“And when all should be quiet your fire burns a river of sleep.” Sally Greenberg, from Hurry Down Sunshine, Michael Greenberg (Other Press, 2008).
From the standpoint of my profession – therapist – I’m trained to always be watchful for the overt and the covert gestures of self-harm. Millions of teenage girls are wrongly diagnosed as suicidal when they
take the leap of faith and disclose that they cut, a self-injurious behavior as coping mechanism – a release. Drawing a razor across your skin to shift your focus from the quivering anxiety inside;
letting out the tension; deflating.
It’s part of the first session, every time: I’m going to maintain a strict confidentiality regarding everything we discuss here, unless A) you are at risk of hurting someone, B) there is child abuse involved, or C), you are at risk of hurting yourself. Do you have any thoughts about hurting yourself? Of course you do; everyone does. But you’re in therapy now, and if you have the means, a plan, intent, then we need to plan for your safety.
Of course, you don’t need training to see the holes in this already. Who is protected by this discussion? When a therapist “contracts for safety,” does it help the client to feel they are obligated to keep
themselves safe? (Multiple studies say the contract for safety isn’t worth the paper it’s printed on.) Then there’s always the problem that arises with severely depressed people: if treatment is
effective, the depression may lift just enough to give the client enough energy to actually follow through with a suicidal impulse.
I haven’t lost a client. It’s only a matter of time, though, or so I’m told by older, wiser therapists. I believe them.
Was DFW seeing a therapist? Was he seeing a psychiatrist; was he on medication? I’m not about to pretend to have any clinical insight into what happened with him. He wasn’t my client, and the “why” is never as simple as anyone needs it to be. Nor was he one of my teachers; maybe one of his students could shed some light on his recent affect in the classroom. Maybe he seemed blunted, withdrawn; maybe he couldn’t get the words out quickly enough, a rapid fire patter of disjointed ideas that made perfect sense to him but was confusing for the students taking a required course. Maybe some of the students were fans, and if he was rapid-fire – if he was manic – the stream of associations from his mouth may have just been taken as genius in action. Part of the deal when you take a course with the guy who wrote Infinite Jest.
I hope he was seeing someone, even if that help proved in the end to be insufficient. Maybe he was able to find some measure of peace before taking his life, some understanding of what was happening. I hate to think he left this world in the dark about his mental state, when understanding was so important to him in writing.