* TRIGGER WARNING – DESCRIPTIONS/THOUGHTS ON SUICIDAL IDEATION AND SELF-HARM*

Part I

Lately it seems that my mind has been filled with thoughts of escape. Sometimes the thoughts are just there, a bit like a day dream; or in the background, filling up the spaces not taken up by life, as it happens. At other times, they wash over me like waves, taking me with them; filling me with a keen desire to break free, and to crash upon a distant shore.

Escape…..to some far off place, perhaps. What would it be like, to just run away? To leave everything and everyone behind? What is it, that that kind of escape would achieve? Who or what would I be looking for? I don’t want another romantic partner – I’m not sure anyone else would be strong enough to bear the immense strain that my mental health difficulties put on our relationship. And I know that if I wasn’t with him, I would end up in a string of twelve to twenty four month relationships, moving from one to the other in a tragic parade of almost-serial and barely-overlapping monogamy. I don’t want other friends  – I am incredibly fortunate to have a few close friends who, though mostly living some distance away, are still wonderfully supportive despite the fact that I am sometimes obstinate, self-centred, and difficult to support. I don’t believe that I would find better ones, even if I travelled to the other side of the world.

When I imagine leaving everything behind, it’s not in order to become someone else, with a new life, a new job, new friends. It’s in order to not think, feel and be, all the things that I think, feel and am. When I imagine leaving everything behind, it’s in order to be better able to retreat, without it being noticed. To be able to withdraw, without the constant need to interact. To be alone with my thoughts and with myself.

But what do I know about being alone? I have never managed it. I have always been either in the ‘parental fold’ or in a romantic relationship. Although part of me likes the idea of aloneness, I also know that it scares me. I know that in practice, it would be only a matter of time before that fear drove me into the arms of new lovers, new friends, a new life. A life still full of the same flaws, the same hurts, the same mistakes.

“She knew that the fault was not in the world but in herself, and so, it was her own self that she hated and wanted to be free of…..”. [From ‘In the Springtime of the Year’ by Susan Hill]

Part II

I know that I could never run away from this life. But my head is full of thoughts of escaping from life itself. Since my ‘therapy break’ started four weeks ago (my therapist is on holiday), I am heaping isolation upon isolation, but it is not enough. I don’t understand this drive to ‘finish what she [my therapist] started’ – to cut myself off even further, as a response to feeling cut off. I persist in not contacting those who do not contact me; I ignore those who do, though I’m grateful for their caring. I must have none of them, because I want to not be. But why, why? It’s not catching, this desire to not exist. I don’t know, I don’t know. I just know that I need to hold it within myself.

***

My eldest child asked me to help him draw a picture on my tablet. He chose a blank brown canvas, and a jet-black pen. He drew tangled lines, and then asked me to do some of the colouring myself. I drew my finger over the screen and coloured in one corner, completely black. We took it in turns, until he got bored, and I was left to finish colouring in the screen. I kept going until the whole picture  became a mirror and was covered in darkness.

Part III

My ex-therapist, Jane, asked me whether I would tell her, if I was feeling suicidal. I said that I didn’t know. Although I knew what it was like to feel desperate and to want to die, I didn’t know what it felt like to be poised on the brink, as it were – to actually be on verge of taking my own life. Under those circumstances, I had no idea whether I would tell anyone about it – but I imagined not. I wondered whether acting upon suicidal thoughts was a similar experience to the one I had had with self-harm. For a lifetime it had seemed like the very last thing I would do, and all of a sudden, I had a ‘light-bulb’ moment:  a complete shift in worldview occurred, the concept clicked into place for me, and it seemed like the most logical thing in the world. Once I realised that pain, which I was so afraid of, was not the undesirable by-product of self-harm, but the very point, and the potential source of much-needed relief, it became the obvious and rational answer to a difficult and intractable problem. Does that sound too ‘rational’, or could that also be the way in which suicidal ideation turns into action?  I’m sure there isn’t a single answer to that question – but for some, perhaps that is the way.

***

There is much debate about whether suicide can ever be a rational decision. Some claim that the desire of a terminally ill patient to take their own life, can be an example of a ‘rational’ decision to die. But the debate always seems to be between rationality versus mental illness – as if a diagnosis of the latter precludes rational decision making, at least where it concerns matters of life and death. And yet there is a growing interest in whether unbearable psychological pain may be the same as the suffering associated with a terminal physical condition, and so this may be another example of an unhelpful distinction between physical and mental illness. Perhaps the key factor is not whether or not a mental health diagnosis exists, but whether there is emotional distress. And is it purely a matter of linguistic definition that suicidal thoughts, in the presence of emotional distress, are always irrational, or is there something more going on?

A few months ago, I decided to start down a path of taking an increasing number of ibuprofen tablets (one more on each occasion), every time I was greatly distressed and wanted to self-harm (which at that time, was frequently). The decision was motivated by a desire both to damage and to prepare, as well by a need to feel in control of a part of my life. I have always found it very difficult to swallow tablets, and I reasoned that if I reached the point where I wished to take a large number of them in one sitting, it would be best to have conquered that particular hurdle in advance. And along the way perhaps I would manage, in any case, to achieve the desired self-destructive result, slowly, without the need to take ‘drastic action’. In the end, I didn’t go very far down that particular path, but that was an example of the ‘rationality’ of my emotional distress. Would a neuroscientist, looking at a scan of my brain, have been able to tell whether my thinking was ‘disordered’ at that point?

