Chapter Four
MADNESS OR SUICIDE, IT'S YOURS TO DECIDE
“The pain of depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne. The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain.”
–William Styron
“I am the wound and the knife!…Victim and hangman alike.”
–Charles Baudelaire
Philosopher Albert Camus once wrote that the only real philosophical question to ask is whether or not to kill yourself. To a person suffering from depression, however, the question of suicide is not academic. The pain of depression is intense, seemingly ever-present, and it feels like it will never end. Being clinically depressed can be compared to having an ongoing nightmare where the only way to end the dream is to annihilate the dreamer. According to the National Institute of Mental Health, 15 percent of those diagnosed with a major depressive disorder who are not treated (or who fail to respond to treatment) will end their lives by suicide (this is 35 times the normal rate).1 People with serious illnesses such as cancer and heart disease do not kill themselves in large numbers; depressed people do.
Many theories exist that attempt to explain the motivation for suicide. Freud postulated a death instinct. Others have suggested that man is endowed with “a drive to destruction.” But to anyone who has experienced suicidal pain, the explanation is so simple, so self-evident, that it requires neither psychiatric nor psychological jargon. Death is chosen because suffering is so acute, so agonizing, so intolerable, that there comes a time—depending on the individual's tolerance for pain and the available support—that ceasing to suffer becomes the most important thing. This “aggregate pain model” of suicide is supported by the DSM-IV in its diagnostic section on major depression:
The most serious consequence of a major depressive disorder is attempted or completed suicide. Motivations for suicide may include a desire to give up in the face of perceived insurmountable obstacles or an intense wish to end an excruciatingly painful emotional state that is perceived by the person to be without end. [Emphasis added]
During my dark night, I met a woman who was battling cancer. She wrote a poem about her struggle and her hope for recovery called “The Crawl Through Hell.”
So I crawl. Slowly I crawl. I inch my way through hell. Count the days. Each one is less to “endure. Each day I am closer to the end. Back to the world. Back to life. Life is the light at the end. The tunnel will end. It is long but it has an end.2
To the depressed person, however, there is no light at the end of the tunnel. One does not crawl, because there is no place to crawl to. Both ends of the tunnel are sealed off, and a sign on the door reads “No Exit.”3
The wailing woman in Pablo Picasso's “Guernica”
People in life-or-death survival conditions, such as being lost in the wilderness or being held prisoner of war, will dream and plan for the future in order to make their present conditions tolerable. The critically ill heart patient expresses his faith in his upcoming surgery by making a date to play golf six weeks after the operation. The imprisoned soldier dreams of being reunited with his wife and family. But the depressed person sees no viable future. There is nothing to look forward to, no dreams to fulfill, only the never-ending agony of the eternal present. In this context, I saw suicide not as an act of self-destruction, but as an act of self-love.
To Be or Not To Be
“To remain as I am is impossible. I must either die or be better, it appears to me.”
“Abandon all hope, ye who enter here.”
I first began to experience suicidal feelings (the clinical term is “suicidal ideation”) in November 1996, shortly after I began the day treatment program. As my pain intensified and I became overwhelmed with the thought of eternal suffering, I remembered Nietzsche's words: “The thought of suicide is a great consolation; by means of it one gets through many a bad night.” Realizing that I could always end my life when the agony became intolerable granted me a sense of peace and relief.
This was by no means the first time I had contemplated suicide. During my two previous depressive episodes, I had made two half-serious attempts—the first time swallowing some tranquilizers with a bottle of beer, and the other, taking a handful of Valium before driving on the Long Island Expressway. (It remains one of the unexplained miracles in my life that I returned home safely.) Moreover, I had been close to at least a half-dozen people who had committed suicide, the most recent of whom was the psychotherapist I had seen before Pat. In a sense, the suicidal demon had pursued me my whole life. Like the legendary St. George, I was locked in mortal combat with a deadly dragon—and he was winning.
I knew I was serious about killing myself when I drew up a will, named my brother the executor, and sent copies to him and a good friend. I wanted to put my financial house in order before I died.4 Having taken care of my remaining fiscal responsibilities, I spent countless hours deliberating on the most efficient way to terminate my existence. My first choice was to use a gun, because it seemed so quick and final. Then I remembered a crisis counselor telling me about a man who suffered irreparable brain damage when he shot himself in the head. “I wouldn't try it,” the counselor warned. “You might end up a vegetable.”
My next plan was to jump off a building, but after picturing myself walking to the ledge and looking down, I remembered that I was afraid of heights. Also, a friend at day treatment had asked me an unsettling question—“What if, halfway to the ground, you change your mind?”
