Talking About Suicide

Talking with Phillip Garber and Janet Berkowitz

 August 6, 2012

I recently had the chance to sit in, long distance, on a meeting of Suicide Anonymous. The support group for people who have attempted or seriously considered suicide has grown little beyond its roots in Tennessee, but an active couple in New Jersey has created another hub and is trying to reach out to people anywhere with meetings via Skype. That’s how I listened in. I found it striking how open Phillip Garber and Janet Berkowitz can be about the work they’re doing, as 12-step groups usually keep a low profile. To them, the word needs to get out there. “Come on, guys. If we had more groups for people who are suicidal, we wouldn’t need all those groups for people who lost someone to suicide,” Janet says.

They now run three weekly meetings and plan to attend the first Suicide Anonymous national conference later this year. They also use creativity and, at times, humor to address suicide issues in the communication and consulting business they run.

I had separate conversations with Phillip and Janet and include both here, starting with Phillip:

Who are you?

My name is Phillip Garber. I’m 47 years old and I live in South Jersey. And I’m originally from New York City, born and raised in Bayside, Queens. And I’m still a Mets fan, so Phillies fans, eat your heart out.

What was your experience? What happened?

Well, I’ve suffered from depression for longer than, well, I’m willing to admit it. I didn’t realize it because I didn’t have the word “depression” in my vernacular. I did not start seeing a therapist until I started dating Janet in 2001.

People advised me to visit a therapist throughout my young adulthood, but I was resistant because my father was very anti- the psychology field. His mother was suicidal, she had schizophrenia, and he just didn’t buy into it, didn’t want to look at it, and for many years didn’t communicate with his mother. He just wanted to make believe mental illness didn’t exist. So I never treated it.

The pertinent history in suicide was, in my dreams I would dream about suicide fairly often. It was my way out. If I didn’t like the way a dream was going, and I started getting fearful, I would commit suicide in the dream, and just before I died in the dream, I would return to the waking state. I knew it would wake me up. Suicide was a way out of my dream world. Then, when things got really emotionally painful, suicide became a way out of my “real world.”

The turning point was when I was 43 and had open-heart surgery. It was really humbling in so many ways. Then there were complications after the surgery. I had to get my lungs drained of excess fluid and then, after finally leaving the hospital, I returned on a number of occasions with congestive heart failure, and I needed a lot of medical attention. At that time, I had several part-time jobs and a full-time job. I was a workaholic and still am. I realized that I was not able to work nearly as much as before the surgery, so I gave up all my part-time jobs. Even still, I found that I could only work 15 hours a week at my full-time job and it was not nearly enough for my boss. He said, “I gotta let you go.” I was left with no income, and collecting unemployment was so farcical because I knew that I was disabled.

Meanwhile, Janet had given up her job because she was in a behavioral health unit, getting ECT, or electroconvulsive therapy. So we had no income. All we had was debt, and the money we did have ran out real quick.

Being a Capricorn _ Capricorns typically focus on career and responsibility _ I took myself very seriously in my role as a financial controller. And when I lost that, I lost a piece of who I am. When my chest got broken in half by surgery _ in open heart surgery, sometimes, like in my case, they have to crack open your sternum to get access to your heart _ I felt my life was broken in half in many ways. I had deep depression. My anxiety went from 2 on a scale of 1 to 10 to about 8 on average. I was getting more phobias by the minute, thinking I was in congestive heart failure many times, when I really was not. It was a real intense time for me. I felt like I was losing my mind. My body was not working anymore. My mind was not working anymore.

That is when I began thinking about suicide. I was just really isolated, even though I was with people. It seemed like I was on this crash course for suicide and that no matter what I tried, I was always ending up with the same answer. And it seemed logical because my thinking was so distorted. I felt like a burden on everybody. My aunt, who has always been a mother to me, came from New York City and just took me back to her house, and I stayed there for two weeks while Janet was still in the hospital. She just mothered me. She was tough on me at times, but it was like she really gave me space to be who I am, and she did her best to keep me out of a behavioral health unit.

When Janet finished her stay at the behavioral health unit where she got the ECT, I went back home to be with her. I just felt so separate from her. Janet said to me, “Phil, your body is stable now. Now it is time to take care of your mind.”

