Life in a Bind – BPD and me

My therapy journey, recovering from Borderline Personality Disorder and Generalized Anxiety Disorder. I write for welldoing.org , for Planet Mindful magazine, and for Muse Magazine Australia, under the name Clara Bridges. Listed in Top Ten Resources for BPD in 2016 by goodtherapy.org.

Category Archives: Self-harm and suicide

If the shadow falls

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I wrote this poem four years ago, as I was emerging from a period of deep depression and suicidal feelings. I’m reblogging it for World Suicide Prevention Day today, as I hope it might bring some light to those who are struggling in the shadows. It was the kind words and support of other people in the blogging and Twitter community, who started to bring light into my own shadows, during that time.

We are a complex mix of forces – of strength, and air, and light. But when darkness threatens to overtake us and those internal forces don’t seem strong enough, we need to wait, just long enough for the shadows to pass us by. We need to say ‘not tonight’. Please reach out if you need help in waiting, and in saying ‘not tonight’. x

Life in a Bind - BPD and me

when shadows fall final

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Sitting to feel safe

*TRIGGER WARNING – SUICIDAL IDEATION*

I’ve sat pretty motionless for the past hour and a half, because if I don’t move, even if I’m not doing something to actively try and distract from these thoughts, at least I’m not doing anything to act on them either.

I can still move my fingertips on the keyboard, as I’m doing now. Twenty minutes ago I typed in the Samaritans’ email address in an open window in my Gmail account, but I haven’t typed anything else in it yet. I got distracted by opening up a private browser window and looking up more information on a particular way to die. As with most ways to die, there appeared to be numerous downsides. And then I came across this:

https://www.victoriahealth.com/editorial/suicide

It is an incredibly poignant article by the late Sally Brampton, who tragically took her own life a few months ago. It is moving, funny, and brutally honest.

I wish I had a suicidal soulmate, like Sally did. Yet somehow I can’t bear the thought of ‘inflicting’ my suicidal ideation on friends, even on those who might on some level be able to relate to how I’m feeling. I don’t want to burden anyone with my thoughts, or cause them to feel as though they are somehow responsible for my safety. I don’t want to talk to anyone; but at the same my inner critic is busy invalidating me and telling me I have no right to share this with anyone. It tells me I have no right to take my feelings seriously; that if they were serious I would have made an attempt on my life already. That if they were serious then my ‘mood states’ would last longer, rather than often being intense but fairly fleeting. I know my inner critic is a liar. I believe my inner critic.

In her article, Sally wrote that when you are in the midst of depression, “the senseless makes sense”. I don’t know whether or not it’s a consequence of neuroplasticity, but I can certainly attest to the fact that over time and given prolonged suicidal ideation, the concept of suicide acquires its own twisted type of logic. I recognise that it is a permanent solution to a temporary problem, and I recognise the devastation it can leave in its wake. But it’s still as if the phrase ‘suicide is logical’ has been rewired into a tautology in my brain. Most of the time I can hold it alongside the concept ‘suicide is not a good solution’. But sometimes I really struggle with that. Like tonight.

I felt such a strange mixture of shock, sadness and relief, when I read how in her darkest times, Sally began to imagine dying together with her daughter, who also suffered from depression; lying side by side, holding hands, and drifting off into an endless sleep. A couple of years ago in one of my own lowest patches, I half-jokingly half-seriously suggested to a close childhood friend of mine who also suffers from depression, that we usher in our next decade together in a similar fashion; holding hands while drifting off into a place of no pain. She called me ‘sick’ and hasn’t spoken to me since. I told another good friend what had happened and she discouraged me from writing about it, saying it wasn’t really one of my better moments. It wasn’t, and I was ashamed of it. But I think I’d always been hoping that behind the ‘sick suggestion’, my friend would be able to see the fact that I loved her, and if there was anyone I wanted to share the terror and intimacy of death with, it was her. She didn’t see it – she didn’t see the strange sort of logic that suicidal ideation sometimes constructs. Thank you Sally for helping me feel a little less ashamed of the fact that sometimes the senseless makes sense to me.

And yet I’m lucky, very lucky. Lucky because I’m able to root myself to the spot and somehow convince myself to ride it out while letting my fingers do the job of trying to bring me back into safety. Lucky because at this juncture in time, this moment is a moment; intense and almost unbearable, but likely to pass relatively quickly. I am not in the midst of a prolonged period of depression; and even when I am, unlike Sally’s months and years of hell, my worst periods tend to last three or four weeks at a time.

