“Mental Illness” is a harmfully misleading phrase that causes suffering by design

I’ve spent close to twenty years looking for reasons behind why I was compelled to think and act suicidally when I was twenty seven years old.  While my search has yielded more questions than definitive answers thus far, I’m convinced that sharing what I’ve learned will help others.

Events happen, and then people think and say things about those events—let’s call those stories.  No matter how accurate or truthful a story is seen to be, events that have occurred and the stories that people tell about those events, are never the same thing.  They can’t be because one is an occurrence in reality while it’s happening, and the other is an after the fact symbolic representation meant to describe a prior real occurrence.  I’m no linguist, but this is the nature of language, right?  We use language and stories to encapsulate and communicate meaning about our reality and our conscious experience of that reality—every word is a story unto itself making sense of existence.  Every diagnosis of every “mental disorder” relies on a translation of stories.  A person tells a psychiatrist a story, and the psychiatrist maps that natural language story onto a “mental disorder” language story from a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM).  Millions of people assigned a “mental disorder” story or a “mental illness” diagnosis end up failing to see the basic event-story distinction I just pointed out.  They confuse their DSM diagnosis or “mental disorder story” with reality itself.  If you don’t believe me visit TheMighty.com, click on “Mental Illness” and start reading.  Unfortunately, many patients are also systematically misled to necessarily attribute the issue that prompted them to see a psychiatrist to a supposed specific brain pathology that mysteriously eludes specific definition and explanation.  

I made these mistakes after nearly killing myself nineteen years ago, in part, because of the forces of institutional corruption at work within our mental health care system written about by Robert Whitaker and Lisa Cosgrove in Psychiatry Under the Influence.  I share this true story as an anecdotal example of those corrupting forces in action.  It is my hope that others won’t make the avoidable cognitive mistakes that I made during my treatment.  I also hope to inspire the many well-intentioned but misguided “lived experience” mental health advocates who are confused like I was to think differently.  They are unwitting participants in this harmful confusion’s perpetuation.  

A few days after I unintentionally fell asleep inside of a car that I had intentionally turned into a makeshift gas chamber, a psychiatrist told me that I was suffering from a “mental illness” called Major Depressive Disorder after talking with me for less than fifteen minutes.  That’s all the time it took him to gather enough information to know which “mental illness” was plaguing me and how to treat it.  He prescribed me a medication called Paxil as he mentioned something vague about the amount of a neurotransmitter in my brain called serotonin and selective reuptake inhibition.  I also began seeing a psychologist for talk therapy twice a week.  In just three or four months I was feeling like my old self again—the same amount of time it had taken me to go from feeling fine to putting myself in that rigged car.  I believed the story my psychiatrist told me about the cause of my despair.  He gave me the name of an apparent disorder with my brain, and a pill to fix the problem.  Back then, it seemed to me that the Paxil did more to help me than anything the psychologist and I discussed.  That assumption was a costly one for me, and my family.  

It led me to make two consequential mistakes that millions of other people diagnosed with a “mental illness” also make.  First, I failed to see my diagnosis as a view of reality, mistaking it for reality itself.  I conflated a series of actual events from my life with a boilerplate story about a “mental disorder” from a big book.  Doctors are trusted authorities.  When you’re unquestionably hurting, it’s comforting when a trusted authority gives you an officially-sanctioned medical reason for why you feel so horrible, and better yet, a remedy to help you.  My mistake was compounded when I came to believe that my diagnosis mapped onto a specific brain pathology necessarily responsible for my problematic thoughts, feelings and behaviors.  My doctor gave no serious consideration to any psychological, social or environmental factors that contributed to the mindset from which my suicidal behavior emerged.  He couldn’t have—he didn’t know enough about any of those factors.  It is no surprise that I blamed my brain for my problems, like millions of other “mental patients” do.  Our collective confusion about a specific brain pathology necessarily being the sole or at least primary causal culpability for our problems is proof of the influence of the forces of institutional corruption within the mental health care system.  

A deeper examination of my suicidal crisis subsequent to receiving my “mental illness” diagnosis revealed how childish, fearful, egocentric thinking and bad luck led me down a path towards self-destruction.  To clarify “egocentric” I’m not talking about arrogance, narcissism or even self-preoccupation.  At the heart of my egocentrism in my younger years was the failure to readily recognize that my view of reality, was a point of view at all.  Growing up I prided myself on being right.  I prided myself on objective, quantitative measures of just how right I was.  I was especially proud when I was deemed 100% right.  Egocentric people become attached to being right, and they often are.  I became so accustomed to being right, that I confused my view of reality with reality itself.  I almost killed myself, in part, because of this confusion, this conflation of what I thought was happening with what was actually happening.  Sounds familiar, right?  There were four other types of childish and/or fearful thinking that led me from being involved in an awkward exchange during a routine business meeting in Toronto to genuinely believing that I was an unintelligent, overcompensated fraud of a human being destined to disappoint my father and myself.  Those types of thinking are called catastrophizing, overgeneralizing, black and white thinking and past counter-example blocking.  Any cognitive behavioral therapy resource of value will explain each of these in detail.  This explanation of the factors that led to my psychological and emotional struggle is patently more accurate and more practically useful than anything my psychiatrist told me.

Nineteen years later, it’s evident that me believing that my suicidal behavior necessarily resulted from a “mental illness” was more beneficial to the psychiatrist who told me that than it was for me.  I’m not claiming that this was a fault of my doctor or a sign of bad faith or ill-intent on his part.  His profession trained him to look for different nails to hit with different hammers, and I was a perfect fit for a hit from Paxil.  He was just doing his job—playing his role in a system.  Unfortunately, like millions of other people who are given a “mental illness” diagnosis, I came to see my diagnosis as a defining part of my identity (only temporarily fortunately for me!) because of my respect for my doctor’s authority, and my belief that my problem was necessarily in my brain.  This belief led me to seriously entertain the fallacy that I was biologically destined to suffer from despair over and over again.  I’m so grateful that someone was willing and able to inspire me to question my psychiatrist’s story about the cause of my suffering.  Powerful authority figures implying that brain pathology is necessarily to blame for the suffering behind “mental illnesses” increases the chances of people believing that they need to buy pharmaceutical remedies to be well.  How else are psychiatrists who only prescribe meds going to their pay bills?  Ironically and probably unbeknownst to the vast majority of people diagnosed with a “mental illness” the DSM itself, the book that contains the rules governing their diagnosis, was disavowed as invalid by the Director of the National Institute of Mental Health four years ago.  When announcing that no more federal dollars would be spent on research based on the DSM going forward, Dr. Thomas Insel said that diagnosing a “mental illness” by asking a patient about her feelings was analogous to diagnosing a heart patient by asking her about her chest pain.  I’m not arguing that “mental illness” does not exist, and in defense of the DSM, I will grant that it explicitly states that the causes of “mental disorders” are believed to be biological, psychological and social or environmental.   My argument is that the words used to describe a problem, and the assumptions those words imply, by definition, can be a causal factor in the problem continuing to exist, or worse yet, new problems arising.  This is clearly the case with the term “mental illness.”  

President Trump continually reminds us of the importance of the language we use to describe problems, and how some language helps perpetuate problems and create new ones.  I am committed to changing the world by changing the words that people use when they talk about “mental illness.”

Here’s an example:

BEFORE

You have a “mental illness” or a “mental defect” resulting from a specific, yet somehow unidentifiable, brain pathology that is causing you psychological and emotional distress.  You can treat your “mental disorder” with a chemical made in a lab that will hopefully mysteriously correct your brain pathology for as long as you can bear the undesirable effects of that chemical.

AFTER

Learning more about yourself, the human condition and the many different approaches proven to help other people maximize their own well-being will help you to grow into a person who experiences less and less psychological and emotional distress over time.

 

If I still haven’t convinced you, please consider this final example from history that hopefully more clearly illustrates my point that a “mental disorder” or a “mental illness” diagnosis is necessarily a subjective story about events, and not an objective description of a constellation of thoughts and behaviors that are necessarily caused by a specific brain pathology.

