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Sarah Couch

is a suicide attempt survivor.
this is her story

Sarah Couch

is a suicide attempt survivor.

"I survived a suicide attempt."

Sarah Couch is a social worker in Albuquerque, New Mexico. She was 36 when I interviewed her on October 8, 2014.

I tried to kill myself when I was 16, so it’s been 20 years. 20 years last month. Damn.

I never thought I’d live to 30, let alone 36. It’s sort of crazy, and I never thought I’d be a social worker, and I never thought I would have chickens.

…When I was an adolescent, I was super good, a super good kid—sort of the traditional story with that: I got straight A’s and everything was great and I was super smart and adults loved me. I was very mature for my age, and when I was about 11, I started smoking cigarettes and hanging out with the creative crowd. A few years later, I started smoking pot, dabbling a little bit in drug use.

I had always been very adamant that I was against drug use and alcohol—just really against anything that wasn’t authentic—mostly because I come from a family where my dad is an alcoholic, and there’s extensive substance use around my family tree. I didn’t want to be like that. So, when I started dabbling a little bit, things got a little uncomfortable for me because that wasn’t who I wanted to be. Then, in my family, I was pretty quickly identified as “the problem” because I was the one asking for help, so I had gone to a school counselor. I was, I think, thirteen, and it was the end of eighth grade, and my mom started questioning my drug use.

I was like, “I’m not using drugs. Fuck you. I’m moving,” so I moved in with my dad who lived in California and was a significant alcoholic drinker and still is. It was a completely different dynamic, and I was so lonely. I didn’t have anybody. I made some friends and things were okay, but we moved back, I guess, nine months later…

I was using drugs. I was starting to feel like I wasn’t okay with that, and then my brother tried to kill himself, so we moved back here. My dad got a job out here, and things were so shaky for me. I think now, from this many years away from it, I thought that maybe my parents could have restrained me in some way. Somebody could have said, “No, you can’t just move,” or, “No, you have to face your behavior,” but that never happened in my family.

There was never this clarity around the boundary around what was not okay, which is why I think I was so perfect, right? I was creating the structure for myself in a brain that was already feeling sort of… I’m super sensitive. I’m super smart. I think a lot. I had all these brutal, good, challenging personality traits, and nobody was restricting that in any way. Nobody was creating this box for me, and so, in my attempt to do that, I spun out and started going in the other direction, but was never comfortable with that. That was never really my identity, and so we moved back here, and I started seeking out support, seeking out help.

[Part of] the process of that was saying, “Yes, I’m using drugs,” and I wouldn’t say I was using crazy drugs. I was smoking pot. I was doing acid. I was drinking and I was taking pills, but I wasn’t using anything that one might consider super heavy or hardcore. But I was using a lot and with the intent of not having to deal with whatever I was feeling. So, when I started seeking out help, I was bringing in this story about like, “My dad’s an alcoholic.” He had just got divorced again from his third wife, so he was now dating, and I was living with him, and I’d never lived with him—just with him. So, when I started seeking out support and saying these things, there was a lot of resistance from my family, so instead of, “Let’s sit down and deal with it,” I became the bad one.


I became the bad kid and the problem in the family, and I went to a school counselor and asked for help, and they told me that I didn’t really need help: “You don’t have problems. You get really good grades and you have friends. Everything’s okay.”

Really invalidating for somebody who’s saying, “I’m using drugs, and I need some help, and things don’t feel okay,” but she did give me a referral. There was a school that was for kids who were using or drinking and who had some challenges, and so I went there. In some ways, it was like a residential treatment center that you left at night, which made it really good and also made it a place of great learning, where you could learn a lot of different ways to cope in the world that maybe weren’t super healthy. I think I started to see sort of a different extreme from people and sort of covet that, in some ways. I wanted to be able to not be so rigid and to be able to express my despair in a way that people would see it and that it would get noticed. Never suicidal, though. Never wanted to kill myself. Always very much loved being alive, and felt connected to people, and just felt like I was struggling.

The whole point [of going to this school] is abstinence and then recovery, and so I quit using and drinking and immediately was not okay. Whatever it was that I was running from started to present itself at night in my thoughts, and there was some sexual abuse history and then this pattern of feeling kind of out, like, not with the crowd and different than other people. Even then, I don’t remember thinking, “I really want to die,” but I remember feeling like, “I’m not safe.”

It was in October. It was the very beginning of October. I got hospitalized. So the first time I got hospitalized, I hadn’t done anything. I had said that I wanted to hurt myself, that I wanted to die. At the time—this was the ‘90s—there was a bigger response, so we had more in the system. Even then, it was not good, but there was more available for people who had mental health needs. Even now, I know that I was super not okay, but what I don’t know is to what extent—I don’t know exactly how it got all constructed in this way, but for whatever reason, I wasn’t feeling good.

I went to the hospital for like three days, and my roommate told me she was going to kill me and make it look like I’d killed myself. I was terrified.

I was like, “I need out of here.” Because of the joint custody laws in New Mexico, my dad said, “Okay,” and my mom said, “No,” and so it began to be this triangulation that I was able to get different needs met by playing in different ways off their relationship and its dysfunction. My dad came and got me out, and they told me at school that I had to go to a psychiatrist if I was going to come back to school.

I feel like going to a psychiatrist is where things actually got worse for me. They put me on Prozac, and this was before there was a black box warning label. This was before there had been this pattern identified that, when you put young people on SSRIs, they sometimes get activated to a different level that they hadn’t been before. Originally, the standard dose for Prozac is 10-20mg. They told me it wasn’t working, and so they kept upping it, and I was on 80mg of Prozac, which is a lot.

I got a little impulsive on that much serotonin, and my behaviors significantly changed. I’m such a scripted—and I try not to call myself rigid—but I’m sort of rigid in my patterns, and I want things to feel predictable and safe, and I was suddenly doing crazy shit. A friend and I, one night, we’re like, “Let’s move to Utah,” so we drove, made it to Winslow. We didn’t have any money. Things like that, where I was suddenly engaging in these behaviors that were not who I was.

Instead of saying, “Wow, we just put you on all of this crazy psychoactive medication,” they say, “Oh, this is clear that you’re so mentally ill.” Then they started adding drugs, and my family—I don’t know that they supported it or liked it, but at the same time, they weren’t going to challenge it or question it. So I was on a lot of Prozac for a while and not doing well.

I started cutting on myself pretty shortly thereafter, with the intent that I wanted to stay alive. I was starting to have… not so much suicidal ideation as thinking of suicide as an option. I wasn’t thinking about killing myself, but I was just starting to say, “Things are so horrible. I don’t know what to do, and I don’t know how to feel better,” and so this became an option for me. And I was struggling against it. I didn’t feel like that’s who I was at all, so I was fighting it as much as I could. I had a great therapist at the time and was really working on [the question of], “How do you stay alive?” For me, that was: “Well, sometimes you hurt yourself, and that’s a lesser evil until you can figure out how to cope with whatever you need to cope with.”

