a special program of the National Emergency Medicine Association (NEMA)
Transcripts: 515-1 to 515-5
Week: 515.1 Guest: Richard A. Heckler, Ph.D. Topic: Life After Attempting Suicide - Part One Host: Richard Roeder Producer: Ed Graham
NEMA: There were certainly great differences in the backgrounds and the lives of the people that you talked about in the book but did you find something that seemed to be a common thread among all of them?
HECKLER: Certainly there were common threads in terms of what their histories were. Most people reported having a history of either traumatic loss - they lost a parent or both parents or a sibling earlier in life or they grew up in an extremely dysfunctional family. There was alcohol and drug abuse, physical and sexual abuse and we know sexual abuse is very prevalent in our country and they also grew up with a very deep and pervasive sense of alienation, of feeling disconnected from their family, community, from their town and even in some fundamental way, from the human race. And when you put all of that together and when there wasn't another adult who was present to really see the pain that this person was in and really reach through the coping mechanism to find them in there and say, you know, "I'm going to help you with this, I'm going to stay with you and we'll work it out together," in the absence of that it leaves a vulnerability in the psyche and a kind of fragileness and brittleness. So inevitably when somebody encounters the challenges of adolescence and early adulthood, they're less able to bring to bear the resources inside of themselves and even find the resources outside of themselves in order to cope.
NEMA: Join me for part two on life after attempting suicide with Dr. Richard Heckler.
Week: 515.2 Guest: Richard A. Heckler, Ph.D. Topic: Life After Attempting Suicide - Part Two Host: Richard Roeder Producer: Ed Graham
NEMA: This is part two in a five part series on life after attempting suicide. My guest is psychologist Dr. Richard Heckler, author of Waking Up, Alive.
NEMA: How common is suicide in the United States?
HECKLER: We know that when someone commits suicide, it affects six other people very very directly. We know that for every minute, for instance, that we're talking on this program, there's a suicide attempt and for every 17 minutes, there's a completed suicide so it's very prevalent.
NEMA: Many of the people in your book had not only loss but had suicide directly in their family, either a parent or another relative.
HECKLER: For family therapists, family psychologists, multi-generational dynamics are kind of the genes that physicians look at and biologists look at. What that really means is that families pass down what they've learned in terms of how they coped with stress and loss and trauma and it's very interesting, sometimes the stories haven't even been passed down completely from one generation to the next but the younger generation ends up acting very similarly to their predecessors at times of stress and certainly suicide is something that's really kind of emblazoned into the family history and people from a younger generation can find themselves responding in similar ways to stress than their grandparents or great grandparents had.
NEMA: In the book you describe stages that a person who is destined to attempt suicide is on and these involve losses you've talked about but also this is almost described as, and I don't mean that you romanticize this in any way nor do I mean to sound like I perceive it that way, but it's almost this dance that's taking place of loss and then descent and then the attempt and return. Could you just briefly describe as complex as those are what that process is.
HECKLER: You may remember when we were kids and we saw a bug or a caterpillar or worm on the sidewalk and we would poke it a little bit with a stick and what you would find is that it would retract and it would pull into itself in order to escape the assault and that's basically what happens to people who begin to tumble into what I call the suicidal trance. They encounter a challenge, a difficulty, a problem. It begins to seem unsolvable and they withdraw into themselves and what they do at the same time is they erect a facade or a mask. T.S. Eliot described it when he said "We prepare a face to meet the faces that we meet," and the terrible thing about this mask is that it works. People prevent others from seeing the pain inside and so it eliminates the possibility further and further that somebody can really help so then that person who's in pain withdraws more from the world. They erect a stronger mask and it begins a kind of cycle of pulling back and pulling back until it's very very difficult to reach that person. Finally they're in a stage that I call the tunnel and it's very much like tunnel vision where all they can see is that the future will be the repetition of the pain in the present, that the pain will go on forever, the problem's unsolvable and nobody can help and at that point it begins to seem like a logical and maybe even compassionate response to commit suicide. There is a particular hopelessness contained in suicide which is the hopelessness about the future, that the future will ever change, that it would be any different.
NEMA: Join me for part three on life after attempting suicide with Dr. Richard Heckler.
