Monday, 2 November 2009

You Might As Well Live!

Today I have been on a Suicide and Self-Harming Course called Razor's Edge.

Not so much a 'How To' but more a 'What To Do When You Encounter It' crash course in delivering a mental Heimlich manoeuvre to distressed students. The course was presented by an energetic and erudite glinty-eyed psychiatrist who dressed like an undertaker and evidently regarded the outer extremes of human behaviour with something akin to the relish of a dangerous sports enthusiast, seeming a little disappointed not to have come across a patient with multiple personality disorder in his wide experience yet!

But for all that and a healthy dollop of black humour, Dr Bourne proved practical, compassionate and endlessly imaginative in the means he devised to postpone would-be suicidal practitioners until they'd had time to think it over and consider other solutions to their problems, and convince self-harmers there were safer means of obtaining that endorphin high or psychological relief achieved by cutting themselves.

During the course of the day he came through the door dressed in several guises, adopting the narrative, mannerisms and accents of several 'patients' for us to offer assistance to in the course of our day jobs. He then changed and came back to dissect each case, the advice we had given and the advice we might like to consider giving if it were to happen in real life. All the cases were based on real life cases so he was also able to tell us the real life outcome of each one.
We also learned some fascinating facts such as;
  • Vets are the profession of highest suicide risk. Social isolation posted in small towns and villages where they might take a long time to be accepted into the community plus they have the means and they are trained to kill (ie put animals down)
  • Hose pipe through the car window suicides have radically dropped in popularity in the last ten years owing to catalytic converters. Most modern cars would require you to sit in them for hours or even days to die, by which time you would have been discovered by interfering dog walkers many times over!
  • The majority of suicides do it on impulse and are more likely to do it if they have the means to hand - therefore pharmacists and hospital doctors have a high suicide rate as they know exactly what to do for a quick, painless and certain end and have easy access to the means. GPs less so as few surgeries keep their own drugs on the premises and most must write out prescriptions for their patients to pick up at the pharmacy (providing the pharmacist is still alive!)
  • When talking someone suicidal out of it, or at least into postponing it, do not underestimate their embarrassment. If they feel too foolish for backing down, particularly in a public place where crowds may have gathered and the emergency services may have arrived they may suddenly pluck up the resolve to kill themselves purely because they feel they could not live with the embarrassment of climbing down, literally, and this has become as pertinent to them as the original problem or set of problems which sent them to the top of the high building in the first place.
  • Many suicides are still not recorded as such for various reasons but labelled 'misadventure' or 'accident' to spare family feelings. In addition it is impossible to be sure re many drug overdoses so it is likely that actual rates of suicide may be several times higher than officially recorded.
He also taught us how to protect ourselves both mentally and physically and how imperative it is to do this first in order to be of best use to the person at risk. But that if the worst still went ahead, it would not be a failure on our part, more our misfortune to encounter a particularly determined individual bent on killing themselves no matter what.

You could tell Dr Bourne was an enthusiast about his work as in an unwitting moment of humour and without a hint of irony he recommended 'Night Falls Fast:Understanding Suicide' by Kay Redfield Jamison as a good holiday read.

It may sound strange but I would recommend the Suicide and Self-Harming Course to anyone who deals with people in their day job. It is a kind of equivalent to First Aid but for the mind and was surprisingly uplifting in many ways taking the fear out of being confronted by such a situation, despite some of the exercises being pretty scary and a certain amount of stepping out of comfort zones required.

And it was of course impossible not to recall Dorothy Parker's famous verse on the subject.


Razors pain you;
Rivers are damp;
Acids stain you;
And drugs cause cramp.
Guns aren't lawful;
Nooses give;
Gas smells awful;
You might as well live.

I've often thought that if I'm ever famous enough to pen an autobiography it might be called 'If Things Don't Get Any Better In Six Months, THEN I'll Kill Myself', the joke of it being it would be a rolling six months which would eventually take me up to the end of my natural span by default!


Dan said...

Wow, just seen the training course website. This looks considerably more entertaining than most office life - a kind of grown-up Punch and Judy show or something!

I think everyone could do with a bit of vaudeville in the workplace.

Steve said...

What a fantastic sounding course. I may take it for use at my place of work (I'd like a few tips on how to push my enemies over the edge).

Geoff said...

But which song tips most suicidals over the edge?

The Theme From MASH or The Wind Beneath My Wings?

KAZ said...

'they are more likely to do it if they have the means to hand'.
That reminds me, I meant to sneak out a bottle of something before I left work - just in case.
Most school laboratories would be a suicidal person's dream come true.

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Nota Bene said...