That went on for like six months, maybe, and it was hell. It was horrible. I couldn’t sleep, and they changed my diagnosis from depression to bipolar and who knows what else. I’ve had everything. I’ve been diagnosed with everything.

That summer, my dad had gotten married again, and then we were going on a family road trip. I was like, “I’ll go, but I can’t see this person that I have this abuse history with.”

“Oh, no, no, no. We won’t make you.”

And then they did. So, for me, in my memory and in my journal, that was really the tipping point: feeling like I was using my voice and that I wasn’t getting listened to. I’m saying, “Something’s not right. I feel like I can’t sleep. I’m fast all the time. Everything feels shitty,” and instead of people addressing that, they just said, “Well, it’s so clear that you’re crazy, and it’s so clear that you’re mentally ill, and this is all about you.” That’s a really good way to destroy somebody’s self-esteem and make somebody feel very lonely.

When I ended up seeing this person [I had the abuse history with], I just sort of lost it. For the next—I don’t know—two to four months, I was just really not okay. People would notice.

People would say, “Wow, you seem really unsettled.”

My friends would say, “You’re doing weird things, or you’re saying weird things, or you’re not hanging out with us,” but nobody else did anything.

I went to the hospital again that summer. We got back from that road trip, I think, in June or July, and I went to the hospital pretty soon thereafter for cutting, for self-injury, and then was in and out several times that summer. There was no change. They added more meds, so I was on all kinds of meds. I don’t even know. I think they added lithium. I was on Prozac, and I was on clonidine for anxiety and Vistaril for anxiety, and they finally tried to put me on an anti-psychotic because I had a nightmare one night and they told me it was psychosis.

I was a compliant and dutiful patient. I did my best. I wanted to get better, so I took everything they told me to take. And I just kept spinning, like in this vortex. That fall, it was September, I had been in the hospital all summer—I think I was in four times or something throughout the summer—and then my insurance ran out.

I said, “Don’t let me out. Don’t let me out.”

They said, “Well, your insurance is up, right?” Because that is what’s most critical. So they sent me to another hospital where my parents would end up having a bill—that I later got written off for them, by the way. But they had a bill and said we were just going to self-pay, and [the hospital] ended up committing me. They took me to a commitment hearing. I was 16 and it was one of the most sort of dehumanizing and silencing experiences of my life. Nobody asked me my thoughts. Nobody asked me my opinion. Nobody asked me what was or wasn’t working. The system had decided that I was crazy and that I needed residential treatment, and they committed me for six months, which they can’t do now. But at the time, you could be committed to these lower level treatment centers where you would just live there for six months, and I didn’t like that idea.

I was there to solve problems and to help people and to be available, but then I was “the crazy one.”

I feel like that’s when things started spinning more for me—noticing and realizing that nobody was going to listen to me, and that it didn’t matter how crazy I got, that nothing was changing, despite my best efforts, and that my family had pushed me at a distance and then, at the same time, grabbed on. I was there to solve problems and to help people and to be available, but then I was “the crazy one.” So I became the loner scapegoat, I guess.

Now that I’d been in the hospital, my friends were sort of freaking out. I had the resistance group. They were like, “No, we’re going to get you out of there” and then the group that was pushing away, going, “We don’t know what’s going on with you, but this is too much for us.”

So I decided I was going to kill myself, and I meant it. It’s the only time. I’ve overdosed in my life twice, but only once was with the intent to kill myself. I’ve cut on myself a lot, but never with the intent to die. This was the one time in my life where suicide was the answer, and I planned it. Again, because of my ability to work a system, I was discharged from the hospital to await placement in this residential treatment center at a shelter. They discharged me with a bunch of meds, and so I took them.

I had them, and when I got to the shelter, they were like, “We’re going to search your bag. Do you have any contraband?”

I’m like, “What’s contraband?” They explained that it was weapons or drugs, and I was like, “No, no. I don’t have any of that,” so they didn’t search my bags.

I’m not blaming the system. I mean, I blame the system for everything, but in that instance, there’s all these things that adults could do differently along the way to help young people. There’s all these different accountability steps that could be taken to help people feel more safe and secure, and it’s just like, all those corners, cutting those corners. That always happened with me because I’m so presentable, and I absolutely used that to my advantage many times. That time, it almost killed me because the system didn’t follow their own policy and procedure.

So I go in and I wrote suicide letters, and I had the day staff take them with her and mail them, and she didn’t know. Nobody asked. I think that one of the things I’ve noticed in my life too, with people I work with or just in general, is there’s so many things leading up to somebody’s final moment of desperation. There’s so many opportunities to step in and to show up, and nobody really did that. That’s hard. I mean, that sucks. So, I had set it up beautifully, right?

I was like, “I can’t have men checking on me.”

I had all of these things in place for myself so that I would be able to kill myself without anybody really interfering, and then I went into my room and I was ready and I had this whole plan. I was ready to do it. I was ready to go, and I looked down and there was a bus token on the floor. I still have it. I still have a bus token because, in my head, it was like, “This is your ticket. This is the way. This is how you’re going to pay to get there,” and I had this real big metaphor around that.

I went in, into the bathroom, and took all these pills. Once the decision was made, I was so on it.

I was like, “I’m doing this,” and I was gagging because they were caking in my throat, and I was trying to drink water. At the same time, I was trying to break this mirror because I was just stewing and everything. I was angry and I was scared and I was sad, and I was just done. I was so done. This was in September, and it was during the state fair, and this building was right across from the state fair. It was cloudy outside. We get these monsoon storms in the late summer and early fall, and so that whole scene is still in my head.

We just passed that time, so my anniversary is always the smells of the fair and the clouds. This whole time of year for me is a lot of reflection around that moment, where I’m in this room and there’s a bus token. I always see that, and I still have that. I think I hung onto it because it just seemed relevant. I guess because I lived, and I thought, “Maybe this was my token to hell,” or whatever. But I decided that maybe it means something different, so it’s actually turned into a metaphor of how I still stay alive—but that’s another story.

So I was gagging and all this stuff. After I took all the pills, I had this moment where I was like, “I don’t want this agency to lose their funding.” I was so naïve. I was so, so naïve. I was like, “I don’t want them to get in trouble for this,” because even in this moment, the worst moment I’ve ever had, I’m going, “But what about all these other people?”

I waited 15 minutes. I asked to go smoke a cigarette, and when I started to feel the effects, I told them. Thinking, even knowing, that it was enough and that at least I wouldn’t die there. They freaked out, as any agency charged with the care of young people is wont to do when somebody tries to kill themselves, and they called the hospital or 911, and they came and lectured me. I don’t remember very much past this point, but I remember that the cops were lecturing me and telling me that it’s against the law to kill myself and did I know that? I don’t care, right? Too late. That clearly wasn’t going to be the thing that kept me from going over the edge.