Week: 515.3 Guest: Richard A. Heckler, Ph.D. Topic: Life After Attempting Suicide - Part Three Host: Richard Roeder Producer: Ed Graham
NEMA: This is part three in a five part series on life after attempting suicide. My guest is psychologist Dr. Richard Heckler, author of Waking Up, Alive.
NEMA: You talk about the combination of depression and hopelessness and I think some people might think of those as being very similar yet you make the point very clear, they're sort of two different components. Talk about that a little bit.
HECKLER: Depression is found in suicide a lot but there are people who are depressed most of their lives who don't turn to suicide. There is a particular hopelessness contained in suicide which is a hopelessness about the future, that the future will ever change, that it would be any different so if you combine the depression and the hopelessness and then add one more ingredient and this ingredient is a particular image of death as a release and a release from all pain so if you combine the depression, the hopelessness and this image of death, what you create is a very volatile mixture which can lead to suicide.
NEMA: Certainly intelligence was not a quality that was lacking in a lot of the people in your book. Am I to assume that this is potentially part of the profile of someone who does try suicide?
HECKLER: We talk about suicide as an equal opportunity affliction and it really covers all intelligence's, gender, race, sexual preferences, where people live in the country and it also speaks to one of the myths that we have about suicide, that people who attempt suicide are crazy or sick and actually that's not true. People come from all walks of life. Oftentimes they are very intelligent, very creative and very much suffering. Sometimes the difference between those who are suicidal and those who aren't really only exists in terms of the duration of the pain and the intensity of the pain.
NEMA: Is the old saying that a suicide attempt is a cry for help a cliché and a myth or is that in fact true? Is that frequently the case?
HECKLER: One could say that any action we take is a communication so in that sense, it's true. But you have to realize that there are many ways to ask for help and by the time somebody gets to the point of using the word suicide or certainly making an attempt, they're in terrible trouble anyway so we consider each attempt or each spoken word very seriously, as serious as the attempt itself so we don't discriminate and it's a very dangerous thing in a way to prejudge and decide that one sentiment might be less dangerous than another.
NEMA: In the book, the stages that you discuss of a person going down this tunnel towards suicide, is there a stage or is the person susceptible at any stage to being pulled out of it by a positive message from the outside or an intervention or someone sensitive enough to realize what's going on or is there an inevitability about the path that they're on?
HECKLER: No. Absolutely. It's possible to arrest the fall and we have a feeling in this country that if you talk about suicide to someone, that it will in fact propel them into the act and actually the opposite is true. There are many many suicides that are thwarted because somebody has had the courage to kind of step into the abyss and speak to a friend or a loved one about a very difficult subject and say something like, "You seem not yourself these days. You don't seem like you're enjoying yourself. You seem distracted. I'm wondering if you think it's not worth it anymore. I wonder if you've been thinking about suicide."
NEMA: Join me for part four on life after attempting suicide with Dr. Richard Heckler.
Week: 515.4 Guest: Richard A. Heckler, Ph.D. Topic: Life After Attempting Suicide - Part Four Host: Richard Roeder Producer: Ed Graham
NEMA: This is part four in a five part series on life after attempting suicide. My guest is psychologist Dr. Richard Heckler, author of Waking Up, Alive. I asked Dr. Heckler about the value of trying to communicate with a person who may be considering suicide.
HECKLER: It creates a bridge and oftentimes people can find the opportunity to begin to talk about themselves and since suicide is such a profound state of disconnection, any connection can help.
NEMA: What can a family who senses that something is wrong with, for example, parents sense that something is wrong with a child. First place, what should they look for in terms of behavior that might indicate that something like this is even a potential event and if they spot such a thing, what is it that they can do at that point?
HECKLER: I counsel people in two different directions. One is to trust your intuition. If you know someone very well, if you've been with them for a long time if it's a loved one, you can begin to discern a change in attitude, loss of will, a feeling that they're not enjoying themselves as they did before, that the interests that they had before seem to slack off, they seem distracted or irritable, they're having trouble sleeping. Those are signs that's something's happening underneath the surface and I counsel people to be persistent, to get closer to the person, to begin to talk about it and that's one set of responses. The other set is to begin to get more educated. For instance, reading Waking Up, Alive somebody would emerge knowing 100% or 200% more about suicide than before. On page two of nearly every phone book in the country, there is a suicide hotline and the staff there for the most part is very well trained and they also can be resources not only for the person who is suicidal but for the family as well so educating yourself is also very important. Also realizing that you can't be a psychotherapist to your loved one and what you can do best is to help them find somebody who is qualified.
