need for affiliation

Been in a terrible mood today. I am glad my therapist doesn’t get all pissy and aggravated with me when I tell her that I am having a bad day and go away. Actually the more I tell her to go away, the more she sticks around and wants more sessions. I am glad today is that last of it and she didn’t volunteer to be seen tomorrow. I wouldn’t have been able to handle it. Already saw her twice this week and today I barely got by. I just am in a deep rut and though therapy usually helps, it sometimes make things worse when all you want to do is put the covers over your head.

I went out today. I walked a lot too. I know I am probably going to pay for it but I don’t care. I wanted a roast beef sandwich from Kelly’s and seeing as I am carless, I had no choice but to walk. I thought about taking a cab but I didn’t feel like paying $20 or more for the ride.

In therapy we talked about my manuscript. I don’t know when that got to be part of the therapeutic conversation. I just look at the binder I have it in and want to trash it or burn it. It just seems like a daunting task to me to edit this monster of pages. A fellow blogger has offered to read it but I don’t know if I am ready for anybody to read it except me, though I have no intentions to right now. I have to move stuff around and add some stuff. I think I am going to add a few blogs here and there as chapters. I know my Knackered blog is going in as a chapter. I did a stat summary and it is my most popular blog, with over 700 views alone. I also think that I am going to have the blog post the other night as a chapter, though I think I will delete the part of killing myself. I just don’t get how this book is going to be helpful to people when I am just telling them my darkest thoughts. It’s not a hopeful book, other than I wrote it and I am still struggling with these thoughts. I know my blog helps some people, and I wish they would comment or something. Hitting “like” is just not a real good indicator. Do they like the fact that I am telling people I have thoughts of death or do they understand the struggle or are they just sick and get off with me feeling this way? I never know. Some fellow bloggers or strangers do leave good comments but they are far and few in between. It’s not like I am looking for comments on all my work, but a few now and then would help. I guess you can say that I have the need for affiliation.

I am really tired and don’t know if I will be able to watch the game tonight. I asked my sister if I could borrow the car tonight to drop off my baby at FedEx. My shoulders were hurting me today otherwise I would have dragged the package with me as I was near there today. I think I slept wrong but don’t understand why BOTH shoulders are hurting. I know my neck muscles are wicked tight and not matter how much I stretch I can’t get the kinks out. I am rooting for two teams tonight, Indians and of course my Sox. The Indians need a win tonight because then the Snankees will be eliminated from playoff contention. If the Sox win, which I hope they will, they will have home field advantage. Unfortunately, they lost last night so they will not have 100 wins this season. I am kind of upset by this. I was so sure they were going to have the 100 mark. But I will take 98. The last three games are going to be tough because we are playing the Orioles. They are also in the playoff berth. The ALDS is going to be interesting!!

broken inside

I know I only posted a few hours ago but I am still feeling the need to write. The heaviness in my chest has not lifted and I am finding it hard to breathe. I just feel this tremendous weight on me and I don’t know why. I feel like my heart is going to pieces and I have no reason for it to be. Maybe I am going crazy? I just know that I hurt and I don’t like this hurt. I think I’d rather be in horrendous physical pain than deal with this heartache. Sadly, I already am in physical pain but I seem to be getting good at tuning it out. It only hurts when I try and move my foot so I try very hard to keep it as still as possible. That has what my life has become. Staying as still as possible. And I just feel broken and lost. My niece today really touched a nerve. She was just being honest. I just feel like I should be working at a “real” job, though my therapist tells me this is my “real” job. I can’t understand how my life went so badly in such a short amount of time. Four months is not even a season. Sure you have the middle of winter and the beginning of spring but neither were full seasons when I lost my jobs. granted I quit one at the end of Jan and then I was forced to leave the other the end of April. so technically it was three months of going from two jobs to none. All because of what? That is what is killing me. The doctors still aren’t sure what is causing my pain. They thought at first it was my back but that was ruled out with MRIs. Then they did MRIs of my leg, ankle, and foot. All negative except for some swelling. I say just cut the swelling out and see how I fair. I can’t go on living like this. I just can’t. I don’t think I will see the light of day again. These black clouds keep circling around me, day in and day out. I got to sleep with emptiness so vast it can fill the Grand Canyon. I am not on an antidepressant. None of them work for me. None provide relief. Yet my therapist thinks that I should be on one. I don’t see why. I will just become sick off them and will have to discontinue them after a month or so. My psychiatrist has nothing left in her arsenal to save me. My therapist is all out of ideas to help me. Yet I continue the course, hoping that there will be a light at the endless tunnel. They (my therapist and psychiatrist) see this light but I never do. It is too far away from me. But what they don’t see is my heart that is torn to pieces. I want to end my existence because the pain is too great. Yet these two tell me I can’t. One will be hurt and the other will hospitalize me. Why can’t they see how much I am pained? Maybe if they saw it, maybe if I describe it better, they will see that the only way to fix it is with my death.