I got into the ambulance. I wouldn’t lay down for them. I was like, “No,” and I was scratching myself and trying to wound myself. I was just so desperate, They took me to the hospital and I got out of the ambulance and just collapsed, and I remember very few things after that. I remember not very much at all. I know that I was funny. I remember people laughing a lot. That’s still one of the things I do. When things get very stressful, I get funny. So they were laughing at me, and I know that they were making me throw up.

I know my mom was there, and I felt so horrible that I didn’t feel like it was right that she was there when I came into the world and that she had to be there when I left, so I think, at some point, I kind of said, “Can she go?” Then she came back later, and I don’t remember that.

I was very out of it, and then I had sort of—I don’t know what the hell to call it—but being, I guess, almost dead is sort of surreal. Unless you’ve been there, I don’t really know how to describe it, but there were moments of comfort even in that. I chose to stay, I guess. Not consciously, I don’t think, but there were things that happened that felt sort of warm and safe, and I guess I lived. I did wake up. I woke up the next day, and I didn’t know if I was alive, which is the most terrifying feeling ever, to know that you have tried to kill yourself and to think that you are dead and to wake up in the reality of the hospital—I was in the medical hospital—and to not know whether or not it worked. Yeah, that was not that fun. When I realized that I was still alive, I didn’t really know what to do.

I made a promise at that moment. I was like, “Okay, you lived. That was your opportunity. You got to fucking figure this shit out. There’s a purpose. There’s something.” I’m nothing if not tenacious, and so, in that moment, I was like, “You’re not doing that again. It didn’t work. There’s a reason.” They had told me I took enough to kill like an elephant. They said that there’s not really a reason why I didn’t die, other than I didn’t die.

I was on one of those units with the things on your heart, and they came in and did a psych eval and decided I was highly suicidal. I don’t know what gave that away! Surprise, you’re suicidal!

Except that I wasn’t anymore. But that would take them like a year to realize.

I was committed. Not committed. I was placed on a hold, on a safety hold in the hospital. They took me over there, and it was sort of indefinite. They were just going to keep me there until they figured out what they were going to do with me now that I had manipulated all of them. That’s what they said. And I’m not stable. I wasn’t stable enough for therapy, so I didn’t get any therapy. I didn’t get any programming at this hospital. They just really treated me like I was shit because I had overdosed, even though I had told them.

Before I left the hospital, I told them I was going to kill myself, and they told me I just wanted attention, which is sort of the theme in my life. People are like, “You just want attention.”

I’m going, “Well, fucking give me some, then. We’ll see if things change.”

After that, I was there for a month, and then they transferred me to the state psychiatric hospital, which had an adolescent unit. I was there for three months, and then I was in a residential treatment center for another month, and then I signed out AMA—against medical advice. Well, my dad signed me out.

I was 16. After they had added all these medications, I had gained like 90 pounds or something. 16 years old and I was probably weighing close to 250 pounds. I just got bigger and bigger and bigger, which the system told me was also my fault, and that I would have to take these medications forever because I was so mentally ill. And I accepted that. I accepted everything they told me in the system about myself and about who I am and who I could be. I took it, and I believed them, and I put so much power into the mental health system at the expense of myself, at the expense of who I was or who I could have been. That was hard because I was so young, and for the next ten years of my life, I lived that life.

I got out of the hospital, and I went to school, and I graduated. I graduated early, even though I’d been in the hospital on and off for a year. I got really secretive about behaviors, about self-destructive behaviors. I still cut for years after that, but I just didn’t tell anybody. If I didn’t feel okay, I didn’t really tell anybody. I went to therapy, and I went to the psychiatrist, and I got on disability. I got on welfare, and I got on Section 8 housing. I really was prepared to live this life as somebody who’s seriously mentally ill, and I missed out on these huge developmental areas of my life.

I did go to college for a little bit, and I never felt like—I didn’t really know what it was I wanted to do. I’d always wanted to be a therapist when I was younger, but I figured now that I was so crazy, that wasn’t going to be the best idea. I had almost no aspirations, except writing. Writing really saved me, and I would write a lot. I would journal every day. I volunteered. I coached soccer and Girl Scouts and my little cousins. I was their person, and I was engaged in things, but mostly I was very isolated. I lived at home alone and didn’t engage a whole lot with other people and didn’t have really any hope for my future, but I wasn’t going to kill myself. I was going to live this life, the hand that I had been dealt, and that was okay. Until it wasn’t.

I sort of started having this thought like, “I need to move away. I need to get away.” I felt really trapped in this sort of mediocre life and trapped in the mental health system but also knowing I needed it. So I started to think that I could leave, and that was probably the first time in a long time that I had grabbed onto this idea that I could. I mean, I had done things. I don’t want to make it sound like [I didn’t]. I worked at summer camp, and I used to travel some, but I wasn’t doing much.

In 2003, my grandma died, and she did have serious mental illness, and nobody was helping out. Nobody went out.  I decided I needed to move. I spent some time figuring out how I was going to do that, and then in the interim, my grandpa on the other side died, so it was like a double blow. I went out to California, and while I was there, it was in Sonoma County, which is where I was born. I moved, sight unseen, to this 240 square foot cabin in the middle of the Redwoods, the Russian River Valley. It was amazing. In so many ways. It was amazing because it was the first time I had this sort of away experience where I was totally alone. I didn’t just feel alone, but I was alone. I met a few people. I volunteered at the Chamber of Commerce, and I got a psychiatrist and I got a therapist because those are the things I’m supposed to do. Kept taking my meds, but it was a desperate sort of place because it was so, so lonely and isolated and rural, and there wasn’t a whole lot going on. It’s sort of a town for mental health issues and serious drug addiction, like meth. It was a sad place but a beautiful place, and so I did well there. I did okay.

Then my stepsister died, and that was the third death in a year, and that sort of shook me up. She was older than me by—I don’t know—nine or ten years, eight years, and she and I were very close. She had been addicted to all kinds of drugs and was a prostitute, and she ended up walking into a hospital. They didn’t do anything because she had been there a lot and had an aneurysm and died.

That was the final straw, I guess. I started to feel this level of unease again, and I use a lot of metaphor, but it just sort of creeps in. It’s like, if you’re not constantly on your thoughts, they creep in and they can get so dark so quick. So I started to have the darkness again, and the darkness with this level of anxiety that’s—I don’t really know how to describe it. It’s like this undercurrent. It’s this sense of, “Things aren’t okay. I’m not okay. Things aren’t okay. I’m not okay.” It sort of speeds up, almost. It’s not a real voice. It’s this feeling, so I started to feel that again.

I was in a little two stoplight town, and somebody was kidnapped. There’s no crime there, except for drug crime and some property crime. So somebody’s kidnapped, and they started to find pieces of the body in the river that flowed 200 feet from my little cabin. And I just couldn’t do it anymore. I was then super anxious, and now the darkness is overtaking me, so I started to have really not good thoughts again. I started cutting again. I had on and off for years, had cut and then not, and then cut and then not. I started cutting again and decided I need to come back to Albuquerque.

I’m a story person, so people tell me their stories very often.