I knew it was difficult to do with a gas oven...didn't realise that Catalytic convertors made a difference though - so helping the environment is also good for would be suiciders? That's a win win...

Steerforth said...

Fascinating, and a whole new dimension to the phrase "died of embarrassment".

Reluctant Blogger said...

Funny how you manage to wander through life not knowing something and then in one week about 4 people tell you the same thing (vets are most likely to commit suicide was the "something" i've heard several times recently).

But I think you are right and sometimes these things which might appear depressing can turn out to be uplifting experiences.

The Sagittarian said...

Such an interesting post, Laura, and I thank you for it. I don't intend to but I can sometimes get called upon to deal with issues which have the potential to result in a suicide or self harm so I will take your advice and read that book. On a personal note, we havea niece who self-harms and is always ina nd out of the "Bin" (as she calls it). She has an illness which she needs medication for, but when she takes it she feels better so stops taking it! You think they would find a way to make a time release drug by now so the decision not to take it isn't there for her!

Wisewebwoman said...

Vets, eh?
All put me in mind of the Hemlock Society which I've considered if I ever get to the drooly, rolly, incontinent bundle of cells stage.
But I've observed others arrive at that level oblivious to their own condition.
So timing is everything.
I love the visual of embarrassment on the ledge...

garfer said...

I tried buying 4 packets of indigestion tablets in Tesco recently when a mad check out person informed me that I was only allowed 2.

It was a supervisor.

If I was going to kill myself I think I'd be be more imaginative and go for KFC, Tesco own brand vodka, and paracetamol.

Donn met twee n's said...

It's Vets in the UK?
I read that Psychiatrists finally passed Dentists on this side of the pond.

I find it disconcerting that Suicide is against the about your basic human right?
Of course this has more to do with a loss of revenue in the tax coffers than any real concern for the person.
Soon the Millenials will have drive-thru euthanising stations to speed up the departure of us Baby Boomers.. sod suicide will be a "thing of the past".

I once drove home a vehicle that had been left by a suicide victim...
nobody else in the family wanted to get in it, as I could appreciate...
it was weird, really weird.

Dan said...

Is there a way you can limit the number of posts per "page", to something sensible like 10? At the moment it is a huuuuugely long single page which takes forever to load up...

The Poet Laura-eate said...

Thanks Dan. I can thoroughly recommend some vaudeville in the work place. Re my blog loading - my archive page informs me that it does indeed archive monthly, even though it doesn't! Mind you, perhaps on your side you could try opening it with less than several hundred applications already running on your screen ;-)

Steve, well since Dr Bourne tailors his courses to need, I am sure he could come up with one teaching how to talk people you don't like into suicide!

Geoff, anything by 'Wet Wet Wet' sends me into a suicidal tailspin. Luckily they are deeply unpopular with almost everyone else too now these days.

Kaz, ah but you could just as easily blow yourself up as commit a tidy suicide using the contents of the school laboratory. Plus they've toned it all down now. Not even real gas in the bunsen burners any more!

Only more people living (particularly if they don't really want to) probably isn't so good for the environment Nota Bene. So not a full 'win win' I fear. Oh dear what am I saying? But I would try and talk them out of it if I came across someone suicidal obviously.

Steerforth. A fascinating observation. Thank you.

RB - you lucky thing being surrounded by all these people talking about suicide - I fear my new skills will turn rusty if I don't find some depressed people to practice on soon!

Sagittarian - apologies for my flippancy above. That must be a real worry for you. Are they trying to wean her onto elastic bands to twang against her wrists when she feels the need to cut etc? Yes that is a common problem with psychotic medication. That and the horrendous side-effects some patients experience which cause them to quickly abandon it. Better to find natural means if at all possible. Presumably she's tried NPL? I find this a fascinating field myself and full of potential for the individual to choose to 're-program' their screwed up bits.

The Hemlock Society WWW? It rings a bell now you come to mention it. On the other hand if one gets to 95 say, is there any point in topping oneself when one has got that far and probably only has a limited time left in any case? Like yourself I am doing all I can to look after myself and hope for the best when old age strikes.

Garfer, that is terribly amusing. Did the Supervisor then follow you home to make sure you imbibed them correctly and had no handy sharp knives in the kitchen?

Donn - of course mass state euthanaesia at a certain adult age has been a recurring theme in sci fi for many years, but surely it is more ethical to either encourage/discourage a nation's birth rate as various factors dictate rather than try and control its death rate! And older citizens have so much to offer if only the opportunities are there for them. Animals seem to have no problem naturally regulating their numbers after all. Not that I advocate the breeding of a human predator. Though they already have other humans as well as themselves to worry about if you think about it.