Drownproofing for Despair

Gatot Adri/Scopio

The subject of suicide reappeared in the news again and I found myself wondering what we can offer people to keep them from drowning from despair. Something they could use before the despair or pain gets so big and suicide seems to be the only way out.

One of the most difficult things about deaths of despair or impulsivity is that the ability to predict suicide is really poor and the research shows that it is incredibly difficult to assess who will make an attempt. When people endorse suicidal thinking in mental health intake information—less than 10% engaged in suicidal behavior in the following year[1]. And more than half the people who died by suicide denied suicidal thinking beforehand[2].

So, perhaps by trying to target specific people about specific problems we have it all wrong. We need less of a mental health stance about suicide and more of a lifeguard stance. In thinking about the recent suicide I’d heard about, I began thinking about my summers working as a waterfront director. All of the kids at the waterfront of this camp were learning to swim at different ability levels—so not all kids could swim well. But all of the kids, regardless of ability level, were taught how to survival float or what’s now known as drownproofing.

The basics of survival float is to take a deep breath and put your face in the water, your body vertical, and your arms hanging down. The principle is that you are using the least amount of energy possible. When you need to breathe again, you push down with your hands gently, lift your head, breathe and put your head back down. No big motions, no big use of energy. This relaxed movement can be sustained for a really long time. The goal of drownproofing isn’t to make you able to swim. The goal is to keep you alive if you find yourself in danger in the water. It is just meant to keep you afloat, alive, and as safe as possible until help can arrive. You don’t need to know how to swim well, but you need to be familiar with the motions and familiar enough with water (and not fear water) that you can do the survival float. It’s the fact that you practiced it, and that you know what it feels like to be in the water—to feel the water on your face. It’s something you should know before you need it.

We need to think of suicide prevention less like mental health treatment and more like drownproofing. Yes, I am all for mental health. But when we put suicide prevention in the mental health category lots of people think “I don’t need that kind of help “ or they think, “I can’t get that kind of help.” Despair, pain and the things that trigger suicide aren’t mental health issues per se: they are human issues. We need everyone to understand that the undertow or riptide of life can happen to anyone—painful emotions of grief, loss, disappointment, shame, rage, hurt. These feelings don’t just happen if you have a mental health diagnosis—they happen to everyone at some time. And because it’s hard to predict how big the tidal wave of feelings will be---and how different people will experience these emotions at different points in their life—everyone has to learn how to survival float in these emotions. We need everyone to know how to ride out the feeling of drowning in despair--just the way everyone needs to know how to do the survival float because if your boat capsizes far from shore, even excellent swimmers are at risk of drowning.

The principles of drownproofing for despair aren’t that different than drownproofing in water: you need activities or actions that keep you alive, require as little effort as possible, and that are sustainable long enough to get help. And you need to know what the actions are, have the information easily available and practice them if you can. Here are 3 C’s of drownproofing for despair everyone should learn beginning in middle school and update as you get older or circumstances change. The three C’s of drownproofing for despair are: Comfort/Distract, Connect, and Counsel.

Comfort or distract:

When massive despair hits, comfort the pain. Wrap yourself in a blanket, nap, watch your favorite movie or TV show, read your favorite book, sit on your porch. Fill your birdfeeder and watch them. People watch. Eat your favorite snack. Drink something soothing. Listen to something soothing. Take a hot shower or bath. Sometimes distracting yourself with tasks works, or helping others. Do any or all of these as often as you need to. [Make your own list of what works to help you feel soothed or comforted, and what distractions are good ones for you.]

Connect:

Find other people who you feel safe around. You can tell them your level of despair if you are up to it, or you can just lean into the connection. You can hang out and be with them, or you can tell them you need someone to be with you—even if you can’t tell them why. But give it a shot if you can. Find the words if you can. Or just ask for company while you get comfort or distract yourself.

You can also connect with something bigger than yourself. In Buddhist teachings they talk about how a tablespoon of salt in glass of water makes it undrinkable, but a tablespoon of salt  in vast lake dissipates and is unnoticeable. This is where mindfulness training, values, purpose, or faith may come in. Why it’s important to have routines and practices in your life that can hold you when you need it.

Counsel:

Know of some places to go if despair hits. Have those places identified.  Is there a clinic, school or hospital? Counseling Center? A house of worship that you can walk into and sit down and seek counsel? A sacred space that you feel connected to and brings out the best in you? Are there people who you can identify who can be of good counsel when things get bad. Have a list of at least 5 people or places. Have the list somewhere you can find it. This list is like a life preserver—you don’t want to be hunting for it when you really need it. The national suicide helpline in the US is 988.

