suicide

September 2, 2010

“In Defeat, Defiance:” Suicide and the Danger of Giving Up Too Soon

When is suicide justified? When is it permissible to give in to the despair and hopelessness that life sends to some of us?

Before you answer, a cautionary tale.

The little girl was born in approximately 1889. She was five years old when her parents died in a home fire. Two older brothers, themselves only in their late teens, were now heads of a household that lacked a house.

The farming community in which they lived in Lithuania (then a part of Russia) offered few vocational prospects and certainly no way for them to support their two younger siblings. A neighboring family made them an offer. In return for the promised work services of the five-year old and the slightly older sister for the next seven years, the head of that family would advance the two boys enough money for passage to the USA. By then, it was hoped, the brothers would have sufficient funds to arrange for the transport overseas of their little sisters.

And thus, this poor little five-year old, already having lost her parents, now separated from the older brothers she loved.

What is seven years to a five-year old?

Eternity.

But the family with which these children lived was good to them, and the brothers made good on their promise. They kept in contact by writing letters to their sisters and, after seven years, had enough money to arrange for a reunion with them in the USA.

—

The now 12-year-old girl was named Johanna. And it was not too terribly long after, when she was 16, that she met the man who was to be her husband. Her brothers had been supporting her, as well as their own young families. It was time for her to marry, she was told. She had to choose among the suitors available in their small town of LaSalle, Illinois.

The man she chose was 16 years her senior — 32 years old. A coal miner. Farming and coal mining were the chief ways of making a living in that time and place.

Johanna had the first of her five children when she was 18. Life was relatively peaceful and she made the best of the marriage that her brothers had required of her. But, in her 37th year, Johanna began to feel less than her best. At first, she thought little of the fatigue and shortness of breath. Others noticed her pallor. Meanwhile, her appetite diminished and she suffered from diarrhea.

Eventually, the symptoms could not be ignored. The physician diagnosed her as having pernicious anemia, a disturbance in the formation of normal red blood cells.

There was no cure. Her doctor estimated that she might live for one year.

LaSalle, Illinois was a small, largely Lithuanian community. And in that place, at the same time that Johanna received her death sentence, so did another young woman, also a mother.

That person became profoundly depressed and hung herself.

Johanna did not. She did not want to leave her children and her husband in such a fashion. There were things yet to do for her children, messages to impart, care to deliver.

Johanna informed her children that she was going to die before long. She instructed them in what they needed to know in order to take over her household duties and become independent themselves. And, she told them that they would almost certainly have a step-mother eventually, and to welcome her as if she were their own mother.

—

In 1926, the year of her preparation for death, Johanna Grigalunas could not know that there would be a second World War 13 years in the future and that the country of her birth would be consumed by it. She might have heard of Winston Churchill, however, the man who became Prime Minister of England for most of that conflict. But she would not have been aware that Churchill battled depression himself.

Things were particularly dark for England in 1940. All of continental Europe had been conquered by the Nazis and night after night, the great cities of that island nation were bombed by the Luftwaffe, Hitler’s air force. The British Empire stood alone against the Third Reich and expected a land invasion. The United States had not yet entered the War and there was no certainty that it would. Virtually no one thought England would survive. But Churchill did and the Nazis were defeated.

In October of 1941, Churchill was asked to speak to the students of Harrow School, an independent boarding school that was his alma mater. Most of his words that day are now forgotten. But his job was to rally and inspire a nation, as well as the young men to whom he said:

“Never give in, never give in, never, never, never, in nothing, great or small, large or petty — never give in…”

—

Just as she could not know of the geo-political events ahead for the world, Johanna did not know that two separate research teams, one in England and one in the USA, were searching for a cure for the disease that afflicted her.

Thus, in 1926, George Richards Minot and William Perry Murphy fed large amounts of beef liver to their pernicious anemia patients, based on the pioneering work of George Whipple, who had demonstrated that the creation of red blood cells in dogs could be enhanced in this way. It was determined that a daily diet rich in liver would prolong the life of those with this disease. All three scientists received the 1934 Nobel Prize in medicine and physiology. Eventually, the crucial healing component in the liver, vitamin B 12, became deliverable by injection.

—

Johanna Grigalunas lived to be 93, more than a half-century beyond the medical death sentence that she received in the 1920s.

Now, you might ask, how is it that I know this story?

Well, I met Johanna Grigalunas, almost blind but full of life,  when she was over 90.

You see, Johanna was my wife’s grandmother.

—

The above image is of Winston Churchill. The quotation in the title is also from Churchill: “In war, resolution; in defeat, defiance; in victory, magnanimity.”

Churchill is reported to have suffered from depression off and on throughout his life. He referred to it as his “black dog.” On the subject of suicide, he said the following:

I don’t like standing near the edge of a platform when an express train is passing through. I like to stand right back and if possible get a pillar between me and the train. I don’t like to stand by the side of a ship and look down into the water. A second’s action would end everything. A few drops of desperation.