Imagine it’s 1972 and a man visits a psychiatrist because despite having a great relationship with his lover and a great job, he’s miserable.  He’s been estranged from his entire family, and he is suffering a great deal as a result.  He can’t sleep.  He’s constantly anxious, and he’s feeling quite hopeless about things ever getting better.  He explains that all of his problems arose when he admitted to his family, a few weeks ago, that his lover was a man.  His family said that they never wanted to see or speak with him again.  The doctor tells the man that the source of his problem is a “mental disorder” in the DSM called Homosexuality.  The man is the son of a southern Baptist minister, and he has been ashamed of his attraction to men his whole life.  He respects his doctor, and his father too.  In fact, he thinks they’re both right.  He sees his love and sexual desire for men as sinful urges that he is supposed to resist, but he is incapable of doing so.  He sees his homosexual acts as mortal sins, and evidence of brain pathology. Feeling utterly hopeless, lost and beyond redemption, a month after being diagnosed with the Homosexuality “mental disorder” the man kills himself.

Please consider helping me spread the idea that “mental illness” is a harmfully misleading phrase that causes suffering by design.

3/9/2017 Update

Evidence supporting the claim that my belief that I had a brain disease in need of pharmaceutical treatment was more beneficial to my psychiatrist:

My stay at the private mental hospital subsequent to nearly dying by suicide was five days long.  I spoke with my psychiatrist on three separate occasions during my five day stay.  We spoke briefly on the day I was admitted.  We bumped into each other once, and spoke for less than five minutes.  And we spoke for about ten minutes on the day I was discharged, and went home.  While reviewing my bill, after being discharged, I noticed that I was billed for “Individual psychotherapy” five times, one charge for each day of my stay.  If memory serves, the charge was $125.  When I called the mental hospital to inform them of the obvious billing error, I was informed that every patient in the facility was charged in this manner.  I explained how this seemed patently fraudulent and unethical to me given the literal definition of the word psychotherapy.  The person I spoke with apologized but said there was nothing she could do, remarking something like, “That’s just how it works.”

The first time I thought and behaved in a way that matched the diagnostic criteria for a “manic episode” found in the DSM occurred after I ingested Paxil.  I’m aware this fact doesn’t prove that the Paxil was the proximate cause of this development in my life, but given the wealth of evidence supporting the hypothesis that anti-depressants like Paxil often have iatrogenic effects on the people who take them, like inducing mania, for example, it’s reasonable to consider that my treatment for Major Depressive Disorder was a causal factor in me exhibiting behavior that led a different psychiatrist to diagnose me with Bipolar Disorder I.

The brand new greatest story ever told is about Albert Einstein’s Unheralded Prescription for Peace

 

The brand new greatest story ever told… is about Albert Einstein’s Unheralded Prescription for Peace and why he was like @thedigitaljesus of our time.

I’m compelled to suggest that Albert Einstein’s free will skepticism–his belief that a person is mistaken in thinking that he or she could have done other than he or she did–is an unheralded prescription for peace that this insightful genius left for the benefit of humanity.

I’m compelled to champion this idea within the suicide prevention community. We have GPS technology and many other modern marvels because of Einstein’s genius insights about reality. It’s time to consider leveraging Einstein’s apparent genius insight into the human condition too.

A world full of people who genuinely view free will as an illusion, and who are committed to maximizing well-being is a world without shame. It’s a world without egotistical pride. It’s a world without revenge–a world without hate of self or others. It’s a world full of people being compassionate, loving and grateful.

Recognizing that we may have already extracted as much utility from the likely fictional idea that human beings are autonomous agents consciously controlling their thoughts, feelings, and actions and therefore their lives, is an important conversation that I don’t hear many people in suicide prevention and mental health advocacy having. I’m committed to changing that reality. Recognizing the likelihood that free will is an illusionary creation of humanity is a silver bullet capable of piercing the heart of the stigma surrounding “mental illness.”

It’s evident to me that Einstein would have said that believing in free will is a major risk factor for depression and becoming suicidal.

It’s time to seriously consider Einstein’s conception of what it means to be a human being. This guy was clever enough to notice that humanity was grossly misperceiving the foundational building blocks of our reality–time and space. Is it so incredible to fathom that Einstein might have had profound insights into the illusory nature of the “self” and free will worthy of our attention and consideration?

Einstein’s conception of what a human being is and how reality works would suggest that we reconsider how we approach describing the problem of human suffering, including the suffering that leads people to die by suicide.

Einstein thought shame arose from a gross misunderstanding of the human condition

Kevin Hines is a suicide attempt survivor whose efforts to try to help people struggling with self-destructive thoughts and behavior have inspired me.  He recently posted a video on Facebook about his #mysevenbucksmoment in response to Dwayne “The Rock” Johnson.  In his video Kevin talks about the shame he felt after his suicide attempt.  As a fellow suicide attempt survivor, I’m familiar with how people who live through suicidal behavior feel guilt, embarrassment and shame as a result.  I was watching the final moments of the Obama presidency draw to a close after watching Kevin’s video, and I was inspired to share the following thoughts with him.

Regarding the shame you mentioned…

Albert Einstein (and many other thinkers) believed that emotions of shame and guilt arise from a gross misunderstanding of the human condition. Einstein said that a belief in free will results from a “delusion of consciousness.” There is a growing pile of evidence being amassed by scientists to back this claim up.

I’m compelled to suggest that Albert Einstein’s free will skepticism–his belief that a person is mistaken in thinking that he or she could have done other than he or she did–is an unheralded prescription for peace that this insightful genius left for the benefit of humanity.

I’m compelled to champion this idea within the suicide prevention community. We have GPS technology and many other modern marvels because of Einstein’s genius insights about reality. It’s time to consider leveraging Einstein’s apparent genius insight into the human condition too.

A world full of people who genuinely view free will as an illusion, and who are committed to maximizing well-being is a world without shame. It’s a world without egotistical pride. It’s a world without revenge–a world without hate of self or others. It’s a world full of people being compassionate, loving and grateful.

Recognizing that we may have already extracted as much utility from the likely fictional idea that human beings are autonomous agents consciously controlling their thoughts, feelings, and actions and therefore their lives, is an important conversation that I don’t hear many people in suicide prevention and mental health advocacy having. I’m committed to changing that reality. Recognizing the likelihood that free will is an illusionary creation of humanity is a silver bullet capable of piercing the heart of the stigma surrounding “mental illness.”

It’s evident to me that Einstein would have said that believing in free will is a major risk factor for depression and becoming suicidal. The Buddha would agree as would Nietzsche. So too would neuroscientist Sam Harris and professors Bruce M. Hood, Thomas Metzinger and Thalia Wheatley.

It’s time to seriously consider Einstein’s conception of what it means to be a human being. This guy was clever enough to notice that humanity was grossly misperceiving the foundational building blocks of our reality–time and space. Is it so incredible to fathom that Einstein might have had profound insights into the illusory nature of the “self” and free will worthy of our attention and consideration?

Einstein’s conception of what a human being is and how reality works would suggest that we reconsider how we approach describing the problem of human suffering, including the suffering that leads people to die by suicide.

Looking forward to talking to you.

Best,
Francesco

An open letter to Dr. Michael Marcus about how institutional corruption in psychiatry led him to violate my inalienable right to liberty

Dear Dr. Michael Marcus,

Screen Shot 2017-01-18 at 6.04.54 PMBack in 2002, I had some ideas on July 31st and August 1st that led me to get into a pickup truck, and drive to Langley, Virginia, from my home in Philadelphia.  Before leaving, I grabbed a glass pipe with a hunk of hashish in it and a poster of Albert Einstein with his tongue sticking out.  A few hours later, after slowly driving past a large sign informing me that I was trespassing onto CIA property, I told the first federal police officer that I encountered, that I had driven there, in part, to identify myself as the person who had just registered the domain name: iamosamabinladen.com.  