Finally, I resolved to take an overdose of the antidepressants and tranquilizers that I had saved up over the past few months. This also frightened me, since I didn't really want to die, and was concerned about the people I would leave behind. I knew that if I killed myself, my friends and family would not only be grief-stricken, but angry and guilty as well. “Why should I drag all of these people into my nightmare?” I thought.5
My concerns about the impact of my death on others were shared by a fellow patient at day treatment.
“Don't do it!” Dennis cried emphatically, when I told him of my plans.
“Why not?”
“My brother offed himself twenty-five years ago and I still haven't forgiven the bastard. Don't make your friends and relatives go through what I did.”
“All right,” I replied. “I'll try to be more considerate.”
Later that day, I reported this conversation to Pat.
“It seems like your friend has developed an ethical injunction against suicide. Do you have any similar moral beliefs?”
“No,” I replied. “I don't believe it is a sin to commit suicide. I can't see why a loving and merciful God would punish someone for wanting to end his suffering.”
“I'm sorry to hear you say that,” Pat responded solemnly.
“Why?”
“Studies have shown that people who lack a moral or religious belief that suicide is wrong are more likely to act on the impulse.”
Pat's analysis was true. Without a clear moral reason not to kill myself, my resolve to avoid suicide was only as good as the kind of day I was having. When graced with five or six hours without symptoms, I would think, “Maybe I'm in remission,” and hope for the best. Too often, however, the respite would give way to a downturn in mood which brought with it the voices of doom—i.e., “Suicidal ideation is a hit across the nation” and “Madness or suicide, it's yours to decide.” My choices seemed clear—either spend the rest of my life in hell (I believed I would live out my days in a state mental hospital), or put an end to the pain. Both outcomes were unacceptable, but I could not imagine a third alternative. In my anguish I cried out, “God! Show me another way—or at least give me some hope that another way is possible.”
Meetings with Angels
“For we are saved by hope, but a hope that is not seen is not hope: for why would a man hope for that which he sees? But if we hope for what we see not, then do we with patience wait for it.”
When Paul the Apostle wrote “We are saved by hope,” he was not speaking in platitudes. Research has shown that the risk of depression is correlated more with hopelessness than with the intensity of the depression. It seems that we can endure all sorts of pain and suffering if we are even remotely optimistic that things will get better, or that there is a meaning to our suffering. Conversely, people with lesser degrees of depressive pain can become suicidal if they lose hope for a better future. Hopelessness, not sadness, is the antecedent to suicide.
If a way out of hopelessness did exist, I knew that I could not find it alone. Since my mind was trapped inside an “either-or” thought loop (as depicted by the rhyme “Madness or suicide, it's yours to decide”), it would take another person to lead me out of my mental prison.
The first person I turned to for help was the Reverend Mary Manin Morrissey, the spiritual director of the Living Enrichment Center. Having known me from the early days of LEC, Mary took a special interest in my case.
“When you start to think that all is hopeless and that there is no solution except suicide,” she said, “remind yourself that you are under the influence of a ‘drug’ called depression. This chemical imbalance is distorting your view of reality. Thus, you should not consider your feelings of hopelessness to reflect the truth of your situation.”
“How do I prevent myself from giving in to the despair?” I asked.
“Try to think of your depression as a bridge instead of an abyss, a transition period instead of an end point. There is a universal law of polarity which says that all states of consciousness eventually turn into their opposites—i.e., pleasure becomes pain and pain becomes pleasure. Likewise, your suffering will one day turn into joy.”
“That's impossible,” I replied. “To me, depression is a bottomless black hole from which there is no escape.”
“Then you will need to have the ‘soul strength’ or ‘spiritual endurance’ to stay in the pain until it repatterns and transmutes,” Mary replied. “There is a Higher Power that is more powerful than any condition, including this depression. Maybe you had this breakdown so you would be forced to turn to God above anything else.”
“Do you have any ideas on how to do that?”
“I know that you are a student of the Old and New Testaments,” Mary replied. “Throughout the Bible, especially in the Book of Psalms, we hear about God's promises of deliverance. I suggest you read through the psalms and write down the verses that give you comfort or hope. You might even want to post them in your home where you will be sure to see them on a regular basis.”
I was glad that Mary had faith in my recovery. In the days that followed, I took her suggestion to heart. I located a number of psalms, as well as inspirational quotations from my book I Am With You Always, and placed them in strategic locations in my office, bedroom, and the bathroom.6 Looking for additional words of spiritual encouragement, I visited my local bookstore and spoke to the store owner, Lisa, about my ordeal. After listening intently, she walked over to the new arrivals table and pointed to a beautifully decorated book called the Celtic Tree Oracle. Lisa explained that the text describes the symbolism of the twenty-five letters of the Celtic alphabet. Each letter was associated with a tree or bush and was linked to a specific aspect of Celtic philosophy and cosmology.7
I have always felt an affinity to the tree kingdom, which I have nurtured through a quarter century of hiking in the forests of the Pacific Northwest. “Perhaps,” I thought, “these trees could speak to me now.” During the Middle Ages, it was customary for monks to open up the Bible at random, point to a passage, and receive guidance from it. “Why not do the same with this book?” I thought.
