“It is difficult to get the news from poems, but men die miserably every day for lack of what is found there.”— William Carlos Williams
One of the most important truths about suicide is almost never heard in public. It is deeply known by millions who have been there, but buried under a pall of silence. It is a truth that society is reluctant to hear, that many who work in suicide prevention do not want told. For those who suffer with intense thoughts and feelings of suicide, it could make the difference between hope and despair. And for our nation, where suicide continues to rise, this subversive truth, as part of a new dialogue about life and death, could radically turn the tide.
As you read this, thousands of people are wanting to die, and many of those are thinking of killing themselves. More than a million people a year in America experience thoughts of suicide, most in the context of personal mental or emotional pain. Statistically speaking, about one-tenth of these make an attempt to suicide that involves medical attention (about 100,000). Among those about 40,000 die, something over 120 per day.
Many know these generalities, and have heard that suicide rates continue unabated in the U.S., despite unprecedented effort. The corollary, more positive, statistic, the one that is not articulated often enough, is that among all those millions who actively consider suicide, less than one in every 10 make an attempt on their own lives. And, of those, only a minority ever go on to die by suicide. This means that, in every community in the country, in every part of the world, we are living among people who have faced the worst of personal pain and doubt and have come through them to better lives.
But few of these millions have had their stories heard. And the many who survive attempts and go from there to live valuable, meaningful, even contented lives? Why is there so little in the public sphere about their trials, triumphs and truths? And what might they say if they did not need to fear judgment, scrutiny and stigma?
They might tell of things that others would not want them to. Truths that fearful societies, cultural taboos and even the professions related to mental health and suicide prevention have conspired to keep silent for centuries. They might tell you something that I’ve heard from hundreds of survivors, that I lived myself – the truth that, for many, going through struggles with suicide completely transforms their lives for the better.
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In many ways, this is a subversive concept. Resistance to it is clear at every level of society. It is clear in the way that people are so often treated when they are in their worst moments -- in the way that treatment in institutional settings is experienced as punishment, humiliation and coercion rather than care. It is clear in the way that civil rights and human dignity are stripped from those who attempt suicide, often even when they seek help for their distress voluntarily. It has been suppressed by religious taboos, social norms, regressive psychiatric practices, medicine, clinical psychology and some in the professional realm of suicide prevention.
This de facto conspiracy against the idea that experiences with suicide are potentially valuable is immoral, unethical and lethal. Along with stigma and discrimination associated with mental health issues, it has terrible consequences on many levels. The worst of these impacts being unnecessary human suffering and an unknown number of preventable deaths. By supporting this conspiracy of silence we have not only done injustice to the human existential condition, we have augmented the suffering of many – isolating rather than embracing people precisely because of personal experiences which will be among their most difficult and potentially profound.
Through the suppression of optimistic messages related to suicide, we have passively supported the contrary message – that suicidal thoughts and feeling can deliver nothing of value, except in their termination, i.e., we have as a society said that the only thing to do with suicidal thoughts and feelings is to end them. And what kind of message is that to someone who is trying to make it through phenomenologically unendurable anguish?
The denial that there could be anything of value associated with suicidal thoughts and feelings relegates people who experience them to a lonely struggle. The reality they live with, possibly for many years, is perceived as flawed in the extreme, egregious to society and devoid of meaning. Therefore their strange and difficult process, already sensed as suffering, can no have any essential value.
Consider the real impact of this to someone who is trying to manage the feeling of wanting to die. For some this is a dark period which they enter and emerge from in a short period. But for many others, the battle with suicidality is not short— not a singular dark night of the soul but a challenge over years or even decades. Already fighting despair, then, they feel more isolation, shame and hopelessness than should ever be the case. Absent knowledge which could dignify their struggle, deprived of that which could give purpose to an odyssey of pain, many who have had every reason to survive their suicidal moments, have died instead, alone and in despair.
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For millions out there, the experience of wanting to die, the most intensely painful moments or even years with thoughts and feelings of suicide, have been the crucible of personal transformation through which their greatest strengths and purpose were revealed. But sharing this knowledge in order to encourage others rarely happens, and when it does it has usually been in whispers.
How do I know this? As a professional in mental health and advocate in suicide prevention and health rights, I have worked with thousands of people experiencing suicide, and intense emotional distress over the years. I have led agencies and developed programs in mental health services, and studied and presented on suicidology, psychiatric services and human rights around the world.
But the knowledge that is most relevant here, is a form of “lived expertise” - one gained from listening many other suicide survivors, and from my own life where I endured years of suicidal thoughts and feelings and twice attempted to kill myself. Each of those most intense crises was a pivotal point in my life. The first time in my teens it led me to seek treatment and break free of a pattern of addiction and self-destruction. The second time, years later, a new sense of purpose emerged for me, the ability to face down social expectations and self-hate, and, eventually, to pursue my course in life in spite of painful mental health challenges that always came back, that likely always will.
In this course, my recovery and life as well has been enriched by many other survivors, in ways too numerous to tell. People who could relate to what others would be afraid to hear, who could support one another in ways no one else might. Thousands of people have similar stories — many that are more dramatic, more personally perilous and traumatizing. And many will tell you as well that those moments were, ultimately, hugely personally important. That what they went through refocused their personal and spiritual lives and their relationship with their own existence in a way nothing else could have.