I explained how I had lost my Internet connection at home earlier in the day, just seconds after registering the bin Laden domain.  I was questioned by a few different federal officers over the next hour as I remained in my truck, and was eventually surrounded by four armed officers, with weapons at the ready—three on foot in front of me and on either side of me, and one atop a military humvee, behind me.  After that an officer wearing body-armor asked me to get out of the truck, and frisked me before cuffing my hands together behind my back.  Then four officers escorted me inside, through a metal detector and down a hallway into a small room with a table and two chairs.  There were two cameras in opposite corners of the room, near the ceiling, that were aimed at the chair they sat me down in.  

Then an officer came into the room and read me my rights, and then, an unassuming, middle-aged man not wearing a uniform came into the room, sat down in the chair across from me and asked me to explain myself.  We had a cordial, cogent conversation for over an hour, during which I explained my reasons for doing what I did, in detail.  After that, one of the federal officers removed my handcuffs, and gave me a citation for misdemeanor possession of marijuana, and for trespassing at the CIA.  Next, my questioner escorted me out of the small room and down the hallway again towards the door I had originally entered the building through.  To my complete surprise, he extended his right hand, as if to shake mine, and said, “Thanks for your cooperation tonight.”  I instinctively reached up, and started shaking his hand.  

“There’s a difference between wisdom and intelligence.  You only made one mistake. You should have thrown the pipe out the window before you pulled up to the gate,” he said.

We were still shaking hands when I responded, “That’s what you think.”  Our handshake ended.  Neither of us said anything else, and I got back in my pickup truck, and headed home to Philly.

Thirteen days later I arrived at the Pathways office at Wilmington Hospital with my mother and older brother.  You told us that you wanted to speak to my mother and brother first, in private, before speaking with me, your patient.  They went into your office, and I accompanied a patient, whom you had just met with, outside for a cigarette.  

“So, what’s up with Dr. Marcus talking with your family without you in there?” he asked.

“I’m pretty sure I’m about to be committed,” I replied.

“Really?  What for?” he asked.

“It’s a long story,” I said.

“Well, for what it’s worth, you don’t look crazy to me man,” he said smiling wryly.  I smiled back.

“Hey thanks man, I’m not.  I just…”

“You just what?” he asked.

“I just don’t think like most people think, I think.  You know what I mean?” I said.

“Sure,” he said.  “Maybe you should get away for awhile.  Bus station’s just a couple blocks from here,” he said.

“I know,” I said, as I reached into my pocket, and pulled out a train ticket to Penn Station in New York City and smiled.

“Even better!  What are you waiting for?!” he asked.

“I don’t know… there’s part of me that wants to be on the inside again,” I said.

“Why?” he asked.

“The last time I was inside a mental hospital I was miserable, but I’m not miserable now.  You ever heard of Nellie Bly?” I asked.

“No, who’s that?” he said.

“She was a reporter in the late 19th century who feigned madness in order to get committed so that she could write about what was wrong with mental health care back then,” I said.

“Is that what you’re trying to do now?” he asked.

“Sort of… I just think I might be in a better position to help the people inside than the doctors who work there,” I said.

“Is that what you’re going to tell Dr. Marcus?” he asked.

“No.  He thinks I have bipolar disorder.  I’m sure he’d think I was suffering from delusions of grandeur if I said that,” I said chuckling.

“I think you’re right about that.  Do you think you have bipolar disorder?” he asked.

“I don’t know… I mean, my energy and mood ebbs and flows sometimes, that’s for sure… but I like to think of myself as more of a… bipolar explorer, you know what I mean?” I said.

“Yeah… I think I do,” he said as he took the last drag on his cigarette.  “Well, wherever you end up… I wish you luck,” he said.

We shook hands.  “Thanks brother.  You too, and be well.” I said.

“Same to you,” he said and walked away.  

Next, I headed back inside the hospital and took a seat again in your waiting room.  A few minutes later, you opened the door to your office, and invited me to come in.  I went inside, sat down in front of you with my brother and mother seated behind me, and you proceeded to ask me questions about my mood, my appetite and how much I was sleeping.  You also asked me if I was having any suicidal thoughts.  I told you that my mood was elevated, my appetite was fine, I was sleeping a little less than usual and that I hadn’t had a suicidal thought in years.  Next you asked me if I’d be willing to admit myself to a psychiatric hospital for awhile.  I said no, and told you there was no good reason to do so.  You asked me if I would be willing to participate in an outpatient, day-program, and I said I was willing to consider it.  Then, you said that we were done talking, and that I was free to go.  I opened the door to leave your office, and I was greeted by two police officers who took me into custody.

In spite of my anger, I cooperated completely with the cops.  It seemed apparent that they were pros adept at handling people in my situation—someone who had just been summarily stripped of his inalienable right to liberty by an agent of the state with considerably less due process and civil rights protections than suspected violent criminals are afforded.  The two cops and I had a convivial conversation on the ride from the hospital to MeadowWood, the private, for-profit psychiatric hospital you committed me to.  It had been four years since I’d been in a mental health care facility.  I was in a genuinely good mood by the time I was admitted, and shortly thereafter I was chatting idly with my fellow patients in the common room of the adult ward.  Within half an hour of arriving I was standing in front of a whiteboard distinguishing Einstein’s theory of special relativity from his  theory of general relativity for a small cadre of my fellow patients, as staffers sized me up.  

I excused myself from the group when a staffer asked to speak with me in private.  She explained that MeadowWood’s resident psychiatrist had issued an order for me to begin treatment immediately by taking a dose of Risperdal, a powerful antipsychotic medication.  

“So the doctor wants me to begin treatment before meeting or speaking with me?” I asked.

“That’s right,” the staffer said.

“Well, that doesn’t seem right to me.  I’d like to meet with my doctor before he decides how best to treat me,” I said.

“Dr. Ekong is a woman,” she said.

“Fine.  Her gender has nothing to do with why I want to meet her before I begin taking a new medication.  How can she prescribe a course of treatment for me without ever meeting or speaking with me?” I asked.

“Dr. Ekong reviewed your file–”

“My file?  I have a file already?” I said, cutting her off.  “I’ve been here less than an hour and haven’t spoken with a doctor yet.  What’s in my file?  Can I see it?” I asked.

“You can discuss that with Dr. Ekong during your time with her tomorrow when she’s here,” she said.

“Okay great. That’s all I was asking for.  Thank you,” I said and turned to walk away, feigning that I thought I had sold her on me not taking the Risperdal.

“Wait a second!  Dr. Ekong’s order still stands, and if you don’t take your medication, I have to report back to her,” she said calling after me.

“I thought you just said that I could wait to discuss this with her tomorrow when she’s here,” I said, continuing with my feigned misunderstanding.

“I said that you can discuss your file and your treatment plan with her when she’s here.  That doesn’t mean that I don’t have to do my job, and administer the medication prescribed for you by your doctor,” she said.

“Okay.  I’m assuming you can reach her by phone then?” I asked.

“Yes,” she said.

“Then why can’t I speak with her?” I asked.

“That’s not how it works,” she said.

“Okay… well…  can you please explain to her that I would like to meet with her before she unilaterally decides on a course of treatment for me?” I asked.

“I can, but if you continue to refuse to take the medication prescribed for you, she’s likely to order us to treat you with a different one.  One that can be injected with a needle,” she said.

“Can we please cross that bridge if and when we get to it?  You just said you would explain that I want to meet her before beginning treatment, and I appreciate that.  I really do… so thank you,” I said.

“Fine,” she said with a smirk as I headed back to the whiteboard to resume my impromptu lesson on relativity.  As I rejoined the group, another patient asked me how long I had been working at MeadowWood.

“Me?  Working here?” I asked smiling.  “I’m a patient just like you brother!” I said.  

“If you’re a patient here…  I’m the Pope,” he replied.  

“Well, it’s nice to meet you… your Holiness,” I responded, smiling even wider and winking.

