Freedom’s just another word for nothing left to lose

14 08 2014

There was another death, of course, one I didn’t so much skip over as decide to mull.

Robin Williams’s suicide, I mean.

I was a fan, I guess. His flights away from ordinary conversation at first made laugh, later made me uneasy, and thought some of his acting schticky, but when he was focused his characters could be, as with Parry in The Fisher King, almost unbearably human.

But as my fandom was mild, I didn’t have much to say.

And then I heard this:

BOB MONDELLO, BYLINE: Those struggles now ended. He is, as his Genie character in “Aladdin” would have it, finally free.

BLOCK: Well, that idea – that suicide is freeing – has prompted a lot of concern in the mental health community. We heard from a number of our listeners about that. Among them Elizabeth Minne, she’s a licensed psychologist in Austin, Texas, and she joins me now. Thanks so much for being with us.

ELIZABETH MINNE: Thank you for having me.

BLOCK: And you wrote in to express your concern. You said, comments like this make my job difficult. Explain what you mean by that. How is it more difficult?

MINNE: I have found that comments like this can be interpreted by families and by individuals as a sign that they too can attain something positive by committing suicide.

BLOCK: Something positive meaning some sort of liberation from the pain that they’re in?

MINNE: Right. Some sense of freedom or view it as a positive way to find – or an appropriate way to find some sense of relief.

Minnie goes on to note that she tells her patients that “suicide is never an option for working through distress – that there is always a way for us to get to a better place.”

Most of the commenters were, shall we say, unimpressed, calling out Minnie’s credentials, expertise, and even motivation—one accused her of wanting to keep her patients alive just to make a buck off of them—and generally decrying her inability to see how awful depression could be.

Her words pricked my ears, certainly, and had I heard something similar when I was in the midst of my own self-destructiveness, I would have lit my own torch against her: Of course I have the right to kill myself! Of course I can free myself of all of this terribleness!

But I’ll give Minnie half a break: she is a psychotherapist who works with greatly distressed people, so if she’s going to be of any help to them she has to carry the hope that they lost. She has to believe they can get through until they can believe it themselves.

I’ve spoken enough about this before to say simply that that mattered to me, even if I wasn’t at the time wholly conscious that and how it mattered.

But it also helps to acknowledge that suicide is, in fact, an option, and that suffering in life can be so great that wanting to shed that suffering by shedding life makes sense.

It’s about recognition: just as telling someone that they can get through is a way to see that person when she, perhaps, can’t see herself, noting that suicide is on the table is a way to see, to allow one to see, her suffering.

You don’t have to agree with it or like it or encourage it, but if you know you can’t save someone else—and therapists damned well better know they can’t save someone—then maybe you have to accept that he can’t save himself. If his life is in his hands, then his life is in his hands.

Depression morphs one’s mind—I look back to old journal entries and think Who was the person?—but it’s not as if one is a less authentic self when depressed when not, that somehow all one has to do is to scrape off the weight of despair and one’s real life will pop back up.

I don’t know, maybe some patients want to hear that, want to hear of the elasticity of the self, and who knows, maybe for some it’s true.

But for some it’s not, for some the suffering has seeped in so deep that the only way to get rid of the suffering is to get rid of the self.

I don’t know how a therapist deals with a situation like that. I mean, I know that the two who worked hard with me kept working, but I don’t doubt that they knew the limits of that work. Do they see mental illness like other potentially fatal illness? that sometimes the surgery and the chemo and the therapy don’t take? Or is that fact that there’s no hospice care for depression mean that the limits themselves aren’t understood?

In any case, my life was in my hands, and only when I finally, finally, figured that out for myself—only when I knew that death and life were both options—was I able to sigh, Okay.

It could have gone the other way, of course, and that sighed Okay could have been my last word. But I don’t know that I could have closed my fist over life had I not also held death in my hands. I had to hold them both before I could let one of them go.

I am sorry for Robin Williams’s family that he let go of life, and I’m sorry for him for the suffering that led to that letting go.

Okay.

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Devil was my angel

14 01 2013

Is it an aha moment if it drags you down and hollows you out?

