Yes, Breitbart, 33,000 People ARE Killed with Guns Each Year

by

J.C. Schildbach, LMHC

There is absolutely nothing controversial about Hillary Clinton’s claim that, in the United States, “We have 33,000 people a year who die from guns”–except maybe to those who don’t understand how words and numbers work.

Yet, AWR Hawkins, breitbart.com’s “Second Amendment Columnist,” posted a “Fact-Check” column, titled “No, 33,000 Not Killed with Guns Each Year” following the third presidential debate, claiming that Clinton deliberately inflated the CDC numbers of firearm deaths by adding in suicides. This is not the first time Hawkins has posted similar complaints.

What Hawkins fails to do is explain how suicides by firearm somehow fall outside of the “33,000 people a year who die from guns.” Certainly, Hawkins must understand that somebody who uses a gun to kill him/herself is dead, and did use a gun in order to die—making that person someone who ‘died from a gun.’

Using Hawkins’ preferred language of people “killed with guns each year” still doesn’t change anything. A person who commits suicide with a firearm still was, in fact, killed with a gun.

suicide-gun-mouth

Hawkins also strikes out by putting the phrase “gun violence” in quotation marks, saying that the use of that phrase (which Clinton did not use in the quote he complains about) somehow plays into Clinton’s strategy of fooling the public. But, again, killing oneself with a firearm does qualify as “gun violence”–first of all, because it involves an act of violence; and secondly, because it involves a gun. Or you can reverse that so the gun is first and the violence is second—still doesn’t change anything.

I don’t want to get into speculation about things that Clinton didn’t say, but perhaps if she had used the phrase “gun crimes” or had referred to murders using guns, then Hawkins would have a better argument. But Clinton didn’t. So Hawkins doesn’t.

And, in case you’re wondering, the 33,000 figure is dead-on. Here’s a chart, showing the CDC numbers of gun deaths for the years 2010 to 2014 (2014 being the most recent year statistics are available) clearly showing that gun deaths have reached well above 33,000 per year for 2012, 2013, and 2014, and averaged 32,964 per year for the five-year period.

avg-gun-deaths-2010-to-2014

A handy chart of CDC statistics on gun deaths, lifted from Everytown for Gun Safety at  https://everytownresearch.org/gun-violence-by-the-numbers/

Now, I get that gun-loving Americans, including the Breitbart crowd, don’t like to believe anything negative about guns. They also don’t like to believe that they may, at some point, end up so distraught, or so deep in the throes of mental illness, that they might use their guns on themselves, and/or their family members or other loved ones—or perhaps even neighbors or random strangers.

By pushing the suicide statistics aside, or pretending they ‘don’t count’, Hawkins ignores a harsh reality here: that people who own guns tend to kill themselves with those guns far more than they kill an intruder in their home, or otherwise defend themselves from the big, bad, scary world out there. People who own guns kill themselves with those guns more often than criminals use guns to kill innocent citizens; and more frequently than ‘gang violence’ leads to gun deaths.

There is also considerable overlap in the “murder/suicide” category—where gun owners kill their significant others, family members, co-workers, or random strangers, prior to turning their guns on themselves. And because guns are such a quick and effective killing tool, the decision to use them in an act of violence on loved ones or oneself is often impulsive—a few too many bad days in a row, a bad argument following a few too many beers, or even a partner deciding they want out of a relationship, and the gun comes out as the ultimate way to put a stop to whatever is so aggravating.

As for mental illness, Hawkins’ argument becomes even less convincing in the face of all the clamoring about how we don’t have a gun problem in the U.S., but we have a mental health problem. Of course, people who make such an argument are usually talking about the mental health issues of mass shooters. Yet, if we (properly) view suicide as a mental health issue, then the numbers of firearm suicides become that much more disturbing. Gun owners kill themselves at a rate roughly twice as high as the rate of gun murders. That’s a vast mental health issue that’s not being addressed, and that is being exacerbated by guns.

Yes, I know that many of the people who want to argue in favor of guns like to point out that people who commit suicide will find the means to do so, even if you take their guns away–an argument which is demonstrably false in terms of overall lethality. There are many ways to map out the evidence showing this falsehood, including the high rate of suicide by firearm–roughly 50% of all suicides in the U.S. are completed using guns. Another way to conceptualize the difference in suicide methods is to compare suicide completion rates using firearms relative to suicide completion rates using other methods. For instance, plenty more people survive suicide attempts by overdosing on pills than survive suicide attempts using guns.

Those who are willing to brush off the connection between firearms and suicide also sometimes argue that suicide is a matter of personal freedom—of being allowed to end one’s life when one chooses. I will say that I’m not completely opposed to people being able to end their own lives on terms they choose. However, I’ve learned enough to know that people are least equipped to make that decision quickly, impulsively, or while in a deep depression (among many other factors). Very few people attempt suicide while they are thinking in the clearest of terms, or making a rational decision based on a comprehensive review of the facts.

Depression and many other forms of mental illness are notorious for their association with cognitive distortions, aka, “thinking errors”—misinterpreting the world around one, the impact one’s actions have on others, and the view other people have of one (again, among many other factors). As I’ve pointed out before, the idea that a gun keeps one safe is, itself, a cognitive distortion. The suicide-by-firearm statistics make that clear.

There is also, perhaps, a great irony here, in that Hawkins believes he is advocating for gun ownership, when the “mental health” approach to suicide prevention involves removing the means for suicide. That is, safety planning for suicide prevention involves taking away those means most likely to be used in a suicide attempt, while the person at risk for suicide gets treatment.

So, how do we address the mental health problems associated with guns and suicide? Take the guns away, at least until the person moves beyond risk for suicide. Of course, mental health treatment is not predictive. Risk factors can be weighed, and support systems assessed, but given the ease with which a person can use a gun to end her/his own life, a dip back into depression, a few more bad days, a drift away from regular engagement with one’s (positive) coping skills, and the risk can escalate once again.

Hawkins thinks he is supporting gun rights by poo-pooing the statistics on firearm deaths in the United States. But what he is actually doing is pointing out that suicide is twice as big a problem, where guns are concerned, as murder is. His solution is to pretend the people who commit suicide with guns aren’t really people who “die from guns.”

At base, he is arguing that people who commit suicide with guns aren’t really people…or perhaps aren’t really people who deserve the support to go on living.

 

Self-Infantilization or Supportive Compromise? On the Controversy over Safe Spaces

by

JC Schildbach, LMHC

In her March 21 piece for the New York Times, “In College and Hiding From Scary Ideas” Judith Shulevitz mocks, among other people and things, Brown University student Katherine Byron for setting up a “safe space” for students who might be “triggered” during a debate between Jessica Valenti and Wendy McElroy that was likely to include a discussion of rape culture.

Shulevitz reported that the safe space “room was equipped with cookies, coloring books, bubbles, Play-Doh, calming music, pillows, blankets and a video of frolicking puppies, as well as students and staff members trained to deal with trauma.” Nothing is said about why such items and personnel might have been present, or what the theory behind such a ‘safe room’ might be, other than Shulevitz’s own assumptions about how college students of today are over-parented and overly-sensitive.

Shulevitz goes on to say that, “Safe spaces are an expression of the conviction, increasingly prevalent among college students, that their schools should keep them from being ‘bombarded’ by discomfiting or distressing viewpoints.” Shulevitz does not provide anything other than anecdotal evidence about the alleged increasing prevalence of such a conviction.

On top of that, one major thing that gets lost in Shulevitz’s piece is that the debate between Valenti and McElroy went on. The ideas were not silenced. No speaker was banned.

Instead, Byron, and those who assisted her, offered a place where audience members could go if they became uncomfortable, not necessarily with the ideas being expressed, but with the content of the discussion, which presumably included descriptions of how rape is depicted in popular culture, as well as how rape and rape victims are treated in the news media, by law enforcement, and in other areas of their lives.  The safe room was established by the Sexual Assault Task Force, first and foremost, to afford a safe space for trauma victims–not a refuge from ideas.

All the comfort of the joys of childhood...

All the comfort of the joys of childhood…

Perhaps Shulevitz’ mocking of the “safe spaces” is particularly disappointing because she has written other pieces on trauma and its impacts, most notably, a November piece in The New Republic, called “The Science of Suffering” which explored research into how PTSD can potentially be transmitted from generation to generation.  In it, Shulevitz includes this succinct and powerful description of PTSD:

Provoke a person with PTSD, and her heart pounds faster, her startle reflex is exaggerated, she sweats, her mind races. The amygdala, which detects threats and releases the emotions associated with memories, whirs in overdrive. Meanwhile, hormones and neurotransmitters don’t always flow as they should, leaving the immune system underregulated. The result can be the kind of over-inflammation associated with chronic disease, including arthritis, diabetes, and cardiovascular disease. Moreover, agitated nervous systems release adrenaline and catecholamines, both involved in the fight or flight response, unleashing a cascade of events that reinforces the effects of traumatic memories on the brain.

Shulevitz’s New Republic article describes research into, among others, Cambodian refugees who suffered through brutal conditions of war. And maybe this is where Shulevitz’ disconnect arises: her inability to see how a sexual assault in the modern-day USA could lead to similar forms of psychological and physical response as living through a years-long period of war somewhere else in the world.

But PTSD just as powerful as that experienced by those who have been through war can arise out of a sexual assault or rape. PTSD is not measured and assigned on some scale where those who experienced the longest, and arguably worst, trauma have the ‘most’ or most severe PTSD.

