For those left behind

‘ She has committed suicide’. 

‘I never wanted to believe it. I told everyone including you that it was an accident. I was lying to my self too’. 

‘Coz she was never that type of a person. I was feeling guilty of myself. Being her best friend I couldn’t save her. I was three minutes away from her but I still failed. I was lying to myself right throughout that it wasn’t a suicide’.

‘sigh’. 

 

I received this text message two hours ago from a dear friend who recently lost her best friend to suicide. It struck a chord in me and with the recent deaths by suicide that have taken place in Sri Lanka, it got me thinking about the impact suicide has on those who are left behind, on those who survive. What happens to them? What happens to us?

A death by suicide, when it occurs,most often shatters the existing status quo of a family, community and society.  It’s like being tossed around in a whirlpool, I suppose. All that we once believed in is shattered and those of us who are left behind often have to pick up the pieces, and piece together a fabric of something that possibly could help us find some solace, barely.

I remember how I cried when a classmate from my Bachelor’s course in India, took her life, when I was far away, in Norway. I couldn’t be there with the rest of my classmates. There weren’t any pieces to pick up. Nothing to hold on to other than Facebook messages sent by classmates, and a few photos that were online.

My friend found her.

The guilt of surviving, shame, feelings of regret, anger, abandonment, emptiness and a whole plethora of feelings come gushing through, maybe not immediately, maybe later, and maybe not at all- there is no one way of feeling about something so ambiguous like suicide. You might ask the question ‘ why’ or you might not. You might wonder what you did wrong, of how you could have saved your loved one’s life, of that one thing that could  have made a difference, but from a different point of view, it might seem pointless to think about it at all, I don’t know. But, what I do know is that it is okay to feel, whatever you feel- because they are your feelings and it is important that what you feel is acknowledged. However, silence sometimes becomes convenient for some and although deafening, a  way of coping for others. Feelings tend to go unacknowledged and unheard, leaving a survivor of suicide in a mass of isolation, heaviness and despair. There is a ‘wall of silence’ that erects itself around an individual or  family who has lost a loved one to suicide and in Sri Lanka, we often see the stigma and shame surrounding suicide only making the wall taller and thicker. It doesn’t have to be that way, and we as a community have the power to change that.

It is important not to isolate individuals and families who have experienced loss due to suicide, even though it might seem rather daunting and confusing to think about ‘ what to say’. I’ll get to that in a moment, but reaching out and not waiting for survivors to reach out is a great way to start. They may not want to talk, or even look at you, but it’s your presence that matters. It takes away the isolation and emptiness.  It is often not immediately after a loss that the most support is needed, but it is when a month or two has passed and people slowly begin to forget. People gradually begin to trickle away, and contact with the community decreases, and this is when you can help sift through the debris. You don’t always have to say much, but checking in regularly, and creating a permissive environment for feelings to be expressed can go a long way in someone feeling supported and cared for. I must also bring in the use of language when talking about suicide. ‘ Died by suicide’ rather than ‘ committed suicide’ is an useful way to talk about suicide. It makes it seem less like an offense or a crime. ‘ Took his/her own life’ can be used instead of ‘ completed suicide’. ‘ Ended his/her life’ can be used and not phrases like ‘ a successful suicide’. You get the gist right?

Are you a survivor of suicide loss?

What can you do to cope in the aftermath of a loved one taking his/her own life?

  • Try not to isolate yourself.
  • Speak about your deceased loved one with other members of your family and friends. Share positive memories you have of the person you lost. It is okay to acknowledge that the person both lived and died.
  • Use creative mediums like journalling, art based activities etc to work through your feelings. Psst, you can also speak to a mental health worker.
  • Keep your loved one’s memory alive- photos, letters, memento’s etc can be used to help you through the process of grieving. The person may have died but can still live on in your memory.
  • Allow yourself to cry, to express emotions, even difficult one’s like guilt, shame and regret. They also need to be acknowledged.
  • Take care of yourself- get adequate sleep and nutrition.
  • Seek support- there is no shame in doing so,

 

Where can you seek support?

Sumithrayo- No.60B Horton Place, Colombo ( 0112692909). 9am-8pm.

