Ecology of Suicide

I don't know

Today is World Suicide Prevention Day. And as usual, the social media will be filled with memes, messages, stories.

I think that is nice— people expressing, inspiring, supporting.

However, I am tired of the single dimensional nature of the communication. A leads to B whose consequence is C. Our need to fix the problem through a linear cause and effect relation.

What it does is reduce a very complex relational issue to something simple, easy, palatable and actionable. Even if the action leads nowhere.

If you have read so far, then perhaps you will read on. It is a long post, not a easy recipe book that we have become used to. It is not a meme, not here-take-5-easy-steps-to-preventing-suicide.

I write this on the heels of a suicide by a young man whom I knew from when he was a teen. He was well-informed, had access to useful resources, showed up for many others who suffered. He loved and communicated. And was loved in turn.

It is seductive to rush and tell a simple story about why he did what he did. Instead, I invited myself to sit with the ambiguity. That I don’t know. I don’t know what passed his mind in the last few hours of his life. That I don’t know if it was that one time he thought that and acted on it and the action was so severe that he had no time to back off. That I don’t know if it was something  that developed over years, like an ulcer bursting. I don’t know.

Any attempt to piece together his life into a single easy narrative does disservice to the complexity of our relationships and the human body. If he had lived, he could have explored. In ways that would make sense to him.

And there is another young man, a loved Bollywood actor who also died by suicide recently. And I and you don’t know what passed his mind those last few hours. We don’t know if it was pressure of the inequalities of the film industry, or a heartbreak reaction, or that moment, when he hated himself and the life story of being not good enough emerged to his awareness and became the only story of the moment. Or all of it, put together.

And another young man from few years ago in my city in a university. We talked about it too. And the same above applies.

I/you don’t know.

We don’t know if the actions succeeded because more men, as per some research, take more decisive strong steps than do women. That if they were women, would they have chosen methods, where there was a lingering, a slow-down enough for help to arrive.

And then not all women, not all men do the same things.

And women and men are blurry categories themselves. Are there personality pieces that make some more vulnerable than others?

And do pieces exist isolated from the whole system of being-in-relation?

Or do we approach this as truth-of-the-moment – what I feel now is so strong that it deletes most else. That if I did glide through this moment, the spirit may kick back in, gushing to connect and engage?

The Suicide Economy

And some say, it is due to mental health issues. Go find professional help. In the last 60 years, the production and use of anti-depressants and related medications have boomed. What was a $14.6 billion antidepressant industry in April 2019 is likely to double to $28.6 billion this year and stabilize to $19 billion by 2023.

Can we take a pause and explore suicidal ideation as an industry? That there are powers to be who have vested interests to dominate a particular discourse of suicidality. And those powers are industries where some of us work—as researchers, as pharmacists, as factory workers, as marketeers, as middlemen, as pharmacy owners. And that when any of us speak their line, we provide free generic advertisement to the industry, we build their markets for them.

And this industry is connected to another professional line—the medical industry. Psychiatrists who earn their living by diagnosing and prescribing medications. And therapists who provide the soft support for those on meds. And the interconnections between doctors-therapists-pharmacies. Mostly well-intentioned and yet, when you step back, you notice the reductive DSM V, which preordains the existence of people into certain categories of neurology and expressions, for each easy drug formulations can be made, erasing the intricate nature of relationships between people and people, people and institutions, people and history, people and their unique life paths that provides them very specific experiences of learning and loss.

And we work together to preserve that ecosystem of knowledge and business. It is simpler that way, you know. Who wants to get into the mess of living and loving and caring and failing sometimes.

When research material that disproves a drug is sidelined, suppressed, or when research itself is skewed – the times when withdrawal symptoms were hidden from public domain, or when protocols developed by industry-funded research already slided in favour of production, and then we know through some channel, we read, we consume and let it be.

It is easier to pop a pill. That there are cases when antidepressants lead to increased suicidal behaviour. That it is a nightmare to get off some of the antidepressants. But it is easier simpler to pop a pill and relieve the stress of your being on others.

