The three common elements of suicide

From my perspective, all suicidal gestures and actions, no matter how large or small, injurious or lethal, share these three elements:

  • Pain
  • Disconnection
  • Disenfranchisement

Pain means any and all pain in all its permutations—be it physical, emotional, mental, spiritual, or any combination thereof. Pain hurts. When we are in pain, we have one goal: to stop hurting. We do everything we can to get out of pain. Often, we don’t care what it takes to be pain-free; we just want the howling, can’t-take-a-deep-breath or think-clearly pain to be over as soon as possible.

Constant, chronic pain—of any variety—changes people. Pain is exhausting and debilitating. Pain makes us cranky and intolerant. Pain wreaks havoc with our sleep cycle. It rearranges our thinking as well as diminishes our ability to cope and withstand the vagaries of everyday life.

When we are in pain, we contract into ourselves. Our world becomes smaller, darker, and enclosed. We shut out the world. There is only so much bandwidth, and we use it to manage the pain. The only thing that matters is to be pain-free, now. And, unfortunately, that can sometimes result in a suicidal action.

Disconnection speaks to the separation between the self and others. Separation is the operative word. We feel unwanted and unloved, alone and isolated, misunderstood and alien. There may be no one in our corner or no sense of connection with another person, a group of people, or a higher power. We can even feel profoundly disconnected among family and friends, who do not understand us and, more pointedly, do not comprehend what we have experienced and what has happened to us. This can be the height of loneliness.

We know from research that people who feel socially isolated (i.e., divorced, widowed, etc.) are at increased risk for suicide as compared with those who have responsibility for family members and are part of some kind of social grouping, network, or organization.

With disconnection, it feels as if there is no tether to stay anchored and grounded on the earth plane. We are alone. No one gets us. This is particularly true of survivors of a suicide loss, the military and veterans, and survivors of childhood sexual abuse.

Disenfranchisement, in the psychological sense, is disconnection to the nth degree. It is the ultimate sense of disconnection; it’s as if we are looking at the world with our nose pressed to the glass. We do not feel that we belong, nor are we connected in any larger sense. We are no longer a part of the whole. We are a free-floating entity adrift in the world, alone, without value, purpose, or plan. There is no meaning in our life. We feel invisible and worth nothing. This is the utmost of pain.

All three elements — pain, disconnection, and disenfranchisement — take us to shut-down, closed-off places. This leads to inactivity, inertia, passivity, and powerlessness. We feel stuck. We have lost our abilities to be creative and expansive. There is precious little energy or flow. And, from that position, it is easy to become dispirited and hopeless, which is another kind of pain. And pain of all kinds can lead to suicidal thinking and action.

Suicide is a complicated and multi-factored issue, and yet there are three common elements that serve as the foundation to suicidality. These elements address the full spectrum of suicide. They can help us understand the ineffable “why” of suicide and, also, serve as warning flags for the future.

These three elements also underscore our need to find better ways to reach out and provide safety nets, support, and aid for our most vulnerable and traumatized.

Some thoughts on peace

In honor of International Peace Day, September 21, 2017….

Ideally, peace is our natural state. More often, peace is hard-won. It takes lots of practice to find peace and lots of hard work to create, much less maintain, a state of peacefulness. When peace does come, it can be a blessing or a miracle. We can take a full breath. We are no longer conflicted or distressed. We have learned to let go, allow, and, most importantly, accept, even the unacceptable.

With peace, we reclaim the vital energy needed to support our life and future happiness. Peace is the root of all healing. Without peace, there is no healing, and we hemorrhage our own life force.

In our chaotic and fractious world today, we need peace more than ever. In our personal lives where there is deep grief and heartache, peace is the ache of our heart.

May this blessing lift your spirits and soothe your heart.

Deep Peace, Deep Peace
Deep peace, deep peace of the running wave to you;
Deep peace of the flowing air to you;
Deep peace of the quiet earth to you;
Deep peace of the shining stars to you;
Deep peace of the gentle night to you;
Moon and stars pour their healing light on you.
Deep peace to you.
Deep peace to you.

