When I was growing up in a terribly abusive environment that I saw no possible escape from, I became incredibly depressed and began contemplating suicide. My senior year of high school, I was going away for a long weekend and planned to end my life before I would have to return home. A day before I was scheduled to leave for this trip, my little brother ran into my room crying. I hugged him and asked him what was wrong, and he said, “I asked Mommy if I could go away with you and she said no and I cried.” He, then, proceeded to climb into my suitcase, and would only get out when I promised I’d call him twice a day and be back in just a couple of days. I told him that I loved him, and he said that he loved me, too, and gave me another hug. At that point, I was certain that I would not be ending my life on this trip. Simply knowing how much this little boy loved me and how upset he was at my being away for just a couple of days knocked that idea right out of my head. To this day, I wonder if my incredibly brilliant, intuitive brother had some idea of what I was planning when he ran into my room that day, despite his young age. In contrast, a friend of mine was growing up in a similar environment, and was hospitalized after attempting suicide. After quite a long period of hospital staff controlling his every move and medicating him into oblivion, he was released from the hospital and, soon after, attempted suicide again.
When mental health professionals talk about crisis intervention with seriously suicidal individuals, the primary concern tends to be reducing any imminent risk that someone will take his own life, often, through involuntary hospitalization. There is a multitude of factors that make this approach unbelievably counterproductive, particularly for abuse survivors. Many abuse survivors are repeatedly told by their abusers that if they tell anyone about the abuse, people won’t believe them and will simply think that they’re crazy, or this may have truly happened to them upon disclosing the abuse. Being involuntarily committed may be seen as confirmation that they are crazy, which, inevitably, is not going to help someone who is already in suicidal crisis. The particular practices of some psychiatric units, such as conducting strip searches and restraining patients by tying them to beds, can be unbelievably triggering for sexual abuse survivors, to the point of feeling re-traumatizing. Simply detaining an abuse survivor in a hospital against his will and replicating the feeling of living with a controlling, abusive person by dictating everything that person does and taking away his personal belongings can be deeply re-traumatizing. When someone who is still in an abusive situation attempts suicide and the response is not to ensure that individual’s safety from her abuser (the reason she attempted suicide in the first place) but to detain her in a psychiatric hospital for a few days to “protect her from herself” and then, send her back into the same situation, another suicide attempt is almost inevitable. Given that the therapeutic methods employed by most hospitals don’t extend far beyond prescribing psychotropic drugs that patients may or may not continue taking after their discharge, and that may make things worse or, at least, produce no substantial benefit, the effectiveness of this type of “intervention” is extremely limited. Years after the interaction with my brother that I previously described, I still can’t remember that day without smiling and thinking about how a little boy with a big heart managed to keep me alive in one of my worst moments.
I was once talking to the caseworker of a young boy I was working with. She told me that she couldn’t believe the progress that I was making with this child, that he was happy, his grades had improved, and he was getting along much better with his foster parents. I responded that I shouldn’t be the one receiving the credit for this child’s behavior, and that he was a really fantastic kid, but I wanted to ask her why every time this boy or any other child in her care acted out, the response was always punitive or even traumatizing, such as moving a child to a different foster home, or threatening to. If a traumatized child acts out and the response is to traumatize him again as “punishment,” I hope we can all agree that this approach is doomed to fail. What was I doing that worked such magic with a child that so many professionals had pretty much given up on? I listened to his problems without judgment. When he did something well, I repeatedly told him how wonderful he was and when he acted out, I talked to him about why he had done so and about better ways of handling such a situation in the future, while continuing to tell him what a great kid he was. I took every opportunity to make him feel special and loved, whether it was by giving him the opportunity to actually celebrate his birthday for the first time in his life, advocating for him when he was in trouble, or simply telling him that I loved him and that wasn’t ever going to change. None of this is magic or rocket science- it’s simply indicative of a culture that is overly reliant on traumatizing, expensive interventions rather than real, human compassion and love.
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