'You're no good!'

Has anyone noticed one of the most consistent themes in our depressed, suicidal patients? Has anyone lately asked them, when they report auditory hallucinations, what it is that they hear? I have. Though I’m no psychiatrist, and though I don’t have much time to talk with them, I try to listen a little, when they’ll talk, and when I don’t have some other crisis or pseudo-crisis brewing in the next room. And I’m amazed and so very saddened by what I hear.

‘The voices tell me I’m no good. The voices tell me to kill myself because I’m worthless. The voices tell me I’m trash. The voices tell me no one loves me. The voices… .’ The voices. Do you hear that? Do you hear the pain of worthlessness?

My wife and I spend so much time telling our children that we love them. Day-in, day-out, we shower them with hugs, kisses, hand-holding, wrestling, tickling, butterfly kisses, tiger-hugs (foreheads rubbed together, for the non-tiger hugging among you). And we lavish them with affirming words: ‘I love you, you’re the best, you are so talented, you are so smart, you’ll do great things, I’m proud of you!’ I like that word, lavish. It has its ancestry in the Latin word lavere, to wash.  Every day, we wash them in affirmation.

Every day our patients, present and future, are left filthy with cruel words, foul language, sexual innuendo or frank sexual abuse, drugs and alcohol, neglect, loathing, anger, violence, hatred and with every form of treatment and word that can be leveled against them, first as children and then as adults.  They are mired in it.  Their minds are filled with it.  They are thick with loathing and hatred, self-loathing and self-hatred.  It is the dust that clouds their minds; the mud that surges through their empty, aching hearts all day, and especially all night as fears grow large like shadows in the dark.  Their minds, bereft of any hopeful words, are left to wander through their own personal hellish museums of dark memories and dark words.

Is it any wonder that they come to us in the ER?  Mental health is hard to access in many areas.  And, like so many things, is unavailable after 5 PM, not at all on weekends.  When night falls, and it seems the ‘crazies’ are everywhere, it’s only because the dark magnifies the misery so many of them carry about.

And in the crushing weight of the words in their hearts, the years of ‘you’re no good,’ the decades of rape and cruelty and near torture, it’s no wonder that they take pills, or slash themselves; drink or wreck cars on purpose.  It’s also no wonder they make attempts that aren’t all that good; what they really want is attention…and I don’t say that the way we usually say it.  They need someone to come to them in the dark and pull them out.  The cry for help is really, very often, a cry for help.  In our snide, cool professionalism, we say ‘do it right next time!’  But that isn’t what they want.

What they want is to be told ‘you are good.’  What they want is to know that the voices are lies.  What they want is someone, in a lighted, clean place, to speak to them as if they were, for a little while, human beings.

I know how maddening it can be.  I know, with all the things we’re tasked to do, counseling is the lowest on the list.  I also know that states and hospitals have little money to commit to it, and often little interest.  It seems so…un-medical, so extraneous, so pointless.  But it isn’t.

So I encourage everyone to take a minute.  You don’t have to be a psychiatrist to say something kind.  To take just a minute to treat someone gently.  If only to say ‘I’m calling someone who is better at this than me.  But can I get you a cup of coffee?’  It doesn’t take much.

But what has to happen is that the voices need to be banished.  We have to teach them that they are good.  That inside them lies someone loved by God, someone worthwhile, someone whose abuse was really abuse rather than a defining trait.  We need to take generations and tell them that they were tricked, lied to, beaten, raped, assaulted, called names, diminished and used; not because it was what they deserved, but quite the opposite.  That they never deserved any of it, and that the voices that call them names in the dark are lying.

And that there are other voices they need to put inside their minds, that will tell them the bright, beautiful, untarnished everlasting truth of their eternal worth.

Now that would be some therapy, wouldn’t it?

Edwin