Know Anyone Going Through A Rough Time?

Are they angry?  Depressed?  Worried?  Did their doctor get them addicted to pain killers?  Alcoholic?  Arrested?  Lose someone they love?  Share with them this phone number and web address to the National Suicide Prevention Lifeline.  They are open 24 hours a day, 7 days a week and are there to listen.
1 (800) 273-8255.  Website: www.suicidepreventionlifeline.org

Over 30,000 people in the United States die by suicide every year which means someone dies by suicide about every 18 minutes in the U.S. An attempt is estimated to be made once every minute.

Share this information.  Print out the NSPL card and leave it in public places such as libraries, work, school, churches, stores.  If you go to church, ask your pastor to publish the hotline number in the church bulletin or newsletter.  Churches are notorious for hating gays, women and sinners and if you have any of them secretly hiding among the "good" people, they may be suffering emotionally and spiritually.  Suicide is the third leading cause of death among those 15-24 years old so churches need to be more careful the things they say for, children will listen.

Gaga Over The Church

While answering the phones for a suicide hotline, not a day would go by that I didn't receive one to six calls from suicidal teens, many of them citing sexual orientation as the source of their pain, confusion and suffering.

Homosexuality is no longer an issue in mainstream society.  Other than the church, most people are accepting and blind to the issue.  It is even accepted among teens themselves.  On a recent trip to Provincetown, MA, a town known to be a haven for homosexual people, half the tourists were breeders and many of them brought their small children with them.  Homosexuality wasn't even something that needed to be tolerated, it just was.  Indeed, within this small town, the lion lays down with the lamb and the child plays at the den of the cobra.  I just wasn't sure who the lions or lambs were.  It didn't matter.  Persecuted and persecutors, no more.

Some of my gay teen callers are sometimes threatened and bullied in school and it is usually because they are in the closet and the bullies are trying to elicit a response from them.  For the kid who is openly gay, a bully can't hold anything over them and tends to leave them alone. The kid who is out also tends to have support from other kids who can see the value in them and appreciate their honesty.  It has been my lifetime observation that in five or ten years, homophobic bullies eventually come out of the closet themselves as their bullying was really the exploration of their own sexuality and boundaries.  They are more to be pitied than censured.

Predominately, having found acceptance by their peers, my gay callers are more alienated by their parents or by the teachings of the church than peers.  Since the Westboro Church has taught us that God hates, and He hates gays most of all, it is no wonder that a teen struggling with his identity can feel alone, abandoned, forgotten, hated and ostracized.  If even God hates you, who could be for you?

Back in biblical days, the life expectancy of an adult was thirty or forty years of age and further complicating matters, most children died before their tenth birth-date due to disease or illness.  If there was a famine, food was given to adults before being given to a child because the chance of a child making it to adulthood was slim and feeding them was considered to be a waste of resources. 

Anyone who partook in homosexual practices or committed "the sin of Onan" (masturbation), was participating in an act which wasted seed.  Those activities did not produce offspring and in those days, for the good of the tribe or community, it was important for procreation to take precedent over self pleasure.  It was also common practice for thirteen year old girls to be sold into marriage as soon as they hit puberty, in an effort for them to produce as many children as possible before they died at the ripe old age of thirty.  A perfect example of this practice is Joseph who was about forty and Mary who was thirteen.

The church and society have long forgotten why homosexuality and masturbation was frowned upon but they still hold blindly on to those archaic prejudices today. According to the National Alliance on Mental Illness, nearly 5000 teens commit suicide each year and approximately 2 million U.S. teens attempt suicide. 

Enter Lady Gaga (Stefani Joanne Angelina Germanotta).  She is a marketing genius for using gimmicks, controversy and over the top behavior and costumes to build an estimated net worth of $190 million.  What she does with those millions of dollars speaks volumes.  Being the product of a Catholic school education, she knows the pain and anguish of being different, even in a Roman Catholic school setting - where she herself was bullied and teased.  Because of the pain the church has inflicted upon her in her youth, the church has become a target in her her music and marketing genius.

