Trapped In Mental Anguish — Chapter. 3

Written by Andi Bazaar & Oliver Schofield Tydalé | July 24, 2022

“I don’t think people understand the reality of what happens when police show up to your house for a wellness check or “safety intervention," if you survive it’s enough to traumatize you and stop you from ever sharing your truth again.”

FORCED INTO A LIFE OF EMOTIONAL ISOLATION

And that’s if you’re lucky, if you’re lucky to survive. This is not a gamble I want anyone to have to take, it cannot be an option. That’s what we need, a world where this is not a fucking option.

The day I was restrained by 5 cops on my front lawn, one of them said to me: “you can get in the ambulance like a good girl or we will take you by force.” — I’ll never forget it because it sounded exactly like what one of my rapists said to me, comply or I’ll do it with force.

The fight for bodily autonomy is inherent to Disability Justice, Mad Liberation and Police Abolition. Most importantly: "we will never truly have bodily autonomy without abolition — cops, abusers and psychiatrists have all use the same words and strategies against me &and many others."

Thoughts from a suicidologist on the new 988 crisis hotline:

• having a simple number is good.
• having more trained crisis teams is good.
• it’s still linked to nonconsensual active rescue which means they can and will trace your call + send police if they deem it necessary.

This is hugely problematic and a barrier for folks who want help, they won't call if they know it's not truly confidential. This is for a good reason, as people can and do get fired from jobs, lose housing, lose access to their kids, etc after being deemed a danger to themselves.

Second, police kill people with actual or assumed mental illnesses at very high rates and they're rarely trained for mental health crisis intervention. They're also an organization based on containment and punishment, "not care or healing."

These issues with police violence are even more prevalent when the person in crisis is a person of color, a trans-person, an immigrant, and or a member of other marginalized groups often facing violence at the hands of police.

Non-consensual active rescue often leads to nonconsensual treatment (being locked in a psych ward without consent), this type of "carceral care" is an incredibly violent and dehumanizing process and suicide risk skyrockets after release.

Here's a great article by "Trans Life Line" about why they never engage if you nonconsensual active rescue:

https://translifeline.org/why-no-non-consensual-active-rescue/

Here's an op-ed about 988 and its downfalls: https://slate.com/technology/2022/04/crisis-lifelines-surveillance-geolocation-algorithms.html

A bit more about nonconsensual active rescue from "Mad In America"

https://www.madinamerica.com/2020/11/suicide-hotlines-trace-your-call/

Official info and FAQ on 988:
https://www.samhsa.gov/find-help/988/faqs

Folks if you are arguing that 988 doesn’t use geolocation, two notes on this:

• the intention behind 988 is to link callers to local crisis centers, right now this is done by area code while the organizers sort out the best tech to make full geolocation happen.
• the infrastructure for all of these local crisis centers just isn’t there yet, if they aren’t present or are currently at capacity 988 is acting as a shortcut to the "National Suicide Prevention Lifeline," which openly uses geolocation and engages nonconsensual active rescue.

This means 988 callers can't be sure whether or not their calls are confidential, there's no clarity on whether or not carceral care is on the table. For a crisis line to be most effective, transparency and consent are key.

SUICIDE + TRAUMA

It felt really unsafe to share this explicitly until now but some weeks back I was driving along a freeway at night, trying to work out the best spot to crash and die by suicide. Thankfully I’m still here and I want to share some reflections.

“because the world we live in is so captured by psychiatric narratives, i have to start by saying i am safe now and i have supports.”

I hate having to say this, it’s bullshit but I’m scared people might report me, scared of violence by cops and psychiatry.

That night on the freeway, I realised suddenly that other people would be in danger if I did this. Maybe even kids? No, no, no! It shocked me into pulling off the road. I started shaking, I sobbed then I called a mate to keep me distracted til I could drive home safely.

The days leading up to that and every day since, have been filled with emotional pain that felt excruciating, unbearable and for a time I lost hope it could change. It’s been hard to understand what I’m feeling exactly, it’s layered and messy but there’s shame, fear and hurt.

That night I was driving home from the town where my dad died recently, it was also the town where I was sexually abused. I was wondering if I was anywhere near where it happened and then I don’t know, I guess I’d had enough of hurting no more.

I think maybe there’s been too many big hurts I’m holding. The other teen rapes, being silenced by mum. Bullying, countless cruelties in psychiatry that left me a dehumanised shell. The pain of activist work that never ends.

