The False Self

A traveling exhibition by Active Minds, an advocacy group, consists of 1,100 backpacks representing the approximate number of undergraduates who commit suicide each year. CreditActiveminds.org

 

 

Some transitional age youth,  budding adults who are trying to find their way in the world, pressured to succeed at Ivy League colleges, pressured to reflect well on their parents, are pushing back, not by failing out of school, or joining a cult, but by saying goodbye, by calling it quits. Each story is unique, and yet the common thread seems to be Winnicott’s concept of the “false self.” Living a life which does not feel genuine or authentic creates anxiety and distress, which when extreme, can feel that the only solution is to shut off the console, shut off the life force. This black and white thinking, so common in young adults who have not figured out the nuances of the world, puts them at high risk for drastic behavior. As the adage goes, “suicide is a long-term solution to a short-term problem.” The problem is that at this tender age, when these “kids” have worked so hard for a college admissions letter, their mental interiors can be shallow, with few resources to navigate internal pain and suffering.

Clay, twenty, female, comes to mind. She had an eating disorder in high school, but when she was admitted to a “respectable” college, her eating normalized. For years, she studied hard, worked on building her resume, and drilled down into the game of college admission. She never gave much thought to what her life would be like when she went to college; she only cared about getting in. When she finally went East for college, despite how proud her parents were, she felt no pleasure in the experience. She felt, by her description, that she was “around a lot of privileged kids who do not understand the world.” She said that not only did she feel empty, she felt that everyone around her did too. The world, by her account, was a meaningless game of giving her parents something to talk about at dinner parties. She resented her parents for making this step, her emergence into the adult world, so much about their narcissism, but she could not express that to them. As a result, she avoided talking to her parents, and if she did, she always said things were “fine.” Yet, things were not “fine”. She had multiple serious suicide attempts, which managed to fall below the radar because she regretted her behavior and then she only told me, months after the fact. When she confessed, she emphatically said that those thoughts are “gone now,” preventing me from being able to discuss her behavior with her parents. Clay, eventually, dropped out of college, reporting that she was now feeling more authentic. She was no longer suicidal, by her report, but she reports painful confusion over what college is supposed to be about. “If I could see how it was for me, I would have stayed, and maybe I should have stayed, but at the time, all I could think about was that I never wanted to go to college, I only wanted to get into college.” Clay’s parents feel she made a horrible mistake, causing Clay to be both resentful of them, and scared for herself. “Maybe I did,” she says, “I just don’t know,” she continues with pain which speaks to her dilemma as to whose life is she leading: hers or her parents? The question remains.

Girls And Suicide: Oh No!

http://www.ctvnews.ca/health/suicide-rate-for-u-s-girls-and-young-women-continues-to-climb-1.2266974

 

“From 2007-2013, the rate for young females went from 2.2 to 3.4 per 100,000. That’s the highest since the 3.1 rate recorded in 1981, when such tracking began.”

These girls and young women, 10-24, are increasing their rate of suicide in the US. What to make of this pit in the stomach feeling of sadness and grief for these developing females and their families? No one knows, so we are left to speculation. They are choosing more lethal means, such that before they may have had an “unsuccessful” attempt, but now they are finishing the job, so to speak. I do not have any glib explanation, except to say that psychic pain is invisible until it is so visible that we squirm when we see it. Does this correspond to my chronic complaining about simplistic interventions for mental health care? Maybe, except that before there were simplistic interventions, there were more people getting no care, returning us to the question of whether bad care is better than no care? There is still a gender gap for suicide, but does this statistic represent a perverse desire for females to close that gap, to show that they can be as violent towards themselves as boys can be? I hope not. Is this a result of social media where there is a vulnerability for developing women to feel that are missing out, based on the images they see on their networking sites? What is the shock associated with these suicides? I wonder if there were any warning signs? As a child psychiatrist, I cannot help but feel that we are failing these girls and women. This data is a call to action. The question is what action? Screening tools?  Should we be empowering teachers to do mental health triage to identify children and adolescents at high risk? Are these foster children, such that more attention needs to be given to this population, a population we know is overmedicated, and is high risk for social ills? Psychiatrists should not stay silent, both to help these kids and to stay relevant. Suicide reminds us about why we do, what we do. We help people with psychic, and hence invisible pain. At the same time, we need to be visible to promote this work.

 

The Suicide Question Continues

 

“A new report from the Centers for Disease Control and Prevention shows a nearly 30% increase in the suicide rate among adults 35 to 64, with the most significant increase in those 50 and older. Why the suicide rate is climbing in this age group is a question without a simple answer.”

 

http://www.cnn.com/2013/05/08/opinion/gebbia-suicide-rate/index.html?eref=mrss_igoogle_cnn

 

Stuck. That is how I feel when I ponder these statistics. What is this change about? I am not satisfied with the stress factors of unemployment, recession, or the floating ideas about access to prescription drugs, or the stress of growing up in the baby boom generation. None of these hypotheses hold together, since every generation has had major environmental stressors, and yet this statistic is a drastic change. Yes, in the United States, there is a tremendous favoritism to youth. Historical perspective is hardly valued. Yes, life can be painfully disappointing, with little vision about how to pivot to make things better. Yes, mental illness can lead to suicide, but none of these suggestions explain the drastic change. I am going to continue to post about this, as the explanation, it seems to me, will shed a large light, on the issues we face in our society.

 

 

Why Are Middle Aged Folks Exiting By Choice?

 

 

“The most pronounced increases were seen among men in their 50s, a group in which suicide rates jumped by nearly 50 percent, to about 30 per 100,000. For women, the largest increase was seen in those ages 60 to 64, among whom rates increased by nearly 60 percent, to 7.0 per 100,000.”

Puzzled. That is how I feel, reading this new statistic. Baby boomers, poor economy, accessibility of narcotics, rapidly changing technology leaving older people to feel left out,  none of these reasons satisfy my sense of the human condition. Fear of old age, disability, burdening loved ones, this might account for elderly suicides, but middle-aged suicides clearly point to a profound hopelessness, or a profound narcissistic injury, yielding a dramatic and final solution to human suffering. As one commenter said, ” Shakespeare expressed some of the same grief in his sonnet 66 — ‘Tired with all these, for restful death I cry.” Leaving both children and parents, seems so harsh, and yet, I can imagine that their pain runs so deep, that thinking of others is nearly impossible. Some statistics stir questions. These numbers stir disturbance and questions.

Suicide Humor