Bent But Not Broken (12 page)

'Beth has had some terrible news,' he said. 'A girl from her class at school has successfully completed suicide.'

'What?' I thought. 'What the hell does "successfully completed suicide" mean?' But I didn't say it. I kept it in my head. Beth looked bad enough. She didn't need any smartarse comments from me. I looked at the others. I reckon they had the same question in their minds too.

'We don't say committed suicide anymore, because attempting suicide is not a crime,' he explained.

Okay, so now we were all on the same page. Someone Beth knew had topped herself.

'I bet you all know someone who has successfully completed suicide,' he prompted.

This was too much! Beth was really upset, and he's talking stupid words! It pissed me off. 'You make it sound like passing an exam or something!' I said angrily.

'However you want to say it isn't important,' he replied. 'But I still think you all know someone who has either tried to kill themselves, or who has actually succeeded in killing themselves,' he pushed.

He did his usual eye laser treatment through the group. I was watching him, but most of the girls were looking down at their hands. Jenny was hugging her doll so tightly, I was glad it wasn't a real baby.

'Yeah, I do. Two, actually,' I said. I figured if he thought it would help Beth, I'd go along with him. For a while, anyway.

'Did you know them well?' I asked.

'One of them I did. He was in my year at school. He hung himself,' I said.

'Did you go to the funeral?'

'Yes. I cried. But everyone was crying,' I said. 'It was his little brother who really broke me up.' Just remembering was enough to make me feel the emotion of that awful day.

'Did you stay in touch with his little brother? Or with his parents?' he asked me.

'No, I stayed away from them,' I said.

'Why?' he asked.

I hadn't given this much thought until now. It took some time for me to answer. 'I guess I was afraid,' I whispered.

'Afraid of what?' he probed.

This made me angry. Why was he pushing this so hard?

'Afraid of making it worse! Afraid of making them sad! Shit, I don't know!' I exploded. 'Why can't you ever just leave me alone?' I shouted. Then I felt bad because I saw Beth flinch like she'd been slapped.

'Do the rest of you know someone who has successfully completed suicide?' he asked the rest of the group. Honestly, Crystal, he's like a dog with a bone! Couldn't he see how Beth was feeling?

'We are all sad when someone dies,' Doctor Harry said gently. And waited. Finally Suzy spoke up.

'There was a girl in Year 11 who did it,' she said.

'Yeah, I know someone too,' Jenny added. 'He was my friend's dad,' she said, so sadly.

'Any death is difficult to deal with,' he said. 'But suicide is so much worse. Can you tell Beth how you felt?' he asked quietly. We were all quiet. Everyone was waiting for someone else to take the lead. So in I go!

'I was sadder for his little brother than I was about him,' I said. 'I suppose that sounds mean. But he did not have the right to do that to his brother!'

'Are you saying that he didn't think about the consequences to his loved ones, Abigail?' he asked.

'I suppose so,' I said. I thought about it a bit more. 'Yeah. I think it was selfish! He did what he wanted to without thinking about how his brother would feel,' I answered.

There was an intake of breath through the group when I said that. Maybe they thought it, but were afraid to say so? I decided to shut up and hear what they were thinking.

'Anger is definitely one of the emotions that we go through in the grieving process,' he responded. 'I wonder if it's worse with suicide?' he asked us all.

'I didn't know the girl in Year 11, so I wasn't so much angry as confused,' Suzy said.

'Confused?' Doctor Harry reflected back at her.

'Well, not confused. Perplexed,' she said thoughtfully. 'I wondered why she did it. She seemed okay,' she added.

'Is that a common feeling?' he asked. 'Did you ask yourselves why they did it?' I could feel that there was general agreement.

'That is the very worst thing, isn't it?' he asked. 'Knowing that we will never get an answer to that vital question?'

We were all sitting quietly, thinking our thoughts. Remembering how awful it was when we found out that someone we knew had killed themselves.

'Is part of the pain we feel because we think we should have seen it coming?' he pressed.

