Today my therapist asked me if I was suicidal, or specifically, if I was having suicidal thoughts. I had to think about it for a few minutes before answering. And the answer is not so much. I haven’t sat down and thought about killing myself in a few weeks now. I am not saying I am no longer suicidal because that would be inaccurate. If given the chance, I would act on a suicidal plan in a heartbeat. It’s just that I am not thinking about it all the time anymore, 24/7. Then she asked me about my perturbation, press, and psychache, the three P’s of the suicidal cubic model. When all three are at a 5, suicide is imminent. Over the last few years I have ranged from a 4-4-5 to a 5-5-4. Always close to killing myself but not quite there. Granted there have been times that I needed to do something to get rid of the pain so I would self-medicate, usually. But lately, I haven’t been perturbed. I haven’t been feeling press. And my psychache has only increased due to my transgender issues. It varies. Some days it is worse than others.
My suicidal thoughts are also partly dependent on my physical pain. I haven’t had a bad pain flare up in the last few weeks. I had pain today that prevented me from going out, again. Seems I have been waking up in pain the last few mornings and I am not liking this. It just ruins my day. I really wanted to go see my therapist today, and I would have if my stupid foot wasn’t hurting. It makes me depressed big time but it doesn’t necessarily make me suicidal all the time.
I have not been in a dark mood in quite some time. I am fearful that it might come back. I am trying not to be too hopeful about things because I know things are always going to suck no matter what. Like my editor not getting back to me is putting added stress on me. I know that she hasn’t gotten to my book because I am a bad writer, but I can’t help but feel that way sometimes. I am hoping she gets to me this week, after her day off. I am really, really disappointed that I am not going to be publishing the first week of April. I had wanted to get a few books out to the AAS conference in Los Angelas. But now that doesn’t seem likely either.
I feel like I have a fractured ego right now, that one wrong thing someone says to me and I will have a meltdown of some kind. I just feel a pressure building up and I don’t know where the release valve is. Right now things are ok, but I am sure any stress thrown in my direction is going to set me off. I guess that is why I have not thought about a suicidal plan. It would be too tempting to have one in place should I have a meltdown.
Also my therapist wanted to ask me a question about my transgender stuff but we ran out of time. I am kind of glad because we have been talking about that most of the week. I am glad next week we don’t meet three times. She wants to meet with me any time she has an opening. But next week I have appointments for myself and my dad. I am not looking forward to my appointment as it is with my PCP. I also have an appointment with my neurologist this week. That appointment is a joke. She meets with me and just tells me to join yoga. Not happening. We also talk about other stuff. I am going to bring up my neck hurting me and my hand/arm falling asleep. It has been happening a little bit too much for my liking. The weird part is that I will be sleeping on my left side when my right arm falls asleep. I hope I don’t have herniated discs in my neck. That will suck.
This is my 400th blog. I want it to be meaningful so I thought I would write about Dr. Edwin Shneidman. He was a wonderful man that I really admire. He was the father of suicidology and really pioneered the field.
His famous quotes, one of many, was that you should not kill yourself while you are suicidal. I think he meant it to be as a sort of giving yourself time before acting on such a dangerous act. I know that in my time I have been putting it off. It keeps me here.
My favorite book that he wrote was called “the suicidal mind”. I swear this guy was in my head as I was reading it. It perfectly described everything that I was feeling. The psychache, the despair, the guilty worthless feelings, all of it. He was the one that termed the word psychache, which is feelings of psychological pain that can best be described as feelings of despair, frustration, guilt, worthlessness, hopelessness, and helplessness.
His other connotations are constriction and perturbation. These two words are the most dangerous in a suicidal mind. The constriction means there is a narrowing of the mind, a kind of tunnel vision that is set on one thing: easing the psychache at any and all costs, by killing oneself. Perturbation is the agitation, frustration, the “must do something now” type feeling that provides that person to think about suicide and it is difficult to calm or settle these feelings once constriction is in full gear.
Another word Dr. Shneidman often uses to describe suicidality is press. This word is sort of a disambiguation. He uses it to describe a lot of things but mostly the pressure one feels to act on suicidal feelings and thoughts. It can also be used as a sort of perturbation. In Dr. Shneidman’s eyes, the level of the perturbation, press, and psychache will ultimately lead to suicide. If you were to rate each on a 1-5 scale model and have a 5-5-5, the likelihood of completing a suicidal act is greatly increased. In fact, he has stated that prolonged feelings of these three things are a major cause of suicide. No one can endure psychache, press, and perturbation for any length of time. You can have fluctuation of the these three things but once they have been at a sustainable level for any length of time, suicide is likely to follow.
Dr. Shneidman was a man that I greatly admire and respect. And what is very special to me and what I will always remember is him calling me out of the blue one day to discuss my paper that I sent him on “ten faces”. It was a paper that I wrote up for the AAS 41st annual conference and was my first poster session for this organization. I will always be grateful for that phone call.