An open letter to Kevin Hines about how propagating the biomedical model of mental illness causes harm by increasing stigma

Dear Kevin,

Subsequent to un-friending and blocking me on Facebook you made the following comment about me:

Problem is I know the guy, he should have had the common decency to just call me, instead of this daily social media kevin bashing.

We have exchanged some tweets and emails, but we have never met.  We’ve never had a conversation in person or on the phone, and I don’t have your phone number.  Your statement to your Facebook audience is so misleading it’s very close to being a lie, if it isn’t already.  Plus it also leaves out the fact that I have been attempting to engage in an actual conversation with you on this topic and others like it for months. I’m not suggesting you owe me anything brother, but the comments you are posting publicly on Facebook paint a patently misleading picture of how often and how long I have been sincerely attempting to have this conversation with you.

I asked you a reasonable question about a post of yours on Facebook, and you claimed that I was invalidating your personal experience with mental illness although I did no such thing.  My words speak for themselves brother.  As do yours Kevin.  Last night, you leveled an ad hominem attack at me on Twitter, and then deleted it after I called it out as such.  

To review the question I asked.

You wrote on Facebook:

Ben believes in the idea that we “live” with mental illness just as one lives with any other true disease.

I asked:

Would you have told this to people diagnosed with the “homosexuality” mental disorder prior to 1973?

Here is your answer to that question:

I’m sorry Francesco Bellafante but I “live” with this every single day. Period. I live well with it most days. I work hard to stay mentally well. Often, I miss the mark. But you are completely invalidating my and Ben Higgs and others personal experiences by sticking so closely to the ideals of the (late) Einstein. Not everything he said, wrote down, or was quoted to have invented is gospel. I’ve read quite a bit of his work. In that regard (and in no way am I comparing myself to him) Neither is anything I’ve said. It’s really open to interpretation based on the individual and their experiences. You have not lived my life. This is the second article you’ve written while debunking words I say. Interesting… 

The question stands unanswered.  Worth noting here again, you don’t owe me a half a second of your time, let alone an answer.  This is precisely why I have been so sincerely grateful and appreciative Every Single Time you have engaged with me.  Except the ad hominem attack last night, of course.

I sincerely believe an interesting, potentially illuminating and valuable conversation could result from my question.  My aim is to contrast the biomedical model of mental illness that you propagate with your language…

“Ben believes in the idea that we “live” with mental illness just as one lives with any other true disease.”

“I wasn’t on that bridge from an external issue”

“I was not on that bridge for reasons outside of me.”

“I found myself on the 25th of September in the year 2000 at nineteen years of age ready to cease my own existence because of my brain.”

“my brain was trying to kill me”

“brain pain”

“brain health”

“my brain was trying to kill me”

“malfunctioning brain”

…with the biopsychosocial model, and to point that out:

“Despite good intentions, evidence actually shows that anti-stigma campaigns emphasizing the biological nature of mental illness have not been effective, and have often made the problem worse.”

I was not just sharing my opinion or view with you here Kevin.  I was trying to make you aware that scientists have studied how talking about mental illness the way that you do, and they have found that it causes harm.  I sent you the article with evidence from studies supporting this claim.

 You can click on the image above to review the footnotes and the scientific journal articles that provide evidence supporting the article’s argument.

Returning again to what you wrote about me, and more importantly about yourself on Facebook.

Problem is I know the guy, he should have had the common decency to just call me, instead of this daily social media kevin bashing.

I am assuming that you would characterize this Twitter post as “kevin bashing.”

Your words patently propagate the biomedical model of mental illness.  Your words create a ripple effect that leads people to believe that mental illness is a brain disease.  I genuinely believe that doing so causes harm by increasing stigma and not decreasing it as the aforementioned article clearly explains.

I’m not bashing you Kevin.  I’m cogently explaining how and why the words you use to describe mental illness can cause harm in spite of your undeniably unimpeachable motives.  I attempted to engage you in a conversation to ask you to consider to slightly tweak how you speak, so that you decrease the chances of unintentionally causing harm.  Subsequent to that, I was compelled to create the provocative image above to summarize my view while simultaneously reaffirming my love of you/your work and the inspiration and hope you create in the world.  You are my brother in the suicide prevention movement whether you acknowledge that fact or not, and regardless of what you think, say or write about me.  Up to this point, you haven’t said or written a single word responding to my view or claim.  For the third time, I do not claim that you owe me a response. You have every right to ignore me.

To say that my criticism of the propagation of the biomedical model of mental illness is “kevin bashing” is a telltale sign of having an egocentric outlook on life brother.  Note the highlighted text in the image below.