More silence. There was a bit of snuffling. Beth was crying openly. I think we were all pretty miserable. I couldn't see why he kept going. His job was to make us feel better, not worse!

'I am going to share an alarming statistic with you,' he said. 'Australia has the second highest youth suicide rate in the world,' he stated. 'But we think it's actually worse than that. The Coroners return a finding of death by misadventure when someone dies in a single car, no skid, accident. We think some of these are actually suicides.'

That made us all shudder. I have known of a couple of these accidents. I think we all did – except maybe Jenny, because she is so young.

'If what you are saying is true, why don't we hear about it more?' Suzy asked.

As usual, he answered with another question. 'Do you have any ideas why it's not reported?'

Again we sat, quietly thinking. All I could come up with was to make the families feel better. But that didn't make sense. They would be feeling like crap anyway. I had nothing. Finally Suzy spoke up. She really is smart!

'I reckon it's because they think if they tell us, we'll all try it,' she said.

'Sounds pretty stupid when you say it like that, doesn't it?' Doctor Harry commented. 'But you have hit the nail on the head, Suzy! If we don't talk about it, no-one will think about it,' he explained.

'That's bullshit!' I said. 'Lots of people think about it! Some people try it. Some don't really want to die…' I petered out.

'Yes, for some it is a scream for help,' he said. 'But we have to protect these people too,' he added.

'What planet are you on? If someone wants to top themselves, they will find a way!' I said. I was getting angry again.

'I want to recruit you girls into being mental health first aiders,' he said.

Okay, now we really were lost. I could tell because there was a general shifting around in seats. Then I did something really inappropriate, Crystal. I had this image of cutting someone's skull in half, and putting a bandaid on their brain. I laughed out loud. Everyone looked at me like I was an alien. At least Beth had stopped crying.

'You know about first aid,' he said. 'I bet some of you have done basic first aid at school,' he expanded. There was a lot of nodding – but we still had no idea where he was going with this.

'What's the job of a first aider?' he asked.

Again Suzy was there, way ahead of the rest of us. 'To try to keep the injured person safe until the professionals arrive,' she said confidently.

'Really good, Suzy!' he smiled his response. There was a general reduction in the tension we were all feeling. He can be good, sometimes.

'Mental health first aid is like that. Except we hope that we can help someone before they have an injury,' he tried to explain. I was still clueless.

'How well people recover from any trauma is directly related to how quickly they get help. This is where you come in,' he said.

I was still struggling with the bandaid image. At least this time I could keep it in my head. As to what he was on about, I had no idea. And part of me was arguing with him. How can a shrink be asking a bunch of crazy girls to look after the "mental health" of other people?

'I can see that you are a bit confused with what I am proposing,' he said. 'It is not rocket science. It's actually pretty simple,' he added as he worked his eyes over each of us in turn. Some things never change!

'I bet you know how your friends are feeling, even when they don't come right out and say what is on their mind,' he said. There was general nodding around the group. We were all thinking about our friends, and how we do know when they are sad or upset without needing to be told.

'There is a simple question you can ask: are you okay? This lets your friend know that you are aware of how they are feeling, and are offering to listen,' he explained.

When he said it like that, it did seem pretty obvious. But we're all in here because we are not okay. How are we supposed to look after other people?

'Sometimes just listening to someone without judgment is enough to get them through,' he said. 'I'm sure you have had times when being allowed to talk about how you feel has made a huge difference?' he asked.

There was general nodding of assent. We are all girls, after all. We talk about our feelings. I reckon that's the main thing that's wrong with boys.

'But what if that isn't enough?' clever Suzy asked. 'What if you think they might be in real trouble? What if they are thinking about killing themselves?' she asked with genuine concern.

'It's actually okay to ask them if that is how they are feeling,' Doctor Harry said.

'Wouldn't that be putting the idea in their heads?' she worried.

'If you think suicide is already in their thoughts, how can asking them straight out be putting the idea in?' he countered.

'Yeah, but what if they go ahead and do it? I couldn't cope with that!' she said emphatically.

