swimming again (I had been a competitive swimmer in my younger less fat with drugs years). But when I realised I wasn’t ‘enjoying’ it, I thought ‘why bother?’. Those buddleia days returned with a vengeance. I projected into the future. If I can do things but they don’t bring me emotional reinforcement, truly why bother? What is the point of life? What nobody told me – what all the myriad psychiatrists (and later psychologists and self-help authors) never did – was that feelings follow behaviours. That the ‘act of will’ (read more about ‘psychosynthesis’ please) can help re-wire sensation, emotion, feeling.

But I didn’t know that, and was both recovering and feeling worse at the same time. I wonder whether anyone is seriously looking at this. In the widening gap between the NHS and seriously under-funded social care, my guess is that suicide figures for this segment of the population may be increasing – anyone know whether this is true. Are the stats there? Anyone looking?

 

Ambivalence

My third lesson about suicide is how it feels when a loved one or friend does the deed. Many people reading this will know of Rosamund Snow’s calculated insulin overdose. She was probably in the Steve and Larry category. And in that respect I almost admire her deliberate act (careful David – taboo thought, you’re not allowed to say that. What the hell. I’m too old to pretend). But I also hate her for what she did, how she deprived us all of her talents. And I also hate myself for not being able to help.

It is this swirl of ambivalent and confusing feelings that is also not allowed of people close to those who decide to die. I hear people telling others who have been bereaved to ‘stay strong’. WTF? How? The need for strong support for the bereaved is my third lesson in coming to terms with suicide. And for those who have tried to kill themselves, to witness someone else doing it leads inevitably to comparison, to guilt of all sorts and the questions about ‘could I do it’? The answer is obvious to me now: Don’t. Just don’t. Trust me: Don’t. But boy the mind can weave some wearying diabolical pathways before you come up with that conclusion.

 

Four Lessons

So here it is, if anyone feels like taking the ‘mental health awareness’ message seriously and putting money where mouths are….

Lesson One: Recognise the different ‘styles’ (I can’t think of a better word, sorry) of those who want to die. Let’s learn to approach support in nuanced ways.

Lesson Two: Acknowledge the danger of the ‘recovery’ period. We need people not to fall into the gaps.

Lesson Three: Don’t tell people who have lost folk to suicide to ‘stay strong’. Go find them and give them space to share their feelings and words. Support them for more than a week or two.

Lesson Four is the one that has been slowly taking root since Dave fucking Webb scored a late Wembley winner that I still think was a foul. And my buddleia experience. That it is OK. Repeat: OK to think about ending it all. That is part of our life experience. We cannot control our thoughts, merely be mindful of them. Stop listening to the shiny shiny positivist ‘let’s be happy’ brigade. It’s OK to think about death, to think about life being futile, to recognise existential doubt.

And when it gets to a bad patch when these thoughts become heavier in volume, frequency and intensity, it’s OK. Repeat it’s OK. This too shall pass – slowly, painfully, slowly, painfully. But they can and they will.

I am glad I did not kill myself. But I think of death a lot. As my lovely uncle Robin once said: ‘what else is there to think about. Cucumber sandwiches’? If we don’t consider death, life is not worthwhile. Think about that. Those who don’t think about it, may well find themselves more prone to the kickback later of emotional suppression.

Good luck. Be gentle, wherever you are and whatever your tricky mind is doing. And: Don’t.

© David Gilbert 2017

If you liked this blog, do read more at http://www.futurepatientblog.com

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4 thoughts on “Let’s Talk About Death – breaking the taboos that surround suicide

  1. Such a difficult subject for many people but oh so lacking in research, understanding & care. The gaps in Mental Health services are many but the gaps in between are life threatening and I’m so proud,eased you’ve highlighted those here.

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  2. You and I need to meet and have a long chat I reckon. I get so fed up with the ‘let’s talk about it’ stuff cos talking isn’t always enough even if you can find someone who will talk. If you need psychiatric help it’s not always there and if you don’t fit the mould or there’s a waiting list if you do need help then it may be too late.

    For last 3 years I’ve been expert by experience on a suicide prevention project and I talk about suicide but it can only be about me cos as you say everyone is different. No one has the same reasons as another, or personal circumstances, or personality. I got told a couple of weeks ago that if I rang the crisis team if suicidal pick out 2 reasons to talk about. No, it’s not like that. It can be a steady drip drip of reasons or one great bloody catastrophe that is the final straw. It’s a bit melting pot of reasons which I can’t just pick apart. Or it can be as 2 weeks ago I really just can’t bear how I feel anymore – it’s just everything

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  3. Yes, Yes, and how timely. I have just been dipping into Pip Waller’s extraordinary book ‘Holistic Anatomy – An integrative guide to the human body’. Her Ch 20 ‘Dropping the Robe’ is a title borrowed from the cultures of the Native American Indians. (To drop one’s robe is simply to let go of the body, the robe the spirit has worn for this lifetime, and move onto the road of the spirit.)
    This is the only place I have ever seen Death and Dying written about in a text. She makes the incredibly important point that in many cultures it is customary to consider one’s own death, to meditate on it, to prepare for it , and to speak of it- so that death is an integral part of life. That must take the pressure off a little, and make normal and more ordinary individuals different ‘styles’, and with those styles, choices.
    Not everyone want to live as long as possible. Quality may be more important than quantity. When I mentioned to a large group of people in their 80s and 90s that I’d been told that 1 in 4 of people currently retired would live to be 100 there was a resounding chorus of “Bloody Hell. I hope its not me.”
    Waller offers a brief overview of world-wide religious perspectives of death that makes our own taboos look very immature. She also tells a great story.
    David, I think this is an incredibly brave blog. Thank you. Lesson 2 – why do we even talk about ‘recovery’, things will never be the same again. Folk have to rebuild some sort of a new life and to find the energy and clarity when one is low, exposed and alone is incredibly difficult and can take forever. Lesson 3 – similarly – as is the rebuilding or accommodation when the numbness of loss from the suicide of a loved one cracks open. The hole in one’s life will last forever and we must understand.
    Who else is brave enough to look at these things?

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