It’s been almost two and a half hours now, of sitting in one spot, waiting to feel safer. I feel a bit safer. Maybe safe enough to risk moving. My inner critic berates me for wasting hours doing nothing. Previously, not making an attempt on my life was evidence of a lack of seriousness; now it’s evidence of a lack of productivity. Another bizarre sort of logic.

At the end of her article, Sally wrote: “So, and I say this with all my heart, hold onto hope, because if we keep it grasped tight, then summer will surely come”. I’d be lying if I said I was trying to hope for summer. Right now I’d like to be able to hope for a crisp, sunny, sparkling day in winter. Right now, that will be more than enough.


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Memory Monday – “It feels like only blood”

This post is only six months old, but ahead of Self-Injury Awareness Day on 1 March, it felt appropriate to share it again. This is a poem I wrote on the subject of self-harm:

https://lifeinabind.com/2015/08/05/it-feels-like-only-blood/

In addition, the feelings described in the poem are very present at the moment, and they are one reason why it’s so hard to write about anything else right now. Over the last few days every area of my life has felt like a battleground at one point or another – therapy, my marriage, my relationship with my children. But most of all the battleground is in my head, and until that arena is better understood, a little quieter, and more in control,  I know that all my other conflicts don’t stand a chance.

I don’t want to have stand-offs with my children where no one is a winner, and no one is an adult, either. I don’t want to feel resentful every time I ‘give ground’ to my husband or ignore comments I’m unhappy with, just because it’s too reminiscent of not having some of my own needs met by my parents. And I don’t want to miss out on some of what therapy has to offer (including things I desperately crave, like unconditional acceptance), just because it always feels as though I ‘want more’ – words, emails, caring, attention – and because I find it so hard both to accept the boundaries and the things I cannot have in therapy, and also the unchanging and unfaltering nature of the things I do have.

I really want to work with my therapist, not against her. I don’t want to fight her – even if a part of me does, and tries to, often, and very successfully. The same issues, the same battles, are coming up again and again but in slightly different forms. I try to take comfort from the fact that this just means that there are clearly things we need to resolve – and it is becoming both more urgent and also easier for matters to make their way to the surface. And if all this is ultimately about me changing, I also take comfort in this wonderful quote about change by therapist Alison Crosthwait (from The Good Therapists): “In order to change you need repeated exposure to your own coming apart, to the border between conscious and unconscious, and to the parts of yourself that you resist being with“.

For the nth time this day, week, month, year, it feels as though I am fighting my own resistance and trying to prevent even the tiniest of victories from unraveling, and myself from coming apart. That fight is so exhausting; and the urge to try and find some peace from it by hurting myself is so tempting, it just feels like just another thing to fight against. But ultimately I know that self-harm is my attempt to avoid sitting with the parts of myself that I resist being with, and what I really need to do is not avoid, but to surrender. Surrender to the process of therapy and to the process of change, which inevitably, as described in my poem, will bring a great deal of grief, before it can bring a long-lasting  – rather than temporary – relief.


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The multiple meanings of self-injury: raising awareness and examining preconceptions

*TRIGGER WARNING: SELF-HARM*

Three years ago I was self-harming three or more times a week. It was such a big part of my life that it felt as though it had become my identity. My emotions were on a constant rollercoaster and my close relationships were under immense strain. I couldn’t make sense of the possibility of a future, or of having a place in the world. I felt helpless, life felt out of control, and depression was eating me up.

I started self-harming as an adult in my thirties. Although it is often perceived as a ‘young people’s issue’, self-harm affects all age groups and not all adults who self-harm will have started as teenagers. Self-harm is a coping strategy, and quite often the strategies we adopt are determined or influenced by the situations we find ourselves in. In my case, the coping strategies of my early twenties – mainly around intense relationships – were simply (and thankfully) not as readily accessible in my ‘married with kids’ situation. The first time I self-harmed, it was in response to perceived abandonment by a therapist; a couple of past coping strategies did come to the fore, but in desperation to find something that would alleviate the distress, helplessness and self-hatred that I felt, I turned to something more readily available, that I felt would be less destructive for those around me.