Complaining of the “self-infantilization” (a term Shulevitz credits to Judith Shapiro) demonstrated by things like the Brown University safe room, Shulevitz also neglects to explore other potential psychological issues stemming from sexual assault, particularly for those who were assaulted repeatedly at a young age. To be clear, I am not assigning a specific causal relationship here (i.e., if this happens, then that is the result, and/or, because a person exhibits this behavior, this particular thing has happened to them) but issues such as Borderline Personality Disorder are often tied to a history of having been sexually traumatized.

Strangely enough, complications associated with Borderline Personality Disorder can include shortcomings in one’s ability to develop into an emotionally mature adult.  Along with the repeated hospitalizations, there are frequently tendencies toward anxiety and overreaction to stimuli, impulsivity, fear of abandonment, hostility and perceptions that one is being personally attacked, and difficulties in forming long-term, stable relationships—issues which might, along with PTSD symptoms, be addressed (at least in the immediate sense of a perceived threat) by the “safe room” tactics that Byron deployed.

Rather than exploring the potentially positive effects of the safe room, though, Shulevitz instead uses it, and other alleged examples of “hypersensitivity” at universities, as evidence that today’s college students aren’t tough enough to handle the real world, and that today’s parents are coddling their children too much. But ongoing PTSD, personality disorders, and other psychological manifestations of trauma are not the result of overly-attentive parenting—and are more likely to be exacerbated by the opposite—a lack of attentiveness and support by those who should be providing it.

Still, Shulevitz pats herself and her peer group on the back for being much “hardier souls” than today’s college students–which includes an explanation that, in her day, college students only censored speakers for the right reasons. She writes, “I’m old enough to remember a time when college students objected to providing a platform to certain speakers because they were deemed politically unacceptable.” Shulevitz isn’t particularly clear on how “politically unacceptable” is markedly different from ‘ideas that make some people uncomfortable.’

Perhaps this is a good time to reiterate that Byron and her Sexual Assault Task Force didn’t actually stop anybody from speaking at Brown, but set up a space, off to the side, out of concern for those who might be interested in hearing the debate, but weren’t too confident that they would respond well to it. If anything, it represents a form of compromise much more than a form of censorship.

So maybe the safe room isn’t the perfect answer. Maybe it seems funny and easy to mock as a form of “self-infantilization,” particularly to those who aren’t all that interested in finding out what it’s supposed to mean or accomplish—those people who, as Shulevitz puts it, haven’t learned “the discipline of seeing the world as other people see it.”

Then again, maybe today’s college students aren’t really that different from past generations of college students—and are just exploring different ways of addressing concerns that didn’t exist in the past—or, rather, were ignored in the past.

Because heaven knows, none of us from older generations ever did anything questionable while we were in college, or came up with ideas that older generations might mock, as we tried, in an atmosphere of rapidly evolving technology, culture, and scientific understanding, to navigate a complicated passage into adulthood.

Suicide at the Oscars, part two: ‘The Phone Call’

by

JC Schildbach, LMHC

It was a great year for crisis lines at the Oscars—or, rather, for films involving crisis lines. Not only did the documentary, Crisis Line: Veterans Press 1 take home a statue, but so did the short, live-action film The Phone Call. And, while Crisis Line: Veterans Press 1 tried (perhaps a little too enthusiastically) to convey a sense of the actual drama that can occur at a crisis line, The Phone Call comes across as a disturbingly simplistic endorsement of suicide-on-demand and irresponsible behavior by crisis line workers, all while portraying a dangerously inaccurate view of the function of crisis lines.

I will begin with the same bit of disclosure I placed at the beginning of my piece on Crisis Line: Veterans Press 1: Having spent more than five years working full-time for a crisis line, and continuing to work in a position sideways from, and occasionally overlapping with, such work, I can’t help but come to these films with something of a bias. And I will also offer up a spoiler alert for The Phone Call: if you haven’t seen it, and you don’t want to know exactly what happens, stop reading now.

The Phone Call seems to have generated most of its praise based on the acting of Sally Hawkins (as Heather) and Jim Broadbent (as Stanley/John)—which is undoubtedly solid, even given the ludicrous material. But most reactions seem to ignore any other critical angle—like the crass manipulations taking place in order to make The Phone Call happen at all.

To begin with, the call center where the story takes place seems to be lost in time. Despite the opening shot of the movie panning by a sign that reads “City WiFi Zone,” the crisis center apparently has no computers and no Internet hookup.

Now, I don’t know the current state of crisis line call centers in the UK, or really the state of any such call centers aside from the ones I’ve worked in, visited, or seen in documentaries—all in the United States. But I will say that if a call center in this day and age equips workers only with a pad of paper, a pen, a phone, and a lamp—they are verging on worker abuse. Absent the most dire of funding situations, failing to provide crisis line workers with computers and Internet access is simply unacceptable, given the relatively low cost of such amenities—and the necessity of such items in making it possible for workers to track down lifesaving information—or even to assist callers who are simply trying to access other services.

At one point in the movie, we see Sally Hawkins’ character, Heather, get up from her desk—thankfully she sat at the front of the room near the bookshelves—to try and look up the “mystery caller” in the notebooks where past call records are kept—handwritten on paper.

Add to that the script manipulation of having absolutely minimal staffing. Despite there being numerous desks in the call center, when Heather arrives, there is only one other worker there–Daniel.  At the only time Heather even considers enlisting Daniel’s help with Stanley/John, Daniel is talking with another caller, back turned to Heather, and flipping through a phone book, or some other reference material. She immediately (and completely irresponsibly) determines she can’t get Daniel’s attention—as if muting her phone and calling across the room would have been too much trouble to stop somebody from dying.

'Would you look at that?  Daniel's busy.  Guess you really are going to die today, Stanley.'

‘Would you look at that? Daniel’s busy. Guess you really are going to die today, Stanley.’

Stanley/John is also supposed to be a sympathetic character, the main reason being that his wife, Joan, died two years ago after a long struggle with cancer. As Heather questions Stanley/John about other family members he may have, we also find out that he and Joan tried to start a family, but had only one stillborn child, 25 years ago, and then were unable to have any children after that. Certainly, it’s a sad tale. Certainly, we can understand Stanley/John’s despair.

But just imagine being in the same situation as Heather—or really any crisis line worker—being treated the way Stanley/John is treating her. Stanley/John has decided he is going to die, and has decided that whatever random worker answers the phone is going to have to listen as it happens.

John/Stanley sobs, makes vague statements indicating he has taken actions to kill himself, and refuses to provide information under threat that he will hang up to prevent anyone from tracing the call and sending an ambulance. The audience has to accept that either the call center does not utilize caller id—further putting workers in a terrible situation—or that John/Stanley blocked his information, in order for the whole ‘hanging up’ thing to really work as a threat.

Stanley/John eventually reveals that he’s taken “Antidepressants” that he got “from the doctor.” But killing oneself with pills tends to be a lot trickier than most people realize—at least to do it in the calm, and apparently quick way that Stanley/John manages, all while allowing for a conversation and a quick death before the ambulance crew can arrive and try to revive him—and without his body doing its damnedest to try and expel the deadly pills he’s ingested. Then again, perhaps Heather waited a good long while before calling for the ambulance, as she was looking through notebook after notebook to find the right person named John who lived around the corner from the Boston.

The big moment of connection for Heather, where she (mostly) accepts Stanley/John’s decision to die, is when Stanley/John asks in a pressured tone, “Can you just stay there and talk to me? Are you allowed to do that? Can’t you just stay there and talk to me and hold my hand? Isn’t that alright?”

Heather’s answer: “Of course, I can. I’m not going anywhere.”

There are an infinite number of much better answers Heather could have given at that time. For instance: “No, that’s not allowed, Stanley/John. I’m not here to make you feel better about killing yourself. And, to be honest, if I was really doing my job, my co-worker, Daniel, here would know everything that was going on, and probably already have an ambulance heading your way.”

Instead, in the course of the short conversation, Heather passes up numerous chances to make more than just a conversational connection with Stanley/John. For instance, Heather and Stanley/John discuss jazz, including Stanley/John telling Heather he could teach her how to play tenor saxophone properly. Yet, rather than latch onto that, and suggest that Stanley/John maybe teach music, or otherwise get back into music, Heather doesn’t push on that point of Stanley/John’s ambivalence at all.

In fact, beyond asking about immediate family, Heather does nothing to find out if Stanley/John was involved in anything else in his entire life beyond his relationship with Joan. Work? Friends? Family? Hobbies? Pets?

Heather also does nothing to explore what Stanley/John has done to deal with his grief over the loss of his wife. All we know is that he got antidepressant pills from his doctor. Apparently, Heather takes this as evidence that Stanley/John really has made a valiant effort to deal with the kinds of normal struggles anybody feels at the loss of a long-time companion. ‘Oh? You got a prescription? Wow—that was very brave of you. I’m sorry you still ended up feeling something.’

And perhaps the most obvious thing Heather leaves out is asking how Stanley/John’s wife, Joan, might react to Stanley/John’s decision to kill himself. Or maybe we are meant to accept that Joan is the kind of person who would want her husband to die—that she’s something of a monster, and Stanley/John is really stressed out because he’s two years late on following through with their suicide pact.

