Sunday, March 20, 2011

Suicide and Mental Health: Australia Journey Day 2

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March 11, 2011 at 17:12:14


We (Coyote Institute) are on Day 2 of our cross-cultural mental health exchange with aboriginal people in Australia.

Today we met with representatives of Life Is " Foundation to explore some aboriginal concepts of mind and mental health. We began with the problem of suicide. As in most of North America, in Australia, suicide from sadness didn't exist prior to European contact. Suicide, when it occurred, was the result of a social error or transgression so great that they only remedy was to offer up one's life in return. Apparently, some people who were banished from the tribe also chose suicide over life without community. The notion that people get so sad that they kill themselves did not exist. This confirms what we have heard from elders in North America, as well. In North America, to suffer loss and trauma produced a pitiable state which was associated with respect from others. Those who suffered greatly were admired and looked at as examples for how to bear the human condition. One aspired to be worthy of others' pity. This was consistent with what we were told about Australian aboriginal pre-contact conditions.

Apparently the idea that one can become so sad or "depressed" as to kill oneself is a European importation. An elder told us that suicide would have not seemed to have offered much of a solution, because generally people believed that one felt the same way after death as one felt during life. Death was not an end but a passage into spirit world. One's problems didn't go away, but followed one into spirit world. What didn't get resolved in ordinary world would have to be resolved in spirit world.

The fantasy of most of my patients who consider suicide is that it will make the pain go away. All pain will stop. Death represents the ultimate sleep. This idea would have seemed ridiculous to aboriginal people.

As we continued our discussions, we settled on the idea that modern blended culture presents suicide as a way to get back at others, as a way to show them how much they have hurt you, and as a way to make a statement about how bad one feels. Suicide gestures are ways of making definitive statements about one's emotional state. Sometimes people accidentally die in making this communication.

In a sense, suicide is a modern phenomenon. In a world in which no one seems to listen or care, suicide makes a stark statement that "I will be heard". Making a suicide attempt is a way of stating how bad one feels. It becomes a way of expressing inarticulate distress. As such our modern day suicide appears to be a cultural template for expressing severe distress in a way in which others who don't tend to notice how we fee can't help but pay attention. Suicide in modern America and Australia is a cry of distress. The exception, of course, is the people who really want to be dead, who usually quietly succeed in killing themselves without much preamble, though this did not appear to exist either in pre-contact aboriginal life. When one has ongoing relationships to spirits and ancestors and feels accountable to them, then the meaning of suicide becomes entirely different. The felt criticism of those ancestors and spirits can be prohibitive since one would then have to hear their criticism for eternity.

Others have written about the romanticizing of suicide in modern culture. The suicides of prominent role models have made suicide seem like a reasonable choice. Substance abuse also makes suicide all the more likely, which also didn't appear to exist at any appreciable rate in pre-contact aboriginal life.

This discussion led to our discussion about how to respond to the modern crisis of suicide. Everyone present agreed that the biomedical model and the hospitalization model is not working. We wondered what an aboriginal alternative would be. The idea emerged for community safe houses. These would be places where people in distress could go to become instantly ensconced in community. No questions would be asked. The person would not be diagnosed or stigmatized. Community volunteers and elders would be regular visitors to the house. People could participate in talking circles, talk to elders and volunteers, eat a good meal, get "doctored", or perhaps participate in other cultural healing activities like yoga, chi gong, t'ai chi, and the like. Referrals could be made to professionals when appropriate. This model fits well the hocokah concept we have been developing at Coyote Institute. We have been looking for grassroots models for helping in keeping with the idea that ordinary people are well-equipped for being healing for each other. The hocokah concept is that every person needs to be part of a healing circle, preferably including an elder, but able to function without one if none were available. Healing circles meet regularly and provide people with an opportunity to be part of a community of others who care for them. Being able to care for others can also be healing. To have healing circles expand into safe houses or sanctuaries is appealing. For some healing circles to be strong enough to offer sanctuary and respite for the deeply distressed could transform our currently broken mental illness system. Clearly a demonstration project is needed and models exist for more peer-led services. One concept is the clubhouse concept which is for long-term housing. In this concept, people live together and co-manage their lives collaboratively with the help of advisors rather than being administered or managed by others as is often the case today in supported housing for the mentally ill. There are peer counseling centers with drop-in opportunities. In Rochester, New York, the Creative Wellness Coalition runs such a center with free classes in yoga, dance, art, drama, and more. They provide support groups and other potentially therapeutic encounters without participation of any clinicians. It's entirely run by peers and former mental illness system clients. Psychologist Andrew Feldman is helping to create houses in Hungary where people with psychosis can go for peer assistance and the healing voices network has gone international. We have seen groups offered in as far apart areas as Melbourne, Australia and Keene, New Hampshire. The resolution was to form a working group for consideration of safe houses and sanctuaries that could exist outside of the mental illness system. Coyote Institute and Life Is" Foundation will coordinate this and I (Lewis) will explore the creation of a faculty interest group at Union Institute & University. This is one outcome already from our trip. Until tomorrow, g'day mates.

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