Kurt Anderson at Studio 360 has been running an occasional series on “Aha Moments”—those encounters with books or movies or music which have changed one’s life.

Most of the stories are enlightening or funny or just sideways; I wonder if he’d want to hear about dark epiphanies?

I may have discussed this before, but what the hell: I was around 15 when I had mine. Two years earlier I had first started trying to kill myself, and after one brief ER visit and overnight psych ward stay at 14, I was trying to come to terms with my inability to end myself.

It was also around this time that I read The Thorn Birds, by Colleen McCullough. There’s a scene late in the book when the priest Dane, Maggie’s son (by the priest Richard Chamberlain Ralph) goes for a swim, saves two women from drowning, then feels his heart bunch up. He begins to struggle to get back to shore, then says, in effect, Isn’t this what I want? To be with God? He stops struggling, spreads his arms, and drowns.

(That’s how I and Ms. Wikipedia remember it, at any rate.)

Well. That made quite an impression: Is this what I really want? To die? I could only answer, Yes. Am I ready to open my arms and let go? Not yet. Ah. This means I should wait until I’m ready, and only then kill myself.

Now, you might think this is pretty fucked up because. . . it’s pretty fucked up. Why did I have to answer Yes to the want-to-die question? I had no other answer. I had so humiliated myself by my failure that it seemed to me the only way to overcome that humiliation was to succeed.

Oddly, then, the Dane-epiphany kept me alive. I couldn’t stand another failure, and I couldn’t stand to live: thinking that I could stay alive long enough to prepare myself for death gave me some breathing space (albeit of rather toxic quality). I’d think about it periodically, check if I were ready, say nope, then keep living.

Of course, the pressure built. I tried and failed again in college, then again my first year of grad school. At this point I just said Fuck it, and stopped dealing with anything having to do with depression and suicide. I avoided books and movies on the theme, and did my damnedest to shut it all down.

And that worked, for years, that worked. And then the cracks, the frays, the quake, the buckling—whatever metaphor you prefer—and there I was, much older, and still not dead.

Which was a problem.

I was at least able to figure out that if I still hadn’t killed myself, well, y’know, there was something I could do about it. Back into therapy, back into the fight should-I-stay-or-should-I-go, blah blah. I did the work, I excavated myself, exposed the structures of my fucked-up living-to-die being, and by the end,  could neither stay nor go.

And then I had another moment. This wasn’t an Aha Moment the way the Dane thing was, but was a recognition, nonetheless. I had been listening to a lot of Beth Orton, and there was one song, Devil Song, which stayed with me, stretched out and empty and barely there.

But looking back in retrospect
Did you ever really get what you’d expect?
Trying to rectify
Got lost a little further
You’ve been trying to justify
Find out how and where it came

Devil was your angel, but it’s not no more
The devil was your angel, when you weren’t sure

Yep, pretty much.  And then there’s this:

Gonna take you back down
I won’t feel no shame
Till my dreams
Are my own again
Gonna take you right down, and I’ll take the blame
Till my dreams are my own again

Here I am again

Those lyrics didn’t save me. In some ways, I didn’t even save me: as I’ve mentioned previously, there was no decision, just a leaf turning this way rather than that.

But I think there was something in this song that said, in effect, you can go with this. Just because you were that before doesn’t mean you have to stay that way.  It’s okay not to die. It’s okay to be alive.

It’s coming up on 12 years since that night, and I’ve remained here. And that’s all right.

Here I am again.

Not yet, but getting there, getting there.





We might as well try: what’s life?

22 07 2012

Is life good?

Is it something to be desired, a good in and of itself, something to be drawn out as long as possible?

I don’t know.

Yes, yesterday I noted that every killing lead to a smaller world, which, given my world-centric views, could reasonably be taken to be a bad thing. And it is. But I don’t think death itself is a bad thing, and if death itself isn’t a bad thing, then life itself may not be a good thing.

