Suicide Prevention: What Works, What Doesn’t

Robin Williams completed his suicide just over a week ago. When I heard the news, all I could do was make the sign of the cross, say a small prayer for his soul, and cry. I felt as though I had lost a friend. I still do. I, like so many, grew up watching Robin Williams, and laughing until my cheek muscles cramped. He was almost a member of the family. “Mork and Mindy” was always my favorite. I think I’ve seen every episode at least twice.

His death comes at a time when there is suffering everywhere we turn- the killing of Michael Brown and the strife that has ensued in Ferguson, the killing of Christians in the Middle East, the continued genocide of the Christians and Muslims in Palestine… It is almost a cosmic joke that Robin himself might have told. It’s as if someone is pouring salt in our wounds, kicking us when we’re down by snuffing out our brightest light, our biggest earthly comfort, our most beloved comedian.

It is sad to think that one of the legacies of this incomprehensibly talented icon of comedy is the manner of his death. Despite how loved he was by millions, he died alone, isolated from his family and the world. In the depths of despair, he completed his suicide.

Once I learned of his death, I had to read it for myself, in the hopes that it was a hoax. I clicked on article after article, trying to wrap my head around it. In all of the media chaos, one post shared on Facebook jumped out at me. I seethed with anger at such a salacious, insensitive, judgmental title coming from a purported Christian.

“Robin Williams didn’t die from a disease, he died from his choice.” This blog post, by popular Christian blogger Matt Walsh, grabbed my attention and made me want to hurl my phone at the wall in shock.

Before I go any further, it is important to say that I believe Mr. Walsh was actually seeking an answer to the question, “why?” He gave a voice to what many have thought or felt in losing a loved one to suicide. Viewing the loss as the person’s choice allows him (or anyone who takes this view) to understand that which can never be understood. We can never know the mind of God in order to understand how suicide could possibly fit into His plan. By viewing it as Robin’s “choice,” we grasp onto a neat answer that we can live with, rather than the existential emptiness which would otherwise terrify us.

I recently completed a year of working in the social services department of one of Atlanta’s psychiatric hospitals. Over the course of that year, I would estimate that I saw over 1,000+ patients in either individual or group sessions who were fighting against thoughts of killing themselves.

When I think back on my patients and their struggles, I cannot think of a single patient for whom Mr. Walsh’s words would have been true, let alone beneficial. He said about suicide: “The complete, total, absolute rejection of life. The final refusal to see the worth in anything, or the beauty, or the reason, or the point, or the hope. The willingness to saddle your family with the pain and misery and anger that will now plague them for the rest of their lives. It’s a tragic choice, truly, but it is a choice, and we have to remember that. Your suicide doesn’t happen to you; it doesn’t attack you like cancer or descend upon you like a tornado. It is a decision made by an individual. A bad decision. Always a bad decision.”

Words like “rejection,” “refusal,” and “willingness” all imply that Robin had control over and intent in his actions. They carry a strongly negative connotation which blames Robin and judges him (and anyone who completes their suicide) harshly for their “choice”.

Instead, I assert that as Orthodox Christians, we believe that it is for God alone to judge willfulness or intent. We should not place ourselves on Christ’s seat of judgment, but should instead let our existential emptiness be filled not with anger or blame toward the person we loved, but by a faith in Christ, His grace and mercy, His Resurrection. We know that we, too, can overcome death, no matter how our death occurs.

In suicide, there is indeed an element of choice. But suicide is the consequence of feeling that there are no choices left. It is not being unwilling (as Matt Walsh said), but rather, being UNABLE to see any other choice. As Martha Ainsworth states on her excellent suicide prevention page, “Suicide is not chosen; it happens when pain exceeds resources for coping with pain.” Almost every patient I ever sat with would said that they didn’t want to die. They wanted the pain to end.

Further, it is important to understand that people who are depressed enough to contemplate suicide are plagued by their own voice. Their inner monologue is one of self-loathing, such that they cannot believe any positive thought anyone else says (I often refer to this as the “if only they knew who I really am inside” syndrome). They have a self-image so low that they begin to believe they are a burden to the world. They believe the world would be relieved if they were gone (especially friends and family who are “burdened” the most). These thoughts and feelings work in concert, becoming a perfect storm which blocks out any light, any hope which might peek through to save them. Like a vicious circle which has no end, it worsens, spiraling further downward, until they are standing on the proverbial (or literal) ledge, ready to end their pain permanently.

The take-away from Robin Williams’ passing is that it brings to light a struggle which is undertaken in darkness, isolation, and shame. It reminds us that the real issue is how to help our struggling brothers and sisters.

How we respond to our suffering brothers and sisters in Christ when they are in crisis can be the difference between life and death for that person. First, it is important then to know what NOT to do. We should not try to guilt them out of their thoughts by using words of judgement like “you will be rejecting life,” or “you are going to saddle your family with pain and misery and anger…” This just feeds into the person’s preexisting feelings of shame, guilt, worthlessness, fear, and hopelessness. It makes them feel judged.

We should not give advice like “you’ll feel better if you…” or “why don’t you just…” Advice-giving only serves to make people feel unheard and misunderstood. Nor should we use phrases like “I understand,” or “I know,” or “it’s going to be okay.” The fact of the matter is, we don’t know what it’s like to be in their situation, even if we have been depressed. We can’t understand what they are going through, because each person’s experience is unique. And we certainly don’t know that everything is going to be okay.

The best thing we can do as a loving Christian is pray, and pray fervently. The second best thing we can do is sit with our loved one, hold his hand, listen to her, and be present. People who struggle with suicidal thoughts need us to be a strong, non-judgmental presence for them. If we truly desire to help, we must allow them to be vulnerable, to let their darkest secrets be known without fear of rejection, blame, or judgment. If we concentrate on listening to their words, and use statements like “you feel…” to reflect our empathy, then we can begin to help.

The most important thing we can and must do is GET. THEM. HELP. If someone you know is contemplating killing him or her self and has trusted you enough to tell you, it is your obligation to get them help. Here’s how to assess the situation in three quick steps:

1. Ask your loved one if he or she wants to die.
Yes, use these words. It is important to differentiate between wanting to die and wanting the pain to end but not being able to see how things can change.

2. Ask if he or she has a plan and what that plan is. If they do, ask if they have the means to carry out their plan.
The more they have thought out and planned, the more likely they are to attempt suicide. If they have a plan and have the means to carry out that plan (such as a plan to shoot themselves and there is a gun in the house), then they are at imminent risk and this should be considered an emergency.

3. Call 911 or a suicide hotline (the National Suicide Prevention Lifeline is 1-800-273-8255).
Describe as much as you can about the situation to the operator. If the person you are trying to help is willing to speak with the operator, put them on the phone. Stay with them until help arrives, and keep silently praying for them.

May the Lord send His comforting Spirit to Robin Williams’ family and friends, and to all of us who feel his loss. May his memory be eternal!

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Posted by the Orthodox Christian Network.  You can find the Orthodox Christian Network on Google+.

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Presbytera Marilisse I. Mars lives in Atlanta, GA. She graduated…
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