my suicidal career (short version)

My suicidal career:

I write about this not in the sense that Ronald Maris created it as that would be a completed suicide and I am not dead. But my relationship with suicide is a long one, from the time I was eight up until now. It is a struggle I deal with on a constant basis. It along with my depression makes life very unlivable for me. I often think about death in so many ways. I plan my death in so many ways yet I am unable to act on it.

When I was younger, I had no problem acting on my impulses to kill myself. But then protective factors such as my niece and nephew entered my life and I couldn’t bring myself to go ahead and kill myself. The loss was too great for them. I couldn’t imagine what my sister would say to these young kids who adored me. They were my saving grace whenever I had a bad day and really wanted to end my life.

Then chronic pain entered my life and made the balance of protective factors seem out of reach. I felt that I had to ignore them in order to let myself get into the suicidal mind frame to end my life. And I got there several times in the last few years. I had one friend call me every single day for a week until the storm had passed. I had therapy with my therapist several times a week. Nothing stopped the pain and the hurting that I was feeling. And when the pain got worse, so did the suicidal feelings. The feelings turned into plans that never were executed. This is the story of how it evolved and how a few suicide attempts lead to more hospitalizations than I can count.

I first thought about killing myself at the age of eight. I don’t remember the particulars but I thought it would be a grand idea not to be alive anymore. This got worse when I was nine. I really thought that ending my life was the answer to my problems. I hated myself because I felt like I was a burden to my family. I felt I had let them down somehow. I started planning my death at my birthday that year because I couldn’t stand the pain of living anymore. But for some reason, the age ten had a significance for my family and my mother was throwing a big party. I don’t know why she was throwing the party and making a big deal out of it but I figured I might as well stick around and see what I got. I was disappointed that I didn’t get a tape recorder that I wanted. I didn’t try to kill myself that year. But I did try later that year when I had an argument with my mother that now I don’t even remember what we were fighting about. I just told her I wish I was dead and went to my room to try and kill myself. I placed a pillow case over my head and prayed for death to come take me away. It didn’t work. The pillow case was too breathable. I was left crying in my room what seemed like hours. I don’t recall if my mother ever checked on me. I hated my life from then on. Suicide was always on the back burner for me.

This is a book detailing my career in suicide and the journey I went on to deal with it. There have been a couple of close calls but nothing recent, though I still feel the need to kill myself at times. But I do not act on my thoughts. I have attempted suicide many times and according to all the statistics, I should be dead. The one study that I often am in awe at is the one where they found that suicide attempt reactions often predicted future suicide deaths. I am in that category of not wanting to live yet I am still here. I am the outlier. And I hate being the outlier.

This story is my life that centers around my suicidality and the works that helped me get through it. Without finding the American Association of Suicidology, the works of Edwin Shneidman and David Jobes, I doubt I would still be around to talk about my life in this way. There are concepts of these people that I hope to explain in layman’s terms so people know about them because they have had a deep impact on trying to keep me alive.

