A Bare Bodkin

When exploring certain website discussions relating to depression and suicidal ideation (let’s say I did this for academic reasons), I came across a statement—not isolated in its character—that basically told readers that their life was a gift, and they shouldn’t throw it away.  The stupidity and arrogance of such nonsensical points is typical of such sites, such discussions, such forums and quorums, and it’s so terribly irritating because it makes me think that the people out there who are nominally trying to help people with depression—a worthy enough cause, and a positive enough intention—know next to nothing, perhaps worse than nothing, about the subject and at least about some of the people they’re presumably trying to help.

A depressed person who is seriously thinking about suicide doesn’t experience life as a gift, and it’s terribly pointless to assert to them that it is.  Even from an objective point of view, it’s ridiculous to say that life is a gift, just as it’s nonsense to say that life is a curse (though the arguments for the latter often seem more convincing).  Life just is; it’s something that happens, and the quality of each individual life varies, even from moment to moment within a given life.  The overall measure of a life—the integral of its happiness, the area under the well-being curve—also must vary across some Gaussian distribution, which means that there will be people who fall both well above and well below the mean, through no fault or credit of their own.  To tell a person two standard deviations or more below the happiness mean—perhaps just through an accident of neurology—that his or her life is a gift is frankly insulting.  It seems calculated to make such a person feel even more guilty than they often do already; it points to the objective facts of their subjective experience and tells them they’re not correct to feel the way they do.  Such a  person must either believe the statement and hate themselves more for being unable to appreciate a “gift” they have been given, or to spurn the point of view of the one making the statement as at best ignorant, at worst frankly malicious.

A similar problem occurs when help websites and crisis sources say things like, “Talk to your friends and families.”  If a person felt able to talk to friends or families about the problems they are having, they probably wouldn’t have quite the problems they have.  A person who has such resources—and, crucially, who feels justified in using them, in subjecting those who potentially love them to the burden of their irrational, depressed, depressing, event horizon thoughts, which may lead to further, perhaps complete, alienation—seems less than likely to reach a crisis where they’re looking for information or thoughts about suicide prevention…or about suicide methods.  Bringing up such things often serves simply to highlight to the seeker that they’re in an abysmal situation, one they probably feel that they deserve.  The message seems to be that most people who come to this resource—whatever it might be—have friends and family they can readily seek out for help, who know what to do, who don’t have problems of their own to deal with, and have the time, expertise, and patience to help a person who is already the scum of the earth.  Someone in crisis is going to feel that they must really be much worse (as a value judgment) than most of the others who seek this source of help, and that he or she is probably is not the target audience for this—or possibly for any—help source.

Of course there are crisis hotlines and related centers available, where one can talk to well-meaning strangers.  These tend to be volunteer-staffed, and those volunteers should be cheered and thanked far more than they surely ever are, but unfortunately, one can have bad experiences with such resources (quite apart from the fact that many depressed people find it difficult to open up to anyone, let alone to strangers).  Such a bad experience happened to a  person I know who called such a center during a terrible personal crisis.  Precisely because that person was in such a severe crisis, the Palm Beach Country Sheriff’s Department was summoned by the help line, and that person in crisis was handcuffed and taken away to a shit-hole mental health facility, the handcuffs doing nerve damage to that person’s hand and wrist that lasted for over a year.  Someone who’s been through something like that is far less likely to try to use crisis lines again, even when in extremis, especially since nowadays it’s so easy to track a caller’s location.  How sure can a caller be that they are anonymous and “a-situ-ous” and won’t suddenly look up to see green-clad thugs from the barrel-bottom-scraping local constabulary come to take them away to a place that makes jail seem (reputedly) preferable by comparison.*

Of course, there are mental health resources available in the form of psychotherapy.  These are of varying quality, but most of them can at times be useful, and the practitioners tend to be well-meaning, sincere, and professional.  However, if one doesn’t have very good insurance—and I mean truly exceptional—let alone if one doesn’t have insurance at all, one tends to have to pay for such things out of pocket.  It’s not cheap.  It can also feel rather demeaning, in a subtle, strange way.  After all, if paying for sex would be potentially embarrassing, then how much more humiliating is it to need to pay to have someone just listen to one’s troubled thoughts…especially when one finds one’s own thoughts hard enough to bear when they’re not even spoken aloud?