CCC Line- 1333.  9am-9pm

Shanthi Maargam- 0717639898. 24hrs

 

 

 

 

 

 

 

 

The Pain Behind the Pride : Student Suicides at Monash University,Malaysia

I was strolling around the Sunway Monash Campus in Malaysia, last week while on holiday. It was a beautiful campus, with everything a student can possibly ask for. There were tall buildings that boasted of fine intellect and academic rigor and you could almost smell the cortisol floating around while students were prancing around ‘ checking the boxes’. However, I also felt a certain eeriness while inside the campus because of another reality I was aware of. Unnoticed and hidden under the pride and acclaim of everything Monash claims to be, is a dark cloud of pain and anguish- student suicides.

I won’t go into the details here, out of respect for those who lost their lives and their families, but there have been quite a few  students who have taken their own lives while and after studying at Monash University, Malaysia. A number of them-international students. However, apart from ‘regretfully’ releasing statements, there appears to be little else done via the university to work towards suicide prevention.

While walking around campus, and while using public transport i.e. the BRT, I saw lonely eyes glued to mobile devices and computers and I couldn’t help but wonder about how their hearts were. What were they feeling?. Were they feeling at all?. Did they have someone to tell them that they are loved and cared for- or was their worth solely based on how academically sound they were. I was thinking about those lives lost to suicide. What were they like? What were their stories? Who did they leave behind?

What do we do with the residual traces of what’s left behind? The lingering vapor of hearts riddled with pain,guilt and loneliness, about low grades, failed exams, friends who have failed them and families who have shamed them.

We have two choices;

  1. To pretend that it never happened and move on with our lives.
  2. To create a more compassionate world collectively.

I obviously advocate for the second choice.

A few pointers for students studying at Monash,Malaysia and their parents

For parents:

  1. Expectations! Expectations! Expectations!- Manage them.
  2. Check on your son/daughter often. You are not being a pain in the behind, just a  caring parent.
  3. Ask after their mental health- not just whether they are eating well or not.
  4. Teach your child about coping with failure and learn some of that yourself.
  5. Provide options not dead-end’s.

For students:

  1. Check on your friends often. A simple ‘ how is your day going?’ would do.
  2. Take your eyes off your smart phone and look someone else in the eye and let them know that you care.
  3. As much as it looks ‘cool’ to make someone else feel like ****, it’s way cooler to help someone out. It doesn’t take much of your precious time.
  4. Quit laughing about suicide and poking fun at people who may talk about wanting to harm themselves. Help them seek support.
  5. Please stop the ‘hate’ on social media and on pages like this. It only adds to the pain.
  6. Take care of your mental health as much as you do your physical health.

For Monash, Malaysia and other universities around the world: 

  1. Check on the well-being of your students- not just their attendance and grades.
  2. Reach out to students who may be having trouble adjusting and actively support them. It really does not take up too many resources.
  3. Include life skills and coping skills education in your curriculum. A degree is not just a piece of paper it is also about life.
  4. Identify suicide hotspots on campus and take measures to prevent further suicides from taking place.
  5. Talk about suicide prevention in your campus and do not just slip difficult conversations under the carpet.

 

Here’s to a healthy, compassionate world.

 

 

 

 

 

 

 

 

Staying well O’er the season

December is a month of joy, colour, bonding and giving or at least that’s what we’ve learnt over time. However, this might not be true for everyone, and hey, it does not have to be the end of the year, for life to be extra joyous and merry. So, what I am really trying to get at is, that December, and everything that comes with it may not always bring happiness and contentment. It could for some, be a very stressful month, and for some, extra lonely.

There is the commercial buzz around this time of year, where people are racing for time, to finish their shopping, and to get some of that spring cleaning done. Santa’s prancing around the streets, gigantic Christmas trees popping up around the city and general bonhomie is what one would notice, at least on the periphery. We however tend to sometimes forget that there is also another side to Christmas and of course the dawning of a new year which is around the corner (Gulp!). I decided to pen down this article, to acknowledge the often-unacknowledged side to the season in Sri Lanka and to share some thoughts on how to cope with the niggles that come with it.