Throughout the conversation, Heather lets Stanley/John bully her into not talking about the things she should be talking about, all with the threat that he’ll hang up, and the assertion of his ‘needs’—how he just can’t go on without Joan, but really needs someone to ‘hold his hand’ at the end.

We are supposed to find it comforting that once Stanley/John insists that it is, in fact, too late for a rescue, he compliments Heather, saying, “you’ve been wonderful. You’ve been a wonderful friend to me.”

But Heather is not Stanley/John’s friend, and isn’t supposed to be acting in that capacity. And really, if Heather was either doing her job right, or actually acting in a capacity as Stanley/John’s friend, she would have done more to try and help him.

And then we get the most maudlin endorsement of suicide ever committed to film—we see the ambulance arriving outside Stanley/John’s home. The camera switches to an interior shot of the home’s front door. We see someone arrive, and…it’s Joan! We never actually see Stanley/John, only hear him talking to Joan for a while.  She talks about how she’s “been looking for” him, and they both agree that they’ve missed each other. So, we get this reunited-in-death sap that makes this suicide seem cute, since it helped an old couple get back together.

'What, John?  You've gone and killed yourself?  You go to hell for that, don't you know?'

‘What, John? You’ve gone and killed yourself? You go to hell for that, don’t you know?’

It’s no surprise that director and co-writer Max Kirby comes out of the world of commercials and music videos. The Phone Call is practically a commercial for suicide, with all the depth of the average music video. It’s a concept piece that tries to press emotional buttons, while keeping the audience from engaging in too much thought.

As we watch The Phone Call, we are not meant to think about the value in going on with life, and finding meaning after loss. We don’t even get a serious look at suicide, depression, or mental illness, because we are given only the most surface reasons for Stanley/John to kill himself. We are supposed to take this all as somehow romantic—the sad, old man who just can’t go on without his wife. Isn’t it sweet that he’s killing himself?

And perhaps even more aggravating is the summation of the movie from its official website: “Heather works in a helpline call centre. When she receives a phone call from a mystery man, she has no idea that the encounter will change her life forever.”

I’m not sure exactly what we are supposed to take away from this tagline—that the big change in her life is that she is now carrying the burden of having sat through this man’s death, while being derelict about trying to help him? The big scene we are supposed to take as evidence of change is one in which we see Heather following through on part of the conversation she had with Stanley/John—to go back and visit a jazz club she used to frequent. We see her getting cozy with call center co-worker, Daniel, a potential relationship that was hinted at early in the movie. ‘Gee whiz, isn’t it nice that all it took was the suicide of an old man to make me get out and live a little? Isn’t this rosé delightful?’

To clarify, my reaction to the movie is not meant as some discussion about the right to die, but about the way crisis lines operate, and the absolutely awful way this is portrayed in the movie. It is simply not the job of crisis line workers—paid or volunteer—to just “hold a caller’s hand” while that caller dies by his/her own hand.

It is a hazard of working at a crisis line that one may end up on the phone with somebody as that person dies. But this is much different than such an occasion being the purpose of that work. A police officer has the potential hazard of being shot on the job—but it is not the police officer’s work to be shot on the job. A teacher may be subject to the hazard of being verbally abused or even hit by an angry child—but it is not the teacher’s job to be verbally abused or hit.

And what kind of horrible people would you be attracting to work at the crisis line if you told them that part of their job was just to listen as people die? What would be considered an appropriate level of intervention if just letting people die was considered an acceptable or even desired outcome?

Heather, like any crisis line worker, when confronted by questions of listening versus intervening, should make it clear that, as much as crisis line workers are there to offer support, they are required to intervene in order to prevent callers from completing suicide. And with experience and training, one will gain a better idea of just when that intervention needs to take place.

In the case of The Phone Call, there was an admission that a suicide attempt was already underway; and for all intents and purposes, Heather did nothing. We are supposed to see that as somehow touching, and even life-affirming.

Don’t just feel about that. Think about that.

 

And now for the obligatory ending: If you or someone you know is having thoughts of suicide, call the national (U.S.) suicide prevention hotline 1-800-273-TALK.

 

Suicide at the Oscars, part one: ‘Crisis Hotline: Veterans Press 1’

by

J.C. Schildbach, LMHC

The topic of suicide came up in at least three acceptance speeches at the latest edition of the Academy Awards on February 22, 2015. (Okay, yeah, I’m late to the party again). And perhaps even more astonishingly, two of those acceptance speeches were actually related to films about suicide prevention hotlines. First up is the documentary, Crisis Hotline: Veterans Press 1. (A post about the short film, The Phone Call will follow soon).

Having spent more than five years working full time for a crisis line, and continuing to work in a position sideways from, and occasionally overlapping with, such work, I can’t help but come to these films with something of a bias.

As a matter of fact, I first saw a portion of Crisis Hotline: Veterans Press 1 on a Sunday morning after coming home from an overnight shift at a call center where the crisis line calls represent only one of many mental health functions with which the staff is tasked. Having spent the bulk of my work week on understaffed shifts, I was perhaps a bit resentful at flipping on the TV to see a scene what Bob Hosk, one of the Veterans Crisis Line supervisors who features prominently in the documentary, described as “five hours here at the hotline” utilizing “about four personnel to help one guy.”

Now, don’t get me wrong. I think it’s great that the resources were available and the effort was made, with (spoiler alert) a positive outcome for an active duty service member in Hawaii.

In the time since I first saw that segment of the documentary, I’ve become more familiar with the workings of the military in addressing the epidemic of suicide among veterans and service members, and will say it is truly impressive to see the complete change that has taken place over roughly the last two decades—from an approach to suicide and mental health issues that could be described as ‘don’t ask don’t tell’ to one of increasing and highly-promoted access to counseling services, to working with suicide prevention specialists and investing in the crisis line depicted in the documentary, among many other avenues.

But, back on that summer morning, knowing that in similar situations (an unknown caller making a vaguely suicidal statement, then hanging up) rather than having a specific staff member on shift to call a special “law enforcement” phone number at cell phone company to get information on the caller’s location by pinging cell phone towers, and then being able to devote ‘five hours and four personnel’ to find the caller, whichever one of us took the call would typically end up trying to call back, and, failing any respone from that, doing a quick Internet search on the phone number (like they show in the documentary) and then making a call to 911 dispatch in whatever location the phone number (probably) originated, to report that somebody had called and threatened suicide—‘no, we don’t have a name; we don’t have an address; we don’t know how they might do it or if they tried anything yet; we don’t know if there are weapons involved; no, we don’t know much of anything about anything—we’re following our protocol, sorry to bother you.’ Then on to the next call—which could range from a hospital social worker inquiring about a client’s mental health history, to a client with chronic mental illness telling us about his dinner, to someone struggling to get help for a family member with a mental illness, to…

In the case of Crisis Hotline: Veterans Press 1, my sense is that the caller from Hawaii was truly coming from a place of desperation, and, perhaps, wasn’t aware of other options available to him, or just what sort of response might kick in as the result of the call he made. He may have thought that by hanging up, he could just drop the whole matter. He may have scared himself simply by voicing the thoughts he was having about ending his life, and so tried to walk away from that.

But beyond my initial reaction to the portion of the film I saw back on that sunny Sunday morning, and my somewhat-tempered-by-time-and-new-information response now, I have mixed reactions to the film.

I’ll say that, overall, I think it’s an excellent depiction of some of the most challenging types of work that happen at crisis lines, and at the Veteran’s Crisis Line Center in particular, which the film notes “is the only call center in the U.S. serving veterans in crisis.” (A more accurate description would be that it is the only call center in the U.S. specifically established to serve veterans, and specifically engaging the particular protocols of that call center in order to assist veterans. Any crisis line in the U.S. will take calls from veterans, and do what they can to help. Call centers affiliated with Lifeline routinely take calls from veterans and their families, in part because the callers don’t always ‘press 1’ when prompted to get transferred specifically to the Veterans Crisis Line Center. And, while Lifeline workers typically will explain to such callers that they have not reached the veteran’s line, they always offer to help.)

Semantics aside, not all calls to a crisis line are life and death—or even crises. Each time the phone rings, it’s not a given that the caller is a someone on the verge of taking her/his life, or a family member of such a person. But you wouldn’t know that from watching this film. You only get the slightest whiff of the lighter calls, when, early on, the camera moves through the call center, the sound of constantly ringing phones and poignant snippets of dialog, reaching the microphones at just the right time: “really proud of you…Where were you stationed?..So twice you tried to hang yourself before?…Do you want me to send someone there for you?…Did you get injured while you were out on active duty?…diagnosed with PTSD?…If there’s anything we can do for you…”

Okay, so those don’t come across as all that light. That particular scene is one of many subtle manipulations used by the filmmakers—layering audio to create a particular impression of an “always on” call center. For the sake of drama, the filmmakers leave out audio involving callers who are just seeking information or non-emergency services. They leave out the repeat callers who are really just touching base and giving a brief synopsis of their day. They leave out those calls having any of a number of angles that aren’t even remotely related to suicide.

The filmmakers also choose to escalate the drama in a completely unnecessary way. For instance, the music, most often quiet, involves drawn-out, high-pitched tones that add to the tension viewers are meant to feel—as if trying to talk a stranger out of suicide isn’t drama enough.

