Suicide prevention

Warning signs, etc

Times six.

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Two summers ago, on a dry Saturday morning in London, Si and I set out for a walk. We headed to our local park, Streatham Common. As we took a turn into the Rookery, we noticed a young man sitting on the third step of the wide, well-trodden staircase descending towards the South-East. He held his bent head in both his hands.

An invitation.

I took a deep breath, softly stepped up to him with a ‘Hi. Good morning.’ He slowly raised his head and mirrored back my faint smile. None of our smiles reached our eyes. They were not real yet, only polite.

We got talking and forgot about the walking. Miles was in his late thirties, a father of two. He had been unable to work for a few months because of disabling symptoms that suggested something like Chronic Fatigue/ ME/ Long Covid. Of late his stress levels had rocketed as his employer had started suggesting ‘malingering’ in his letters. Even though his GP understood and validated his medical condition, his employer showed no understanding.

We gathered for coffee in the park on two more occasions that year. We enjoyed our chats, kept in touch and met up regularly even though not frequently. This year, he tells us he has been dismissed from his job after a “fair process” for “gross misconduct” for being physically and mentally unable to work. Gross misconduct includes physical violence, theft and fraud, intoxicated while at work and similar serious offences.

A study at King’s College London looked at the causes of death in 2000 patients with CFS/ME conducted over the years, 2007-2013. A total of 17 patients died in that period – eight died from cancer, five from suicide, and four from other causes. When compared to the general population, less than one suicide would be expected in a study population of this size. Yet five deaths by suicide were recorded. This means that, after controlling for age and other factors, the rate of deaths by suicide in this study was approximately six times higher in people with CFS than in the general population.

The reasons for this vulnerability are – poor quality of life with no hope for relief, loss of employment, finances, and/or relationships, chronic pain, secondary depression, and other associated mental and/or physical illnesses.

Miles felt he was losing his sense of self as a capable human being with integrity. People didn’t always believe or understand him. Maybe he is what they called him, a malingerer. This is hard on his family, but they support him all they can. The kids are delightful. He still has good days and bad, still has serious brain fog he cannot work through sometimes, still can’t do much but he tries his best. He carries a lot of shame for this thing that happened to him. He feels trapped.

No tests can prove his diagnosis. No definitive treatment is available yet.

Resource: Action for ME: https://www.actionforme.org.uk/

What’s been good?

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(Canna indica – grows wild by the roadside everywhere in Sakleshpur)

What’s been good?

It’s healthy to ask this of oneself – what’s been good? Not with the aim to overlook or deny what’s not been good or run away from it. Simply to acknowledge the things that have felt and still feel positive, no matter how tiny. The good and the not-so-good coexist but the mind tends to focus and fixate on what we resist which often falls in the latter category. This is a great way to redirect the mind and train it to pick up on the good, one little thing at a time.

Here’s my list from the last few days:

  • An unexpected packet of 100% Cacao powder showed up in the kitchen cupboard. The previous packet had finished. So, yay!!! This kind of a thing is a special blessing when you live at the back of the back-of-the-beyond and the nearest proper confectionery is a five-hour drive away.
  • Our neighbour sent across the freshest, sweetest pineapple from their garden.
  • For the last 24 hours we’ve had no electrical supply (normal) but our inverter worked beautifully, which meant we didn’t spend last evening in darkness.
  • Mangoes are in season!!! Need I say more?
  • The long-awaited monsoon is here. The farmers are happy and the temperature has dropped to a very comfy range.
  • Our landlord was clearing up his Heliconia bed and offered us 35 root balls!
  • There was a break in the rain this morning and I could squeeze a nice little walk in the coffee plantation where I saw the tiniest yellowest butterfly flitting past.
  • The breeze was cool and refreshing.
  • Most of the shoots of the Jade-plant that I was trying to propagate have taken root.
  • Playing rummy with friends yesterday, I surprised myself by closing two hands that were utterly hopeless to start with.
  • When I returned from my walk and opened the fridge, it lit up. The electricity was back.

How does this list help?

It shows us our resourcefulness in the middle of chaos. Helpful and friendly neighbours, ability to enjoy food and be creative, prioritise physical health, ability to feel relaxed and connected with nature, be joyful and have a sense of achievement – all the things that we can easily take for granted.

So, what’s been good in the last week for you?

Connection of Care

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What did I miss most when I retired from being a doctor?

Patients.

The dignity with which they put up with so much angst and uncertainty constantly inspired me. They smiled. They tried to be gentle, often through pain. I felt a deep connection of care with them. When I stopped working, I missed my patients most.

Over the last 15 months, I have been studying the principles of Hypnotherapy and learning the skills of Solution Focused Brief Hypnotherapy. Anaesthesia is to Medicine what Hypnosis is to therapy. The parallels are clear to me. The course was enjoyable and insightful, and the practice is deeply satisfying. I can now work online with my clients from this remote little village where we live. Once again, I have that caring connection with people.