Upon her suggestion, I went into a behavioral health unit, my first in-patient stay. It was just before Thanksgiving 2008. I followed up with five weeks of outpatient therapy. In the meantime, I was still having major anxiety issues. I could not even help Janet with her drama teaching jobs, like I had been doing for years. I could not even sit in a crowded restaurant. I was getting so paranoid. Also, my brain functioning was not the same. I believe it was the extraordinarily strong anesthesia that is used during open-heart surgery. To this day, I don’t think my brain functions the way it did before my heart surgery. I would say that after April of 2009, eight months after my surgery, I might have been at about 75 percent of my normal brain functioning.

About a week after I was released from the outpatient therapy, I had a psychotic episode, starving myself, not taking meds, not drinking, completely dehydrated, not sleeping. So I went to another hospital and I stayed there 11 days. That helped. I was on a mood stabilizer after that.

Even with the mood stabilizer, I began to think of suicide again, and I really wanted out. I voluntarily checked myself into another behavioral health unit in March of 2009. During that in-patient stay, I had told the psychiatrist about the strained relationship between me and my father, mainly because he would not accept my decision to be with Janet. My father never wanted anything to do with her. He saw Janet as a threat. Janet was sick and needed me to take care of her. Meanwhile, my father wanted to make sure that I would be available to take care of him. The psychiatrist promised that if we had a family meeting between me, Janet and my father, it would be fruitful. We ended up having the family meeting with the psychiatrist just before I was discharged, and Janet had to go out of her way and pick up my father from Pennsylvania. And thank God she had friends in the car to buffer her from my father. And sure enough, the loose cannon that my father was, during the meeting he said, “The main problem is her. She’s poison. My son never had a mental problem or illness until he met her.” Janet is very sensitive, and that really stuck. She had been steadily going downhill during my absence. I had been at the behavioral health unit for two and a half weeks, the longest so far. I believe that my father’s remarks about Janet sent her over the edge. So, like 10 days after I was released from that behavioral health unit, Janet went back in another behavioral health unit and had more ECT. I was like, “I’ll take care of everything.” I committed to taking over Janet’s drama teaching jobs completely impulsively.

As soon as I got out of the behavioral health unit, on March 26, 2009, I was just pushing and pushing and pushing like I always tend to do when I get out of the hospital. I finished up a lot of paperwork and got caught up on bills. I wanted to get back to work, to be able to do something to help our financial situation. Inside, I was just a mess. On April 15, 2009, I completed both my taxes and Janet’s taxes, ran up to Princeton to see her and have her sign the tax return, mailed it at the very last minute. It was also the ninth anniversary of our first date. There was no time, and neither of us were in any mood, to celebrate.

The next day, I attempted suicide. In my distorted state of mind, I truly believed that everyone would be better off without me. I blamed myself for everything! The bottom line was, I judged I was going to be a continued burden, and people might miss me, but in the long run they’d be better off without me. These were the types of lies I was telling myself. My whole life had become a mess, a failure. I was facing a second bankruptcy.

The tough part through that whole period is that I stopped feeling God’s presence. I had been a really spiritual person since at least my early twenties. I meditated often and felt God’s presence often, before my heart surgery. Now, I just couldn’t feel God. I believed that I was unworthy of God. Just after I had made my attempt, I laid on my bed and said, “God, please take me!” I was believing that God makes junk _ me _ which is another lie that I was believing.

And I don’t like to tell how I attempted suicide. One of the things we discourage in the Suicide Anonymous rooms is the methods. I will say that basically because of what I did, I was incoherent and stumbling around for nearly two days, until a friend found me. The only thing I remember is tripping and falling and breaking things and cutting myself up. Those are just a few vague memories of that time period. The weird part is, the man who found me said, “Seems like you were perfectly lucid.” He didn’t even think it was an emergency: “OK, you did this and this, but you looked fine.” He wanted to take me to a behavioral health unit. But others were there and said, “Hey, we’ve got to take him to the emergency room. There’s a suicide note.” I had written a suicide note. I said, “Please don’t blame Janet. I was really fucked up long before she came along.”

When I woke up in the hospital, I was filled even more with shame. And I was even more of a burden to everybody. Between the shame, the guilt, I was beyond depression, like I was despondent. And I was in a lot of pain, physically and emotionally.