I love this woman: Maureen--Crisis Line Responder, Extraordinaire

I love this woman: Maureen–Crisis Line Responder, Extraordinaire

On top of that, the final segment of the film takes place on Christmas Eve. The scene opens with outside shots of the call center at night, American flag flying, trees wrapped in colorful, twinkling lights, as a soft jazz version of “Have Yourself a Merry Little Christmas” plays–the song adding a sting of dark humor with it’s ‘all our troubles will be miles away’ and ‘let your heart be light’ emotions. The timing of the scene was undoubtedly selected because of the heightened emotions many viewers are likely to have around the idea of a “Christmas miracle” or notions of family togetherness at the holidays. But it also serves to reinforce the popular, but ill-informed, notion that ‘the holidays’—Christmas in particular—are a time of heightened depression and increased suicide, an impression reinforced by a shot of the notepad where the crisis responder has written a quote from a suicidal veteran: “Holidays are depressing.”

There are other things that could be taken as manipulation, but which I think were not only clinically sound decisions, but also place the focus where the documentarians wanted it: on the people working at the crisis line. Not hearing the callers, for instance–while likely done just as much for clinical reasons, as for legal and artistic reasons–provides for greater control over how the information will be presented to the audience, and also removes any impressions viewers might have of the callers based on their voices, or the tones they are using.  While I obviously don’t know the specifics of how any of the callers in the documentary spoke or sounded, anybody who has spent time working on a crisis line knows that many of the callers can come across in a way that, shall we say, challenges empathy. Responders need to be aware of the potential biases they bring to calls, and need to develop skills for de-escalating and connecting with difficult callers. At any rate, difficult or not, hearing the callers’ voices would create a completely different film.

Still, one of the most valuable aspects of the film is in giving voice to the crisis line responders, not only in their moments of calm where they appear to be completely in control, but when they are giving voice to frustrations as well. During one call, Robert, a veteran himself, complains that the response time from police is “ridiculous.” In a separate interview segment, Robert expresses the anger that crisis line responders can feel toward callers: “How dare you take your own life?” But part of the reason Robert’s rawness comes across in a potentially endearing fashion is that the filmmakers also let him speak about his struggles with questions of his own abilities, whether or not he has made the right decisions, or whether he made them in time—questions born of situations where the interventions failed.

There are other responders in the film with whom I had a harder time connecting—feeling a sense of kinship, or understanding their particular reactions, or the ways they tried to connect with callers. I don’t want to dwell too much on my snotty, hypercritical reactions, though—or even mention them in any specificity. For one thing, I know only a very limited amount about what was happening in those particular situations. And I don’t know how those people move about in daily life, or in their routine work at the crisis line.

But why I will most back away from potentially harsh or nitpicky-sounding criticism of any of the responders is because I can’t imagine having to work a crisis call with the knowledge that cameras are on me, and that whatever I do could end up on HBO.

That said, there is one responder in particular, Maureen, who comes across as the undoubted ‘star’ of the film. Little is explained about Maureen or her background, except, perhaps, that she reveals that she has sons, as she is complimenting a caller on her handling of a difficult situation.

Beyond that, Maureen demonstrates the perfectly complicated balance of compassion and detachment that is rare in crisis line workers. She is able to connect to the callers, but does not get visibly drawn into the drama, despite mentioning calls that ‘stay with you.’ Early on, we hear her say, “It’s ultimately the veteran’s decision if they are going to live or die…and as a responder, you have to have a really good grasp of that.” Truer words have never been spoken.

Maureen is able to deliver lines of perfect connection to callers–lines that may seem odd to those unfamiliar with such situations. After asking a caller about how his friend (who died in combat) would react to news of the veteran’s suicidal intent, she listens for a bit, then says, “He’d kick your ass? So he’s a good friend.” Maureen is able to drably ‘contract for safety’ with callers, getting them to promise that they at least won’t kill themselves while they are on the line with her, and then works to expand on that promise.

Maureen is the responder featured in the final scene of the movie—the one that takes place on Christmas Eve. Against this backdrop of heightened emotion, she is tasked with drawing a soldier with a gun out of the desert, and back to his parents, despite much of his life unraveling. She is further challenged by limitations on her involvement—having to direct the veteran’s mother on how to bring him home, and then sitting silently, listening, and hoping it all works out.

In the end, Crisis Line: Veterans Press 1 leaves much to contemplate—whether from a clinical or technical perspective—or any of the other myriad perspectives that could be brought to the film. It is incredibly effective in that it is able to provoke a range of emotions, and could, potentially, be used as a tool for training crisis line workers and volunteers, service members and their families, or really anyone who wants a better understanding of how crisis lines work, how the mental health system can be accessed, or how the military is responding to concerns of suicide among its ranks.

It remains to be seen if the film will help draw more workers and volunteers to crisis services, or perhaps scare more of them off. And this is where I have the most difficulty with the film. How much is too much when trying to convey the intenstity of real-life situations? What level of manipulation and film-making technique serves to create understanding, and what level serves to drive only emotional response?

Granted, the vast majority of people who see Crisis Line: Veterans Press 1 will never work in a crisis line call center. But, there’s always a chance they might need one.

So (obligatory ending)…

If you are concerned that somebody you know may be struggling with thoughts of suicide, call (or get them to call) the National Suicide Prevention Lifeline at 1-800-273-8255—Veterans Press 1.

Yes, Gina, There is a Bipolar Disorder: Tom Sullivan’s Pretend Apology

by JC Schildbach, LMHC

I have a hard time believing anybody really cares about anything Fox News Radio Host/Fox Business News Anchor Tom Sullivan said two weeks ago, or a week ago, or ten minutes ago. But, after a segment on his radio show, wherein Mr. Sullivan expressed his belief that Bipolar Disorder is a made up malady, Mr. Sullivan got a bit more attention than he maybe wanted.  And then he apologized.

I feel compelled to share Sullivan’s apology in all of it’s glory, because it is such a perfect example of a non-apology, the kind that one writes when one is drunk, and mad at the people to whom one is being made to apologize–the kind of apology that would properly elicit a playground response of “If you were really sorry, you wouldn’t have said it in the first place.”

You can hear the questionable five minute clip of Mr. Sullivan’s rant–mind you, on the web site for his own show–here: Bipolar “not a problem” and “not a disability” says Tom Sullivan.

To access his apology, you need only scroll down through the Facebook-linked comments on the same page.

Sullivan’s apology starts off thusly: “Gina, Thank you for your email.” From the get-go, it’s just plain weird. Sullivan is apologizing via Facebook to an (alleged) email that nobody can see. I’m not sure if Gina’s email is presented somewhere on Sullivan’s Facebook page, or elsewhere. I have the feeling he doesn’t want anybody to see the alleged email he is pretending to respond to, because Sullivan isn’t actually addressing any concerns that any real person has about what he said. He’s interested in presenting himself as the victim in the ruckus he started, as a means to reiterate some of the same obnoxious points he made in his original rant.

He continues: “May I tell you I have received a number of similar messages but usually laced with profanity. Your message stood out for the kindness of your words.” Oh, poor Mr. Sullivan, bombarded with bad language from nasty people. But, lo—here is one kind soul, just one person moved to express words of concern and seek clarification about just what happened in this horrible controversy that was visited upon the abused Mr. Sullivan.

“First,” Mr. Sullivan goes on (in sharp contrast to his original words for which he is now apologizing), “I need to tell you I do believe in bipolar disease.” I won’t hammer on Mr. Sullivan too much for not using the proper term “Bipolar Disorder” rather than “bipolar disease.” But I do have to question what he means when he says that he ‘believes in’ Bipolar Disorder. Bipolar Disorder isn’t some mythical creature like the Yeti or the Easter Bunny to entertain or scare people or to serve as a fun part of some childhood tradition. It’s not, as Mr. Sullivan says in his audio clip, some disease made up by pharmaceutical companies and the mental health industry for the purposes of financial gain. But, I suppose when you work for a network that promotes the idea that climate change is a hoax, and white privilege is mythical, your sense of reality can get knocked out of whack.

And speaking of having problems with reality, Sullivan then writes, “There is a two minute clip going around of my comments out of a two hour discussion. It is easy to take comments out of context.” Sullivan’s complaint of a two-minute, out-of-context clip is just a few scrolls down from a five minute clip, again, on the web site for his own show, in which he says he does not believe Bipolar Disorder is a real thing, but a ‘created’ illness.

He then repeats his newly-found belief system: “Of course I believe bipolar is real and is a mental illness that needs to be treated.” Well, of course, Tom! Why would anybody think you would have any other view–I mean, aside from the five-minute (not two-minute) clip where you repeatedly say that Bipolar Disorder didn’t even exist 25 years ago, and is completely made up?

Sullivan does a 180 and becomes a champion for those with mental illness--asks why people think he said things he plainly said.

Sullivan does a 180 and becomes a champion for those with mental illness–asks why people think he said things he plainly said.

Sullivan clarifies: “The program began with the subject being the huge increase in disability claims made to the Social Security Disability Fund which is going broke in 2016.” Never mind that what Sullivan means is that the Social Security Disability Fund could be insolvent as early as 2016 if changes aren’t made to the structure or funding of benefits—saying it is going broke in 2016 is much more alarmist and easier for his audience to understand, so that they can get angry like he wants them to.

