Suicide: A Personal Loss

Yesterday morning I was sitting at the breakfast table, sipping chai tea when I received a text message from my mother saying, “Let me know when you’re up and around.” A pang of fear punched me in the stomach for a moment. I thought, “Grandma must have passed away.” She’s been sick for a long time, my grandmother, and we’ve all expected her to pass at any moment. I sat with the thought for a moment, and decided that it was OK if she was gone–it was time.

I texted my mother back saying, “I’m up and having breakfast.” A moment or two later my phone rang. I picked up.

“Good morning, Mom,” I said.

My mother’s voice was grave, “I have some bad news,” she said.

“OK,” I replied.

“It’s really bad,” she said.

That pang in my stomach was back. Maybe it wasn’t about my grandmother. “What is it?” I asked.

“Ian killed himself,” she said.

My lungs forgot how to take in air for a moment. Ian was my cousin. I’d grown up with him. My eyes welled up with tears and I sobbed in a breath. Tears ran down my cheeks. A moment later I recovered myself enough to ask for details, but everything I learned made me feel worse.

I thought of my aunt, Ian’s mother, and of Ian’s brother. Their hearts must be broken. I cried for them. I thought about how much pain my cousin must have been in that he felt that death was the only escape, and I cried for his pain. I thought of the rift in our family caused by suicides–this is not the first one–and I cried for that great gaping hole of loss. I thought about what it must feel like to lose a sibling, and felt a surge of love for my brother and my sister, and sent them a message telling them how important they are to me. I don’t say it enough.

I called my friend, Jessica, and she listened to me while I cried, and then suggested we meet at the mall. So, I took my feelings shopping. I’m not ashamed. Later on, I met up with another friend for wine and conversation. I am so grateful for my support system. I love you so much.

I have experienced suicide from all angles, and possess a knowledge of it’s intricacies that few people do.

As a therapist, every day I ask the question, “Are you having thoughts of killing yourself?” It is a question that most people fear to speak out loud, but it has lost its power over me. I say it without even thinking–like most people ask about the weather. Much of the time people say no when I ask this question. But they say yes more often than you might think. An unexpectedly large portion of the population walk around thinking that they would prefer to be dead. I believe this is a symptom of just how sick our society truly is. We need to be kinder to each other. We need to show each other more compassion. We need to learn to love ourselves more. I do my best to guide people towards love.

What I don’t tell these people is that I truly understand their pain and their hopelessness, because I have been there myself. During the worst part of my illness, a neurologist told me that there was nothing more to be done for me, and that I would, “just get better with time.” I was so ill that I was completely unable to function. I couldn’t eat, keep food down, sleep, think straight. Over the course of a few months I had gone from a vibrant and self-reliant woman who loved to dance to the kind of person that the nurses recognized as a frequent flyer in the emergency room. I didn’t have time. I was dying and it was taking too long, and hearing that there was nothing more to be done nearly put me over the edge.

I had a plan. I would go to the beach, take a handful of the random pills doctors had prescribed to me and swim out into the ocean, never to return to land. I even drove to the beach and parked there a few times, but I didn’t get out of the car. I kept thinking about what it would do to my mother. I thought, “Let’s give it a month and see if I feel better.”

Miraculously, I did feel better. Only a little bit, but enough to give me hope. And then the next month I felt still better, and so on. I am healthy again, and living a full life.

While I wish I never had to go through that hopelessness, I’m glad that I gained that insight into suicidal thoughts. It makes me a better therapist. I can truly empathize with the feeling that death is the only way out.

Usually, however, it’s not true. Usually, there is another way.

When people are in the depths of severe depression, their minds tell them things that aren’t true. These thoughts are symptoms of severe depression in just the same way that fever and chills are symptoms of the flu. These thoughts do not reflect reality or truth, but they feel like they do, and people are so uninformed about the symptoms of depression that they often mistake these thoughts as truth when they are really just symptoms.

