Letter to a compassionate doctor

This morning I awoke thinking about retirement and how my “retirement” has been the very opposite of what I originally imagined. Here I am now retiring from another position in my life, the directorship of The Soldiers Project WA, only to embark on another mission which I believe has been providentially bestowed on me, the directorship of The Jensen Suicide Prevention Peer Protocol, The JSP3©.

As I move forward I want to thank you for believing in me and not judging me when I admitted suicidal thoughts.  In “Just Because You’re Suicidal Doesn’t Mean You’re Crazy”, I reveal suicidality is a coping mechanism that began as a way to deal with untenable, seemingly unsolvable problems early in life. That helplessness early on leads eventually to hopelessness as life continues, as life inevitably does, to present a procession of difficult challenges.

When feeling desperate and in pain, I have made the mistake of revealing suicidal thoughts to a number of my doctors. Not knowing that suicidal thoughts are merely cautionary road signs indicating a mounting problem in need of identification and resolution, those doctors have deserted me with a curt conclusion and a quick fix prescription. The last doctor got up, opened the exam room door, quickly handed me a prescription for an antidepressant and said, “I’m sorry you are having such a hard time. Good luck”. I imagine he leaped to the judgment that I was trying to manipulate him somehow. Perhaps he noticed I’m in recovery from alcohol and drug addiction since 1985, he suspected I was trolling for pain meds.  Many reasons run through my brain as I sit in the exam room chair after a doctor has “escaped” from my revelation. Doctors seem less afraid of virulent contagion than of a patient revealing suicidality.

Each time this happens I ask myself, “Why did I let that slip out?” Docs never stick around long enough for me to explain what suicidal thoughts mean. I’ve come to understand that suicidal thoughts are simply caution signs that I need help identifying a problem and finding a solution. I’m usually in the doctor’s office consulting them to solve that problem. Reminding myself out loud of that urgency involves acknowledging my re-emerging suicidal thoughts. But I am no longer afraid of those thoughts. I know what they mean, how they got started and why that unconscious automatic neural pathway that is suicidality is still not fully extinguished and probably never will be.

As yet, I may be the only one that understands the suicidal neural pathway. I am trying to disseminate the information to the world. But not understanding the psychobiology of suicide as described in my book, is the reason most are terrified of suicidal thoughts and panic at the mention of them. Consequently the many suicidal millions keep quiet. We carefully shelter our thoughts protecting doctors from our inner landscape, not generally for their benefit but more pointedly for our own. We have had our fill of judgment. Doctors are not unlike the general public in that what they don’t know about suicidality can fill volumes. Unfortunately no voluminous instructions exist for these situations, so they, like the general public, cannot truly be blamed.

Filling those critically needed volumes is one of my tasks as a patient, a suicidologist, and a person with a long history of both active and nonactive suicidality. It is from individuals like me that you and your colleagues can learn about suicidality and how to deal with it. I encourage you to let your colleagues know that there is a nonpharmaceutical method of recovery using specific support from trusted educated peers. It is outlined in my book and on my website (http://www.jsp3.org) and will be feathered out in more detail in future publications.

In my current book, “Just Because You’re Suicidal Doesn’t Mean You’re Crazy: The Psychobiology of Suicide”, the explanation for undulating long term suicidal thoughts and plans frees readers from the panic that is engendered by ignorance of the psychobiology of suicide. Studies conducted by intrigued researchers, books written by survivors, stories told by individuals with schizophrenia or bipolar disorder, and websites published by suicide prevention alliances conclude that suicidal individuals are each and every one mentally ill and emotionally unstable. The truth is most suicidal individuals are successfully employed with deep familial and community involvement.

That is why many docs, friends and even closest loved ones refuse to believe that someone who usually acts happy and well-adjusted could possibly reveal alarming thoughts of self-destruction. The more successful and accomplished the suicidal person is the harder it is to believe they could be harboring suicidal thoughts. Therefore dismissal comes easy. Rationalization provides the more palatable belief that this person could not possibly be contrary to what they seem. This is the conspiracy of denial.

Unlike other doctors I have seen, you abide by the enlightened adage…You can’t judge a book by its cover. You are a most remarkable healer and I have been so very fortunate to be under your compassionate care for almost three decades. I depend on being able to be honest with you and not have you panic or dismiss me. I know someday you also will retire. It will be one of the saddest days of my life.

If you could do me one favor…start telling your colleagues what you’ve learned from me about suicidality so they won’t panic when their patients are honest about their suicidal thoughts. Tell them they are on the front lines of not only physical healing but they have the venue to provide inroads to psychological healing as well. If you can impart to them the importance of not panicking at suicidality – but instead to be the purveyors of hope in explaining the psychobiology involved in it. In so doing, maybe someday they will approach your understanding and compassion.

Gratefully, RJ


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