Not that life is a bad thing; it’s simply life and death are neither good nor bad, but part of the necessary conditions (biology, mortality) of our existence—conditions which themselves are, well, to repurpose a quote from a mad German, beyond good and evil. We enter the world through birth and exit through death, and neither the entrance nor the exit is a moral issue. We have no say in our births and that we die is inevitable; it is difficult to argue the morality of matters utterly beyond one’s control.

I didn’t always think this way; I once thought that my life was bad, and my ongoing existence both a symbol of my moral failure to and proof of the need to end it. I purchased days against weeks, weeks against months, months against years—until the years piled up and the credit ran out and spent from the running and loathing I lay myself out and whispered, finally, enough.

Funnily enough, the ending wasn’t the end. I claim no mastery over the moment; it was, simply, a moment, a leaf blown this way rather than that, life, not death. I picked the leaf up, that’s all; I would have picked that leaf up, regardless.

Did I “choose” life? No. I recognized it, recognized it as mine, and said, Well then. Enough.

Would killing myself have been a lessening? I didn’t see it that way, then, but, yes, I guess it would have been—not for me, but for those around me, who cared about me. My world prior to the turning had already been lessened; my suicide would simply have capped off the decades-long hollowing out of my world.

So now I live. I don’t think it’s good that I live or bad that I would have died, but I also don’t think that it’s bad that I live or good that I would have died. I take my life as a given—not a gift, but something simply there—and recognizing it as such, try to do something more with it.





History is an angel being blown backwards

6 06 2011

Finally finished Richard Evans’s The Third Reich at War. Yes, I already knew the ending, but still, so, so satisfying.

Not everything about it satisfied. The Nazis grew ever more fanatical as the Reich’s prospects worsened, and so many—tens of thousands—of people were killed by the SS as the Allies pushed the Eastern and Western fronts ever closer together. And the Soviet soldiers, pfft, they raped their way west—gang-raped their way west. American and British forces also abused and raped civilians, but like nothing on the scale of the Red Army.

Given what the Germans had done on their march into the USSR, what the Red Army did was hardly a surprise. Still.

And too many Nazis escaped, either through subterfuge and help from an anti-communist official in the Vatican or because they were useful to the victors or by killing themselves. They—Hitler, Goring, Goebbels, Himmler, Borman, among too many others—escaped judgment by a shot to the head or a literal poison pill. They got to control their own deaths, just as they controlled the deaths of tens of millions of people.

They did not get what was coming to them.

Two further thoughts: One, while I have mentioned that I am under all circumstances opposed to the death penalty, I am not in any way exercised by the penalties imposed on those brought to trial. However problematic the juridical underpinnings of a victor-imposed war tribunal, I think it was better to have had the various trials than not; is no justice to be preferred to rough justice? (This is a real question, actually, tho’ I ask it only rhetorically, here.)

That my desire to have kept these anti-human genocidaires alive for the sole purpose of tormenting them—forcing them to live in a fallen world, a world where Germans are not the Master Race and Jews and Slavs and leftists and every so-called inferior would be in a position to look down with contempt and derision upon the Leader and his ilk—does point to my less-that-exalted moral position regarding the death penalty and these men. As with the suicides, the death penalty seems too easy a way out.

Second, I felt a great and unexpected rage at those alt-historians and pundits (Niall Ferguson and Pat Buchanan, for example) who spin out fantasies of woulda-coulda-shoulda and call it scholarship. I enjoy alt-history—Robert Harris’s Fatherland is a fine weekend read, and I’ve got Philip Roth’s The Plot Against America on my shelves—but I don’t treat it as anything other than what it is: fiction.

Even reading Ian Kershaw’s first volume of his biography of Hitler I find myself annoyed by his asides of but for this and had this judge not or if only the police had: Hitler wasn’t sent back to Austria to serve in the imperial army and he was allowed to enlist in the Kaiser’s force and the judge didn’t deport him after the beer hall putsch, etc. Again, the woulda-coulda-shouldas get us nowhere beyond dismay, exasperation, and not a little bit of unreflective smugness: We know better.

Maybe time does not constrain us in other quantum realities the way it does so here, in this reality of the 21st century, but since we do live within time, pretending that we can overcome the winds which blow us into the future is just that, pretending—or pretense, if you call it scholarship.