One of the things that Depression says is, “Death is the only way out of this pain.” Unless you are terminally ill, this thought is a lie. If you wait, the pain passes. This thought is a symptom of depression and nothing more. Don’t believe it. Get help.

Another thing that Depression says is, “The people in your life will be better off without you. You are a burden to them.” This is also a lie. The people in your life love you and want you to be in the world. They would rather help and support you through a depression than lose you to suicide. I promise you that.

Lastly, Depression likes to say, “The people in your life will be OK with your suicide. They might be sad for a bit, but they’ll get over it and go on with their lives as before.” I have had intimate therapeutic conversations with the family members of people who have suicided, and I know that they mourn the loss for the rest of their lives.

Depression lies. Do not believe it.

If you have been having suicidal thoughts, please get help. Go to your nearest emergency room, call 911, make an appointment with a therapist, or call a suicide hotline. There are many, but the National Suicide Prevention Lifeline is 24 hours per day, and the number is 800-273-8255.

If you are the family member of a suicidal person, please take their suicidal thoughts seriously. You would be shocked by how many suicidal clients have shared that they told a family member about their suicidal thoughts in an effort to get help, only to have their family member tell them “to just do it already,” or that they are “just trying to get attention.” I promise this is not true. It may make you feel safer to believe that it’s just an attention-seeking behavior, but it’s not.

If someone you love tells you that they are having suicidal thoughts, take them seriously. Help them to get to the emergency room, call 911 for a welfare check, help them make a therapy appointment, or call the National Suicide Prevention Hotline number above. It is better to be safe than very, very sorry.

My heart is heavy with loss, but I’m sending love and healing out into the world. If you need it, I hope that you feel it. Take care of each other.

Gaslighting: What it is, and How to Recognize it

It wasn’t until after my first marriage that I first heard about the concept of “gaslighting,” and as soon as I understood what it meant, I thought, “Wow! I wish I’d known about that years ago. That perfectly describes my 6 years of marriage.” I’m hopeful that I can save you years of pain and frustration by sharing this information with you now.

The term comes from the 1944 black and white film, “Gaslight,” which I’ve actually taken the time to rent on Amazon and watch for myself. It’s dated, but still a wonderful psychological thriller, and I definitely recommend it. In the movie, the main character marries a man that seems perfect in every way. He’s charming, handsome, wealthy, and appears to be completely in love with her. After the wedding they move to his ancestral home where things slowly and insidiously start to unravel. The woman’s belongings keep going missing and appearing in strange places, and the gaslights (from which the movie gets its name) keep turning on and off at strange times.

When the woman tells her husband about these peculiar occurrences, he tells her that they aren’t actually happening and that she is losing her mind. He even goes so far as to get a psychiatrist to examine her and back up his claims of her insanity. His insistence on her mental instability is so pervasive that she actually starts to believe that she is going crazy until the big reveal in the end, when we find out what his devious plan was the whole time. I won’t spoil it for you.

“Gaslight” is a wonderful example of the slow, methodical and insidious nature of gaslighting. It’s a long game power play where the perpetrator slowly makes the victim question her/his own reality. The Psychology Today article, “11 Warning Signs of Gaslighting” by Stephanie A. Sarkis, PhD, describes gaslighting this way, “Gaslighting is a tactic in which a person or entity, in order to gain more power, makes a victim question their reality. It works much better than you may think. Anyone is susceptible to gaslighting, and it is a common technique of abusers, dictators, narcissists, and cult leaders. It is done slowly, so the victim doesn’t realize how much they’ve been brainwashed.” The slow and methodical nature of gaslighting is what gives it such power. Because of the steady and mounting message the victim receives that her/his senses can’t be trusted, it begins to feel like the truth.

11 Warning Signs of Gaslighting by Stephanie A. Sarkis Ph.D.

According to Sarkis, there are 11 warning signs of gaslighting to watch out for, and I’d like to explore them here.