There is a hype of activity around this time of year, and a great deal of pressure for some to part take in the festive cheer. A whiff of consumerism is in the air, with shops beautifully decorated, whippy adverts on television and of course those provocative discounts and sales. Television shows portray love filled families, sitting around crackling fires and gobbling down turkey. Radio hosts (some of them) are extra cheery and bubbly. While I am totally for joy and happiness, I also know that parents may feel pressured to buy gifts for their children, people may feel obliged to host the ‘party of the year’, and for others, the season might bring with it the necessity to guzzle down spirits, in order to belong and to feel bonded. December can be a very lonely month for certain segments of society and this could also bring about bouts of depression, anxiety and cause high levels of stress.

It’s okay, to not feel as bright and cheerful as you are supposed to feel. You are not defective, just because you do not feel like donning your best, and celebrating. You, my dear friend, don’t have to snap out of the sadness you feel, just because it is Christmas. You can say ‘no’ to a party you are invited to, and for you beautiful parents out there, you are allowed to not buy your child the most expensive gift this year. You are also important, and your well-being is as important as everyone else’s. You can give yourself permission to take a break. It is not a catastrophe, to not put up a Christmas tree at home, or to not bake at your best this year. Balancing your reality versus expectations you, and others have of you can be a way of staying well, this season.

We are vulnerable sometimes to developing mental illnesses and some may be already diagnosed with a psychological disorder. A few simple strategies can prevent the onset of mental health issues or the exacerbation of already existing illness, especially in this time of year.

  • Create a balance of activity and rest into your day.
  •  Get enough sleep and try keeping your sleep cycle in place.
  • Watch the alcohol and other substances – you do not always have to drink or get high, to be merry.
  • Be aware of certain triggers that cause distress (i.e. a Christmas movie, portraying a warm family- while this can provide comfort and hope, it can also bring about difficult feelings).
  • Reach out and give some of your time to others who may want some company this December.
  • Keep a tab on your expenditure so that you can minimize the stress of over-spending. You can use a worksheet like this to keep track of your expenses.
  • You are allowed to talk about the difficult stuff, it doesn’t’ always have to be cheery.
  • There is support available in Sri Lanka, even during Christmas and new year’s.

 

So, folks, I wish you a mindful and peaceful Christmas and a hopeful new year.

 

Stay well, and keep each other well.

 

 

 

 

 

 

 

An Open Letter to the Commissioner General of Prisons, Sri Lanka

Sir, I write this as a citizen of Sri Lanka who values human dignity and I have a thing or two to say to you.

I acknowledge the fact that I maybe a tiny speck of dust when considering the larger scheme of things, but, I still want to raise my voice and to be heard. I think every citizen of any country deserves that basic right. I hope you will hear me out.

I am a mental health worker who has been visiting the Welikade male prison for the past one year. I visit the prison twice a month and spend a couple of hours counselling individuals who are referred to me via the welfare division of the prison. I also deliver short talks on mental health and well-being for the prison population from time to time. I enjoy my visits and find them to be meaningful and rewarding.

Now that we’ve gotten that squared away, the real reason I am writing is to share both what needs to be celebrated and also what tends to make me feel sad and angry about the corrections system in Sri Lanka.

First, kudos to you and all those who work with you and for you, for the progress made over the last few years. There are efforts to ensure rehabilitation and reintegration through avenues like vocational training, counselling, medical and psychiatric care, religious facilities and other steps taken by all stakeholders to create a better functioning system overall. I know it’s not easy with the limited funding and priority given by the government. So, hats off to you sir.

Having said that, as a mental health worker I believe in the need for advocacy  and social justice. Therefore, I feel I must yield the proverbial sword, my pen, to bring to light injustice and human rights violations that occur within the prisons system. Individuals enter the corrections system in Sri Lanka for various reasons. Some because they commit crimes that make them a liability to their families and society, others because they cannot afford bail or a fine and some others because they’ve been wrongfully detained and charged, just so that certain quota’s get filled. There are some who are return customers and others who become an institution within an institution. They come from varied backgrounds, and from all corners of the country. You might agree with me when I say that some live a cushy life inside prison whereas others are dealt a tough round of cards.

Sir, would you take a minute or two to just bear witness to a few moments of the life of an individual who has just entered prison to start with?. The uncertainty, fear, the desperation and the looming months and years that seem so far away. Memories of beautiful wives and children they’ve left behind, some of whom might not even know that their husbands and fathers have been imprisoned. Can we just sit with these feelings for a minute?