Egocentrism is something I am all too familiar with… it almost killed me in fact. Here’s the opening of my talk.

On the morning of March 2nd 1998, less than five years after graduating Magna Cum Laude from Notre Dame, I found myself inside of a completely pitch black space when I realized I had stopped breathing.  As it was happening… I had no idea where I was.  I couldn’t see a thing.  And all I could hear was the terrified voice in my head… yelling at first… then screaming… before eventually wailing… as I desperately tried to breathe.  I had unintentionally fallen asleep inside of a running car that I had intentionally turned into a makeshift gas chamber.  Based on medical records I obtained a couple of years later, the near death experience I had occurred in an ambulance, en route to the hospital.  Nineteen years later, I have asked for this opportunity to speak with all of you because I want a shot at decreasing the chances of you and anyone you love or know from either dying because of or ever having a suicidal impulse.

Putting myself in a position where falling asleep would likely result in my death was a desperate act arising from a twenty-seven year old, sleep-deprived, addled mind in the midst of psychological and emotional turmoil.  For reasons I can only surmise, at 27 years old, I was compelled to view life through a childish, fearful, egocentric lens prior to nearly killing myself.  To clarify egocentric, I’m not talking about arrogance, narcissism or even self-preoccupation.  At the heart of my egocentrism 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 in matters of fact 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.  This talk is also about getting over and beyond your “self.”  Fair warning, tonight I will be trying to slightly alter your conception of that voice in your head that you likely think of as you, in order to increase the peace within you and the world around us.  

You, Des, DeQuincy and Leah Harris have all provided inspiration for me at key times in my journey leading up to truly dedicating myself to our cause.  I’ll be forever grateful to you for helping to cause me to fully engage in this life-saving work.  Every single word that I have sent your way is unequivocally aimed at doing just that brother:  decreasing the number of lives lost to suicide.

I would love to have this conversation if you’re open to it.  If not, then I implore you again to seriously consider slightly tweaking how you talk about mental illness as you continue to inspire hope and healing in the people you undoubtedly help, to ensure that you don’t unintentionally add to mental illness stigma.

Love,
Francesco

 

Regarding my attempts to engage Kevin in this conversation…

Trying to CHANGE the WORLD by changing the words that Kevin Hines uses when talking about “mental illness”

Kevin Hines is a suicide attempt survivor who is partially responsible for the fact that I write and speak about my suicidal crisis.  He’s a living inspiration.  That said, we don’t always necessarily see eye to eye on the subject of the most empowering way to talk about the suffering associated with “mental illness.”

Kevin published the following post this morning on Facebook from Australia. (emphasis mine):

Sat down with me ol’ pal, I today consider a brother… the incomparable, tattoo covered man himself, Ben Higgs he’s been through a lot, and has triumphed over great adversity. It’s an honor so share a cup of tea with him and talk all things #MentalHealth and #BrainWellbeing Ben believes in the idea that we “live” with mental illness just as one lives with any other true disease. He spreads his message right across Oz and soon around the globe! Ben is a proud member of #TeamRippleWorld & #TeamRippleOz & will very soon have a featured episode in our forthcoming show… #HopeTheRippleEffect Australia a series about stories like Mr. Higgs From all walks of life in Oz. He’ll be headed to America soon with #TeamRippleWorld for the National Council for Behavioral Health 2017 conference, and we are excited!

I will let Kevin correct me if I am mistaken, but he also “believes in the idea that we ‘live’ with mental illness just as one lives with any other true disease.”

I replied with the following comment:

“Ben believes in the idea that we ‘live’ with mental illness just as one lives with any other true disease.” Would you have told this to people diagnosed with the “homosexuality” mental disorder prior to 1973?  i.e., “Jim, You need to face the fact that your desire to have sex with Steve is a symptom of your diseased brain. These feelings are symptoms of your true disease called homosexuality just like your angina is a symptom of your heart disease.”

My concern is that you imply that the cause of “mental illness” is necessarily a brain pathology despite the fact that the DSM itself notes that the causes of “mental disorders” are believed to be biological, psychological and social or environmental. Leaving aside the fact that the NIMH stopped DSM-oriented research into the causes of “mental illness” four years ago, it seems clear to me that your message of hope about the nature of human suffering includes a potentially disempowering idea: you’re destined to live with this problem your whole life because your brain doesn’t work right. Your exact message or one like it propagated prior to 1973 undoubtedly led some? many? to die by suicide. I think it’s important to consider that it still can. Surely someone’s fallacious beliefs can lead them to engage in disordered thinking & behavior.  No brain pathology is necessary.  A person can exhibit the signs of “mental illness” with a brain that is functioning perfectly.

