While increasing numbers of Americans are being prescribed antidepressants, the Centers for Disease Control reports that suicide rates increased 28% from 1999 to 2010. Trained professionals remain unable to predict who is at risk. Their guess is as good as chance.
Additionally, current prescriptive practice is based on an alarming gap in research – and so, in turn, of informed consent and care – on the risks associated with the long-term use of antidepressants (typically, human trials are 6-8 weeks). Practitioners rarely understand that symptoms of post-acute psychiatric drug withdrawal can last for months, even years, and can include reoccurring, even impulsive thoughts of suicide.
Given this gap in knowledge, how can providers understand and support a patient whose withdrawal process includes suicidal feelings – the experience they’ve been trained to see as a brain disorder in need of medication?
I believe Wallace’s own words – which he used to point out our most dangerous liability as human beings – aptly names a large problem with our medical model of mental health care: “Blind certainty, a close-mindedness that amounts to an imprisonment so total that the prisoner doesn’t even know he’s locked up.”
The solution, Wallace suggests, to this problem of certainty, is a humble willingness to pay attention to what’s right in front of us, “and to truly care about other people and to sacrifice for them over and over in myriad petty, unsexy ways every day.”
Yesterday, I sat at my desk for two hours to write then delete the last paragraph of this blog. I wanted to illustrate what might it be like to take Wallace’s advice in service of supporting someone who is depressed, or suicidal. But my memories, old and recent, of being with other people who were feeling suicidal, were hazy or somehow missing. Unable to draw from lived experience, the exercise felt too cerebral.
That’s when my good friend called. I was glad to see his name come up on the caller ID. His humor, our laughter, I thought, would be a welcome break in my labored task and frustration.
I picked up the phone and said, “hello”. In a quiet voice, he explained that the night before he had checked into a hotel and attempted suicide. He was badly hurt, disoriented, and feeling unsteady. He did not want me to call an ambulance. He asked for my help. He gave me the nearby address. My whole body shook, then kind of shut down. I couldn’t believe I had been called to serve a friend in this way, just as I was writing about it…
Read the rest of this lovingly crafted, informative, and moving blog post here.
Applied philosophy as an antidote to scientism.
A lot of philosophy concerns fairly theoretical issues – the correct definition of concepts like justice, the relation between mind and body, or the nature of the soul. These are problems that have been inherited down the years from Plato and Aristotle, Descartes and Kant. There is another tradition which sees philosophy as a reflection on life. This includes discussion of ethical problems that we face, but also focuses on the way we conduct ourselves, the way we live, the way we relate to each other. I see my book as a contribution to that tradition. Not so much an attempt to solve complex metaphysical problems, or problems in the theory of knowledge or the philosophy of mind, but a reflection on the way we live.
The quote above is from a longish interview with Emrys Westcott in which he discusses five books that deal with the philosophy of everyday life. For me, it had rich connections with Foucault’s late work on the care of the self, and it was a useful expansion on that because it approaches it in a less heady and academic way. Westcott discusses the Stoics, Nietzsche and The Joyous Wisdom, George Eliot’s psychological and moral insights, and the ability of contemporary hunter-gatherers to live in the moment.
I particularly enjoyed the following exchange, discussing Nietzsche’s views on joy and suffering:
Is joy important in this book as well?
Yes, joy is an important concept in Nietzsche. He was a classical philologist. He’s steeped in the classics of Greece and Rome, particularly Greek tragedies, and his first book was on Greek tragedy. He starts out by accepting the tragic view of life. As Sophocles said, “Greatly to live is greatly to suffer.” Life is going to involve a lot of suffering; the human condition is fundamentally tragic. We’re mortal; we’re bound to fail to achieve things we want to achieve. His whole life is spent, in a way, trying to argue that the greatest affirmation of life is to affirm it in the face of that tragic insight – to say that life is good, even though it’s suffering. That’s the greatest way of saying “yes” to life one can imagine. He thinks the Greeks, in a way, did that, and he’s trying to do that himself. Are you familiar with Nietzsche’s idea of the eternal recurrence?
I know it’s a big theme in Nietzsche, but you’d better explain.
At the end of Book IV of The Gay Science he introduces the idea for the first time. It’s a very beautiful passage, called The Heaviest Burden. He says, imagine that one night a demon were to whisper in your ear that this life you’ve lived, with all its joys and all its heartaches, you’re going to have to live again and again, an infinite number of times. The natural thing to do, Nietzsche assumes, would be to fall down and grind your teeth and pull your hair out and say, “This is awful!” – because life is suffering. But, perhaps, he says, there was a moment when you wouldn’t have done that, when you would have said, “This is great; I welcome this news. It’s the finest thing I’ve ever heard.” That would be the peak of life-affirmingness, where you could embrace the eternal recurrence of all things, the eternal recurrence of your own life, despite the fact that your own life may include a great deal of misery.
Modern psychiatry seems to have lost this view. Anything other than very mild and transient suffering is medicalized and and labeled as some form of depression, and our whole culture seems at this point to have bought into the idea that the appropriate next step is to throw drugs at it.
I don’t like that. I am more attracted to what I think of a “applied philosophy” than I am to dumbed-down semi-science.
It’s not true that life is painful, or that it’s painful to think about life. What’s true is that our pain is grave and serious only when we pretend it is. If we let it be, it will leave just as it came, it will die down the way it grew up. Everything is nothing, our pain included.
The bravest thing I ever did was continuing my life when I wanted to die.
During a match, you are in a permanent battle to fight back your everyday vulnerabilities, bottle up your human feelings. It’s a kind of self-hypnosis, a game you play, with deadly seriousness, to disguise your own weaknesses from yourself, as well as from your rival.
Keep your overhead low
“The key to eternal happiness is low overhead and no debt.”
Anybody who tells people to “do what you love no matter what” should also have to teach a money management course.
Low overhead + “do what you love” = a good life.
“I deserve nice things” + “do what you love” = a time bomb.
A good life is not about living within your means, it’s about living below your means…
“What I regret most in my life are failures of kindness.
Those moments when another human being was there, in front of me, suffering, and I responded…sensibly. Reservedly. Mildly.
Or, to look at it from the other end of the telescope: Who, in your life, do you remember most fondly, with the…
the only calibration that counts is how much heart people invest, how much they ignore their fears of being hurt or caught out or humiliated. and the only thing people regret is that they didn’t live boldly enough, that they didn’t invest enough heart, didn’t love enough…and that’s how we measure out our real respect for people - by the degree of feeling they can register, the voltage of life they can carry and tolerate - and enjoy. end of sermon. as buddha says: live like a mighty river. and as the old greeks said: live as though all your ancestors were living again through you
It’s hard to overcome adversity; it’s even harder to overcome prosperity.
It’s natural to want to share experiences with the people you care about. After all, the classic postcard greeting is ‘Wish you were here’. But I think our reasons for sharing experiences on social media are more cynical than that. It’s not sharing, it’s bragging. When we log in to Facebook or Twitter we see an infinitely updating stream of people enjoying themselves. It’s not real life, of course, because people overwhelmingly post about the good things whereas all the crappy, dull or deep stuff doesn’t get mentioned. But despite this obvious superficiality, it subconsciously makes us feel like everyone is having a better time than us. We try to compete by curating our own life experiences to make it look like we’re also having non-stop fun and doing important things. It breeds in us a Pavlovian response that means every time something good is happening to us we must broadcast it to as many people as possible.
The life of every citizen is becoming a business. This, it seems to me, is one of the worst interpretations of the meaning of human life history has ever seen.
A tribute to ROGER EBERT
Don’t wait to find solid ground. Dance in emptiness.