No Empathy Allowed
by Anonymous

"I knew my pain would soon be over."

I had had suicidal thoughts before. But this was the first time I acted on one. I poured an entire bottle of pain killers into the palm of my hand. I swallowed all of them, one handful at a time.

I had no choice, that's what I thought. I had to disperse the terrible black cloud, my depression, that engulfed me. It felt like a straightjacket was constricting my chest, suffocating me. It was unendurable, a knife that stabbed my heart again and again. But the pills would end all of it. A calm fell over me.

I knew my pain would soon be over.

But then I panicked. I knew I had taken enough pills to kill myself. I didn't want to live, but death was an unknown. And no matter how miserable I thought my life was, I was suddenly more afraid of that.

So I told my husband what I had done.

He said, "How stupid could you have been?" His was the first of many unsympathetic responses I would get in the next 24 hours. He was actually embarrassed because we had to decide, quickly, which neighbor to call to come watch our two young children. I think he was simply stunned. It was a Friday night. My father-in-law later recalled that when he came to the house he realized how upset I must have been that night: I had forgotten to light the Sabbath candles.



The first thing I remember after rushing out of the house is waking up with a tube down my throat. They had pumped my stomach at the hospital. A male nurse was standing over me, preparing to pull the tube out of my body.

"I hope you know that you committed one of the worst sins a person can commit," he said.

I asked to see a rabbi. Or even a priest. I still thought I was going to die. I was grasping for someone -- anyone -- to show me some compassion.

The nurse said, "do you really think you deserve a rabbi?"

Suicide is against the law. Even though I was in a haze that day, I remember, vaguely, seeing two blue uniforms moving around me. My husband had to lie and tell them that it had all been an accident. It was like a dream. I know, now, as a mental health professional myself, that I was suffering from Bipolar Disorder. I was a sick woman.

No one cared about that fact, however, and now, looking back, it disturbs me. Not even the psychiatrist who examined me in the hospital or my own doctor. When he came to adjust my IV, he actually said, "you deserve what you get."

This is when I began to see, truly, how the mentally ill are viewed in our culture and the harm that it does. Where empathy would save a life, instead we find disdain. Or worse, disgust. How does this help anyone?

"...disclose and lose your job..."

People with depression are not criminals. We are not bad people. But in order to survive, to recover, we need a large support system. We need understanding doctors, nurses, family members and mental health professionals.

Many years later, when I was finally able to face what I had done, my experiences with my disorder propelled me into a career as a mental health professional. I returned to school and became a clinical social worker so that I could offer the empathy that was denied me.

But I found, ironically, that my job prevents me from disclosing my disorder and experiences to patients when it would be appropriate and helpful to them. There is nothing written, of course - that would be illegal - but it is implicitly understood in our profession: disclose and lose your job. People in the profession still feel that if you have some kind of mental illness, you won't be able to separate your patients' issues from your own. Suspicion abounds: if my boss knew about my disorder, he would watch me closer than he does now. He would wonder if I was showing "signs" every time he saw me in a good or bad mood. Eventually, I would lose my job.

This is decidedly backwards to me. People with depression are much better equipped to help those with the same disorder. If you are a substance abuse counselor and also a former abuser, it is appropriate and acceptable for you to disclose this to your patients. It is expected, in fact. Why doesn't the same apply to mental health professionals?

Empathy can make all the difference in treating patients.

I remember walking into the waiting room a few years ago to ask a recently discharged patient to come into my office. Her angry looking spouse stood up, looked at me and said "I'm coming too."

"I would definitely appreciate your help," I replied.



This sad woman shuffled in, shoulders stooped and took her place on the sofa. Her husband sat on a chair across the room. Tears streamed down her face, though she didn't seem to notice them. Underneath her flat affect was a painful, tortured expression.

Her husband didn't understand. "My wife has just been stressed out recently and didn't realize she was taking so many pills. If she would just stop thinking about herself and concentrate on the children and her job, she would be just fine. I keep telling her to just get over feeling sorry for herself and get on with life. Believe me, there is nothing wrong with her."

I knew the truth just by looking at her and it was obvious this woman needed help. Her husband was choosing not to see the reality. People often create fantasies about the people they live with who are afflicted with depression: that they just need to stop feeling sorry for themselves, that nothing is wrong, that they just want attention.

This woman wasn't just feeling sorry for herself. She was sick. She was too emotionally wiped out to cry with any energy. I remember the tears just flowed from her eyes and down her face. She kept her eyes lowered and refused to make eye contact. She wouldn't speak.

