Wanting to Kill Yourself, But Not Wanting to Kill Yourself

This is such a great topic and I've avoided it for too long. But a comment on an old post reminded me that you have to hear the other side of suicidal ideation. This is sanitized a bit. The bold font is mine.

I am a victim of a violent crime by a person in my family. Now I am planning on being a psychologist/counselor. I know that it will be difficult but I want to be there for those who have gone through this situation and I want to let them know that they don't have to let this ruin their lives. Depression is one out of many symptoms, I know, but is it normal to have the desire to kill yourself every time you remember your past? I have had trust issues because of this, so I sympathize with all the victims out there and only wish that I could bring forth justice in all their lives.

I'm not sure where, "Just shoot me," entered my particular vernacular. Some of us say this then put a cocked index finger to one ear, click, pretend to off ourselves, and everyone laughs.

Anyway, I've been saying it a lot when I hear about things in my personal life that leave me speechless, make me shake my head, as in, "What now? What next?" When I'm frustrated with people.

What's interesting about, "Just shoot me" is that the person who says it obviously doesn't mean it, is just signaling frustration with life's impossibilities. We can't control most of it, certainly not the behavior of other people. So we laugh it up, say, Shoot me.

I give up.

Which implies that someone else wins, but it's okay. We concede the victory with relief. Let it go.

I think this happens on a much deeper psychological level in trauma victims. If a person suffers a trauma, even secondary trauma (hears about someone's trauma and feels the pain), it can trigger suicidal wishes and fears.

Immediately after a trauma or during the trauma, the thought, I would be better off dead is seeded in some neuropathway. Then you get the emotion, the fear, the terror, or it's there first, doesn't matter. But the reasoning, the thought processing about the event becomes unconscious, and that happens rather quickly. All that remains for eternity is the conclusion, I want to die. Sort of stuck like a broken record. You can turn off the juice, but someone keeps turning it on when you least expect it.

And the fears remain, associated with the conclusion, better off dead. You never wanted to die, you never wanted to be raped, to use a common example, or sexually harassed, perhaps, but the thought and the fear originated at the same time, under heightened arousal, and became inextricably linked in the brain.

Our brains are simply out of control. You would think they would get a grip.

But no. Get a bad thought, link it with a negative event, and there's your negative thought, warmed over easy again and again with the thought of the event. And then, the evolved negative emotion, the depression that lingers beyond fear. Fear may have burnt itself out. Maybe not. Just shoot me.

If you grow up with someone who is suicidal you are literally fed this thought with every suicidal threat, wish. You could be a happy go lucky kid, someone with a fairly happy little neurotransmitter, and you listen to the gloym and doym and you think, Oh, for crying out loud. You don't get a corner on suicidal ideation, I have my own, damn it. And you do, not because you want it, because you breathed it.

Hard to be tough sometime, hard to have great boundaries, to know,in your heart,

This is not what I want, this is not who I am. This is merely something I thought once, under a great deal of stress.

Or

It's something someone else wanted, under stress. But it has nothing to do with reality, not mine. I really don't want to die, I certainly haven't the guts to kill myself even if I did.

But here are these stupid thoughts, coming home anyway.

So I wrote her back, said something like this:

Not to answer you personally, but hypothetically people do have what I call "normal" suicidal desires and fears, and these mean absolutely nothing, meaning, people who have these desires and fears would never in a million years kill themselves. You might be one of these people, probably are. That said, for sure, you gotta get therapy to work it out and you really can work it out. Reading about it on the Internet probably won't cut it.

So you want to know, don't you, what happens in a therapy that works it out?

You go over the trauma, for there usually is one, even if it is imagined. Some people have amazing imaginations and they make themselves upset with their own creativity. Doesn't matter if it's real or imagined, most of the time it's real. You go over it again and again, line by line, verse by verse, and examine your responses, how they were normal fear generated thoughts under stress and how wanting to kill yourself rather than face others in the shame of it all felt like a normal solution.