—Traditional Gaelic Blessing

Sally’s Story

Sally and Pete had found each other. It was the second time for both of them. This time, they both felt like they had hit the jackpot. They simply loved being together and enjoyed their small adventures, like traveling to the shore for lunch or even playing toss in the grocery store. It was always fun, always a good time. Pete lived in the here and now. He was playful and spontaneous. He was Sally’s best friend.

In 2001, Pete was diagnosed with prostate cancer and underwent a radical prostatectomy. Pete never wanted to know the details of his medical condition; he focused on getting better and had Sally act as his point person. Sally researched his illness and did everything she could to keep Pete healthy and alive. The doctors finally convinced Sally to accept and believe that Pete could live a long life, given that his type of prostate cancer was slow growing.

In the fall of 2005, Pete discovered a sore in his mouth. The dentist sent him to an oral surgeon, who, in turn, scheduled Pete for a biopsy. The oral surgeon was vacationing when the pathology report came in. The pathologist called Sally and said, “What are you guys doing? You can’t wait. Your husband has stage 4 oral cancer.”

Sally was furious. Totally enraged. Pete had been smoking cigarettes on the side. She didn’t know. She was madder than hell at what he was doing to her and the kids. He was destroying his life as well as hers.

They were referred to a specialist for surgery. The surgery was botched. Pete left the hospital with an infection. There was chemo and radiation and a referral to an amazing doctor in New York City. There were more surgeries. They cut open Pete’s jaw and neck to take out the infection; they stripped muscles from his chest and wrapped and packed them into his neck for his body to absorb and fill the spaces where there had been infection. His neck was like raw meat. Over and over, there were surgeries—and there were infections. Through all of this, Sally had the utmost confidence in Pete’s doctors and knew they were doing everything in their power to save his life and restore him to health.

Sally learned how to dress and change his wounds with special gauze pads and sterile gloves twice a day. She dealt with doctors, as Pete never wanted to know the nitty-gritty. He was focused on beating the cancer.

Sally had returned to work when Pete got sick. She never missed a day of work. She couldn’t. She used her vacation days for surgeries.

There was unbelievable stress. “I wanted him to live. I wanted my life back. I did everything I could. My emotions were all over the place—I loved him with all my heart and soul, but at the same time I felt betrayed and was so full of anger because Pete continued to smoke after he had been diagnosed with prostate cancer in 2001. I totally believed he had quit. I had been working so hard to help him beat the prostate cancer that when the oral cancer diagnosis was delivered, I felt like I had been punched in the stomach. I had been fighting for his life and he was destroying his life with smoking behind my back.” It took a tremendous toll on them both.

In the summer of 2007, Pete realized he couldn’t beat it. He had no quality of life. He had already undergone several major surgeries, and more were on the horizon. He wasn’t going to live this way and be a burden to his family. Pete started talking suicide. Sally would hear nothing of it. This was too painful. Sally had lost her dad to suicide.

Pete took his case to the Ethics Committee of the hospital, and they ruled he could stop the feeding tube and refuse any artificial feeding methods.

Sally was beside herself, stressed, and furious with Pete. “It was hard enough watching him die.” Pete was unable to eat or drink anything from March 2006 until he died in September 2007. During the last few months of his life, it became increasingly difficult for him to talk; in fact, Sally’s nerves were so raw that it became difficult for her to understand what Pete was saying.

“We resorted to having Pete write out his part of the conversation and I would answer him. My nerves were shot. I had a hard time focusing and was fighting for my own survival. I was not in a good state of mind. At times, I was a total witch with him. I couldn’t eat. I was taking care of Pete, doing the best I could while working full time. I didn’t know which way to turn. I just wanted off the merry-go-round and a return to normalcy. I wanted my husband and our lives back!”

Another surgery was scheduled for early October, 2007. It was Labor Day weekend, Pete was home that Saturday, and Sally was working. Normally, Sally’s daughter would stop by unannounced to check on Pete. However, that weekend the kids were away. When Sally got home from work that day, there were notes on the doors.

Pete had left identical notes on both the front door and garage door: STOP. DO NOT COME IN. CALL THE POLICE. Sally knew immediately and ran to her neighbor’s, banging on the door, telling them to call 911 and saying, “Pete killed himself. I know he killed himself.”

