I hate that word. Probably because I teach middle school and, “ugh, triggered” or, “i know, I was soo triggered” are phrases that the 8th graders say with regularity when referring to any minor inconvenience. That’s one of the risks that comes with normalizing mental health conversations-words start to lose some of their power. Because when I say triggered I mean I have lost control of my brain and I am transported back to the terror, shock, and sadness of learning my husband had died. I don’t mean I am feeling annoyed. I don’t mean that bothered me. I mean I am having a psychosomatic reaction to a stimulus that is out of my control. That doesn’t mean we always have to be serious when discussing triggers, but it should be real. I love the way Nora Mcinerny did it on one of her podcasts. When someone asked how she was doing she responded in a sing songy voice, “fall is my trigger season and it’s about to get sad.”
Fall is also my trigger season. We have my birthday, my husband’s birthday, Thanksgiving, Christmas, our anniversary, one right after the other. Those are all normal, expected grief triggers. But to kick things off we have Suicide Prevention Awareness month every September and that is a big punch in the gut. My husband died by suicide. It’s not something I talk about a lot because suicide is so complicated and nuanced and I still haven’t worked out exactly how I feel about it. Normally I have no problem spouting off an undeveloped opinion but not with this-this is too sensitive and, well, triggering.
The suicide prevention messages are…complicated for me. The teen text line is clearly posted in my classroom as are our local crisis lines and ways to connect with our schools student assistant program. I have the suicide prevention lifeline available in tear off sheets-anyone who comes in my classroom can grab one at anytime (1-800-273-TALK). I just never thought I would also need to post them in my home; and, to be honest, I’m not entirely sure it would have made a difference if I had. But it might have. And there lies the issue with statements like, “suicide is a leading cause of death, but it’s also preventable.” That’s not necessarily wrong, but it’s also not true-at least not in the way it’s commonly understood.
***Disclaimer: what follows, like everything on this blog, is my opinion. In this case it is an opinion formed both through professional training and my personal experience of having a husband die by suicide. But I am not an MD or a licensed psychologist, I’m just a person with a lot of thoughts.***
I think I’ve come to the conclusion that suicide is preventable in the same way that skin cancer is preventable. You can surround yourself in protective factors, you wear sunscreen. You engage in healthy coping strategies, go to therapy, pursue medication as appropriate; aka wear a hat, seek shade, avoid tanning beds. But you could still have terminal depression-sometimes you still end up with skin cancer. That doesn’t mean you should start tanning more than a Jersey Shore contestant and throw out your sunscreen. All of the preventative measures are objectively good, healthy habits. We should get the word out, encourage people to make sure their friends are wearing sunscreen at the beach, and lobby retailers to make a sun shirt that doesn’t look like it’s for either a toddler or a grandma.
But if someone still ends up with skin cancer, we don’t ask the people closest to them if they knew that person wasn’t wearing sunscreen. Yet when someone dies by suicide the question that springs to everyone’s mind is, “were there any signs?” So lets talk about these signs. And yes, I am very familiar with the signs. I am QPR certified. Every year before school starts I participate in the mandatory “Youth Suicide: Awareness, Prevention, and Postvention” training and I spent the first part of my career working with students who had significant mental health needs-so I’m acquainted with the signs. Many, but not all, people who are considering suicide exhibit certain signs. They may withdraw from social interactions, they don’t seem to enjoy activities that previously brought them pleasure, they could even clear their calendar or stop making plans, they may give away possessions and say goodbyes that seem more formal than the occasion calls for. These are all real signs that people should know and be aware of (and if you see someone exhibiting these signs you should talk to that person).