Then with your therapist you do a cognitive behavioral therapy. You challenge the date on the inserted thought.

Wait a minute. The date on that thought is August something, 2004! It's now November, 2009! That thought has expired!

And you let it expire, die a natural death.

You challenge your shame, you say,

And I did nothing to deserve this! Why should I kill myself over something that happened to me?

As my daughter is fond of saying, Most of the time things happen to us. And she's right. We can take responsibility, sure, and we should, and we should rectify whatever we can, make whatever amends are necessary, do whatever we can to right life, but owning things to the degree that they make us sick? Forget that.

Be charitable, pass them along.

therapydoc

Coming Home

Law and Order, Special Victims, if you haven't seen it, is a weekly television drama about people who commit murders and sex crimes. When it's about incest, there's usually a big twist at the end.

Rape is featured in many of the episodes, sometimes stranger rape, sometimes acquaintance rape. Incest happens to be a type of acquaintance rape.

A blogger (Isle Dance) wrote and asked me to write about a situation that involves children and young adults who have sex with the friends of their parents, swingers. Some might call this a gray area for sex crimes since the "adult" in "young adult" technically implies informed consent.

Swinging, when it is with children, or perhaps even with young adults, can pose the threat of psychological problems we associate with sexual boundary violations.

When I read the email I wrote back:

"Sure, sure, remind me to write about this. Shoot me another email in March. Remind me if you don't see something on Everyone Needs Therapy by March."

But I was thinking,

Not now. Too depressing. Must we go here? It's so gray outside, the days are so gloomy and cold. Who needs more depressing posts?

I'm telling myself,

Go with something happy, TherapyDoc, something funny. Tell them you cried watching Mama Mia, because it made you miss your daughter, that the tissues are still on the sofa, whereas most people couldn't get past the first scene and nobody, nobody you know admits to having cried along with Merrill Streep.

And besides, if you take this one on, TherapyDoc, this topic, it's likely you'll end up ranting and moralizing, and there is enough of this on the web. The voice is boring. It is your job to educate, not to lecture, and you'll get so much spam, especially if you use the word, swingers.

But anyway.

I won't wimp out entirely, although this isn't exactly what my blogging pal requested. We'll poke about a bit in this not-so-murky territory.

When incest (the ultimate sexual boundary violation) came to our attention in the mid-twentieth century,* authors of textbooks dubbed it pathognomic, something associated with very serious mental and behavioral psychopathology, the winner, hands down, of the gold, the silver, and brass Olympic medals for both the victim and the perpetrator.

The experts said: Keep them in therapy forever.

That we kept them in therapy for years speaks to the sensitivity we had about sex back then. Sex without boundaries or permission was considered a really bad thing, morally wrong, bad for people, pathogenic. It caused disorder. And that thinking generalized to other sex crimes, as well.

Then and now, mental health professionals think that boundary violations can hurt kids and adults, too, sometimes irreparably, to the degree that the human psyche does not always forget.

We may always grieve an unprotected invasion of personal space. It may affect the way we see ourselves, the world, and everyone in it. Every sexual crime is an invasion of personal head space, too, not just a body memory.

But we're a lot better at treating it now, thanks to war.

It so happens that even acquaintance rape, certainly stranger rape, can mess with your brain in the same way that combat messes with a soldier's brain. The diagnoses and treatment protocols can be the same, too.

Post-traumatic Stress Disorder (PTSD) is the primary disorder associated with sexual crimes like rape and molestation, even secondary trauma, the witnessing of events that are ego-dystonic, that make us extremely uncomfortable.

But if it weren't for war, the psychological treatment of sex crimes against women and men, might still be enigmatic.

We know what we're doing now when we treat rape because governmental agencies (hospitals) have had to find ways to treat the flashbacks and nightmares suffered by war veterans. Thus the funding for research, and an explosion of knowledge about PTSD as it manifests in the twentieth century.

