A new way to disrupt suicide
Christian D'Andrea Developed by
with help from Reyn Archer, MD
The Survivor Cadres initiative is based on something I've seen work in the fight against suicide.
Shame and fear of stigma make people who are suicidal suffer in silence, and this isolation speeds them on their path to suicide. The good news is that this path to suicide can be disrupted when sufferers encounter someone they respect and trust, who makes them feel it's O.K. to break their silence and talk. And sufferers are more likely to trust those who've also wrestled with suicide—those who've lost loved ones to it, or almost committed it themselves. The Survivors.
Rally and organize survivors into Survivor Cadres.
Reduce suicides by enabling people who are suicidal to connect to (and join) Survivor Cadres. Survivor Cadres can help sufferers manage their isolation and shame (which are big obstacles to care), break their silence, and get connected to resources they can trust. Survivor Cadres can help with this because they
a) know what does and doesn't work, from firsthand experience
b) are more trusted by people who are in crisis.
Tap into the insights of Survivor Cadres to support and empower suicide prevention policymakers.
Suicides are on the rise. The CDC says the suicide rate hit its highest number—14 out of 100,000—in 2017 (the most recent year with records). Over 47,000 Americans take their own lives every year. And 17 veterans kill themselves every day.
There are good resources in the fight against suicide. But sufferers oftentimes can't get connected to those resources, because shame, lack of trust, and isolation act as barriers. New tools are needed to smash those barriers.
A Discovery, and the birth of an initiative
I wrote a book with a Naval Special Warfare veteran named Jimmy Hatch, telling the story of how he battled despair and barely survived his struggle with suicidal thoughts. The book is called Touching the Dragon.
In the process, we've discovered something: people who are seriously considering killing themselves sometimes decide not to, because they encounter Jimmy and his story. An example
Why Jimmy has this effect
Jimmy was a formidable tier-one guy in the Navy's special missions unit, and then he got knocked out of that intense life (which he loved) when he got shot. When he shares his story (in speeches and the book), Jimmy shocks people, because instead of bragging about being a bad-ass, he admits how broken and depressed he became, and how ashamed he was of his depression, and how he ended up with a gun in his mouth. The candor with which he admits all of this gives people permission to admit their own brokenness, too, because they think, If that high-achieving guy bottomed out and needed help, then maybe it's OK for me to
A glimmer of hope (and our model)
A sufferer turned Survivor, who's now a lifeline for other sufferers
admit I need help, too... maybe there is no shame in it. And that realization saves lives, because it makes the suffering person more comfortable with the idea of asking for help. People who are thinking about killing themselves (and who are isolated and paralyzed by shame) can break their silence and share their secret.
This is critical, because shame that stays a secret will kill you. Jimmy knows this firsthand, from his own experience. He says shame is a river. And sufferers are on one side of it, alone. They know that on the other side, there are resources, many of them good. But they can't get to the resources because they can't cross the river; Shame is too terrifying. So someone trustworthy has to intervene, take their hand, and help them across the river. And then connect them to resources on the other side.
Someone did this for Jimmy. And now Jimmy does it for others—sometimes in person, sometimes by sharing his story. This "Jimmy effect" is not theoretical. It is a real disruption of the trajectory toward death by suicide, and the result is a life saved. We need more of these real disruptors, given that time is of the essence: 128 Americans will kill themselves today.
Where we'll focus our efforts
One way to think of suicide is as a downward trajectory. This Suicide Trajectory starts with a trauma or crisis (or the accumulation of pain that reaches a critical mass) that sets the person on the steadily downward path. At the end of that path is death.
A new anti-suicide initiative (like this one) cannot address all of the complexities tied to suicide, or deal with every issue that's tied to every moment along that Suicide Trajectory. So we will focus on a key area where we can help: the space where we can deploy resources that disrupt the trajectory and prevent it from reaching its conclusion, the chunk of bandwidth on the Suicide Trajectory where encountering someone like Jimmy can have a profound impact. For now, let's call this chunk of bandwidth the Disruption Zone... we'll think of a better name later. It's a window that begins just after the moment when a sufferer has started to think seriously about killing himself, when he has no one to talk to (or is too ashamed to talk to anyone). Our mission will focus on reaching people who are in this extremely dangerous zone: contemplating suicide, unable and unwilling to talk to anyone, alone. At this critical juncture, encountering an honest, candid, and humane survivor like Jimmy makes people feel that they can talk to someone, that they can overcome shame, and this realization saves lives.
Jimmy shared his story with graduating midshipmen at the Naval Academy. Afterward, one of the leaders of the class took Jimmy aside and admitted she was thinking of killing herself. She had told no one, and was suffering alone, because she felt ashamed, and as though she was letting everyone down. She said she was comfortable telling Jimmy because he'd gone through it himself, and because she realized that if a high-achieving guy like Jimmy could admit he'd been suicidal, publicly, to a room full of hard-chargers, then maybe it was OK for her to admit it to someone, too. She had thought that what she perceived as her failures were too shameful to discuss, that it was too shameful to ask for help. Jimmy showed her it was not. Jimmy then pointed her to resources and counseling teams that he trusted, which made her trust them, too.
What is it about the nature of Jimmy and his story that disrupts people on their path to suicide, and how can we multiply and expand that effect?
Jimmy makes sufferers feel safe (and even empowered) being vulnerable and talking about their problems and crises. It’s not just that he makes them feel there is safety in vulnerability. He makes them feel there is strength in vulnerability. This is a profound shift in outlook.