I made plans to do that, and I made some poor choices in that planning around who would be with me and my ability to manage relationships. I ended up driving back with somebody who probably wasn’t the healthiest choice for me, and felt even more disempowered through that experience. While driving back, saw a wreck. This car changed lanes and they had a trailer on the back, like a little RV, and as they changed lanes, they started to sway and they jackknifed off the road. I’m already in this elevated state where the world is not safe, so I was like, “Pull over! Pull over! Pull over!” We pulled over, and I went and talked to this person. I’m a story person, so people tell me their stories very often.

This man had been married for a million years. I don’t know. They’d just broken up, and he didn’t know what to do, so he got this little trailer and was driving across the country and trying to figure out where to land and jackknifes off the road on I-40. People are driving over his stuff; his clothes are in the road and papers. I couldn’t take the cruelty of the world, so I called AAA, and they came and helped him. Just as an aside, his wife sent me a note and said that they got back together because of that and thanked me for helping him. But it was one of those moments where the world is so cold and so callous, and people are so isolated and selfish, I guess. That was another sort of breaking point, that trip, and I got back here and, again, didn’t feel safe.

I would say I was probably suicidal, but because I was so clear with myself that I wasn’t going to do that again, I didn’t know what else to do. I went to the hospital, and I had never been in the hospital as a grown-up, and it was horrible. It was also the only place that they can keep you safe, so I went there. I was cutting on myself a lot again. A lot. They kept me and then, while I was in the hospital, I fell off a chair and broke my foot and was denied medical care.

They had me on nine different medications. I probably have a list of them somewhere because I carry them around to remember. They had me on atypical antipsychotics and anti-anxieties and thyroid medicine, even though I didn’t have a thyroid problem—because it could work. It might help. They had me on, I think, lithium, anti-depressants, two or three of them. I was on all these meds. I was taking a handful a day, and it was a weekend at the hospital and I was helping. I was organizing activities because it’s so boring in the psych ward, so we had made quotes, positive quotes, and were putting them on the wall. I was taping them up, and I fell off this chair. I got up. “Oh, no, no, I’m fine,” but I’m limping, and I knew that my foot was broken. I went out to the nurses’ station, and they were horrible. So I went to my room and I was crying, and they came and brought me ice a little later, but they had to get orders for it. I couldn’t have ibuprofen. There was just all these rules. They didn’t x-ray it.

Then later—much later—I got my chart and read it, and they had essentially pathologized my broken foot as a mental illness. My mood had changed from I was in a good mood and I was so helpful, to being labile and depressed, but nobody ever charted that I fell off a chair. So, in my medical records, what it looked like was that I was unstable and totally crazy and just wanted attention, and yet my foot was broken. I called my nurse practitioner, and I called several people, and they started calling the hospital saying, “Can you get her an x-ray?” They finally did, and they x-rayed my ankle. Well, my ankle wasn’t broken, so then they had all this ammo to say that I was really lying. I’m like, “It’s not my ankle. It’s my foot,” so when they finally took the right x-ray, it was broken, and that was like three days later. Then they discharged me because obviously I was a problem on all these meds.

I was back pretty soon. By then, I was spinning again, and there’s this desperation. When you don’t have your own foundation of stability and you don’t have your own ability to use your voice… I could still talk, but I had this whole history of the system into my family and everybody saying, “Whatever you say doesn’t really matter,” so I didn’t use my voice to share anything that was real or my own experience because, every time I did, they told me I was wrong.

I was cutting on myself, which is a way to scream, to say, “Something’s not okay. I need help.” I was getting stitches, and again, there’s a million opportunities for people to step in. I made an appointment to get stitches the next day.

I go to get those stitches and my nurse practitioner says, “When did you make this appointment?”

I said, “Last night.”

She was livid, livid that nobody had done anything. She said, “Why would you make an appointment the night before?”

I said, “Because I knew I was going to wake up and do this. I need something.”

In that moment, she just got tears in her eyes. I had been seeing her for a lot of years. She’s like, “I just don’t understand. I don’t understand why you’re doing this.”

I said, “Well, because I believe that, even though I know it’s not true, I feel like, if you sew me up, that that’s going to mean that I’m fixable.”

She just had these tears and she said, “You’re not broken, Sarah. You’re not broken,” but I didn’t believe that because everybody else was telling me I was broken.

That was such a huge moment for me to have this realization that my behavior’s affecting other people and that my despair was affecting other people and also that she cared. She cared enough to ask because nobody ever asks, right? Nobody says, “Why are you doing that?” or “What’s going on? I know by your behavior that you’re not doing okay.” It’s always like, “You’re crazy or you’re just wanting attention.” It’s like we push the blame in another way instead of just asking. By doing that, she opened a window for me, I think.

I went back to the hospital after that because it’s really where I needed to be, for me, and it didn’t get better. I was playing this game with them or they were playing this game with me, where they were like, “You just want attention. You don’t need help.”

So I said, “No, I’m really suicidal and here’s my plan.”

They said, “Well, you’re not going to do it.”

I said, “I wouldn’t want the liability of me saying this and then leaving.”

Well, they sent me away, so I went and had behaviors that would suggest maybe I had more of an intent; however, it was not a suicide attempt. They begrudgingly, begrudgingly admitted me to the hospital and then got me out as soon as they could. That happened twice more, so I was in three times.

Then, on the fourth time, because apparently there’s a three strikes rule—three strikes at the psych ward, you’re done. They don’t tell you that. They discharged me, and I said, “Please, don’t discharge me. Do not discharge me. I cannot do it. I’m on nine medications.”

The psychiatrist at the time just looked at me and he just said, “This is it. This is your life. You just have to deal with it. You need to figure out how you’re going to deal with this. You’re severely mentally ill, and this is it.”

It was a great moment in that I knew that was a fucked up thing to say to someone. I knew that saying, “By the way, you’re hopeless,” is not really where our mental health system should have been, but that’s what he said. There was a part of me, just a small part, that almost got angry—and I didn’t get angry at other people. That was a good moment, I think, but I wasn’t ready yet.

So I came back to the hospital. Well, my psychiatrist called the hospital and said that she wanted me back in, and they said, “She’s already been here three times.”

She’s like, “What can we do?”

They said, “Well, she can come if she agrees to have shock therapy.”

I said, “I can get admitted if I agree?”

She’s like, “Yeah.”

I was like, “Fine. I agree. Whatever.” Like, whatever, just let me into the hospital. Then I get there and they put me on the geriatric unit because they said I was having too much fun on the adult unit.

Then they did all these little things like, I said, “I don’t want you checking in my clothing without me there,” so they went and checked in my clothing, wrote my name on everything without me there. There were all these little ways they were intentionally making sure I didn’t have any say in anything.

So I said, “Okay, I’m not doing that shock therapy thing unless you put me back on the adult unit.” I started just playing their game. I had known the doctor in the past because Albuquerque’s relatively small, our mental health system is super small, so I had seen her at some point. I was like, “Can you just put me back on the adult unit?” So they did. Then I said, “I’m not going to do shock. I’m not going to do it.”

