I interviewed Samantha Nadler at the American Association of Suicidology's annual conference in Los Angeles on April 11, 2014. At the time, she was a MSSW student at the University of Tennessee, a supervisor at a crisis call center, and facilitator of a suicide loss survivor support group. She was 25.
I first had thoughts of suicide when I was 12. I attempted suicide—I lose track [but], say, at about 8 or 9—I forget the number, not that it matters. My last attempt was May of 2008.
My parents had a messy divorce. I think that really impacted me a bit, ‘cause I didn’t have a whole lot of support through that. I’m the oldest, so I ended up having to take care of siblings through that mess. My mom lost custody of us and that was really traumatic. I didn’t get along with my dad’s wife. Just, you know, the normal family dysfunction stuff that I didn’t really handle very well, and so I ended up attempting suicide multiple times. A lot of it was because I didn’t like living where I was living and I didn’t feel heard with my struggles. I was in therapy. I was hospitalized, but once I got home, I was very isolated and cut off. I felt alone.
I was in therapy a lot, but I wasn’t getting a whole lot of support. I ended up self-[injuring] a lot, and I did that for several years. I got sent to a troubled teens program when I was 16. That’s how I ended up in Tennessee, actually. The program itself wasn’t necessarily helpful, but being removed from my house was.
I think a lot of my attempts stemmed from feeling trapped and feeling like I had no sense of control in my life. Part of that’s [because I was] a minor... Not having any control over what was happening to me and the help that I was getting—or the lack of help I was getting—I didn’t feel like I had a voice in that, so that left me feeling really powerless. My solution was, 'Well, I’ll just kill myself because that’s how I’m gonna get out of this. I’m not gonna be able to actually leave my house.'
CPS did try to intervene a few times and they never found grounds for removal, so again, I was stuck and I was trapped. Then I got sent to this program against my will, and I was stuck and I was trapped. I was there for about two years. I finished, and in the last month, I was told that my parents didn’t want me back. So again, I was stuck and I was trapped in this program that I had finished. I had done everything they wanted me to do, but because I was a minor, I couldn’t leave.
Once I was 18, they let me go, but I didn’t have any place to go, ‘cause I was sent there against my will. The only people I knew were staff members who worked at the program. I ended up couch surfing for several months, just trying to figure out what was I supposed to do, because I was more or less homeless. Then I [moved in] with my boyfriend at the time, who ended up becoming my husband (now ex-husband). I’ll get into that. My last attempt was while I was living with him and his family. Again, I was living with him and his family out of necessity because I was homeless. Things were not going well there, and so there goes the trapped and hopeless theme again.
I [attempted suicide] and ended up being in the ICU for four days at Vanderbilt. That almost killed me. It was really difficult because I exposed my boyfriend and his family to suicide, and they didn’t understand it. I'd put myself in another environment where people were not understanding and supportive and, really, were judgmental—more than anything—about what I had done. That action ended up following me all through my relationship into my marriage and was thrown in my face a lot. It was perceived as, ‘You did this to me, you tried to leave me,’ even though that’s not what it was about. Though I understand that perspective, that’s not what I was trying to do. He never really took the time to understand what things were driving that attempt, ‘cause there were other things going on.
Suicide doesn’t happen for one reason. It’s usually just the one event that broke the camel’s back and that's it—that’s the thing that gets focused on—but there were other things happening. I wasn’t on medication at the time. I wasn’t in therapy. I went from this 24/7, very structured environment, to, "Good luck, figure it out." I was working at Subway and Barnes & Noble, just trying to figure it out. After I had been hospitalized, I chose to not get on medication. I chose to not go to therapy because I didn’t have the funds to do it. I had health insurance, but that wasn’t enough.
Fast forward to a year out from my attempt. I volunteered at the call center. I was a psychology major. I wanted to go into clinical psychology and knew that if I did something like this, it would help me get into grad school. Part of it was selfish, too. It was also an, ‘I want to see what it’s like being on the other side of this, ‘cause I’m constantly the patient or the client or the person who’s at risk,’ kind of thing. So I went through training there. I wasn’t open about my history at all. I told them that my sister had attempted, which is true—my younger sister. I’m one of five girls. My sister, who’s closest in age to me, has attempted multiple times too and ended up being hospitalized in a lot of the same places I was, in New York.
I told them that so that way I could say, “Yes, I have experience with suicide,” without having to tell them about me, because I know what it would have sounded like.