It’s also cheap, intellectually and morally. It’s one thing for, say, military tacticians to say if you had done X rather than Y in this battle, that might have opened up possibilities for Z—to say, in other words, that something limited can be learned about a specific event—but it’s quite another to assert with authority that had the British not joined the battle against the Hapsburgs and Ottomans and Hohenzollerns, say, that Imperial Germany would have imposed a cautious authoritarian rule over Europe, contained or otherwise short-circuited the Bolshevik Revolution, allowed the British to keep its empire, stymied the rise of the Americans, and oh, by the way, prevented the rise of Hitler, the Nazis, and the conflagration of WWII.

It’s quite another, in other words, to spin a whole counter-history which makes it seem as if the abattoir that was Europe in the first half of the twentieth century was, oopsie, all a big mistake, one which could be erased by hopscotching back to 1914 Britain and whispering in the King’s ear. History is made of chalk; let’s erase and start over.

The problem is precisely that history is made of chalk: There is nothing indelible in what happens, and we remember only because we remember. We have to chalk and re-chalk and re-chalk again the contours of our deeds if they are to remain visible to us amidst those blowing winds.

Six million Jews and however many thousands of Roma and hundreds of thousands if not millions of Slavs were murdered by members of the Third Reich,  millions more soldiers killed and were killed in turn, and hundreds of thousands of innocent and not-so-innocent civilians died because Hitler and the Nazis and a fair proportion of the German population thought it only right that they should run riot over Europe and the world.

These are the facts, tethered to us only by intersubjective agreement that they be treated as facts.

Treat them as pieces in your game of counter-factual what-if and whoops, you loosen the tether and allow the pieces to be scattered, lost. You allow all those people to be scattered, lost, again.





When I break down just a little and lose my head

11 01 2011

Deep breath.

I don’t know if this is the first but I do plan for it to be the last time I talk about this.

This is about Jared Loughner. And me. And the one thing that might connect us: neither of us were committed for mental illness.

As mentioned previously, I do not know if Loughner is mentally ill, and I really wish so-called experts would quit diagnosing him over the airwaves. But mentally ill or not, his actions prior to the shooting have led to a fair amount of discussion as to whether he should have or could have been committed.

Here’s where I come in: A half a lifetime ago, I had a commitment hearing. It was not a pleasant experience.

The judge was fine, the court-appointed attorney was fine, even the room in the locked ward of the psychiatric wing of the hospital was fine. And I wasn’t even committed, tho’ I do think I had to agree to stay on the ward and do x, y, and z.

I was deeply angered at having been incarcerated in the psych ward in the first place, and for years afterward felt that the incarceration was both unjustified and unjust.

Hey, I just wanted to kill myself, that’s all, no one else. No big deal.

The details are, pfft, details. There were cops and handcuffs and then at the hospital, restraints (which I managed to pull off*)—all of which sounds ghastly and it was, but it was ordinary, too.

Ordinary in that the cops were decent, as were the hospital staff, and the ward was clean and everyone had their own semi-private rooms and it was probably as good as these truly shitty things get.

It sucked, yes, and it sucked because I needed to be there.

It took me awhile—years—to realize that corralling me into a psych unit was both just and justified.

So, zoom back out: Does this mean I believe that everyone with an untreated or refractory mental illness should be consigned to a psych ward?

No.

But while it might have once been too easy to commit people for too long (for-ever. . .), the problem now is that too many people—both those who want help and those who don’t—have difficulty getting that help.

That’s where the focus should be: on access to good treatment for mental illness. Any discussion about making involuntary commitment end must begin with that concern.

William Galston goes about this the exact wrong way:

The story repeats itself, over and over. A single narrative connects the Unabomber, George Wallace shooter Arthur Bremmer, Reagan shooter John Hinckley, the Virginia Tech shooter—all mentally disturbed loners who needed to be committed and treated against their will. But the law would not permit it.