  1. They tell blatant lies
  2. They deny they ever said something, even though you have proof.
  3. They use what is near and dear to you as ammunition.
  4. They wear you down over time.
  5. Their actions do not match their words.
  6. They throw in positive reinforcement to confuse you.
  7. They know confusion weakens people.
  8. They project.
  9. They try to align people against you.
  10. They tell you or others that you are crazy.
  11. They tell you everyone else is a liar.

Let’s explore these symptoms in more detail. I think that the first two make a good pairing. Gaslighters love to lie. They use it as a tool to confuse you. Even if you have a recording of them doing the thing that they’re lying about, they will continue to lie and tell you that it didn’t happen. They’ll do it with a straight face and belittle you for trying to stand up for yourself, truth and reality. Why do they do this? Well, because over time it makes you start to question the nature of truth and facts. It makes you think that maybe nothing in the world is certain, which is exactly what they want. When you no longer know the nature of truth, you are easily manipulated to believe whatever the gaslighter wants you to believe.

Number three, using what is near and dear to you as ammunition against you, is a potent tool. My ex-husband used to use my religion against me–attempting to control me based on religious beliefs about gender and relational power dynamics. I’ve worked with clients who intimidated their partners into staying with them by saying that they would take away their children if they left. Remember that this is a power and control tactic. It’s not based in reality, but because it touches on deep-seated fears, beliefs, or values it works to intimidate and control the victim.

Number four, “they wear you down over time,” is an important one. Gaslighters start out with a friendly and welcoming demeanor, and charm their victims into trusting them, and then over time begin to introduce their power and control tactics one subtle drop at a time. By slowly chipping away at the victim’s reality and relationship to truth, victims often don’t realize that their worlds have become more and more confusing until they don’t trust their own senses at all, which leaves them in the precarious position of looking to the gaslighter to tell them what to believe. This is exactly the outcome that the gaslighter wants.

Number 5 is probably the biggest give-away of a gaslighter. “Their actions don’t match their words.” They tell you that they are going to do something, and then they don’t do it. They tell you something was done, and you then find out that it wasn’t. They make promises that they don’t keep, and then they tell you that they never promised it in the first place. If you start to notice this trend, run!

Number 6, “They throw in positive reinforcement to confuse you” works like this. The gaslighter has told you that you’re crazy and don’t know anything one too many times, and you’re starting to think this person is a bully and you need to get out of the relationship, leave the company, or even the country. Then, suddenly the gaslighter does something nice for you, gives you a gift or a compliment, a tax break, etc. You think, “well, maybe they’re not so bad. Maybe I was over-reacting,” and then the gaslighting resumes even stronger than before.

As the victim’s confusion deepens, number 7 comes into play, “They know confusion weakens people.” Our ability to trust our own senses and interpretation of reality gives us a rootedness in life. By eroding your ability to trust that you know what is true and not true, the gaslighter is literally cutting you off at the root, leaving you weakened and dependent on them for support. That is the entire point of the gaslighting process.

Number 8, “They project.” This one is super weird when you experience it. You confront the gaslighter about bad behavior, and instead of taking responsibility, they accuse you of doing whatever it was that they did instead. For instance, my ex-husband used to accuse me of being bad with money when I would talk to him about the fact that he had just emptied our bank account. Gaslighters do this because it distracts you from the reality of what happened and makes you start defending yourself instead.

Number 9, “They try to align people against you.” This tactic may or may not be reality.
Gaslighters tell their victims that others are against them, and that the only person that the victim can trust is the gaslighter. Remember that they lie, so they may be making it up, but they may actually go so far as to poison people against you. I had an ex-boyfriend who called me “psycho-bitch” to anyone who would listen. By making people believe that I was crazy, he isolated me from my support system in an attempt to make me more dependent on him. This tactic also served to make people question the validity of my statements, especially about him and the way that he treated me.