My cousin Len called me like every day and basically stopped his life for me and came and talked to the psychiatrist, talked to my support people. I have a tremendous support system, but I felt I was not worthy and didn’t call a soul on the night I attempted suicide.  Len would call me every day, and it was a surreal scene. I would talk to him, and he’s part motivational speaker and part guru, he’s very spiritual. He’s Buddhist, and I’m more Hindu than any other religion. We were both born Jewish, that’s the funny part. He told me, “I want you to go and look in the mirror and say, ‘I love myself.'” Mind you, the bathroom door was open because I was under 24-hour watch. I could just imagine what they were thinking, “This guy just attempted suicide and was yelling in the mirror, ‘I love myself,’ what’s that about?” But it helped open me up and helped me to heal. I began to understand more and more how meaningful I was in other people’s lives. It really humbled me, filled me with gratitude.

Maybe five or six days later, I just felt God. It was the first time I got back to feeling God. I felt that God was saying to me, “Phil, you’re here for a reason, and it’s very specific. You’ll know what it is. Just be open to it.”

Months later, I began to start thinking that I really wanted to put the whole issue of suicide behind me. I wanted to move on with my life. Meanwhile, Janet was still struggling with suicidal depression. In May of 2010, a friend suggested to Janet that it might be a good idea to go back to creating her suicide awareness workshop. Then, because Janet finally found a place to talk about suicidal ideation and behavior safely, Suicide Anonymous, Janet decided to start a Suicide Anonymous meeting of her own in southern New Jersey.

Then, for me, it really felt like, “OK, this is it, the bandwagon to jump on. This is where the mission is. This is no coincidence, that two people met each other and fell in love, who have both suffered, although in different ways, from suicidal ideation and behavior.”

And that pain in the end has brought me, like the old Jewish saying _ maybe it’s not Jewish _ “What doesn’t kill you makes you stronger.” Even though I still struggle tremendously, I thank God for it because otherwise I couldn’t be the person I am, couldn’t be of help to people. From my early 20’s on, I have wanted to help people in one way or another.

I believe that what Janet and I have to offer is of great value. People have said just that. We do have a staff psychologist who works with Creative Communication Builders. We even have done workshops for clinicians for continuing education credits. That’s been just a great experience. It’s been a struggle for me because I have less education. And I have been seeing myself as “less than” the clinicians because of my lack of education.

But I’ve been getting amazing insights lately. I see an amazing therapist and I work really hard at everything. I’m just grateful for the help I get. I’m not the same person I was, even yesterday. I keep improving and moving forward.

When you made your attempt, did you think this was going to do it?

Oh yeah. I had done some things that in my mind made it a certainty. Part of it was from a distorted sense of reality. And part of it was, on that day it was more impulsive. I had not really thought it out: “How many of this do I have to take?” It wasn’t researched. I think sometimes there are people who are just really serious about it and think it out and have a sound plan, and I didn’t. Within a two-hour period, I just went from a fairly stable moment to a complete and utter determination to attempt suicide, to complete it. And so it was like in that moment, a moment of clarity. Looking back, yeah, I’m sure now I have the knowledge that my method for attempting suicide was not sufficient enough to complete the task. But the point is, yes, in that moment I thought that was it. And some people say they get kind of a rush or relief when they attempt suicide or before they attempt suicide. I did get that sense of relief: “Oh, I’m now unburdened. I don’t have to deal with this anymore.”

That seems like a heck of a risk to be taking.

Yeah, it really distorts your thinking. It was a psychotic moment. It was just not normal thinking. And after that, I never got to that point. I got to points where I was seriously thinking about it and wanting to die, but not any kind of serious plan. And my bottom line in SA is, whenever I have any kind of serious thought, like, “I really feel like dying” _ the mind plays tricks, and I don’t call someone every time it pops in my head _ that’s when I call someone. And I’ve stuck to it. And I’ve celebrated a year’s sobriety. We started SA in August 2010. It was not until May 2011 that I finally planned that bottom line and stuck to it.

You said you had a tremendous support system, but you didn’t call them. How can you be sure you’ll call them in the future?

That’s just it. I force myself now. Here is an example: I was watching our dog, Dodger, today because he had major surgery two days ago, so I’m really nervous about him. Today I accidentally brushed against him with my leg, and I was like, “Argh!” I screamed. I realize that I have a serious problem with anxiety. I said to myself, “Wait, I’m gonna call somebody.” I called someone from my men’s group. Then, the woman he is dating _ I’d introduced her to him _ calls me and tells me that she just wanted to check up on me and see how Dodger was doing. I unburdened myself to her. She’s very spiritual, and she decided to lead me through a visualization exercise, and it really helped calm me down. That’s when my heart says, “See? God is here.” And so I’m determined to reach out because I didn’t reach out on that night. And I see the possibilities and beauty left in my life. I see beyond the hopelessness. I get into that hopeless place sometimes, and I can move through it a lot more quickly now.

