Content warning: this blog contains description of attempted suicide
We live in a society where we keep death behind closed doors. In our attempt to preserve life and our striving to live it to the full, we keep the process of dying at bay.
This reality struck me when at 20, I started my first full-time job working in a nursing home. The immediacy of death was a daily concern. Whilst doing everything we could to help our patients have as comfortable and peaceful deaths as possible, I was acutely aware of the way in which the realities of dying were being hushed away from the rest of society. This dying-place would never need to be encountered in daily life, unless death was happening to you or someone you loved.
If this is how we treat physical illness and old age, then death by suicide is an even more silenced subject. Death poses an existential threat to us all, and the idea of taking your own life seems a threat to the inherent value we place on life. We all tend to agree that life is worth fighting for, protecting and maximising - that it is our moral imperative to cultivate our “best selves” in order to live our “best lives”. Somehow we see the idea of not wanting to live any more - even attempting or completing suicide - as a rejection of all we uphold as important.
So we don’t talk about suicide. We steer conversations away from dark places, dismiss the proximity we all have to death, and make all sorts of judgements about suicide and those who contemplate or complete it.
But our collective silence around suicide is not risk-free. In reality, keeping talk of suicide at bay protects nobody. By failing to provide opportunities for people to vocalise their thoughts and feelings about death and suicide, people are left contending with these difficulties alone. Being unable to listen to people talking about suicide without reacting in horror, playing it down or focussing on the positive, is in itself dangerous.
I know this from my own experience of being dogged by thoughts of suicide for several years. For a lot of that time, nobody wanted to hear what was going on in my head. I was already in mental health services with anorexia, but when I told anyone about suicidal thoughts, I was given little space to talk about how that felt. Doctors prescribed and prescribed, and sought to minimise the risk of me actually attempting suicide rather than listen to what was driving the impulse. I didn’t want to be drugged out of my pain and made safe enough until next time - I wanted to talk.
Powerful suicidal thoughts were made more frightening by not being able to talk about them. Attempts by the professionals to “fix” my suicidal thoughts, in a way that avoided actually talking about suicide in depth, did little to abate their relentless presence in my mind. The fact that the professionals were made uncomfortable by suicide made me have very little confidence that anyone else would be able to sit with the subject either, if I were to tell them.
So the thoughts grew, the plans elaborated, and my own death became a shadow that was ever closer at hand. A lot of the time I didn’t really want to die - I just didn’t want to life the life that I was having, and there seemed few options and little prospect that things would become easier. I was unable to access treatment for my eating disorder, was losing opportunities, and felt I was causing pain to those around me as I lost my physical and mental health. Thinking about suicide wasn’t a rejection of the value of life in general, or that life was something worth living for. I just felt I couldn’t do life justice, and I wanted to protect those I loved, who I thought could live better without me.
In the end, talking saved me, but the space to talk about suicide was found almost too late. I’d had times when I’d been ambivalent about living, and had attempted overdoses without the intent to actually die. Whilst I still feel ashamed about these times, I believe that if I’d received the help I needed before this stage, and had developed other ways to cope, then I wouldn’t have needed to use an overdose to express of my anguish. At other times it was darker than this. After having to drop out of my studies I felt there was little point in carrying on. I went to the GP. “Some people think eating disorders are just attention seeking”, she said. What more could I do? It seemed I had exhausted all the options.
Just days later I took a large overdose. I wanted my life to end and not to wake up - just as I had prayed I wouldn’t for so many weeks. But after some time, panic crept in. Was this what it felt like to die? Despite the terror that washed over me, I was still full of ambivalence about whether I wanted to carry on living. I didn’t want an ambulance and medics - to be fixed and sent away without talking to a single person about my thoughts, as I’d been before. I needed to talk, so I rang the last place I could think of - the Samaritans.
I can’t remember much of what happened after that, or even how I got to hospital that night. But I do remember the power of someone finally listening to me without judgement, without rushing in to problem-solve and push the subject away. I remember the realisation that there were other options, that hope still existed outside of this dark place of no escape which was my life as I knew it. Whilst the intervention of ambulance staff and medical care meant I could recover, it was talking that saved my life.
What shocks me most about my experience is the lack of availability of spaces to talk about death and suicide. If mental health services struggle to provide that safe and non-judgemental space, then what can be said about society as a whole? Today is World Suicide Prevention Day, and I believe that we need a national programme aimed at destigmatising suicide across public life. For example, I would love for young people to visit nursing homes, college students to volunteer in hospices, and schools to talk fearlessly about death and suicide as part of the curriculum.
Talking about suicide doesn’t “plant an idea”. Instead, it makes it a subject that is OK to talk about. This is essential when society upholding a taboo around suicide means that people struggling with suicidal thoughts uphold their silence. Value for life and the choice to keep living requires that we also acknowledge our deaths, and the possibility that the impulse to live can wane. Death is part of what it means to be living, and should be talked about. And talking saves lives.