About five minutes later, the staffer called me over again and told me that Dr. Ekong had confirmed that I was to begin treatment immediately.  She said if I refused to take the Risperdal, that Dr. Ekong had instructed her to give me an injection of Haldol.  I told her that I would not willingly take any medication before having the chance to speak with Dr. Ekong, but added that I would not physically resist being injected against my will.  I asked the staffer if I could make a phone call before being given the injection.  She said yes, and I called my father and explained to him what was going on.

Five minutes later, in a private room, a woman gave me an injection of Haldol.  After giving me the shot, she began preparing a second injection.  

“What’s that?” I asked.

“It’s called Cogentin.  It’s to counteract the side-effects of the Haldol,” the nurse said.

“What side effects?” I asked nervously as I felt my pulse quicken.

“Muscle spasms… muscle rigidity… stuff like that,” she said.  Then she injected me with the Cogentin shot.  

I was already feeling dizzy and nauseous just seconds later as I went back into the common room.  I walked right by the patients still gathered around the whiteboard, ignoring their calls to rejoin them, and headed straight for my bed in my room.  I laid down, my whole world spinning, and quickly lost consciousness.  The day following my harrowing experience with Haldol I began swallowing the Risperdal tablets originally prescribed for me by Dr. Ekong.  I’m grateful that I didn’t know then what I know now:  having Haldol injected into me and swallowing a single Risperdal tablet could have killed me via Neuroleptic Malignant Syndrome.  Imagine my utter lack of surprise when Dr. Ekong released me from my involuntary psychiatric care experience ten days after you committed me.  This was the same day that my case would have necessarily been reviewed by a judge in a court of law, if Dr. Ekong had not released me.  I don’t believe it was a coincidence in timing.

Imagine if judges in our legal system could imprison suspects and order them to be injected with potentially life-threatening substances without meeting or speaking with them.  Imagine if imprisoned criminal suspects and criminals were financially responsible for paying fees for being in prison, including one to the judge who jailed them.  Even though you are referred to as a doctor, and not a judge, these ideas are just as absurd as a reality in our mental health care system as they would be if they were part of our legal system.  To be clear, I do not blame you or Dr. Ekong for treating me as you did.  I blame the poorly designed system that empowered you to mistreat me as you patently did.  I share this true story publicly with the intention of trying to improve an improvable system.  

I harbor zero ill will for you or for anyone else involved in my mental health care mistreatment.  I believe that you and Dr. Ekong were necessarily influenced by forces of institutional corruption at work within our mental health care system.  Robert Whitaker and Lisa Cosgrove have written masterfully on this subject in Psychiatry Under the Influence:  Institutional Corruption, Social Injury, and Prescriptions for Reform.  I’m simply playing my role by highlighting a perfect example of what institutional corruption in psychiatry looks like in reality.  I don’t seek attention for my anecdotal experience with mental health care mistreatment for the purpose of retributive justice against you, or for sympathy for myself, and unlike some survivors of less than optimal mental health care, I do not want to burn the existing system to the ground.  Rather, my motivation is to increase awareness about human rights violations occurring within our mental health care system in order to inspire social change and systemic reform.  I can’t help but wish that I had been compelled to share this true story earlier.  Dr. Caroline Ekong might still be alive and Christopher Frick might not be in custody for the rest of his life, if I had done so.

As you must know, in October of 2015, Christopher Frick, at age 21, stabbed Dr. Caroline Ekong to death, three years after she had committed him to the Rockford Center, claiming that he was a danger to himself.  I share the true story of my forced “care” at the hands of you and Dr. Ekong to highlight her tragic death with the aim of preventing others like it.  Despite the apparent fact that she ordered that I be treated before ever meeting or speaking with me, I saw her as a caring and conscientious mental health care professional.  I write apparent, because I can’t know for sure if the staff that treated me was actually in touch with her that day.  Despite the apparent fact that you decided to hospitalize me against my will before you examined me, and despite the blatant incompetence or dishonesty you clearly documented on my committal paperwork, I see you too as a caring and conscientious mental health care professional.  

I share this true story, Dr. Marcus, so that you, and other doctors empowered by the state to suspend people’s liberty, will be less likely to use that authority in a way that leads some patients, to want to kill their psychiatrists.  Caroline Ekong and Christopher Frick were both victims of a broken, reformable mental health care system.   I come in peace brother, because that is what I see you as, a brother.  All those who dedicate themselves to caring for the well-being of others are my brothers and sisters.  You and I are brothers on the front line in the battle of trying to bend the U.S. suicide rate curve.  I am in a special position, given my considerable professional experience in systems quality assurance to provide valuable critical feedback on the mental health care system, as a result of my interactions with you and Dr. Ekong almost a decade and a half ago.  Feel free to consider me your personal Nellie Bly.

You necessarily took action to have the police waiting outside your office prior to your examination of me, and to this day, you and I have still never exchanged a single word about my unauthorized visit to CIA headquarters in 2002.  Four federal CIA police officers and a staffer from the CIA questioned me for about three hours with a degree of professionalism that still blows my mind, especially considering that I pulled this stunt just forty-one days before the first anniversary of the 9/11 attacks.  It’s worth pointing out that these men, despite the fact that I was in possession of a controlled substance when I illegally trespassed at the CIA, decided to release me on my own recognizance versus throw me into a jail cell for the night, pending arraignment.  Things played out the way they did for me at the CIA because the people there that I spoke with were open to hearing a reasonable explanation for my actions… which is precisely what they received from me… and precisely why they let me go.  

committal documentYou and Dr. Ekong on the other hand, were patently not open to even attempting to reason with me. You failed to give me a chance to explain my actions before stripping me of my liberty, and she treated me with a potentially life-threatening medication before ever meeting or speaking with me.  It is clear to me, as I am confident that it will be to many others, that the forces of institutional corruption in psychiatry were at work in your respective decisions.  The knowledge that you had about what happened at the CIA was the by-product of a five-person game of Telephone or Whisper Down the Lane.  I told my father some of what happened that day, without much explanation as to why at all.  My father told my mother.  My mother told my brother.  And then my afraid-for-the-life-of-her-son mother told you.  You did what you did, and then Dr. Ekong became Telephone/Whisper Down the Lane player number six. The assumptions that you both necessarily made about me are gross examples of professional misconduct.

While you were very sympathetic about the anxiety experienced by your patient’s mother, you failed to even try to understand me, your patient, whom I believe you assumed was psychotic.  The fact that I was exhibiting some of the symptoms of a “mental disorder” described in the Diagnostic and Statistical Manual of Mental Disorders—a nosology disavowed in 2013 by Dr. Thomas Insel, the former Director of the National Institute of Mental Health—is a pathetically inadequate justification for involuntarily subjecting me to forced care that could have ended my life.  If you failed to notice this label on the committal form:  “as observed during my examination of the patient” you were reprehensibly incompetent when you filled out the form.  Not one scintilla of information about my unauthorized visit to the CIA or about anyone breaking into my home was provided by me to you.  If you did notice the aforementioned label, then you were necessarily reprehensibly dishonest by claiming that any of that information was discussed during your “examination” of me.  Why I willingly trespassed at the CIA with marijuana and a big poster of Einstein was, and still is an absolute mystery to you.  

I invite you to speak with me, in front of a live microphone, for a podcast—a frank talk about mental health—to provide me the opportunity that you denied me years ago.  If you meet with me, I will also explain my version of the stories that you were apparently told by my mother and/or brother that prompted you to write down what you wrote about me on the aforementioned form.  

I genuinely believe that a public conversation between you and me could be very valuable for people besides you and me, and that is my aim—to create value for others as I try to improve the mental health care system in this country.  If you have no interest in engaging in a public conversation with me, to provide the reasons why you behaved as you did, I will offer up my best guess as to what I believe motivated you, when I explain my own actions, in a subsequent message.

Sincerely,

Francesco Bellafante
American Foundation for Suicide Prevention Philadelphia Chapter Board Member
Zero Suicide Champion
frank talk about mental health ~ leveraging the genius of Einstein to end suicide and to maximize well-being
iameinstein.com

 

Are people who die by suicide or attempt suicide selfish?