Then, explaining (well, sort of) why he chose to target people with Bipolar Disorder, Sullivan writes, “The increase in claims is startling and the number one reason for the big increase in claims is mental illness and a subset (according the way Soc Security categorizes) of mood disorder.” Sullivan doesn’t bother to explain that what now comes under multiple categories of “Mental Disorders” used to be categorized as two separate categories: “Mental Retardation” and “Neuroses and Psychoses.” It wasn’t until 2010 that Social Security broke down those two categories any further, to include numerous items, including the “mood disorders” that so irk Sullivan.

Sullivan pouts, “All I was trying to do was to point out that out of that big increase I suspect there are people who are not sick but looking for a disability check.” Yes, “all” Mr. Sullivan was doing was accusing people on disability of trying to cheat the government. No big, deal. Everybody likes to take pot shots at people on disability, right? But Mr. Sullivan didn’t just voice his ‘suspicions.’ He outright said that Bipolar Disorder is “not a disability.” In other words, Mr. Sullivan said that anybody receiving disability payments due to a diagnosis of Bipolar Disorder is cheating the government. In fact, the title of the same page of Tom’s website where he posted his pretend apology is “Bipolar Woman Says She DESERVES Disability Benefits. Tom Tells Her She’s WRONG!”

The pout goes on: “My further point was by doing so, those people were hurting those who really are sick and need help, i.e. funding, treatments, etc.” In other words, people who get disability payments for mental illness are not really sick—people who can’t walk, or who have cancer are sick!! This is perhaps the best part of Sullivan’s whole apology—the part where he truly demonstrates that he’s learned nothing from the reaction he provoked with his ignorant comments by engaging in the exact type of behavior/speech/thinking that demonstrates classic stigmatization of people with mental health issues: the ‘you don’t really have an illness, you just feel bad’ way of thinking.

And then comes the righteous indignation of a true champion for those with mental illness: “I have for years advocated on my program for more funding and insurance coverage of mental illness. Too many have ignored it and as a result our jails are now the ‘mental institutions’ where the people get zero help.” First of all, if you have advocated so long for “more funding and insurance coverage of mental illness” but are now mad that there is more funding and insurance coverage of mental illness, what is it you really want? Where is this funding and insurance supposed to come from? What form is it supposed to take. Oh…I get it. You mean that when there have been mass shootings, you’ve complained that we do not need gun control, but we need more funding for mental illness. Got it. The jails…right. So, yeah, more mental health funding to stop people who might go on a shooting rampage—but anybody else can step off. Way to advocate, Tom.

Sullivan then writes, “I apologize to those who were hurt by the clip of my comments.” I think he might be apologizing to himself right here, as he seems to think he’s the victim in all of this, and the only one who was really hurt by the unfair “clip” of his comments—which he maintains is all out of context. It’s one of those classic ‘I’m sorry you got upset about what I did’ apologies. He doesn’t actually say he’s sorry for what he said—he says he’s sorry if you had a stupid reaction to it.

Mr. Sullivan then explains that he is just misunderstood: “I am a somewhat jaded person who thinks some people are gaming our system due to their greed.” Yes, plenty of people are out there pretending to have Bipolar Disorder because of their all-powerful greed–the kind of greed that drives them to want to live off of an $1100/month disability check. I can see how life as a corporate accountant and media figure has caused you to see the true evils in life and become hardened by them, Tom.

“But,” he goes on, returning to his sensitive side, “I also believe mental illness is a very serious problem that is ignored by too many.” Well, at least you aren’t ignoring it, Tom, like those “many” others.

Quick switch back to victim: “This episode shows how easy it is to distort a persons (sic) comments, especially when the subject is very important.” Wait, where’s the distortion, Tom? You do realize that there is a five-minute audio clip of you talking smack about people with Bipolar Disorder and mental health professionals, right on your web page, just slightly above your apology—don’t you?

Then, he brings the powerful close: “It will and has reinforced my commitment to making mental illness on a (sic) equal par with physical illnesses instead of the stigma it currently receives. Again, thank you for your email and your concern, Tom Sullivan.” Well, it’s a good thing Tom’s had his commitment reinforced, because in that five-minute clip there, it sounded a whole lot like he was super-supportive of stigmatizing people with mental illness—especially phony mental illnesses like Bipolar Disorder. And, really, could that sentence about stigma be any worse? It’s like somebody read over the rough draft and said—‘Not bad, just make sure you add in some bullshit about stigma and how mental illness is just as important as physical illness in there at the end,’ but Tom wasn’t quite sure how to properly use the word “stigma” in a sentence, and didn’t feel like taking the time to look it up.

In the end, Sullivan wants to be viewed as someone who is just the victim of vicious attacks, with his words taken out of context. Unfortunately, it’s hard to have much sympathy for someone claiming his words were taken out of context when, well, they weren’t, but also when he made no effort to provide any context for anything he said in the first place, such as by touching on the way Social Security disability operates, the different categories now used, and why those changes were made. The simplest explanation (although there are a wide range of factors) is that there has been an evolution in the way “disability” is viewed and understood—in terms of both physical and mental illnesses. And, in terms of Social Security disability, there have been changes in the ways statistics have been kept and various issues have been categorized.

To give some credit, there is support for Sullivan’s complaints that the number of disability claims for “mood disorders” is increasing substantially. However, that increase is not grossly out of proportion to the increase in overall numbers of disability cases, particularly when one considers that mood disorders such as Bipolar Disorder and various forms of Depressive Disorders are more widely understood today than they were 25 years ago (when Mr. Sullivan apparently thinks the mental health community, in cahoots with pharmaceutical companies, fabricated the idea of Bipolar Disorder as a way to make money).

So, as I said in an earlier piece about Sullivan’s original comments (which you can read here), we can either find legitimate ways to address issues like the funding of Social Security disability, and support those suffering from mental illness, or we can demonize them and…uh…let them…er…receive stigma like always. And now, at least we all know where Mr. Sullivan stands—right, Gina?

Bipolar Illusion: Tom Sullivan, Rand Paul, and the Economics of Disability

by JC Schildbach, LMHC

Back on Wednesday, January 28, in a discussion of Social Security disability benefits on his Fox News Radio show, Tom Sullivan, who also serves as an anchor for Fox Business Network, said some incredibly stupid things about Bipolar Disorder. Sullivan, or whoever is responsible for the content of his web page, then proudly promoted Sullivan’s ignorance by posting what I can only hope is the worst part of that day’s show in a brief written piece, and a 5-minute audio clip, which you can see here: Tom Sullivan argues that Bipolar Disorder is a myth.

Among his statements, Sullivan called Bipolar Disorder “the latest fad,” adding, “We all have good days and we all have bad; and I don’t consider that an illness; and I don’t consider it a disability.”

Sullivan said plenty of other amazingly idiotic things, like suggesting people are talked into thinking they have Bipolar Disorder, and that it is a “made up” condition, as well as vilifying the entire “mental health business” and “big pharma.” (Wait–I thought Fox “News” liked big pharma.)

Broadcasting live from the Fox studios in the depths of hell, it's the Tom Sullivan Show.  Today's topic: Yes, you should hate and fear your neighbors.

Broadcasting live from the Fox studios in the depths of hell, it’s the Tom Sullivan Show. Today’s topic: Yes, you should hate and fear your neighbors.

On top of that, Sullivan asked a question that anyone with the most rudimentary knowledge of psychology, or the skill to do an Internet search, could answer: “What were these people called 25 years ago before they came up with this Bipolar diagnosis?”  (He didn’t mean that as a question that had an actual answer, but in the sense that he believes Bipolar Disorder was dreamed up by psychologists and drug companies 25 years ago).

I could let Jimi Hendrix answer Sullivan’s question in a song from 48 years ago, but I’ll let the good people at Healthline take this one.  Read their answer here: Bipolar Disorder just may have been recognized more than 25 years ago.

In case you didn’t bother to check the Healthline article, it basically notes that the first modern diagnosis of the illness that was eventually deemed “Bipolar Disorder” was first established in the mid-1800s, but that the basic condition was recognized in one form or other going as far back as the time of Aristotle and even before.  And prior to the Bipolar Disorder moniker, it was common to call the condition Manic Depression or Manic Depressive Illness, among other, similar things.

Sullivan’s staggering ignorance of mental health issues (and classic rock) aside, the truly insidious question that he asked in all of this was, “So what are you going to do when the money runs out?” By “the money,” Sullivan meant the Social Security disability fund, which he claimed will be bankrupt by 2016.

Beyond the more obvious stigmatizing of people with mental health issues, Bipolar Disorder in particular, Sullivan’s big question, and his chosen targets, may just be another entry into the vast library of right-wing fear-mongering about Social Security, and why it needs to be privatized. I’m sure it is. But it’s also part of a discussion that’s (once again) rumbling up about “entitlements” and poor people defrauding the government.

In fact, it appears Sullivan’s ill-informed rant about Bipolar Disorder may have been inspired by earlier comments from Rand Paul. As “support” for the items on Sullivan’s show that day, Sullivan’s website features a clip of Rand Paul, Republican Senator from Kentucky/compassionate ophthalmologist, speaking to a crowd in New Hampshire about how at least half the people on disability payments are collecting those payments fraudulently. You can see the clip (from CNN of all places) on Sullivan’s website here: Rand Paul is a medical expert who knows you’re not hurt, you crybaby!