With a prayer on my lips I opened the volume and found myself staring at a page with the Celtic letter “Eadha”—which translates as “white poplar.” The interpretation reads as follows:
This tree is concerned with finding the spiritual strength and endurance to face the harsh realities that life presents to us, often over a long, debilitating period of time. It conveys a sense of the ability to endure and conquer. In this way it prevents death and the urge to give way under the impossible odds you must overcome. It is, therefore, of great assistance on the journey toward rebirth. [Emphasis added]
I was deeply moved by how clearly the reading depicted my predicament, as well by as the hope that it offered.
“This is an auspicious event,” Lisa remarked after I showed her the passage. “It indicates that you want to live, and that spirit will help you to survive your ordeal.” Lisa then photocopied the image of the poplar (as well as it's interpretation) so that I could carry it around as a symbol of protection. In future weeks and months, I looked at the picture and read the words of encouragement whenever I felt myself slipping.
The White Poplar
My next visit was to a spiritual counseling service sponsored by a New Thought church in the Portland area. As I approached the space where the lay ministers were seated, I wondered how they would respond to my situation. If I have one criticism of New Thought spirituality or its psychological counterpart—the power of positive thinking—it is that it focuses exclusively on the good and neglects the dark side of life. And so it came as no surprise when the volunteer approached me with a cheery smile and said, “What shall we affirm today? Prosperity? Health? Happiness? Creative self-expression?”
“Actually, I was thinking of committing suicide,” I replied.
With a combination of concern and amusement, I watched the volunteer's face turn white. “I think I should get my supervisor,” she said, as she hurried out the door.
When the supervisor arrived, I assured her that this was no joke, that I really was depressed and needed help. Understanding the seriousness of my predicament, she sat down with the volunteer and recited two “positive prayers” which affirmed my capacity for healing and wholeness.
I find no fault with the church practitioner for being overwhelmed. Many friends, and even some psychotherapists, could not handle the intensity of my suicidal pain. Whenever I tried to share my suicidal thoughts, they would either get angry or abruptly change the subject. Only those people who were specifically trained to treat major depression, or who had “been there and back,” could deal with my extreme condition.
One such person was a social worker named Judy. Having attempted suicide herself, she knew firsthand what goes on in the mind of a suicidal individual. Judy saw her clients, many of whom were in severe crisis, out of her small Victorian home, nestled in the Columbia River Gorge, twenty-five miles east of Portland. At our first meeting, she got right to the heart of the matter.
“Suicide is not chosen,” Judy said emphatically. “It comes when emotional pain exceeds the resources for coping with the pain.”
While speaking, Judy showed me a picture of scales to illustrate her point.
“You are not a bad or weak person,” she continued. “Neither do you want to die; you just want to end your suffering.”
I nodded in agreement.
“Your problem is that the scales are weighed down on the side of the pain. To get the scales back in balance, you can do one of two things: discover a way to reduce your pain, or find a way to increase your coping resources.”
I explained that the former option seemed impossible.
“Then let me give you a coping resource that I'm sure you will find lifesaving,” Judy said, as she handed me a pamphlet titled “How to Cope with Suicidal Thoughts and Feelings.” I read it briefly and felt a mild sense of hope.8
“One more thing,” Judy added. “I know you think that killing yourself will end your pain. But according to what I've read, consciousness continues even after death. Some people even believe that we reincarnate and return to earth in order to work out issues that we didn't resolve in this life. Perhaps there is no easy escape.”
“What other option are you suggesting?”
“Stick around until you get better.”
“Beating Michael Jordan in a one-on-one basketball game would be more likely.”
“Crises, including suicidal ones, are time-limited,” Judy countered. “Eventually, something's got to give. Provided you don't kill yourself, you will be around to experience the next chapter of your life.”
“That's easy for you to say, but you're not in this hell. My intuition is telling me that I'm stuck here forever.”
“Cognitively, you cannot help but think ‘I am permanently frozen in horrible pain.’ This is what depression is—a failure of the imagination. The chemical imbalance in your brain is preventing you from envisioning a positive future. Nevertheless, I want you to at least make room for the possibility that some unexpected good might grace your life.”
Sensing that I was stuck in unbelief, Judy leaned back in her chair and recounted the following parable.
According to an ancient tale, a Sufi village was attacked and captured by a group of warriors. The king of the victorious tribe told the vanquished that unless they fulfilled his wish, the entire village would be put to death the following morning. The King's wish was to know the secret of what would make him happy when he was sad, and sad when he was happy.