I have had individuals tell me about feeling utterly lost and powerless when they enter prison with no knowledge on how to survive. There is no survival manual but they say they learn to keep their heads low and their eyes averted when they receive slaps that sting and baton strikes to their faces and heads. Repeated beatings are administered to break them in and alas, the institutionalization has already begun. Those who are newly imprisoned just fall in line with the rest, like a herd of wild cattle and go through the initial days in a haze. The insipid and unhygienic food, the cramped spaces they are expected to sleep in and of course when an young ‘ hurubuhuti kolla’ is spotted, the accidental brushing against genitals and attempts to take them to secluded spaces are just a few examples of what they have to endure.

I apologize for putting you on the spot, but, how do we balance what our hearts want  and what the system has in store for those under our supervision and care?. How do we seek dignity for those in the corrections system when jailers themselves physically violate prisoners and senior prisoners violate the junior prisoners. How do we go about ensuring health and well-being for all when there is a rampant flow of skin diseases, Tuberculosis, Sexually transmitted diseases and other infectious diseases. Oh, and mental illness? don’t even get me started.

Sir, for you, they might be just visitors with only some taking up permanent residence at the various institutions under your supervision. They are rejects and failures in the eyes of general society, defective products of god or whoever else who created humanity. But, for me, they are human. Human like you and me. Vulnerable like you and me. If you really peeked into their souls, you might find festering wounds and deeply etched scars that never leave. If you took a glance at most of the genograms I draw in my counselling room, you will find missing links, dotted lines, and of course the dreaded crosses.

So, with all due respect, please take heed. There is always opportunity to change and to allow some of those soul wounds to actually heal, instead of band-aiding them for our convenience. Can we prioritize kindness over batons and acceptance over disgust?.

Can we?.

Commissioner General of Prisons, Sri Lanka- over to you.

 

 

Mortui Vivos Docent

You know, how some places leave a lasting impression etched somewhere in your person, and gives you a whole different perspective to life when you least expect it. A visit to the Judicial Medical Officer’s (JMO) office in Colombo recently gave rise to this intense need to want to place somewhere, the images that emerged, before they fade away into just vague memories. It is almost as if I want to have a tight grip on everything that I saw,heard,felt and smelt, because it was sacred, but at the same time to dissect everything in postmortem. It was for me,the ultimate truth about being human.

In case you are wondering, I was at the JMO’s office on official work, but I was also very curious to explore the mortuary located at the same premises. There was a feeling of despair in the air, as I walked into the morgue along with two colleagues only to be greeted by a weird mixture of humidity and eerie coolness. The strong stench of disinfectant mixed with rotting organs in waste-bins was an assault on the senses, as we walked in to the room where they conduct postmortem’s. There were cold,steel workstations with dried blood stains on the floor underneath them.Remnants and reminders of bodies unceremoniously emptied. Each stain would have a history behind it.

The postmortem room led to the area where the refrigerators were, and I was engulfed at once by the torrid stench of decadence, this time the handkerchief I had over my nose was not enough to ward any of it off. It was present, and it followed me around, lurking in the backdrop, creeping up on me like an elusive chilly breeze, on a hot day. The kind that gives you goose-flesh.  My colleague described it as being stuck in her throat. It would not go away.

One of the refrigerators was opened, casually, almost like you and I do when we want respite in a glass of iced water, after a hot, tiring day. There was a pair of feet visible, with all its toes intact, and trays containing intestines and other spare parts (pardon the pun) stacked on top. It felt like a store-room, but with just human filth in it. It is a very vivid image, that has rooted itself somewhere in the depths of my brain, and it had to come out like this. What kind of lives did these people lead? Who did that pair of feet belong to? What paths have those feet walked? Were they weary?. I was grappling with these questions, but it was also time for me to get out, as curiosity was replaced by queasiness.

On the way out, near the exit, there was a lone body, wrapped in a white sheet, on a gurney, waiting to be either preserved or taken apart. Waiting, just lying there, resonating with the deafening stillness pervading the morgue. This brought about a stark realization of how fragile and temporary human life is. I was confronted by my own mortality and that was a revelation. Human bodies that were once whole, become mere inhabitants of a wasteland store-room, with nowhere to belong to. You become a memory in the annals of history, and everything else is a facade. Nothingness.

The dead teach the living. 

 

 

 

 

 

The call.

