I’m a psychiatrist who has seen an unusual caseload of suicide attempts. It’s time we acknowledge self-centered individualism as the destructive force it is.
Content warning: This piece discusses the topic of suicide. If you need to talk, the 988 Lifeline is available 24/7.
The name Helen Palmer means little to most people. But you’ve certainly heard of Dr. Seuss, born as Theodor Geisel. The death of Geisel’s first wife, Helen Palmer, is a lesser-known episode in his life. Over their 40-year marriage, Helen, a children’s author herself, tirelessly supported her husband’s career. (“That’s a very fine flying cow!” she told him when they were both students at Oxford, after viewing drawings of some of his characters. “What you really want to do is draw.”)
Later in life, Helen struggled with the aftereffects of Guillain-Barré syndrome. Instead of offering his wife support—as she had—Geisel began an affair with the couple’s friend, Audrey Dimond.
During a period of hopelessness from worsening illness and life stressors exacerbated by her awareness of their betrayal, Helen ended her life. She left a heartbreaking suicide note:
“Dear Ted, What has happened to us? I don’t know. I feel myself in a spiral, going down down down, into a black hole from which there is no escape, no brightness. And loud in my ears from every side I hear, ‘failure, failure, failure…'”
Imagine you need care at your most vulnerable. Your husband emotionally abandons you and hurts you in the interest of satiating his desires. You see no end in sight. The heartache of self-hatred and hopelessness with no promise of relief is one I know well.
Helen Palmer’s story is especially disheartening because it ends with the triumph of patriarchal selfishness: Geisel married Dimond eight months after Palmer’s death, then went on to establish his legacy as a beloved children’s author.
Discussing Suicide: A Tightrope Walk Between Caution and Empathy
I’m a psychiatrist, and I write this piece after an unusual caseload of suicide attempts. I learned a lot in the process, not only about my patients and myself but also about how we discuss suicide as a society.
No antidepressant will uplift a hopeless woman who needs care and feels chronically devalued.
In my world of psychiatry, I routinely witness the graphic details of people’s lowest moments and try to figure out where I can intervene.
Journalistic standards caution against publishing exact details and recommend promoting a message of hope. These guidelines make sense; they have specifically been designed to prevent contagion, a significant risk when popular media wrongly glamorize suicide, with shows like 13 Reasons Why.
Yet I sometimes wonder whether our implementation of these guidelines precludes our ability to truly understand the mindset of these patients. As a doctor, I need to view suicide as a maladaptive, pathological response and promise hope and support. But as a woman, I can understand why some patients feel as though they have no other alternative, and I pathologize their pain reluctantly—because I’ve felt it too.
It feels intellectually dishonest to promise hope when I know in my heart there are limitations to what I can feasibly do. I don’t make promises I can’t keep, and I wish I could do more. My patients need better societal support.
There is a common thread I’ve noticed among the cases I triage: a firm belief that life will not get better. Contributing to this context of hopelessness is a multitude of factors. I can act on some but not on others. Lately, I’ve met a few patients who share the same burden that I cannot control: women who do not receive what they give to their relationships and feel chronically devalued by the people who committed to loving them.
Till Death … or Inconvenience
I don’t intend to generalize all men, but undeniably, women disproportionately take on caregiving responsibilities and domestic labor, despite their increasing presence in the workforce and outpacing of men in higher education. Women’s labor is simultaneously invaluable and undervalued. Women’s invisible labor comprises our country’s safety net—as sociologist Jessica Calarco, Ph.D., argued in her recent book, Holding it Together.
But what happens when America’s caregivers need care themselves?
I see myself in these women who merely want the tenderness they would offer someone else.
A 2009 study revealed that the divorce rate among a population of cancer patients reflected the general population on aggregate. But digging down into the numbers showed a gender gap: Partner abandonment was 20.8 percent in heterosexual marriages after cancer diagnosis of female patients, compared to 2.9 percent for male patients. Among the abandoned patients, quality of life decreased dramatically.
This is not limited to potentially terminal illness. How many stories exist of men pursuing affairs when their partners are pregnant or postpartum? (And let’s not forget: The leading cause of death for U.S. pregnant women is homicide, typically at the hands of their partner.)
As a mental health professional, I know the bedrock of marital stability isn’t women’s submission but shared values and mutual selflessness, especially during life stressors. Yet many Republican lawmakers and right-wing personalities promote so-called family values by focusing on the former: with draconian abortion restrictions and denunciations of feminism. I wish politicians would address the latter. When men like Newt Gingrich, who abandoned two wives with cancer and multiple sclerosis, or John Edwards, known for similar actions, or Donald Trump, allegedly unfaithful during Melania Trump’s pregnancy and postpartum period, occupy the spotlight, the quality of male role models is bleak.
We need to acknowledge self-centered individualism as the destructive force that it is. I encounter its effects far too frequently.
I Can’t Cure Selfishness
Feeling hopelessness perpetuated by chronic devaluation, many women struggle with depression, and some feel that they have no other alternative but to take their lives. The thought process isn’t, I want to end my life, but, I wish the pain would end.
I am one of those women. That expected feminine generosity was deeply ingrained in me from childhood as the eldest Asian daughter in a family that values collectivism and filial piety. I genuinely don’t mind. It makes me happy to make my loved ones happy. But I long for the same intentional effort that I try to put out into the world. Who doesn’t?
And then, I married the wrong person. Today, I am plagued by intrusive memories every time I see a woman like me as a patient. During my medical school OB-GYN rotation, I assisted with a birth. The unadulterated joy on the father’s face as he kissed his exhausted wife brought tears to my eyes. I thought about my then-husband: He won’t treat me like that when I have our first. If anything, he’ll be furious that I kept him awake for so long.
My critics might respond, Pick better next time! But the data suggests that picking better is not easy. For as long as there is male selfishness at the expense of women, I will always encounter this problem in women’s mental health. I can offer medication, coping skills, talk therapy and support groups. But I’m limited in what I personally can do. No antidepressant will uplift a hopeless woman who needs care and feels chronically devalued.
How can I possibly convince these female patients of their worth, when the people closest to them have deprived them of self-worth, not with words but through deliberate, hurtful choices? A little part of me dies each time I face this defeat because I see myself in these women who merely want the tenderness they would offer someone else.
The only relief I can conceive of is a Herculean societal shift where women’s needs for care at vulnerable times are prioritized. Where Jessica Calarco’s extensive research on structures of power and privilege is regarded without mockery or indignant cries of, Not all men! Where politicians stop preaching about family values and start living those family values they promote.
As I said: Herculean. I will probably have similar cases next week—where I know I’ll again struggle to offer hope in the face of systemic injustice.
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