Together with her mom, Lady Gaga created a foundation called "Born This Way" which is a non-profit organization founded in 2011.  It has the support of Harvard University, the Berkman Center for Internet & Society, the John D. and Catherine T. MacArthur Foundation and the California Endowment.  In September of 2012 Gaga was awarded the LennonOno Grant For Peace from Yoko Ono for her work with the foundation actively campaigning on pro-tolerance and peace issues.

The foundation aims to create a "braver, kinder world" for youth, to create safe-spaces, promote the learning of life skills, and provide opportunities to improve their local communities.  Some priorities of the organization are teen suicide, bullying, homosexuality and school violence.

It appears that Lady Gaga has done much to save the lives of many teenagers struggling with sexual identity while the institutional church appears to be unconcerned for the loss of many.  The score is Gaga: one; the institutional church: zero. 

Lady Gaga teaches us the very valuable lesson that even the most ardent Puritan can learn, that acceptance does not make "wrong" right, it only makes what was "wrong," precious.  Another lesson Gaga teaches us is that oppression breeds the power to oppose it and oppose it she has.  She has used the church's own intolerance to challenge it to grow.  Don't hate her when she blasts the church.  Instead, ask why she is blasting the church.  Maybe it is time for the church to fix something.

Ultimately, who cares what a hater thinks.  I often try to get my callers to discover that the wrong person they'll never mean anything.  To the right person, they'll mean everything.  Thank you Lady Gaga for making my job answering the suicide hotline much easier.  To any church of intolerance, I'll pray for you. 

There are many churches who are gay accepting and they proudly wave the rainbow flag but, the gay community doesn't want their own church.  They just want to be part of everyday society.  We don't see signs at restaurants advertising "Blacks welcome here" or, "Woman may use front entrance."  Why do we need flags and signs advertising acceptance?  It should just be.  Isn't "Come, all are welcome," enough?

National Suicide Prevention Lifeline (NSPL)
Call 24/7
1-800-273-8255

"To understand blue, first you have to understand yellow and orange.  In other words, in order to really understand anything you have to understand its opposite."
-Vincent Van Gogh

https://www.youtube.com/watch?v=quXq65p7YD4

Suicide

A library recently asked me to present a workshop about being a volunteer answering a suicide hotline.  There were almost 50 people in attendance ranging in age, race, economic diversity and motive for being there.  I transcribed some of the questions people asked of me.

Why did you decide to answer a suicide hotline?  Having been raised in a private rest home for the elderly, which my parents ran out of our 19 room house, caring for and helping people has always been part of who I am, it's in my DNA.  I spent 25 years volunteering at the Stratton VA hospital and since I wasn't doing that anymore, I wanted to find another way to reach out to people who were in pain.  I also volunteered at a homeless shelter.

How many volunteers were there answering the lines?  There were at the most, five us us who were paid during the day and at night there was usually only one volunteer on duty.  There were about thirty volunteers in total.  We were open from nine in the morning to ten at night.   Now that the center has lost their funding, the lines are only open a few hours each day. 

What happens if you were on the phone with someone and your shift was over?  We all took a pledge that the caller would come first and if we were on the phone with them at the time of closing, we would remain there to finish the call for as long as it took.  I was covering for a volunteer one evening and a call came in minutes before ten.  It was a long call.  After hanging up and writing out my report, it was well after midnight. 

What was the longest call you've had?  Calls can range from five minutes to two hours.  There are many variables.   My longest call was about an hour and a half.  We also had an internet chat line.   One time my supervisor was chatting with a person for two hours when she had to leave.  She discreetly passed the chat off to another staff member who chatted with the person online for another two hours when she had to begin a training class for new volunteers.  I was about to leave and she asked me to stay and continue the chat.  I was there for about two hours when the person finally decided to end the chat because they felt that they were going to be okay.  That was a difficult chat to take because I had to read the entire chat log and continue the current conversation at the same time.  That sort of thing rarely happens. 