Number 10, “They tell you or others that you are crazy.” I touched on this earlier, but this one is super important and bears repeating. I find that the operative word tends to be “psycho.” If anyone ever calls you psycho, run. If they call their exes psycho, run. If they call their family members psycho, run. Don’t look back. This person is very likely a gaslighter.

Number 11, “They tell you that everyone else is a liar.” Your world is already on shaky ground. You don’t know what is real and what isn’t anymore. You’re not sure that you can trust your own senses or that you’re mentally sound. Then, the gaslighter tells you that your family, the media, your friends, other countries, or some group are always lying to you. Since you don’t know what’s true anymore anyway, this gives the gaslighter the power to shape reality to his/her own benefit.

Anyone can fall victim to these tactics. This isn’t something that only happens gullible people. It happens to smart, educated and powerful people all of the time. If you’re reading this and recognizing that there is a gaslighter in your life, don’t blame yourself. It’s not your fault. Don’t try to change the gaslighter or reason with them. It won’t work. Just leave.

It will take time for the world to start to make sense again after being gaslit, and that’s OK. Give yourself the patience and gentleness that you were missing with the gaslighter while you heal and find your footing again. The important thing is to just be with yourself as long as it takes to get to the other side of healing.

The Healing Power of Yoga

It is my fervent belief that yoga saved me from a life of chronic illness, but when my neurologist at the time, Dr. Purcell, suggested it, I didn’t have any idea of the healing powers that yoga offered.  I was just so desperate to be well that I would have done anything that might actually help.  It was only later that I came to understand why yoga healed me the way that it did.  

It shocked me at the time that my nausea went away almost instantly after starting yoga classes.  I couldn’t account for it, but I was grateful for it beyond words.  The constant year-long nausea and vomiting had been the worst part of my illness, by far.  After that, I quickly re-gained the strength, stamina and motivation that had abandoned me, and I began to live again.

It took years to obtain the diagnosis that eventually led to a coherent treatment plan.  It wasn’t until well after I recovered that the label “spasmodic torticollis” came into my life.  I had to google it to understand exactly what it described, having never heard of it before.  It’s such an unusual and odd sounding term that when people ask for my diagnosis and I give it to them, they usually give me a blank look and say, “What was that again?”

In his book, Healing Yoga: Proven Postures to Treat Twenty Common Ailments—from Backache to Bone Loss, Shoulder Pain to Bunions, and More, Loren Fishman, MD has a fortuitous little blurb about my condition.  He writes, “A third condition that occurs in the neck isn’t as common, but if you’ve had it or even if you’ve seen it on someone else, you won’t forget it.  It’s called spastic torticollis—literally spasmodic turning of the neck.  It happens when one group of muscles gets really tight and turns the neck.  Sometimes the head turns in jerking motions, and sometimes it turns and stays in an unnatural place.” (Fishman 122-123).  

For some time after recovering from the worst of my illness, I had the jerking motions Dr. Fishman describes above.  My head would involuntarily turn to the right over and over.  It was embarrassing.  During the day, when I was in public, I would fight the head turning with everything that I had, and completely exhaust myself.  At home, when I was alone, I would relax and let my head do what it would, leading to half watched TV shows and great difficulty in keeping my place when reading.  Fishman writes, “This is a condition so painful and so intransigent that you may need a yoga therapist or a doctor who can give an injection that will alleviate it at least temporarily” (Fishman 122-123).  

Dr. Fishman’s assertion that spasmodic torticollis is extremely painful is, I think, the reason that my diagnosis and treatment took so incredibly long to obtain.  I don’t have much pain at all.  I have the odd headache, and my neck and shoulders tend to be a little bit sore, but I really don’t have significant pain.  In the very beginning of my illness, my ears and my scalp on the left side of my head hurt, making it difficult to sleep or wear a headset, but that pain went away fairly quickly.  

