Thursday, August 26, 2010

Darkness Visible: A Memoir of Madness, by William Styron

A beautiful book... almost plain-spoken, and all the more profound for it. Describes depression very accurately and gives a just account of its innumerable intricacies—all the more impressive, since it’s a short book. Reading this book was the greatest solace in my loneliness, where no one can relate. The focus, the honesty, the disarming lyricism, the sensitivity, that constant rueful sadness, even humor—and, yes, redemption. There isn’t any attempt to glamorize or romanticize depression—Styron even reflects on centuries of artists who seem to be inexplicably blighted by the disease. A mix of personal defeats, friends, the writing life—and how one’s existence is just permeated with the darkness. Oh, there’s just so many things I want to share, to discuss—I want to point to a page and say, “Yes, that’s true,” and then to another, “He’s right.” Depression is sometimes termed "the invisible illness", because it is not apparent—nor is its severity accessible—to an outside observer.

William Styron (1925 – 2006), Darkness Visible: A Memoir of Madness

[A] fascinating aspect of depression’s pathology . . . This concerns not the familiar threshold of pain but a parallel phenomenon, and that is the probable inability of the psyche to absorb pain beyond predictable limits of time. There is a region in the experience of pain where the certainty of alleviation often permits super human endurance. We learn to live with pain in varying degrees daily, or over longer periods of time, and we are more often than not mercifully free of it. When we endure severe discomfort of a physical nature our conditioning has taught us since childhood to make accommodations to the pain’s demands- to accept it, whether pluckily or whimpering and complaining, according to our personal degree of stoicism, but in any case to accept it. Except in intractable terminal pain, there is almost always some form of relief; we look forward to the alleviation, whether it be through sleep or tylenol or self-hypnosis or a change of posture or, most often, through the body’s capacity for healing itself, and we embrace this eventual respite as the natural reward we receive for having been, temporarily, such good sports and doughty sufferers, such optimistic cheerleaders for life at heart.

In depression this faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come- not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying- or from discomfort to relative comfort, or from boredom to activity- but moving from pain to pain. One does not abandon, even briefly, one’s bed of nails, but is attached to it wherever one goes. And this results in a striking experience- one which I have called, borrowing military terminology, the situation of the walking wounded. For in virtually any other serious sickness, a patient who felt similar devastation would by lying flat in bed, possibly sedated and hooked up to the tubes and wires of life-support systems, but at the very least in a posture of repose and in an isolated setting. His invalidism would be necessary, unquestioned and honorably attained. However, the sufferer from depression has no such option and therefore finds himself, like a walking casualty of war, thrust into the most intolerable social and family situations. There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship. He must try to utter small talk, and be responsive to questions, and knowingly nod and frown and, God help him, even smile. But it is a fierce trial attempting to speak a few simple words.



Thank you, Mr. Styron. You saved my life, and you are deeply missed.

Thursday, August 5, 2010

Is Suicide Selfish?

“Suicide is not selfish. Period."

—John Kevin Hines, a suicide prevention advocate and suicide attempt survivor.

Kevin Hines, at the site of his suicide attempt.

It is easy to assign blame. Whenever people are disturbed, their propensity is to assign blame, to get "justice" by holding those responsible for the offense accountable, whether through force, verbal attack, or shunning.

It's curious how the first emotion you feel when you hear about the suicide of somebody you know is fear—the fear that you are somehow responsible for the death. One day, when I was in Berkeley at my volunteer site entering data, I got a call. It was Pierre, my good friend from San Diego. His voice sounded grim, and after an exchange of 'how are you's', he said he had something serious to tell me and asked me to sit down. I was puzzled and asked what happened. He told me that David, our mutual friend—the one with whom we used to hang out and play the board game Risk—had committed suicide. The news sounded unreal to me, and a strange stream of emotions passed through me; one of the strongest ones, thought irrational, was fear—the fear that I was somehow responsible for his death, that there might have been something I said or did that caused him to feel so bad as to come to this end.

David, several months before his suicide.

My friend's death came as a surprise and a shock to me. And as I found out later, his family and friends, including Pierre, who brought be this terrible news, were no less stupefied. He left no explanation as to why he did it, and it is up to our imaginations to speculate what might have led him to take his own life. He had a good job, his family is well off, he had friends, and many people knew him at his Church.

You may read David's last words here.
Outside you act so tough
But inside you cry
All the pain inside just makes you want to die
—Brian Head Welch, L.O.V.E.