This post is obviously more of a rant than it is a call to action or a suggestion of answers.  I don’t know that there are any good answers, and the people I’m criticizing probably deserve better.  But that’s kind of the point.  The world is neither just nor fair nor kind, and we are given no guarantees that there will be solutions—not just ideal solutions, but any solutions at all—to given problems.  Some functions are just non-computable.  Reality, via the unassailable mathematics of the second law of thermodynamics, makes only one promise in this life, and that is that it will come to an end.  There are times when this promise doesn’t have the character of a threat, but is actually the most reassuring, soothing offer of relief.

Is that thought a symptom of illness?  Is it a mark of enlightenment?  Or is it just another highly stochastic, directionless outcome of natural forces acting on very large, very diverse populations of nervous systems which exist in environments quite different from those in which their ancestors survived and evolved?

What is one to do when one is more well-aware of the processes that lead to depression than many of those one could seek for help?  What is one to do when one has heard and considered the arguments and points of, for instance, Cognitive Behavioral Therapy and is well aware of all the mental pitfalls it is designed to circumvent, and finds it less than useful against the nihilism and pro-mortalism of one’s (provisional) philosophical conclusions?  What is one to do when one understands—as well as it can be understood so far, anyway—the function of SSRI’s and related substances, and has experienced their effects, and finds that the detriments outweigh the expected benefits, at least in one’s own case?  What is one to do when one understands, at an intellectual level, that one’s thought processes are maladaptive, but one still cannot thereby correct them, and one knows—at a professional, expert level—that we simply do not have adequate resources to correct them in any reliable, durable way (other than that final “correction” that is the bare bodkin)?  And what if these problems are further complicated by chronic, daily pain, and the parallel loss of essentially everything one had held dear?

I don’t expect to receive any useful, surprising, answers to such questions.  One tends to encounter trite nonsense such as the “life is a gift,” and “there are people who care about you,” tropes when one puts such inquiries out into the world.  The latter point might even be true, but it’s beside the point.  Is an individual ethically obliged to endure long-term and short-term net suffering because a modest group of people, with whom one has occasional, superficial contact on social media, will be transiently saddened if something happens to that individual, before the others all just get on with their lives as before (which is what they should do)?

I’m obviously not the first person to ask such questions.  I’m quite certain that I won’t be the last.  I expect no benefit to come from having asked them.  To be honest, I expect no net benefits from the world at all.  This is Iterations of Zero, after all…and the net outcome of all our exploring will be to arrive where we started, and to know the place for the first time…which is to know nothing.


*I’ve been in both, and to be honest, jail is worse, if only because, when they think you’re a danger to yourself in jail, they lock you in a very cold, small room by yourself, with only a flimsy paper gown to wear, no mattress, no pillow, and a hard metal bunk frame (with sharp corners, weirdly enough).

A daily game of roulette

As someone who’s suffered from dysthymia—not infrequently veering into full-blown depression—since he was a teenager, and whose personal philosophy is borderline nihilistic, and who suffers from chronic pain, and whose marriage failed, and who spent three years in prison in Florida for trying (naively, it must be admitted) to help treat other people who have chronic pain, and who lost his license to practice a career he’d worked at for a very long time, and—this is the most unkindest cut of all—who doesn’t see his children because they don’t really want to see him (one of them won’t even interact with him); and as someone who bothers to keep going at all mainly just because he’s writing books and short stories, none of which may ever be read by anyone other than family members and possibly old friends…as such a person, each day for me is very much like a game of Russian roulette.

The cylinder with which the game is played is very big, to be sure, and there are many, many more empty chambers than that one full-but-oh-so-consequential one.  If there were not, the game would have long since ended.  Nevertheless, if one plays that lottery often enough, one is sure, eventually, to “win,” and I play it daily. It’s been a very long time—subjectively, it seems like a lifetime—since I’ve had a day without at least a moment in which I suspected that permanent oblivion would be a net gain when compared to its alternative.  There’s plain few days in which I never feel like just lying down in the middle of nowhere and never getting back up, just letting the elements do their implacable work. There are many days in which I fantasize about wading into the Atlantic Ocean (conveniently nearby) and then just swimming out, as far as I can, until I can’t swim anymore. (This latter idea is appealing because it causes very little inconvenience to others; one might as well not be rude).