What kind of people were the volunteers and what was their motive for doing that kind of work?  There were many reasons people answered the phones.  Some volunteers knew someone or had a family member complete suicide so they wanted to answer the phones to help others and, to honor the memory of their loved one.  One volunteer's son completed suicide so as a pseudonym she took on the feminine version of her son's name in remembrance of him.  Others where college students looking to get something impressive on their resumé.  They usually didn't stay long.  Some were retired people looking to do something to keep busy or give back.  Some were people who were unemployed hoping that if they could prove themselves, they may get hired if an opening presented itself.  One woman was arrested for drugs and prostitution and was required to perform community service so she chose this.  Regardless of motivation, everyone found it rewarding on many levels and most of us cared deeply for the callers.  There was only one person I couldn't figure out.  He used to surf the internet during calls and grumbled when a call came in.  We were both given the task of verifying referrals and in one day I had called over a 100 people and he called about 25.  He said it was because he got a lot of calls but I checked his call log, plus, I was first in the queue that day. He kept an iPad discreetly tucked into his employee handbook and had an earphone tucked into his headset.  He spent most of his time watching movies online or playing video games.  He was the exception.   Ironically he got a big promotion.

Did anyone who called in actually take their life?  There is no way to know that.  I don't know.  We do know about some of the people whom we have saved because they call back.

Why do you say "complete" and not "commit?"  I had an English teacher who taught us Latin roots.  COM means "with" and MIT means "thread."  So for me it means to follow through with something with no indication of outcome, and it also has negative psychiatric connotations such as committing someone.  COMPLETE means "with" and "full."  It means to fully perform the task rather than follow a thread.  It is just my preference. 

Have you ever answered the phone and known the caller?  Six times.  That's why some of us with unique names take on a pseudonym.  I also answered the phone three times and saw that the callers lived a few blocks from my house.  The first thing I do when a call comes in is to type the number into our program.  If the caller has called before, a record of their previous calls will come up.  That way I can better help them by reading about their call history.  I also reverse search their number in an attempt to get an address in case the call becomes a medical emergency. 

Have you ever gotten any prank calls?  All the time.  Mostly teenagers.  I listen carefully to the background sounds of every call because those sounds can reveal a lot about the caller.  If I hear a dog or cat for instance, I can use that knowledge later in the call as a "Protective Factor."  I also listen for giggling or someone else whispering in the background.  Many prank callers aren't prepared to answer questions and you can hear a friend in the background helping with the answers.  After a while you get to know when someone is truly depressed, in crisis or prank calling.  Their tone and answer content doesn't lie.  Despite that, we treat every call as a real call.  Once we discern that it is a prank, we politely end the call because a real caller may be trying to get through.  As much fun as some of them are, we have to keep the lines open.

What is a protective factor? A reason to live.  A person who owns a pet may not kill themselves because they are concerned about what would happen to their pet if they were no longer around to care for them.  Other protective factors are family, friends, someone who is with them at the time of the call, the fact that they called, plans for the future or even religious beliefs that forbid suicide.  Listening carefully to the caller is important to help identify these factors for and to them.  It is also important to weigh these against any existing "Risk Factors" such as previous attempts, the means are there, the intent is strong, any kind of loss the caller is concerned with such as a relationship, job or poor health.  Many callers will consider suicide because of seemingly insignificant concerns but,those are usually the "final straw" and not the real problem.

How do you know the identity of the person calling?  We have caller ID but we also ask the caller for their first name.  If they don't want to give one, we tell them it is okay but I then ask for a fake name.  I like to call a person by a name throughout their call.   I think it is important to call people by name.   If they block their caller ID information, that is okay.  I once had a woman use a fake name and before she ended the call, she shared with me her real name.  That was very touching to me.

Do you ever call 911 on a person contemplating suicide?  It was our office policy not to.  Other suicide hotlines may vary.  We would call 911 if we had permission or the person lapsed into a non-responsive state.  We call those "medical emergency" calls.

