What we don't want to acknowledge about mental health and suicidology
Was sipping coffee in what has become a familiar space, surrounded by two fellow clinicians who are also friends, one new and one old. The annual Psychotherapy Networker Conference has become something of a respite and a way to replenish the spirit that, for me, at times gets lost in the work we all do. Being a healer of any modality is rewarding work, without question. The work is also exhausting. Heavy. Frustrating at times. These past 2 years have been particularly taxing, furthering the need for connection and whimsy and joy!
The Networker was started 45 years ago by a brilliant and vibrant man few of us who attended knew personally, but felt like we all “knew” him. During coffee, our conversation drifted to thoughts of how Rich Simon’s absence felt at the first in-person conference since his suicide. It was difficult for some to even use the word, suicide. Such a stigma still exists in our world around mental health and suicide. Seated at this table, we are all therapists. Yet, it was still difficult. How could this happen? How could the world see this brilliantly funny, entertaining, and passionate man and not also see the pain that existed deep inside? A pain so deep, death appeared to be a more appealing pain.
Not being among the inner circle with Rich (others with me knew him and even called him “friend”) I sat quietly and listened to their processing this experience. Not only was his presence missed greatly, but wondering with great dismay how they never saw it. I could feel the pain inside of them, both grief and dismay after the loss of their colleague and friend.
It has been said of those who are diagnosed with lifelong mental health diagnoses like Depression or Bipolar disorder don’t fake being sick, they fake being well. I know. I am one.
Rich’s story struck me, not because I knew him personally, but more because in some ways I am him. Working to feel what I assume is normal is really hard work. Participating and showing up in social situations, putting on a face of joy and happiness and contentment feels like a monumental task somedays. Agreeing and showing up to go to a networking event, dinner out with a group, or going dancing takes so much energy, draining the fragile reserves that exist deep within. The inner battle looks like this… do I sit home and read and write and think how I am going to get through this next day, or do I do what is expected of me by family/friends/society fully knowing it will set me back and I will feel that intense struggle and pain bubbling to the surface inside me?
It’s an everyday battle of what the world wants to see in each of us, in stark contrast to what is really happening inside.
The WORLD didn’t know about Rich’s deep despair not because he didn’t want the world to see that part of him (I have no real idea if that’s true, maybe it was a factor) but more because our society still has a deep stigma attached to mental illness. We don’t want to see it. We don’t want to talk about it. We want to hear the success stories, not know the pain that the person endured to get to the healing and space outside of the pain. As a society, we show up for people diagnosed with cancer or heart disease or insert whatever other illness, we acknowledge no one asked for those diagnoses and meet those diagnosed with great love and compassion and support. However, people still think those living with mental health diagnoses choose to be sick. We are told messages like:
Snap out of it.
Think positively.
Just be happy.
You have so much to be grateful for in your life.
Have you tried therapy? Meds? Rest? Exercise?
Things could be worse.
Why can’t you just be happy?
As if any of us who live with mental illness don’t know and wish for all those things? At least on some level. I fake happiness because, daily, I am scanning the room and assessing what it is others need from me. I know people want me to be positive, attentive, conversational, and light. And at times, I am all of those things. When most meet me, I am quite certain that is what they see, wanting or needing to see that in me. I know they do. I have mastered the ability to read what others want to see in me and match that expectation.
I have been told, “you are prettier when you smile.” I grew up in a culture that praises one’s outer beauty so, of course, I try to put on the obligatory smile to appease others even when inside, I am often faking that smile. Inside, at times I feel like putting on that obligatory smile is as taxing as climbing a mountainside, without all the grounding and safety gear. I am unsettled. I could be shaking inside, but a good swish of lipstick on my lips and a smile, none around me are the wiser.
Being a psychotherapist who also has a long history of mental illness feels like I am a fraud. Even though I am pushing myself to talk more and write about my journey, there are still times I fear others really knowing how much I struggle and how that could impact my credibility as a therapist. Yet, keeping the secrets inside me feels like I am slowly dying inside. I feel broken, and know that continuing to hide my true self only contributes to more shame which feeds more of my depression. No matter what I have tried, I cannot escape the pain inside me. The darkness. Always returns.
When I heard my friends suggest somehow we as clinicians failed Rich, I felt irritation surge inside me. In his end, Rich did decide to end his life, I can imagine it was a last effort to end his own pain. I couldn’t stay silent and just listen at the table anymore. What I asserted, is this: What if we as clinicians didn’t fail Rich? What if we, whoever his clinical team throughout his life were, helped him each day to get to however old he was in the end? Isn’t that a success of sorts? What if he wanted to give in, let go, be free of that pain countless times at 20, 35, 50? What if the work we all do, the support we all give to others enabled him to live among us for just a few more moments until he was ready for the end? Or the beginning?
I am not advocating for suicide. I am not! I fight the thoughts more often than I would like to admit. What I am saying is, we never know what someone else is going through inside, and we cannot know how much another can handle until they cannot anymore. We cannot. Our system is flawed, our treatments are limited, and our ability to handle pain and discomfort is still so difficult for others to talk about, even among clinicians. We want all the people in our world, near and far, to be light, happy, positive and cheerful, and beautiful and when they are not, it makes us very uncomfortable. If we as clinicians are uncomfortable with it, imagine the rest of the world!
Knowing a few others who have made this decision, I often wondered not the why like others may, but more the how they came to that eventual decision. It scares me a little to spend too much time thinking about, something I need to keep under check. But Rich, like too many, died from suicide. He didn’t “commit suicide” as if it is a crime he should be punished for as I have no doubt he lived that reality every single day of his life to some degree. The BIG and painful emotions are punishment enough, deserving to put an end to this hurtful and insulting phrasing of the decision he ultimately made. I pray and hope he is now at peace, and truly living a life filled with joy and enthusiasm he so desperately deserved in this life. We all do.
It isn’t that I am afraid to talk about my emotions or my inner-darkness. Rather, I have learned I am “so much prettier” and “pleasant” when I am talking about light things and thus, keep most of my struggles inside. Consciously, I know there is a huge danger in this practice, but also know that the world doesn’t want me to show up how I really am. They want me to be fun, they want me to be light, they want me to be happy. Imagine how that feels to know what you really feel is wrong, what you really feel no one really wants to hear about, what you really feel is painful and you are told it’s a choice and you could feel differently if only you tried a little more?
I have traveled alone. I have run marathons. I have publicly dipped my toe into blogging and writing and speaking about my own journey in hopes to help raise the consciousness of others and perhaps increase societal understanding and then perhaps compassion surrounding depression, but get stuck in the darkness loop when I realize this journey is one I will forever face alone.
So yeah, I get it Rich. I am so sorry our world doesn’t know what to do to help us live happier lives. I have no doubt you tried it all! And hope there is a day when the smile on my face isn’t forced, when I can talk about my struggles as a memory rather than my reality, and forever will be grateful for a world you were part of, connecting others who do this work, so one day we can be even more effective in helping others get to natural death, rather than hastening it along.
Wishing us all peace and joy in this very complicated world.