I’m not sure what keeps the other chambers of that roulette gun empty, to be frank.  It’s probably nothing more than that mindless survival drive that was brutally driven into my biology by the clumsy, wasteful, blundering, low, and horribly cruel work of natural selection.  There certainly isn’t much inherent to the continuing struggle that makes it seem anything but a pointless, Sisyphean task.  I often feel like one of Tolkien’s Ringwraiths:  they do not die, but neither do they grow or obtain new life; they merely continue, until at last each breath is a weariness.

What sensible person would bear these whips and scorns when he could his quietus make with a bare bodkin?

Well…so far, I would, it seems.  I’m far from convinced that it’s the correct choice.  I spin that metaphorical cylinder every day, and I am, quite honestly, not afraid of the day when the hammer falls on a live round…not in any real, deep way.  But the damnable organism that I am just mindlessly carries out its functions, at high and low levels alike, without so much as a “by your leave.”  It’s most inconsiderate.

I don’t really know what to say or do about all this.  I’m not really asking for help.  I’m a qualified medical doctor, though no longer in practice, and I understand the neurology and the neurochemistry and the psychology involved better than 99% of the general public.  I’ve called crisis hotlines before and was once handcuffed by imbecilic PBSO deputies for my trouble—causing nerve damage in my left wrist that lasted almost 2 years—before being brought to a squalid and pointless place where the limitations of our mental healthcare delivery systems became even more viscerally apparent to me than they had been before.  I don’t mean to go through that adventure again.

I’ve been medicated (the latter occasion a case in point), and I’ve been in therapy, and I’ve used neural stimulators and meditation.  I’m quite well read in the philosophy and science and fiction and poetry and music on the subject matter, let alone the trite, banal, condescending, and sometimes frankly insulting social media memes that relate to it.  I sincerely doubt that anyone has any arguments about the topic that I’ve never encountered nor thought of on my own.  After all, it’s a subject that’s consumed me for three quarters of my life, and I’m a voracious consumer of information, who has little to no social life to distract him.

I honestly don’t know that there is an answer, and I’m not even sure what question I should ask.  Nature isn’t obliged to be satisfactory of our wishes or convenient for our needs.  I don’t really even know why I’m writing this.  Maybe it’s just to avoid misleading anyone about me.  I have the faculty of humor, and tend to respond to things I find funny, and to try to make amusing comments, and to show appreciation for good intellectual points, and for noteworthy events, and for fine people and organizations.  I have a strong sense of curiosity, and I like to understand things, and to share matters that seem interesting.  Because of these facts, there are times when I probably seem upbeat and positive, happy and amused; indeed, there are probably occasional moments when those descriptions really do match my mood, if not my character.

Yet the game is always there, every day.  The cylinder spins, the hammer is cocked, the trigger is pulled, and the firing pin strikes—so far—an empty chamber.  I’m not talking about a real gun here, of course (I no longer can legally own one); it’s a metaphor.  But it’s a true metaphor.  The specifics of the game are not literally as described, but the stakes are just the same.  And one cannot, in principle, keep playing forever.  I frequently can’t help but wish that some happy turn of fortune would take the game out of my hands, preferably in a slow, degenerative, and painful fashion.  But such is not likely to be my fate; I come from a line of mostly physically robust forebears.  I guess the slow, degenerative, and painful process for me is the very thing I’ve been describing, the thing that makes me wish for something more direct and literal.  I don’t know whether that counts as irony, but it is certainly an impressive little twist of the knife of fate, and that, I guess, it the only other weapon with which I am met, even as I spin the wheel of the first one each day.

The undead of Terry Pratchett’s Discworld say that life is wasted on the living.  I’m often inclined to agree with them, at least about myself.

Not all the time.  But a lot of the time.  At least once a day.

Whether I need it or not.