Doctors kept asking me about pain, and when I said I didn’t have much, they immediately dismissed me as a “hysterical woman” trying to get attention for something that wasn’t really very bad.  I would like to point out that pain is not the only thing that makes an illness terrible.  In fact, I probably would have preferred pain to the ongoing nausea and vomiting that I endured for a year and a half.  At least people that are in pain can eat, and they don’t starve to death.  

However, Dr. Fishman is right about the injections.  Every three months I go in to see my current neurologist, Dr. Matich, who is wonderful and warm and helpful, and she uses a machine to measure my involuntary muscle contractions.  She does this by inserting a probe into each affected muscle and listening to the sounds they create through a special machine.  Sometimes my muscles whoosh and growl like storms.  Dr. Matich then injects botox into the extra loud muscles to help them relax, and I can hear the muscle-storms grow calm.  Over time, this has been a helpful addition to my care, but I honestly don’t think it’s nearly as helpful as yoga.

In Healing Yoga, Dr. Fishman describes how “Laboratory and clinical studies have confirmed that pain from upper cervical joints and muscles can be referred to the head” (Fishman, 121).  I think this was exactly the complicating factor in my own illness.  I believe that what happened to me goes something like this: the whiplash injury that I endured caused the upper cervical muscles in my neck to go into spasm, which irritated muscles and nerves in my head, leading to migraine symptoms, but no pain.  I had the visual disturbance, nausea, vomiting and cognition problems that go with severe migraine, but the pain never showed up, which confused everyone—including me.

If he had known about me and my illness, I believe that Dr. Fishman would have backed up my neurologist’s suggestion that I treat my symptoms with yoga.  Dr. Fishman writes, “Appropriate yoga is good for almost anything that ails the neck and for pain referred from the neck to the head. . .  It improves suppleness of the neck muscles and increases the versatility of the joints so they can move more easily in many different ways.  It refines the coordination of the various muscle groups, so muscles aren’t pulling against each other with such ferocity” (Fishman, 123).  I believe that these benefits are part of the reason that I began to feel much better quickly after beginning my yoga practice.  With my neck muscles in spasm, I needed something to interrupt the process of pulling muscles irritating the tissues in my head, and yoga miraculously did that for me.

However, I think there was another contributing factor.  I think that the muscles, nerves, and other tissues in my neck and my head were terribly inflamed by the whiplash injury, at least partially causing the migraine symptoms.  Multiple studies have shown that inflammation is a leading factor in many of the chronic illnesses that people suffer from, such as fibromyalgia and chronic back pain.  Treatments for pain often focus on decreasing inflammation using NSAIDs (non-steroidal anti-inflammatories), such as over the counter ibuprofen, or stronger prescription versions, like Naprosyn.  Many people, including myself, take a daily turmeric pill, which is a spice used in some forms of cooking, because it’s been shown to have anti-inflammatory qualities. 

I didn’t know it at the time that I started my yoga practice, but yoga decreases inflammation too.  Dr. Fishman writes, “We physicians can’t do much apart from medication for swelling of joints; your body can do more by itself, using a molecule called PGC-1alpha. This is a potent endogenous anti-inflammatory that reduces swelling anywhere it occurs in the human body.  Gentle activities such as yoga and tai chi, and especially yoga done for long periods of time, encourage the body to release this miraculous substance from your muscles” (Fishman, 122).  The joints in my neck were certainly inflamed after the traumatic whiplash injury that I suffered, and I believe that getting involved in yoga significantly helped to reduce that swelling through the release of PGC-1alpha.  How miraculous!  

Because of its anti-inflammatory effect, I believe that yoga should be a frontline treatment for any physical ailment that is caused by inflammation.  Can you imagine the wellness that would result if doctors would prescribe yoga for arthritis, fibromyalgia, back pain, and any of the other ailments that they usually prescribe pain medication for?  I truly believe that the world would be a much healthier and happier place.

