Welcome to the surreal world of post-hospitalization for a mental health issue. Glad you could come. Suspend all disbelief at the door.
Seriously, this is a bizarre journey. Come along if you like. Today Blake had his first real appointment since he was released from the hospital. He met with a psychiatric service that was meant to help him continue with his medications until he connected with a new psychiatrist. I checked on him just after the video appointment was to begin. Hearing no sound coming from behind the door, I knocked to check in. No one had contacted him yet. He was sitting and waiting, almost willing someone to email him a Zoom link for his appointment which was supposed to have begun five minutes before. I coached him to call and he was given a way to connect and I left the room once more.
When he finished, several minutes later, he was more confused than ever. The wrong medication was prescribed and he had been told to go back to his previous psychiatrist and outpatient therapists. This is NOT what the hospital had told him to do. And, all importantly, there was no blood test ordered to check his Lithium levels (one of his new medications is Lithium, and he must have regular blood tests. In fact this was the most important reason for his appointment).
I recognized, after hearing of his experience, that I need to step in and advocate for my young adult son. He is scared and confused.
”In the hospital, they do everything but spoon feed you,” he noted. “Now I’m supposed to know how to manage everything and I don’t. It’s all my fault.”
“No. You’re not. And it’s not helpful to pile blame onto yourself,” I told him, gently. “This is confusing for Dad and I, too. We’ll figure this out together.”
I helped him call his psychiatrist, a man he’s seen only once before he was first hospitalized a month and a half ago, and helped him book an appointment. Thank goodness he had something within a couple days. I hung around while Blake completed a mass of online documentation and I provided moral support and assistance as he needed it. He got through it all.
Later, the pharmacy left a message. I’m pretty sure they refilled medications he is no longer taking. I haven’t even told him yet. He doesn’t need more confusion for the day.
Tomorrow, we celebrate his birthday. It can wait until after that. His birthday had been planned as his death day. Our plan is to help him avoid fulfilling that plan. He seems on board with that and has given us permission to commandeer the day with special surprises. Thank goodness for that. Perhaps we can have one day of delight – one day where the weirdness waits. It’ll be back on Friday, I’m sure.
It’s been a little while since I’ve written and someone just reached out to me to ask how things have been since Blake’s hospitalization. I’m guessing this person is not the only one who has wanted to know so I’d like to share a little update. This style is uncharacteristic for me on this blog, but I’m so very tired lately, and it’s the easiest way for me to share with you what has been going on.
Not long after my last post Blake returned home and started in a partial hospitalization program (for OCD, anxiety, and depression). That means he went five days a week for six hours each day. Without sharing too many details, I can say that it did not go well for him and he was admitted back to the hospital within a couple weeks of being released. This second hospitalization was longer and he is now home again. We are working as a family to put together the pieces of what aftercare will look like.
I can share my own personal experience of this as being scary, confusing, and an emotional roller coaster. When your young adult is admitted to a psychiatric ward and held, they (and you) lose control over exactly what happens and when they get to leave. There are twists and turns on a daily basis – he’s going to be trying this procedure. No, wait, he’s not. He’s on this medication. No, we changed that two days ago. We’re recommending this program. No, we’re not. We think it’s this diagnosis. No, we changed our mind – it’s this. Oh, can you pick him up in two hours? He’s coming home.
My head has been spinning and it’s not been easy to regain my balance. I’m decreasing my workload as much as I can to attend to my family. As many of you know, I’m a psychologist who specializes in treating anxiety and Obsessive-Compulsive Disorder. I can tell you that none of my education, training, or experience has prepared me to face this situation more than anybody else. I don’t like that. Sometimes it feels like Blake has been moved from professional to professional and there’s no one staying involved long enough to keep things moving forward in a logical direction. It feels like we, as a family, have been tossed around – and now it is our job to sort out what’s next with the leads we have been given.
I’ll keep you posted on our progress. We are diving into uncharted waters. I hope that, someday, I can use this experience to help make is less scary and confusing for others.
Please be aware, short reference to suicidal ideation below:
I can see her waiting patiently out of the corner of my eye, as I listen to the social worker’s voice on the other end of the line. She can’t see or hear me; my camera is off and my mic is, too. I can see the fuzzy blackness covering the square that would be me in this telehealth call. She looks uncertain about what to do as she waits. The social worker on the phone talks on, giving me updates and directions. I dutifully take notes, painfully aware of the time that has lapsed since I darkened my screen and left this mom, mother of one of my young patients, waiting. I hang up the phone. Six minutes have gone by. I turn my camera and mic back on and she looks at me with concern and with what I imagine is a question that hangs between us.
