Lifting their Voices: Suicide Attempt Survivors Speak Out

[Reprinted from American Association of Suicidology's NEWSlink June 2011]

The roadmap of suicide prevention is filled with challenging terrain and blind spots around the curves. Just when we feel we have advanced to a new frontier, another uncharted land lies ahead. Last year at the annual conference for the American Association of Suicidology we heard the voices of the clinician survivors come to the forefront: clinician survivors built solidarity around unaddressed needs and created a forum to advance the work to address these needs. At this year’s conference another group got organized and found momentum for organized empowerment: survivors of suicide attempts.

AAS Panel about helping attempt-survivors and their families (photo by David Covington)

Most notably, the conference featured a plenary panel about suicide attempt survivors called “Silent Journey: Helping Suicide Attempters and their Families.” Stephanie Weber, the Executive Director of Suicide Prevention Services in Batavia, Illinois shared her experiences running a support group for suicide attempt survivors.

“At last year’s conference,” Stephanie said, “a woman asked me ‘This is for survivors, but I am a survivor of my own attempt, not of someone else’s death. What is here for me?’ I told her ‘Next year we will have a panel of attempt survivors who are no longer alone or ashamed.’” Stephanie continued, “This is the last stigma. Why is it when we lose a loved one to suicide, we grieve, but when we have a loved one who attempts suicide and survives we are angry and don’t know how to talk about it?”

CW Tillman, a suicide attempt survivor, talked about his experiences with first responders and family members. He said, “There are several ways to help suicide attempters. The first way is just to be honest. At first, after my suicide attempt they told me, ‘That was a stupid thing to do,’ and I know they meant ‘I love you’ and ‘I want you around.’” CW recommends not using the term “failed attempt.” He explains how he sees his suicide attempt as a success by virtue of its not resulting in his death.

Jason Padgett, Project Coordinator for Tennessee Lives Count, talked about his experiences with family members who had gone through suicidal crises. He said, “For all those out there who support those who struggle with suicide, you need support too.”

Finally, Dr. Kate Comtois, Associate Professor at University of Washington, shared findings from her research. After evaluating the similarities of effective psychotherapies for suicidal individuals, she concluded they have at least three qualities:

1) Suicide is treated directly, not just by treating the diagnosed mental illness or by observing or constraining the individual. She said these therapies focus tightly on what is making people suicidal and what can be done about it.

2) These therapies employ an overt, determined, and persistent collaborative stance. The therapist connects with the individual, not using the perspective “We, the experts will fix you, the patient,” but rather “Together, let’s see what we can figure out.”

3) Clinicians work as part of a staff team – they meet regularly to discuss cases and burnout.

Dr. Comtois also summarized what participants in her research said about their journeys after attempting suicide:

1) The pressures on individuals who have attempted suicide are tremendous. The response of our mental health system is to diagnose mental illness and prescribe medication, yet this will not solve their problems.

2) Individuals who had attempted suicide reflected that the researchers asked many more questions about their suicide attempt and their history of suicidal coping than the referring clinicians or team had.

3) Study participants engage in and appreciate the suicide-specific treatment that the researchers developed. This was not consistently the case for the treatment as usual group.

4) Study participants followed most of the recommendations from emergency departments, inpatient units, and the researchers.

Some of the conference attendees found the panel moving. Eduardo Vega, himself a survivor of a suicide attempt, said, “Suicide is not a problem that is fixed in a hospital. Bringing the voices here really touched me.” David Covington, Executive Committee member of the National Action Alliance for Suicide Prevention said, “The leaders of suicide attempt survivors are changing the way we think.”

I too am moved by their lived experience and believe their inner wisdom holds the keys to our ability to better understand suicide prevention.

Guest Blog: Why I Donated My Psyche to Science

I am delighted to introduce my guest blogger Amy (Cooper) Rodriguez. Her husband Dave was a good friend of my brother Carson's; they all attended Bowdoin College (class of '93). Last month she reached out to me to tell me they thought of Carson a lot and remembered his vitality. She also told me that she suffered from depression on a number of occasions (including while at Bowdoin) and did her best to hide it at all cost. Recently, she met with a group of medical students to let them interview her about her experiences with depression and anxiety and to let them know how good people can be at hiding it. Thank you, Amy for sharing your story. In her words...

Amy Cooper Rodriquez, Guest Blogger

 As Robert Frost said, “I experience everything twice. Once when I experience it and once when I write about it.” Therein lies the reason I don’t like to talk-much less write- about depression.

But after successful treatment for post-partum depression, I was intrigued to get an email from my psychiatrist saying, “How would you feel about being interviewed by some second-year med students? You can tell them what you’ve gone through and help them understand a bit about depression and anxiety. You’d be great!”

Hmmm. What did this mean? I couldn’t figure out whether to be flattered or alarmed. Did this mean I was the epitome of anxiety…the most extreme case he’d ever seen? Or did it mean I was just high-functioning enough to put some answers together?

