Do you believe that most of us are the keepers of our own minds, bodies and spirits? Do you believe that we should be empowered to do for ourselves and for others what we believe is the best for us. So what do you think about suicide?
I have been pounded with the issue of end-of-life decisions for several months now. Starting last summer with deciding about the life of my cat, while at the same time a friend asked me to support her about getting an abortion. And then early in the fall, I was offered the opportunity to take an online course about recognizing the signs and identifying the treatment issues with people with terminal illnesses and with end-of-life realities. At the time I signed up, I registered, and then forgot about it while the program decided on my application.
In November, a family member committed suicide and my family asked me hundreds of questions. Why? Why didn't he reach out? What else could they have done? Why didn't they recognize the signs? I could only console them, could only spout the institutional knowledge, and hope that they could pick up the pieces and cope with the loss. I thought then, "maybe this course would help me better help them cope the next time."
Then three weeks ago when the online course came around, I scheduled myself to do the 6 4-hour modules. But I kept putting it off.
Coincidentally, two weeks ago, another friend told me that she had seriously contemplated suicide. She explained that after her mother died, the sermons, the cards and the friends kept saying that her mother was free now. That she was at peace; she went to a better place, free from the pain of life. To my friend, struggling with depression and some physical pain, that peace sounded like a good solution, and she thought seriously about killing herself...she "just didn't. "
So, I got back from the US, thought I would start that module this week, while my other work was slow, and I even opened one of them briefly over the weekend, but something came up and I didn't even read the first vignette. I thought, "This is too heavy for the weekend, I'll wait until Monday..."
On Monday, another dear friend came to see me. She had cancelled our normal bike ride that day. She was very depressed. She talked about her life, her family, her loves, her history. She didn't talk about her future. She looked as if she hadn't slept in a week. She didn't get enthused about my attempts to cheer her with plans for a trip, the movies or a bike ride. She didn't mention suicide, and I didn't think to ask (it doesn't usually come up over tea) but the next day, she killed herself. And now I am the one asking why didn't I do more? What could I have done differently? I am a psychologist, why didn't I recognize the signs? If only I had...
One thing I did do in the aftermath was start the module. In it, I learned a lot about end of life decision making processes and that most clinicians aren't good at predicting suicide because our own issues/fears/lack of understanding with death interfere with our understanding of someone else's pleas for release or for help. And that the strongest predictor of a suicide attempt is when someone has given up all hope. ALL hope. But I still beat myself up. Why didn't I see this coming? Why didn't I intervene?
And then Bette reminded me that I believe passionately in our power and responsibility to choose how we want to live our own lives and that includes our deaths. I needed to see my friend's decision as hers. I might not like it, but it was ultimately her decision. And I respect that.
So, while I am so sad to lose my friend, and I cry for my loss and for hers, but I will try to understand that this was her decision to make. She told me she had no power to choose anything in her life, and she felt as though she were living someone else's life. In hindsight think this was her most powerful moment. I wish she had seen the power in the choice, instead of only the choice itself.
It could be that ultimately we all make a choice about living and about dying. It's just that I am encouraging us to think about looking at more than the extremes when contemplating your choices, and remember that doing nothing is a choice, too. I will deeply miss Catherine for what I hope is a very long rest of my life.
Peace in this life.
Update: We now know that maybe it wasn't Catherine's clear minded choice, but rather a reaction to an anti-depressant medication that caused the rapid and severe downward spiral for her, clouding her judgment and distorting her thinking. It is a tragedy, no matter why or who, that has directly impacted many lives, and one that might have been prevented. But on this day of her funeral that doesn't change the ultimate fact that she is gone, and a lot of people will miss her.
I have been pounded with the issue of end-of-life decisions for several months now. Starting last summer with deciding about the life of my cat, while at the same time a friend asked me to support her about getting an abortion. And then early in the fall, I was offered the opportunity to take an online course about recognizing the signs and identifying the treatment issues with people with terminal illnesses and with end-of-life realities. At the time I signed up, I registered, and then forgot about it while the program decided on my application.
In November, a family member committed suicide and my family asked me hundreds of questions. Why? Why didn't he reach out? What else could they have done? Why didn't they recognize the signs? I could only console them, could only spout the institutional knowledge, and hope that they could pick up the pieces and cope with the loss. I thought then, "maybe this course would help me better help them cope the next time."
Then three weeks ago when the online course came around, I scheduled myself to do the 6 4-hour modules. But I kept putting it off.
Coincidentally, two weeks ago, another friend told me that she had seriously contemplated suicide. She explained that after her mother died, the sermons, the cards and the friends kept saying that her mother was free now. That she was at peace; she went to a better place, free from the pain of life. To my friend, struggling with depression and some physical pain, that peace sounded like a good solution, and she thought seriously about killing herself...she "just didn't. "
So, I got back from the US, thought I would start that module this week, while my other work was slow, and I even opened one of them briefly over the weekend, but something came up and I didn't even read the first vignette. I thought, "This is too heavy for the weekend, I'll wait until Monday..."
On Monday, another dear friend came to see me. She had cancelled our normal bike ride that day. She was very depressed. She talked about her life, her family, her loves, her history. She didn't talk about her future. She looked as if she hadn't slept in a week. She didn't get enthused about my attempts to cheer her with plans for a trip, the movies or a bike ride. She didn't mention suicide, and I didn't think to ask (it doesn't usually come up over tea) but the next day, she killed herself. And now I am the one asking why didn't I do more? What could I have done differently? I am a psychologist, why didn't I recognize the signs? If only I had...
One thing I did do in the aftermath was start the module. In it, I learned a lot about end of life decision making processes and that most clinicians aren't good at predicting suicide because our own issues/fears/lack of understanding with death interfere with our understanding of someone else's pleas for release or for help. And that the strongest predictor of a suicide attempt is when someone has given up all hope. ALL hope. But I still beat myself up. Why didn't I see this coming? Why didn't I intervene?
And then Bette reminded me that I believe passionately in our power and responsibility to choose how we want to live our own lives and that includes our deaths. I needed to see my friend's decision as hers. I might not like it, but it was ultimately her decision. And I respect that.
So, while I am so sad to lose my friend, and I cry for my loss and for hers, but I will try to understand that this was her decision to make. She told me she had no power to choose anything in her life, and she felt as though she were living someone else's life. In hindsight think this was her most powerful moment. I wish she had seen the power in the choice, instead of only the choice itself.
It could be that ultimately we all make a choice about living and about dying. It's just that I am encouraging us to think about looking at more than the extremes when contemplating your choices, and remember that doing nothing is a choice, too. I will deeply miss Catherine for what I hope is a very long rest of my life.
Peace in this life.
Update: We now know that maybe it wasn't Catherine's clear minded choice, but rather a reaction to an anti-depressant medication that caused the rapid and severe downward spiral for her, clouding her judgment and distorting her thinking. It is a tragedy, no matter why or who, that has directly impacted many lives, and one that might have been prevented. But on this day of her funeral that doesn't change the ultimate fact that she is gone, and a lot of people will miss her.