“Is everything okay?”
It is not like me to abruptly leave a therapy session, and the call came in so early during our meeting I hadn’t yet been able to tell her. This has been a week unlike any other. I’ve told each and every patient or parent that I might be interrupted. I’ve mastered the drill by this point – a family member is having a health crisis; everyone is safe; doctors call me unexpectedly and I have little control over when that happens; if it happens, I’ll turn off my camera and microphone, take the call and return as quickly as I can; please forgive me if it happens. But this time, I had no opportunity to share, the call came so close to the beginning of our session. Then I tell her more than I’ve told any other person I’ve met with this week, pausing only for a millisecond in my head to debate whether it is appropriate.
“My son is in the hospital,” I say. Now it is out there. “I deeply apologize that I didn’t have the chance to tell you that I might get a call.”
“Was it planned?” she asks.
“No,” I answer, “though things are stable. I just get calls from doctors and I don’t have any say when they do that. I’m so sorry that this took from our time. I will make that time up.”
“Are you sure you’re up for being here? We can reschedule.” I see the caring and concern on her face.
“Honestly, there’s really not anything else for me to be doing right now. If I wasn’t working, I’d be sitting around waiting for time to pass,” I tell her. Then I lean in to the monitor, “Right now I’d like to be here with you, if you’d like to be here with me, too.”
She decides to continue and this honestly is exactly where I want to be.
Blake has been in the hospital for eleven days as I write this. For those of you who’ve followed this blog, you’re aware he’s struggled with depression and OCD. At times, it has been confusing which is more pressing. He’s been open, for the first time in a long time, to participating in treatment. He’s been working with a couple therapists and a psychiatrist. While he’s been the driver of his treatment, he’s also felt little hope or joy. He’s found nothing he wants in life. Depression is a thief that way; it robs us of seeing any possibility life might hold for us. Still, he continued on, trying a new antidepressant. Then, OCD’s intrusive thoughts took hold, constantly locking him in a fight against the torment. Simultaneously, his muscles started twitching uncontrollably, making him that much more uncomfortable. It took a while to realize that the twitching was a likely a side effect of his medication. The entire experience led him to hatch a plan to end his life – a plan he luckily shared with my husband and I, and later with his therapist.
Now our journey will take a new direction. Blake is scheduled to begin a Partial Hospitalization Program for OCD and anxiety shortly. He has never had treatment this intense ever in his life, and he is understandably scared. I have never had such brain fog in my life as I have this week, nor have I ever recognized so starkly the incredible beauty and supportiveness of those around me. I’ve had little energy to interact with others beyond what I “must” do, but those interactions have made me appreciate the power that exists in supporting one another.
And so, dear reader, thank you for coming to visit with me today. There’s nowhere else I’d rather be than here with you, if you’d like to be here with me, too.
Being a loved one of someone who has Obsessive-Compulsive Disorder is hard. It’s hard because you watch that person suffer, and, when you love someone, you don’t want them to suffer. Very commonly, when someone we love has OCD, we get caught up in doing things that don’t help. One way we do this is by accommodating. That is, we do things that OCD wants (e.g., washing our hands because maybe they touched something suspect, we reassure our loved one that of course the feared thing won’t happen, we do things our loved one is capable of doing themself so that their OCD doesn’t get triggered – the list goes on). Accommodation, although it feels loving, actually keeps our loved one stuck in the OCD cycle.* On the other end of the spectrum, but also problematic, is what I did with Blake the other day. I got into conflict with him over his OCD.
Yes. Yes. I did get into conflict with him. I was downright not very nice. I share this with you at the risk of being judged harshly, but I have a purpose for sharing it. I want to emphasize something for loved ones everywhere. Loving someone with OCD can present some challenges – and you will not always meet those challenges in the best way. You are human. You will mess up. I messed up the other day, and I am a psychologist who is an OCD specialist. I deal with these issues every single day of my professional life. I should know better. And I can admit that this is hard.