[They would have heard,] “Yeah, I’m a year out from my attempt and I want to come and help your people.”
They would have said, “No thanks, go get some therapy,” and judged where I was at, even though I knew I was in a good place. I knew, [to them], I would never be 100 percent stable, whatever that is.
I did that and then they hired me on a couple months later. I finished my bachelor’s degree while working full-time for the call center. I was working evening shifts and did a lot of healing being on the other side, being able to walk people through suicidal thoughts using my training—and also using the little that I learned about myself. Actually, working in the call center really helped me to kind of figure out why I did what I did, ‘cause there wasn’t a whole lot of reflection [before]. It was just lots of reacting to whatever was happening before that caused that.
I ended up being promoted to supervisor two years ago, which was pretty cool. I did that, not necessarily because I wanted to supervise people doing the work, but because I wanted to oversee the operations of the crisis line. I felt like being young and excited and passionate about that could really help our services because I think a lot of people sometimes accidentally fall into this work, for whatever reason. It doesn’t happen too often, but I did see that happen.
I’ve been doing that and I also started facilitating the support group for survivors of suicide one year into my employment at the call center. That really helped me, more than anything, with my own thoughts. I have to say, I’m hearing myself, and it sounds like I do this work for me. And I do, a little bit. I do it to help other people, but I think I’m just surprised at how much I’ve gotten out of it too, because I wasn’t really expecting that. Sitting in a support group and hearing family members talk about the effects, that's something that I was aware of when I was suicidal, but not really.
When you’re going through that, you’re aware of it, but at the same time you’re thinking, ‘They’re better off. I’m a burden. Who wants to deal with someone who’s chronically suicidal?’
The support group ended up being really helpful and allowed me to get a different perspective on suicide that I really hadn’t thought of... Working in the call center has done more than I realized for me and my healing.
I ended up coming out about my history when I had the opportunity to facilitate the attempt survivor group. I wanted to do it in the community as a volunteer thing. My supervisor had spoken with the CEO, trying to figure out how [we could] collaborate.
Then I got pulled aside and they were like, “This is not an age thing. We just don’t feel like you have enough life experience to work with this population.”
I just couldn’t be quiet at that point. I was like, “Well, let me tell you. That’s actually so far from the truth,” and went on to tell them that I have a history of multiple attempts and, in fact, that’s why I worked there, and I think that’s why I’m a little good at this.
I had such a supportive reaction, which was great because it could have gone either way. So that was really good, and from then on, I’ve used my story and call center training and overall suicide prevention training. [If I'm facilitating a training and it's relevant, I will share some of my story], because it tends to open people up, like, ‘Oh, our trainer has that history so I can ask questions that maybe I wouldn’t normally ask because they have that experience.’
I still struggle with thoughts. I got divorced six months ago from the guy who ended up doing all of that. Of course, divorce happens for more than one reason (like suicide). The big thing was, for me, why I wanted to leave was the lack of understanding about my mental health and having that constantly thrown in my face. In the end, he ended up threatening to kill himself when I wanted to leave. The difference is that, when you do that, that’s domestic violence. It’s the power and control wheel.
When I wanted to call the police, he said, “Well, if you do that, it’s gonna be my word against yours. You’re the one with the mental health background, so who do you think they’re gonna believe?”
That’s when I was like, “I’m done. I’m not gonna be married to somebody who does that. It's five years out from my attempt. If you're still gonna hold this stuff over my head, this is it."
I thought maybe over the years there would be more understanding since I was working in the field, but there wasn’t. It actually ended up being regressive more than anything, so I got out of that for that reason. But during that whole time, I was really suicidal because again, I felt trapped. I was in a marriage that obviously it takes...you can’t just walk away from it. There’s a process. When I tried to leave, my history was thrown in my face and so it was, again, just a trapped, hopeless feeling.
I, luckily, did not engage in suicide behaviors. Looking back on a year ago, I really should have been hospitalized. Even if I wasn’t planning my suicide or trying to kill myself, I was thinking about it often. The fact that I almost died from my last attempt has been a deterrent for me. That sucked. I survived that, and that was unfortunate to go through, being involuntarily committed as an adult. That had never happened before. I think that’s what really kept me safe.
My sister, who also is a suicide attempt survivor, lives with me. It was really helpful to have somebody else right there during the worst of it who I could be very frank with.
I could say, “I’m suicidal.”
If I ever said that to anybody else, it would be like, “Oh my god.”
[With my sister], I’m like, “I’m okay, I’m gonna keep myself safe, but I’m suicidal. That’s how it is.”
