Rounded Apathy
Longing to return to stardust
- Aug 8, 2022
- 772
Well...it's done. I would like to say the final chapter was underwhelming; but in all fairness, the author is a psychologist with a special interest in suicidology after all - not an activist, politician, or social policy maker. The ideas are there, and while it's great to see them coming from someone in his role, there was little to run with outside the scope of practice.
Chapter starts with some stat observations: in analyzed US states, two studies saw higher minimum wages, proportion of insured citizens, number of physicians, and spending on mental healthcare all correlated to lower rates of suicide (shocking!). A third observed a positive correlation in several global locations over a 10-year period between periods of increased air pollution and rate of suicide. Bryan acknowledge there are some driving factors behind suicide that conventional treatment simply cannot touch.
Next bit talks about a particular patient of Bryan's who dealt with sexual assault-induced PTSD, PTSD in general, and a particular treatment called cognitive processing therapy (CPT). The patient struggled for years with the condition, and despite multiple attempts at therapy eventually began to consider suicide as they all failed to help enough. She reluctantly decided to try the intensive two-week CPT program as a last-ditch effort (which entails daily sessions), and after less than halfway through, felt as if she'd already made progress she didn't think was possible. She followed up after six months saying she was still doing exceedingly well, yet the shitty people in her life who hadn't supported her after she came forward about the assault were still shitty - so she chose to remove them from her life. All the perfect therapy in the world, Bryan says, would only be like a wearing hazmat suit in a radiation site if you're living in an unsupportive environment.
After this is some stuff about desire and reasons for living having a disproportionately power influence over desire and reasons for dying, and zeroes in on this element of DBT. The examples kinda got away as I felt there was too much emphasis on living for the sake of optimism and family, but I think the point was (like many previous times in the book) to use this for more acute suicidal crises - explanations of how having people describe details of positive things in life can help de-escalate people in crisis situations (maybe an alternative to hospitalization?). More talk of cumulative protective effects of happiness and meaning; these things jumped exponentially for people in periods of days/weeks/months/years the further they were from their most recent suicidal thoughts. No shit...
In the last couple of pages, the points from the start of the chapter are revisited and ever-so-slightly expanded upon, with recognition that unlike the aforementioned patient who up and relocated from her toxic human relationships, not everyone is in a position to be able to do so - as such, it is up to collective bodies to enact the necessary changes to societies in order to promote the creation of lives worth living for as many as possible.
-----
Phew. If nothing else, all this reviewing should help the contents stick in my brain as long as it keeps functioning. A satisfying endeavour and I've got a little less than half the pages scanned in case anyone wants them (and can recommend the best way to share). While I think I did learn a few things from the book itself, I think the most interesting thing I've learned comes from the application of the contents to this community: I honestly believe there is a significant proportion of users here who could benefit from the strategies laid out in this book (and conversely that there are some of us for whom no amount of change or positive intervention would help; enter euthanasia...)
Knowing how and why mental health treatments fail in the case of suicidal people, and why in many cases mental health has nothing to do with the picture...I have seen so many users crying out in agony because of things that seem they could be addressed if only the systems were different. Even if the people supposed to be helping were still kinda shitty people, if they were doing things properly, help still could be achieved. It's a weird analogy, but an auto mechanic doesn't need to be a saint in order to get a busted car running - assuming it can be fixed. So too with therapists, physicians, and whoever else is a position of supposed care.
Of course, this easily can get into murky territory of institutional corruption, corporatisation of healthcare, capitalism, greed and human nature...and then holy shit, it seems like we might be doomed. But I staunchly believe there's no reason to simply give up and not make or even care about progress just because the immediate gains might feel negligible. I think of the history of any social justice cause for an analogy - usually these things are painfully slow, take tiny-seeming steps toward progress, but looking back and comparing the present to the very beginning of the movement, the change is far more marked; look at the state of things for Black Americans the day after the Emancipation Proclamation. Pretty fucking grim, barely better than the day before, most likely - but it was a necessary step in the path to where things are now (still pretty awful but I'd wager most Black Americans would say astronomically better than January 2, 1863).