So, here’s what happened. Blake and I went grocery shopping. He was not thrilled to go. I actually didn’t give him a choice. He’s been in the house almost nonstop and I thought it was important for him to interact in the world for a brief bit. With our masks donned, we moved through the medium-sized store as I grabbed some bread and produce. Blake was clearly anxious about the experience, although he did stop briefly to say hello to an employee he recognized from his volunteer work. When we got home, I still had one more errand to run. Blake was to take the two bags of groceries into the house. He walked around the back of the car and lifted the hatch.
“I don’t know what to do about this, Mom. Can you help?”
I got out of the car to see what the problem was. One of the bags had fallen over and the apples inside it were now lying on the car liner. Without thinking much of it, I picked up the apples and placed them with their mates in the bag. Blake seemed to recoil. I knew right away what it was. OCD was saying all the apples were contaminated. I felt frustration rising in me; that should have been my sign to stay quiet and leave. Instead, I confronted Blake.
“You’re upset about the apples, aren’t you?”
“Well, I just don’t know what to do with them now.”
“Blake, we wash our produce before we eat it…”
“But they were in the back of the car…”
“Apples grow outdoors. They fall on the ground before they get to the store. They touch all sorts of things. You’re not going to eat these now, are you?”
“No. Probably not.”
Nice, huh? Great example of a loving exchange between mother and son. And the mother is an OCD specialist! So, it went on for just a bit more and ended up with me saying something really brilliantly supportive like, “That sounds like such a hard way to live, honey,” before I drove off, leaving Blake with the grocery bags.
Within moments, I knew I’d been out of line. I’d been unkind. Airing my frustration at my already-anxious son was not going to make anything better. What he did or did not plan to do with the apples was not my problem. It was his job to either challenge his OCD and eat them or to miss out on a favorite fruit. As I drove I crafted my apology in my head. I would write it as soon as I was parked, but before I even arrived at my destination I received a text from Blake.
“Hey Mom. Sorry for how I responded. I’m tired and I’m panicking and I felt like I just couldn’t deal with the situation. I went with what made me most comfortable in the moment.“
Tears stung my eyes and rolled down my cheek.
“Hi Blake. Thank you for the text. I was just about to text you, too. I feel terrible. I cornered you about the apples and that was wrong. I am so sorry.“
We spoke some more when I got home and each acknowledged our part. We recognized areas where we are each a work in progress. Will I be perfect now and never mess up again? No. I will absolutely mess up again. What I refuse to do is to beat myself up over it as I have done so many times in the past. It doesn’t help me and it doesn’t help Blake, who worries about me when he can see I’m doing that. Instead, I can strive to improve. I can acknowledge that I am flawed. I can recognize that growing signs of frustration in me are not imperatives that I act or speak, but signs to step back and evaluate. And I can remember that when Blake is appearing anxious that he is not going to be able to take feedback from me; it’s best I wait. We can learn and grow – together.
*Note regarding accommodation. Please, if you see yourself in this and recognize that you engage in accommodating your loved one’s OCD, refer to more information on the subject. Do not change and remove your accommodating behavior until you have consulted with your loved one, a professional, and/or professional resources that can teach you how to do this. One possible resource is the International OCD Foundation: https://iocdf.org/
It has been emotionally exhausting to be a mental health therapist this past year! Actually, it’s been emotionally exhausting being a human. As a psychologist, I have never before experienced a time where I have felt so many depending on me, while I try to navigate similar circumstances to the people I work with. And I have felt so drained after hours in front of the computer screen doing teletherapy that I have honestly found no energy to sit and write in this blog – until today.
Without going into details in this post, I will note that Blake and Michael are back in our home with the hubby and myself. What the future holds for them, and so many young adults I know and work with, is still to be written. For now, Michael is completing a graduate program from a distance, and Blake…. Well, Blake returned home wanting to go into therapy (not for OCD; for something else), and we are supporting him in doing that.
Now, here’s something to note: when you are a mental health professional, you cannot be therapist to your own family members. First, it’s actually considered a professional no-no. At the same time, your spouse and your children absolutely do not want you digging into their psyches. I mean, really, who among us wants our parents probing our emotional health? Makes sense, yes?