Do you ever get depressed after talking to people and hearing about all their problems?  I don't.  I have the ability to drop and forget everything after each call.  I can answer each call fresh and new with every person who reaches out to us.  Our supervisors are always available to talk and debrief us if needed.  Once my supervisor was listening in on a call, for quality control, and after the call she came over to ask if I wanted to talk about the caller.  She was even teary eyed.  I have a good genetic self defense mechanism and can let things go.  It has always been easy for me to forgive and forget.  In "Star Trek: Into Darkness," Spock elegantly waxes about how his choice not to feel does not imply that he is cold.  On the contrary, he chooses not to feel because he feels too much.  Maybe that is me.

How come you lost your funding?  People don't think suicide is important or is as pervasive as it really is. Write your congressman!  A suicide center is not a money making business and our office was unable to sustain itself in this economy.  You need space, phones, computers, internet, IT personnel, heat, electricity, software, supervisors, people to train volunteers, people to seek and screen volunteers.  There is a lot of overhead that most people are not aware of.  It is not just a phone line.  Although, I do currently answer a hotline for a prison organization and they provide the phone.  It is more laid back, the calls are not recorded and no records are kept.  I am just there to  offer support and listen.  Write your law makers asking them to support these services.  There is a large portion of our population who are either depressed, struggling, thinking about suicide, or wish they were dead.  It's a sin that we are not there to help them while congress can vote themselves raises. 

Why would you record a call?  Quality assurance and training.  Each and every call is totally confidential.  No data, information or recording leaves our office.  Supervisors listen to the recordings so they can provide feedback to us in an effort to improve our service to the callers.    We also write up reports about the call so that other people who answer the phones can read the reports both for learning purposes and in case that person ever calls back.  The information from previous calls can help to steer the conversation especially if the caller is quiet and reserved. 

If someone calls after ten pm and you're not there, what happens? It gets routed to another suicide hotline office.  It is all automated.  The National Suicide Prevention Lifeline is 24/7. 

Do you ever get a caller who doesn't want to kill themselves but needs to talk?  All the time.  Most callers have ambivalence (both + strength), that's why they call because they don't want to die.  All of our callers are going though some kind of emotional pain and don't know how to make it stop.  They do have the strength and courage to call for help.  We are there to get them through the moment.

Do you get people who harm themselves in other ways such as cutting?  All the time.  Especially teenagers.  I don't know where they get this idea of cutting.  Many people think that the pain of physical cutting will take away their emotional pain.  I ask many of these callers that the next time they want to hurt themselves, instead of hitting, cutting or biting, try holding an ice cube in their hand.  They will get the pain and not scar or bruise or bleed.  It does not solve their problem but ameliorates the symptom of wanting to feel pain without doing permanent damage.  We often ask people if they want referrals to support groups, counselors, hospitals or mental health agencies. 

SUICIDE

I used to answer two suicide hotlines in both a volunteer and paid capacity.  Because of this experience, I often get many people in various social circles asking me questions about suicide.  Usually it is about "a friend" but I have sometimes found that third party queries can be personal.  In those cases, I would quickly turn the question around and ask the person questioning me if they have ever thought about suicide themselves, then, take their question from there as it pertains to the "friend." 

When I first began my training, I was asked if I knew anyone who attempted suicide and I didn't.  After the training, I realized that I had indeed known over 15 people who attempted suicide or completed the act.  How quickly the living can forget.  That is something the people contemplating suicide are rarely aware of.  One of them was a priest friend whom I had lunch with every Sunday for 25 years as I went in to do volunteer work at the VA Hospital.  He had written some not very flattering anonymous letters about the sexual proclivities of our Bishop, who then found out who wrote them and called my friend, Fr. Minkler, in from his vacation to sign documents stating that he didn't write the aforementioned letters.  As I met with Fr. John that Sunday afternoon, I was running late and we skipped lunch.  He told me that he was having problems and he asked me to pray for him.  I told him that I would and then went on my oblivious and preoccupied way.  He completed suicide that night and I was most likely that last person to speak with him.