Kevin responded as follows:

I’m sorry Francesco Bellafante but I “live” with this every single day. Period. I live well with it most days. I work hard to stay mentally well. Often, I miss the mark. But you are completely invalidating my and Ben Higgs and others personal experiences by sticking so closely to the ideals of the (late) Einstein. Not everything he said, wrote down, or was quoted to have invented is gospel. I’ve read quite a bit of his work. In that regard (and in no way am I comparing myself to him) Neither is anything I’ve said. It’s really open to interpretation based on the individual and their experiences. You have not lived my life. This is the second article you’ve written while debunking words I say. Interesting… Margaret HinesLauren Kate Breen and others..thoughts ?

And I responded in turn as follows:

“But you are completely invalidating my and Ben Higgs and others personal experiences by sticking so closely to the ideals of the (late) Einstein.”

With all due respect Kevin, I didn’t write a single word that invalidates your personal experience brother, rather I am challenging the implications and/or claims that you guys are making based on your experience. This is an important difference. Plus, my comments made no mention of and do not rely on anything that Albert Einstein said, nor on my own free will skepticism. Words matter, and so do facts. I would respectfully disagree that facts are up for interpretation. Your messaging consistently implies that “mental illness” necessarily results from brain pathology. This claim doesn’t stand up to empirical scrutiny. If that’s not a belief of yours, then my confusion is important information for you, because that’s the message that I get from your communication, and as I said in my prior post… I think this is a potentially disempowering message. I.e., If you have a “mental illness” you need to accept that you are destined to live with this problem your whole life… because your brain doesn’t work right.
Events happen, and then people think and say things about those events—let’s call those stories. No matter how true a story is, events that have occurred and the stories that people tell about those events, are never the same thing. They can’t be. One is an occurrence in reality as it’s happening. The other is an after the fact symbolic representation. We use language, we use stories to encapsulate and communicate meaning about reality as it seems to us. 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” story from a book called the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM. I failed to remember the basic event-story distinction I described a moment ago when I was told my “mental disorder” story about my past after nearly dying by suicide.

I confused my DSM diagnosis or “mental disorder story” with reality itself. I conflated a boilerplate story from a big book with a story about a series of events from my life. When you’re suffering, it’s comforting when a doctor, a trusted authority, gives you an officially-sanctioned medical reason for why you feel so horrible, and better yet, a remedy to help you. I made another critical mistake when I was diagnosed. I believed that my diagnosis mapped onto a specific brain pathology that was necessarily responsible for my problematic thoughts, feelings and behaviors. My psychiatrist didn’t know enough about the psychological and social or environmental factors in my life to seriously consider them before diagnosing and treating me. It is no surprise that I mistakenly blamed my brain for my problems, like millions of other “mental patients” do. I was so grateful that there was a pill that could repair the problem in my brain, and help me feel like myself again. “Diabetics take insulin to fix diabetes. I take Paxil to fix my brain, and to avoid feeling depressed!” I thought. Essentially, I was told and believed, that I was a mentally ill person who would have to cope with my mental illness for the rest of my life.

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 the doctor’s fault or a sign of ill-intent on his part. He was trained to look for different “nails” to hit with different “hammers,” and I was a decidedly perfect fit for a hit from Paxil. He was just doing his job, and playing his role in a system whose approach to solving the problem of human suffering has evidently been corrupted by profit-maximizing motives. (See Whitaker’s and Cosgrove’s – Psychiatry Under the Influence.)

Unfortunately, like millions of other people diagnosed with a “mental illness” I came to see that diagnosis as a defining part of my identity for a period of time. I didn’t think that I had or was exhibiting the signs of a “mental illness” — rather I thought, “I am a mentally ill person.” A respected authority led me to believe that I had a brain disease, and I saw no reason to doubt him at the time. My belief led me to seriously entertain the fallacy that I was biologically destined to suffer from despair over and over again, unless of course I continued to ingest the Paxil tablets. I’m beyond grateful that someone was willing and able to inspire me to question my psychiatrist’s explanation for the cause of my suffering. White coat clad authority figures (and world famous advocates like you brother!!!) 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.

I’m not arguing that “mental illness” doesn’t exist or that people should never consider taking a psych medication. I’m simply questioning if the medical paradigm of “mental illness” is the best way for us to address the problem of certain types of human suffering.

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

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.

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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

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.  

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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.