Oh, and also, the more you know about a subject, the more your family has absolutely no interest in hearing what you know. Yes. It’s true. I have specialized in anxiety and Obsessive-Compulsive Disorder for over a decade, write articles on these subjects, teach professionals at workshops, educate the public…BUT I KNOW NOTHING! If I even move to share information about anxiety or OCD among family, it is of no interest. So, I have learned (as my mental health professional colleagues have) to listen to my family, and even my friends, talk about their symptoms while I keep my mouth shut. I offer no recommendations or information unless I am specifically asked, lest it I be reminded, “Stop playing psychologist with me!” (and, yes, you do detect some frustration there – it’s like I know the coolest information, but no one wants to hear it. I digress.).
Anyhow, this state of “Mom-knows-nothing-about-anything-that could-be-helpful-to-me” made something that happened today all the more stunning.
“Mom…” Blake says. “How was it that I used to deal with intrusive thoughts when I was in ERP therapy for my OCD? I’ve been trying to purposely think the thoughts, but I’m only getting more uncomfortable.”
“Hmmm. Tell me a little bit more.”
“Well, I couldn’t sleep last night in part because of the thoughts, so I tried to think them, but it just felt worse. I didn’t feel better.”
“Would you be willing to tell me a little more, or would you like me to connect you with a colleague who can help you sort this out?” I ask.
“I’d like to see if you and I can figure out what I’m doing wrong,” he says.
“Of course,” I say. “I’m heading out to take something to Grandma. When I get back, you let me know when you’re ready. Set aside time with me.”
And I fully expected that would be that. When I returned home, though, Blake found me again. He actually wanted to learn what I know! And so we sat down. I was able to share the little understood secret of OCD: if you practice exposures with the goal of making your thoughts or discomfort go away, it will backfire on you. Your brain is too smart. OCD already tells you that you can’t handle being uncomfortable and that you’d better do something to make yourself feel better – and that is where it traps you.
“So, my job is to practice getting good at being uncomfortable,” Blake deducts.
“Yes,” I say, “but you have to have a really good reason that it’s worth doing that because why do it otherwise?”
And together we find his “why” and we create a mass of exposures he can use. He picks one he’s going to try over the next week. And then he says THIS:
“Thank you, Mom. It’s so nice having a therapist for a mother.”
The hubby and I are in the back yard having a moment alone when we notice Michael and Blake coming out the door. Their faces look purposeful. Michael’s looks gleeful.
“Mom, Dad – We’re moving!”
We’re not suprised by the announcement. The two have already been talking for over a week about driving across country, getting an apartment for a few months, and creating a small social bubble with a couple of friends Michael went to college with. It’s been an uncertain time for two young adults living in a pandemic. Job opportunities have been sparse for Michael (a recent college grad). What he can find he is way over-qualified for. They’ve both felt isolated. Fears have abounded: Will we ever find work? Maybe we’ll never have relationships or families of our own. What is our future?
Michael has also been worried about his brother. He sees him frequently stuck at home, sleeping way too much, struggling with a view of the world that lacks joy. He thinks time away is just what his brother needs. And one more thing: he adores Blake.
“There is no one else in the world I can better imagine doing this with,” he tells his brother.
Blake is uncertain. He worries about the money it will cost. He worries he won’t finish the book he’s about thirty pages from completing. He worries he won’t like living nearly two thousand miles from home. Nevertheless, he agrees to go – and he almost instantly regrets the decision. But OCD has made him a man of his word. If he makes a commitment, there is no gray. There’s no re-evaluation, no backing out.
On a Sunday morning, almost two weeks ago, they leave our driveway in a car their grandmother has lent them. One of our dogs repeatedly tries to stow away with them, but he doesn’t succeed. Two pieces of my heart drive away. I’m happy and I’m sad.
The photographs from the road tell an adventurous story. Two brothers on the road together. The phone call when they arrive at their new apartment reveals that Blake has been nauseated since he left. Anxiety has taken over. He immediately is offered a job at a book store, which he takes. It’s his first “real” job. His nausea does not abate. His mind is a storm of unwanted thoughts.
Michael, awash in pride over having single-handedly installing wifi in their new place, is an incredible source of support for his brother, even as he deals with the reality that moving across the country is not as romantic in reality as it is in fantasy (friends aren’t as available as they promised they’d be; many hours are spent pacing the apartment floor, jobs are still difficult to come by). He drives his brother to and from his new job. He buys him ice cream to settle his stomach.
Blake wonders if he’ll last the three months he committed to. So does Michael. The hubby and I remind them that doing new things is hard, and to stay focused on the moment. One moment at a time. One hard thing at a time.