The first is Edwin Shneidman’s conception of the word psychache. It is a word used to describe psychological pain which is defined as the combination of hopelessness, despair, loneliness, guilt, worthlessness, unbearable anguish, intolerable pain, and helplessness one feels when in deep despair. It is the pain one feels that is deep within you when contemplating your life. His other concept, the twenty frustrated needs is another brilliant sign of what constitutes suicide. They are:
ABATEMENT The need to submit passively; to belittle oneself
ACHIEVEMENT To accomplish something difficult; to overcome
AFFILIATION To adhere to a friend or group; to affiliate
AGGRESSION To overcome opposition forcefully; fight, attack
AUTONOMY To be independent and free; to shake off restraint
COUNTERACTION To make up for loss by retrieving; get even
DEFENDANCE To vindicate the self against criticism or blame
DEFERENCE To admire and support, praise emulate a superior
DOMINANCE To control, influence, and direct others; dominate
EXHIBITION To excite, fascinate, amuse, entertain others
HARMAVOIDANCE To avoid pain, injury, illness, and death
INVIOLACY To protect the self and one’s psychological space
NURTURANCE To feed, help console, protect, nurture another
ORDER To achieve organization and order among things and ideas
PLAY To act for fun; to seek pleasure for its own sake
REJECTION To exclude, banish, jilt, or expel another person
SENTIENCE To seek sensuous, creature-comfort experience
SHAME-AVOIDANCE To avoid humiliation and embarrassment
SUCCORANCE To have one’s needs gratified; to be loved
UNDERSTANDING To know answers; to know the hows and whys

When you have frustrated needs your thoughts of suicide go up. One feels the need to be loved and nurtured and when that doesn’t happen a certain loneliness occurs and it is painful. According to Shneidman, one must rank these needs so the final sum of all is 100. I have never been able to rank them but I find that these needs are important in everyday life. He got them from another psychologist, Henry Murray in his famous book explorations in personality. The theory is that frustrated needs are a causal factor in suicide. Decrease the frustration and reduce the suicide. Then you have the ten commonalities of suicide (suicidal mind):
I. The common purpose of suicide is to seek a
solution.
II. The common goal of suicide is cessation of
consciousness.
III. The common stimulus in suicide is intolerable
psychological pain.
IV. The common stressor in suicide is frustrated
psychological needs.
V. The common emotion in suicide is
hopelessness-helplessness.
VI. The common cognitive state in suicide is
ambivalence.
VII. The common perceptual state in suicide is
constriction.
VIII. The common action in suicide is egression.
IX. The common interpersonal act in suicide is
communication of intention.
X. The common consistency in suicide is with
lifelong coping patterns.
Within suicide you have a vocabulary of suicidal terms. The list is exhaustive but I have a few favorites:

Hopelessness, psychache, lethality, perceived burdensomeness, thwarted belongingness, press, perturbation, fearlessness and competence.

Perceived burdensomeness, fearlessness, competence, and thwarted belongingness are not Shneidman’s term but of another suicidologist Tom Joiner. I read his book why people die by suicide and found it fascinating. It really is a good read and helped me to understand my suicidality a little better.

Hopelessness, the feeling of being lost in hope, that nothing is ever going to change, that things will always be the same no matter what.
Psychache is defined as despair, intolerable anguish, hopelessness, guilt, worthlessness, and unbearable psychological pain one feels. It is like pain in the heart that no one else can feel. Your heart feels heavy and you feel like a burden because of it. Nothing soothes this pain. No medication can touch it. And suicide seems like the only answer for this type of pain and anguish.
Lethality, the degree to which someone is at risk for suicide. Whether it be a loaded gun or a few bottle of pills or some cuts on the wrist. This is what determines how suicidal a person is and how they are going to act. If the risk is high and eminent, involuntary hospitalization is called for. If the risk is low, then more contact is need and assessment at every visit.
Perceived burdensomeness, the idea that you are a burden to those around you but in reality you are not,
Thwarted belongingness, the idea that you don’t belong anywhere and feel the need to belong somewhere. It is a very awkward and lonely place that hurts very badly. Everyone wants to feel like they belong somewhere or to something and when that need is not met, they feel detached and alone.
Press, similar to stress. It is as if the building of the press is similar to the pressure of a volcano ready to explode. It can lead to further perturbation and make things worse.
Perturbation, the need to feel or do something to ease the pressure and anguish and despair they are feeling and to feel better. It can lead to want to do something but the idea is that you need to do something to relieve the pressure of the feelings on your chest.
Fearlessness, the absence of fear. In this regard, it means that people may be fearless when trying to take their life, like a type of Russian roulette.
Competence, the meaning is the level of competence to carry out the means for their suicidal plan. Examples include rope for hanging, gun handling and shooting, knowledge of drugs, etc. High competency is a high risk factor.