Paul tells the (New Hampshire) crowd that, “everybody in this room knows someone who’s gaming the system.” Now, I’m not the kind of person to show up at a Rand Paul event, but I have to wonder about the people who do, if they all know somebody who is “gaming” the disability system. Then again, maybe Paul is just jaded, since his home state of Kentucky ranks third among the states in terms of the percentage of total population collecting disability payments. (I got that information from looking at the actual source of some of the Social Security Administration stats that were posted in an incomplete image on the same page of Sullivan’s website with the Rand Paul video) One might also ask what those stats, and Paul’s claims of fraud, could possibly say about doctors in Kentucky, who are signing off on all those disability claims.

Among those actually deserving of disability payments, Paul counts only paraplegics, quadriplegics, and the “horrifically disabled,” noting that “half the people on disability” are no worse off than anyone else, only “anxious, or their back hurts.” Paul’s standard for not deserving any kind of disability payments: “if you look like me and you hop out of your truck.” So, I guess a whole lot of white males with trucks are headed toward losing their disability payments, unless they’re careful to avoid getting caught hopping out of said trucks.

One would think that Paul’s background in medicine, as well as his position as an elected official might lead him to realize it’s his job to productively address problems with the way government systems work—particularly if those systems are tied to an area of his expertise. Likewise, Sullivan’s background in economics, along with his national platforms on both radio and television, should mean that a discussion of how to fix the Social Security disability system’s funding problem might be in Sullivan’s wheelhouse.

But rather than seeking out ways to tackle, say, the potential of those receiving Social Security disability payments to find work through job training programs; or promoting ways of obtaining additional funding, like removing the income cap on Social Security taxes, we get more condemnation of the poor–calling them lazy thieves.

Instead of having an informed discussion about the needs of those on disability, and why somebody who doesn’t “look disabled” might actually be struggling with things that many of us take for granted, we get accusations that people coping with mental illness are faking it and claiming to have conditions that don’t even exist.

Hell, Sullivan and Paul could even look into ways to make the disability system more functional by addressing the ways disability payments are established and rewarded.

But, no—we get wealthy white guys complaining that people with disabilities are a bunch of cheats, stealing from their neighbors. We get those with tremendous privilege trying to pit the poor and middle class against those with disabilities—’Hey! Let’s all pile on people who’ve been injured! Let’s knock down those who suffer from mental illness!! Get ‘em!!’

There are plenty of other things absent from these discussions of the Social Security disability system, like that those receiving the payments have to periodically have their status as “disabled” validated by doctors or mental health professionals, or that many of them end up assigned to a “payee” who controls the way their money can be spent, or that they have limits on things like what portion of their disability check can be used for housing. They are often confined to extremely limited options for government-approved housing, where their homes are subject to inspections, including being warned with ‘corrective actions’ if they aren’t keeping things clean enough.

Perhaps Mr. Sullivan and Mr. Paul think that those taking in, say, $1100 a month for being diagnosed with Bipolar Disorder (which is roughly the average monthly payout) are scamming us all, and stealing our tax dollars because they’re lazy. But the amount of money one can earn is hardly worth the effort that goes into obtaining it in the first place, or keeping it over time.  It might be a fun and entertaining exercise to have either Paul or Sullivan attempt to live on that amount of money for a month, and under the same restrictions.

Yet when one is so completely ignorant or out of touch as to think that Bipolar Disorder is make believe, or that we are surrounded by people stealing from the government through the Social Security disability system, then one has given up any credibility in the discussion of how to address the problems of vulnerable populations in our society–or even the discussion of how to address the possibility of fraud in the Social Security disability system.

Demonizing fellow citizens by claiming they have phony injuries or fabricated mental illness is a great way to stir up righteous anger among the poorly-informed. It may even achieve the goals of getting votes, or making disability requirements even harder to meet, or of having Social Security privatized or partially privatized.

So, don’t be surprised if you start hearing more and more about scammers bankrupting the Social Security disability system, or even more about mental illnesses being phony. Even if Sullivan did attract the ‘wrong’ kind of attention with his obnoxious comments, all he needs to do is get the poison in the stream. Then, Rand Paul and his ilk can still seem educated and rational and folksy enough that they appear sensible by comparison.

Dropping Keys, Dropping Letters

by Jonathan C. Schildbach, LMHC, waning ASOTP, reforming soul-eater

An eighth-season episode of The X-Files was built around a “soul-eater”—a person who could draw the disease out from others into his own body, eventually vomiting it out. The concept of the soul eater is based in various forms of folklore involving a range of ideas about curses and cures, and the ability of some to take away those things that most harm or most sustain a person. Unfortunately for this particular soul eater, the demands of those who knew of his powers began to overwhelm his ability to process and expel the disease. He existed in a perpetual state of deformity and misery.

I like the soul eater as a metaphor for the work done by many people in “the healing professions.” In this field, many of us work at building a skill set that allows us to help extract the mental and spiritual toxins in others. Ideally, those receiving help will find a way to vomit out the toxins themselves. Yet, such toxins are in no short supply, and many who are most in need of help thrive on a constant diet of disease coupled with a willingness to let others take on the burdens of that disease. It becomes far too easy for helpers to end up like the suffocating soul eater, awash in the illness of others.

In the professional parlance, we call all that business of being overwhelmed by the problems of others “secondary trauma.” There’s a tendency to assume that, as trained professionals, we are able to recognize and address our own forms of distress. But, like many people in positions of suffering, particularly those who are considered high-functioning, it is entirely too easy to soldier on without addressing our own needs. We know how to address all this, and yet we often don’t, or we often address it in an unhealthy fashion, assuming it will pass in time. We take on more than we can handle, and think nothing of it. Whatever doesn’t kill me makes me more convinced I’m strong enough to take it.

Hey--eat any good diseases lately?

Hey–eat any good diseases lately?  The X-Files’ soul eater.

I bring this all up by way of saying that I’m in the midst of a career shift—not out of the helping professions, but into some different channels in the same field.

In particular, last night I dropped off the keys to the office where I’ve been serving as an ASOTP for the last year-and-a-half, at least temporarily distancing myself from a particular portion of the field that I have been involved with for over seven-and-a-half years—the treatment of sex offenders.

The change was forced by way of making a shift in my full-time employment in crisis services. As I write this, I am deliberately allowing myself only some small bit of awareness of the insanity of my professional life over the past several years. Yes, I have been working full time in crisis services, while also working anywhere from zero to ten hours per week with sex offenders. Such arrangements are not unusual in the helping professions—where we are pushed to learn our craft in rigorous, unpaid positions, while also attending school and working a paid job just to stay afloat. The habits of overextension established while in graduate school can extend out into professional life, and feel totally normal, even as we are pushed toward deformity and misery.

Currently in a break from a years-long pattern of toxic soul-eating, and ready engagement with secondary trauma, I realize I’ve become numb to plenty of very bizarre things. Running plethysmography assessments, I can sit through audio scenarios of sexually violent behaviors, paying them as little attention as if they were overplayed Top 40 hits from yesteryear piped over a grocery store or dentist office sound system. I’ve become entirely too comfortable asking people about their masturbation habits, and pressing them when I think they’re lying (only in the course of assessments, of course—well, mostly). Fortunately, I haven’t become so numb that I’ve lost all awareness of the twists and turns of my mind, although I frequently find myself stumbling in otherwise polite conversations when frighteningly dark and vulgar jokes spring to mind—an entirely appropriate coping mechanism in certain circumstances and with particular people—but definitely nothing you want to spring on friends of friends who don’t even have the most limited of contexts for understanding where such thoughts could come from.

And all of that was on top of 40-plus hours per week of run-of-the-mill crisis intervention, suicide prevention, utilization management…

So, if I want to mix in some metaphors, I can say I’m now a ronin—a samurai without a master—an ASOTP without a CSOTP—which, really just makes me a guy with an expensive piece of paper that says I’m an ASOTP until next September, but which conveys no real ability to treat any offenders unless and until I take on another master/CSOTP. Weighing the massive number of hours I still have to accrue across assessment, face-to-face treatment, and supervision, in order to get the full credential myself, I think this may be it for my involvement in offender-land.

I’ve dropped off the keys; and, with no further action, the letters, too, will drop—as will the level of…expulsion required of me on a regular basis. Sure, I’ll still do what I can to draw out various forms of mental/spiritual disease when that is required of m—but hopefully now in more manageable, fun-sized portions.

 

 

You Are Here

By J.C. Schildbach, MA, LMHC, ASOTP, Carbon-based being

If any of you pay all that much attention to this blog, then you may have noticed it’s been a little quiet over the last few weeks.

When I look at it objectively, the inactivity here makes plenty of sense. I caught a nasty summer cold at the same time I had a lot of extra work at my second job, along with the usual work at my full-time job, which has been predictably plagued by the summer vacations and seasonal staffing changes, leading to workload strains.

I was also trying to finish some of those summer projects—particularly the pressure-washing and re-coating of the deck. Even in summer, trying to get the weather to cooperate with my days off can be a challenge, not to mention my complete inability to accurately predict how long any project will take me. I’m working on a formula that is something like AT = h x 4 + 36d, where AT = actual time, h = the total number of hours I predict something is going to take, and d = days.