The village people constructed a large bonfire, and all night long their wise men and women strove to answer the riddle: what could make a person happy when he is sad, and sad when he is happy? Finally, sunrise dawned and the king entered the village. Approaching the wise ones, he asked, “Have you fulfilled my request?” “Yes!” they replied. The king was delighted. “Well, show me your gift.” One of the men reached into a pouch and presented the King with a gold ring. The king was perplexed. “I have no need of more gold,” he exclaimed. “How can this ring make me happy when I am sad, and sad when I am happy?” The king looked again, and this time he noticed that the ring bore an inscription. It read, This, Too, Shall Pass.
“It is an immutable law of the cosmos,” Judy continued, “that the only constant in the universe is change. Haven't things happened to you that you never would have predicted?”
I nodded my head as I recalled the many experiences, both good and bad, that life had unexpectedly brought me.
“Since you cannot know your future with absolute certainty, then, allow for the possibility that a healing may be waiting for you around the corner. Pat tells me that you have already created a survival plan for yourself.”
“I use it to get through each day.”
“Good. Then stick with your strategy. Instead of fretting about the future, simply create the support that you need to stay alive, one day at a time. Please repeat this statement: “I am creating the support that I need to stay alive, one day at a time.”
“I am creating the support that I need to stay alive, one day at a time,” I said meekly.
“Good! Now I want you to repeat this affirmation every day. It doesn't matter whether you believe it; keep saying it anyway. I know that you are going to live.”9
Judy's heartfelt sincerity and intensity left a deep impression on me. Although I felt hopeless, she seemed so confident. “Maybe she's right,” I mused.
Lisa, Mary and Judy were three guardian angels who came to me in my darkest hour. They presented a vision of healing to me that I could not see for myself. Although their faith in my restoration did not remove my physical and psychological pain, it did give me a reason to hang on. And as long as I stayed alive, a miracle was possible.10
Prayer for Going Through a Dark Night of the Soul
This is a combination prayer and affirmation that I composed and read during my depressive episode. I hope that it may be a support to you as well.
1. I accept the fact that I am going through a dark night of the soul. I am dying to the me that I have known.
2. I embrace my pain fully and accept my present condition. I understand that on some level my soul needs this experience.
3. Although I feel all alone, I know that God is with me.
4. I realize that this experience has a purpose and teaching, and I ask spirit to reveal it to me.
5. Although I am in pain, I know that my travail will end, and that love, inspiration and direction will reenter my life.
6. I ask the universe to give me the strength, courage and guidance to see my way to my rebirth.
7. I give thanks for my situation just the way it is.
1 This statistic comes from the National Institute of Mental Health. Suicide in America kills more people (about 32,000 a year) than homicide. Comparing this figure to 43,000 breast cancer deaths per year and 42,000 driving fatalities, one realizes that suicide is a major undiagnosed health problem in this country. Moreover, for every one person who commits suicide, sixteen attempt it, which translates to 500,000 attempts per year, or one every minute.
2 Used with permission. Excerpted from “The Crawl Through Hell,” by Lynne Massie, published in the book, The Buttercup Has My Smile.
3 Other images of hopelessness include: being trapped in a dense black fog: falling into a bottomless abyss; being locked in a cold, dark dungeon; sitting helplessly on a melting ice floe.
4 Putting one's house in order is one of the classic signs of someone who is serious about committing suicide. There are other signs as well—for example, people who talk about suicide are more likely to act on it. If someone you know is exhibiting these danger signals do not ignore them! Get the person to a hospital or someplace safe.
5 I later learned that taking pills is not always lethal and, like a gunshot wound, can cause permanent brain damage. Even jumping off a bridge doesn't guarantee death, as I learned from a man who broke his back trying. “Remember Murphy's Law,” the suicide counselor had emphasized. “It's not so easy to kill yourself.”
6 The quotations I used can be found on pages 280-281.
7 The Celts were an ancient tribal culture that inhabited the British Isles before the time of Christ. The Druids, the wise elders of the Celts, had a very special relationship with the natural world and considered trees to be particularly sacred.
8 The information from this sheet, as well as other strategies for preventing suicide, can be found in chapter 11.
9 In addition to her counsel, Judy gave me her phone number as well as the number of the National Suicide Prevention Lifeline (1-800-273-TALK) and said that I must call anytime I was in danger of harming myself. She also gave me a number of Internet sites on suicide prevention that proved to be amazingly helpful (see Appendix C).
10 Suicide is not just my personal problem. It is the eighth leading cause of death for all Americans and the third leading cause of death for young people aged 15 to 24. On July 28,1999, the Surgeon General of the United States officially recognized suicide as a national health crisis and issued “The Surgeon General's Call to Action to Prevent Suicide.” To learn more about this important campaign to raise awareness about the causes and prevention of suicide, call the Office of the Surgeon General at 202-690-7694 (or visit the website at http://www.surgeongeneral.gov).