I think it’s something I’m always gonna have thoughts of, and through lots of therapy this last year, I learned that it comes from anxiety, not depression so much. I think the hopelessness is depression, but I’m a very anxious person and my anxiety is highest when I’m feeling trapped and hopeless and stuck in my situation. When I’m anxious, that tends to be when it comes out, so it’s just kind of maintaining that anxiety more than anything.
I’m hoping that, with finishing my master’s, I can be more on the front line with it. Right now, because I’m supervisor—which I love—I’m a little bit more removed than I want to be long-term. I’m hoping that, once I get my master’s, I can start being on the front end of it again, face to face or wherever it takes me.
Des: Would be the best way to try to get the community at large to learn about suicide prevention? How can we implement something so that people are knowledgeable?
Samantha: I think some of the smaller steps, the easier steps, are providing opportunities to learn about it, like training. In Tennessee, we have conferences about suicide, specifically tailored for Tennessee and the resources that are available there. We just had one in late March. [We should be] offering that to the community at a low cost or free so it’s accessible for the people who need it—QPR, ASIST, any kind of training. Most of the time, mental health professionals are the ones that go to that, but if you can, market it in a way that this is helpful for anybody, the way QPR does. This goes from the doctor to the janitor. Everyone, at some point in their life, is going to interact with someone who has thoughts of suicide. If you feel confident in handling that, even if it's just a little bit, even if you're not an expert, that makes you a better person to intervene.
When it comes to media, if we’re gonna talk about it in a show, [we need to provide resources]. I don’t know if you watch the show Nashville. I do, because I live there and it’s interesting. They had a suicide storyline for a couple of the episodes several months ago and then, at the end of the show, they wouldn’t advertise the hotline. That’s a mistake. You can’t bring up this content and then not show that number.
Everyone’s like, "If you watch Law and Order, they cover a different problem every week and they often don’t advertise lines..."
But this is life or death. This is actually life or death, and it’s the hands of the person who is experiencing these thoughts. We should provide multiple numbers.
Glee did it a couple of seasons ago and I was so impressed with that. They did the Trevor Project and then the National Suicide Prevention Lifeline. I thought that was really great. Nashville did not, and I was really disappointed because, you know, I’m watching the show and getting all geeky. I’m like, ‘If this guy was actually in real life, he’d be calling our crisis line if he had known about it.’ But they’re not advertising it.
I know it’s hard, because everyone’s gotta poke fun at something. I think suicide gets a lot of comedy, and I’m always really torn about it because I have a very sick and twisted sense of humor. I often laugh at the things most people will not, but I think making a joke about something that is killing more people than most things that could—they were just saying earlier that suicide kills more people than homicide and HIV combined—but again, it’s at the hands of the person who is feeling that way. I think we need to be careful about how we joke about suicide and mental health because people are already reluctant to come out and do that without feeling like that’s not gonna be okay for them to do.
I will tell you this. I was told at work just this week that, sometimes, my passion for suicide gets in the way of the big picture of the work.
Des: What does that even mean?
Sam: I know. I’m like, "What’s the big picture? Saving lives? What?"
Des: My passion for trying to kill myself?
My response was, “Well, you know what? When I decided to be open about this three years ago, I knew that that left me up for criticism. That can be used as a reason why maybe I didn’t make a decision that others would agree with.
[They might think,] ‘Well, it’s because she’s got this experience and it’s too personal to her.’
And that’s what I said. I was like, "This is why people don’t talk about it. Now, because I have, that’s left me up as an open target for [questioning]..."
Of course, there were no examples to follow it up, so I actually really have no idea what they were trying to say with that.
Des: That’s helpful.
Sam: [The person who said this to me was] no one who actually works in our crisis center program. They were more administrative.
But I [just told my supervisor] today, “I’m so glad I’m coming to this conference after this remark was made to me because I’m gonna hear everything contradicting that statement because I walked away going, ‘God, was it a mistake for me to share this?’ Like, I thought it was-like, so far it’s been a good thing and it’s not like, you know, it’s impacting my work in the sense that I can’t do my job because I’m suicidal today. That has never really been a problem except for that, like, one week where I was going through my order of protection and divorce and all of that. Like, that was when I, like, couldn’t work but I think that would be like that in any place of employment. So, yeah.
Des: What do you do if you’re worried about somebody being suicidal?