And it worked – for quite a while. I do not mean in any way to advocate self-harm; and I hope that ultimately I will be able to rely on ‘healthier’ ways of coping. But I think it’s important to acknowledge that those who self-injure do so because they find it helpful, or at least they did when they first started. For those who use it, it does alleviate distress, and many would say that it has afforded them the possibility of staying alive when their emotions felt almost too intolerable to be borne. As well as this fact, if there is one other thing that I have learned about self-injury that I am passionate about wanting to convey to others, it is that it is incredibly complex, and has multiple meanings. There are as many reasons why people self-injure, as there are people who do it. The reasons vary from person to person; but also, crucially, they can vary for the same person, at different times.

I have used it as a way of punishing myself when feeling worthless or guilty or ashamed. I have used it as a way of punishing others – even though they never knew about it – when I felt hurt by them but incapable of conveying it directly. I have self-harmed in order to try and cope with immense emotional pain by masking it with physical pain instead. Conversely, I have done it in order to feel something, anything, rather than bear with the truly horrific frustration of feeling emotionally numb and cut-off from myself. I have used it as a way of expressing acute distress, even if only to myself – a ‘silent scream’ as it is sometimes called. And I have used it as a way of self-validating my distress and keeping it and myself ‘real’. So often my ‘inner critical voice’ would accuse me of being a fraud and ‘making it all up’; seeing the cuts on my body was ‘evidence’ of the reality of what I was experiencing. As the days went by and the cuts started to heal a little, and as even more days went by and the marks started to fade, I used to become extremely anxious – as if the reality and legitimacy of my emotions depended completely on those marks.

But by far the strongest and most enduring factors behind my self-injury, have been a desire for comfort and control. When I first started self-harming my confidence and self-worth were at their lowest ebb, and it felt as though cutting myself was the only thing in my life that I had power over. And although I know how strange this will sound, the self-injury did not just represent something I could control, it represented the only thing I felt I could ‘get better at’. Having always been afraid of pain and the sight of blood, being able to overcome that actually felt like an achievement. As for comfort – I have never fully understood this aspect of my self-harm, and yet it is a powerful motivator for me. When I feel immense sadness, grief, or abandonment, pain itself seems like a great big, enveloping hug. I don’t understand why I have made a connection between pain and comfort, I just know that for some reason that connection has a great hold over me.

People talk about self-injury being addictive, and I do think that for a while, I was very emotionally dependent on it, if not physically dependent. At some of my worst times I have sat in meetings at work unable to get thoughts and images of self-harm out of my mind, and giving in to the desire to hurt myself only increased the need to do so again. At one point the desperation was so strong I went in search of ‘suitable tools’ in the stationery cupboards. When I first started self-harming I tried to ‘restrain myself’ and only use it when I felt ‘really bad’. I think I knew that if I started to give in to it regularly, it would become both more frequent and less effective. And that’s exactly what happened. It became my ‘go-to’ coping mechanism; my first port of call, rather than my last. It acquired a kind of habitual nature – and that too, can be a feature of self-harm for many people. It isn’t always carried out impulsively or in the height of emotion. For some people self-injury is ‘ritualistic’, involving particular times, places or tools. For me, the practical restrictions of having a partner and children in the house, meant that I was rarely able to self-harm impulsively and ‘in the moment’.

And perhaps the strangest thing of all – sometimes I self-harmed when I was happy. At the time in my life when self-injury felt like a core part of my identify and my main means of expression, it felt ‘natural’ for me to turn to it to express positive emotions as well. Moments of joy were incredibly rare at that time, and when they came my first thought was to respond by cutting. Perhaps it was connected with the part of myself that found it hard to accept and hold onto hope in any form, including accepting joy – but I have to be honest and say that I don’t really understand this aspect of my self-harming either. But it’s an example of how self-injury can confound people’s expectations and of how assumptions should never be made about what it means to any one individual.

My self-harming has gone from three to four times a week, to once a month or less. It has gone from involving numerous cuts on each occasion, to normally not more than one or two each time. The change has been very gradual, and thinking about how and why it has happened, leads me to believe that there are two key factors to reducing self-injury. The first is a close supportive relationship with someone who accepts and tries to understand both the person and the self-harm – in my case, this is my therapist, whose acceptance of my self-harm is just part of her unconditional acceptance of me as a person. The second is making the decision to ‘postpone’ self-harming. Putting a distance of time between the desire to self-injure and the act itself, has the effect of allowing the intensity of my feelings to reduce, as well as the desire to harm. In addition, postponement doesn’t feel as though I am trying to prohibit self-harm or replace it with something else. Postponing feels easier because I tell myself that I can still do it; but I will simply do it later. It doesn’t try and remove the option and I still feel I have some control. But 9 times out of 10 postponement does mean that I do not end up cutting.