The police arrived. They took Sally’s door keys, opened the front door, and her dog came flying out of the house. The police cut Pete down and put him on a stretcher. (Pete had used the most vulnerable part of his body—his neck with the tracheostomy opening and skin grafts—and hanged himself. He had been hanging there awhile.)

Sally was told that Pete was conscious and still alive, but the scene was too gruesome and they would not let her see her husband at that moment. They medevac’d Pete to the hospital. He flat-lined in the helicopter, and they brought him back to life. When Sally arrived at the hospital, she fully expected that Pete would be awake. It turned out he was on life support. The hospital kept Pete alive for another day so that the kids could make it home to say their good-byes.

When Pete died, Sally had so many emotions she thought she was going to die. Her weight had plummeted to 102 lbs. Sally was furious with Pete for taking his life. How could he? Sally was at a full boil, full of fury and deep despair following Pete’s death. She spent the next year living her life on autopilot, going to work, eating meals over the sink, walking the dog when necessary, and retreating to her bedroom. There was precious little relief.

For a solid year, every day, Sally looked for a note from her husband. “I thought he died hating me because of everything we had gone through. I was a witch, fighting for my sanity. My pregnant daughter needed a biopsy in July, and that was two weeks of torture. There was so much going on. ”
One year to the day after Pete’s death, Sally was in the garage, getting ready to do yard work. She noticed a police car driving around the circle of her street. She knew they were there for her. Sally went to the front of her house and there was the police car.

Chris, the police officer, told Sally that something told him to get the note and come today. “If you don’t want it, I won’t give it to you.”

Sally said, “I’ve looked for a year for a note. I thought Pete died hating me for everything I said and my inability to maintain my sanity throughout our ordeal.” Of course, she wanted the note.
Chris handed Sally the original note that Sally never knew existed.

Sally couldn’t read the note by herself. She read it with her daughter. Pete had written paragraphs to everyone—Sally, the kids, neighbors, favorite aunts, uncles, and cousins. He said it was his time to go. He told the kids how proud he was of them and reminded them that “Mom will need you now.” He thanked the neighbors for their help and support; he told anecdotes of happy memories with his relatives. And to Sally, Pete told her he loved her, he was sorry for all the hurt and pain. He apologized for his stupidity in smoking. And, if there is another side, he said he will be there waiting for her.

Given her initial rage, Sally later said that if she had found that letter when Pete had first died, she would have torn it into a million little pieces. Now, his note is very precious to her, and she is so thankful for it.

“My husband gave me the ultimate sacrifice: he killed himself so I could live. I owe it to him to live. It took me a long time. I was not sure I wanted to live. Now, I look forward to life…never thought I’d say that. There is happiness beyond it all. You have to want it and you have to work for it.”

Wise words from a survivor


If I had to tell someone who is a survivor of a loved one who committed suicide, one piece of advice I would say is experience the wound; experience the shock, the trauma, and let it wash over you knowing it won’t destroy you, and trust that in time, like all wounds, you heal, and feel peace that your loved one is no longer suffering.

These and other sage words of wisdom, advice and counsel are included in Making Peace with Suicide: A Book of Hope, Understanding and Comfort.

Resting in peace


Make peace.   Find peace.    Rest in Peace.  Be at peace.  Give peace a chance.
Peace be with you.

Peace is part of our everyday language. The word is familiar. It conveys warmth. It speaks of an absence of war, conflict, and struggle. Peace rests in the geographic center of grace. Its voice is calm, tranquil, and serene.

When we are peaceful, we are no longer at odds with the world, our loved ones, or ourselves. We are not being defensive, nor are we playing the offense. We are detached and neutral. We rest in emotional and mental balance. Free-floating, we are nurtured in a sweet pool of equilibrium.

Understanding helps us heal

After you have lost a loved one to suicide, you feel anything but powerful or strong. Most likely, you are at your most vulnerable, full of heartbreak and deep grief.

Suicide leaves a trail of questions and uncertainties. Knowledge can help make some sense of the unimaginable. When we learn more, we have a basis for comparison. We realize, perhaps, that our situation is not so unusual. Plus, we can accept more fully the biochemical or psychosocial elements that have led to a suicidal action. When we understand more, we are no longer so confused, confounded, or upset. We find steadier footing, and we find ourselves more emotionally and mentally stable. Indeed, knowledge can serve as a powerful healing ally.