The impulsivity part of suicide must drive therapists wild. Do you have any suggestions on how they should approach it?

One of the things I have realized over the years is that my greatest strength is in owning my weaknesses and asking for help. People get so lonely and cut off. It’s just a matter of finding someone who cares. And there’s somebody out there that I’m a gift to. And there are others who are a gift to me. And sometimes I gain more from the times that I am speaking with someone in an effort to support them, than when I call someone to support me. So giving and receiving become one and the same for me. With this in mind, I think that the most important thing a therapist can do for a client is encourage them to be a part of support groups. Also, one of the things I have realized about my life, which applies here for therapists, is that I cannot fix anyone. They have to do the work. I can only assist as much as they let me. Also, I am not responsible for another’s behavior. I could love and support a person and do every possible thing I can think of to keep them safe. In the end, if they complete a suicide it is their choice. I am not speaking of the morality of that choice. This reminds me that I am not God. Because, for me, attempting suicide was me believing that I was God. I realize in my life that God is in charge, not me.

Also, another thing I have discovered is that ultimately, my vocation is irrelevant. I am here to love people _ starting with me; sometimes the most difficult thing for me to do _ and allow myself to be loved by others _ also difficult for me, sometimes.

How did people respond when you started talking about this?

I look at it this way. I got to a point where I was willing to be vulnerable, bare my soul, because I felt and I saw that in baring my soul, somebody’s gonna get something out of it. So it became worthwhile. And at this point, my personal anonymity is not important. I go by SA traditions as much as I can, but if I see a higher purpose, I say, “You know what? I need to go with this higher purpose.” I’m not proud of everything I’ve done, but I’m proud of who I really am _ a child of God. And so, we do things that sometimes push the envelope. We had an article in The Philadelphia Inquirer about SA: “Hey, you might not know this, but there is SA.” You see, tradition No. 5 states that each group has but one primary purpose: to carry its message to those who still suffer from suicidal ideation and behavior. But then tradition No. 11 states that our public relations policy is based on attraction rather than promotion. We need always maintain personal anonymity at the level of press, radio, TV, film and other public media. We need guard with special care the anonymity of all fellow SA members. So by having these newspaper articles, it may be dangerous to someone’s personal anonymity. We did our best to make sure that we were following No. 11 as best as possible. We keep our focus on No. 5 because there are so many people out there with suicidal ideation and behavior that never heard of SA. And because we can now Skype them into meetings, they can be a part of our meetings from the other side of the world.

How did the reporters respond when you contacted them?

They were basically intrigued. Like, “Really, a suicide support group? OK.” Then they start thinking, “It’s dangerous.” But recent studies show that talking about it helps more than it hurts. Then the 12-step part: “Addiction, how? You do it and you’re gone.” But it’s like a default mechanism in my brain. It starts for me when life and relationships get very difficult or if I am suffering with severe emotional pain. Then the thoughts of hopelessness come. Then the thoughts of suicide come. The thoughts of suicide become similar to an alcoholic getting a drink. A psychiatrist has done a study that the addictive pattern of suicidal behavior is the same as the addictive pattern of every other addiction. I can send it if you want.

What kind of responses did you get?

It’s interesting. We seemed to get more from the story in the Burlington County Times! Maybe it wasn’t clear in the Inquirer that we have Skype availability. We’re still working on getting it in The New York Times, working on getting it out in the public and having people in mental health facilities use us as a reference. You know, to tell people, “It’s a good idea to go.” A lot of people are really shy about it because it’s all about liability. Because when you come to an SA meeting, no one’s going to report it. We do other things. It’s one of the things where it makes it more difficult on Skype, but if I’m in a room with somebody, I’m getting used to telling whether someone is a danger to themself or others. If I judge they are, I don’t leave them alone. If they want us to take them to the hospital, we can. I leave it to them. I just do my absolute best not to leave them alone. I also make sure to keep their confidentiality.

Have you had to do that?

We do what we have to do not to leave them alone. You can leave it at that. A lot of professionals have that fear, what if someone goes to an SA meeting, then attempts or completes suicide after that? The professional has that fear they can be held liable, lose their career. A lot won’t recommend SA.

