A person is more willing to speak about the scars on their arms when they notice the scars on the arms of others
Dr Shiva Prakash Srinivasan About 18 years ago, I was a 27-year-old psychiatry resident in the US. Four months into my residency, during a busy 24-hour emergency shift, I completed a document expediently rather than responsibly. Addressing pragmatic concerns: Nearly 18 years ago, I struggled to know whom to approach or how to seek help.
I admit that I am human and asking for help after having been accused of having done something wrong and then having tried to end my own life seemed like I was attempting to manipulate the system myself and therefore was even more ashamed for it. Because that shows that somewhere deep down they do have a will to live, i have repeatedly told people that I am thankful that they are having a conversation with me despite having such thoughts. Because that is where they feel heard and seen, young people often seek support from others who have experienced similar problems.
A signed safety plan cannot guarantee safety, but it provides a clear course of action when someone feels unsafe.
I never told my wife anything much either. “We are here for you,” she said. Having implicit trust: Many a time, parents and administrators blow off a young person’s comment of wanting to die as a “negotiating tactic”. If an individual wants to express their suicidal thought, they can do so without the standard parental exhortation of “don’t think like that” or if they want to talk about their ambivalence to be alive, being told to calm themselves down. After all, as psychiatrist and Holocaust survivor Viktor Frankl has said, “He who has the why to live can bear almost any how”. Many young people have been irritated with me for having made comments such as “Please take out the latches of the kid’s room; they are allowed to close their doors and not lock them”. Building support: Enough parents of teenagers have heard the dialogue — “You don’t understand me”.
A consultant discovered the lapse, yelled at me in front of staff and patients, and threatened to have me expelled. Humiliated, I returned to my flat, fearing I would have to return to India in disgrace. I concealed the real reason from my flatmates, whose support only deepened my guilt. By Monday, after two sleepless nights and bouts of nausea, palpitations and restlessness, I felt overwhelmed by shame and decided to end my life. I wrote down my feelings, experiencing what I remember as the longest and loneliest time of my life. I was interrupted by the ring of my phone alarm. It was time to return to the psychiatric emergency room. I changed into my scrubs and left for work. I walked into work, reached out to the chief resident, who listened without interruption over coffee and accompanied me to the program director. After hearing my account, she asked why I hadn’t called them. I was hospitalised in a psychiatric facility for a few days, and received therapy and medication. In training, I was placed on probation, which I completed successfully. Several factors may have contributed to my crisis — being in a foreign country can be lonely, the demands of the first year of residency, the pressure many middle-class Indians feel to prove themselves, the humiliation of being reprimanded by a superior, and my reluctance to seek help. This is a compilation of what helped me through and what I have seen work with others. It doesn’t matter what age the person is, they all have the same needs when in distress. Being seen and heard is essential: Creating a non-judgemental and safe space is oft-repeated in training sessions but what does it mean? In my case, it was my distress of being called out in public despite being a trained mental health professional and my inability to deal with the crushing anxiety. I have over the course of my work with individuals who have engaged in self-harm or voiced suicidal ideas found it helpful to acknowledge an individual’s beliefs and experiences as true — in the moment. They also get into the pattern of trying to find out the reason that they are having these thoughts as if it is the one reason why someone would want to end their life. Being non-judgmental also requires for people to know that what they are saying is accepted as such without question. I believe that someone who has had suicidal ideas or has tried to harm themselves have been in intense pain. I may not agree with their proposed solution, but I agree that they did want to harm themselves at that time. My faculty in the university did not ask any questions about whether I did something to harm myself, they just made sure that I was safe. Creating a safe space: Individuals must feel safe to express and experience their thoughts, and emotional and physical experiences. This means that there are no thoughts that are off limits to express. The question is can we explore and find a reason. In clinical practice, protecting lives means addressing mental health concerns while ensuring a physically and emotionally safe environment. There is a need for privacy but it needs to be balanced with the need to keep our loved ones safe. Support may also involve practical steps, such as helping a recent graduate find a job or volunteer to feel productive and leave the house. Not every problem can be solved with medication or introspection in therapy. Even in a densely populated country such as India, it is possible to feel lonely. A person is more willing to speak about the scars on their arms when they notice the scars on the arms of others. Again, the bleak darkness of loneliness need not always be dispelled by the companionship of peers in suffering but also by just hanging out with everyone else. This is something that needs to be developed further in our increasingly isolated communities. This involves a lot of skill transfer in communicating with and supporting individuals in distress
Today, I believe my conscientiousness about work probably saved my life.
This article is not about pontificating about what is right or wrong or stating how I faced adversity and came out on top. I am hoping that a person in distress will read this and know that they are not suffering alone, people before them have suffered and been close to where they were but are still around. There is no need for a permanent solution for a temporary problem. I also hope that the public understand that all individuals irrespective of their academic background, work, marital status, socio-economic status can have thoughts of self-harm and suicide, but what makes a difference is whether they got help in a way they could accept or not.
Call Sneha’s suicide prevention helpline at 044-24640050 You Can Also Check: Gold Rate in Chennai | Silver Rate in Chennai | Bank Holidays in Chennai | Public Holidays in Chennai | Chennai AQI | Weather in Chennai | Petrol Price in Chennai | Diesel Price in Chennai | CNG Price in Chennai | LPG Price in Chennai Stay updated with the latest Chennai news. They can also save someone’s life in a time of distress when they learn how. I also hope that health and social science researchers can take some of the lessons of survivorship and build resilience from the other end, rather than just focusing on preventing untimely deaths. I hope that administrators and health officials will recognise that unless we talk about suicide in the way it is supposed to, we are going to see the loss of precious lives. (The writer is a psychiatrist, who heads the Department of Youth Mental Health at Schizophrenia Research Foundation India) If you or someone you know is experiencing distress or suicidal thoughts, reach out for support. Download the TOI App.