The frequency of my self-harm started to change very soon after I started blogging. That is because my main method of postponement is writing; and I am using it now. Earlier, I felt a strong desire to ‘punish myself’ but I made a decision to write instead – and it is what has kept me from self-harm on countless occasions over the last two years. These days, the strength of the bond with my therapist (who I have been seeing for two and a half years) also means that I want to stop for her – and although I know that eventually the desire to stop has to come from within me, at the moment I will take any motivation I can find! Postponement works for me, most of the time; but fundamentally, it is the relationship with my therapist and the ongoing work that we have been doing in understanding and addressing my underlying difficulties and distress, that is the key to helping me reduce and eventually to stop self-harming. Self-harm is not the message, but the messenger; and we shouldn’t be looking to shoot the messenger – but to figure out who sent them, why, and what it is that they are trying to express. I believe that that is the most compassionate, patient, respectful and enduring way of making the messenger, finally, redundant.

[Self-injury awareness day takes place on 1 March each year. Please note that although I have used the words self-injury and self-harm interchangeably in this post, they are slightly different. Self-injury is behaviour that causes direct harm or damage to one’s body (such as cutting or burning). Self-harm is a broader concept that includes self-injury, but which covers other behaviours such as eating disorders, risk-taking behaviour, and substance misuse.]


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Memory Monday – “Swallowing up the storm – BPD and anger”

*TRIGGER WARNING – SUICIDAL IDEATION*

For many people with BPD, changes in mood and can be sudden and dramatic, particularly when precipitated by a powerful trigger. In my own experience, my resistance to particular triggers wears down over time, so that rather than becoming gradually ‘immune’ through exposure, the opposite happens – the more often I become triggered in a certain way, the more easily and more quickly I spiral down into incredibly negative thought patterns. It’s as if the feeling of being ‘trapped’ and the belief that the situation can’t and won’t change, is reinforced every time I find myself at that point.

I haven’t said a great deal about my marriage in my blog – out of a sense of ‘propriety’, wanting to protect my husband’s privacy, and to avoid any awkwardness given that a couple of friends who know us personally, read my blog. However, I don’t think it would be too ‘disloyal’ to admit that unfortunately, my husband is one of my greatest triggers – or rather, his words, and our arguments, are. I think it would also be fair to say that the triggers are as powerful as they are, because of the way in which I have come to associate him, and certain patterns of behaviour, with my mother and how I felt when I was younger. After these arguments, I am left feeling worthless, annihilated, and despairing. My mind turns to suicidal ideation, and the phrase ‘I can’t live like this’ repeatedly presents itself to me.

Last Friday was one such triggering evening, which led to me, for the first time, to begin to act on thoughts I had had for a long time, of driving to ‘the place in my plan’ (if I can put it that way). Not necessarily because I had definitely decided to end my life, but because I felt I needed to know what it would be like to be there. How would I feel? I also had a vague thought I might phone the Samaritans but didn’t want to do that from home. I picked up by bag, put my coat on, told my husband I was going out, and went out of the door – at which point my husband said something perfectly ordinary, but something that made me hesitate and come back in.

Sunday night was also triggering – but that time things were different. I think it was probably one of the briefest spikes in intense despair I have had, dying down almost as quickly as it appeared. The suicidal ideation was there and for a short period I felt very unsafe, despite being at home with my husband and children still around. But the feelings of worthlessness did not continue all evening and rather than being consumed by sadness, I was angry – I still am. And I think that made a difference. Rather than absorbing it all into myself as I had done on Friday night, and turning it into a different, self-critical emotion, I gave my anger outward expression. Perhaps not in the best or most productive or most helpful way, but not in the worst way, either. It involved some fridge door slamming, and some use of swear words, and some heavy sarcasm (though directed self-mockingly at myself, rather than at him). But it seemed to work – at least with regard to reducing the desire to inflict pain (or worse) upon myself.