It’s a big week upcoming for OCD! Saturday, October 10, is not only World Mental Health Day, it is the Virtual 1 Million Steps 4 OCD Walk. Usually the walk is a live event that takes place in various places around the world. Groups meet and participate in activities along with the walk. This year, people will walk on their own and, perhaps, participate in activities virtually. Yours truly has her own shirt and will be walking with the hubby around our neighborhood.
Then, Sunday, October 11, OCD Awareness Week begins. Above, I’ve posted a photo from the International OCD Foundation. It shows a variety of activities going on during the week to raise awareness about OCD. Have OCD, or a loved one or friend with OCD? Check out an activity and share with others.
When I first began to prepare my practice for the possibility of a pandemic, I failed to imagine the potential impact on my own emotional well-being.
In February, I heard the murmurs. On the fringes of my OCD support group some members were talking about their “novel coronavirus” fears. I chalked it up to OCD playing its tricks. Surely we had nothing to fear from this faraway virus. In early March, I shared with patients my plan to go virtual if the virus made it necessary to close my office. I never imagined I’d actually be doing it, but the American Psychological Association had recommended that psychologists have a plan. I’m a rule follower and it seemed prudent, so I made a plan. Just over a week later, I saw my last patient in the office and was fully a telehealth provider by the next day. Five months later, I’m still providing OCD and anxiety disorder treatment from a little corner in my home.
“So, what’s the big deal?” one might wonder. Indeed, I am lucky – blessed even. I’m in a career where I can work from home, as long as I have a secure internet connection and a private space. And, hey, research demonstrates that OCD treatment via telehealth can be very successful. I’m luckier still that I already did some of my work via secure video, seeing patients who didn’t have an OCD/anxiety disorder specialist in their corner of the world (actually, not the world – just their corner of the state I’m licensed in, but I digress). I didn’t have to make the switch to telehealth overnight without previous experience or training. Great, right? Grab the morning coffee and head to the office in the corner. No commute.
Sure, there’s the adjustment to the new working setting and the unintended consequences of that shift (can everyone say “chronic pain from poor ergonomics?”). That part, I’m dealing with. The unexpected part, the part I think the mental health provider community is going to be dealing with for an unforeseen amount of time, is the unprecendented demand – and the long term toll on our well-being. You see, here’s what happened: my state went into shelter-at-home. Most of my patients stayed in treatment; a few decided to take a break and wait things out. There were crickets – silence – where there used to be new referrals. My free support group went virtual and saw better attendance than ever – with the same faithful attendees. We fumbled through this together. Many of my OCD patients seemed better prepared than most to deal with the newly-named COVID-19, their skills at coping with uncertainty being an asset. All in all, it was relatively quiet, minus the shifting and adjustment. It was actually eerily quiet – for a bit. Maybe I should’ve taken note of what happens before a tsunami – the drawback of water from the shore before the deluge.
An Emotional Toll
It started with patients who were on an “as-needed only” basis requesting to come back in for regular sessions. The stress of the ongoing isolation and the unknowns taxing their coping skills (as I write this, on a weekend morning, yet another of these has called asking to come back). Then those who’d taken a break mid-treatment during the shutdown wanted to return. And then came the new referrals, people who I’d never seen before, calling and pleading for help. Struggles with their mental health that had been manageable before were overwhelming them now. It continued until my practice was bursting at the seams, until I just could not fit anyone anywhere else.
My support group went similarly. In non-COVID times, one or two new inquiries in a month was a lot. I began to see one a week, then a few a week, then eight in four days. I couldn’t keep up with screening the new referrals. I wondered if the group and its community feel could withstand the constant flow of new attendees. I started to feel burned out.
I’m normally known as the therapist who connects people with therapists (“Call Dr. Angie. She’ll be able to help you find someone good.”). I don’t like to hear that a person in distress has been unable to find a mental health professional who can see them. I listen to them. I find out their needs and I take it upon myself to find at least a few therapists in my network who are open and ready for their call. In recent weeks, I grew weary of the constant need. I took a step I’ve never taken before in my nearly two-and-a-half decades in private practice. A week ago, I changed my voice recording: “I am unable to return calls from new referrals.” It kind of devastated me to do that. The group followed on its heels two days ago. Now a message about my group reads, “This group is currently not accepting new members. Please check back in the future.”