About how many people have come through the group so far?

Anywhere from 50 to 75. We’ve had people come and go. Sometimes they stay for a long time. Janet would say 100 at least. We’ve been one year with one meeting, two years with the other. A lot of people have trouble talking about it, owning it as an addiction, and would sooner go to other 12-step groups. But a lot of other 12-step groups say, “Oh, we can’t talk about suicide.” For these reasons, SA has not caught on as fast as some other 12 step groups. I think it’s gonna take time.

You mentioned the first SA conference later this year?

Yes, there’s gonna be a conference in Memphis, where SA started. We haven’t really firmed up plans about it, but it will be when we go down in October. I’m looking forward to that, to see how that works. And our organization, CCB, is doing something on World Suicide Prevention Day this year. It’s on Sept. 10. We’re gonna have the four-hour version of our suicide awareness workshop. We do a very different workshop, filled with creative arts. Janet does mime pieces. And it’s a lot of interactive exercises. There’s not much of a didactic element. I don’t believe in PowerPoint presentations. We’re more of a hands-on, artsy, creative approach. We even have a game with a point about suicide, and we have fun with it. Fun and laughter have been medicinal for both of us. I’ve always said laughter is the best medicine.

How does the game work?

It’s called “Sequential Ball Throw”. We have a circle of people. Each person gets a number. I could be number one, let’s say, you’d be number two, but you wouldn’t be next to me. So what happens is, each person throws to the next number, one to two to three, and you have to remember who is before and after you. And what happens is, we have, like, if we have two circles, Janet is in one and I’m in the other, and at different times each of us says, “I gotta go to the bathroom, cover for me.” The rule is that you have to throw it the person with the next number. Covering for someone would be breaking the rules. So what happens when someone leaves the circle? The analogy is, what happens when someone commits suicide? You just go on? No, we have to stop, to heal, to look at this, make sure it doesn’t happen again. They say every person who completes suicide potentially affects the lives of hundreds. If a student completes a suicide, it affects every student in the school and their friends, neighbors, etc. Such a wide range of effects.

Do people like the game?

Yeah. And the idea is, we have them guess how it pertains to suicide. Sometimes they get it right, sometimes they get really creative.

(I ask about the stigma around suicide and what to do about it.)

One reaction that pissed both of us off is, someone who was active as a peer specialist _ I didn’t witness it, but a close friend said _ that when they heard about SA they said, “Ooh, that gives me the creeps.” And you know, it’s like, “You’re in this business of being a peer specialist and helping people who are potentially suicidal or have been, and you don’t want to discuss it?” To me, SA is a monumental discovery, like we discovered another planet out there, you know? For Janet, it was an oasis in the desert, when she needed it the most. For me, it has continued to keep me on track and allow me to have a quick course correction when I get a little off track. As much as I love the men in my men’s group, a lot of them just don’t get it. So maybe that is one of the reasons why I did not reach out to the men in my men’s group for support on the night I attempted suicide. If they knew, maybe they would shun me. In SA, I’m with people who get it.

Does the men’s group know now?

I’m tremendously honest with them about everything. I’ve opened up about all of it since. It’s not like I’m proud of it, “Hey, I attempted suicide, look at me!” It’s that I put myself out there because I wanted help. And I’m not backing down from telling anybody. And I must say, a couple of my bookkeeping clients I’ve not told person-to-person. They know I have issues. I’m trying to draw an analogy here. It’s the same way I don’t discuss my spiritual beliefs with them either, you now? I’m there to do the job, and I do the job. Meanwhile, they could have read about me in the Inquirer, which talked about me and what I did. The reporter put the method in there. I guess it doesn’t matter to me anymore. So even though I haven’t told some people face to face, I’ve put myself out there. If they found out, it’s OK

What have I not asked you that you’d like to mention?