Thoughts from  about selfishness and suicide via TheMighty.com.

thinkstockphotos-497517286-1280x427

When a Friend Said ‘Suicide Is Pretty Selfish When You Think About It’

“Like… I get that it’s not the person’s fault really but… suicide is pretty selfish when you think about it.”

Flash.

Instantly, it was like somebody lit that spark in my mind that never fails to ignite my passion for mental health advocacy. For me, there’s something about stigma that turns an ordinary passion into the sort of fire you can just see in someone’s eyes.

The above sentence was said to me (paraphrased, of course) a couple of years ago. I was tabling with a fellow Active Minds member and a friend of hers had joined us to hang out. I think we were tabling about suicide, which is why the subject came up.

My immediate reaction when she said this was to be offended. Did she really have the nerve to say that while we were tabling about suicide prevention? Once I took a step back from my emotion I realized that she didn’t mean to insult anyone. She probably didn’t understand how stigmatizing it can be to label suicide as “selfish.” How could I expect her to understand when the topic of suicide is so seldom discussed in our society?

“The thing about suicide is….” I paused, not wanting to offend her or make her think she offended me, “Even if we can call the act of attempting suicide selfish, the person behind it is not acting out of selfishness… if that makes sense.”

I could tell she was truly listening to what I was saying, so I continued. “When someone is so far into that dark place they want to end their life, they might not be thinking about who their actions are going to hurt. Maybe they are in too much pain to think about it. And even if they are aware of how it might impact their loved ones, the desire to end their pain may have become too great to bear anymore.”

If I remember correctly, that’s about all I said. I could’ve gone in-depth about the known risk factors for suicidal behavior. I could have explained how feeling like a burden (a common experience of those contemplating suicide) might make someone think they’re doing their loved ones a favor by taking their own life, which might completely negate any feelings of selfishness or guilt that they might have had. However, I could tell she was really considering what I had just said, and I didn’t want to go too far and overwhelm her.

The notion that suicide is selfish is something I had spent a great deal of time thinking about.

When I was 14 I felt so incredibly guilty for wanting to die, because I knew if I killed myself my family would be devastated. For years, that guilt and the selfishness I felt for thinking about suicide kept me from reaching out for help. All of the stigma about suicide — much of which I had internalized — had me convinced it was better to suffer in silence than to have someone else think what I did: that I was selfish for wanting to die. I’ll never know for sure if that guilt had pushed me closer to the edge or further from it, but I do know that I’m grateful to be alive.

Make no mistake, I didn’t lose any respect for this acquaintance because of her statement, and there was no animosity created between us. In fact I’m glad she said what she said, because it reminded me that the stigma we need to face is not just in the media and our larger social systems, but in the people around us who don’t even realize these ideas are stigmatizing.

It’s one of the things that make the work I do as an Active Minds member or in other advocacy settings that much more important. I also realized that it was important for me to listen and understand where she was coming from too, because a one-sided conversation is not a productive conversation, especially in the pursuit of social change.

Being part of the social movement against mental health stigma can be difficult and discouraging, especially with the seemingly endless sea of misinformation and disrespect shown in various media outlets, but it’s worth it. Thinking back, it makes me happy to remember how respectful and thoughtful that conversation was. It gives me hope to know that “fighting” the stigma doesn’t have to be a fight —sometimes it’s as simple as a conversation.

I wanted to share this story here because I hope to see a day in which we can completely put to rest the idea that victims of suicide are selfish, weak or otherwise bad people, and think instead with empathy by making an effort to understand what someone might be going through if they are contemplating suicide.

My thoughts on the subject:

As a fellow suicide awareness / mental health advocate, I think it’s important to have conversations like the one you describe in this piece. I shared some of the same feelings of guilt regarding my own suicidal intentions and behavior when I nearly died as a result of untreated depression in 1998.

I think the conversation around suicide and selfishness is an important one. I think it’s important to acknowledge the pain and suffering experienced by suicide loss survivors. I think it’s a completely normal reaction for a suicide loss survivor to wonder: how much consideration did my love one give to me before dying by suicide? I think it’s equally “wrong” to blame someone for being suicidal as it is to blame a suicide loss survivor for wondering about the thoughts and feelings of their loved one prior to their death.

I often turn to the dictionary definition of the word selfish in conversations like the one you had: (of a person, action, or motive) lacking consideration for others; concerned chiefly with one’s own personal profit or pleasure.

It seems apparent to me that some people who die by suicide may not give very much consideration to the impact of their actions on others. They do not see themselves as a burden to others, rather their suicidal crisis stems from feelings of shame, embarrassment and guilt. Sometimes simply for feeling and acting suicidal.

I know that some suicidal people go through a series of desperate mental gymnastics to try to think of anything else besides the impact of their death on family and friends. This is part of a process that some suicidal people go through to work up the nerve, to work up the courage to take suicidal action. I know this because I did it, and I don’t believe that my suicidal crisis was unique.

Here’s how I’ve described my thinking in the past about why it doesn’t make sense to think of suicide as a selfish act:

Many view suicidal people as selfish cowards, but I believe it takes courage, massive amounts of courage to turn suicidal thought into suicidal action. Trying to cause your heart to stop beating, while knowing, to some degree at least, how much pain and suffering your death will cause for those who love you requires a special kind of morbid audacity. I won’t claim that there has never been a person who has died by suicide who lived selfishly during his or her life, but I insist that anyone who thinks those two words: selfish and cowardly — about the suicidal act itself, has no first hand experience with the macabre deed. The biological instinct for self-preservation is an almost insurmountable force to overcome. Death is the greatest unknown and fear-inspiring phenomenon facing each of us, which explains why possessing an enormous amount of courage is a prerequisite for dying by suicide.

Suicide can’t be accurately described as selfish either, although it’s understandable why people are prone to do so. The dictionary defines selfish as: lacking consideration for others; concerned chiefly with one’s own personal profit or pleasure. I think it is unavoidable for survivors of suicide, the friends and family of people who die by suicide, to wonder how much consideration was given to them by their loved one or friend, prior to their suicide. Regardless of how much time and consideration someone who died by suicide gave to those left to deal with life after their death, the end of physical and psychic pain resulting from suicide can not bring pleasure nor profit to the deceased. So the suicidal act, by definition, cannot accurately be described as selfish. Suicide extinguishes any notion of the self. An act that causes the sense of self to no longer exist is inherently not selfish.

An open letter to President Obama about suicide prevention | frank talk about mental health | episode 9

November 14th, 2016

Dear President Obama,

Beau Biden was my captain on the tennis team in high school, and Hunter and I nearly won a football state championship together back in 1988.  As a self-declared brother of their father, you are undeniably an honorary member of our extended Archmere family.

I remember the moment during the early morning hours of August 23rd back in 2008 when I got the text message announcing that Joe Biden was your running mate, and I will never forget the moment later that year when you were elected president.  It was that night that I committed myself to getting into a position to leverage my personal connection with Vice President Biden, before you both left office, to the benefit of an important but underserved cause in this country:  suicide prevention.

My namesake and paternal grandfather died in a mysterious explosion at the factory where he worked two days after Christmas in 1951.  Within a year my fourteen year old father-to-be was working two jobs, and giving $40 a month (about $350 in 2016) to his mother to help support her and his two younger sisters.  He joined the Army after graduating from high school where he learned how to be a land surveyor.  After returning from his tour in Europe, he met my mother-to-be, bought a small land surveying firm in Delaware, and started a family.  My father ran the business while my mother ran just about everything else at home.  My parents, two high school graduates, paid for every penny of their four children’s education, which included private grade schools, the same private high school attended by the Bidens, and the colleges of our choice.  Good luck, hard work and love have made the story of Judy and Franco Bellafante an unequivocal example of the American Dream.