Speaking of happiness, I’d like to say a little about how chronic illness affects mood.  Dr. Fishman writes, “. . .chronic pain does more than cause people to lose days of work.  It’s depressing.  It produces anxiety.  It makes life so hard that sometimes it doesn’t feel worth living.  I think it’s extremely important to address pain that could be or is becoming chronic and end it as soon as possible” (Fishman, 86).  While Dr. Fishman talks about chronic pain being depressing, I would like to add that chronic illness is depressing whether pain is involved or not.  Before my injury and subsequent illness in 2011, I was the happiest I’d ever been.  I had found a group of people where I seemed to fit in completely for the first time in my life.  I was active and social and enjoying every minute of it.  Then, the whiplash injury happened, and my happy life became very small and extremely unpleasant.  

As I sought help, doctors kept telling me that my symptoms were the result of anxiety, and they kept pointing out how anxious I was in the appointments, and how sad and alone I was.  I argued that I was anxious because I kept seeking help from professionals who dismissed my symptoms, and I was depressed because I was terribly ill and unable to do the things that made my previous life so wonderful.  But the doctors continued to insist that my symptoms were the result of anxiety and depression, not the other way around.  I found this incredibly frustrating and demeaning, and it’s refreshing to have Dr. Fishman acknowledge that chronic illness leads to a life that doesn’t feel worth living, because it absolutely does.

However, it appears that the psychological effects of chronic pain and illness are even worse than I previously thought.  Dr. Fishman writes, “. . . there is a less-recognized reason: chronic pain that lasts more than a year seems to have negative effects that last much longer.  A study done at Northwestern University shows that a year of chronic back pain actually shrinks the gray matter in the brain by as much as 11 percent, the equivalent of ten to twenty years of normal aging, and that loss is directly related to the duration of the pain” (Fishman, 86).  Ten to twenty years of normal aging caused by one year of chronic illness!  Honestly, that blows my mind, but I’ve seen it happen.  

In my own case, after my illness went into remission, and I got treatment that made sense, it took a couple more years for me to be able to focus on reading a book, or to be able to write the way that I had prior to getting sick.  I’m sure that recovering from brain atrophy was one of the reasons that it took me almost 10 years to get my book project together.

My grandmother became ill within the past few years.  Within a year of getting sick, she went from a vibrant older woman who managed a home of her own and loved to sew quilts, to a woman who needed 24-hour care and couldn’t recognize her own grandchildren.  Now she’s living in a nursing home that specializes in dementia care, and I’m certain that her illness was a major contributing factor to her mental decline.

Truly, we must take chronic illness and chronic pain seriously.  It not only decreases life satisfaction, causes anxiety and depression, it actually causes brain damage.  The good news is that in addition to other wonderful effects we’ve already discussed, yoga can help with the terrible mood and brain problems brought on by illness.  Fishman writes, “Clinical trials confirm that yoga helps reduce distress and depression and promotes a sense of calm well-being” (Fishman, 191).  He also explains that yoga is being used to treat PTSD. “The Naval Medical Center in San Diego and other military VA hospitals are offering yoga to help Marines, soldiers, sailors and others wounded in Iraq and Afghanistan who are suffering from post-traumatic stress disorder.  Preliminary military studies have found that the calming effect of yoga can assist PTSD patients in dealing with hypervigilance, flashbacks, depression and anxiety” (Fishman, 201).  Honestly, I think yoga is the cure-all that people are looking for, but it is under-prescribed and under-utilized.

Please spread the word about the healing effects of yoga.  Even though it’s more work than taking a pill, I think it’s more than worth the effort.  It saved my life.  It could save yours too.  Dr. Fishman lists multiple ailments that he has personally and effectively treated with yoga, including: back pain (both neurological and musculoskeletal), rotator cuff syndrome, headache, weight control, bone health (osteoporosis), insomnia, scoliosis, premenstrual syndrome, depression, restless leg syndrome, bunion, and plantar fasciitis.  While this is an extensive list, I’m willing to bet that there are many more conditions that would respond positively to treatment through yoga, and I encourage you to give it a try.