'If someone is determined to kill themselves, Suzy, they will. Where you are so important is your friendship. You can encourage the person to talk to a professional,' he answered.

'So it really is just like regular first aid?' I asked, finally getting the drift. 'You do what you can, and wait for the professionals!' I said.

'More than wait, Abigail. Actively support your friend to seek the right help. Go with them, if they want you to. In a nutshell, that's what a mental first aider does,' he said.

Thinking about this later, I realised that by talking about suicide in general terms he had helped Beth through the first shock and grief she was feeling. The way he talked to us, like we could understand, was empowering. And without saying it in so many words, he was telling us all that we would get out of here – that we weren't going to be stuck here forever. That made me feel more confident. But it's shocking to think that suicide is such a big thing in Australia. No-one talks about it, which makes it even worse when it happens. Talk to our mates, Crystal. Ask them, "Are you okay?"

Love,

Abigail

 

 

CASE FILE #2794 ABIGAIL LEE MANUS D.O.B. 02/04/1998

ENTRY 38: 30/05/2014

Today I decided to really lay out the treatment program to Abigail. I believe she is sufficiently intelligent and educated to be frank with her.

'You know about 911, don't you?' I opened our session.

'Of course!' she said. 'Do you think I'm stupid or something?' she angrily replied.

'Do you know that the terrible events of 911 actually proved that cognitive behaviour therapy is the most effective method in facilitating recovery from trauma?' I asked her.

'What's cognitive behaviour therapy?' Abigail asked.

'It's talking and listening,' I replied.

'What? Like counselling? How could that fix people?'

'After 911 there were thousands of people who sought help to cope with their traumatic experiences,' I said. 'It was the first time that there were so many people linked by a single event.'

'So? How do you know that talking is the best way?' she asked.

'There was an entirely voluntary program set in place. About one third of the post-traumatic stress victims chose to use medication to help them deal with their stress responses,' I said.

'Like the pills I have to take?' she asked.

'Yes,' I replied. 'Anti-depressant and anti-anxiety medications. Often supported by medication to allow them to sleep.'

'Is that what I take?' Abigail asked.

'When you first came here you were very unstable, Abigail. We were not sure why. So I ordered a low dose of both anti-depressant and anti-anxiety medications.'

'When can I stop taking them?' she asked.

'We will work that out together, Abigail. It's a discussion we will have later,' I said.

I could tell that she was skeptical. Obviously she still does not see that she is the key to her recovery. She still sees herself as a passive recipient of our care.

'But that is not for now, Abigail. Can I go on and tell you what the decade-long study of the 911 patients proved?' I asked.

'Yeah. I want to know,' she said.

'As I said, about a third of the patients chose medication alone as their way of dealing with their trauma. About another third chose medication in conjunction with cognitive behaviour therapy.'

'Counselling, right?' she asked.

'Right. And about one third chose counselling without medication.'

'You said this study proved that talking was the most effective way to fix people,' she said. 'How could you prove such a thing?' she challenged.

'The study did regular MRIs on the brains of all the patients,' I explained.

'That's a fancy X-ray, yeah?'

'Basically, yes. A MRI takes shots of the brain like it is being sliced really finely,' I explained. 'Best done this way – people really don't like having their brains sliced up,' I joked.

'So back to the proof,' she said. 'What did the MRIs show?' she asked.

'You have heard of neural pathways?' I asked.

'Yeah. We did that stuff in science. About how the nerves don't join and the electricity has to leap across tiny little gaps,' she said.

'Bang on the money, Abigail. But what the MRIs proved conclusively was that the patients who participated in cognitive behaviour therapy had created the most new neural pathways. Far more than the group that chose only medication,' I expanded.

'Neural pathways?'

'When you learn, your brain filters and sorts. If it's a new idea, it makes a new pathway. Which, in turn, allows new ideas to further develop,' I explained.

'Is that why sometimes it's hard to learn something new? Like when I had trouble learning some stuff in Chemistry because it just made no sense to me?' she asked.