I enrolled at the University of Notre Dame in the fall of 1989.  Archmere and AP tests gave me a 30 credit head start, and I earned a Bachelor of Arts in just three and a half years, graduating Magna Cum Laude with a Phi Beta Kappa Honor Society induction to boot.  Mr. Tom Brokaw closed his commencement address to the class of ‘93 in South Bend like this, “It’s easy to make a buck; it’s harder to make a difference.  We need your help.  Go Irish!”  Four years later I became the youngest Principal out of 350 staff at a financial IT consulting firm located a couple of blocks from Wall Street.  I was 26 years old, and my bill rate was $250 an hour.  I won’t deny that I worked hard, but Mr. Brokaw was right.  The advantages afforded me had made it easy for me to become someone who billed in excess of half a million dollars a year in consulting fees.  Back then being successful at my job was paramount to me, while “making a difference” had been temporarily relegated to a distant backburner.

Less than a year later and a few weeks before being accepted into UCLA’s Anderson School of Management, a foreman at a warehouse arriving for work in Secaucus found me clinging to life inside of a running rental car that I’d turned into a makeshift carbon monoxide gas chamber the night before.  I had a near death experience in the ambulance on the way to the hospital, and I woke up a couple of days later in the ICU.  Suffice it to say that my suicidal crisis stemmed from an unshakeable belief that I had become unable to live up to expectations I had for myself as a result of being the beneficiary of so many advantages and so much privilege.  Countless hours of introspection and study over the ensuing years have made me a “lived experience expert” regarding how some young people, with no prior trauma and with many apparent advantages, feel so self-loathing and so hopeless that they become suicidal.

In April of 2015 I left my day job in IT to work full-time in suicide prevention and mental healthcare advocacy.  I became a volunteer in the speakers bureau of the Greater Philadelphia Chapter of the American Foundation for Suicide Prevention.  I began to share some of the lessons I’ve learned since my suicidal crisis by giving talks at Philadelphia area schools and businesses aimed at lowering the suicide rate and reducing the stigma surrounding mental illness.

In June of this past summer, I was on Capitol Hill with hundreds of volunteers from the AFSP advocating for more federal funding for suicide prevention.  Thanks to Hunter and an assistant of the Vice President, I was poised to introduce the executive leadership of the AFSP to the Vice President and his policy staff when the mass shooting in Orlando derailed our plans to meet.  

You are taking questions from the press for the first time since the election as I write this message to you, and I’m compelled to share the following as if I was at the presser and you had just called on me.

Based on 2014 CDC statistics, about 58 Americans die from self-inflicted gunshot wounds every single day—a death toll nine lives greater than the deadliest mass shooting in U.S. history.  Annually that’s 21,334 lives lost to suicide via a firearm.  Comparatively just half as many Americans died by homicide via a firearm in that year, and only 18 Americans died in mass shootings in all of 2014 according to Mother Jones reporting. Imagine that at 12:00 noon tomorrow, 58 Americans simultaneously die by suicide via a firearm.  Imagine that twenty four hours later it happens again—58 simultaneous suicides via a firearm occur at 12:00 noon. Twenty four hours later it happens yet again.  

Am I right to assume that if this slight and absurd modification to the details surrounding the daily tragedy of firearm inflicted suicide occurred in reality, that you would be compelled to say and do things to try to prevent suicide that you have yet to say or do?

If so, why not consider adding more achievements to your team’s list of accomplishments in suicide prevention before leaving office?

There is still time for you to try to change what this picture looks like in order to bend the rising U.S. suicide rate curve.

research-chart

You are an elocutionary potentate and a transformational leader of humanity.  I imagine that you have inspired millions of Earthlings to serve the public’s interest in ways that they might not have without your influence.  I am grateful to include myself in this group.  Your vision for the future of this country inspired me to do the hard work to try to make a difference for others by being the change that I wish to see in this world.

With the election behind us, I’m happy to report that I am in the process of rescheduling the meeting between the AFSP executive leadership and Vice President Biden.  I will be sure to share the time of that appointment with you and your staff once it’s scheduled just in case you might be available to join us.

Thank you for all that you have done to prevent suicide and to improve mental health care in this country.  Thank you for being a constant reminder of the positive difference that someone can make in the lives of others.

Sincerely,

Francesco Bellafante
American Foundation for Suicide Prevention, Greater Philadelphia Chapter Board of Directors
Zero Suicide Champion
frank talk about mental health ~ leveraging the genius of Einstein to stop suicide and to maximize well-being
iameinstein.com

A letter to the man who killed the psychiatrist who treated me before ever speaking with me

November 4, 2016

Dear Christopher,

On August 14th 2002, I was civilly committed to the MeadowWood mental hospital by a psychiatrist who worked at Christiana Hospital.  The doctor who committed me failed to ask me one single question about the incident leading to my involuntary psychiatric treatment.  After being admitted to MeadowWood and prior to meeting or speaking with the psychiatrist who was responsible for my care, Dr. Caroline Ekong, I was informed that she had directed the staff to treat me with Risperdal, an oral antipsychotic.  I respectfully refused to swallow the Risperdal, and asked if I could at least speak with Dr. Ekong prior to commencing taking any psychopharmacological  drugs.

Dr. Ekong refused my request to speak or meet with her prior to commencing treatment. Staff at the mental hospital told me that I would have the chance to meet and speak with Dr. Ekong the following day, but that I still had to begin taking the Risperdal immediately.  I was told that if I refused to swallow the Risperdal that I would be given an injection of Haldol, another antipsychotic.

I told the staff I thought it was wrong for me to be treated against my will by a doctor who hadn’t even spoken with me yet, and I told them that I would not willingly take the Risperdal.  I also told them that I wouldn’t physically resist being injected with the Haldol if they were compelled to treat me without my consent.  They were so compelled, and I did not resist.

Subsequently I began swallowing the Risperdal to avoid receiving any additional Haldol injections.  Ten days later, the same day that my involuntary commitment would have been reviewed by a judge, Dr. Ekong released me from the hospital.

In May of this year, while working on a memoir manuscript about my mental health care journey, I Googled “Caroline Ekong” and first learned about your story.

A couple days after learning some details of your mental health care journey I posted this on Instagram.

screen-shot-2016-10-12-at-10-53-08-am

Christopher Frick stabbed Dr. Caroline Ekong to death in October of last year at her home in Hockessin, Delaware, three years after she civilly committed him to a private psychiatric hospital.  I just learned of this event this week.

Dr. Ekong was the same caregiver who ordered me to be injected with Haldol before ever meeting or speaking with me after I trespassed at CIA headquarters five weeks before the first anniversary of the 9/11 attacks back in 2002.

Imagine if judges in our legal system could imprison suspects and order them to be injected with potentially life-threatening substances without meeting or speaking with them.  Imagine if imprisoned criminal suspects and criminals were financially responsible for paying fees for being in prison, including one to the judge who jailed them.  These ideas are just as absurd as a reality in the mental health care system as they would be if they were part of our legal system.

I do not blame any individual for my harrowing experience with Haldol, even if their actions were illegal.  On the contrary, I am exceedingly appreciative of anyone who dedicates themselves to caring for the well-being of others.  They are my brothers and sisters on the front line in the battle to bring about the beginning of the end of suicide.

I don’t seek attention for my anecdotal experience with mental health care mistreatment for the purpose of retributive justice or sympathy, and unlike some survivors of less than optimal behavioral health care, I do not want to burn the existing system to the ground.  Rather, my motivation for sharing this story publicly is to increase awareness about human rights violations occurring within our mental health care system in order to inspire social change and systemic reform.

Caroline Ekong and Christopher Frick are victims of the same thing: a broken, but fixable behavioral healthcare system.

I’m sorry that you’re in the position that you’re in, and I’m sorry that I wasn’t compelled to share publicly about my experience with Dr. Ekong prior to last October.  I can’t help but imagine how telling my story could have been the cause of you thinking and acting differently than you did.  But that is not how our stories played out unfortunately.

Fortunately we are both still in a position to try to improve the mental health care system that treated us without our consent.  I would appreciate the opportunity to learn more about your mental health care journey if you’re open to communicating with me.

Warmest regards,

Francesco Bellafante

Why do people without trauma in their past become suicidal?

In this post I will answer some of the questions that I posed in frank talk about mental health, episode 7 | Why do people attempt suicide? 

