Alternatives to Suicide
Sensitive Seekers! Graham here. This one’s a guest post, by long-time Big Feels Clubber, Amie.
In this piece, Amie writes about her experience with a grassroots, peer-led approach called ‘Alternatives to Suicide’.
I've written a lot about how important it is to 'find your tribe' through the hard stuff. To hear from other people with big feelings, whether it's through our newsletter, our podcasts, or our online talks.
But what about when 'the hard stuff' is the really hard stuff? When you're deep in the darkest part of the big feelings forest, and you're not sure how to keep living like this?
Can finding your tribe help with that too? And what would that even look like?
Amie’s written for us before, you may remember her recent newsletter about trying ECT. This time, she tries a very different approach, with surprising results.
Note: this one's about one of the more loaded big feels topics (the 'S' word). The focus is on something that helped one person, but if you'd rather not go there at all today, you are very welcome to head over here instead, and watch a group of baby tortoises munching a hibiscus flower. (Honestly look at them go.)
For those keen to hear more, over to Amie...
My (not uncommon) story of conventional help
I’m sitting face-to-face with a psychiatrist who I have just met and yet holds all the power over my immediate future.
Somehow, despite his disheveled appearance, he fills the room with authority. Maybe it’s the way the chairs are arranged, with him directly opposite me and the other two doctors and a nurse sitting on either side of us. It feels a bit like I’m in a TV interview and they are the makeup support.
It doesn’t help that no one else is speaking - he never invites them to. They just sit there taking notes.
I hate this.
I don’t understand how they can possibly expect me to sit here and admit my fears, explain my sadness. There’s a level at which I don’t understand these things myself, and I’m not willing to bring these strangers into my world.
I tell him that I want to go home. That I’m not going to get better in hospital.
He sighs, and looks at me like he is about to explain something very important.
“I can’t let you go home,” he says, shaking his head. “I don’t understand why you’re feeling like this, and if I don’t figure it out, I think you’ll kill yourself.”
Hang on, who needs to figure this out?
I almost want to laugh when he says this. Whose life is this?
Does he seriously think he can spend half an hour talking to me and figure out exactly why I feel this way?
What does that say about me, that I have been trying to figure out that very thing myself for years and yet this guy reckons he can nail it right here and now?
This was some time ago now. Not the first time I’d been in a mental health ward. But it was the first time I knew for sure that I needed a new approach.
I just had no idea what this new approach was going to be.
Connection and loneliness
Like so many of us, I’ve been looking for help for years. I have tried, and tried, and tried to do the things that are supposed to help.
Different medications, different treatments, different therapists. Some things were helpful, and would give me hope for the future. Some things made no difference. Some things made me feel worse - like losing memories during ECT.
Somewhere along the line, I realised something important.
Most of the useful experiences I’ve had in the mental health system have involved talking to other people who have been through similar things. People who, like me, were trying to find a path through their distress. In hospital wards, in group therapy sessions, in residential services - it was the people who understood what I was going through on a personal level that made me feel like a valuable human being again.
But even in these conversations, there were topics that felt unreachable. Topics that could be hinted at but never explicitly brought into the room to sit in plain sight.
God, is it lonely not having anyone you can talk to about the most painful parts of being alive.
So when I found out that there was a support group specifically for people who experience suicidal thoughts, run by people with lived experience of being suicidal? I knew I had to look into it.
Alt2Su
It’s called Alternatives to Suicide. Or as those in the know call it, ‘Alt2Su’.
A friend sent it to me, in a work context in fact. He knew I was training to work in mental health, and he thought I might want to check out this very different, peer-run approach to people in distress.
I soon realised it might actually be the thing I’d been looking for myself. The ‘new approach’ I’d been longing for in that hospital room.
So I did what I always do when something sparks my interest in this space: I read everything I could find about it.
I read about how Alt2Su groups started in the US over a decade ago. How the response from participants has been overwhelmingly positive, with people finding that the groups offer them a space to talk about things they haven’t felt able to talk about in years.
The freedom to really be honest?
On a more personal note, the thing that really stuck out for me was the fact that I could show up anonymously, without the risk of consequences. No one would call the crisis team on me. I wouldn’t end up back in hospital. If someone was worried about me, they could tell me - but ultimately, I would be respected as the expert on my own life.
This was very different to my past experiences of seeking support. It felt like an opportunity to really tell the truth about what was going on in my head.
But, honestly? I was also a bit skeptical.
Was it really possible to create a space where people could talk openly about suicide, without it just making everyone feel like shit?
Before dialling into the Zoom call, I felt a mixture of hope and a kind of preemptive disappointment - preparing myself for yet another failed attempt at finding something useful.
Worst case scenario I can just leave the call, right?
