Dark and Light – Refuge, Glory, Hope

(This article contains content about suicide. If you or anyone you know experiences suicidal thoughts or impulses, please call your local suicide hotline or emergency services.)

“…the thought of suicide is a great consolation: with the help of it one has got through many a bad night.” – Fredrich Nietzsche 

The renowned existential thinker and Philosopher Fredrich Nietzsche wrote liberally about themes related to death. I never read him, philosophy never being my taste, nor in the wheelhouse of my long trauma fogged mind. I don’t know where I first heard that quote, but somehow it stayed with me. Years later, when I can think and read, I am curious about him and the life of the brilliant and epoch-making man. But probably not enough to slot him into my ever-higher, sky-scraping tower of books waiting to be read. Oy vey. I guess books, at least sometimes, were the way to get through bad nights and days for me. 

I remember long ago reading somewhere that the only thing that got him, Nietzsche, through his pain and anguish was that escape hatch he left open for himself, although he never used it. Suffering from unrelenting migraines beginning in childhood and later beset by debilitating dementia that left him unable to care for himself in even the simplest ways in his early forties, he died of pneumonia at age 55, leaving to the world an erudite inheritance.


Like Van Gogh, whom I have always been able to appreciate and love, his pain somehow benefitted us all.


Death always seemed to me an avenue to glory and, ironically, long sought-after attention. My favorite character in Luisa May Alcott’s  famed staple for every little girl of my generation’s reading list, Little Women, was Beth. Her early and precipitous childhood death of Scarlet Fever pitched her three sisters and her parents into the kind of consuming grief, love and value that I did not know how to get but endlessly craved. I remember Tom Sawyer feeling similarly, looking down from the clouds and seeing himself sadly missed by those who in his ordinary life seemed barely to know where he was. I don’t remember where in Twain’s famed book I read it, but again it stayed with me.

I sometimes wonder if our dad carried a weight of ambivalent guilt, shame and inferiority for not being one of the six million who perished in the Holocaust. Although his suffering was massive, and we heard quite enough about that too, it was somehow not quite “enough” to merit that ultimate badge of courage. I don’t know how I got the idea.  

Somewhere, I similarly got the idea that dying a martyr’s death, in the line of altruism, heroism and/or macro-level self-sacrifice, would provide not only Nietzsche’s proposed solution for pain but also forgive a debt, paying for my sorry existence and unearned right to take up space on the planet. 

Che Guevara, the heroic and brilliant internationalist revolutionary leader of then-successful guerillas movements in embattled countries not even his own, became my role model. His fiery, dramatic death at 39, in tireless pursuit of justice and freedom, somehow personified glory to my young and desperate psyche. Was this another manifestation of “the intergenerational transmission of trauma?” My attempt to be “enough” in the way our dad never could? Another contorted attempt to win his attention or esteem? All of the above?


Visiting Cuba for the first time in 2015, I saw the now 55-year-old “graffiti” (older than Che was when he died) still on an old brick wall: “Seremos como el Che!” We shall be like Che. At this point, I still struggle with how to do that, perhaps without dying.

For about six years in my twenties, I was beset by persistent suicidal thoughts throughout pretty much every day. I never made an actual attempt (if we can except anorexia which was early and unconscious, but almost achieved it), but I could not shake it. 

The only respite in those dark days came when I finally reached AA: my twice-daily Alcoholics Anonymous meetings. Those two daily hours, 6:00am and 5:00pm, sitting in those (then) smoky rooms, were my only islands of peace. I couldn’t explain it. I certainly had no use for God or any sort of higher power. Rather, I now think it was being part of a group, a loose amalgam of vastly varied folk, connected by “something”. That seemed stabilizing, containing, comforting. 

Perhaps even more importantly, as I think on it now, was some largely unspoken sense of a future. The nature of trauma and neglect is a pervasive ennui of futurelessness. In the course of traumatic events (or non-events), time stands still or appears to. We now know that this has to do with aberrations in brain function during overwhelming experiences. Paralysis of not only movement but the proverbial clock are hallmarks of the trauma experience. 

This motley “community” where I never made friends with anyone, barely spoke, and even had trouble keeping a sponsor, became not only an affiliative group but a symbol or representation of the possibility of dynamic change. I am sure I did not register this in awareness, but I kept going back. And sometimes, there was even humor.

Group therapy seems something of an endangered species in our area now, which is a terrible loss. The potency of connecting with a group, which so many survivors never have, is no joke. I probably never consciously got it, how powerful that was for me, but in the first decades of my incarnation as a trauma therapist, I offered multiple weekly groups until it became just too hard to work so late into the evening.