random 654

The shipping box for my new laptop came today. Now I just have to drop it off at FedEx to ship it. This will give me a chance to go to my old Starbucks hang out in Wellington. I hope that I can take my sister’s car tonight to drop it off, otherwise it will have to be tomorrow morning.

So far my day is going ok despite my allergies flaring up. I have had two sneeze attacks since getting up at noon. I woke up at three-thirty in the morning and fell asleep around six. I slept for about six hours. But I was productive during the early morning hours. I got to work on my book (nothing triggering) and came up with at least six pages. I am excited because this line of writing will be at least fifteen or so pages, if I am able to keep it up.

I am feeling less depressed than I was yesterday. I have more energy and I hope this isn’t a crash before a fall. I still am worried that I am going to lose my data on my laptop. But seeing that I have what I need, my blogs and book, I am not so worried. I have my music on my phone that I can always back up and Amazon has all my music is on cloud. The rest of the music is on CDs (actual CDs not CDRs) so I can always make copies of those to put it back on my phone if need be. It is weird working on my old laptop. I forgot how different the keyboard is. I am just hoping that I don’t have any more blue screens of death or that my monitor screen get funky.

This week is National Suicide prevention week. I think there was a chat on twitter about it that AFSP and Mayo clinic were holding. I wanted to see what it was about but I missed it. I don’t usually say anything, unless they discuss treatment options. Then I will put in my two cents about Jobes’s CAMS and the Aeschi model. More clinicians need to be aware of these two similar modes of therapy if they ever want to get the suicide rates down. Course the biggest hurdle is actually getting the person the help he/she needs before they act. I know it wasn’t easy for me to reach out and get the help I needed in the beginning. It took me several calls to Samaritans before I ever saw my first therapist. And I only saw a therapist after I tried to kill myself because I felt like no one would believe me otherwise. I was an intelligent teen and didn’t seem to have any behavior problems so I just felt like they wouldn’t believe me. I felt that if I cut my wrist, it would give me more creditability. After all, my own mother didn’t believe me when I told her I was suicidal. And it took the school nurse to convince her that I needed help.

There were no anti-suicide campaigns at my high school, least none that I recall. I know now they have a counseling center as well as a health center at the school, thanks in part to the movies they have made around the school and other donations. I don’t know how I got through high school as I was extremely depressed and suicidal. But I guess part of it is the connection I made with the school nurse. After I had my problems, I saw her nearly every day just to say hi and chat for a few minutes. I think those chats were the most helpful.

While I was up in the wee hours of the morning writing, I was also reading a little bit in the Comprehensive Textbook of Suicidology. I wanted to see if they had anything about “suicide careers” by Ronald Maris. And to my surprise it did. I don’t know why I wrote this book off. It also has Shneidman’s ten commonalities of suicide. I also included that in my chapter that I am writing. I think I will make what I am writing a blog post. It will be long as already it is almost seven pages or I could just write about it separately. I haven’t decided yet what I am going to do. But I am glad that I don’t have to go searching for “pathway to suicide” by Maris to find the definition of “suicide career”. The way he defines it, is a lifelong depressing road that ultimately leads to completed suicide. In the book, he uses Sylvia Plath as an example.

In finding this little tidbit of information, I feel energized to continue writing a book that talks about the newer age treatment of suicide rather than the old. I talk about my experiences and hope that one day someone will read my book and not feel so alone. Maybe they will have attempting, maybe they have been thinking about it. I will never know.