So, what was it like??
There were six of us on the call.
The group started with an introduction by the facilitators. They mentioned how they'd both had their own experience of suicidal thoughts and attempts, and that being facilitators didn’t necessarily mean that they wouldn’t share what was going on for them as well.
There was a short period of silence, waiting for the first person who felt like sharing. Then, when someone did start talking, there was a kind of comfortable attention given to them - the space to just talk, and be heard.
It was an extremely accepting, open space.
The funny thing? There wasn’t actually a lot of talk about suicide itself - it wasn’t really necessary. Once you take the focus off suicide, the discussion can tackle the bigger questions. Why do people feel this way? What would need to change in their life to not want to die? What is keeping them alive?
Eventually, and with a little encouragement from one of the facilitators, I shared a bit of what was going on for me. I stumbled over my words trying to explain the turmoil in my head, but it didn’t feel like that was a problem. Unlike in the hospital room, where I’d had a similar task of sharing a bit of myself with a group of strangers, I felt accepted and understood.
No one wanted to figure me out. No one wanted to take responsibility for my life.
Good things do exist
When the group ended, I closed my laptop and stared at myself in the mirror across the room. I felt a kind of buzzing excitement in my chest, an optimism about the potential for this group to have a positive impact on my life.
I had the distinct feeling that I had stumbled across one of those things that I should keep in my life.
I spoke to myself like I was soothing a grumpy, pessimistic teenager within me.
You see? Good things do exist. You’re going to be okay.
Part of the answer
Since that first online session earlier this year, I have dialled in most weeks.
Sometimes I’m having a really rough time, and I appreciate the space to be honest amongst people who will not judge me. Other times I’m doing well, and I do less talking and more listening.
Whatever I’m feeling, showing up to Alt2Su has become an important feature in my week. A time when I am reminded that I have a place in this world, no matter how big my feelings are.
A very different approach
It’s worth saying, in some ways this is a radically different approach.
It’s anonymous, with no clinicians in the room. This can bring up a lot of questions for people - including one of the thorniest questions in mental health:
Is it safe?
Alt2Su organisers have been running groups in the US for more than a decade, with a great deal of care and consideration placed on how to truly meet the needs of people in suicidal distress. In their experience, they’ve found it to be no more risky than more clinical approaches to suicidal distress.
But the evidence base is still emerging, and this approach may not be for everyone. So I can only speak to my personal experience.
The mainstream approach wasn’t enough for me. It didn’t stop me thinking about death. It just stopped me being honest about it.
Alt2Su is somewhere I feel I can finally be honest. And for me, there’s real safety in that.
Where can I find an Alt2Su group?
There are currently four Alt2Su groups running in Australia. They’re based explicitly on the Alt2Su model that’s been tried and tested by US peer-run organisation the Wildflower Alliance.
Alt2Su NSW currently runs two groups over Zoom that are open to people across Australia. Once the COVID situation improves, one of these groups will switch to being in-person. You can find more info about these groups here.
DISCHARGED WA currently run two groups, both of which are specifically for trans, non-binary, gender diverse and gender questioning people. One is run in-person in Perth and the other is available nationally over Zoom. Their open groups (for anyone aged 18+) are currently taking a break while they train up new facilitators, but will start back up in the future. You can find more info about these groups by heading over here and signing up to receive email updates.
— Amie.
Last word from Graham...
Graham here again. Many thanks to Amie for all her time spent crafting that powerful and tender missive. This stuff is hard to write about, so we hope it's useful.
A few things I'll add for those interested in the Alt2Su approach.
The ABC's All In The Mind podcast did an episode featuring the original US-based Alternatives to Suicide, which you can listen to here. In that same episode you'll also hear none other than my own dulcet tones talking (and briefly, singing) about the Big Feels Club, as well as regular Big Feels contributor Gareth Edwards. Small world (big feelings).
Like everything we mention in this newsletter, the Alt2Su approach won't appeal to everyone. We share this in the spirit of, 'here's something some people are finding helpful. See what you make of it...'
If you're outside Australia... I'm not sure where else you can find Alt2Su groups, but one place to start might be the Wildflower Alliance. They're the US-based peer-run organisation Amie mentioned, who pioneered this approach, and who are featured in that All In The Mind episode.
Finally, if you’ve just stumbled on this page at 4AM after searching something like ‘have I ruined my life completely?’, welcome. This is a club for people who regularly ask themselves that very question.
If you want more, I recommend you start with No Feeling Is Final, our podcast about what it’s like to ask for help for years, and still not have the answer. It won a bunch of fancy awards and accolades from places like the New York Times. But more importantly, our club members tell us it helped them feel seen for the first time in years. Check it out here.
— Graham x
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