And there’s probably a 4th C that is ongoing which is to Cultivate a relationship with emotion. Get to know your emotions. Get to know the names of them. Get to know their impact on you and what works to help you feel better when you experience them. Cultivate the ability to communicate them as best you can. Normalize emotions, difficult emotions and the practice of sharing them.

© 2023 Gretchen L. Schmelzer, PhD

[1] Simon, G., et al., Psychiatric Services, Vol. 64, No. 12, 2013

[2] McHugh, C. M., et al., BJPsych Open, Vol. 5, No. 2, 2019

Finding a Way Forward When the Path isn’t Clear

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“It takes enormous trust and courage to allow yourself to remember.”
— Bessel van der Kolk

When I first started in therapy, my therapist had a flat basket of small rocks and stones in her waiting room. I thought this was awesome because I was a therapist (in training) who also had a flat basket of small rocks and stones in MY waiting room. I took this as a sign of validation (Look! I am a cool therapist too!) And the similarity and familiarity gave me the hope that I could feel ‘at home’ there. The rocks in the flat basket in my office were stones I had picked up from the coast of Maine—all different shapes and colors—most were different colors of granite and many with a big stripe of white in the middle—rocks that were called ‘lucky rocks’ by my nieces and nephews. The rocks were something that the teenagers who came to see me could take with them if they wished—reminders of the work that they were doing or talismans to give them strength. The stones in the flat basket in my therapist’s office were more polished but there was one larger flat rock which I quickly decided use as the base of a small cairn.

Now, cairns are traditionally piles of large rocks usually placed along trails as trail markers. I saw my first cairns hiking in the White Mountains when I was a teenager. On the first day, in the bright sunlight of a summer day the cairns looked totally unnecessary—the trail ahead was obvious; it looked like there was no need of a giant pile of stones every 20 yards to mark the way. But when I woke up the next day to fog and rain—and I couldn’t see more than 25 feet in front of me—then the purpose of the cairns shines bright and clear—they are beacons. The cairns were the only possible way forward. Our group traveled for two whole days above the tree line on that trip only ever seeing the way to the next cairn. And that summer I learned this amazing lesson that you don’t have to be able to see the whole trail ahead of you in order to keep going—you just need to be able to see to the next cairn.

In my therapist’s office in those early first few months I would pick up a rock and place it on the flat rock. Then I would put one more small rock on top, and would sit down in the waiting room chair, pleased with my effort and my miniature cairn. I never said anything to my therapist about them.

Actually, I barely said anything to my therapist about anything.  Because in the beginning, I found it really hard to talk. As someone who had failed ‘self-control’ in second grade because I couldn’t stop talking—I was stunned to find myself unable to find words—any words at all. As Bessel van der Kolk says, ‘it takes enormous trust and courage to allow yourself to remember.’ And what I found was that it takes an enormous amount of bravery, effort and patience to find the words that may help you remember. In the beginning, I didn’t have words. But I had those stones. And with those stones I built cairns to find the path forward.

The cairns in the basket of rocks were a source of play—it gave me the feeling that I could move and not feel stuck-- the way I felt stuck with language. Sometimes I would come in to the waiting room and the stones would have been moved. It felt like a conversation—a back and forth— without any of the pressure to know words. It felt like the only conversation I could have at the time—a conversation in stones, a conversation in play. Over time, the play with the stones in the basket made its way from the waiting room to the office—with metaphor, with poetry, with art. And all of these cairns slowly helped me find my way forward, to words, and to myself.

I had mostly forgotten these small cairns, my training ground for words until a weekend away a few years ago when I came across a whole beach of little cairns on Peak’s Island in Maine. Maine has a rocky coast, and along one whole stretch of one of the beaches there were hundreds of little, one to two foot high, cairns made of beach rocks. Cairns as art, or practice, or devotion.

Looking out at them I remembered how powerful the cairns in the Whites and the cairns in the office had been. And before I left the island, I added my small cairn to the beach too, maybe as a way of saying thank you. I was so grateful for the reminder of cairns and how they make it possible to stay on a path when you can’t quite see where you are going. I needed this reminder so badly right now as I am working on two difficult projects—one in the outside world and one in my inner world—and both of them are going to take a while. They are long expeditions. And both of them, for better or worse, are currently shrouded in fog. The whole path isn’t visible, the way forward isn’t clear.