And so given recent events, I thought it would be timely to link to a post from the summer of 2014, on BPD and anger:

https://lifeinabind.com/2014/08/17/swallowing-up-the-storm-bpd-and-anger/

Re-reading it now, the idea that  ‘disappointed expectations’ might lie behind at least some of my anger, seems very persuasive. Friday was even more of a blow because it came so soon after an evening when for the first time we had spoken more openly about how we felt about our marriage and what we wanted to change, in the presence of a couple from church. For a short time it felt like a step forward – and then on Friday it felt as though nothing had changed. Opening up and being vulnerable was incredibly difficult for me – I spent a good part of the meeting physically shaking with the effort. And yet to have ‘business as usual’ occur on the Friday night felt as though everything I had said had gone unacknowledged and unheard. I’m sure he feels the same about me – and that we both have a lot to learn about ourselves, each other, and the way we relate to one another. But in the meantime, I will try to give expression to my anger a bit more often – not in deliberately hurtful or vengeful ways, but in ways that allow me to express something, rather than internalise something, and in ways that aren’t likely to be as risky to my well-being.


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Fear – a haiku or two

On New Year’s Eve some words were going round my head and I realised that they made a pattern. One I hadn’t written down since childhood, as an exercise at school – a haiku. Seventeen syllables, three lines, a 5-7-5 pattern. Remarkably, with only a little alteration, the pattern fit:

I’m scared of living,

I’m scared of dying; I don’t

Know which scares me more.

But then I remembered that haikus are supposed to have a contrasting final section, and are supposed to convey an image or feeling but without subjective judgement or analysis. They are supposed to show not tell, perhaps even to be ambiguous, in order to allow the reader to feel their own emotions in response, and to draw their own conclusions. And so I tried again, in a different way, to write another imperfect haiku about fear.

haiku fear 2


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My ally against self-harm

*TRIGGER WARNING: SELF-HARM*

Five minutes before the end of my last therapy session before the summer break, I asked my therapist if she would be disappointed in me if I self-harmed that evening. I think I took her by surprise – I hadn’t mentioned self-harm for quite some time. She didn’t say ‘no’ – but then, she rarely gives a direct answer to my requests for reassurance! Instead, she encouraged me to think about why I wanted to self-harm, and why I wanted to punish myself. She said that I had other coping mechanisms – for example, I had talked about communicating more with friends, and about learning to play a particular piece on the piano. She would never tell me not to self-harm, and in the past our conversations about it have focused on trying to understand why I do it and what it means. So I think this was the first time she had actually gone as far as to try and encourage me to resist. It was a risky strategy – I’m incredibly sensitive to control and she couldn’t be sure I wouldn’t react against it.

But the strategy (if it was one – she hardly had time to think!) paid off. I saw her encouragement as caring – it felt good that she trusted me and our relationship enough, to tell me something that might be hard to hear and that I could so easily misinterpret. It felt good that she thought I might have come far enough to be able to consider the possibility of resisting the impulse to self-harm, without simply feeling panic at the thought of a vital coping strategy being taken away. Not that it was physically being removed as an option; but I would find it very difficult to do anything that I knew would disappoint her.

As well as encouraging me to think about why I wanted to hurt myself, and pointing out I could use other strategies to deal with my intense feelings, she did acknowledge that I may, despite those things, feel that I needed to do it. But she didn’t ‘let me off the hook’ of having to really think about it if I were tempted, by simply telling me she wouldn’t be disappointed. And perhaps she knows that in many ways, she has already done all that she needs to do, to reassure me in that regard.

Strangely, though I sometimes doubt her acceptance in other ways, I am confident that she does not judge my self-harming. I cannot doubt it, after I asked her many months ago if I could show her some recent cuts, and she said that I could. I was shocked, and completely unprepared for the fact that she might say yes. It was an incredibly important, personal, and emotionally intimate moment. I had shown her something no one else had seen, and however she might have felt about it, she was prepared to see what I had to show her and to share that with me. For me, it was a very bonding experience, and it spoke of her acceptance. I am sure she feels it would be better if I did not hurt myself in that way – but I have never felt any pressure from her to stop, and her comment at the start of the therapy break, did not change that.

I emailed her during the break to let her know that I was happy she had responded in the way that she did. I said that I had felt that she trusted me and that she’d taken a risk in encouraging me to refrain, when I might have reacted negatively. She turned my email on its head, and said that I had taken a big risk in asking her to support the part of me that wanted to stop. And until she wrote that, I hadn’t realised that it was true.