January 24, 2010

Can You Sleep At Night? Being Ashamed and Feeling Guilty

There is an important distinction between being ashamed and feeling guilty. Both are connected to wrong doing, errors, mistakes, or failures. Both involve emotions. Feeling guilty, however, unlike being ashamed, doesn’t require an audience.

A person typically feels guilty almost automatically when he believes that he has done wrong. It matters not whether anyone else knows or finds out. Often, it doesn’t even matter that others might forgive the transgression. Thus, a sense of guilt is an internal state connected directly to an act thought to be wrong.

Shame, on the other hand, requires an audience, or at least, others’ knowledge of the inappropriate behavior or failure, even if they did not directly witness it.

By these definitions it is possible to feel guilty without being ashamed. One need only believe that one has done wrong. But someone who has been shamed (in other words, found out and condemned) might only come to feel bad if his behavior is widely known.

You might think that this always happens, but it doesn’t. Take the recently removed Governor of Illinois, Rod Blogojevich, who has yet to admit any guilt and who certainly doesn’t act ashamed; indeed, who appears quite shameless. Shamelessness is never a compliment, but rather a statement about someone who has no “shadow,” no sense of ever doing anything inappropriate.

To cite a couple of other examples, one a therapist and one a minister, neither felt guilty even after having their iniquity publicly exposed. In both cases the misbehavior was of a sexual nature that involved infidelity, as well as a violation of the code of ethics of their professions.

In the former case, the therapist had sex with ex-patients; in the latter example, the clergyman had sex with parishioners. Both were married (not to each other) at the time of these acts. The public exposure of their actions and ensuing humiliation mortified each of them and, indeed, each one contemplated suicide. But neither really believed what had happened was terribly wrong, and rationalized the transgressions in defense of his own self-image. In both cases the rationale involved holding the sexual partners largely responsible for the romantic encounters.

The connection between shame and suicidal depression is interesting and can be found even in the epics of Greek mythology. When Achilles died in battle, the Greeks held a vote to decide who among them should be awarded the splendid armor of Achilles, which had been fashioned by the god Hephaistos. Ajax (Aias) the Greater, the best warrior after Achilles, lost this competition to the cleverest of the Greeks, Odysseus, who had designed the Trojan Horse strategy that won the war. In his humiliation, Ajax went mad and eventually killed himself. Such is the devastating effect of a “loss of face.”

It should be said that the therapist and the minister I have referred to were quite narcissistic people who saw themselves through a very forgiving lens. Both terminated contact with old friends following their public embarrassment, in order to avoid facing them. In a sense, the self-love and lack of a well-developed conscience of the two people in question set the stage for their wrong doing — they believed that they were without moral flaws and therefore that anything they thought to do would automatically be a morally acceptable behavior.

Beware of those who say that they can sleep easily at night and use this standard as their primary method of judging or evaluating their own behavior. I doubt that the worst of the totalitarian rulers and despots of history would have failed this test of moral correctness, despite the murder, unhappiness, and genocide they created.

In the USA, on the political front, we have seen lots of people who don’t admit wrong, who rationalize what they do, and who serve themselves while claiming to be acting “on behalf of the American People.” I’m sure some of them come to believe their own story, their own rationale — shameless, as I said before; indeed, almost a kind of self-delusion.

In my experience, people who come to psychotherapy because they feel ashamed (but not particularly guilty) don’t usually take responsibility for their actions in the course of treatment. Rather, if the process follows the typical course, they will recover from the injury to their ego and be able to go on with life, still guarded against significant self-awareness. Moral self-reflection doesn’t seem to come easily or naturally to them.

By contrast, individuals who experience guilt that causes them to enter counseling often can learn to forgive themselves and recover from the depression that usually accompanies their guilt. For them, however, the risk is in taking too much responsibility and being too severe in their self-judgment, exactly the opposite of the person who is only ashamed.

It is useful to be capable of feeling guilt, to admit wrong doing, and to feel ashamed; that is, if one is to lead a moral life. On the other hand, it might be argued that those who are shameless and who rarely feel guilt probably have more fun in life and are less troubled — the mirror reflects their image back to them in the way that they want to see it, and not in the way it actually looks. They live in a state of ethical blindness. Whether that permits a satisfying life is another story.

You be the judge.

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The above image is Shame by Libertinus Yomango, sourced from Wikimedia Commons.

December 12, 2009

Are You Too Emotional?

https://i0.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/7/7d/Frenchmanweeps1940.jpg/512px-Frenchmanweeps1940.jpg

You’ve heard it before — “You are too emotional!” Surely you heard it as a child, at least once. But, what does it mean? How do you know if it is true? What is the proper place of emotions in any life? And, if you are “too emotional,” what should you do about it?

First let us establish some ground rules. Emotion is necessary. Imagine a life without it. No  love, no families based on that love, no compassion, no empathy, no righteous anger. What would be left? A life of relating to others as objects, like chairs or tables, their only value in utility — the function that they perform; only reason would be left — cold computation of what to do and how to do it. No laughter, no tears, no gratitude, no passion.