I remember watching a documentary on a child abuser. (I know that feels like a hard pivot but stay with me-it’ll make sense soon) I was screaming at the screen, “don’t let him do that, that is known grooming behavior!” Or, “she is clearly exhibiting signs of sexual abuse don’t let him be alone with her!!” You see every year I also complete a series of trainings on identifying potential signs of physical, emotional, and/or sexual abuse in children and teens. The man featured in this documentary lived in the time before mandated reporters and required trainings. In that case, the trainings would have made a difference. This year I noticed a distinct difference in tone between the abuse and the suicide trainings. The abuse trainings are careful to use language like, “these may be signs” or “these symptoms [big reactions, withdrawing] can also be part of typical adolescent development.” There is space for the complexity of the issue. Yes, this could be a sign of abuse, but it could also be a teenager acting like a teenager.
The suicide trainings say things like (and these are direct quotes from trainings I was required to complete), “School staff members who are trained and aware can literally make the difference between life and death.” Or “Most youth suicides can be prevented” On the surface these statements are true, but they are also incredibly hurtful to survivors. When you say “can literally make the difference between life and death” what I hear is, “you could have stopped this, but you didn’t” When you say, “most can be prevented” what I hear is, “but the one that mattered to you wasn’t-what do you do wrong?” I have done an enormous amount of work in and out of therapy to convince myself that this wasn’t my fault, but a couple statements in a mandated training can bring all of those feelings rushing back and by 15 minutes into the training I am sobbing on the floor trying desperately to catch my breath, shaking, and wondering why there is so much weight on my chest. I believe the technical term for this is “triggered.”
The reality is that many people, especially teenagers, contemplating suicide show some signs-but some don’t show any. You can make the difference between life and death-but sometimes you aren’t given the chance. And that doesn’t make you inadequate or incompetent or unloving or a bad wife. It’s hard to remember that when the training says, “If a student is confiding in you it means they trust you.” The message my trauma brain hears is, “I guess your husband didn’t really trust you.” The reality is someone can completely trust you and still choose to withhold information. I wish the training had also mentioned that.
We need to have open and honest conversations about mental health, but we need to do so in a way that isn’t triggering to survivors. If you know me, you know that having to ask for some kind of special treatment because I can’t do the required task is basically a nightmare scenario. But after finishing the Youth Suicide: Awareness, Prevention and Postvention training I was ready to write my HR director and let her know in no uncertain terms that I would not be taking that training in the future. I could write an essay or get a note from my therapist but I would not be subjecting myself to that agony again.
Before I could even draft that email my brain was screaming at me, “You absolutely will not do that!! It was only bad for an hour or two…or six or seven. You only have to do it once a year, you can handle it, do not make a big deal!!” But it is a big deal. It is a big deal that the person who is perhaps most aware of suicide is literally triggered by the training-and not because it is reminding me that my husband died by suicide. It’s because it makes me feel like my husband’s death by suicide was somehow my fault, my oversight, my mistake. That is a huge problem in the way we talk about suicide.
So how do we do it better? I honestly have no idea but I think a good start is to allow for the complexity of the situation and to write trainings in a way that is sensitive to survivors. A great example is this TikTok (yes, a TikTok) from Mayim Balik. For those of you who don’t do TikTok she basically says talking about suicide is really sad and really hard but talking about it is the only way to end the stigma. She doesn’t assign blame, she shares resources, she voices the sadness and the complexity and leaves it at that. Sometimes there wasn’t a sign. Sometimes there isn’t an answer and we humans hate that. So we desperately try to find a pattern, a sign, a reason and in the process we end up further hurting those who are already traumatized.
Suicide Awareness Prevention month is triggering. The posters that say, “Rock your Role. Suicide is preventable, everyone has a role to play” or “Know the signs. Suicide is preventable!” or the one I walked past every day last year “To one person you may be the world. Choose to stay.” Yeah, by this point you can probably guess that one made me feel like total shit. I guess that’s the main take away. If we’re going to have a suicide prevention awareness month we need to have it in a way that doesn’t make survivors feel like total shit.
If you are struggling there are resources out there. Please use them. And if you have lost someone to suicide, it wasn’t your fault and I hope this month isn’t making you feel like shit. But if it is-well, same. We can feel like shit together.