But the small cairns from that weekend were the perfect reminder that the whole way forward doesn’t have to be clear. You don’t have to see the whole path, you just have to be able to make it to the next cairn. And the cairns don’t have to be big! They can be little cairns! In my work of healing, in the beginning, the small stones, the cairns, were literally the trail markers until I found words. And now, in both projects I find that my cairn is simply one word—one word that I can get to until I can find the next one. Just like the stone cairns—each time I can find a word I look for one more word to place on top of it. Sometimes this goes more easily than others—like hiking in the sunshine and seeing the cairns stretched out ahead of you along the trail. And sometimes, I sit with that one word for a long time, and shout to myself, pleading, as the playwright Suzan-Lori Park’s says, “WHAT’S THE NEXT WORD?!”

These journeys can feel long and lonely, but it is important to remember that cairns aren’t an individual effort. Traditionally in Scotland, hikers carried small stones up the mountain and placed them on the cairn on top—collectively helping the markers become ever larger. On the famous pilgrimage route, the Camino de Santiago, the pilgrims carry stones from their homes to place on the cairn at Cruz de Fierro. This cairn marks the pilgrim’s way because of the thousands who have gone before.  And in a small way, the many cairns I saw all along the beach on Peak’s Island also marked a way forward. They were gifts left by others—tiny lights shining reminding me of what I once knew and needed to learn again. These small cairns came during a weekend retreat with old, dear friends who each shared their struggles and their stories, sharing that one small stone that helped each of us find our way forward. Cairns are made by all those who are making their way along the path—and are able to drop one small stone on the cairn to make the way more clear for the others who might follow. And it is one of the true gifts of healing and learning and growth—that each of us can, as we make our way forward on our own paths-- we can leave a stone, or a word, or a poem, or whatever we have on the cairns as we pass them.  The gift is, that in struggling along our own trail, we become the trail makers. Each of us makes it possible for the next person coming along, the next person who can’t see a way forward, to make it to the next cairn. And the next one. Making their journey forward possible.

© 2023/2016 Gretchen L. Schmelzer, PhD

 

For more on Suzan-Lori Parks

And a special thank you to my salon sisters: Jane, Sarah, Alison, Cheryl and Laura. 

Training our Inner Sheepdog

“Suddenly every horse was down, kicking and grunting helplessly in the mud. They lost their heads. They seemed to like to jump off into the ponds. We tugged, hauled, kicked at the brutes; unpacked the sacks, lugged them to shore, pulled on tie ropes, tails; battered heads, poured water down nostrils till they hissed like serpents. One was out, another was down. Oh, our beautiful oaths! Hot, hungry, dizzy, insane with mosquitos, we struggled waist-deep in yellow muck, unsnarling slimy cinches, packing, repacking shivering, exhausted beasts. It was endless.”
— Robert Dunn, Shameless Diary of an Explorer

The Shameless Diary of an Explorer is a tale about the first ascent up Mt. McKinley. What is most striking about the book is how very hard this trip was —but not just hard from a high adventure standpoint, but hard from it being really hard, messy, relentless work. One of my favorite parts of the book is that they had to buy pack horses to pack their gear across Alaska and into the mountain range. But they didn’t buy pack horses because you couldn’t. They had to buy wild horses and train them to be pack horses.  And if you know anything about wild horses, they are not very keen on being tame, especially when trained by people who have never trained horses. The outcome of all of this is that the expedition party would set out walking miles with their horses, through mud and muck with horrible biting flies and mosquitos. Then the horses would freak out and break loose and run away, all the miles back to where they had started the day. Not liking the packs on their backs, they would roll and rub off the packs—containing all the food and gear, into the wet bogs. And the expedition party would have to walk all the way back to where they had broken camp that morning, picking up their lost gear, drying out food and clothes and rounding up the horses. They would have lost all the ground they had gained, and have less gear to show for it. This happened repeatedly.

I loved this description because I have lived there. I knew exactly what it felt like to have my inner, frightened wild horses break loose and run back to base camp. I knew how frustrated I was to have to walk all the way back to get them, picking up my gear along the way.

For most people who have lived through long term trauma, the story comes out in bits and pieces. There is an odd paradox that you can feel like you have so much to tell, and then when you try, it feels like all you have is the same story over and over. Some stories seem to stand for the whole. Sometimes it can take so much courage to say one sentence and in saying it you feel like you have told the whole story, and really, all you have given was the headline: I thought I was going to die. Often you  come out with different sentences and feel like you have all of this emotion and you aren’t saying anything at all. It can feel so disorganized.

