It’s Not That Simple

August 13, 2014

I have hesitated for several days now, thinking, praying, reading.  I am not sure I can say what I want to say correctly, without hurting someone’s feelings, without stepping on some toes. I am not even sure I am gifted enough with words to write accurately what I believe deep in my core. I am not sure I am up for conflict right now.  But because I can’t let this go, I am writing about it.

“It could have been prevented,” seems to be America’s default response when we deal with catastrophe.  After 9/11, we heard for months how the attack could have been prevented.  After every bombing, every public shooting, every plane crash, every kidnapping, every thing that goes wrong we want to know how it could have been prevented.  And that is not a bad thing.  We continue to make important changes that save lives and make our world a better and a safer place.  We have prevented many more catastrophes just in the last decade.  This work that we do to prevent suffering is good and it gives us something to do with our anger and our outrage and our pain.  It gives us purpose.

The death by suicide of Robin Williams has elicited this response again.  “It could have been prevented” posts are flying around the internet at warp speed, and all the talking heads on every media station are talking about how this death could have been prevented.  My fellow mental health professionals across the planet are posting about suicide prevention and how important it is to get help and how we can keep people alive if they just get the right kind of help.  I am one of those professionals and I believe in suicide prevention.  I sit with people in their despair day after day and year after year, holding out hope that there is a way through the darkness and out of the darkness.  I am sure I have saved many lives by knowing the signs and doing the right thing.  I have helped others save lives by knowing the signs and doing the right things.  I march with the survivors of suicide and I support all the efforts that are being made to prevent suicide.

And yet.  It is not that simple.  I was given a great gift by a wise psychiatrist when I was a 30-year old fledgling therapist.  I was seeing a client with treatment resistant bi-polar disorder.  She was often suicidal and I often felt completely incompetent, impotent, and hopeless about my work with her, even though I knew I was doing all the “right” things.  Sharing this one day with my colleague, he said to me, “You have to remember, Amy, that some mental illnesses are terminal.”   I remember twitching.  I remember dreaming that night of losing my client to suicide.  I woke up from the dream sweating and remembering his words.

Why have those words been a gift to me?  Because I know now after more than 25 years of practicing therapy that no matter how much we know, we cannot know the mysteries of the human brain and the human psyche.  Many seasoned psychiatrists have talked about not always knowing where the line is between someone who is really going to be ok and someone who is at risk for suicide.  All the correct questions can be asked, and yet, it is not always that simple.  There are intricacies in the brain and the psyche that are a mystery.  Medicine is a science and an art.  There is mystery and intuition to good medicine, and no matter how much we want the illusion of having some control over things, the psyche often refuses to be controlled.  Even with all of our sophisticated methods, mood disorders can be terminal.

We never know the mystery of someone’s psyche or soul.  We can guess.  We can intuit.  We can project.  What causes someone to decide that there are things worse than death?  The answer to that might be different for each of us, and I allow every person the autonomy to know the answer to that.  In many ways, it is the mystery and uniqueness of each client in my office that keeps calling me into this work in deeper and deeper ways.  It is the mystery and the unfolding of that mystery that I believe continues to help my clients to find healing and wholeness and to want to live a rich, full life.

We can do more to prevent suicide.  And I will continue to fight that good fight.  But it is not simple.  It is never simple.  I believe we need to leave room for the mystery that is each of us.  I believe we have to get better at living with hard and unanswered questions without the knee-jerk response of blame and shame.

I am very sad about Robin Williams’ death.  I will hold his family up in my prayers.  Perhaps for Robin the ultimate mystery has been revealed and he can finally rest deeply and peacefully.

I am ending this post with a poem by the Sufi poet Hafiz.  Read it slowly and without judgment.  It is not a poem encouraging death or dying or suicide.  It is a reminder of how impermanent life is, and how each of our lives here is a precious gift, no matter how long it lasts.  My favorite line is this:  “All I know about life and myself is that we are just a midair flight of golden wine between His Pitcher and His Cup.”  Robin Williams was a beautiful flight of golden wine.  I will miss him.


Deepening The Wonder

Death is a favor to us,
But our scales have lost their balance.

The impermanence of the body
Should give us great clarity,
Deepening the wonder in our senses and eyes

Of this mysterious existence we share
And are surely just traveling through.

If I were in the Tavern tonight,
Hafiz would call for drinks

And as the Master poured, I would be reminded
That all I know of life and myself is that

We are just a midair flight of golden wine
Between His Pitcher and His Cup.

If I were in the Tavern tonight,
I would buy freely for everyone in this world

Because our marriage with the Cruel Beauty
Of time and space cannot endure very long.

Death is a favor to us,
But our minds have lost their balance.

The miraculous existence and impermanence of
Always makes the illumined ones
Laugh and sing.

(return to Quotable Quotes/Poems)


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