They said, “Well, then, we’re going to kick you out.”

At the time, you would have to wait like six months [to get a psychiatrist]. I was on Medicaid and Medicare, and so it was an insane way to get a psychiatrist. So [my outpatient psychiatrist] said, “Well, if you don’t do the shock therapy, I’m going to fire you.”

We call that coercion, and from what I know now, obviously, it happens all the time in the mental health system, but I didn’t know that then.

So, for somebody who’s believed for ten years that my only option in life is to rely on the mental health system, it was sort of a moment where I didn’t know what to do because I didn’t want to do the shock therapy and they were telling me I didn’t have any other option. We call that coercion, and from what I know now, obviously, it happens all the time in the mental health system, but I didn’t know that then.

I agreed to do the first one, and it was horrible, and it was as traumatic and violating as one would expect it to be when they knock you out and they shock your brain and you wake up in complete and total pain and confusion. And then they deny that.

It was really not that fun, so then I did the same thing where I said, “I need out.”

They were like, “No.”

Then I told them I was religious. I needed a chaplain. I need a minister. I’m not religious, but I knew they couldn’t deny me that right, so I wrote it on every goal sheet for a week. The chaplain came to see me, and again, this amazing woman who came—and she would come two times a day, sometimes three—she was the only person who told me I had a choice. She would walk through the choice with me and say, “You might not like the consequences, but you have a choice.”

In my head, there still wasn’t really a choice because I couldn’t risk losing my psychiatrist and I couldn’t risk getting kicked out of the hospital because it wasn’t safe and I was afraid I was going to kill myself if I was on my own. I did four shock therapies. I don’t know what else to call them, shock therapies, like they’re freaking shots. I did four. I had four treatments. I didn’t want to call it treatment because it didn’t feel wellness related. It was horrible, horrible, and then I got out.

They told me I was such a “quick cure” because, after that first one, I was so terrified of it that I knew I had to do whatever I could to get out of the system. I’d been denied medical care for my broken foot, which was still broken by then. I had this doctor basically tell me that I’m completely hopeless, and I just have to accept my life, the shitty, mediocre life where I’m on disability, on housing. Shitty, right? I have to accept that, and then I get coerced into having shock therapy.

For the first time ever, I started to question the mental health system, and I questioned whether or not this was really what the intent was, or this is really what I needed.

I got out and I started seeking. I didn’t really know what I was seeking. I feel like, in the hospital, I had learned a little bit about—I could advocate for other people, but I really couldn’t say anything on behalf of myself. And I’m such a structured person that I had things in place. I had power of attorney, and I had family, and family was visiting me, but nobody was sticking up for me because the power of the system, right? In our heads, there’s so much stigma around anything mental health that it was like, “Well, we’re just going to trust them to do what they do, because she’s clearly not okay.”

The danger in that is that people like me then get really fucked by the system. Nobody’s questioning what’s happening. There’s no accountability. Whatever they write is the gospel, and so I ended up getting really screwed in that—and then seeing that happen at worse levels to other people there, so sort of from a social justice perspective, [I was] really bearing witness to this huge injustice that happens in our mental health system. I’d done it as a kid and then again as an adult and didn’t—and knew it wasn’t okay, but didn’t have any voice at that point. Couldn’t say.

I got out and just kind of carried on. I was cutting myself, and I had a case manager at that point. That was all. Now I had a case manager. I was really moving up the severely mentally ill ranks. I was getting all of these services. I got to go to “how to boil water,” “how to vacuum your house,” these psychosocial rehab classes that are designed in such a condescending way. If you’re good all week, you get to go bowling and have a piece of pizza. It was, again, like bearing witness, and I was always “the most functional” one of any group I was in. They would have us hand out our phone numbers to each other, and they’d all call me.

So I started carrying all of these different weights, and there was some good in it that I was getting out of the house more, but my case manager is the one who started asking me, “What do you want to do with your life?”

Nobody had ever asked me. Nobody had ever said, “Your life could be different than this,” and so, in my mind, there wasn’t an option. All the the hospital [staff] and everybody would be telling me, “Well, you don’t want to get better,” and I didn’t know how to articulate, “No, it’s not that I don’t want to. It’s that nobody’s ever told me that’s possible. Nobody’s ever told me it could be different. You’ve always just said I have to take medication and do this and this and this, but nobody’s ever said, ‘You can dream.'”

My case manager said that and, actually, I said, “I want to write.”

She said, “Well, you should go to school.”

I’m like, “I don’t think I should go to school. I don’t think I can,” so she just brought me the application. These little steps that I didn’t know how to take.

I said, “Well, it’s past the date of turning it in.”

She’s like, “Well, just turn it in anyhow. Doing the application is the important part. You don’t want to go.”

Well, I got into college. I already had an associates, but it wasn’t that big of a deal, apparently, and so I took a class. It’s these little, teeny things that happened that then put me on a different path.

For me, the biggest part of my story is the recovery part of it because, trying to kill yourself, it’s a moment, but it’s a moment on this foundation of hopelessness and sadness and despair and loneliness. Creating a life that has less of those things is really what’s hard. It’s why I think so many people return to this thought or this belief that suicide is the option or the answer because it’s hard to do the rest of it. It is painful and horrible sometimes, and really beautiful and amazing.

I took two classes, and that literally shifted everything because it created possibility. And when there’s possibility, there’s so much more light. Even when it’s confusing, desperate, I-don’t-know-what-choice-to-make possibility, it’s still different than no options. I will forever be indebted to that woman for telling me that there was potential. That there could be something different.

I dropped out of the psychosocial rehab group not long after. By then, I was starting to really explore the mental health system and what it was, and I started researching a little bit and looking for anything, any opportunity to learn more. At the time, they were changing legislation in New Mexico around mental health and mental healthcare, the publicly funded mental healthcare system. I read that piece of legislation. I’d never read legislation, so I didn’t really know what it was saying, but I read it.

My mom was working for a state department, and because of this new legislation, they were starting these little local groups of people who had utilized mental health services and providers and family members with the intent of shifting our system to a recovery-focused system or a strengths-based system. There was money attached to it from the feds. I was so naïve then. So naïve and hopeful. I went to a meeting and it was this first place I’d ever been where people were just talking about how fucked up the mental healthcare system was and talking about how to make it different.

I was completely silent because I had been trained to be silent about all of my opinions in the mental healthcare system. I talked under my breath a lot. I don’t know if it was my second or third meeting—I think it was my second. This lady was sitting next to me, and she says, “I’m listening to you, and you have so much to say.”

I’m like, “No, I don’t. I’m just negative.”

She’s like, “Will you email me?”

I’m like, “Why?”

She’s like, “Because I want to know what you’re thinking about all of this.”

So I did because, okay, you want to hear from me, right? I emailed her, and we emailed often for years, for several years. She worked for the state as well, but again, it’s these little moments where somebody says, “Are you okay? What are you doing? What are you saying?”

I had enough of those experiences over my first couple of years in this group that I started to believe people might want to hear what I had to say.