I think that ultimately, the only way to deal effectively with self-harm is to deal with the underlying issues that give rise to the urge to harm, and at the same time to learn to try and sit with those feelings until their intensity diminishes. But the very very first step, I think, is that some part of you must want to stop. I’m not sure how that happens – for me, there was a realisation at the start of the Easter therapy break, that part of me wanted to stop for her (my therapist). Although lasting change would need to be based on internal motivating factors, I’m not convinced there is any harm in taking motivation, initially, where one finds it! And then waiting for that motivation to shift, and for it to become something that you want for yourself, and not ‘only’ for another.

I had wanted to discuss these feelings with my therapist a few months ago, but somehow never got round to it, and they faded. And so when I asked her in late July, if she would be disappointed in me if I self-harmed, those feelings were the furthest things from my (conscious) mind, and I genuinely believed I was asking for reassurance and ‘permission’ to self-harm. But her interpretation was exactly right. Part of me did want to stop – and unlike a few months ago, I think it may even have been more for my sake than hers. I was asking for her support – even if I hadn’t realised it. But I’m so grateful that she did; and that she provided it.

Did I let her down? Yes and no. ‘No’ because she accepts me and that acceptance doesn’t depend on whether or not I turn my pain in upon myself, or express it in a less self-destructive way. And ‘no’ because this is not a question of ‘balancing’ the harming acts against the non-harming acts, and nothing can negate the fact that for the vast majority of the therapy break, the way in which I approached the desire to self-harm was different to how I have approached it in the past. In the last couple of months I have played the piano more than I have in the last few years. As well as giving me an insight into how significant it must have been in helping me to deal with my emotions and circumstances when I was growing up (even though I didn’t realise it at the time); it also gave me an immediate and concrete way of both seeking and expressing connection with my therapist, while also putting a distance of time between my desire to self-harm, and the possibility of acting on that desire.

But eventually I did self-harm, a few days before the end of the therapy break. And so although I know that she is not disappointed, it’s still difficult to completely eradicate the sense that I let my therapist (and myself) down. The incident was not directly connected to her – it was related to an argument I had had with my husband. However, it may be that my feelings of being alone (and possibly of being abandoned) during the last few days of the break, contributed to the fact that I did not even try and resist. I realised afterwards that it had felt as though there was absolutely no part of me left that wanted to stop, or refrain. And that was what was different at the start of September, compared to the start of August.

Earlier in the summer, a few mental health charities put out through social media a number of strategies or alternatives for dealing with the desire to self-harm (for example, holding an ice cube, ‘pinging’ an elastic band against the skin). For me, there has been no better strategy for trying to resist self-harm, than postponement, although I can appreciate that this won’t necessarily work for those whose self-harm is very ‘immediate’ and ‘of the moment’. For me, it’s often the case that I cannot self-harm when the feelings are most intense (for example, because my children or my husband are around), and the passage of time, even sometimes of short duration, allows the intensity of the feelings to subside a little, and with it, the intensity of the desire to harm. Although I know they work for many people, the difficulty I have with a number of suggested strategies is that they are essentially seen as ‘alternatives’ – and yet self-harm is such a very complex thing, that it feels very difficult to simply try and substitute something else in its place. Whereas ‘postponement’ does not try and replace it or forbid it – it very much leaves the option open, but it simply says ‘later, in a little while, in a few minutes – you can do it later’. And that, particularly in the absence of other motivating factors, has often been my biggest ally.

But what this therapy break has taught me is this: with my therapist’s support, I have an even more powerful ally in my struggle against self-harm; and that ally is, quite literally, a part of me.


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World Suicide Prevention Day – 10 September

World Suicide Prevention Day is observed on 10 September every year. It promotes awareness, commitment and action towards preventing suicide, with events and activities being held around the world. Suicide is still a taboo subject, though more people die through completing suicide than through murder or war – more than one million every year worldwide, with twenty times that number attempting suicide. Over the last few months I have written about the importance of talking more openly about suicide, and the factors that might prevent us from doing so.

