Reflections on Suicide From a Retired Psychotherapist

⚠️ WARNING: This article contains content about suicide.
Hand open the curtains,low light
⚠️ WARNING: This article contains content about suicide.

The first time I tried to end my life by suicide, I changed my mind at the last minute. I was in my late 30s, depressed, having left a job for which I was unsuited and had moved, reluctantly, to a city far away from home. My girlfriend didn’t want to join me. I parked in a remote spot with a hose leading from my car’s exhaust to the driver’s side window where I was sitting. The motor had been running for quite a few minutes and I was beginning to lose consciousness. As devastating as it felt, it dawned on me that being rejected by a girlfriend was not a good reason to die. Just in time, I opened the car windows, removed the hose, and drove home. 

When I arrived, I put the hose in a closet, thinking I might want to use it again. The next morning, a colleague who had no idea what I was going through asked how I could always be so cheerful. I was good at putting on a happy face no matter what was happening to me. 

The second time, about a decade later, was a much closer call. I ended up recovering in a hospital psych ward after the emergency room charcoal treatment cleared my system of the overdose. At that time, I was the ongoing recipient of many years of effective and useful therapy and was taking prescribed anti-depression medication. I was a well-trained psychotherapist with a thriving practice and a co-author of my professional association’s Standards of Practice. Nevertheless, when circumstances arose which felt intolerable, I didn’t give even one second of thought to the impact on other people if I killed myself, or to any of the many reasons not to.

What I remember

Painful as it is to think about it, over the years I’ve reflected on what it was like when I tried to kill myself that second time. A dark black curtain seemed to fall all around me. It included nobody and nothing else. All that existed was me and the surrounding darkness. The idea of falling asleep and never waking up felt entirely comforting. There was no anxiety or fear. It felt like the only and right thing to do. 

I put a note on my door saying the office was closed today. Then I lay on my couch and took all the pills from the three bottles I’d placed on my coffee table. I drifted off into a deep sleep where I felt, saw, heard, and thought nothing. 

And that was it.

Except that a family member realized she hadn’t heard from me in 24 hours (which was highly unusual) and she asked one of my old friends to check on me at the office. He did. He found me passed out on the couch and couldn’t rouse me. He called either the police or an ambulance and I ended up in the emergency ward. Because I was unconscious through all of this, some details are a bit fuzzy to me. 

Later, the chief psychiatrist at the hospital apologized to me for the rather grubby décor there. I told him not to be the least bit concerned. I was quite content and grateful (once I got over my surprise at still being alive) to be taken care of in safe surroundings. The drab walls and shabbiness of the furniture were of no importance. 

What I know with certainty

As a now-long-retired psychotherapist looking back not only on my own suicide attempts but also on those of my clients and the clients of my colleagues, it seems clear that not every suicide can be prevented. A person determined to kill themself will do so if they have the means and the desire. 

For example, a mental health professional telling a profoundly depressed patient, “I will stop being your therapist if you threaten suicide,” or “you must tell me if you have a suicide plan,” or asking, “will you call me if you’re contemplating suicide?” is generally a waste of breath. When things feel so bleak that killing oneself seems to be the only answer, following an agreed-upon safety plan goes right out the window. 

One of the more shocking aspects of my own suicidal episode was that the wife of the friend who found me at the office was furious with me. She was religious and excoriated me for sinning in this way. How could I possibly have abandoned my children like this? Why was I being so selfish? Didn’t I realize the pain and worry that I had caused? She didn’t talk to me after that. Sadly, that kind of judgement is still common. 

Wondering why?

Ideally, if we’re close to someone who appears to be contemplating ending their life prematurely, it’s helpful to wonder why, instead of judging or criticizing them. What might be happening that would cause them to want to take such drastic action? To believe they ought to be grateful for what they have, or that they should realize that they’re not alone in the world, or that you’ve had it much harder than them and it never crossed your mind to kill yourself, completely misses the point. 

Suicidal feelings can have lives of their own separate from the reality of the world as seen from somebody else’s perspective. 

At times, in any individual’s life, normal day-to-day existence can seem intolerable, their feelings overwhelming and the depth of despair out of proportion to another person’s “objective” view of the circumstances. 