The better treatment interventions, cognitive behavioral therapy, relationship therapies, are working. We don't need to keep people in therapy forever anymore, although surely, for many, long-term therapy is a great idea. It is a lifeline purchased on the cheap at your local community mental health center.

It is fascinating that rape victims and combat veterans share the same syndrome, but makes sense. Life is a battle field. Nobody's in Kansas anymore.

The real difference between then and now is that now we hear so much more about sex in general from the media. We hear about normal sex and about criminal sex, and your bread and butter sexual boundary violations, some perpetrated by teachers and clergy. We hear about it in newspapers and magazines, and we catch it on cable, let's talk, although it's obvious you can absorb quite a bit of chatter, see every sort of video on the Web.
Your average media gulping adult or child, sees a pervasive treatment of sex, one that acknowledges sex as a normal, healthy part of loving relationships, and as a dangerous, sometimes perverted element to crime. Sex is in our face any way we shake it.

As they say in the marketing business,

It sells.

Always did. But because it is so pervasive, because we're inundated with it, it is only an issue, a problem, if: (a) you can't find it; (b) you need to learn how to do it; (c) your partner is too tired or not interested; (d) you or your parents feel it might be sinful,

(e) Or you, as a mature adult, think your sexuality needs enhancement, which can be purchased in pill form, a pill that will sustain an erection long past any need or desire, as advertized on television. Thank heavens we don't have to see that on those commercials.

And sex is a problem if (f) someone takes you by force, obviously, or

(g) someone takes advantage of someone else's age or gullibility.

Only this one can be an iffy call, a question of informed consent. It's iffy because kids have consumed the notion that sexual behavior is so much a normal part of life that they never need to ask or question whether it is appropriate. It's always okay, sex.** Didn't you know?

Uh, oh. This is a rant.

It is so normal that nobody pays much attention to what we might call iffy relations.

An under-aged person, a child of fifteen, perhaps, has sex with an older person, technically statutory rape, but our fifteen-year old wanted it. Shouldn't that be okay?

Or maybe it is a young adult, a person almost of age, who gets very stoned and doesn't object, seemingly wants it, then wakes up and thinks, "Uh, oh. What the hell did I do?"

Or does object, but the objection is over-ruled.

No means No in any State of the United. When a person of any age, in any relationship, says no and is overcome by someone who thinks that no is really yes, it's rape. Believe it or not.

But what about when you're of age and you say yes and you're high? Is it rape then?

Well, yes, if you weren't in a state of mind to give informed consent and wouldn't have said yes, were it not for the Ecstacy or whatever designer drug it was that you or someone else added to your evening.

Do you see how iffy things can get?

Which leads us to Winter Break, which is almost over. Winter break, summer break, spring break, these are peak therapy times. Kids come home and they don't look so good.

And it is often about trauma. We can thank federal initiatives. College coeds now know the definition of all kinds of rape because of federal funding. Educators, some of whom are peer counselors, some teachers, some social workers or rape victim advocates, are running workshops on campus.

And sometimes this education triggers memories of experiences past.

Research (I've read, mountains of it) suggests that if you were violated as a younger person, that you will be violated again as an older person. Something about self-esteem and unresolved issues.

So people like me see young people, mostly college students, during winter break, kids who are remembering the iffy times, those one-night stands, the stoned sex they thought they wanted at the time. Some have new content to add to old.

It's a therapy for post-traumatic stress.

You know, I could easily have waited to post this one, but winter break is almost over. If you think you need it, get some therapy on campus if you're heading back to school.

And if you want a few more stories on the subject, read my post on innocence lost at TheSecondRoad.

Or check out Mama Mia. There is a subplot about the unintended, if not traumatic, consequences of unbounded sexuality, normal sex as we're defining it in the twenty-first century.

I'm telling you. The movie's not that bad!

therapydoc

*When I say "our" attention, I mean that generation of mental health professionals.

**Yes, I am being sarcastic, or would you prefer, facetious.