The Blue Hill Fair takes place for three days over every labor day weekend in Blue Hill, Maine. There are horse pulls and oxen pulls and pie eating contests. There is a midway with rides and King and Queen French Fries. From atop the ferris wheel you can see out over the Blue Hill Bay.  I loved this fair long before I ever attended it in person because it is where Charlotte the spider saves Wilbur the pig in Charlotte’s Web. The fair can feel like a pilgrimage for a child self who wants to believe there is goodness in the world—that there really is ‘some pig!’ 

My favorite reason to go to the fair is to watch the Northeast Sheepdog trials. Sheepdog trials have three key players: the dog handler, the sheepdog and the sheep. The handler must use the sheepdog to guide the sheep through an obstacle course in a predetermined path. The sheepdog and the handler work together to try to get the sheep through the course. The sheep are always consistent—they are terrified and disorganized. And the sheep tend to make each other more frenzied and anxious. The sheepdog is often torn: Do I want to please my master or do I want to act like a wolf and go after the sheep? Follow my training or follow my instinct? You can almost watch the inner conflict of the sheepdog as it both follows and then ignores its handlers, it’s muscles twitching. The handlers are all really different. Some use whistles, some yell commands. Some are quiet and some sound angry.

Your brain on trauma looks a lot like the sheep. Your thoughts can get away from you, running around, bumping into each other—with a wild look in their eyes. As you begin to get your story out—your words and feelings can feel a lot like the sheep---the sheep come out of the pen and begin to try to find the path through, but the sheepdog—the part of your brain that will help you talk and think and trust— is young and untrained. At first, the sheepdog is almost afraid of the sheep—and chases after them. The handler works on getting the sheepdog to listen to the most basic commands, but while the sheep dog is learning the commands, the sheep run amok. It’s all you can do to get them back in their pen at the end of the day. This is another reason I am keen on a solid preparation phase for healing. If the sheepdog can learn some of the commands before the sheep are let loose, it’s easier to use the sheepdog to shepherd them.

Other days, it can feel like the sheepdog is a wild maniac who won’t even let the sheep out of the pen—instead—it sits in front of the pen, tensely growling at you and growling at them and everything feels stuck and anxious. The sheepdog wants to make sure that no one ever sees the sheep or hears from the sheep. That’s the thing about healing—it never feels in balance, it never feels smooth. The sheepdog trials are the culmination of years of work between handler and dog. So much patience. So much care. So many missteps. So much love.

The thing that can catch you off guard or the thing that can make this phase of healing feel like punishment is that it begins because you feel good. For the slightest moment you give up your vigilance, or your mistrust, or your cynicism, or your need to control, or whatever you favorite form of protection is—and you lean on someone or something. You let go and for a moment you feel something else. I can’t say that the experience is positive or negative—it’s new. It is new and it shakes up the system. It is both the wild sheep feelings and the new experience of handler and dog working together. You get the new because you risk the old. You get the new and something changes.

A few summers ago when I was watching the sheepdog trials, the man whose job it was to watch the sheep who were waiting to go in wasn’t watching so carefully. In the ring there was a dog and the handler and the four sheep. The dog and the handler started their round with the sheep--moving them along the course, over a bridge, through a gate. And then suddenly, four more sheep broke through the barrier and jumped in the ring. Which is just what it can feel like when you are healing and get overwhelmed. You had a plan, you were figuring it out. You were moving things along, and suddenly, there are four more sheep with eyes full of terror. 

The handler looked lost, as did the announcer of the event. But not the dog. He completely took it in stride. He looked around, and if he could have spoken, he would have said, “I’ve got this.” He immediately went to move the extra four sheep through the elements of the course.

Because it was a competition they had to stop the round. But the dog had already shined, had already taught us all a wonderful lesson. He didn’t lose his head. He didn’t do anything special. In a bad situation he just took what he knew and put it in to practice. He looked to his handler, he reined in the sheep. And most of all he looked around and said with every fiber of his being, “I've got this.”

© 2023/2015 Gretchen L. Schmelzer, PhD

On nests, incubators, and what it takes to heal our tender shoots of new growth

“Every day we slaughter our finest impulses. That is why we get a heartache when we read those lines written by the hand of a master and recognize them as our own, as the tender shoots which we stifled because we lacked the faith to believe in our own powers, our own criterion of truth and beauty. Every man, when he gets quiet, when he becomes desperately honest with himself, is capable of uttering profound truths. We all derive from the same source. There is no mystery about the origin of things. We are all part of creation, all kings, all poets, all musicians; we have only to open up, only to discover what is already there.”
— Henry Miller

On the other side of the deck of the house where I am staying is a lattice support for a hearty clematis vine. And tucked inside the vine and the lattice, a robin has built her nest. I have watched and listened over the course of Spring as the hatchlings have moved from peeping invisibly to sitting on the edge of the nest with open mouths waiting for mother to return with their meals.

