September Is National Suicide Prevention Awareness Month
I’ve survived four suicide attempts. I deeply regret the pain I caused my family and friends. In the moment, I was disappointed I didn’t succeed, but today I have a different perspective. I kept my first attempt in 1984, when I was twenty-three, a secret from the therapist I was seeing at the time. After the second attempt in 1990, when I didn’t die, I took the F train from Queens into Manhattan to the psychiatric day program I was attending. Another patient noticed I was acting strangely and told one of the therapists. I confessed and was transported to the emergency room where the doctors pumped my stomach.
Someone called my mother. She and my father showed up at the emergency room. They stood at the end of my stretcher, shoulder-to-shoulder, almost touching, but not quite. They hadn’t been in the same room since they divorced my senior year of college. My mother had a married boyfriend and my father who drank until I was thirteen, had become a recluse, retreating into the dark cave of depression. My father’s countenance was expressionless, my mother was holding back tears.
Following this attempt, I was diagnosed with borderline personality disorder (BPD). I’d already acquired the diagnoses of major depression and anorexia. On this acute psychiatric unit perched on the Upper East Side of Manhattan, the psychiatrists told my parents my prognosis was poor and not to hope for much. My parents were devastated. Several years ago I’d been a successful Consumer Promotion Development Manager at one of the largest packaged goods companies in the world. How they reconciled their memory of that young woman with this disheveled girl, gouges running the length of her arms, I’m not sure.
Neither I nor my parents had ever heard of borderline personality disorder and I felt as though I had no place to turn. My childhood friends were getting married, and having babies and I’d been deposited in a locked mental hospital high above Lexington Avenue. The plan was to transfer me to a prestigious psychiatric hospital about thirty minutes north of New York City as soon as a bed became available. This particular hospital housed a long-term unit dedicated to patients diagnosed with BPD. The unit specialized in using a new therapy called Dialectical Behavior Therapy or DBT. DBT focused on being in the present and consisted of four modules: Mindfulness, Emotion Regulation, Interpersonal Effectiveness, and Distress Tolerance.
I waited six interminable weeks for a bed and when I arrived, I felt I’d finally found a community of women like me. Women who’d cut themselves. Women who’d tried to kill themselves. I was no longer a freak because we all understood this was the only way we knew how to communicate our pain. I stayed for ten months undergoing intensive DBT until my insurance refused to pay for additional time. I was terrified to leave. The chief psychiatrist believed I was still a danger to myself and arranged for a transfer to Creedmoor, a state hospital in Queens, N.Y.
My mother stepped in. “No child of mine is going to a state hospital,” she declared. A compromise was reached and in 1991, I was discharged to a 24/7 supervised residence and a BPD day program, also utilizing intensive DBT. The insurance agreed to pay for this. I stayed at the day program for eighteen months and at the halfway house for three years.
The third attempt came in 2004, two years after my mother’s death. I was seeing Caryn, a therapist in private practice who had been my therapist at the day program. Floundering in therapy and in my life, I was flopping around like a fish stranded on the deck of a boat. I missed my mother terribly. To have had her ripped from me three months after her diagnosis of pancreatic cancer left me feeling as though I’d crumple with the effort of each step. I was mired in grief and depression for months, then years, until I finally had the energy to act on my suicidal thoughts.
In 2005 I entered into transference-focused psychotherapy (TFP) with Dr. Lev, a new psychiatrist. TFP is a psychodynamic treatment developed to treat BPD. As its name implies, TFP is based on the transference or the relationship that develops between the therapist and the client. The premise is this relationship mirrors patterns in the client’s relationships outside the therapeutic office. By gaining insight into behaviors that occur within the therapy, the client can begin to change her destructive patterns in the other relationships in her life.
When I entered TFP, I signed a contract stating, among other things, “If I try to kill myself, Dr. Lev will do everything she can to save me, then end the treatment.”
My fourth attempt occurred in 2014, following my father’s death the prior year. I wasn’t grieving; I was imploding, full of rage and resentment. I was never good enough for him, constantly longing to hear some form of praise. Now that he was gone, I’d never hear those words escape his pursed lips. I seethed that he dared to die leaving me to question if he was ever proud of me.
I spent two days in the medical hospital to stabilize my vital signs, then I was transferred to a psychiatric hospital. I was terrified Dr. Lev would refuse to take me back. We’d been working together for nine years. At the end of my week-long stay, I received word she agreed to meet with me to discuss the possibility of continuing our work together.
It was in that meeting I expressed anger for the first time. Anger was not an emotion that was permitted in my childhood home ruled by Johnnie Walker Red. I’d grown up pushing fury down. In that session, I raged at Dr. Lev, at my mother, at my father, and at myself. After nine years with Dr. Lev, after decades in therapy, I began to heal.
Suicide is not a selfish act, nor is it an act of cowardice. Most people who attempt suicide don’t want to die, we long for our emotional pain to end. The depth of our suffering is unfathomable to those who have not experienced it. I have multiple comorbid medical conditions and I attempt to educate each of my physicians that no disease, no procedure is as painful as enduring an intractable depression.
I terminated with Dr. Lev two years later, at the end of 2016. Today, I’m working full-time as a psychiatric social worker. I’m also a freelance writer and blogger, specializing in the topic of mental health and recovery. I never married or had children, but my brother and I are close and I have an active social life with good friends.
I remain vigilant regarding my mental health. There are no guarantees. Dr. Lev continues to manage my medications. I’ve accepted I’ll be on antidepressants for the rest of my life. I have no desire to glimpse life off psychotropic medication as the risk is too great. Some people say they feel like zombies on the SSRIs. I know for certain if I don’t take them, I’ll quickly plunge into a suicidal depression.
I don’t typically volunteer my history of suicide attempts, but I don’t conceal it if I’m asked. I’m not ashamed I tried to kill myself. I try to use my lived experience including the suicide attempts to fight the stigma against mental illness that continues to persist in this country. My close friends know about my history and that element of trust has drawn us closer. Many of them suffer from depression as well although they haven’t experienced the utter despair of suicidal depression.
My biggest regret is my mother didn’t live to see me as an emotionally healthy adult. I was still so ill when she passed away. I know she is watching me, guiding me from wherever she has found peace. One thing I learned in therapy was that she was a human being with flaws and anguish of her own. Mom, I’m sorry I caused you so much pain — and thank you.