There are many reasons people think about suicide.  Here are just a few.
A teen who identifies as homosexual and has homophobic parents; or he discovers that his religious faith forbids and condemns it or him; he may witness or is the recipient of bullying and persecution at school.  Ironically, our mainstream society is indeed very tolerant and unflinching about the topic.  It is the intolerant religious groups, media, politicians, parents worried about their child's future happiness and people who protest too much who are the real problems.

There have also been parents who lost their job and they see no hope of obtaining employment in the future and they think that the only way to provide for their children is to kill themselves for the insurance money.  Some people think they are a burden and their family would be better off without them.

Someone who was hurt and betrayed by someone they love and thinks that completing suicide will "show them" or get even.  Teens think this way quite often.  Sometimes a call for help can go unheard one too many times.

There are many people who are intolerably lonely and may feel friendless, lost or ostracized.   Each long day is a struggle to get through.  Sleep is their only relief from the pain of loneliness.

Another caller may be someone who was arrested.  It isn't the remorse for the crime which can make them think about suicide.  Restorative justice can easily resolve any wrongs they've committed and they know this and would gladly put things right given the opportunity.  It is the shame of getting arrested.  Then, maybe losing their job because of it, losing friends, the feeling that they've shamed their family and are facing an uncertain future with expensive courts, lawyers, prison and legal proceedings.  This is our punitive and unforgiving society at its best.

There are many people who suffer from biological, prescription or event  created depression.  I've had many people who witnessed something horrific such as military personnel, who then don't know how to deal with their experience.

Some people are in tremendous physical pain and see no relief or hope in their future.  Many of these people are trapped in a downward spiral of addiction to prescription drugs where either the drugs have no effect anymore or weaning off of them is intolerable. Doctors are quick to try other drugs or mix and match a cocktail of them.  This doesn't always resolve the dependency. 

The one thing to remember is when someone calls, they are not looking for somebody to fix their problems or give them a solution or tell them what to do.  They are looking for someone to be there and to listen.  To help them get through the moment.  To be a friend.

During my first few days of answering the phone, every time it rang I was terrified.  The key though, was in remembering that the caller was looking to get through the moment.  To live another day.  And, I was there to only listen.  To steer them into their pain of the now.

I had a caller who had a gun and was intent upon shooting himself.  I asked him to put the gun down so that we could talk.  He did.  Later in the conversation I asked him to take the bullets out.  He did.  I then asked him to place the bullets in another room and put the gun away in a separate room, which he did.  We then had a very long conversation.   At the end of the call, I invited him to call back tomorrow to let me know how he was doing and he said he would think about it.  He did call back the next day but got a different suicide specialist.  He wanted to thank me for saving his life and told the other suicide specialist that after he hung up with me, he was going to follow through with killing himself.  What saved him was his promise to call me back the next day.  His word and promise was more important to him than all the problems he was going through.  Making dinner, getting a full nights sleep and getting up the next morning was enough for him to be glad he was still alive.  I didn't fix his problems, but I did get him through the moment and gave him something to look forward to.

I had a frequent caller who kept a bottle of vodka and prescription pills under her bed.  That was how she was going to do it.  Her problems were many and she didn't want to complete suicide, but she did want to die.  Her life held no joy.  I once convinced her to pour the Vodka down the drain.  She continued to call to both check in and to make sure we were still here for her.  She would call sometimes just to say hi.  I would ask her if she was thinking about suicide today and she said yes, but wasn't going to do it.  Then, on cue, she would tell me what she was going to do for the rest of the day to get through it and we'd hang up.  One day she procured a new bottle of vodka and called us.  She got a new person on the phone who panicked at the fact that she had the means and the intent so, he called 911.  The police went to her home, broke down her door, put her in handcuffs, the neighbors all came out, the lights were flashing and they then transported her to a mental institution where she had to remain for three or four days of observation.  We never heard from her again.

There are many right and wrong things to say to a caller.  Trust me, some callers will let you know when you say the wrong thing.  They can either blow up at you, insult you, or hang up the phone.  The irony is that all the wrong things to say are very natural to us.  They include things like,
"I'm sorry."
"Let me tell you what happened to me."
"I know exactly how you feel." 
"The same thing happened to my sister." 
"This is what I would do." 