There is no growth without a nest.

I have been thinking a lot about nests, about incubation, and especially about the idea of incubators. Places where vulnerable infants heal. About what it takes for the premature, the vulnerable, and the hurt inside of us to heal and grow. Thinking about the aspects of healing that can show up years into a long process -when hurt aspects emerge and are not yet ready to withstand the elements of the outside world.

So much of what we think of when we think of healing focuses on what you do. It focuses on action. But there needs to be attention, not just on doing, but on the container in which the doing happens. On what holds you while you are healing. On your nest, or, if the situation requires, your incubator.

Healing is a non-linear process. I have described it as cyclical—as a healing cycle—a process where you cycle through stages. And yet even describing it as a cycle can make it sound more consistent –or the work you need to do-- as more consistent—than it can can feel. There is an intermittentness to healing. There are stretches of time that go by quickly and there are periods of time that are slow and gentle, or even completely still.

I know incubators aren’t usually discussed when thinking about adults. Incubators are for infants or the newly hatched of an organism. An incubator is a piece of equipment used ‘to maintain environmental conditions suitable’ for a pre-term or vulnerable infant. It is intended to create the right conditions for development (e.g., heat, oxygen) and it protects the vulnerable infant from impingement and overstimulation. An incubator is an environment of intentional nourishment and protection.

Healing can be so confusing. I can hear you ask: I thought I was supposed to be ‘working hard?’ What about challenging and stretching myself? What about the zone of proximal development—that place out of our reach where we stretch to and heal and grow? This is exactly why healing isn’t a simple one-size-fits-all solution—across individuals or groups, or even, within an individual across time. It takes discernment to observe where you are in the continuum from zone of proximal development (appropriate stretch and challenge) to a place that needs incubation (a place that needs tender care.)

I’ve said before that trauma shatters -- but when trauma shatters, not everything is equally broken. And in our course of healing, we can sometimes repair things enough for now. Meaning—we can get ourselves moving—or we can use our stronger, and least detrimental, or more socially acceptable defenses to keep ourselves moving forward in our lives. So not everything gets healed or healed fully. We have parts of ourselves that have waited patiently to heal.

Healing repeated trauma isn’t just about what happened. It’s also how we protected ourselves from trauma, and what didn’t happen while the trauma was occurring.

And it is our old protections –that worked so well to help us survive—that often keep us from being able to learn or practice what didn’t happen. This is where the idea of the incubator comes in. It’s a protective external environment so you don’t have to use your protective internal defenses. It’s a nest bigger than the one you created internally to survive.

The amazing thing about the power of healing is that despite the fact that you can create these defenses that seem to keep everything out—new tender shoots of healing and growth still emerge. And when these tender shoots emerge you need something else besides doing— you need an incubator.

Sometimes these moments show up because the world offers you an exit ramp or a period of slowness—and your job, as Miller states, is to recognize that tender shoot as your own. You may be aware of the hurt—you are exhausted, you are in pain, you can feel or see your wounds. This can be hard, but it makes seeking or leaning into a supportive environment a bit easier because it comes with an understandable narrative---it comes with a way to explain it to yourself and others.

But it can be even harder if you recognize the tender shoot or old wound and have to intentionally seek out a nest or incubator on your own: the day off, the week off or a sabbatical of some sort. Yes, it can be hard to recognize them when they show up. But the real challenge is to seek or create an incubator for the that thing that is newly healing, that needs more time, space, love, care—to grow and take hold. It can be hard to explain, and hard to see—and it may not make sense to you or anyone around you. These tender places often defy language or logic. You can feel the need but may have a hard time describing it in language that you think others will understand. You may have a hard time describing in language that you can understand.

But there are also different kinds of understanding—and when we are healing often we seek the kind of understanding that lives in our minds. But the kind of healing that needs incubation is made up of a different sort of knowing. A knowing that lives somewhere in our hearts or bodies. A knowing that I have described before as  living in your bones. A knowing that is as undeniable as it seems to be invisible or ephemeral. And this knowing requires, not more knowledge, but instead, faith. A faith in the wisdom you have that recognizes and protects the need slowness. A faith in your longing for an environment of protection and nourishment. And it requires a faith in your inner voice asking you to trust in the process of growth.

© 2023 Gretchen L. Schmelzer, PhD