Part IV

In 1990, Roy Baumeister published an article in Psychological Review entitled “Suicide as escape from the Self.” There are six primary steps in his theory – a tick in all six boxes renders suicide a ‘probability’. A helpful summary of that paper can be found in this blog post, entitled, “Being suicidal: what it feels like to want to kill yourself”. The abstract to the article itself, reads as follows:

“Suicide is analyzed in terms of motivations to escape from aversive self-awareness. The causal chain begins with events that fall severely short of standards and expectations. These failures are attributed internally, which makes self-awareness painful. Awareness of the self’s inadequacies generates negative affect, and the individual therefore desires to escape from self-awareness and the associated affect. The person tries to achieve a state of cognitive deconstruction (constricted temporal focus, concrete thinking, immediate or proximal goals, cognitive rigidity, and rejection of meaning), which helps prevent meaningful self-awareness and emotion. The deconstructed state brings irrationality and disinhibition, making drastic measures seem acceptable. Suicide can be seen as an ultimate step in the effort to escape from self and world.”

The first four steps in the causal chain seem so easy for me to tick off, although the following is a very incomplete summary of what they entail: falling short of standards, my own and others’; not meeting others’ expectations and having my own set too high and being constantly disappointed; awareness of what I’m feeling or doing and why, but with no power to change those feelings, or for the self-awareness to change me; negative, destructive, judgemental, harsh emotions about myself. Feelings of complete lack of self-worth.

In the UK charity SANE’s latest research on suicide and suicidal thinking, lack of self-worth is one of three key factors identified, that contribute to suicide. The other two are lack of trust (in others and in ourselves), and “suicidal exhaustion”.  The SANE researchers talked to people who had attempted suicide, and one of them said this:

“Throughout all my depression I’ve always been able to be okay for other people. But I couldn’t do it anymore, I just couldn’t. And they kept saying to me, what is it, what is it? I’m going “I’m just so tired”. That’s all I kept saying, “I’m so tired”. For ages. And they were going “but why?” And I couldn’t explain what that meant, I just knew that I was so tired. And I wanted peace, I wanted some peace. And suicide was the only way.”

Part V

Back in January, I was in a deep depression. Every morning, for the briefest nanosecond on the threshold between sleep and semi-consciousness, my spirit felt light and unencumbered. But almost immediately the immense weight of fear, desperation, darkness and of wanting die, settled down upon me, and the only relief from it came at night, with the oblivion of sleep.

I’m not sure how to explain how this feeling, over the last week or so, differs. Except to say this: the darkness is not weighing me down as much, but it feels as though the tiredness, the sheer, utter psychological exhaustion, is bringing me to the end of the road. At times, I have felt calm, rather than desperate. Clear, rather than confused. I feel so little as if I exist, would it make much difference if, in fact, I did not? Somewhere, right at the back of my mind, common sense is ringing out a bell – is this the calmness of ‘madness’, of a rationality gone wrong?

***

I believe unquestionably in the benefits and importance of increased self-awareness, but living with it can be beyond painful. I’ve opened up worlds of thoughts and emotions that I was never aware of, and that I can’t now escape. And despite my protestations whenever my husband voices doubts about the possibility of recovery, I realise I have very little hope of it myself.

It feels like such a simple, logical thing. I don’t want the waves upon waves of loss. I don’t want the perpetual bitterness of the bittersweet moments. I don’t want everything that is, to remind me of everything that will, at some point, cease to be. I don’t want the constant reminders of death or abandonment. I don’t want the intense yearning for what I didn’t have or for what I can never have. I don’t want to keep remembering those that I need to forget. I don’t want the corroding regret, or the anguish of time lost or wasted. I don’t want to never be held by those I want to be held by, or to even want to be held by them.

“The world was quite empty, although the sun still shone, the birds sang……there seemed nothing whatsoever that might comfort her or give her strength and protection.” [From ‘In the Springtime of the Year’, by Susan Hill]

***

I keep asking myself, over and over again: if I didn’t have children, if death was as easy and as painless as flicking a switch, if someone else would do it for me, would I ask them to? Do I want it as much as I think I do?

***

Random thoughts keep entering my mind.

“I must fill in that form to indicate how I would want my pension lump sum to be distributed in the event of my death.” “Do pension funds pay out lump sums if death is self-inflicted?” “I need to ask my therapist if she will let Jane know if something happens to me.” “I wonder what the drug is called that vets use to put animals to sleep?” “I don’t know any vets. I don’t know any vets….”

Practical details – there must be no loose ends. But this is all backwards – how can I think of the incidentals, when I haven’t yet decided on a ‘how’, or a ‘when’? But when the impulse comes, if it comes powerfully, there must be no loose ends. Nothing left to chance.

***

The briefest, silent prayer, runs through my head. The first one in a long time. I feel guilty and irreverent – full of cheek and ingratitude. But if He’s the one who gave me life, who else can I plead with but Him, to take my life away?