Whatever the equation or excuses, it’s not like I haven’t had plenty to write about. Hell, I’ve even cranked out a thousand-plus words on each of a few posts—a follow-up piece to one I wrote about a conversation I had with my niece; and one on Will Hayden of “Sons of Guns” getting arrested for allegedly raping his daughter repeatedly over the course of two+ years. (Just now, it occurred to me that the way to make those two posts work might be to combine them and dump at least half of what I wrote). When I couldn’t make these newer efforts work out, I tried re-tooling some things I had written earlier that I never liked enough to post. But all of it was turning into disjointed, bland, repetitive…stuff…stuff that I couldn’t quite untangle and reweave to the level I wanted. Trying to make any of it work at all started to feel too much like drudgery and burdensome obligation.

There were other things going on as well—upsetting situations with friends that, although, or perhaps because, I couldn’t do anything about them, were very draining. On top of that I was jumping through hoops to try to get adjustments made to the particulars of a contract, after spending over a month jumping through hoops to get to the point where any contract had been established at all. Expressing an intention to walk away rather than trying to fix anything more turned out to be just the thing to motivate a real resolution. Now why hadn’t I thought of that sooner?

A number of valued co-workers have also been moving on to what I hope are greener pastures for them, pastures that I hope will not become so lush and large that they put us out of contact. Among those who are moving on is a talented, funny, and inspirational artist.  Another who has made the big career shift is an ever-observant thinker who, with a few counselor-ly questions and observations—including pointing out the need to ‘mourn’ or otherwise acknowledge the little losses, such as co-workers moving on—has repeatedly helped me recognize whether I’m actually charting a course, or merely bobbing about in the tides.

Straddling the line of done and undone, looking for the passage to motivation.

Straddling the line of done and undone, looking for the passage to motivation.

I could turn this into a more deliberate post about self-care and minding one’s moods—about paying attention to those signs of situational depression—like pushing too hard and not having enough fun when trying to write one’s blog pieces. But really, getting this out was just about writing something that wasn’t a big struggle to be clever or original or even relevant. It was about scanning the map for that red dot or arrow that says, “You Are Here” so that maybe I could make my way to an exit and head back home.

In truth, none of the points I mentioned above are completely resolved. But at least I decided to go find that big, light-up plexiglass mall-map rather than wandering about looking at things I don’t want or need.  And now that I have some idea of where I’m at, it might be a little easier to get back to where I parked my car…after I hit a restroom.

 

 

 

Suicide?!? Shazbot!

By J.C. Schildbach, MA, LMHC, ASOTP

Before we get started, let me just mention that I spend the better part of my workweek involved in crisis intervention and suicide prevention. And let me note that anybody’s reaction to the death of another is going to be personal, and related to the kind of connection between them.

Now, let me tell you something horribly, selfishly, insensitively awful about me.

When I first heard of Robin Williams’ death by suicide, my thoughts were, more-or-less in this order…

1)  Damn!

2)  60-something-year-old man…history of mental health issues…history of substance abuse…makes sense.

3)  I wonder what else was going on with him.

4)  I am NOT going to write a blog post about this.

5)  Uggh! There’s gonna be a shitload of extra calls on the crisis line tonight!

Somewhere down the line was, “Shazbot!!” I totally f*cking wish “Shazbot!!” had been my first thought.

Anyway, before you climb all over me for my previously-mentioned insensitivity and selfishness, or whatever you might want to call it (I think I’ll call it “appropriate clinical detachment”), let me explain, in order of those thoughts.

1)  Yes, “damn!” It was shocking and unexpected to hear such a thing, essentially out of the blue. As for the context…I received a text message from my daughter about Williams’ death while running a plethysmography assessment (look it up). What this means is I was sitting in a small, dark, very stuffy and hot room running what I imagine would seem to most people to be a very disturbing clinical assessment to determine what kinds of really terrible things might lead to…ahem…responses for somebody with some admittedly inappropriate arousal patterns.

In such a situation, I didn’t have a lot of options for furthering a conversation or following whatever breaking news may have been happening. I had to shelve whatever thoughts or emotions I was having, and continue on with the assessment.

(You may ask why I wouldn’t have turned my phone completely off during a forensic assessment, but the reality of it is that the trace of the assessment is being recorded for later review, where it’s much easier to spot problem situations, and that turning my phone off only leads to things like my daughter destroying a sliding glass door because she locked herself out of the house on a cold day in early March—long story—well, not really, I think I just told it).

2) Which leads to…”60-something-year-old man…history of mental health issues…history of substance abuse…makes sense.”

Sitting in that dark, stuffy, hot room, staring at a double-lined forensic “trace” on a computer screen, with few responsible options available for furthering my knowledge/understanding of the situation, the defense mechanism of clinical detachment kicked in. Think about it, yelling “Oh my God!,” or sobbing openly, or exclaiming, “Shazbot!” all would have been pretty inappropriate.

At any rate, the quick run-through of Williams’ risk factors is the kind of clinically detached comment that I suppose is hard for a lot of people to take, especially when it has not been filtered at all. I can’t speak for everybody in the field of counseling/therapy, mental health, or even crisis intervention and suicide prevention, but there’s an odd dichotomy that exists in most people who get involved in such fields: we tend to be highly sensitive people; we learn to be very objective about that sensitivity.

If I wanted to get all sci-fi, I could say people in this field are empaths…empaths who have honed their skills away from making them one big, raw nerve, and toward using that sensitivity to discern a deeper sense of what is happening in others without being overwhelmed by it. Most of us have some pretty pronounced defense mechanisms. So, ideally, our training leads to an ability to pick out risk factors and make judgments about how those risk factors affect a situation, so that an appropriate course of action can be taken. Such risk factors are not predictive, but tend to be more actuarial.

Furthermore, the assessment of risk factors tends to weed out irrelevant elements. I’ve heard so many people go off about Williams’ fame and money as if that should have kept him from suicide, but those factors are irrelevant to a suicide assessment…except perhaps in the context of Williams’ available resources for obtaining help. But, and here’s a big generalization (as well as a big but), for somebody who is at the point of committing suicide, the concept of “help,” regardless of one’s resources, has become rather abstract and unreachable. From such a viewpoint, the available “help” appears to have been exhausted and shown to be inadequate. So, pushing past the money and fame, if one looks at Robin Williams from the standpoint of demographics and his personal history, he fits into a high risk category—or, rather, multiple high risk categories, even before other information about his health was revealed.

3)  “I wonder what else was going on with him” was merely a further part of the assessment of risk and what led Williams to his course of action. In suicide risk assessment, this is a huge factor. (Can I get a ‘duh’?). If the demographic factors alone played the deciding role in whether somebody was going to commit suicide, then we’d have near-universal suicide by people who fit into the same demographic categories as Williams.

Hence, one of the things that is always asked of people expressing suicidal thoughts is some variation on “Is there anything in particular that’s leading you to feel this way?”

The big idea behind such a question is to open up a conversation with someone who has, perhaps, not had such an opportunity to discuss what’s going on with them. A lot of people who attempt suicide, or are headed in that direction (here’s another big generalization) have been very closed off about their thoughts, and what they’re going through. Sometimes, broaching this conversation, being able to “normalize” suicidal thoughts (let people know they’re not as rare as they might think), and giving somebody a chance to talk through their immediate experiences, can lead to a person discovering that they have supports and strengths they weren’t considering when they were staying closed off and keeping it all to themselves.

4) The idea that “I am NOT going to write a blog post about this” came from a number of places. As someone who works in suicide prevention, and who writes a (mostly weekly) blog it seemed almost obligatory for me to at least note Mr. Williams’ passing. I shudder at “obligatory.”

Also, following any highly-publicized suicide, a whole slew of TV pieces, articles and blog posts (among other things) commenting on suicide and depression and the lives of those who complete or attempt suicide go flooding out into the world. It makes sense that people want to find out what happened, or understand how it could’ve happened, or share their personal feelings, or pay tribute, or say obnoxious, ignorant things…and there is often plenty of overlap in all of that.

And all of the posts and articles, and TV pieces close out with the phone number for Lifeline, the National Suicide Prevention Hotline, urging people to get help for themselves, or for anybody they know, who is considering suicide or having suicidal thoughts.

As I’ve noted in other posts, I don’t do death too well. And I don’t really like talking about a particular celebrity because they died, or talking about suicide because that’s how someone famous died. I don’t generally shy away from talking about suicide, but I’m not deep into worrying about what celebrities are doing in their private lives. At any rate, when such conversations happen, I find myself slipping too far into the clinical, or just keeping my mouth shut. As for Robin Williams…I’m pretty sure I saw the entire run of “Mork and Mindy” and the “Happy Days” episode that spawned Mork, although I couldn’t really tell you much of anything about any of those storylines…as apparently memorable as they were, what with the rainbow suspenders and flying eggs and all. I’ve seen several, but definitely not all, of Williams’ movies.

Williams, like almost any accomplished artist who is around long enough, and productive enough, is going to put out work that is great, and some that is less great. The last thing I saw him in was “World’s Greatest Dad”—strangely enough, a story about a man who becomes a sort of celebrity after he ghost-writes a suicide note to cover up the fact that his teenage son died from autoerotic asphyxiation. I really enjoyed this movie, like I’ve enjoyed all of Bobcat Goldthwait’s movies (the ones he writes and directs). They tend to involve a kind of dark humor and exploration of at least mildly taboo subjects that are right up my alley. And, as a special bonus, “World’s Greatest Dad” was partly filmed at a bookstore and “mall” about five minutes from my house.

Williams as the most talkative mime ever in "Shakes the Clown"...shattering expectations for better or worse.

Williams as the most talkative mime ever in “Shakes the Clown”…shattering expectations for better or worse.