I work non-stop, I’ve got surgery coming up plus this damn opti diet they insist on and for the first time in my life I am trying to connect with my body — something I have never accepted or cared for, it’s bringing a lot up.

Any one of these is a big thing I suppose, I knew the emotional weight was getting too heavy but I guess I like to pretend I can deal with anything. I forget that healing is not a thing we ever finish and the work I feel like I must do — sometimes it feels like it’s tearing my heart out in slow motion.

Like other times suicide has come to visit, it smashed through fast and powerful. Thankfully I could see that while parts of me wanted to die, much more of me wanted to live. Those parts helped me connect to folks I trust and to life but that left me with the pain.

Old self-injury urges rushed up stronger than they have in the last decade and I feel awful, but a few times I caved. I wanted to stop the pain so badly, I needed respite it was eroding me. I’m working on accepting my survival skills, that’s hard sometimes.

I feel like I’ve experienced decades in the past 3 weeks and there’s another thousand years to go. I’m not gonna share it all, I’m still trying to work it out and to keep myself in less painful spaces. I am blessed with incredible support people and friends but I do want to say that most of the info out there about suicide bloody sucks especially advice for "supporters."

So much of it says to get us "professional help from a GP," to call 000 or to refuse to keep what we say private. For me anyway it’s awful unsafe advice, many of us advocate to stop using the term "committed" suicide because suicide is no longer a crime but really? That’s a lie shit!

Because we still get locked up and I’m saddened by how that reality made my recent experience with suicidality more scary and unsafe. I've had people do these things to me before, whats it’s meant is cops yelling and threatening me, being stitched without anaesthesia, forced drugs or being left naked in EDs with male security guards hovering.

Calling 000 is about everyone else feeling safe, not us. So there’s not a chance in hell I’d call a crisis line for help even though many nights I wished I could they are not actually safe or trustworthy.

Thankfully I did trust a few folks I know and they were so worthy of it, this has all been a shock to find myself here again. I feel this pressure to be some kind of positive example, yet really that’s a silly idea.

I’m just me, life is messy and I think this "here" is kinda different. It’s another, deeper layer maybe. I am changing somehow I hope.

I am still working through this, probably will be for a while but it’s begun to lighten and shift, tendrils of hope and wisdom are slowly wrapping around me. I’ve found some ways to get respite while I process, I am taking small steps forward. Yesterday I even laughed with friends.

If you’re where I’ve been, my heart and hope is with you. I wish we lived in a world where it was safe to get help, I wish we lived in a world where we weren’t hurt in the first place. I want to keep reaching for that world, so I’m sticking around even though it hurts.

Many therapists don’t know what they don’t know about "Suicide Risk Assessment."

Some mental health prof’ls got upset wuth me this week for saying in the NYT that some therapists don’t ask about suicidal ideation, even with depressed clients.

The psychologist who started the pile-on said he asks abt thoughts of “harming yourself.” — well, that’s not asking suicidal thoughts.

Sure, you might consider harming oneself to be suicide and suicide to be harming oneself. That’s bc suicide is so taboo that we’ve created euphemisms for it but not all self-harm is suicide and not all suicidal people see suicide as self-harm.

Self-harm can include many things that are not suicide: "cutting without no suicidal intent, head banging, burning oneself without cigarettes, pulling hair out, etc."

https://medlineplus.gov/selfharm.html

Many suicidal people don’t view suicide as self-harm, they view it as self-deliverance. In their eyes, suicide isn’t hurting themselves. In their eyes, suicide ends the hurt.

It can seem like I’m nitpicking about semantics, I know. Definitions aside, everyone knows “harm yourself” and “hurt yourself” are code for “kill yourself.”

So what’s wrong without using code? What’s wrong without using code for suicide is it perpetuates the idea that asking, talking and thinking about suicide are shameful and bad. It treats suicide as unspeakable, that which must not be named.

Therapists, of all people should be able to name suicide and speak of it.

"When asking about suicide, be direct. Use specific wording such as 'kill yourself,' 'suicide,' or 'take your life.' I don’t think lethality inquiries are any place to risk misunderstandings.” — Shawn Shea, MD: Practical Art of Suicide Assessment

"If therapists won’t talk directly and specifically about suicide, how can we expect clients to?"

If you want to know if someone is thinking of harming (hurting) themselves, by all means ask if they’re thinking of harming themselves but if you want to know if someone is thinking of suicide ask that.

