Who brought me my casserole? The role of compassion in preventing suicide in men.

Over the past year, the news has been filled with stories of well-known celebrities, sports stars who have taken their own lives. But they only represent a small number of men who each year suicide in NZ. Men in all age groups and most ethnicities are the largest group that kill themselves. These men are our sons, grandsons, fathers, grandfathers, uncles, cousins, friends and workmates. US science writer Paul Brodeur stated that “statistics are human beings with the tears wiped off”. Having worked in suicide prevention for over thirty years with an interest in men and suicide I have experienced way too many tears. Men’s tears of anguish and despair as they have agonised about whether they could keep living as well as the tears of grieving families as they try to make sense of why someone they love has killed himself.

Suicide prevention is complex and requires a multi-dimensional approach. I have sat on several advisory committees writing suicide prevention strategies. I have been part of many roundtable discussions with the world’s leading suicide prevention researchers and practitioners on what the evidence indicates needs to be done to lower the suicide rate. But in all these strategies and discussions I believe there is one protective factor that has not been more forefront in our deliberations and that is the role of compassion and kindness.

World Health organisation states that suicide prevention is everyone’s business. The Dalai Lama reminds the world that “compassion is not religious business, it is human business, it is not luxury, it is essential for our own peace and mental stability, it is essential for human survival.”

I have lived with an enduring melancholic depression for most of my life. For most of those years it has been manageable and not interfered greatly with my day to day functioning. My episodes of clinical depression have been short and I had enough resiliency to navigate my way through the darkness. I would have been described as a high functioning depressed man. At times it felt hopeless but I never experienced despair. However in recent years I have experienced a deep and long term depression. In my early fifties, I didn’t seem to have the energy to fight the depression. I caved into the constant bombardment of depressive and distorted thinking that framed my life as failure and futility, resulting in self-loathing, my sense of personal and professional efficacy and confidence eroded and for the first time in my life, where death seemed more attractive than living.

As I come out the other side of this destructive period in my life I have been reflecting on what was it that kept me alive. What helped when I was lying in my bedroom for days too scared to leave it, or when I had to lock the balcony doors and give the key to someone else because I couldn’t trust myself not to jump off my apartment building or when I gripped for dear life to railings at train stations while the almost deafening intrusive voice in my head said how easy it would be to jump in front of the approaching train. The answer: the compassion and kindness of others for I was incapable of being compassionate and kind to myself.

During my darkest hours filled with dread and despair I wondered what people would think of my life’s work in suicide prevention if I killed myself. Would they see me as a fraud? I thought about the many people I have helped over the years who have seen me years later and thanked me and said how glad they were still alive. I thought about all the things I have said to people, challenging their distorted thinking, helping them to find the voice within them that still cried out they wanted to live. But none of that was enough to instil in me hope or a desire to keep living. It wasn’t someone asking me “R u ok?” I got asked that many times but like many men, I lied and minimalised my pain and said, “I’m fine, just going through a bit of a rough patch.”

It was acts of compassion and kindness that broke through the darkness and despair and reminded me that that there were people who cared for me. It was their actions that muted my internal destructive voice and shouted boldly the message that I have said to many people over the years, “Your life does matter and the world will be fundamentally different without you.” It was the mystery friend who anonymously every week mailed me $50 so I could buy food. It was the friends who even though I never answered my phone or replied to their texts, kept me leaving me messages of hope or reminding me how important my friendship was to them.

As they say actions speak louder than words. It is acts of compassion or kindness that are more likely to interrupt the suicidal thought than any words. The effectiveness of phone lines such as Samaritans does not come from some telephone listening skills training. It is the fact that these generous volunteers are a testament, on behalf of us all, that there is someone who gives a damn, that people are not alone in their despair. It is compassion and kindness, showing unconditional positive regard, being present or attentively listening that connects us in our humanity and connection to others is one of the most protective factors against suicide.

Sociologically, it can be argued that the rise in suicide is in part symbolic and even a by-product of a throwaway society. Something doesn’t work, it is often easier to throw it away than get it fixed. Throwing your life away may seem easier than sticking with it and getting it fixed. I am spurred on in my work by the words of Pope Francis “We must never allow the throwaway culture to enter our hearts!..No one is disposable.” It was the compassion and kindness that allowed me to finally say say I was not disposable, that enabled me to re-engage with the world, to regain hope and embark on my current journey of healing and recovery.

I write this not as some form of self-indulgent catharsis. My story is not unique. I have heard it from many men. Their stories can be summed up by a suicidal 45 year old man whose business had failed, his marriage broken up and he had lost custody of his kids. In the middle of one night I sat with him on a milk crate in an almost unfurnished bedsit listening to his pain. He felt alone, betrayed and was filled with shame and failure as a husband and a dad because he couldn’t provide for his family. He told me how his friends and family had gathered around his ex-partner and children offering support. He looked at me soullessly and asked “Who brought me my casserole?”