Starting in the 1970s, civil libertarians worked to eliminate involuntary commitment or, that failing, to raise the standards and burden of proof so high that few individuals would meet it. Important decisions by the Supreme Court and subordinate courts gave individuals new protections, including a constitutional right to refuse psychotropic medication. A few states have tried to push back in constitutionally acceptable ways, but efforts such as California’s Laura’s Law, designed to make it easier to force patients to take medication, have been stymied by civil rights concerns and lack of funding.

We need legal reform to shift the balance in favor of protecting the community, especially against those who are armed and deranged.

Yes, the point of treatment is not the unwell, it’s the rest of us.

Think I’m misreading Galston? Well after arguing for an expanded list of people who should be held legally responsible if they have “credible evidence” of someone’s “mental disturbance” and don’t report it to “both law enforcement and the courts”—not emergency rooms, not health officials—he argues that “A delusional loss of contact with reality” (whatever that is) should be enough to begin the process of commitment.

To be fair, he does say this process should include “multiple starts with multiple offers of voluntary assistance”, which, if one doesn’t volunteer, could end with “involuntary treatment, including commitment if necessary.”

That actually would sound reasonable as a way to try to get help for people, except, of course, that’s not Galston’s real concern:

How many more mass murders and assassinations do we need before we understand that the rights-based hyper-individualism of our laws governing mental illness is endangering the security of our community and the functioning of our democracy?

That’s right: people sleeping on heating grates or hiding out in rooms or basements and unable to care for themselves or anyone else is not the threat to democracy, it’s that “mentally disturbed loners” might take a shot at a president or pop star or member of Congress.

I have absolutely no truck with murder and assassination, and believe that if better care for the mentally ill would lead to fewer violent crimes, that would be wonderful.

We’re not going to get that better care, however, if all that matters is the fear of the well and the punishment of the unwell.

Right now, punishment is the driving approach to mental illness. According to a 2006 Human Rights Watch report,

More than half of all prison and state inmates now report mental health problems, including symptoms of major depression, mania and psychotic disorders, according to a just-released federal Bureau of Justice Statistics (BJS) report, Mental Health Problems of Prison and Jail Inmates.

In 1998, the BJS reported there were an estimated 283,000 prison and jail inmates who suffered from mental health problems. That number is now estimated to be 1.25 million. The rate of reported mental health disorders in the state prison population is five times greater (56.2 percent) than in the general adult population (11 percent).

Women prisoners have an even higher rate of mental health problems than men: almost three quarters (73 percent) of all women in state prison have mental health problems, compared to 55 percent of men.

Galston should be pleased: we’re already locking up a lotta crazy folk! Too bad that they’re not getting treated once they’re in jail.

Prison staff often punish mentally ill offenders for symptoms of their illness, such as being noisy, refusing orders, self mutilating or even attempting suicide. Mentally ill prisoners are thus more likely than others to end up housed in especially harsh conditions, including isolation, that can push them over the edge into acute psychosis.

Would involuntary commitment have helped these prisoners? Again, if one follows Galston, the deranged should be reported to “law enforcement officials and the courts”, not to anyone actually in a position to help them.

And where would all of these people go, if not to jail?

According to Human Rights Watch, the staggering rate or incarceration of the mentally ill is a consequence of under-funded, disorganized and fragmented community mental health services. Many people with mental illness, particularly those who are poor, homeless, or struggling with substance abuse – cannot get mental health treatment. If they commit a crime, even low-level nonviolent offenses, punitive sentencing laws mandate imprisonment.

The new BJS report reveals that state prisoners with mental health problems were twice as likely to have been homeless and twice as likely to have lived in a foster home, agency or institution while growing up as those without mental health problems. Prisoners with mental health problems were also significantly more likely to have reported being physically or sexually abused in the past, to have had family members who had substance abuse problems, and to have a family member who had been incarcerated in the past. An estimated 42 percent of state inmates had both a mental health problem and substance dependence or abuse.

(See also: here, here, and here, or just run a search on “mentally ill prisoners”.)

I don’t think this is working. It’s just possible, in fact, that if there were better patient-centered options—options which could include involuntary treatment—that fewer mentally ill people would end up in jail. Good for them, good for us.