As a reminder, I am a suicide attempt survivor who had a near death experience due to semi-intentionally caused acute carbon monoxide poisoning eighteen and a half years ago when I was 27 years old. 

As I explained in episode 7, I’m aware that my answers to these questions don’t apply to everyone who becomes suicidal or who dies by suicide.  With that said, I still don’t believe that my answers are unique, and apply only to me.  While my answers may not resonate with you or with what you think your loved one was thinking and feeling when he or she attempted or died by suicide, I’m convinced that they apply to many people.  A growing number of suicide attempt survivors are sharing about the circumstances leading up to their suicidal crisis.  While it’s impossible to know for sure precisely what someone who died by suicide was thinking, I believe it’s possible to gain insight into the state of mind of a loved one or associate who died by suicide by exploring the growing number of personal accounts provided by suicide attempt survivors like myself.  By revealing insights about my suicidal mindset, I hope to provide, at the very least, a modicum of understanding and peace to those left to mourn and remember loved ones who have died by their own hand.  

I also hope to be a source of hope for those who may be feeling hopeless and suicidal.

1.  Why do people who have every single thing that they need and almost everything that they want have suicidal thoughts?

If you are a human being that has a sense of self, if you have a sense of personal identity or an ego, I think you are susceptible to having suicidal thoughts.

The problem of suffering arises from our reaction to what-is, our resistance to it, or our interpretation of it, which is a function of our conditioning.

Lionel Corbett

My paternal grandfather died when my father was just thirteen years old.  Within a year of his father’s death, my father worked two jobs to help support his family to the tune of $350 a month (in 2016 dollars).  Neither of my parents went to college, but they were determined to provide my siblings and I with the highest quality education possible given their middle class income.  I went to private school from the time I was in fourth grade through college.  I graduated from the University of Notre Dame in just three and a half years, and by the time I was twenty six years old I was working for an information technology consulting firm a couple of blocks from Wall Street.  My bill rate was $250 an hour.  While on assignment in Toronto, I had a troubling experience at work.  The genesis of the crisis that nearly resulted in my suicide was a single, negative interaction with the senior client on my sub-team in Toronto.  At our first meeting, the senior client manager on the team asked me if I had any prior experience working with commercial lending, credit risk management systems.  The way he framed the question indicated he assumed I would respond affirmatively, but I had no such relevant experience.  I balked at saying no, and then pivoting to explain why I would still be a valuable asset to the team and the project as a whole.  Instead, I responded, “Excuse me?” as if I didn’t hear his question.  The man was less than five feet away from me, and he spoke quite clearly;  I was instantly and irrevocably mortified.  By the time he had finished rephrasing his question slightly, I was ready to give him my “no” which I did, but I failed miserably, in my view anyway, when I tried to pivot back to why he should still be pleased to have me on his team.

I began to suffer as a result of this interaction, not because of what had happened, but rather because of my interpretation of what had happened.  My self image and my sense of self-worth had been based on what authority figures in my life thought of me.  This worked fine for the first twenty six years of my life.  My parents were the first authority figures in my life, followed by my teachers and then my superiors at work.  My sense of self-worth and self-esteem was probably higher than average because the feedback that I had received from these people was overwhelmingly positive.  This incident at work in Toronto changed all of that.  I became convinced that an authority figure (my client) thought very poorly of me.  He never said this, but I believed that he was thinking thoughts like this:  I can’t believe that we’re paying this guy two hundred and fifty bucks an hour!  He’s not worth $2.50 an hour!!   Whether he thought this or not really wasn’t important.  It’s what I thought an authority figure thought about me, and in a very short period of time, I believed it as the irrefutable truth.  I came to see myself as an under-qualified, over-compensated fraud.

It still seems incredible to me how quickly I unraveled; how quickly hope and excitement for the future were replaced by fear and apprehension.  Within a month’s time, my internal monologue became almost unrecognizable to me.  The voice I was accustomed to hearing, one brimming with confidence, resourcefulness, excitement and determination was replaced by one saddled with uncertainty, doubt, indecision and distress.  Thinking and feeling so negatively about myself for an extended period of time was a novel experience for me.  I searched my psyche in vain for something to reverse my psychological and emotional slide, but the unrelenting pessimism of the voice in my head stripped away my self-esteem and hope for things to come.  Silencing my fearful, troubled, constantly-questioning self-talk at night was so difficult that getting sound sleep became impossible.  Night after night I only slept between zero to three hours at most thanks to the ceaseless barrage of dark, automatic thoughts that bombarded my consciousness, and ate away at my sanity.  As I continued descending a downward spiral of disempowering thoughts, I began to ruminate over what I was doing with my life.  I remember the first glimmer of my very first suicidal ideation.  It happened on a particularly turbulent flight home to New York from Toronto on a Friday afternoon.  Normally unnerved by turbulence, I found the unlikely prospect of crashing oddly comforting.  I remember thinking:  If only this plane would go down, I wouldn’t have to worry about this miserable assignment any longer.  

Within just a couple of weeks of my professional faux pas in Toronto, I had discounted all of my prior accomplishments, as my formerly steadfast belief in my ability to intellectually tackle any problem waned.  Some bad luck left me socially isolated as my five closest friends all coincidentally moved away from New York City over the course of a few weeks.  The lack of reassurance received from my usual sounding boards to bolster my flagging self-confidence paved the way for my suicidal crisis.  My ability to concentrate was so impaired from lack of sleep, that completing simple tasks—like deciding what to have for dinner, or packing my bag for the week ahead in Toronto—became cognitively burdensome.  Not surprisingly, given my deteriorating mental faculties, effectively performing the duties of my job became impossible.  I became certain that I wasn’t ever going to be able to live a life that would honor my parents and all of the sacrifices they had made for me.  In a short period of time, my thoughts of death gave rise to thoughts of suicide, followed eventually by a practical plan to end my life.

2.  What goes wrong with someone that has so many gifts, talents, privileges, and advantages?

The good fortune that I experienced through the first twenty-six years of life left me with high expectations for myself and my future.  The incident in Toronto caused me to confuse being unknowledgeable in a particular subject (commercial lending risk management) with being un-intelligent in general.  This cognitive mistake and my faith in the veracity of my conclusions due to my track record of being a high performer in school and at work led me to believe that the expectations that I had for myself were beyond my reach.  I became consumed with feelings of guilt, embarrassment and shame as a result.  I felt guilty that I was even considering the idea of checking out given the depth and breadth of suffering experienced by countless others in the world.  I felt guilty that I had achieved so little in life after having been given so much.  I was embarrassed that I had ever thought I was intelligent and that I could achieve anything that I set my sights on.  I was embarrassed that I was in a situation where I obviously needed help and was mortally afraid to ask for it.  I was ashamed that I was considering ending my life because I feared that I wouldn’t be able to earn an above average living.  I was ashamed of the imagined prospect of having to move back home to Delaware to live with my parents, and get a job in the local shopping mall.

Guilt involves falling short of one’s own moral standards.

Embarrassment is the feeling of discomfort experienced when some aspect of ourselves is, or threatens to be, witnessed by or otherwise revealed to others and we think that this revelation is likely to undermine the image of ourselves that, for whatever reason or reasons, we seek to project to those others.

Shame arises from measuring our actions against moral standards and discovering that they fall short.

Dr. Neel Burton

3.  How can someone who has love for his family and friends and whom is loved by his family and friends be suicidal and not tell a loved one?  How can they not reach out to a loved one for help?

I did reach out to a few close friends to express that I was having trouble, although I never went so far as to explicitly say that I was in need of help.  I even told my closest friend at the time that I had gone as far as considering ending my life.  Regarding reaching out to members of my family, I had a single conversation with my parents from my hotel room in Toronto several weeks before I nearly killed myself, where I expressed concerns about my performance at work.  In each case, my communication was only as effective as the responses that it elicited.  I received constructive advice from one friend—he suggested that I quit my job and try doing something completely different for awhile like go work at a ski resort or on a cruise ship.  Another friend was moved to discuss his concerns about my situation with his father who subsequently telephoned me to check in on me.  The friend I explicitly shared about my suicidal thoughts with became emotional as a result of my revelation, and was supportive in the moment, but he still wasn’t compelled to talk about our conversation with anyone else.  As far as the interaction with my parents, as novel as it was for me to express concerns about work to them, they too didn’t grasp the severity of my situation.  Me engaging in suicidal behavior wasn’t an eventuality that they seriously entertained.