I had my first bout with depression when I was a sophomore at Bowdoin College. My boyfriend and I had broken up, and he was dating someone new. I watched them stroll hand in hand as I plodded across the quad to class. I felt as if I were wearing a lead vest from an x-ray. The campus still looked idyllic, like the brochure. The pine trees still reached into the brilliant blue sky while the sun shone on the students playing Frisbee, yet I could only observe: “The sky is very blue.” I had a hard time understanding people. When I think back, I picture cocking my head to the side while I listened to them, as if I were a dog, or squinting my eyes while I watched their mouths, as if I were hard of hearing. Worst of all, I didn’t tell anyone how I was feeling. Not only did I feel depressed, I felt ashamed.

When I recovered, I swore I’d never feel that shame again. But the next time, the shame was worse because this time my depression came with the birth of my first baby, my daughter. I remember how guilty I’d felt lying next to her thinking, what gives me the right to be sad when I have a beautiful, healthy baby? I wondered how many moms were out there now, lying next to their babies, crying. And I knew I had to contact my doctor and see what I could do.

I emailed my psychiatrist asking him what the meeting would involve. He left me an enthusiastic voicemail, “Oh, they need to learn how to listen to their patients. They’ll be more nervous than you! You’ll be wonderful!”

So, a week later I drove into Boston. Like everyone in hospital waiting rooms, I was nervous and fidgety. I sat up straight, slouched back into the chair, stood up, looked out the windows, and rummaged through my pocketbook.

At last, my doctor appeared, smiling warmly. He gestured behind him to a flock of eager young people in white coats. Beautiful people right out of Grey’s Anatomy.

“Amy,” my doctor said, “you’ll be coming with us. “Mike, here,” he pointed to the cutest one, “has agreed to do the interview.” Mike, with his dark hair and olive skin, smiled at me with piercing blue eyes. I found myself wishing he were less handsome.

My doctor led us to the hospital cafeteria where I scanned the room to see if I knew anybody. This seemed like a strange place for a confidential interview, but my doctor found a table tucked toward the back of the room. The students and I jockeyed awkwardly for seats. I didn’t want to be at the head of the table, like I was leading a boardroom meeting, nor did I want to be alone on one side of the table like an inmate at a parole board hearing. I was hoping for a we’re-all-in- this-together feeling.

I finally sat in the middle of one side, and hospitably waved for the students to sit. They looked nervous and, because of my habit of talking when I am nervous, I began to babble. “It’s so great that you guys are doing this. Wow. Med school. I went to PT school.” Smile. Smile. Babble. Babble. I was playing emcee for this group of medical students. I looked at my doctor as if to say please stop me.

He intervened. “Mike will ask you some questions, and you answer with whatever you are comfortable sharing.”

Mike smiled. He made excellent eye contact.

“So Amy, how’ve you been feeling?”

I reverted to the role of the happy patient. “Good. Good,” I answered, nodding my head and smiling.

Mike raised his eyebrows.

“Oh well, I used to be depressed,” I said, laughing nervously. “You know, back in college, when my boyfriend and I broke up. And then after I had my daughter. Sometimes I don’t feel so great, but then I see Dr. Sharp, and he helps me.”

Mike nodded and leaned toward me.

I leaned in, too, ready to be impressive and articulate. But then I thought, What am I doing? I am not here for a job interview. I am not trying to convince people of how capable I am. I took a deep breath and sat back. I remembered why I came. Why I paid a sitter to watch my kids. Why I drove through crazy Boston traffic. Not to chat with a handsome guy but to help doctors learn how to figure out their patients. To take time. To dig deeper. To really know them. Because they would all have patients like me who try to appear peppy and bright when they are dying inside.

I let my shoulders fall. “It’s been really, really hard,” I said. “I’ve been depressed a few times. I have to be careful to make sure my life is balanced. I take medicine, but I also have to talk about it and make time for myself.”

I scanned the table. They were all listening intently. So I held nothing back. “I’ve given birth twice, had surgeries, been hospitalized with infections, had migraines, and I would gladly take all of those experiences over being depressed. That’s how bad it feels.”

Suddenly I was acutely aware of my surroundings--not in anxious way--but in an empowered way. I had wanted to be honest, to try to help others, to reduce the stigma of mental illness. I had never been sure of how, but maybe this was it.

The students looked at me and nodded. I didn’t babble or fidget and neither did they. We sat in silence for a moment, and I knew they had heard me. After a pause, they began asking questions, and I answered them. It became less of an interview and more of a conversation. They asked me what made me tell the truth to Dr. Sharp and asked what they could do to get patients to talk. I told them, “I saw a lot of doctors who were fine but they never knew how much I struggled. Dr. Sharp took the time to chip away until I told him how bad things were. I think the doctor has to be open and caring, and I think the patient has to be ready.”

They thanked me graciously as we stood and shook hands. Then my doctor patted me on the back as he walked me to the door. “See?” he said. “I told you you’d do great. Thanks for helping us.”

Maybe it was the idealist in me, the romantic--the Grey’s Anatomy viewer, but I drove home feeling like those young people would understand more about their patients someday. Maybe someday a college girl like me would come in to their office- or a new mom ashamed to admit just how desperate she feels. Maybe it would be a middle-aged man-a CEO- or a new dad, and maybe these doctors-to-be would help. At least I hope so. And hope, so they say, is the best antidote to depression.