- Knowing what not to say, is as important as saying something
Destigmatizing depression or suicide can seem like a Herculean task. But it all starts with unlearning one neoliberal lie: “Preventing suicide is a matter of personal responsibility”.
A person does not attempt suicide because he hates his life; rather he hates the circumstances in which his life appears to have become permanently entangled. While discussing suicide, using the word ‘intentional’ is itself only technically appropriate. The ‘intention’ is to escape the toxic circumstances which the individual may not have been responsible for. At times, suicide may result from a botched attempt at self-harm rather than the ‘intention’ of ending one’s life. There are cases labelled suicide, like in drug overdose, where the intention may have been neither death nor self-harm. The person may simply have used the drug illicitly as a means to escape pain, and may have unintentionally lost one’s life in the process.
We say that a person “commits” suicide, which I find curious. A soldier intentionally commits himself to a battle with high risk of injury or death; but I’ve never heard the term “committed martyrdom”. We respectfully imply through our words, that the soldier is not be blamed for his own death; it was circumstances that caused his demise. Martyrdom was not committed, but achieved. To say that person “committed” or “carried out” the act of self-harm, is to accuse the victim of being the villain of his story.
When discussing victims of suicide, we pretend not to notice the stigma in words like “commiting suicide”. People who understand suicide as a societal problem rather than a personal failure, tend to say that a person “died of suicide”. Our words matter enormously.
Ultimately, suicide is a societal problem. It’s not just you. It’s not just the doctor. Many things must go wrong at the same time with respect to social support, financial means, politico-legal situation, the economic order, and the healthcare situation, before we lose a loved one to suicide. It’s not the fault of one person, and the victim is certainly not be blamed
When you understand that preventing suicide is not strictly a matter of personal responsibility, you may notice a shift in the way you speak to friends or classmates who might be feeling suicidal. Phrases like “Stop worrying!” or “Stay positive!” begin to appear thoughtless and insensitive. Such phrases spurt from the erroneous notion of suicide as something entirely within the sufferer’s conscious control. People don’t stop worrying just because you tell them to. There’s no secret lever you can pull to change your mood from ‘negative’ to ‘positive’. Psychiatrists, clinical psychologists, and other mental health professionals don’t go through years of rigorous training just so they can tell their clients to “cheer up”.
We all want to help out our friends who are found to be struggling with depression and suicidal thoughts. But what you don’t do, is far more important than what you do. Firstly, don’t be too eager to hand out advice. A worthy psychiatrist thinks thrice before giving advice to a patient. There’s no reason a non-professional should be blurting out advice like, “Just pray five times a day, and it’ll be all right!”. Be mindful of your limitations. Just as it’s okay for you to avoid performing surgery on your friend no matter how much he needs it, it’s perfectly reasonable for you to feel uncertain about conducting psychosocial therapy.
What you can do, is to listen empathically. Acknowledge that it’s not the body that a suicidal person is trying to escape; it’s the situation. Understand the situation that your friend is trying to escape. What went wrong? What is your friend’s perception of the situation? Is there a practical way to fix it?
If appropriate, some physical contact– like a hug– could be helpful and reassuring. It’s regrettable that the value of compassionate physical contact really needs to be hammered into men, who are often uncomfortable with such interactions. It’s okay. You’re allowed to hold your friend tight to make him feel safe, as long he’s willing to be embraced like that.
Don’t challenge your friend’s emotions or attempt to minimize them. Don’t tell him that someone you know went through something ‘much worse’. A senior psychiatrist I’ve had the good fortune of collaborating with, explained this point in a particularly smart way through the following example. The same rain makes different sounds when it falls on different surfaces. It’s quiet when it falls on a heap of sand, and loud when it hits a tin roof. The same situation can be perceived subjectively by different people, so it’s important that you attempt to understand how your friend feels about the particularly situation he’s in. Nobody likes being made to feel “crazy” for feeling the way one does. Don’t shame someone for feelings that seem “out of proportion” to the situation.
Above all, encourage your friend to seek out professional help. As discussed earlier, it’s prudent to acknowledge your limitations. Don’t let the hubris of knowing your friend better than anyone else, get in the way of directing him or her to a healthcare professional.
Ultimately, suicide is a societal problem. It’s not just you. It’s not just the doctor. Many things must go wrong at the same time with respect to social support, financial means, politico-legal situation, the economic order, and the healthcare situation, before we lose a loved one to suicide. It’s not the fault of one person, and the victim is certainly not be blamed.