There is a huge focus currently on "resilience" and how we should create resilient young people who are more resistant to experiencing suicidal crisis. The issue was discussed during one of the recent oral evidence sessions of the Health Select Committee's ongoing inquiry into suicide prevention (1).
The drive to increase the emotional wellbeing and mental health of young people is extremely important and welcome. However, I question whether resilience is a helpful word to use. It can make those of us who experience suicidal crisis feel that it was a failing in us - that we lacked the necessary resilience to prevent it from happening.
Prior to 2012 I had no contact with mental health services and had never attempted suicide. After a random, horrific experience in that year, I developed symptoms of post-traumatic stress disorder and attempted suicide twice.
The lack of previous history could suggest I was not especially vulnerable. So why did it happen? Was there anything which could have prevented me from going into such crisis? Was I simply not resilient enough - was that the problem?
In the months prior to the event I had been under huge personal stress, caring for someone who was seriously ill, and trying to cope alone. Perhaps the emotional impact, extreme exhaustion and lack of support made me more vulnerable, leaving me unable to withstand a deeply traumatic experience.
I now run a Suicide Crisis Centre and I regularly see individuals who for most of their lives have been the person who other people depend on. They are often men in their middle years. When there is a major life event, they are the person who supports everyone else and their own emotions are often suppressed in order to put other people's needs first. Mike always did this. Everyone in the family turned to him in times of crisis. When there was a death in the family, he looked after the needs of everyone else and was there for them. It was as if he locked his own pain, grief and distress in a compartment in his head, he told us, and just carried on. Then one day, his wife announced that she was leaving him after decades of marriage. He was given no warning and he saw no signs that it might happen. She just walked out that day.
The shock of the totally unanticipated event destabilised him. That event was the final trigger for him. It unlocked all the boxes in his head, he said - all the boxes containing unresolved grief and trauma. He was having to experience them all at once, and it was overwhelming.
Mike was at high risk of suicide in the early days of his contact with us and we worked tenaciously to support him. He has now gone on to build a new life as a single man, but it has been a very hard journey for him.
Many of us feel that in being self-reliant and caring for other people's needs that we are doing the right thing. Outwardly, Mike appeared to cope with everything that life threw at him. Resilience is often defined as "the ability to adapt and recover from adversity". Mike adapted to adversity by suppressing and moving on. He appeared extremely resilient. However, in never seeking support for his own needs during traumatic events in his life, and storing them away in his mind, he never processed them.
I wish I had learned to seek support rather than always try to cope alone. I recall when I was at university, a friend said "It is as natural for you to hug your problems to yourself as it is to me to share mine liberally around my friends." We both smiled at that at the time.
We know that men in particular find it difficult to seek help. Mike told me afterwards that he felt he was "weak" and "stupid" when he made his first journey to see us. I do wonder if the use of the word "resilience" risks being an unhelpful one for men. Might it make them feel, quite wrongly, that they are not "resilient" enough, if they have a suicidal crisis? Might it be misunderstood in that way? We are trying to do all that we can to encourage men to seek help when they are in crisis. We are emphasising how courageous it is to seek help from others. That is why I hope we will focus instead on more neutral phrases like "emotional wellbeing" and that it will be emphasised that seeking support and help is vital for a person's wellbeing. It is the connotations of the "r" word, and how it could be interpreted, which concern me.
I believe that a suicidal crisis can happen to any one of us. Each of us could encounter a unique set of circumstances which would be sufficient to trigger such a crisis.
At our Suicide Crisis Centre we see clients who have been through severe trauma. We all have a limit to what we can endure. Some traumatic incidents are so extreme that they are beyond anything we could have imagined. Our minds were incapable of conjuring up such horror.
It may be that nothing could have prepared us enough for withstanding such events. In that case, it is even more important that throughout our lives, from childhood onwards, we become accustomed to seeking help and support. The ability to do so in the days, weeks and months after such destabilising trauma will be vitally important in helping to ensure that we survive.
For information about the Suicide Crisis Centre: http://www.suicidecrisis.co.uk
References (1) Oral evidence session of the Health Select Committee's ongoing inquiry into the measures needed to prevent suicide. The final report is due out soon.
"Mike" is not our client's real name.