It feels like I’ve been in a shipwreck. People all around me are drowning – or at least feel they are. They see me as the stronger swimmer – the one who can bring them to safety. They reach out with their hands. Their voices beseech me to help them. But there are endless numbers of them. I can’t see them all, but I can hear them. What they don’t realize is that on top of reaching out and pulling person after person to safety, I’m in the water, too. And I’m swimming and dog paddling as best as I can – and I’m getting exhausted. But, still, they call out. I want to help them all. I don’t want to watch anyone drown. But if I keep going, I may drown myself. I feel beyond torn. What choice do I make? Save one more? Rest, so I can help more in the future? And if I do rest, how long will I be haunted by the sounds of drowning voices, pleading to be rescued?
Looking After Our Mental Health Providers
I’ve come to believe that my experience is not at all unusual among my colleagues. I frequently see shared experiences of being “exhausted” and “burnt out.” Our practices are brimming with need. Many of those who come to see us have reduced or, increasingly, limited ability to pay us. We are in this field to help. It flows through our veins like our lifeblood. We respond to those who are struggling. But now we are struggling, too.
In the past, a mental health professional experiencing exhaustion, overwhelm, or burnout would pull back, take care of themself, perhaps even see a mental health provider. But now our fellow mental health providers are coping with the same situation. We’re all in this pandemic together. We are all being called upon to do more. We’ve been asked to see first responders who are coping with the distress of caring for the ill. I’d venture to say that we are the forgotten first responders, the ones for whom the flow of the affected is not letting up. Not now. Not in the foreseeable future. And I am fearful of what may become of mental health if our professionals stay on the current path, veering ever-closer to mass burnout.
I do not have answers; just thoughts about the direction we might go in. I know that I cannot help every single person in need right now. If I’m to go on to help more people, I’m going to have to step back and do what is necessary to build my own emotional strength back up. A mental health provider is ethically bound to step back when they see their own emotional health suffering. We must be in a good place to help our patients get to a better one than they are in.
To my fellow mental health providers: I see you out there. I know your level of caring and dedication. I know the need out there calls to you. The need will far outlast the physical distancing measures. Just remember that you are needed in as healthy a place as you can be in. It’s not a case of “better to give compromised mental health services than no services at all.”
It’s been suggested that the medical community look at this pandemic as a marathon, not a sprint. I suggest mental health providers look at it as something else – a relay race, perhaps. None of us can marathon forever, but maybe, just maybe, if we can keep passing the baton to one another, and give each other a break – even reach out to one another for reprieve and support – we can go the distance. For sure, we will have stories to tell, and regrets of what we could not do, but the work we do is far too important for us all to burn out at once. Obviously, I wrote this because I am struggling. Now to take my own advice.
*This is not meant to be advice; it is simply something I’m learning as our family navigates having a family member with suicidal ideation. If you are thinking about suicide or have a loved one who is struggling with thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255 (In the United States. In other countries, please reach out to a similar service in your country).
The hubby and I began participating in therapy with a specialist from a suicide prevention center just a few weeks ago. Our son, Blake, had been sharing a good deal of suicidal thoughts with us and, since he was not interested in any ongoing treatment, we recognized we needed support ourselves. So far, we’ve done an intake meeting and two sessions. Although I’m a psychologist who specializes in treating anxiety and OCD, it’s a completely different story being a patient. I am learning, for sure, so I thought I’d share three nuggets I’ve gotten so far:
1. It’s not necessarily a bad thing that someone is talking about suicide.
Emphasis here is on “talking.” It was terrifying to me when Blake shared the thoughts that go through his mind, how much he suffers, how much he thinks of dying. I became alarmed at the very presence of these thoughts. However, our therapist (and others) have told me that it is actually a positive thing that Blake is talking about his thoughts. Talking and sharing are attempts to reach out and connect with others. This is a better thing than keeping these thoughts all to oneself – and not connecting with others.
2. It’s important to listen, not try to problem solve.
Many times when Blake has shared his pain with us, the hubby and I have worked to problem solve with him about ways to cope. We’ve also tried to shine a light on the bright side of things that he may be overlooking. What I’ve learned is that the most important thing I can do when my son shares his thoughts and feelings – even though they contain very dark and frightening content – is to listen and accept them as his. It is not my job to problem solve. That’s not where he’s at; he’s in sharing mode and he simply wants to be heard. As far as pointing out the bright side, our therapist noted that, for someone who is not ready for that, it’s kind of like shining a light in the eyes of someone who has been sitting in the dark. It’s going to be jarring and unappreciated. So, I’ve been working on listening and simply hearing.