It was by pure chance or luck or whatever that I ended up in this group of people because they were all the people that were running the agencies that I had just been fucked by for the past ten years. One of them was the CEO of the place I was committed to when I was 16, the place where I overdosed. All those same agencies were here, and they were the people who had been there then, too. At the time I didn’t realize it, but later it was like, “What a powerful opportunity to be able to be next to those people, and then to have this whole other story and to be able to share that with them in a venue that they could hear it,” because I wasn’t their client right then, and it was in the past enough that they could—not that they looked at what they were doing and not that the system got better—but that these individual people were able to see this whole system differently based on my story.

That was really cool, and then people would say things like, “You know, your community really needs you to get a degree,” which is a great way to compel somebody to go do something if somebody doesn’t really like themselves and is committed to helping others. So I went back. Well, I stayed in school because I was already taking those two classes, so I decided to get a degree. I got a bachelor’s degree and I had this party, and everybody in the community came, and I just knew so many people by then. I became an executive director. First, I was on their steering committee and I was a chair, and then they started paying me a little bit to do the work, and so I got really surrounded by these people in a way that I don’t think I ever could really imagine.

I didn’t believe that there was anything about me that had value, and they would tell me that I had value. They would tell me that they wanted to hear me and what I wanted to say.

I had been living in my subsidized apartment for all these years and then lived in California, and I was at the height of isolation in my life. I drove myself to the hospital four times because I didn’t want to bother anybody to take me. So, to have this different experience was hard because I didn’t believe them. I didn’t believe that there was anything about me that had value, and they would tell me that I had value. They would tell me that they wanted to hear me and what I wanted to say. They would take me to lunch, and I was on disability and people would—they were so nice to me—they would buy me coffee, and this was a whole other world. I didn’t leave my house, and here I’m drinking Starbucks.

That wasn’t part of my world, and so it was hard in that it was also different, but then in some ways, it was such a hopeful time. It was this time where we believed we were changing the world. We believed that we were going to change New Mexico’s mental health system and that people were going to be treated with dignity and respect, and that people were going to get better, and that the funding was going to be reallocated to really support what people need, and that we were going to look at integrating communities and creating places in the community for people with mental health needs. It was just a really idealistic time, and I was so naïve and so passionate—so passionate about people not having to have the same experience that I had.

But about five or six years in, I started to get a little cynical, because the truth was that it wasn’t changing and that the state had spent a lot of money, a lot of federal money, and that things weren’t actually getting better. We couldn’t get data, and we couldn’t get information, really. Everything was spun in a way that made it look like things were better because we were now providing this service instead of that service. And the reality is that services do so much less than these interactions with human beings that are just authentic and real. I decided, at that time, that I was going to have to figure out how to not do so much of that.

I was advocating a lot—I was the poster child in a lot of ways. I was the poster child for mental health and mental illness, and I understand why. I’m a good token. I’m easy to talk to. I’m pretty smart. I have a lot to say. I’m authentic. I have these stories that are real. But I’m also really easy to negate because it was easy to say, “Well, you’re not like the rest of them. You’re not really as crazy as all those other people. You’re not who we’re really talking about because you’re articulate or you’re smart or you’re…” Whatever it was. I had a lot of people say that. I had people come up to me and say, “I wouldn’t have considered you as one of the mentally ill.”

I didn’t know what to say because I have this story that is like, “Yeah, well, it was my experience, and so it’s almost worse to have you then deny that.”

I still get that a lot. People say, “I don’t think you were ever mentally ill.”

I said, “Well, if I was mentally ill, then my story’s an amazing story about recovery and the power of community. And if I was never really mentally ill, then my story’s an amazing story about how a system can pay somebody every month because they’re mentally ill, can give them medical care and housing and food stamps and keep them in the shadows and mediocrity and tell them they have no hope for their life if they’re not really mentally ill. So, either way you look at it, it’s a pretty good story, right?” That usually shuts them up.

So, I was doing all this advocacy. Newspapers. I was very open about my experience and I’m not ashamed. I’m not ashamed of my story, and there’s some ability to detach from my own emotional experience of my story because I was telling it everywhere. In that process, I began to lose my voice again. What had become very empowering, and my ability to say, “I don’t have a voice and here’s my voice and here’s my story,” then sort of flipped on itself, because I was saying, “Here’s my whole story. Here’s everything about me, and let’s use it to change the world.” I didn’t ever connect with my own emotional experience around how terrifying and traumatizing these tenures of my life had been. I still really haven’t been able to go and do that because I came out of the system so angry, and I was fighting and fighting and fighting, and after I got tired of fighting, I didn’t know what else to do. And so I keep fighting because it’s easier.

In all of that, I was like, “Okay, now I’m working.” I was working a little bit. I ended up getting a job and thinking I could get off disability, and what would that mean to not to be on disability? It was terrifying. Terrifying. If I give up this label of “disabled and mentally ill,” then who am I? And I didn’t know. Fuck, I still don’t know who I am. But I have chickens!

I’d always worked with adults in this group I was running, and we had an opportunity where young people wanted to do suicide prevention work. I thought that was great. It was amazing. Good for them. Somebody from the school system was going to fund the kids to do this event, and they asked if I would help.

I’m like, “No, no. That’s not my thing. I don’t work with kids. I don’t do youth. I do grown-ups and community organizing.”

They were like, “Please? We have this funding, but we gave it to an agency and they haven’t done it. We need this to happen. The young people need to happen.”

I can’t say no, so I’m like, “Okay, I’ll come to the meeting.”

They were like, “We can’t pay you.”

I’m like, “It won’t be that hard.”

Several months later, I coordinated this massive suicide prevention event, and this year is our sixth year. Different funding now. I mean, it’s sort of a different thing, but working with young people who were sort of committed to making a difference in their world was really valuable for me. That experience and those young people made me feel needed in a different way, and made me feel a different sense of purpose, because when you’re doing advocacy work and you’re fighting and you’re fighting and you’re fighting, you can’t stop and breathe. You’re always on guard. But when you’re working with the young people, you’re sitting there and you’re watching and you’re breathing and you’re really slow, because everything is about teaching them how to have a different experience in the world and teaching them how to be leaders and teaching them how to feel empowered.

Through that process—I’m always doing something—I was always doing training, and I was building these little things, like this program stuff around, “How do we help young people who are either currently in the system or at risk of being in the system, and young people who aren’t in the system? But how do we create these venues where they understand the power dynamics that are at play in the world and they also understand how to know themselves in a way that if they, then, are disempowered throughout their experiences in the system, they are able to sort of maybe retain some of that, or at least have a foundation of, ‘Here’s who I am. Here’s what I believe in. Here’s what my values are—even knowing they can change?'”

I started doing more of that work, on really seeing prevention and suicide prevention as this broader context around connecting, and that was really good for me. That sort of catapulted me to this next level. It was valuable to me to do that, and I did that for five years, through that one funding stream, and then this year, I wasn’t going to do it. I actually gave it up, but somebody else came to me and they’re like, “Please. We need it,” so we’re doing it again, and it’s always fantastic. Working with young people is valuable.