But for this World Suicide Prevention Day I wanted to re-post I poem I wrote just as I started to come out of a three week period of feeling suicidal in August 2014. What prompted the poem, and the start of that emergence from suicidal feelings, was the incredibly supportive response to a post I wrote describing my depression and desire to escape from life. That support helped me to turn a corner; and as I drove past a beautifully lit medieval castle at night, which only days before had triggered mental images of falling from its crumbling walls into the shadows below – words of strength started to flow through my mind instead. I hope this poem can be an encouragement to anyone who is struggling with suicidal thoughts now, on 10 September itself, or in the days afterwards. An image of death and despair can become an image of strength and survival, and sometimes all it takes are a few words from some one or some others who can see that you have a place in the world – however impossible that might feel to believe right now.

The poem is called ‘If the shadow falls’.

when shadows fall final


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What holds us back from talking to someone who is suicidal

The ‘National Attitudes to Mental Illness’ survey, carried out annually since 2003,  has shown a very encouraging shift in the attitudes of people in the UK towards those with mental illness. According to the mental health charity Mind, since the launch of the current Time to Change campaign in 2011, an estimated two million people (almost five per cent of the population) have improved in their perceptions of mental illness. More people than ever before are admitting to knowing someone with a mental health problem (more than 6o% of those surveyed in 2013) – and yet, almost half of respondents still say they would feel uncomfortable talking to an employer about their mental health difficulties.

The evidence of a general increase in tolerance is persuasive, and the worries individuals still have about trusting in that tolerance when it comes to their employer (a worry that I have to say I share),  may  over time start to lessen as more and more employers are putting time, money and often a great deal of passion, into promoting positive attitudes to mental health within their organisations. Employers are running raising awareness campaigns; they are training up staff members in mental health first aid; they are holding charity events to raise money; well-being and mindfulness events to reduce stress. It’s happening in the workplaces of my friends up and down the country, and my own workplace is no exception. There is definitely more talk about mental health in the corridors and in the tea room, than I have ever heard before.

It’s not just a welcome change – it’s an intriguing one. People are voicing what they actually think, what their own fears and reservations are around talking about mental health; and it demonstrates just why these campaigns are needed. When it comes to talking about suicide, there is a particular nervousness, and there are two completely contradictory views that I have often heard spoken – occasionally by the same people. It’s not necessarily that individuals are afraid that by talking about suicide they will almost ‘encourage‘ it or make it more likely to happen – most campaigns that I know of (for example, the excellent STOP Suicide campaign, which I have written about previously), tackle that particular myth head-on and make it clear that this is NOT the case. My feeling is (though I have no evidence to back this up) that this is also more of an ‘organisational concern’ (which includes a subconscious paranoia that suicidal thoughts might somehow be ‘catching’), than one which operates at an individual level. The two contradictory views that I am thinking of, can be summed up as “my words will have no impact and so I am not responsible/don’t need to do anything“; and “my words could have a huge impact, and if something happens I will be responsible“.

I have heard colleagues say that they would worry about talking to someone who was feeling suicidal, in case they ‘said the wrong thing’, or ‘made matters worse’. Though it is mostly unspoken, it is clear that there is an underlying fear here. “What if this person, who I am trying to help, does actually attempt or complete suicide? What if I said something which  made them feel worse; or what if I didn’t think of saying ‘the right thing’ that would have helped? Am I responsible?”

NO. Assuming you are a genuine and caring person and that you have not been subjecting your colleague to harassment, bullying, or other words or behaviour which could potentially make you culpable in some way – you are not responsible for their subsequent actions and you are not responsible for saving them. If they have come to you in need and confided in you, you may well have a moral duty to try – but that is far as it goes. It would be entirely natural, I think, to feel guilty in such a situation -but that doesn’t mean that there would actually be something that you are guilty of. And I’m not going to lie to you and say that it will never happen. It is possible that, despite your best efforts, someone that you try and help, may complete suicide. They may even do it within a few hours or days of talking to you. But it is NOT your fault. Remember this – your conversation with them was part of a large and complex history of events and conversations, in all likelihood stretching way back in time, possibly before you ever met that person. The interaction of all those words and circumstances; the way in which they became linked with and interpreted in the light of the past, and through the lens of depression or another mental health condition – none of that is within your control. Will this situation happen to you if you start talking to people about their suicidal feelings? It is unlikely – and here’s why.