You choose to lose choice. You are now part of a conveyer belt that keeps an economy well-oiled.

And in this mix, are the health insurance companies. Strange no, they mostly don’t have provisions for hospitalization and treatment connected with mental health issues. That if you did attempt suicide, strangely at that point, it isn’t even considered a hospitalization for medical issue. And if you need extended rehab and in-hospital counselling, unless you can get the money, it is best you return home.

That anyone who has attempted suicide knows that along with social shame, it is the money you had to spend out of pocket – on hospital bed, ICU, doctors, medicines, ambulance and whatever else.

Suicidality is an expensive expenditure, sometimes, one that you cannot afford.

It makes sense for insurance companies to severely restrict mental health hospital expenses – so many of us would land in mental health retreats and drain away their money. It helps for them to keep physical and mental health separate. Because, if you go into hospital for a gall bladder surgery, there are only so many times you will access the hospital.  It is clean, done.

The more repetitive the possibility of a condition, you drop in the clause of pre-existing conditions. Oooh. Also a great way to sustain brand loyalty. You can’t switch insurance easily after you are in a specific chronic disease.

The disease is the relationship channel to the insurance company.

Taking History, Talking Ecology

Mental health issues are chronic, no? How much of this is clean and only and only to do with the juices in our bodies? And how much specifically with everything else?

Suicidality in teens and young adults—supposedly for failure to get specific results in an exam or fear of writing an exam is because of what? Parental pressure. Peer pressure. Malnutrition. Specific dynamic of  a student with a teacher or teachers in that area of study in that institution. The education system itself. The history of learning and how it is connected to future livelihoods and prosperity and future joy. Or a history of shame, passed down from one generation to another, a history of identity crisis, a history of learned helplessness. Or were some of those instances an angry/sad reaction of the moment?

Or suicidality due to failed romantic relationship. Where do you fix the reason? Because of misplaced emphasis on love, because of lack of self-worth, of the specific nature of that relationship—was there a history of abuse, gaslighting, a dysfunctional relationship connected to history of other dysfunctionalities. Of cultures where not having a partner is a mark of failure. Of cultures where access to social status, money, resources, belonging comes via a romantic sexual partner. Of how our bodies are pledged to economy.

And how about when partners threaten each other with suicide to ensure they continue to stay in that relationship. What if it is a threat attempt gone wrong? What if suicidal ideation is a way to stay in a relationship in the mind, long after the partner is gone. Response to such threats are also related to everything else—the nature of relationship, the economy, the social structures, the particular family histories, the histories of our being.

And related to urban living. The isolation of living in matchbox apartments, with very narrow territories of being, in continuous negotiation with others for space, for belonging, for acknowledgment. Where buildings and cars and gadgets mark the life, and not the trees that grow in your backyard, or the fields over there. Where we have 100s of channels on TV, several ways to watch TV, several more OTT, and multiple forms of online entertainment including this space.

Where all we have to do switch buttons, tap on our keyboard, to connect to the world. An option to easily leave, mute, block what we don’t like, what is unpleasant. To have so many options to buy, to access, to live with. The specific way the nervous system is enculturated to being in the world. And how they seep into our in-person relationships—I can walk out, walk away, move on, from one heady drink of a relationship to another, until drunk from the ramble, I land in a therapist chair or a psychiatrist, to now feel relieved I belong to a particular category of DSM-V.

And become the passionate scribe and spokesperson for that DSM category of being—you may be so too, go, go, go ask for help.

On platforms such as this via easily consumable memes and posters and heartbreaking stories of loss or survival.

You know you could even come to an NLPer like me—we do better at looking at unique nature of being, at structures of experience and we help you change your unresourceful maps into useful resourceful maps…and forget the territory. And scream map is NOT the territory on the sidelines. It is wonderful to change maps nah and feel you are coping better? And what you feel becomes –you cope better.