Asking about suicidal thoughts means asking about suicidal thoughts, for examples:

• “do you have thoughts of suicide?”
• “are you thinking of killing yourself?”
• “do you want to end your life?”

If you want to know about self-harm and suicide, great. Ask if the person is having thoughts of self-harm or suicide but name suicide. Be clear and then talk separately about suicide.

There are cultural considerations, in some cultures talking about suicide or death in general is considered or disrespectful or even forbidden but the suicidal mind doesn’t submit to taboo.

Not talking about suicide doesn’t = not thinking about suicide even in cultures where speaking of suicide is verboten suicidal thoughts still come.

Shouldn’t people who experience them have someone they can talk to about them without rebuke?

I give other advice on how to ask about suicidal thoughts here, using validity techniques described by psychiatrist Shawn Shea.

https://www.speakingofsuicide.com/2013/05/15/uncovering-suicidal-thoughts/

A suicide risk assessment shouldn't be an interrogation, it can and should be a conversation even if you're required to use a specific protocol such as the "Columbia Scale" you can still invite the person to tell you the story of how they came to think of suicide.

This article is not intended to convey that all therapists don't talk openly and directly without clients about suicide, of course it's not all therapists but some therapists don't.

If you're reading this because you have suicidal thoughts and want to see a therapist, good help is available but you might need to look for it.

https://www.speakingofsuicide.com/2013/07/22/therapists-who-do-not-panic/

I’m not a fan of risk assessments but I am a fan of being able to talk frankly about ssuicide followed by empathetic, rights-based support. This article does some good myth busting on that and yes self-injury is different.

Here’s a few bits I’d add from lived experience.

If we say we’re thinking about suicide, don’t panic. It may or may not be a crisis, it may feel odd to you but some of us have thought about suicide for decades regularly. I consider myself largely healed but I still have regular suicide thoughts. (don’t panic, i’m ok!)

It’s helpful to understand the different nuances of how we are thinking about suicide, are thoughts abstract or occasional or a lot or increasing but for how long? and is it a thought (‘I could’) or a desire (‘I want’) or an urge (‘I need to’) or a plan (‘I’m ready’).

THE BIG QUESTION IS WHY?

Suicide is not a meaningless sign of "mental illness," — typically it’s a sign of two things:

• the person is feeling unbearable pain (any type).
• the person has lost hope it will change.

If you want to help, you need to understand these whys. More than that you need to listen really well, stay out of judgement and demonstrate excellent empathy.

We are not going to talk to you if we think you don’t care, you should care and you should show it.

Know that the simple (not really simple) act of listening can have healing value all by itself, often not enough but sometimes it’s enough. So do really good listening!

You need to do something if we want you to, you should ask if we know what would help then help us to get that. Sometimes we’ll know, sometimes we won’t.

Please don’t suggest we try a bubble bath, it’s a really dumb idea if we’re wanting to die for so many reasons. If we’re not sure what might help, focus on exploring with us ways to alleviate the unbearable pain. Right now and short term or long term later.

You could talk about hope but that’s a much tougher gig when we’re in this place, alleviating pain will help with the hope anyway. You might ask if there are people or places that feel safe or comforting to us, maybe we could access those supports.

We may feel too ashamed to ask for support so we might need a hand or not. Ask!

Please, don’t call the cops, the ambo or a CATT team unless of course we want you to. Then do. Forcing us into a carceral system at our darkest hour can really add to unbearable pain and hopelessness kinda the same with psych drugs.

Ask if folks find them helpful, sometimes drugs can really help in a crisis or sometimes they can make everything worse. Rights-based support recognises that people can and should make their own choices about what happens to our bodies.

“think and ask about trauma, adversity and existential crisis. most often, there is a reason out in the world at the base of our distress.”

Be an ally in naming these structural issues, help break them down if you can. Don’t just individualise the issues in us.

I’ve had so many suicidal crises over the years, I’ve had coercion, judgement, compassion and sometimes nothing at all.

What sticks with me most are those folks who could just be with me, in the pain. Not trying to fix me and not leaving me stranded. Be with people, be allies.

A Special Thanks To:

• Dr Oliver Schofield (Co-wrote)
• Henrie Louis Friedrich (Analyst)
• Clayton Euridicé Schofield (Journalist/Editor)
• Style and GQ’s Studios by José Schenkkan
• Timothée Freimann schofield (Photographed)
• Benjamin Schenkkan Joseph (Model)
• In collaboration with: The Me: You Can’t See