 In January, I read of the death by suicide of 2019 Miss America Cheslie Kryst. She was the proverbial “rockstar”, beauty pageant gorgeous, an accomplished attorney with a degree from a fancy school, and social justice leader bringing African American women into the frontlines of the fierce and racist, sexist beauty industries. She was 30. 

Often these celebrity suicides stun: these people who appear to “have it all”, Anthony Bourdain, Kate Spade, and Robin Williams, to name but a few. (In the cases of Amy Winehouse or some of the many head-injured football star suicides, some of the possible “causes” may seem more transparent). What was wrong? I have to wonder how many suffer from primal attachment wounds, given that what I know to be most effective for bringing sufferers back from the edge is a sustaining attachment. In my case, besides the AA group was my brilliant therapist, whom I had the good fortune to fall in with in the nick of time.

In her recent memoir In Love, Amy Bloom takes us through her personal story of first noticing distressing “changes” in her beloved husband, which led them to learn of his diagnosis of early Alzheimer’s. He was 66, the age I am now. For him, it was a “no-brainer” that he was unwilling to go through and drag his wife through the predictable sequence of mental and physical degeneration. He simply and adamantly refused. So, they set about finding a way to forestall and abrogate such an outcome. 

In the US, where very few states have legal assisted suicide, the regulations surrounding it are tight. One must have a terminal illness with a medically predicted six months to live while, of course, being fully competent to make one’s own decision. 

Bloom’s husband, like many doomed by degenerative illnesses, did not make the six months cut. So the couple undertook a quest to find one of the almost only programs in the world – Dignitas in Forch, Switzerland, a scenic town in the high Alps close to the French border. For a hefty sum, a peaceful and timely death with dignity for which Bloom’s husband qualified became available to them. Although the book does not take us deep enough into the character’s felt experiences for my taste and therefore left me feeling less moved than I would have expected, it is a fascinating and worthwhile journey through what, to me, seems a comprehensible decision. Always in support of assisted suicide, I was unaware before of how stringent and exclusive the rules are.


In Delia Ephron’s recent memoir, Left on Tenth, she details her recent experience with a rare and aggressive blood cancer. She describes, much as I imagine Nietzsche felt, physical pain so relentless and untreatable in its time that she fully intended and begged for help with ending her life. 

Pulling through it with valiant help from her husband and doctor, she has been unspeakably grateful for help in surmounting that hump and regaining the truly wonderful life she now has. Still, she describes the desperate moments in a way that makes so much sense. My story, less dramatic, has a similar “moral.” Hang in.

I once had a client who, before she came to me, had made a suicide attempt that not only “failed” but left her with a crippling disability. Although she had had a change of heart and called 911 midway through the attempt, she was ambivalent and racked with shame about having tried, and also the living evidence, not to mention pain and frustrations, of her regretted impulse. 

I think in my suicidal moments, that might have been another, if faint deterrent, not only the guilt of causing more nuisance to my already overburdened parents but that I might somehow bungle it.

The most impressive scenes in Michael Pollan’s recent Netflix series, How to Change Your Mind, is the interview with a police officer. News to me was that “suicide claims more law enforcement lives than felonious killings or accidental deaths in the line of duty”. This, to me, however, was not the most compelling part. What impressed me was that the one treatment that stopped his unrelenting suicidal ideation was MDMA-assisted therapy for PTSD, which not only resolved his suicidality but changed some of his other misbegotten law enforcement attitudes and impulses as well. Most hopeful of all was his decision and recommendation for the complex problem of police brutality, to himself become a guide for MDMA-assisted psychotherapy for Police Officers. That is the first suggestion for our hugely tangled and conflict-fraught challenge of police violence and racism, which has inspired a flicker of optimism for me. As FDA approval of MDMA edges ever closer, I almost dare to hope. 

As in the old Spencer Davis Group refrain, “I’m so glad we made it!”  I am infinitely grateful that I did not “do it.”  Although, like Ephron and Nietzsche, I do profoundly understand how it could seem to be the only way out. Trite but true, that suicide is a permanent solution for (most often) a temporary problem; my truly great life is living proof of that. And hey, I wouldn’t be around to write these blogs!

Thankfully only once in my life have I experienced the “completed” suicide of someone I knew, if not well. He happened to do it, certainly unwittingly, on my birthday. In his memory, every year on my birthday, I make a sizeable donation to San Francisco Suicide Prevention. I profoundly appreciate the therapists and volunteers committed to work, which I know I am unsuited for. Thank you!

Today’s Song: Bautista von Schowen, a German-born internationalist revolutionary fighter, died under torture by the Chilean Dictatorship in December 1973.

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

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