If you agree with what I’ve just said, then it is clear that emotion has a place. It binds us to others, plays a part in letting us know when we have been injured, allows for the possibility of good relationships and a joy in living. It also creates an energy that is necessary for self-defense and for the pursuit of causes. Emotion motivates us and permits the creation of communities.

But, when you are called “too emotional,” the accuser usually isn’t referring to love or happiness or even anger. No, usually he means that you are too easily hurt. And, when you are young, especially if you are male, you are encouraged to “be a man” and live by the “athlete’s creed;” if you are hurt, in other words, rub some dirt on the injury and get back into the game. Don’t complain; that is for whiners and wimps and little kids.

Well, if you are an athlete, that is what you have to do. Think too much about the injury and you won’t be able  to perform. Moreover, if you even think too much about your past failure in the game, you won’t have the confidence and focus to be able to succeed in the remainder of the contest. So, under those circumstances, being “emotional” does, indeed, get in the way. Similarly, emotion interferes with necessary behavior in war-time or in other crises that require focus, indifference to pain, and steadfast action.

But how about situations that are less demanding and fraught with danger or competition?

For me at least, emotion has become, for the most part, a friend. I can be moved by the sadness of my patients and those in my life who I love. I do not consider it a weakness. It is simply a part of being the responsive, sensitive person I aspire to be. And I can be moved by music or drama, again to the point of a tear. Life seems richer, warmer, more eventful and worthwhile that way. I don’t feel the need to keep up a brave front, an appearance of having tamed my emotions.

No, I’m not often whipsawed by my feelings, but, in part, that is because I give them their place in things and don’t keep them all bottled-up, looking for a way to burst out of the container that I would otherwise have put them in. And, when it is required, I am prepared to seek solace from a few of those closest to me, just as I give solace to my patients and those I love.

True, being emotionally vulnerable means that you can be injured. But, don’t fool yourself, life will have its way with you whether you are deadened to feelings or not. By killing your emotions, you are probably only succeeding in limiting the fullness of your life while attempting to create an illusion of strength.

Put another way, it is only human to have emotions and best if you are comfortable with that fact almost all the time.

But, beware when the emotions have you!

At the extreme is a condition called Borderline Personality Disorder (BPD).

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, states that “the essential feature of BPD is a pervasive pattern of instability of interpersonal relationships, self-image, and affects (emotions), and marked impulsivity that begins by early adulthood and is present in a variety of contexts.” These folks are, unfortunately prone to “frantic efforts to avoid real or imagined abandonment,” instability, recklessness, suicidal behavior, rapid and intense mood changes, emptiness, and anger. They are the flesh-and-blood definition of what it means to be “too emotional.” And, not surprisingly, they are difficult to treat, although Dialectical Behavior Therapy is a treatment specifically designed to do so, and has demonstrated great promise with this patient group.

For those who are not categorized with this diagnostic label, how do you know if you are too emotional? Here are a few questions you might ask yourself:

1. Do people, not only family members, often tell you that you are too emotional?

2. In an over-heated moment do you tend to make impulsive decisions that you later regret?

3. Do you have many arguments and blow up easily?

4. Do friends and relatives have to handle you with kid gloves?

5. Do your emotions suck the life out of you, change easily and quickly, and generally whip you around?

6. Do you weep easily and often in the absence of major set-backs or great losses (I’m not talking about having a tear come to your eye here, but something more gut-wrenching)?

7. If you are in mid-life, are you no less emotional than you were in your teens? (Most of us become less volatile, more in-balance, over time).

If you’ve answered too many of these in the affirmative, you may want to seek counseling.

A last word or two. Life is challenging. We need to permit ourselves feelings and we need to express them, within limits, and to have a sympathetic soul there to bear witness and listen to us. Balance is the key most of the time. It may help to remember a portion of the “serenity prayer:”

God grant me the serenity

to accept things I cannot change;

courage to change the things I can;

and wisdom to know the difference.

If you do not “know the difference,” often enough and go to emotional extremes over the routine ups and downs of life, if even the small things seem too big, then it might be time to seek professional help. Not to kill your feelings, but to make sure that they don’t destroy your ability to have a good life.

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You may find the following post of related interest: Vampires and Buried Feelings: The Therapy of Getting Over Your Hurt.

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The above scene, Frenchman Weeps 1940, was used in the 1943 US Army propaganda film Divide and Conquer (Why We Fight #3) directed by Frank Capra. The photo shows “French people staring and waving at remaining troops of the French Army leaving metropolitan France at Toulon Harbour, 1940, to reach the French colonies in Africa where they will be organized as Free French Forces fighting on the Allied side, while France is taken over by the Nazis and the Petain regime collaborating with them.”

Wikimedia Source: Records of the Office of War Information, NARA. *Date: June 14, 1940 *L.

Surely, under the circumstances, this man’s emotions were quite appropriate.