It all began with the familiar ringing of my mobile phone, while I was driving. Incidentally, that’s also when the sky decided to open it’s floodgates on Colombo, filling tarred streets fast with slush. The rain pelted incessant droplets onto my windscreen, as if trying to warn me, that bad news was on the way.

“……….. had attempted to take his life, drunk something…taken to a small hospital in Koswatte”. This is what I heard on my end of the line, and then everything else became a big blur, as I turned the car around to head in the opposite direction, to the hospital. I stopped by my office, and my colleague joined me for support and off we went, battling the rain and the traffic that followed.

My heart was on overdrive, when I received another phone call saying that he was on his way to the National Hospital, Sri Lanka at the back of a ‘nee naw’. I changed direction again, this time with hazard lights on, willing that traffic lights would work in my favour and that the vehicles in front would speed up ( none of which happened,obviously), but I ended up in Ward place, and I parked my car at a relatives store. I remember blabbering a string of garbled words, almost incoherent, and my colleague and I jumped into a tuk tuk for a short drive to the out patient department (OPD). 

We arrived at the OPD gates, and I rushed in, and then, I saw him. I went closer just to make sure, and it was him, lying on a gurney sporting a purple t-shirt and beige pants. There was a ‘sili sili’ bag placed in-between his thighs. His eyes were flickering, his face almost expressionless. He was unconscious, just lying there at the entrance and no one was really acting with the sense of urgency that I wanted them to. I almost wanted some chaos, to validate the chaos and the noise inside my head. I needed to hear orders being barked out, and to see flashes of white and blue whizzing past.

But, No. The hospital had lost electricity along with the whole of Colombo, and the good doctor in charge of admissions did not have a source of light to write up the ‘ kole’ required for admission. ‘ Ah, the state of our hospitals’ I heard one of the attendants saying and then voila, a torch appeared from nowhere and the documents were filled in, finally granting him as being eligible for treatment. We barreled through the hospital, a few attendants and I pushing the gurney along, and there was a blur of a family member somewhere in the background shoving the gurney forward as well. We reached the elevator and there were no welcoming red lights on the display screen. They were flickering too, just like his eyes. However, the elevator did eventually work and we got him up to the 8th floor, and then to Ward 42, where medical staff took over his care, with a sense of quiet urgency.

I took a step back. I was leaning against the nurses counter, when my own floodgates opened, and out poured anger, shame, guilt, fear and dread.  It all came together, and I didn’t quite know how to react to any of it. All that went through my head was ‘ what if’, ‘ what if I’, ‘ What if I did…’. Questions, and more questions. I was in a haze, just barely registering the shouts of protests by university students nearby, and the calming words of a lovely friend who stopped by to support me.

It was now time, for a translucent tube to be inserted via his nose down to his throat, so that charcoal and other solutions could be administered. I remember the nurse saying dang api batayak nahaya athulata daanawa, eeka oya gilinna oney’ ( Now, we are going to put a tube down your nose, and you must swallow it). In it went,and when it reached his throat he began to splutter and cough, and all I could do then was to hold his hand.

I just held his hand.

Suicide be it a successful attempt or not, leaves a horrible feeling in your gut. It breaks you, it shatters your core and you begin to question everything about yourself as a therapist and a human-being. I was so angry at myself and I felt angry at the world. I wanted to tell him, that he is worth so much more than a girl who does not care enough. I needed to be angry at something else besides myself. Maybe, I can channel that anger towards preventing suicide.

It took me a while to come to terms with what happened,  my parents and my supervisor helped me process everything in a gentle, supportive manner, and I began to see things in a clearer perspective. But, it’ll always remain etched somewhere within me.

And…it all began..with a call.

 

On the way home.

prisons-160x120

” Prisoners are human beings too”

I have seen this seemingly ‘meaningful’ quote painted outside the Welikade Prison on baseline road since the time I could read, while on the way to and fro from the airport. It was never something I would stop and think about until, I began to work at the Welikade male prison as a Psychologist, twice a month.

The work I do there is not relevant here, but this post is about Asanka* a 35 year old, male inmate I met yesterday at the counselling room. He has always been around, identifying potential inmates who require screening or counselling and bringing them to see me. He was always very polite, and had a smile to share with everyone . ‘ Good morning Uduman sir” would be a common utterance. However, yesterday was different, because he asked to see me individually. It appeared that he was due to be released the following week.