A profoundly depressed person may or may not be helped by medication, brain stimulation technology, loving support, deep understanding, or distracting activities. There is no one-size-fits-all formula that guarantees that someone determined to die will have a change of heart. And if someone you care about does kill themself, it is easy to become a victim of their suffering by thinking that if only you had done something more or different, they might still be alive. But they might not. For them, it is over. Tragically, they left the world far too soon. We can mourn their loss. But we will never know if there was one thing which would have stopped them from ending their life. Ultimately, it was their decision and nobody else’s. 

Don’t get me wrong. As a therapist, I’ve never been the least bit cavalier about clients who showed signs of suicidality or who threatened to kill themselves. In my two decades of practice, not one client died by their own hand, not even the one who threatened death by suicide regularly and frequently. Initially, their intense declarations alarmed me, but I came to understand that what they meant was that they felt like dying and as if they were dying, but they didn’t want to die. They wanted to feel better. From time to time, they still threaten to do it, but are very much alive even though it can be a struggle for them to stay positive.

How to offer support

If someone appears to be in danger, there are many responsible choices to be made, including taking them to a hospital. Or making sure that families and friends are on the alert, ready to take measures which might prevent the individual from ending their life. Above all, it is essential for therapists (but much harder for friends and family) to allow the suffering individual to express anything and everything connected with their most negative thoughts and feelings – and to listen with deep empathy and without being in any way judgemental. 

Exploring the consequences of this “permanent solution to a temporary problem” may or may not be helpful. Suicide is seen and felt differently by the person who is contemplating taking their own life. They are not looking objectively from the outside in. They are suffering internally in a way that reason or logic may not penetrate. Their perception of reality is distorted and that perception may feel solid and brilliantly grounded to them while seeming off-balance and make no sense to a family member, a friend or even their therapist. 

They may be trapped in rigid thoughts of escape from the pain of overwhelming insoluble (to them) circumstances. Their own shame may lead them to believing they don’t deserve to live or that the world will be better off without them. Shifting their thinking so they can see a more constructive route is achievable with some individuals but not possible with others.  

As for me, I’m very glad I’m still alive after my two attempts to die – many years apart and now long ago. Had I been “successful” I would not have known what I was missing, and the burden of my absence would have been borne not by me but by those closest to me. 

In that sense, by failing to kill myself, I avoided inflicting pain on them. That’s one good reason for me to go on living, and luckily, these days, that’s no hardship at all but a great pleasure.

I can’t easily explain how, when I survived my own suicide attempts, my mood shifted. With enough bouts of depression, I began to see that I could survive them, that the depression always lifted and life carried on. I was lucky to have supportive friends, family and colleagues. Circumstances changed, relationships came and went. I found myself enjoying many kinds of activities. Working through my complex issues with the help of therapy also helped.

My reaction to life shifted from responding to everything I felt and experienced as if it mattered greatly, to noticing that as my feelings changed from moment to moment, day to day, and month to month, the experience of observing how I felt and noticing what was happening seemed to anchor me solidly. Instead of reacting to everything viscerally, I began to watch the process of “being” with a kind of positive, detached, benign, sometimes amused or ironic sense of appreciation. Letting go and not trying to control how things turn out was both life-affirming and liberating. And my professional work as a psychotherapist (intimately connecting with other people who needed my full attention and support) profoundly distracted me from my own challenges and put my woes (when I was woeful) into perspective.

Now, with no thought of attempting suicide again, I’m comforted by the idea that being dead is not the worst thing that can happen to a person. And perhaps that can be a comforting thought for you too if someone you love has ended their own life by suicide. What happened was tragic and is now irreversible. But as deep and as permanent your feelings of loss may be, their suffering is now less than yours. Given what I know of the punishing, relentless darkness of depression and hopelessness that some people with intractable and complex mood disorders or profoundly challenging life circumstances endure, they are now at peace. And they would wish that you go on living as fully as possible without them.

Eli’s Place will be a rural, residential treatment program for young adults with serious mental illness. To learn more about our mission and our proven-effective model click here.

David Schatzky | Eli’s Place Volunteer

David Schatzky retired from his psychotherapy practice in 2016. Before that, for over 20 years, he was a CBC Radio broadcaster. He now enjoys painting, and writing plays.

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