The point that I am making here is obvious—that no matter how much you think you know a person, you really don't. This point is illustrated clearly through the words of Karen Kenyon, author of the book Sunshower who has been married to her husband Dick Kenyon for almost sixteen years. One night, instead of coming home as he always did, Dick, then an administrative worker at UCSD, ended his life on November 3, 1978, by jumping to his death from an eleven-story building on the campus where he worked. "There were no observable clues, no threats of destruction, just a slightly noticeable withdrawal", write Ms. Kenyon; his suicide note to his wife began, "Karen, This job has killed me." This goes on to demonstrate the extreme dichotomy between the inward and outward manifestations of pain. A person may be burning in agony on the inside while showing no outward signs of distress.
"When someone takes his or her life, it is seen as the saddest statement anyone could ever make. At least in our culture, this is so. Suicide is covered up, hidden by family and friends. It is seen as a mark on the lives of those connected with it. But it happens. It is part of our human experience."
—Karen Kenyon, Sunshower

Death is a part of life (there is joke that goes "death is a part of life, namely the last part", which is also true), and so is suicide. In my suicidal ideations I do not blame anybody for my wanting to die. If I ever decide to kill myself, the decision would be deliberate, well-thought out, and my own. I would not take my life by impulse or folly, rather the decision would be rational and carefully thought out. We all sometimes cause suffering and mistreat each other, whether deliberately or unintentionally, but we never wish our loved ones to die. So you see, it is irrational to feel like you're to blame for another's suicide. Friends and especially families of suicide victims often find themselves in deep distress, because they feel responsible for their loved one's suicide, and the society may perpetuate this feeling. But this is never the case. It is never the family's, or anyone's fault. The pain of the tragedy of the sudden loss stings, but it is not because close ones are responsible. It is because a big part of them has died with that individual, and they need time to grieve and accept the death.

Blame is a fatal emotion. Along with shock, sorrow, shame, and sense of failure, guilt is the hardest emotion to get through for the survivors. All of the questions torture those left behind, making them want to punish themselves with things like cancer and death. It is important to support suicide survivors and to let them know that you do not blame them for what happened.
“Nobody realizes that some people expend tremendous energy merely to be normal.”
—Albert Camus (1913 - 1960), French existentialist author and philosopher


...To Be Continued
"We the living are likely to feel accused by this person who 'voted with his feet.' It appears to cast a subversive judgment upon the social polity as a whole that what was supposed to work in life—religion, family, friendship, commerce, and industry—did not."
—Edward Hoagland, "Heavens and Nature"

It is ignorant and arrogant to judge somebody’s decision of taking their own life, because everybody’s life belongs to them, not us, and to judge them is to claim ownership of their life. Furthermore, dismissing suicides as rash decisions is abhorrent because it diminishes the suffering of the suicide victims and prevents the society from recognizing its own role in contributing to suicides as well as addressing the dysfunction within the society that led to the suicide victims' suffering and the eventual death. It prevents others from holding themselves accountable for their lack of effort to prevent that person’s suicide and maybe even their own contribution to that person’s suicide. Life is every person’s inherent right, and so is the right to die.

"I went over everything in Dick’s and my life together. I felt we belonged together. But now I built case after case against myself. Maybe I wasn’t a good enough wife or a friend, I would conclude. And yet all my questioning was self-centered...

"After a long while, I did wonder if he didn’t have that right...

"... I know that if I could have stopped Dick I would have done almost anything within my power. But who would I be doing this for? Really myself. I am the one who didn’t want to suffer the separationthe loss. So now I want to say to Dick‘I let you go’. Now the only judgment I can make is that it is very hard at the point of separation (Journal excerpt, November 14, 1979).
"So I began to realize it was Dick’s decision. No one else would have wanted that in any way. He did not tell a soul. He kept his secret, and made the choice, for reasons I can only speculate about now, and still the reasons don’t really matter. People have said everything from “He was a saint and martyr” to “He was very sick”. He did what he did, and in a way we have no right to interpret it. He did it for reasons he considered right and necessary—the only thing to do. In a way I feel—Can’t he even have that?
"I do believe we are all responsible for our lives, and so acceptance of our involvement in what happens around us is essential, but I feel we have to also know and respect that others have their own ultimate choices, as we do ours.”
—Karen Kenyon, Sunshower

My friend David died by suicide two years ago, without showing any warning signs. His family and friends are terribly devastated and are still grieving his loss, but it is not up to me to judge his decision; I don’t know what he was going through. Even thought his family and friends deeply miss him, we respect his decision to take his own life. It is ignorant to blame the suicide victim, and it is selfish to call him selfish, because when we do so, it is only our own pain—and not the pain of the deceased—that we care about.