Asanka was almost at the end of a two year prison sentence, due to him being found in possession of Heroin, a dangerous, addictive and an illegal substance, easily accessible in most parts of Sri Lanka.You get it on the streets, and you get it from high-end dealers, peddling out of their plush homes, just like in Bad Boys -1. Oh, and I almost forgot to mention, you get it inside the prison too, for a price. The price might be a monetary exchange or it might also involve performing sexual favours for someone else. You get the drift.

Talking to Asanka, I found that he had been imprisoned before his current sentence, due to him being arrested for a robbery. ” I’ve had a relationship with the prison services for about ten years of my life”. He also told me about his early years, where he lost his father at the age of 16. Asanka and his brothers watched their father being stabbed and murdered, and they suffered injuries as well. It was due to a land dispute. ” My father was an innocent man”. Being the eldest son in the family, he had a great deal of responsibility on his shoulders, and that’s when ” My world collapsed”. Heroin made an appearance in his life, and played a huge role in his relationship with his wife, and in everything else he did. ” I would go to bed with my wife, only after using Heroin”. He showed her affection ” Only after using Heroin”.

My client has two daughters aged 9 and 1, and the younger child was born after he entered prison for the second time. He has missed out on watching his children blossom. They visit him, along with his mother and wife and talk to him through ‘grilled partitions’. ” Maybe my older daughter knows, she must wonder what her father is doing without coming home”. She has been told that Asanka is working and hence is not able to come home. ” I will tell her when she is about 12″.

There was something Asanka told me that really touched my heart. He said ” My wife stayed, she didn’t go with another man just because I am in prison”. It was evident that he was grateful for the love he received from his family, and his mother still looked out for him.She was coming to take him home. He mentioned how countless other prison inmates lost their young wives to other men, and had their families fall apart. But, his wife has held it together, and was waiting for him to come home. His family did not reject him.

You might have this image in your mind , where the prison gates open with a rumble next week, and Asanka walks out with his mother holding his hand, to freedom. But, freedom comes with a great deal of questions as I found out yesterday. ” How will I find a job, to support my family?”. This was a pertinent concern that was brought out, and it did leave a heavy vibe in the room. ” What will I do?”.  Another difficult question. There are so many anxieties about going home, because institutionalization does have an impact on your self hood and it does not necessarily give you the skills required to reintegrate into society.

Asanka had fears about being drawn into the world of drugs again, and his family had also made compromises by moving to Wadduwa from Ratmalana just so that he can have a new life, with minimal temptation ( I say minimal because Heroin is available in Wadduwa too). There are going to be changes, and how equipped is he to cope with those changes?. ” I used to last long without ejaculating when having intercourse with my wife because of the Heroin, but now, will I be able to last long, will I be able to perform?” This was a very immediate concern he brought up in the counselling room, and a very real concern for him.He was worried about how his wife would cope with changes that have occurred within  him. ” How do I tell her, prepare her? Where can I find support?” 

This is just one story, but there are countless others within the corrections system going through similar or worse experiences. There are those who I see released, but are back in prison the next time I visit. There are others who feel lost, isolated and ostracized once they step outside the prison walls. But, there are also some who somehow make it. But, the larger question remains, is imprisonment doing it’s job?. We have fancy terms like rehabilitation, correction, reintegration etc, but to what extent is this happening in Sri Lanka. How hypocritical is it to acknowledge that prisoners are ‘human beings’ too, and then address them as ‘ Party’ instead of calling them something more respectable (for the uninitiated, inmates who go out on work parties are called ‘ Party’). How is it human to shackle about 25 inmates together, and have them squat near the prison gates, pressed against each other like chicken waiting to be slaughtered. I witnessed this yesterday, and it brought to mind a scene from old movies where people were taken to be guillotined. How is it rehabilitation when inmates are not given the confidence and skills needed to survive in the outside world.

Welikade and Wadduwa will intersect for Asanka, the stench of incarceration will follow him around until he finds the support needed to live again. But, the question remains, are people like Asanka not our business anymore, once they are released and do we just let ‘society’ deal with them. Are they just a speck of dust in a seemingly compassionate country and in an apparently caring world?

The onus is onto you, the reader.

*  A pseudonym has been used to protect the privacy and identity of the prison inmate.