He makes them feel they have entered into a real human relationship. They are not just being given some pre-fab treatment or drug, which is one-size-fits-all. They are being treated as individuals, and there is dignity in that. They are not being treated as their diagnosis, which is how the current system often makes them feel (you are your diagnosis). Jimmy makes them believe it’s possible for someone to view them as a human being, not as a diagnosis.
Jimmy is inspiring. In him, people see that you can be deeply broken, but that doesn’t make you a disgrace. And you can emerge on the other end. He gives people a believable and achievable picture of what a Survivor looks like.
Jimmy represents an authentic approach to facing their problem, not a patronizing one, or one that makes the sufferer feel tricked or infantalized.
The sufferers have been told that they should not feel ashamed, but it does not resonate and they do not trust it. They have been told there is no stigma, but then parts of the process often make them feel stigmatized. So they feel lied to. They feel the system sometimes relies too heavily on what seem like marketing solutions and mantras, which gives them the impression that they are being sold something. Jimmy is different; his survivor's story engages them in a way where they feel and believe the authenticity. They trust Jimmy when he says there is no stigma, because they can see that he views them with truly no stigma. He lets them actually experience what “no stigma” looks and feels like. He smashes stigma. They didn't believe it was possible to not feel shame. Jimmy changes their mind.
They are surprised to feel an esprit de corps. Instead of being ashamed, they actually feel they are in good company. This feeling of esprit de corps surprises
them, because they thought the group they were now a part of was a shameful group, but it turns out it is not. There is actually some pride attached: “We are the broken who have decided to try to heal.”
THEY ARE MEMBERS OF A SURVIVOR CADRE.
The Survivor Cadre initiative is about re-calibrating the perception, and building on this nascent pride dimension. “Cancer survivor” is a badge of honor. But “suicide survivor” is a badge of shame. We can change this. We can flip the shame to a kind of pride. I've seen people who feel this kind of pride once they feel that they're fellow travelers with Jimmy: “This is another battle we’re in. We are warriors. We are not 'fixed.' We fight every day. We are surviving every day. But I'm in it with my crew. I'm not alone.”
What we will do
Jimmy's story of survival saves lives, because of the reasons listed above. We will multiply this "Jimmy effect" by creating new cadres of survivors who can do what Jimmy does.
Survivor Cadres are groups of people
• who've considered suicide or attempted it
• whose family members have committed it
Through outreach and events where they share their experience and connect with sufferers (whether in person or anonymously via video etc.), Survivor Cadres can:
1) reach people who are suffering alone, help them conquer shame, and allow them to feel OK admitting their struggles and taking that first step in asking for help.
2) become rallying points and provide community and fellowship in ways similar to what AA groups do.
3) guide sufferers to vetted counseling and care resources. Sufferers will be more inclined to trust guidance from survivors who’ve been through it themselves. This is one of the core yields of Survivor Cadres: the vetting and curation of real, proven resources trusted by actual survivors, and then getting sufferers connected to them.
Survivor Cadres do not just make sufferers feel like they are no longer a liability. Survivor Cadres can actually
4) help sufferers feel like an asset, by engendering the surprising insight that the sufferer is a critically important resource to others. This is something they did not expect to feel. It's one thing for sufferers to learn that they are not a negative (not a disgrace). But it's surprising (and empowering) to also learn that they are a positive. It’s part of that much-needed dimension to healing: giving people more than just care, giving them a mission. They are not just The Broken, the passive recipients of care. They are people who can give something valuable to others. This is about turning their suffering into a strength.
Using public roundtables, Survivor Cadres can
5) shed light on—and serve as an ideal focus group for—the current suicide prevention system (providing key insights for organizations and government as they shape policy).
We can use technology to multiply the survivor effect. And when we do, we will always ensure that whatever we develop has the human dimension at its core. For example, if there were an app or digital community dimension, it would have to pass rigorous standards of trustworthiness/authenticity/humanity.
Survivor Cadres will be for civilians, too. Not just military.
STEP 1 - The first catalytic event: a Survivor Cadre roundtable
We will host the first Survivor Cadre roundtable, with 15 survivors and an audience of suicide prevention experts and leaders.
A Survivor Cadre roundtable is different because the key resources are the people who’ve almost committed suicide and the families of people who’ve died by suicide. They are the ones leading and sharing. They are center stage. The experts and PhDs are the ones listening. We are flipping the standard dynamic. Why? Because it’s clear that some new thinking is needed to move the needle and break the disturbing trends.
• There will be real, meaningful learning. What does the Survivor Cadre think about tools, techniques, and resources that work? What do they think healing is? What do they think doesn’t work?
• Our core idea (that the sufferer can be a resource to others and can help others, that the sufferer can be an asset) will be on display and validated.
STEP 2 - Create Survivor Cadres in the ten states with the highest suicide rates
We will start in the states with the largest total numbers of suicides, so as to hit concentrated areas. California, Texas, Florida, Pennsylvania, Ohio, New York, North Carolina, Illinois, Michigan, Georgia. Eventually we will organize Survivor Cadres in all 50 states. A key facet of Survivor Cadre gatherings is that folks can attend anonymously, and just listen, if they want. We will ensure that, for sufferers, the barriers to entry are low.
STEP 3 - Create and distribute digital versions of Survivor Cadre events (and a comprehensive documentary) to expand the reach of the Jimmy Effect and widen the invitation to get involved in Survivor Cadres
Experiencing the work (and insights) of Survivor Cadres in a compelling film or video can be a first step to get sufferers to break their silence and ask for help.