I was just discharged from the hospital yesterday evening after spending two days and three nights in the emergency department. I went because my family doctor insisted I go: either go voluntarily or we will have the police escort you. So, I got in the taxi they called for me and I went and checked in.
I told the doctors that I was profoundly suicidal. I talked about recent events which had spurred the crisis and, most importantly, I disclosed my plan. I had several long discussions with several different doctors, interns, residents, 4th year medical students. It was endless. Eventually, they put me on a 72 hour “hold” and admitted me. I was soon ushered to a place down a back hallway of the emergency department where I was told to get up on a gurney and “wait”. So, I did. I spent all my time there on that gurney mostly feeling very sorry for myself and regretting that I had disclosed my plan to my doctor.
I have lived with suicidal ideation almost my entire life. My first suicide attempt was at age 16 when I took an entire bottle of aspirin. Over my lifetime I have probably made more than 15 attempts. The last time I made a serious attempt, I ended up with a very serious brain injury from which I have almost completely recovered but which took years to happen. After that attempt, I made a promise to myself that if I ever felt suicidal or that desperate again that I would NOT take another overdose. In fact, I decided that I would kill myself with carbon monoxide in my garage. So, that was the plan this time. Drink about a fifth of vodka with orange juice, take all the pills I have in my possession, get into the car and turn it on. It’s a plan I know will work. I had decided that I would take my little doggie with me because he is my best friend in the whole world and I could not bear to leave him behind because I know he would end up at the humane society shelter where he would eventually be euthanized.
So, there I was in the emergency department telling the resident psychiatrist about this plan. Of course, they admitted me. What else could they do?
So, how did I get to this point again?
Time for an important DBT skill called Behavioural Chain Analysis. This is a tool which asks the person to look at the chain of events which led up to the crisis and figure out what they could have done differently to keep from getting to the point of utter desperation.
My Behavioural Chain Analysis
The first link in the chain is that my boyfriend broke up with me while we were on vacation. First he assaulted me and then he broke up with me. Though I had been anticipating this would happen for months when it finally, actually occurred, I was completely taken by surprise. I attribute that to the assault which happened first. I never in my life imagined hew would assault me. I just couldn’t deal with it. None of my DBT skills were helping. I could not distract myself enough, I could not practice radical acceptance. Nothing was working and I spiraled down into the black hole of my emotions again. This is what happens to me almost every time. I get sucked into the vortex of my black thoughts and can’t find my way back out again.
The second link in the chain was that I began to put the plan into motion instead of distracting myself, I started to wallow in and fixate on it. I should have gone to the mall or gone out to see a movie. I should have called a friend but instead I allowed myself to get pulled deeper into the muck. And I allowed myself to just stay there.
The next ink in the chain occurred when I began to actively plan for my death. I called a crematoria and arranged for my own cremation along with my little doggie. At that point, I should have gone to the hospital but I was too far gone. It was only when I sat in my family doctor’s office that I was finally able to put the brakes on.
Love, Lust and Attachment
While I was in the hospital I read an interesting blog piece from a blog called Tiny Buddha. I have followed this blog for a long time. It is called Love, Lust and Attachment and it made so much sense to me. Because I was abandoned as a baby I have always had a very difficult time attaching to people in any meaningful way. This man came along and he was “perfect” in every way imaginable. But really he wasn’t. There were all kinds of red flags but I chose to not see them. One of my faourite people, Karen Salmonsohn wrote a book about this phenomenon which she called Prince Harming Syndrome. Even though I knew about this book, I never thought I would fall prey to this syndrome. Well, here I am right in the middle of it!
I realized that my relationship with this man was not based on love even though I believe that I loved him enormously. But rather was I was experiencing was an attachment problem which only fueled my anxiety. When I think back on it, anxiety was the primary emotion I experienced during my four year long relationship with him. When we first met, he was still married and it took him almost three years to finally file for and obtain his divorce. He never loved me in the same way I loved him. Although I supported, encouraged and accepted him unconditionally, he was never able to return those things to me. This set up a perpetual longing in me, an itch I couldn’t scratch.
I had my entire future wrapped up in this man. I told him many times about my desire to create a life with him. Of course, he never really responded to those words. Never even really acknowledged them. So, why was I so taken off guard when he broke up with me? Because I was living a fantasy. I wanted nothing more than to marry him and live in the crook of his arm forever. When that dream was snatched away from me, it was more than I could bear. I felt utterly heartbroken and bereft.
Now, this is very strange because I don’t consider myself to be a woman who needs a man to “complete her.” I am very independent, have my own money, own my own home and am a completely self-sufficient person. So, why did I go off the deep end? I think it has more to do with wanting to be loved and accepted, two things that he could never really do for me.
While I was in the hospital, a friend came to see me. This friend knows all about my history and he knew all about this current episode of suicidal ideation. He told me that my suicide would be a “tragedy” because my work here is not finished. Of course, I scoffed at this. But after this discussion I thought about his words long and hard. I came to the conclusion that I do not want to leave a legacy of suicide behind for my children or my grandchildren. I know that when a person commits suicide they are essentially saying to their loved ones, “I can’t carry this burden any longer, here YOU carry it for me!” and they pass the pain along to the next generation. I don’t want to do that to my children. So I take out my DBT skills yet again and brush them off and put them into practice. My wise mind tells me that this pain too shall pass, that I will not be in this awful place forever, that I have to stay alive long enough for these terrible feelings to pass because I know even in my troubled heart that they will pass if I just give them enough time. Tomorrow is another day and the sun will come up again. I will do what I need to be able to greet the morning with a grateful and happy heart.
So even though part of me feels like a fraud (How can I profess to teach DBT skills to others when I can’t put them into practice for myself when I so desperately need them?) I realized that his is a great example of something I talk about all the time: three steps forward, two steps back is STILL forward progress. Despite how it might appear on the surface, this is actually a great victory for me because I did not allow my feelings to get in the driver’s seat and throttle me right off the precipice. My work here is not finished. In some ways, it may be just beginning.