It is uncomfortable for many of us to not be able to help someone fix their problems.  It is our nature and desire to fix people but in reality, it drives us further from the person seeking help.  A caller calls because they want to talk.  The more talking we do, the less they get to.  The more we talk about ourselves, the less they get to talk about their problem.

Sometimes a caller is silent and that can be very uncomfortable for us because we feel like we have to say something to fill the void, when in reality, just being there is enough.  One caller told me that she didn't want to talk.  She just wanted to know that somebody was there.  Some of my callers had their greatest breakthroughs in the silence.  Silence was my greatest tool in my suicide toolbox.

Here are a few questions I would ask a caller to get the conversation started.  The next time someone shares a problem with you, and it doesn't have to be about suicide, resist the natural urge to wallow in their complaints or fix them and their problems.  The hard part is to just listen and steer them into their pain.  When they can talk about what is bothering them, they can begin to heal.  Try these and see where the conversation goes.  Notice that these questions, comments and concerns get the other person to talk more and you, less.  The key lies in truly listening and caring.  Only then can you hear the subtle cues as to what to ask next for, one answer can open up a dozen more questions and comments from you. The questions may be:
What would you like to talk about today?
How have you been dealing with that?
You said that this problem has been bothering you, what is most difficult?
Tell me what happened when . . .
Say more about . . .
What is it that you want from . . .
It sounds like that is very difficult to deal with.
How did they make our feel?
Tell me more about how feeling ___ is like for you.
It is not always comfortable talking to someone about these things but take your time.  I'm here to listen and support you (after a prolonged silence).
Have you told anyone how you're feeling?
What do you think you can do?
What may stand in your way of . . .
What support options do you have?
You sound like you are in a lot of pain (note, that's not a question).
Does anything trigger that?
Where do you direct your anger?
Have you been trying to stop?
How did you feel when . . .
What kind of coping techniques do you use?
What can you do right not to take your mind off of . . .

As you can see, those questions get the caller to talk about what is bothering them.  But, that is just the tip of the iceberg.  After establishing rapport, defining the problem, exploring their feelings, I would come right out and ask them if they were thinking about suicide today, if they haven't already told me.  I would also come right out and ask them if they have a plan, a time, the means, or if they ever tried it in the past.  At this point they are very comfortable admitting anything.   Even that they are standing at a river's edge or there is a gun in their lap.

When I feel that they are safe for the moment, I would get them to make plans for after we end the call.  These are called distracting activities.  At this point I know quite a bit about the caller and can make suggestions if they are at a loss at coming up with their own.  They may include: 
Calling or visiting someone
Exercise, going for a walk or ride a bike.
Go shopping.
Watch TV.
Cook or eat something they enjoy.
Play with a pet.
Create something with art or music, a letter or a journal, meditate or take a shower.
Go outside and take pictures.
Clean the house.
Etcetera. 

The fact that someone calls us in the first place and is willing to talk about suicide shows that they have ambivalence and that is a great way to start.

There are hundreds of suicide hotlines.  Many are funded and staffed through schools and colleges.  Unfortunately they may have limited hours, are open mostly during the day or not on the weekends.  The National Suicide Prevention Lifeline (NSPL) is seven days a week, twenty four hours a day.  Their toll free and anonymous number is 1-800-273-TALK (8255).

"Like" NSPL on FaceBook (FB is also a source of depression for many people, BTW).  Blog about NSPL.  Print out their cards and leave them around schools, the library, at work, in your church, on bulletin boards, on coffee tables, on store shelves, anywhere where people are.   Keep the toll free number on your cell phone so when you encounter someone with a problem, ask them if they would like to speak with someone about it then pass them your phone. Check out the NSPL website to learn more:  
https://www.suicidepreventionlifeline.org

Suicide should not be a secret.  Are you thinking about suicide today?

-Malcolm Kogut.