Then, without warning, a low, almost inaudible, plea came out of her lips. "Please, help me. I am so miserable and it hurts so much."

I was startled, but I could empathize. And empathy, I believe, was needed.

Her husband turned to me. "She doesn't know what she's saying. It's just been a tiring experience for her."

I began seeing her regularly. Her husband continued to deny anything was wrong and refused to come with her.

"This is my last hope for a life," she said to me once. "No one understands that the pain I feel is as real as if I had a knife in my heart."

I understood and she seemed to sense that.

"She never attempted suicide again."

"When I was here with my husband, the look on your face mirrored the pain I was feeling," she said. "The way you sat looking at me. Your soft words said 'It's ok, you'll be all right, I hear your pain.' "

"I believed you," I told her. Often that's the most important sentence someone suffering from depression can hear. And it's easier to say when you've been there yourself.

I treated this woman for one year. Sometimes the phone would ring and I would hear "I can't take it, the pain is back." It meant she was off her medication.

She never attempted suicide again. We actually wrote a contract: when the pain was back, she would contact me. Several times she called while I was enjoying chamber music or the symphony. Being there for her meant more to me then any concert.

One day I received a telephone call from her. She said she was going to run away with a stranger she had recently met.

"I am so excited," she said. "He's handsome, rich and says he will treat me like a queen."

"But, but but but..." My words went unheard.

"I just bought the most exquisite wardrobe for the cruise. We're leaving tonight. I'm going to leave my husband a note telling him I'll be back in two weeks."

Compulsive shopping is often a symptom of manic behavior.



I was desperate to convince her not to go on that trip. I had always suspected she was Bipolar and this manic behavior fixed it. I would have tried any trick of the trade to get her to come see me that day. Finally breaking in I said "there's nothing I love more than clothes. I hope you have some time to come and show me everything you've bought." She took the bait. I was able to get an emergency appointment for her with a psychiatrist. He prescribed an additional mood stabilizing medication. To this day I am not quite sure how we convinced her to take medication and go home. Her husband refused to speak with me. But I was so familiar, myself, with what it felt like to be elated and irrational that I was better equipped to convince her.

How well I remember the day I went shopping with my young daughter and purchased $2,000 worth of linens.

The cashier said "Miss, are you sure you mean to get all of these?"

My daughter tugged at my hand, "Daddy's going to be really angry "

"No he won't".

We went home. Into the washing machine and dryer went all the newly purchased linens and onto the beds. I felt proud. I should have been an interior decorator, I thought. My husband was furious.

I had other obvious symptoms, much like the woman who came into my office. One morning at 2 a.m. I sat down and played Fuer Elise on the piano. I thought I was playing better than I ever had. My son came downstairs and angrily said: "What do you think you're doing? It's 2 A.M.! " Of course, the rest of the household woke up.

My question was: "What's wrong with them?!"


"...the stigma of mental illness continues to be prevalent..."

I know that my own experiences can help me treat the patients that come into my office every day. But the stigma of mental illness continues to be prevalent, even if it is becoming less so. My patients would benefit from my self-disclosure, but my job status would not. In fact, I've seen a few colleagues lose their jobs after disclosing their illness to patients.

Recently I went through perhaps my worst episode of depression and hypomania. I sat day after day wearing my therapist/patient hat, listening to several patients with severe depression and suicidal ideation. A young girl sobbing, pleading for her pain to disappear. "Every day I wake up and think about which tree should I hang from, how can I get my father's gun or should I take pills. I ask myself which would be the least painful."

With lowered, sad watery eyes she answered her own questions. "Anything is less painful than life."

I thought to myself that I felt the same way. I thought, But I want to help others like you and this gives me a purpose. Maybe I should self-disclose. Would it help you?

Listening to this young girl was heart wrenching. Her suicidal thoughts and ideas were identical to my own. How could I be so selfish and not let her know I had been where she was? Someone saying, "I know the intensity of what you're feeling. I was there just six weeks ago." ... would go a long way toward helping her.



At the end of one session with this girl I seriously considered "coming out of the closet." She deserved more than just the usual therapist. But I remembered a conversation I heard not long before. My co-worker said about another, "Jeff just told me he had major depression. I remember the last person that worked here who had Bipolar Disorder? He's long gone now. I don't need any moody professionals. The patients are enough.

I decided that there was too much at stake and I couldn't tell this young girl what I secretly had in common with her. I felt guilty, but also as if I had little choice.

"Put adhesive tape over your mouth any time you want to disclose" will remain my motto

How sad.


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