I decided to return to my original dream for my life, and I’d always wanted to be a therapist. I felt like a). it was pragmatic. It would legitimize me in a different way in the system, in advocacy, and it would allow me to be a therapist. I wasn’t sure I wanted to, at that point, actually be a therapist, but I wanted to work in mental health in a different way. I wanted to be a professional. So I went to graduate school. Who would have thought? I went to graduate school, and I worked through graduate school. I paid everything myself. I don’t know that I slept for a while—for two years—but for me to be able to own that?

When so many people have owned so much of my life in so many different ways, for me to say, “This is for me and I’m doing this, and I’m not going to take any loans. I’m not going to owe the government. I’m going to own my education, and I’m going to own this label,” was really intentional. It was intentional for me to shift it in a way where I was empowered through the process.

And grad school, social work grad school, was hell, because you see how the people who work in the mental health system are trained, and you understand differently. It’s not a personal thing. These people aren’t necessarily bad, but we are trained through our institutions to systemically dehumanize the other, and I was the other, so I had a lot of challenges in social work school in terms of, “How do you go from being the other to this? How do you change sides? And how do you do that in a way that is authentic and real to yourself, and honors your story and your journey, but is also really mindful of this dynamic that occurs where if you share too much about yourself, people will discriminate against you, people will treat you differently?”

At first, I was really afraid. I spent a while where I didn’t tell anybody about my past, and that didn’t feel real either. I didn’t feel like that’s who I was. So much of my entire recovery story is based on sharing that part of myself and saying, “This matters. It matters that people are treated this way, and it matters that we’re doing this in our systems, and that we’re not really meeting people’s needs.” So, to then switch teams and deny that part of myself was not who I wanted to be.

I started writing again, a little. I don’t do it enough because I’m very busy, but I started writing about that collision of, “How do you be all these different labels and still just be okay with being who you are?” I’m not okay yet, but I’m working on it. So I started doing that, and—oh, I forgot a piece. I got to add that piece back in.

I got out of grad school, and I was like, “Whoa, I finished! I totally finished grad school, and I could be a therapist now, or I could do all these different things.” It paved the way for me to have a lot more flexibility in my life. I decided to do clinical work for two years and get my independent license with a clinical certification so that I would have that balance, so that I would be able to say, “Okay, this is how we can do clinical work in a way that is different,” or to see if maybe we can’t. Maybe what I believe about our mental health system is wrong, and maybe there’s only one way to do all this.

I wasn’t wrong, so I spent the next two years doing clinical work and really focusing on, “How do I work with people and not pathologize them and not label them to the extent where they take that on, and really focus on their potential and on connection and helping them feel empowered, and understanding that if you come in and you’re saying that you’re mad at this person, looking at that? Looking at the power dynamic and understanding there’s this broader context for all of it.”

I really have done that, and I don’t feel like the system supports it at all. The system I work in does not support the way that I work. They’re fine with it, but it’s not what the culture of the system supports. So I’m always the one on the outside. I saw you can do it. This ideal, this dream that we’ve been talking about, and it’s across the nation. It’s not just New Mexico. There’s been federal funds poured into this since 2001, around, “How do we change the culture of the mental health system?”

We never go back and say, “Why isn’t it changing?” Because there’s so many levels. Look at how they’re teaching people in school. Look at how deeply ingrained. Look at the cops killing people.

People have this view of what it means to have a mental health issue, or what it means to have a substance abuse issue, what it means to be suicidal, and they then discriminate and they’re prejudiced against that.

There’s all of this… I don’t want to call it “stigma” because I feel like “stigma” really targets the wrong thing. Stigma says that I have something that you’re discriminating against. Really, it’s just straight up prejudice, right? People have this view of what it means to have a mental health issue, or what it means to have a substance abuse issue, what it means to be suicidal, and they then discriminate and they’re prejudiced against that. And it’s fear based, right? I get that. Most prejudice is, and it just permeates. It permeates everything about our culture. The media. There’s federal laws that are supposed to protect people that don’t necessarily [do so]. There’s just all of these different places where you see this level of discrimination, and I will always be that person. I will always be affected by that, I think, but now I feel more stable. Not always stable, but more stable in the belief that the work I’m doing is legitimate and also that it’s valuable. It’s valuable to do it different.

Actually, I’m teaching college this semester. I have these markers for myself of like, “Okay, if you really want to make a difference, how do you do that?” One way was trying to do it different, so I’ve done that, and I’ve done my two years. Now, I recently took the yoga teacher training, so I became a yoga teacher because, for me, yoga’s one of the things that saves me. Being able to breathe and be in my body and not freak out. Now I’m using that and I’m teaching young people how to breathe. How do you get through hard moments? Well, you have to learn how to breathe. You have to learn to trust that you’re going to breathe through it, and it’s going to be okay, and that that’s not simplistic. That’s reality, right? It sounds simplistic. It sounds like it’s not as crazy as going to the ER, and [being given] some crazy downer, right? No, you’re going to learn how to be in your body, and you’re going to learn how to be with your thoughts, and you’re going to learn how to get through that. So I do that now, and I think that was not on my list, but that’s another thing I’ve added where it’s like, if I’m really going to do… I don’t want to say world changing; I’m not trying to change the world. I’m trying to have some sort of impact, and to know that there’s some reason for it all.

I lived. I freaking lived, so I have to figure out, “How do I make that count, and how do I make myself count?”

I’m not there yet. I feel like I’m doing all right with it.

…I will always question the system, and that’s part my ethical code as a social worker. It’s also part of my core values. It’s part of who I am, and that’s kind of where I’m at now, is trying to come to a place of acceptance where I will always be all of this. If I’m somebody who’s always going to question the system and push it to be better, then that’s who I am. If that means I can’t work in the system in the same way, [I’m] trying to figure out how to do my own thing because I am devalued and undervalued, I think, in a lot of ways in the mental health system, because I will always push all of us to do better, because I lived it and because I know that it’s possible. I know that it’s more important to show up for somebody in an authentic and real way than it is to do some of this other crap.

And that’s not a judgment. People think I judge a lot. I’m not judging people. I’m not judging the system. I’m saying that we all could be doing it better and that, for so many years, the narrative in my life was that I wasn’t okay and I should be doing better. It’s just flipping it on the system, and the system doesn’t like that.

Des: Talk more about why it’s important for clinician to talk about their experiences.

Sarah: This is an area that is a struggle because we are taught the clinical boundaries, and yadda yadda. I struggled with this. I don’t know that I struggled with it, but I have played with or toyed with the level of my own sharing that I do in all my venues. Because I work with young people in suicide prevention, it’s a different boundary than it is in therapy. They know more. And now I’m teaching college, and I haven’t said that much. It’s sort of always trying to figure out how, and part of it is like, knowing my story and being able to say it in a way that’s not apologetic. I don’t apologize for my experience, and I’m not asking anybody to have sympathy or to paint me as, “Oh, you poor thing.” No. That’s all of us, right? This is our world. This is the cultural norm within our society, so it happened to me, but it’s happening to other people right now. That’s not negating my own trauma from the system. I have PTSD, probably, from the system. I choose not to attach myself to any of the labels anymore. You can call me whatever you want. Whatever.