So yeah that's my book report. Hope y'all enjoyed.
Tagging @lyles, @avoid_slow_death & @LaVieEnRose in case any of you three are keen on having the scans I took
Chapter starts with some stat observations: in analyzed US states, two studies saw higher minimum wages, proportion of insured citizens, number of physicians, and spending on mental healthcare all correlated to lower rates of suicide (shocking!). A third observed a positive correlation in several global locations over a 10-year period between periods of increased air pollution and rate of suicide. Bryan acknowledge there are some driving factors behind suicide that conventional treatment simply cannot touch.
Next bit talks about a particular patient of Bryan's who dealt with sexual assault-induced PTSD, PTSD in general, and a particular treatment called cognitive processing therapy (CPT). The patient struggled for years with the condition, and despite multiple attempts at therapy eventually began to consider suicide as they all failed to help enough. She reluctantly decided to try the intensive two-week CPT program as a last-ditch effort (which entails daily sessions), and after less than halfway through, felt as if she'd already made progress she didn't think was possible. She followed up after six months saying she was still doing exceedingly well, yet the shitty people in her life who hadn't supported her after she came forward about the assault were still shitty - so she chose to remove them from her life. All the perfect therapy in the world, Bryan says, would only be like a wearing hazmat suit in a radiation site if you're living in an unsupportive environment.
After this is some stuff about desire and reasons for living having a disproportionately power influence over desire and reasons for dying, and zeroes in on this element of DBT. The examples kinda got away as I felt there was too much emphasis on living for the sake of optimism and family, but I think the point was (like many previous times in the book) to use this for more acute suicidal crises - explanations of how having people describe details of positive things in life can help de-escalate people in crisis situations (maybe an alternative to hospitalization?). More talk of cumulative protective effects of happiness and meaning; these things jumped exponentially for people in periods of days/weeks/months/years the further they were from their most recent suicidal thoughts. No shit...
In the last couple of pages, the points from the start of the chapter are revisited and ever-so-slightly expanded upon, with recognition that unlike the aforementioned patient who up and relocated from her toxic human relationships, not everyone is in a position to be able to do so - as such, it is up to collective bodies to enact the necessary changes to societies in order to promote the creation of lives worth living for as many as possible.
-----
Phew. If nothing else, all this reviewing should help the contents stick in my brain as long as it keeps functioning. A satisfying endeavour and I've got a little less than half the pages scanned in case anyone wants them (and can recommend the best way to share). While I think I did learn a few things from the book itself, I think the most interesting thing I've learned comes from the application of the contents to this community: I honestly believe there is a significant proportion of users here who could benefit from the strategies laid out in this book (and conversely that there are some of us for whom no amount of change or positive intervention would help; enter euthanasia...)
Knowing how and why mental health treatments fail in the case of suicidal people, and why in many cases mental health has nothing to do with the picture...I have seen so many users crying out in agony because of things that seem they could be addressed if only the systems were different. Even if the people supposed to be helping were still kinda shitty people, if they were doing things properly, help still could be achieved. It's a weird analogy, but an auto mechanic doesn't need to be a saint in order to get a busted car running - assuming it can be fixed. So too with therapists, physicians, and whoever else is a position of supposed care.
Of course, this easily can get into murky territory of institutional corruption, corporatisation of healthcare, capitalism, greed and human nature...and then holy shit, it seems like we might be doomed. But I staunchly believe there's no reason to simply give up and not make or even care about progress just because the immediate gains might feel negligible. I think of the history of any social justice cause for an analogy - usually these things are painfully slow, take tiny-seeming steps toward progress, but looking back and comparing the present to the very beginning of the movement, the change is far more marked; look at the state of things for Black Americans the day after the Emancipation Proclamation. Pretty fucking grim, barely better than the day before, most likely - but it was a necessary step in the path to where things are now (still pretty awful but I'd wager most Black Americans would say astronomically better than January 2, 1863).
So yeah that's my book report. Hope y'all enjoyed.
Tagging @lyles, @avoid_slow_death & @LaVieEnRose in case any of you three are keen on having the scans I took