I learnt to eat spinach. Look mommy, my muscles now grow. To do what…

Small Circles, Other Circles

And in all this effort to prevent suicide, what about those who are very sick and in pain. Or old. And when they think of a clean way to leave earth, is that suicidal ideation? A lack of ability to continue to engage with the world? Should they be pilled? Therapised?

I remember a woman, I called her sister, didi, who lived upstairs with her other sister. They both were unmarried for we-don’t-know-reasons. And one sister died in a two-wheeler accident. And the other fell in a separate incident, they say, and broke her back. And that one day she fell from the terrace, I am told. What was that about?  Lack of coping? A history of shame around unmarried women? Trace of grief of losing a sister, a close friend?

And where do you draw the lines between you-must-cope and I-understand? What is this imperative of living?

And I remember the neighbour lady when I was a child of ten years of age. One day she burnt in her kitchen. Was that a stove that accidentally burst, a woman who burnt herself, or was she burnt? How often are murders passed as suicide? And how often are suicides converted to murders to serve the interests of those who live?

Abetment of suicide. A law. And before that there was another law in India which criminalized suicide. After you attempted suicide, there was a possibility of being arrested for having dared to harm your life. And at that time, life was owned by the state. Now there are no FIRs, no possibility of bribing police officers to hide the incident. But the trace of that law continues. In the abetment clause. That space when suicide becomes murder.

And even when the law is not invoked, the social guilt is invoked. For those who survive someone who died by suicide. What did each person fail to do that would have made a difference? The closer the relationship, the greater the unsaid accusation, the finger-pointing, the sense of culpability.

The structures of social guilt that demand new ways to be, and sometimes a withdrawal, a scarring, spilling over to other relationships.

This guilt also used by those who threaten suicide – a way of shaming, blaming, a way of manipulating into accepting certain ways of relating. Because you did not do xyz, I suffer.

And why is suicidal ideation not a planning for a genocide? For when we kill our bodies, don’t we also kill 60 trillion organisms belonging to 10,000 microbial species who live on our skin, our organs, our gut? Why is suicide not a genocide? A planetary devastation?

Where does the edge of self begin? Where on that edge does the other emerge? And where does history begin and where exactly do I say, I am here in the moment?

And in all this, whose suicides are talked about and whose not. Whose suicide brews hashtags, poems, songs of grief and love, of crowds milling on streets.

Yesterday P. Sainath tweeted 330,000 farmers have died by suicide in India. Mostly men. Died why? Because of inability to ask for a loan? Or repay a loan? Or ask for more loan? Hounding by collectors? Or of a history that is sliding away, a profession that is no longer status worthy, a collective sense of unbelonging to a world that has hop-skip-leapt away, a loss that preceded the loss of income?

And are those suicidal ideations? Requiring pills? Therapy to cope better with the unbelonging? Strangely our solutions for farmer suicides are different. Change economy, they say. Respect farmers, they say. Our annadata. As if they farmers are only their professions, not humans in relationships with other humans and institutions and structures and histories and rules and norms.

You can’t make money out of those who have no money, no? I mean the banks tried and failed. Why would the drug industry and medical industry bring their suicide discourse to the pastoral lands of India?

And why are those who live in city in not-agriculture professions not treated with an economic restructure, to a change in social structures? Posters declaring – Respect Teens. They are our Future. Respect Single Women. They are torchbearers of Change.

And whose suicide is a relief to a burdened system, crumbling from suicidal people giving services to other may-become suicidal people.

The difference that makes the Difference

And when is suicidal ideation not necessarily a desire to end life but to explore the edges of living, like how some experiment with psychedelics. Like how some race cars. When winning includes and builds on that energy of suicidal ideation. Do we think of putting them on pills, sending them to sit in a therapist office, create an insurance clause – “death by car racing is covered clause pertaining to self-harm and other related injuries.”

Like how some join military and go fight on the battlefronts. And isn’t war a suicidal ideation?

And how similar is winning a war to winning exams, winning job and business opportunities, winning partners, gaining lands and houses and children.

And where exactly do we cease to ideate suicidally and live?

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