The fundamental physiological principle on which Hypnotherapy is based is that of Neuroplasticity – the ability of the brain at any age to grow and morph in response to repeated use of certain neural tracks. Cells that fire together, wire together, states Hebb’s law. This essentially means that the repeated use of certain pathways strengthens them and disuse of others, weakens them.

The belief at the root of this practice is that all the resources we need are already present within us. The art is to have access to them, to be self-aware and make decisions from a place of strength, not fear.

Insomnia, weight loss, depression and anxiety, stopping smoking, grief, getting over a phobia, relationship issues and stress are the most common presenting complaints. I am fascinated with the process as I see people identify small steps for themselves that add up over time to produce the big changes they want in their lives. One or two bonus ones as well.

One of my clients was mainly concerned about her weight. She didn’t like her photos and hated shopping for clothes. Otherwise, her life was good. She shared it with her husband of 28 years. After 6 weeks in therapy, she started to comment on her relationship with her husband, which seemed to be improving. She was responding differently to the things he said and did. That really helped. By Week 8, she was enthralled by how famously the two of them were getting on. At our 10th and last meeting, the weight wasn’t even mentioned. She had taken charge of her life.

“I think I have been more positive since we started. More considered, certainly.  My responses have become calmer. This has helped many of my interactions, especially with Mike. There are people who trigger me, however, that I still find it difficult to respond in a calm way (my mother). My activity levels have been steady. I rate my confidence as being a bit improved. I am trying to value myself more and my body. I am still a very organised person, but I suppose I am ‘letting things happen’ a bit more. I find that the small improvement in my levels of confidence and interactions have made a difference.  My reactions and responses help me.

As far as happiness is concerned, I often rate how I feel and think about what little thing I could do to improve how I feel. In general, the sessions have helped me view how I act and interact with others. I can ‘hear’ your voice calmly in the background when I take time to consider how I feel. I am also good at scoring myself. 

There have been some difficult moments recently (regarding my mother), and I have managed to step back for a few days and recharge.”

I feel fortunate to have found this new line of work that is essentially a series of creative conversations.

Resource: An international School for training to be a Hypnotherapist: https://inspiraology.com/

The perils of being DIFFERENT.

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This is the month of his birth. I have not forgotten the 6th of May.

The questions still sneak in on stormy nights and on special days, especially the supposedly ‘happy’ ones. Yes. Blessed is the day he was born. Aren’t I lucky?

All the questions that I can ignore and shove out the window on other days of the year come back and stand firmly in front of me on his birthday.

What would he be doing at 32?

What would he make of the state of this world?

Would he still be playing the drums?

What would he look like?

Would he have a girlfriend? Would he be engaged? Married?

Kids?

What music would he be listening to?

Job?

Health?

Cricket?

Friends?

Where would he have chosen to live?

Blah. Blah. Bloody blah!

Pointless noise.

What if he wasn’t bullied at school for being different? That’s a biggy!

What if his class teacher had listened to me when I told her about it?

What if his small, protestant, primary school in Dundonald, Northern Ireland had acknowledged the issue?

What if they had taken appropriate action?

What if I had moved him to another school there and then?

“Adam is always on my side when the other kids bother me.” He said one Sunday morning, at the age of 6. We were having a lazy morning in bed.

“Do the other kids bother you a lot?”

Silence.

“What do they say?”

“You worship a God with an elephant head!”

Sometimes, I am grateful that he doesn’t have to deal with this hateful world of genocides and mad wars.

Hope the world you’re in is a peaceful one, my love. Happy Birthday Saagar.

We’re crying for softness.

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(A tapestry by Sheila Hicks)

Threads. Blankies. Comforters.

If we let it, this hard world of sharp angles and square blocks, straight logic and serrated edges can seep into us and concrete us from the inside. That must not be allowed to happen as it may be impossible to undo.

We, tender-fleshed people, need cushioning. We, supple spongy beings, seek preservation through rounded, silky, fluffy coverings. Our need to be nestled with tenderness inside the pliable delicate tissue of another’s compassion is primal. It must be recognized as the ultimate necessity for living.

To keep softness alive in a world so harsh is the job at hand in this moment.

In any moment, ever.

Secretly we’re all yearning for something that is warm, welcoming, and soft. Born into the young arms of our mother, held against her soft chest, we’re rocked gently to sleep, patted rhythmically on the back and hummed to. Lullabies ringing and sleep half-arriving into this space of trust and love. Remember how easy it was to rest into it, knowing all was well and would be well? Let it be thus again.

“Life is better when you surround yourself with people for whom kindness isn’t a strategy, it’s a way of life.”