NEMA: Is the person who survives a suicide attempt and goes on to be even enriched and evolved as a result of the experience the same person as someone who died from their suicide attempt - just the one that died died and the one that lived lived - or in fact are we talking about some other whole force going on - maybe a will to survive that the person who actually died - I hope I'm phrasing that right, it's a difficult question to ask but I think you maybe know what I mean by that.
HECKLER: Yes Richard. It's a wonderful question. There are two classes of people who survive the attempt. There's one class who will continue to make attempts later in their life. They haven't been able to substantially change what has been going on with them and we know when someone's made a suicide attempt there's a 50% greater chance that they'll make another. But the question became for me, what separates those people from the people who really legitimately embark on the road back to life? And what I discovered was that early on when they discovered that the attempt didn't work and it was often a very confusing and painful time for them, they asked themselves a series of simple questions but they were very profound and powerful questions and they went something like this. After all the planning, after all the hoping, after all the anticipating committing suicide, why didn't it work? Why am I still here? Is there some purpose to my life that I'm not aware of? Is there some meaning to my life that I'm not aware of? And even if there's some higher hand or greater force that interceded to prevent the attempt and if the answer is yes to any of those questions, then I better damn well find out what that's all about.
NEMA: Join me for part five on life after attempting suicide with Dr. Richard Heckler.
Week: 515.5 Guest: Richard A. Heckler, Ph.D. Topic: Life After Attempting Suicide - Part Five Host: Richard Roeder Producer: Ed Graham
NEMA: This is part five in a five part series on life after attempting suicide. My guest is psychologist Dr. Richard Heckler, author of Waking Up, Alive.
NEMA: Should anyone, adult or child, that ever says to somebody - I'm thinking of killing myself - whatever form or phrase they use to communicate that, should they be taken seriously no matter who it is or how they phrase it?
HECKLER: Absolutely. Again, there are many different ways to ask for help and when someone begins to use the word suicide, it's essential that we take it seriously.
NEMA: In the book, you talk about healing the past as a crucial part of recovery from a suicide attempt. Talk about that a little bit.
HECKLER: This is the second stage of coming back to life in that it's about rebuilding the self that had been so torn apart during suicide and this is the time when people turn to psychotherapy, both individual and group psychotherapy, to look back at the past and begin to heal some of the wounds that happened back there. What's powerful about that time is that it's the first time that people really allow themselves to grieve. Grieving is very powerful because here they allow the pain to surface without turning to suicide. They allow their tears to wash over them. They allow themselves to drown for a couple of moments in the ocean of tears that they feel but to their surprise and astonishment, they feel better afterwards. And so it's one of the first times that they can feel inside themselves and feel something other than pain. They feel release. They feel relaxation. They feel a little bit more in contact with one another. And once people enter psychotherapy they begin to embark on what is a perennial spiritual quest, it's the great quest that we've had since the beginning of humankind, to answer the question "Who am I?" When people are in the suicidal trance, they can only answer that question in one way which is - "I'm a person in terrible pain and that will last forever." But now people begin to discover that they're artists or they're able to communicate when they didn't know they could communicate before or they are attractive when they thought that they weren't. I remember interviewing a man who had been drafted by the New York Jets football team. He had been an All-American. He was on the championship national football team that year and he was drafted and he was this enormously fearsome linebacker but he knew since he was 14 years old that he was gay and he had kept that a secret so now 10 years of his young life he had kept one of the most essential identities about himself a secret for fear that he would be rejected, ridiculed, judged. And now after his suicide attempt, he began to discover not only that it was okay for him to be homosexual but he began to discover that he was a songwriter and a poet and he began to discover that there were many different parts of him that he had never entertained before and it left him with a feeling of excitement and adventure in his life.
NEMA: What kind of feedback have you gotten back from your book?
HECKLER: I've gotten phone calls and letters literally from all over the world and it's interesting that people were in different stages of the process. Some of them had just attempted and had read the book and found it very hopeful and uplifting. There were some people who were descending into the trance and it actually arrested their fall and they said to me that it was the first time they really felt that they were mirrored back, that somebody really understood how they felt so it's been universally a powerful and positive response to this book and this book is really the silver lining research in what is a terrible social condition so I'm very gratified and heartened by that.