But then again, I had also written some spotty notes about how “Good Will Hunting” is one of numerous movies that gets the therapeutic relationship all wrong. I could continue on about liking how “Alladin” made good use of Williams’ rapid-fire joking, as did “Good Morning, Vietnam” and how he did some good stuff around mental health issues, like “Awakenings” and even “Patch Adams.”

I could tell of how I once spent half of a 9th-grade biology class trying to stop laughing uncontrollably after attempting to relay part of a Williams comedy routine to my lab partner (who is still my closest friend, not counting my wife). To completely butcher the joke, it involved Williams doing an impersonation of E.T. saying “ouch” because he was standing on his testicles.

5) Which leaves only “Uggh! There’s gonna be a shitload of extra calls on the crisis line tonight!”

I’ll concede that this is a pretty damn selfish thought. But, to provide some context, the call volume on Lifeline, the National Suicide Prevention Hotline on Monday, the day of Williams’ death, was double the call volume of the day before. On Tuesday, August 12, Lifeline had its highest call volume ever in the history of the service.

It’s true that not all of those calls involved people with suicidal thoughts, or suicidal intentions. The calls were not all from people standing on a bridge, or sitting in their living room with a gun in their lap, or lying in bed with several containers of pills and a bottle of gin beside them. Many of the calls were people asking how to get help for people they know. Many were people upset and sad at Williams’ passing, and just trying to process their own thoughts. But many were from people struggling with suicidal thoughts and intentions, several of them consumed with the idea that if Williams, with all he had achieved, was going to kill himself, then why shouldn’t they?

And, of course, people being the way they are, whenever the Lifeline number gets widely published and shared around on social media, there were more than the usual number of prank calls. (Quick note, kids: DO NOT prank the Lifeline—we have to take suicidal threats seriously, which means you might get a visit from the police as the price of your little joke, and as the price to the people of your hometown, who now have police officers responding to a non-emergency situation because you thought it was funny to be the kind of asshole who mocks people suffering from depression).

On top of the massive increase in Lifeline calls, most of the Lifeline call centers also serve as local crisis lines, and there was a huge uptick in the calls to local crisis lines (I don’t have specific numbers on this one yet, but trust me). Several of the Lifeline call centers, including the one I work in, also serve multiple functions within the local mental health system. To say the least, things got a little overwhelming.

I could go on about a number of other factors involved here, like how, while some call centers may be able to call in additional volunteers to address the short-term spike, generally speaking, the staffing, as with any business, is aimed at addressing an ‘average’ workload.  And there isn’t any way to suddenly increase the number of telephone lines and work stations to deal with what is, ultimately, only going to be a short-term (even if massive) increase in call volume.

By Thursday night/Friday morning, things seemed to be calming down a bit, easing back down to normal…at least in terms of call volume.

But we’re all still left with the sadness and the loss of an entertainer who reached people worldwide, and the struggle to understand and accept whatever this means to us personally, or societally, or clinically.

And, oh yeah…

If you or anyone you know is struggling with suicidal thoughts, PLEASE PLEASE PLEASE call LIFELINE, the National Suicide Prevention Hotline, at 1-800-273-TALK.

Suicide Notes from the Cosmic Web of Coincidence

Back around Christmas, I posted a piece about how, contrary to popular belief, the ‘holiday season’ is not the most suicidal time of the year. I’m gonna let you in on a little secret…spring is.

I wasn’t giving the idea of springtime suicide all that much thought, until the news of a note from Kurt Cobain’s wallet—mock wedding vows that turned out to have been penned by Courtney Love—bounced into the news for a day or two, and I realized I’d been hearing about a lot of recent suicides–well-known and mostly-unknown.

Hearing the specifics of Cobain’s wallet note, on a local radio show as I drove home from work, knocked down a self-imposed wall that had prevented me from engaging with the stories of recently-released information and evidence from Cobain’s death, leading me to think back on my memories from that time.

Back then, my wife and I were making a living designing and printing T-shirts out of our apartment, selling them at the Fremont market, and through ads in a local paper, The Stranger, and in national publications Spin, Vibe, and Rolling Stone, as well as doing custom jobs for businesses, bands, and other organizations. News of Cobain’s death had managed to elude us until I saw it in a Seattle Times headline, there on display by the sales counter at a gas station/convenience store across the road from our apartment, where I had gone on a late-afternoon beer run.

As with most deaths, my reaction was one of stunned silence–an unvoiced, “Wow, that’s weird.”  Back home, I hemmed and hawed and didn’t quite manage to relay the information, instead turning on the TV news and waiting for the story to come on.

We had only recently confirmed my wife’s first and only pregnancy; and it hadn’t been long enough for us to share the news with friends and family. I couldn’t stop thinking of that photo of Kurt, Courtney, and baby Frances from the cover of Spin. Cobain, not even a year-and-a-half older than me, had achieved what we were all supposed to want—right? Money, fame, a family—all while getting to tout his artistic integrity and give a big middle finger to…well, whoever he wanted, I guess. He was just getting started. He could continue on being a vital artist, or get old and boring, or become a recluse, or whatever he wanted. He had the resources now, and…

Kurt and courtney and frances

Well, if I steer clear of the conspiracy theories, he killed himself. How was that even possible?

Looking back through a lens of pop culture references, I think of Tyler Durden confirming that we weren’t all going to become millionaires, and movie stars, and rock gods. But Cobain had become that…or at least two out of three.

Also, prior to Cobain’s death, I’d read interviews with Eddie Vedder where he talked about being depressed and drinking too much wine, and I was worried Vedder was going to kill himself…intentionally, passively, or accidentally. Cobain said plenty of dark things, sure, but he was just kidding…right?  And, yeah, I had all the Nirvana albums, and all the tracks that turned up on compilations, credited and uncredited…No Alternative, Hard to Believe, The Beavis and Butthead Experience

In my earliest thoughts about this post, I had some germ of an idea about making a connection between Cobain’s death and my current work…like Cobain’s death had some impact on the trajectory of my life, and…oh well, whatever, nevermind. I think we all try to fit various life events into narratives that make everything add up into some kind of “everything happens for a reason” bumper sticker idea…as if the suicide of a celebrity I had never even met was meant to guide me to my purpose.

It was a good 12+ years from the time of Cobain’s death until I bounced back into school with the intention of becoming a therapist, and then a few more before I had gotten involved in suicide prevention, almost more by happenstance than by a powerful drive to do so. I found out I was good at it–able to handle the stress of trying to redirect people in crisis—trying to suss out what it was they were after, and find a way to address that (which often just comes down to listening and validating the underlying emotions of their distress).

Cobain may have been one tiny thread among numerous others leading up to where I landed, just like the other people I knew (mostly peripherally) who had taken their own lives—or tried to—the bulk of them in spring. But Cobain was never some overtly motivating factor. In fact, I think if I cited him as a big reason for my work, it would be kind of ridiculous… “Man, Cobain’s suicide really changed me, and I decided I wanted to help people.” But to be clear, I have no harsh judgment for whatever factors direct people to engage in ‘the helping professions.’

A supervisor of mine, who was instrumental in providing me with the fundamentals for dealing with people struggling with suicidal thoughts, theorized that the increase in suicides in spring might have something to do with the dashing of expectations…that slogging through a cold, dark winter is one thing when everybody has to put up with the cold and the darkness. But when spring starts peeling open, turning itself toward the sun, grasping those opportunities to grow…and you’re still stuck in that winter mindset…cold, despondent, unable to see the sun or feel its warmth, or to even care about dragging yourself out into it…well, that’s when you lose hope.

In thinking about springtime suicide, I’ve had this other little germ of a thought…that when we are constantly exposed to the idea that everything happens for a reason, it can have the inadvertent effect of making people seek out connections for why they feel shitty. And when they can’t find particular reasons…or perhaps the reasons they find are viewed as trite or easily resolved by the people around them…or maybe the reasons they find all land in the arena of self-doubt, shame, or a sense that they are apparently deserving of the bad things that have happened to them and the lack of happiness they feel…well, it can hurt that much more.

Instead, why not embrace the idea that plenty of things in life happen for no reason at all, except, perhaps, for the culmination of random factors and arbitrary decisions…the cosmic web of coincidence…which can end up dropping anyone down a deep dark hole? (Arguably, this is a ‘shit happens’ bumper sticker argument, but I like to think of it as much more involved).  And why not embrace the idea that darkness is an essential part of being human? As much as happiness may be the goal, as much as we may all want to be millionaires and rock stars and movie gods, even the millionaires and rock stars and movie gods among us can’t completely avoid disappointments, disasters, trauma, and loss—hell, a lot of them are born of that negativity (although I don’t want to promote any ‘tortured artist’ stereotypes).

None of us get to insulate ourselves against negative feelings. Those negative feelings–even feelings of suicide–are actually much more common than people think. But when we’re so fixated on happy, and so fixated on the idea that we can ARRIVE at happiness once and for all, with just the right combination of attitude and effort, we set people up to wonder just what is wrong with them when happiness seems so elusive.

So, check in with your friends and family this spring and every spring (and every other season for that matter). That celebration-free, often contact-free, stretch from New Years Day until the world starts warming up in spring can be long and dark as hell…and when spring rolls around, and people are left feeling like they are still disconnected and down in a hole, despite all the blossoms and rays, that darkness can become something much more overwhelming.