I viewed my deteriorating mental health as a character flaw, because I believed other people would see it the same way, and I believed that asking for help to deal with what was going on in my head was a sign of a personal weakness. Thoughts and beliefs like these lie at the heart of the stigma surrounding mental illness, and explain why many people suffering like I was back then never seek help.

4.  What motivates someone without traumatic experience who has access to loving support from family and friends to harm themselves?

Unsubstantiated beliefs about myself and my future coupled with irrational thinking due to sleep deprivation motivated me to engage in suicidal behavior.

5.  What could a loved one (or anyone else) of a suicide attempt survivor or someone lost to suicide have done to prevent the suicide attempt or suicide?

Obviously, there’s nothing anyone can do to change the outcome of an event in the past.  As a free will skeptic, I don’t believe that human beings consciously author their thoughts or intentions.  We live in a cause and effect physical reality that is governed by immutable laws.  Like Albert Einstein, I too believe that the thoughts and intentions that arise in consciousness do so according to these natural laws.  Given this view of reality, there’s no coherent way to explain how an organism, human or otherwise, makes freely-willed conscious choices.  Einstein believed that the subjective experience of making “choices” was a “delusion of consciousness.”  As a result, Einstein believed that thoughts and feelings like regret, guilt and shame are all based on a gross misunderstanding of reality that arises from an egocentric view of life.  I think Einstein’s answer to this question would have sounded something like this:  There is nothing that a loved one (or anyone else) could have done differently to prevent the suicide attempt or suicide of someone.  The person who blames him or herself for not behaving in a way that he or she thinks would have or could have prevented the suicide attempt or suicide of someone is misunderstanding how the universe works.  For that person to have done something other than they did, the universe would have had to have been in a different state than it was in at the moment in question.  

The universe is going to unfold how it is going to unfold based on the immutable laws of physics, whether we can foresee what’s going to happen or not.  In simple cases, we can accurately predict the future.  In unfathomably more complex cases—predicting the thoughts that arise within a human being’s consciousness and what she is going to do as a result—we cannot reliably make accurate predictions yet.  Our understanding of neurobiology has yet to reach the point where we can accurately predict the output of the most complex object in the known universe:  the human brain.  

screen-shot-2016-11-03-at-3-25-42-pm

Make no mistake, I still believe that preventing suicides from occurring in the future is possible and worthwhile work.  Knowledge of the warning signs and risk factors for suicide and vigilance can be the cause of someone avoiding a suicide attempt altogether.  Also worth noting, there is always help available for someone in the midst of a suicidal crisis.  You can always call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

6.  Why was I “gripped by fear” about life?

Fear seems to have many causes. Fear of loss, fear of failure, fear of being hurt, and so on, but ultimately all fear is the ego’s fear of death, of annihilation. To the ego, death is always just around the corner. In this mind-identified state, fear of death affects every aspect of your life.

Eckhart Tolle

I don’t recall precisely when I came to understand that my lungs will cease drawing breath and my heart will stop pumping blood and I will die.  I also don’t remember when I realized that absolutely no one has any certain knowledge about what is going on in existence.  The apparent unknowability of the answers to the “big picture” questions that homo sapiens ponder can be unsettling to some.  The certainty around the inevitability of the death of the body coupled with the uncertainty around what is going on in existence is enough to give any contemplative person pause.  

Serial Podcast story pitch

Dear Serial Podcast producers:

In 1993 I graduated Magna Cum Laude from the University of Notre Dame in just three and a half years, and was elected to the Phi Beta Kappa Honor Society. 

In 1998 I had a near death experience in the back of an ambulance due to semi-intentionally caused acute carbon monoxide poisoning.  I drew this picture during my first ever stay in a mental hospital.

screen-shot-2016-10-28-at-10-47-08-am

In 2002, less than a year after I learned that my birth name literally translates to “candid catnip soldier” and within several weeks of watching the movie The Bourne Identity, I trespassed at CIA headquarters with a large framed poster of Albert Einstein with his tongue sticking out, while in possession of marijuana. After being questioned for a few hours, I was cited for two misdemeanors and released.

The next day I told my father a story about what had happened.

Subsequently my father told a story based on the story I told him to my mother and my older brother.

Twelve days later my mother and brother told a story to Dr. Michael Marcus, a psychiatrist, based on the story they had heard from my father.

Without asking me a single question about the story Dr. Marcus had been told by my mother and brother, he committed me to a for-profit mental hospital for emergency involuntary medical care.

Hours later, Dr. Caroline Ekong reportedly read the civil commitment document filled out by Dr. Marcus about why I needed emergency medical care.  Without ever seeing or speaking with me, Dr. Ekong directed staff at the mental hospital to treat me with an oral antipsychotic.

I respectfully refused to swallow the medication, and requested to speak with Dr. Ekong before she began providing me with medical care.

Staff at the mental hospital informed me that Dr. Ekong was not at the hospital, and was not willing to speak with me by telephone.  I was told that if I continued to refuse medical care, that I would be injected with a different antipsychotic medication.

The hospital staff did not inform me of the potential “side-effects” of the two antipsychotics which include a non-zero chance of causing death due to Neuroleptic Malignant Syndrome.

I refused to swallow the oral antipsychotic, but I did not resist the hospital staff when they injected me with Haldol.

Subsequently, I agreed to take the oral antipsychotic medication due to the horrible state of consciousness induced by the Haldol.

Dr. Ekong restored my inalienable rights of liberty and the pursuit of happiness on the same day that my “civil commitment” for involuntary medical care was subject to review by a judge in a court of law.

Four years later, in October of 2006 I made another unauthorized visit to CIA headquarters in order to illustrate ways to improve this country’s mental health care system, and was cited for trespassing again.  Judge T. Rawles Jones of the Eastern District Court of Virginia presided over the ensuing 18 minute trial where I defended myself, and was found not guilty.  

Nine years later in late 2015, I watched Sam Harris’s 2012 talk at the Festival of Dangerous Ideas about the illusory nature of free will.

In May of 2016, while working on a memoir manuscript about how the events described above led me to view the life of free will skeptic, Albert Einstein, as “the brand new greatest story ever told,”  I learned that Christopher Frick, a 21 year old man whom Dr. Ekong had civilly committed in 2013, stabbed her to death in October of 2015.

A couple days later I posted this on Instagram:

screen-shot-2016-10-12-at-10-53-08-am“Imagine if judges in our legal system could imprison suspects and order them to be injected with potentially life-threatening substances without meeting or speaking with them.  Imagine if imprisoned criminal suspects and criminals were financially responsible for paying fees for being in prison, including one to the judge who jailed them.  These ideas are just as absurd as a reality in the mental health care system as they would be if they were part of our legal system.

I don’t seek attention for my anecdotal experience with mental health care mistreatment for the purpose of retributive justice or sympathy, and unlike some survivors of less than optimal behavioral health care, I do not want to burn the existing system to the ground.  Rather, my motivation for sharing this story publicly is to increase awareness about human rights violations occurring within our mental health care system in order to inspire social change and systemic reform.  Caroline Ekong and Christopher Frick are victims of the same thing: a broken, but fixable behavioral healthcare system.”

In October of 2016, after securing an appointment with Vice President Biden and/or his policy staff at the White House to introduce him/them to the executive leadership of the American Foundation for Suicide Prevention, I submitted this story to the creators of Serial.

Thank you for your time and consideration.

Sincerely,

Francesco Bellafante
American Foundation for Suicide Prevention Philadelphia Chapter Board Member
Zero Suicide Champion
frank talk about mental health ~ leveraging the genius of Einstein to end suicide and to maximize well-being