I have traumatic response from what’s happened to me in the system, and I don’t have a general rule, but I think it’s important for grown-ups to talk to young people about surviving, and as a grown-up who happens to be all of these roles, I finesse it as I need to. I think [it’s important] for young people to know that you can be 11 or 12 or 16 or 18 and feel so desperate and so alone that you want to kill yourself, and that you can live through that—live through this, right?—and that you can grow up and become the other. Or that you can grow up and have chickens, or have a garden, or write a blog, or take pictures, or do whatever it is you dream of, and that’s what you can’t imagine. You can’t imagine that you’re going to survive this moment and get through it and have this whole experience you never would have lived otherwise and that you can’t even envision yet, that we can do all the visioning exercises we want, and you cannot imagine the moments of deep suffering you will have that will be so real and so painful, but so important. And then the reverse of that: these moments of joy and enlightenment and peace and contentment.

I remember the first time I ever really felt gratitude. I didn’t feel anything for a lot of years. Nothing. Because every time I had a feeling, they told me it was wrong. The first time I felt like gratitude, it was such a small thing. I’m laying in bed, and it’s morning and the sun is shining through, and my cat’s sitting there. It was this moment. I just said, “Oh, this is gratitude. Oh, wow,” because we all think it’s bigger, right? We think that living is such a bigger, explosive experience than it really is.

So I feel like talking to young people is critical, but then from a professional perspective, talking to people who have lived it is important because it’s that piece about hope. If I did all of this and became this and then I deny my entire experience, that’s not real either. To be able to say, “Yeah, so that was what happened, and I lived through it, and what’s more important is how.” How did I live through it? Because that teaches other people how they can.

The kids I work with in therapy, I don’t talk a lot about that. I might say, “I really know how hard it can be,” but it’s not appropriate for me to share my experience in that way, and I don’t have to, because they know. Young people and people who are having challenging moments are so attuned to somebody’s authenticity that they know they I don’t have to say it, and they get a sense that I really get it. I do bring them resources… Here’s other people who have lived through it—so that they know that there are people out there.

In other realms, I have been very open about my experience, and I think that it does reduce stigma and that it helps people be able to broach the subject in a safe way. It’s funny now because I’ve been working in the community for like ten years, and so I do these presentations or I go to conferences, and I forget who knows already. I forget who was around when I was doing advocacy and who heard me give press conferences with every detail of my trauma and who knew me in grad school, where they heard less. So I never know, and there’s something good about that because I just talk about it now. I’m like, “Oh, you didn’t know that? I thought everybody knew,” so it sort of demystified it, but it has become, I think, a safe way for people to then ask more. And I’m not against answering questions.

When I talk about non-suicidal self-injury—so, cutting—I do share some of my own story because I think [it’s important] for adults to have another adult saying, “Kids can get through this and kids can be okay.” Our job, as adults, is to not shame them and invalidate them, but to acknowledge the pain. Not to say like, “Hey, you’re cutting. That’s a big deal,” but to say, “Hey, you’re hurting. That’s a big deal. Let me show up for you now, and see how can we help you hurt less,” because that’s all it is. “How can we help you feel more connected?” A lot of people choose not to talk about their personal experiences, and that’s fine too. I totally respect that.

For those of us who have gone to the other side, I think it’s important to keep the conversation going in whatever way is comfortable—and it does change from day-to-day, right?

…If I’m not willing to do that, then a). I’m denying such this huge part of myself and b). I feel like it’s unfortunate. It’s unfortunate that then I have lived this story and that this story is in my head. I envision it like it could be a lighthouse. I’m not trying to save people. I’m not going to jump into the water with you. If there’s a storm a-brewing and you’re out there floating around, I will throw you a life vest, but if you choose not to take it, then I’m going to stand here on the shore, and I’m just going to keep letting my light shine because there’s a boat beyond.

You look for those people—the people who showed up in those moments and asked a different question. The people who weren’t afraid to say, “You have a choice,” and then help you look at that.

There’s always more, and I have my lighthouses too. I think I incorporated them unintentionally because that’s how I live my life. You look for those people—the people who showed up in those moments and asked a different question. The people who weren’t afraid to say, “You have a choice,” and then help you look at that. The people who were willing to cry and say, “This is affecting me because I care about you.” Those people were my lighthouses, and they’re the people that, if they hadn’t been up there, if they hadn’t told me there could have been a different way, or that they cared, or that there were choices, then I wouldn’t be here.

The people who really save lives are the people who don’t think they are, right? They’re the people who are just showing up and showing up in a really real way, and so that’s why I try and envision my life in that way. I’m just a lighthouse, and I tell people I don’t have the answers: “You know more about your life than I will ever know, and I have a few suggestions and I have some history that allows me to believe that some of these might work, and you might not try them, and that’s okay too.”

Thanks to the New Mexico Suicide Prevention Coalition for sponsoring Sarah’s interview, and to Alison Rutledge for providing the transcription.

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About Live Through This
Live Through This is a series of portraits and true stories of suicide attempt survivors. Its mission is to change public attitudes about suicide for the better; to reduce prejudice and discrimination against attempt survivors; to provide comfort to those experiencing suicidality by letting them know that they’re not alone and tomorrow is possible; to give insight to those who have trouble understanding suicidality, and catharsis to those who have lost a loved one; and to be used as a teaching tool for clinicians in training, or anyone else who might benefit from a deeper understanding of first-person experiences with suicide.
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Please Stay
If you’re hurting, afraid, or need someone to talk to, please reach out to one of the resources below. Someone will reach back. You are so deeply valued, so incomprehensibly loved—even when you can’t feel it—and you are worth your life.
Find Help

You can reach the 988 Suicide & Crisis Lifeline by dialing 988. Trans Lifeline is at 877-565-8860 (U.S.) or 877-330-6366 (Canada). The Trevor Project is at 866-488-7386. If you’d like to talk to a peer, contains links to warmlines in every state. If you’re not in the U.S., click here for a link to crisis centers around the world. If you don’t like talking on the phone, you can reach the Crisis Text Line by texting HOME to 741-741.

NOTE: Many of these resources utilize restrictive interventions, like active rescues (wellness or welfare checks) involving law enforcement or emergency services. If this is a concern for you, you can ask if this is a possibility at any point in your conversation. Trans Lifeline does not implement restrictive interventions for suicidal people without express consent. A warmline is also less likely to do this, but you may want to double-check their policies.

Live Through This is dedicated to the lives of so many friends and family members lost to suicide over the years. If you would like to add the name of a loved one to this list, please email me.
Live Through This is dedicated to the lives of so many friends and family members lost to suicide over the years. If you would like to add the name of a loved one to this list, please email me.