Sam: Well, I would ask questions that explore the things that make you think that someone might be suicidal. If you see some warning signs, ask about them. Instead of just taking them for where they’re at, explore whatever invitations they’re offering, like preparatory behaviors or saying things that are kind of vague that would allude to thoughts of suicide. One of the more important things is to then ask about it, and ask in a very clear, direct, nonjudgmental way.
Don’t say something like, “You’re not thinking of killing yourself, are you?”
When I went to go get help last year, to get an antidepressant, my doctor said, “Are you suicidal?”
I said, “Yep.”
She said, “Well, do you have a plan? ‘Cause if you do, I’m gonna have to hospitalize you.”
It was like, "Well, that’s a loaded question. I feel like you kind of set that up for me to say no, so no, I don’t have a plan..."
Ask in a way that allows someone to feel like they can actually answer you in an honest way and do it confidently too. If you ask in a way where it's clear that you’re scared, they’re gonna be scared to give you the answer and wonder how you’re gonna respond. If there’s no question at this point that, yes, we’re talking about suicide, [the person is] suicidal, you want to persuade them to get help, and [start to talk through how you might help keep them safe]. It doesn’t have to be long-term safety. I think that’s where a lot of people get stuck.
They’re like, “Oh, but they don’t know about next week.”
Don’t worry about next week. Worry about 24 hours. That’s probably easier for me to say because I’m in a crisis center. We do triage. We’re not long-term care. I work really well in that kind of a setting. You just deal with right now. What can we do for 24 to 48 hours? What’s realistic for this window to keep someone safe? Because, again, time can make a difference. I hate the phrase, “It gets better,” because I think that’s very misleading...
I’ve been through way more difficult shit this last year than I really ever have in my whole life, but I didn’t attempt, and it’s not because I got better. It’s because I was able to learn about my thoughts and figure out a way to cope, and also lots of trial and error and learning. You know, 'Maybe I don’t want to do that because I did almost succeed, and that kind of sucked.'
Des: Is suicide still an option for you?
Sam: I think suicide will always be an option because I’m a person and I have the right to choose that. Will I choose it? No. I try so hard not to [think in terms of] black or white. I think I will always experience thoughts of suicide. I don't think I will engage in those behaviors because talking about my experience has been a buffer for me. It acts as a buffer because—I think this also played a role in why I didn’t engage in behaviors [the last time I felt suicidal]—I felt like a hypocrite, which sucked because it wasn’t a happy place to be in during the time.
I was like, ‘God, I’m talking about my story and now I’m feeling this way. I’m a hypocrite.’
[Another thing that kept me from doing it is that] I knew that some people got something from my story and I didn’t want to be like, “Look, there’s no hope because even I did it.”
I think that that helps, and I think knowing the impact that it had on someone helps, too. My sister, who I’ve mentioned a couple of times, her attempts happened after my last attempt. It turned out—I didn’t know this until a couple years ago—that her most lethal attempt was identical to mine. My parents didn’t tell me this. I did not know that she was also in the ICU for three days and it nearly killed her and all of that... I know that that would kill me.
So now, she and I are both very open about our history. We both got a suicide awareness tattoo on our back and we have all our sisters' initials outlined in it, because we ended up being our reasons to live. We’re our support system. We’re all very open.
It's like, “You cannot do that because it will kill me. I won’t survive that. I won’t survive that.”
That’s the one instance where we’ve all been like, “If you do that, you realize you’re gonna take me with you? That’s just what’s gonna happen.”
That’s also been a nice preventative thing for us and so I don’t think I will. Again, I think I’ll have thoughts of suicide for the rest of my life, but I don’t think I will engage in that anymore.
Editor's note: A week after our interview, Samantha was let go from her position at the call center. She is now employed with the Tennessee Suicide Prevention Network.
In April 2014, for the first time in their 47 year history, the American Association of Suicidology (AAS) created an organizational division for attempt survivors and others with lived experience of suicidal thoughts and actions. At the conference that week, Samantha, Craig Miller, Misha Kessler, and myself each shared our stories for a panel entitled, "Can You Hear Me Now? New Voices of Suicide Attempt Survivors." This was lauded as a groundbreaking event in the field. The following Monday, the New York Times published an article about the new division at AAS. Watch the video of our presentation below.
If you’re feeling suicidal, please talk to somebody. You can reach the National Suicide Prevention Lifeline at 1-800-273-8255. If you don't like the phone, check out Lifeline Crisis Chat or Crisis Text Line. If you're not in the U.S., click here for a link to crisis centers around the world.
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