3. An increasing number of conversations about suicidal ideation does not necessarily mean the person is about to act.
In our last session, I noted to our therapist that the freqency of conversations seemed to be going up. Our son was having more conversations with us about his pain and his thoughts of death. He wasn’t sharing intent to act, he was just sharing more often. It was emotionally exhausting, at times, and I was concerned what it meant. The therapist reminded me that we’ve shifted our conversations from problem-solving and pointing out the bright side to actually just listening and accepting. She noted that the increased frequency may simply mean it’s become more safe to share and that, when a person feels like they will be heard, they’ll take the opportunity to talk more often about what may be going on in their head. So, although it feels scary to me to be hearing my son’s thoughts more, it may just be that he feels more accepted in voicing them now than he did in the past.
We still have a way to go on this journey, and we have to listen to our son to ensure we are not missing signs of intent to harm himself. On the way, I am learning, and I hope our experience can help others.
*If you are thinking about suicide or have a loved one who is struggling with thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255 (In the United States. In other countries, please reach out to a similar service in your country).
“I called the suicide hotline the other night.”
Blake casually drops this line as he and I sit lazily on the patio chairs and cushions in our yard. I do everything in my power to keep myself from reacting too strongly. I want to encourage him to keep talking, not shut him up with my own anxiety.
“You did?” I ask. “When was that?”
“Saturday night. I just couldn’t sleep. I couldn’t stop thinking about what a failure I am and I thought, ‘Maybe I’ll check this out.’ Honestly, I expected it to be a waste of time, but I’m actually glad I called.”
“I’m so glad to hear you called,” I say. “You must have been feeling pretty awful to reach out.”
“Yeah. I tried the text line first. But there were a lot of people ahead of me. I waited over half an hour. I decided I’d try the actual phone line because the service suggested it as an option. I thought I’d wait even longer, but there was someone on the phone with me in about three minutes.”
He pauses a bit, then he continues, “I thought it would feel stupid, but I have to say, it felt so good to tell a stranger how awful I feel. I told them about stuff that I’ve never told anyone else. I felt like what I’m so upset over is so petty, but the person on the other end of the line said, ‘That sounds so hard.’ It felt so good to hear that.”
We go on to talk about more of the particulars. My young adult son shares how he struggles to decide if he should live or if he should die. I tell him how courageous he is for reaching out, and for being honest with me now. But afterward I am hurting so much. I want to cry and feel the relief of deep, cleansing sobs, but the tears won’t come.
It’s well after midnight and my husband is asleep. I turn to the internet. I’m not sure what I’m looking for, but my son (my beautiful son) – the one I carried when he cried as an infant, explored the world with, delighted in each new step he took, soothed through huge spikes of anxiety and OCD triggers, and championed through his many brave steps – frequently feels that his life is not worth living and that he is not worth the effort of saving. I’m looking for something to help me help him see that it IS worth it. I feel desperation…and then I realize – it’s not my choice to make. It is his life and I cannot coax, cajole, or convince him to stay here. It is selfish of me to do so because, while I’m thinking of him, moreso I’m thinking of my own pain.
And that is when I realize that I am the one who needs help. I have to take care of me right now. It’s not about saving him. Yes, he could use help and support when he chooses it. But right now it’s about taking care of me so that I can live with a family member who I love fiercely and who is frequently contemplating suicide. That is a lot to navigate alone and, until now, I’ve pretty much done just that.
Maybe it’s because I’m a psychologist and I think I’m supposed to know how to handle suicidal thoughts, but I suspect that it is also about being a mom. As parents, we are supposed to take care of our children. We worry about them from the moment they are conceived until we draw our last breath. When they struggle, we look to get them help. We forget that we must be in good shape to be a support.
The next day, I call the suicide hotline myself. It had never occured to me that I could call the hotline as the parent of someone who was dealing with thoughts of suicide. As much as it sucked to make that call, it felt so good to be heard and held by another. That call led me to reach out to a suicide prevention center and today, in less than an hour, I will have my first consultation session with a specialist. It’s not for Blake. It’s for me – so I can learn how to take care of myself. I’m nervously optimistic. I’ve lived with my son’s suicidal thoughts for so long, never considering how I was doing. Let’s see where this journey leads.