We can’t just jump ahead to involuntary treatment and commitment, however, before building up the infrastructure for all treatment, voluntary and not. It wasn’t until 2008 that the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act was signed into law, and even with that law, treatment for mental illness may legally go uncovered.

So let’s make treatment possible. Let’s make sure the vulnerable have a place to go where they can actually get help before we call on cops and judges. Only after we make sure treatment is actually available does it make sense to talk about laws to draft the resistant into that treatment.

There’s nothing easy about any of this, not least because some mental illness are just damned hard to treat, but if commitment is to be both justified and just, then it makes sense that in our rights-based hyper-individualist society that we actually pay attention to the individual at the center of the debate.

*This is why you should always wear a watch: if anyone tries to tie your wrists together or to something (like, say, the rail of a hospital bed), you can use the extra space provided by the watch to wrench and wriggle your wrist free.

~~~

Coda: I got lucky—although it sure as hell didn’t feel like it at the time—because I got care.

A person shouldn’t need luck to get care.

h/t The Daily Dish





It Gets Better

29 09 2010

This is a terrific idea—and one you probably already know about:

Dan Savage, profane sex columnist (is there any other kind?), author, and alternatingly-amusing-and-irritating pundit, had heard one too many stories about queer kids who killed themselves, and decided to do what he could to buck up all of the rest of those kids who aren’t supported in schools or loved at home: he set up the It Gets Better project on YouTube, posted a video (with his husband, Terry) of his experiences, and invited queer adults to add their own stories—all as a way of reaching out and hanging on to those kids who might just let go.

It’s a wonderful idea, and it’s wonderful that so many adults have contributed to this project.

(I won’t be making a video because my bisexuality only emerged in the past couple of years; whatever difficulties I had in high school could not be traced to my sexual orientation.)

I do, however, have one observation: Some of these videos—the San Francisco Gay Men’s Chorus vid, for example—include exhortations to the kids that they should just be who they are, that in a few years they can get out and find a place where people will love them for themselves.

A beautiful thought; alas, it is not enough.

This is in no way a critique of the project: no one project can do everything, and, as Dan pointed out in his column, there are other resources that adults should support and kids should turn to. To remind this particular adolescent community that it’s okay to be queer, that the problem is with the bullies and the hateful and not with them, is exactly what so many of them need to hear.

But some of them won’t hear this. For the kid who feels that who he is is awful, for the teen who believes that her real self is bad—to tell those kids that they just need to hang on to their real selves and everything will get better is to miss the fact that them, their sense of their real selves is the problem.

They hate themselves because they are queer, or because their inherent badness made them queer, and thus they might believe that they deserve to be bullied: the problem isn’t that the bullies don’t know who they are, but that they do.

Maybe these videos will help a gay kid to reconsider himself, to question her belief that to be a lesbian is to be bad, and to help those kids find a way out of their self-hatred.

It would be wonderful if that would happen.

But it’s not enough to tell those kids that they can survive the bullies when they can’t survive themselves.

It Gets Better is a start. It tells so many gay, lesbian, bi-, and trans teens that there is so much more in life for them, and that they can make it through these tough high school years to liberate themselves into that life.

But we also  need a way to reach those self-hating kids, to tell them that not only can they live a better life, but that each and every one of them deserves that better life.





Her body trembles with the effort to last

1 01 2009

Emma Bee Bernstein, 23, killed herself.

I didn’t know Emma, didn’t know anything about her until Courtney Martin ran an obit for her at Feministing.

All I could think, upon reading the obit, was, Awww, Jesus.

This is how I know I’m over my own folie a deux with suicide. Before, when I heard or read that someone had killed themselves, I’d be envious. Ah, I’d think, so they managed what I could not. But this time, all I could think was, Awww, Jesus.

Twenty-three. One lifetime. She could plausibly have had three more lifetimes, but chose not to.

What do you say to someone? There’s so much to live for. . . You’re so young. . . Things’ll get better. Not necessarily. Even if you believe it, she won’t.

Would it help to say, There’s no point to life. Live anyway.?

Live anyway. Through it all, live anyway.