The vast majority of people are helped by talking about their suicidal feelings. And saying absolutely nothing, or walking away from someone who is clearly in distress, is likely to be much more upsetting than saying something which is ‘not quite the right thing’. And you really don’t have to say very much at all. Helping someone who is feeling suicidal is about letting them know that you’re there for them, that you see them and their distress, that you accept them and what they may want to tell you – and that you’re listening. Listening, and just being present. Your presence, and a small number of caring words, is all that is required. Everyone is different – you don’t know exactly how this person in front of you, got to this point in their lives. You couldn’t possibly know what the ‘exact right thing’ to say in this situation would be – they probably don’t know either. But it doesn’t matter. Emotional isolation is a killer – literally – and by interacting honestly and compassionately with someone who is feeling suicidal, you are doing the right thing in that situation. And yes, it’s okay – more than okay – to ask them if they have a suicide plan, and if they have the means to carry it out. Trust me, they are likely to see it as evidence that you care, and that you are not judging them, and that in itself, is a HUGE deal to someone who may feel invisible and worthless.

Which is why, your words are both less powerful than you fear, and more powerful than you hope. If you are concerned that the impact of saying ‘a negative thing’ would be so significant, why would you be unwilling to believe that the impact of saying ‘a positive thing’ could be significant? Acting on the belief that ‘whatever I say or do won’t make a difference because if someone really wants to complete suicide, they will’, is doubly flawed. Flawed because it significantly underestimates the power of a few caring words in such a situation, and flawed because fundamentally, you have no way of knowing whether any particular individual ‘really wants to complete suicide’. The individual themselves may be ambivalent about it – they may have an intense desire to die combined with an intense fear of death. They may be absolutely sure they want to leave this world – until hope, or at least doubt, enters in. And you can provide that. And it’s very, very simple for me to prove that to you.

Look at the story of Jonny Benjamin and his ‘Find Mike’ campaign, which tracked down the person who talked him down from the edge of a bridge in 2008. Look at the story, which has gone viral, of a young man who saved someone’s life by asking them if they were okay. Three words  – but packed with meaning. I see you; I care about what happens to you; talk to me, I’m listening; I’m here. A hundred words in three – with COMPASSION tying them all together. Compassion – from the Latin word meaning ‘to suffer with‘. To be really present with someone in their suffering.

I have said that you may never know what brought someone to the point in their lives at which all they want is to die. I have said that that journey may have been long, complicated, and multi-faceted. But here’s the beauty of compassion, and of ‘suffering with‘. It’s about the here and now, not about what has gone before. It stands out because it is different from the rest of the landscape in which that person is currently standing. It’s not that what has gone before is not important – it’s that ‘suffering with‘  shows that what has gone before is not all that there is. It’s that it enables the person to answer the question ‘Are you okay?’ with ‘No, no I’m not okay. And I’m so glad that you see’.

As for ‘no, I’m not okay – but will I be’? Well, that is for another day, a day beyond the brink. Because that is another way in which ‘suffering with‘ is powerful- it leads to hope. And hope is about knowing that what has gone before is not all that there will ever be.

So if you have been tempted to think, as some of my colleagues do, that when speaking to someone who is feeling suicidal your words may either too powerful or too weak – I would say that in the moment, they can powerful enough. Speak them with boldness, but most of all with compassion. Be present, suffer with.

 

[If you would like more information on how to talk to someone who is feeling suicidal, please do look up the resources on websites such STOP Suicide, Grassroots Suicide Prevention, and the Samaritans.]


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It feels like only blood

*TRIGGER WARNING – SELF HARM*

[Note: the picture on which the poem is superimposed is of red paint. The image was obtained from Morguefile at http://www.morguefile.com/archive/display/910529 . Although the image is meant to represent the subject matter of the poem, it is intended neither to offend nor to ‘promote’ self-harm.]

I wrote this poem a few months ago, possibly during a therapy break, although I cannot remember the exact circumstances. I remember thinking it was unfinished – but then when I came back to it a few weeks ago, it felt as though it was complete as it was. Trying to ‘tidy it up’ or add a more ‘positive’ ending felt like a denial, an attempt to ‘tidy up’ something that is anything but tidy. This is how it feels to me, when I want to self-harm – not the sum-total of how it feels; and not how it feels every single time. But it captures some key elements of most of my urges to hurt myself. I wrote it ‘in the moment’ – it’s un-tampered-with emotion.

And so I think it’s important to present it as it is.

It feels like only blood FINAL