This is not to say that any one of those who have been there would wish this journey on any other. Or to deny the reality that suicidal thoughts and feelings accompany truly agonizing inner pain. It is not either to paint a simplified picture of a psychological journey in which one hits a singular definitive bottom and bounces back, superhero-like, to conquer all. For every person’s path of recovery is different and uniquely theirs. Yet, as with so many deeply personal challenges, the experience of wanting to die contains within its field of struggle many valuable seeds. Seeds that flower into wisdom, resilience, compassion and creativity. That can become gifts to the world at large, and the fruit of hope for others.
Too few of these gifts have been shared openly. Too little of the fruit that could nourish people in despair has reached them. Because as a society we fear to discuss existential crises, death and anything related to emotional pain, people living with those as part of their daily reality are given to feel isolated, ashamed, invalid and flawed. Because social opprobrium on these issues manifests in discrimination and rejection in many ways, smart people, who might make a difference through their story, keep it close to the vest, and choose not to disclose.
The institutions involved with the issues of suicide and suicidal behavior have worked within and passively augmented this matrix of societal stigma. Suicide prevention, public safety and emergency services, mental health services and even research into suicide (“suicidology”) have focused on assessment of risk and intervention to stop the damage caused by suicidality, rather than helping people to develop internal strengths through the course of their struggles with it.
This focus supports the prevailing view that suicidal thoughts and feelings are the result of, or a form of, illness, from which certain people who are weak, broken or vulnerable suffer, the only positive of which lies in its termination. It finds expression in messages that one should only discuss suicide with trained professionals, under expert guidance, or in highly constrained ways so as to prevent spreading it like a communicable disease. And in the practical bias, expressed in policies, procedures and practices, that people living with suicidal thoughts and feelings need to be isolated from others, treated with skepticism at least and coercive intervention at most.
The problem is that such messages, no matter how positively intended, reinforce fear, stigma, and a cultural bias against most all that is mentally painful. They place suicide in the realm of extremes to be avoided if at all possible and dismiss the experience of those who have been there as aberration. They foster a conversation about suicide that is based in fear and judgment and advance a set of solutions based in containment that have limited effect because they don’t meet people where they are, in the way they need to be met. They prevent us from talking openly as human beings, about an experience many are having at this moment. An experience which can have consequences as negative as death and trauma, or as positive as growth and personal transformation.
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If we are to turn the tide on suicide death and despair we cannot continue with half of the story. We cannot have the rewards of trial and recovery kept silent by fear and taboo. We cannot have people continue to view themselves as problems who broken or sick, rather than individuals moving through process fraught with trial which at the same time promises great rewards. To evolve as a society, we need to embrace the richness of the terrible journey of suicide and the strength of people who’ve been on it. And we need hear about them out loud.
To reverse the increasing suicide rates in America we need a new dialogue about the experience of suicide itself. This dialogue, the only one that can make a radical difference, is the opposite of that which society has had for years, and that our suicide prevention efforts have promulgated to date.
This dialogue does not dismiss the suffering that people are going through, or the pain and fear that may extend to their loved ones. But it also sees within these difficult processes the seeds of hope. It supports the dignity of all who experience suicidal intensity by seeing them as people in the throes of a growth that may be essential to their lives. And foregrounds the knowledge that, as a result of surviving it, they will make great strides for themselves, and likely for others as well.
For those of us have been there know that hope to not suffer pain, if valid, is marginal as a resource for strength. But in the face of pain that may seem endless or meaningless, the hope, the truth, that struggling through the darkness itself can create great and positive things in the world, is a more than a deterrent to suicidal actions. It is the best possible reason to live.
Lives can be saved with this simple knowledge. We who have been there know it. For it to happen, though, real-life stories of survival, hope and transformation must be heard, from the thousands of survivors out there. To make a difference for people struggling with suicide now, we need those who have been to the edge and back, who have cultivated strength through doubt and pain, to come out, and tell their tales. From any one of the millions who have been there, including any of you who may be reading this, our communities need to hear more of what you lived, what you learned, what helped you get through it and what you gained in the process.
As a nation we can turn the tide on suicide— but only if we are willing to do something totally different. If we target and eliminate taboo, professional pride, and social stigma as barriers, and we put the insight of survivors first we can have newly honest dialogue about life and pain and recovery. By embracing this wisdom of lived experience, by using this new resource of truth, things can change for many who now feel alone and in despair. We can see thousands of lives transformed rather than ended. We can make save many lives tomorrow by talking differently about death today.
This is the first in the blog series Reclaiming Mental by Eduardo Vega
Eduardo Vega, M.A., is CEO of Dignity, Recovery, Action! International, a founding board member of United Suicide Survivors International and Chair of the US Destination Dignity Coalition. He serves on the Steering Committee of the National Suicide Prevention Lifeline and the Executive Committee of the National Action Alliance for Suicide Prevention, through which he developed the first Suicide Attempt Survivor suicide prevention task-force.