You asked about impulsivity. I’ll send you something else, too. I think it summarizes it well. We took this training, applied suicide intervention skills training (ASIST). It’s one of the foremost suicide prevention trainings in the world. We were very lucky. It was offered by the most wonderful people in the world, the New Jersey Self-Help Clearinghouse. They’re so amazing. I pray Gov. Christie doesn’t cut them out, they provide such amazing service. You can just call them up. They have information on every self-help group in NJ. They provide trainings. They support people in starting meetings. I don’t know if we could have started two SA meetings without the help of the Clearinghouse. So the ASIST training, it talks about somebody who absolutely is in crisis, has a plan of suicide. It offers a very specific model and the steps to go through. You listen to that person tell you everything, why they want to end their life, then you say, “Wait a minute. Is it fair to say there’s some things in life you do like? Some reasons you do want to live?” To establish an ambivalence, which is to say, that part of them wants to live, part wants to die. If they didn’t want to live, they would have ended their life already or attempted to do so. That’s the cold hard fact. So you establish what draws them to life, what is their hope. You get them back in touch with that hope, the possibilities in their future, the joys of their past that could happen again. You start to focus on that, and it short-circuits the tendency impulsivity. When I am impulsive, all I can see is what is happening inside me right now. But what about the future?

I don’t want to get into guilt: “You have a child, you need to stay here.” I don’t like to motivate with guilt. Meanwhile, Janet will tell you her story, and the dog who just went through with surgery. Janet is clear that that dog kept her alive. They had a bond where she felt like she didn’t want to leave him standing in the window waiting for her. I have enough support, I could deal with it, but that poor dog wouldn’t know what to do. At the end of the day, whatever keeps a person alive, I will use. Sometimes I get Machiavellian. Sometimes there are no rules. The rules are what God tells me to do in this moment.

Who else are you?

I love baseball. I love sports. My father and I could argue about a million different things, but we could talk about sports forever

I’m a lot about deep connection. A lot of the most beautiful work to me is connecting with people. The other thing is, I’m impulsive and I can be very impulsively silly and ridiculous and goofy. I love to make people laugh, I love funny movies, I love watching Bugs Bunny. I love feeding my inner child. I found a therapist who is not only cool with that but encouraged it. I am willing to be ridiculous, and that’s a part I’m really willing to share. It seems to me that people are too serious in the world. People need to loosen up and lighten up, enjoy the moment. There’s so much comedy to be grasped, if you look at life like it is a movie. As Bugs Bunny said, “Don’t take life too seriously. You’ll never get out of it alive.” And I try my best to remember that always

And my deep spirituality, and belief in God, that’s a very big part of who I am. I follow the teachings of a man who is not with us anymore, but he brought a lot of India’s teachings to America. I’ll send you his name. It’s a tough one. Janet and I met at this interfaith church. And it celebrates everything. I call it a New Age hippie church. It is called Pebble Hill Interfaith Church in Doylestown, Pennsylvania, and it was recommended to me by a friend back in the late 80’s. I went there once, it was too weird, everybody was overly happy. Then, when I was at this spirituality group, about three years later, they told me about Pebble Hill again, and I stayed for a number of years. Janet and I had a ceremony there. And so Pebble Hill’s very near and dear to my heart

There are so many times when I feel God’s presence and miracles all around me. It is humbling and brings me great gratitude.


Who are you?

Janet Berkowitz: Well, I am … I don’t know how to answer that question. My life is about creativity. My whole core, everything I do, is about finding a creative solution to a problem. And some of the ways I manifest that is through mime. I’m a mime and an actress. I’m a dancer, a very unique dancer.  I’m an artist; mostly I do collage. I’ve taught drama since the 1980s to all kinds of children, some being emotionally disturbed or cognitively challenged. I’ve also done it in prisons, where I love to perform. What else? I’m an animal lover. My pets are like my children. I’m just basically an artist, very blessed in the arts. And everything I do is a devotion to my Higher Power, which I call God.

What has been your experience with suicide?

The first time that suicide actively came into my life, I was 8 years old, and I was bitterly teased every day. I hated going to school and made up all kinds of excuses not to go. Then I planned at 8 years old to jump off a bridge near my house. And I found out a few years ago that the water was only two feet deep. So my body would have been a mess had I jumped. I don’t know how I came out of it, but I did. It started again after I graduated high school in 1976. I traveled cross country with friends and I remember being extremely scared, always covering it up so no one knew. I remember having a vague sense of wanting to die.

And it came back again in 1979. I was in college, where I was studying psychology. I wanted to be the greatest psychologist that ever lived _ grandiose thinking like that is common with bipolar disorder, I soon found out. I finally dropped out of college. Actually, my therapist suggested that I drop out, which was very devastating for my family. I was raised Jewish, and there was a lot of pressure for Jewish children to become doctors, lawyers, all that. I was doing drugs, mostly marijuana. I loved marijuana. And I was doing LSD, not a lot, about 10 times. This became what I call my “manic summer of ‘79.” I’d go to New York City and dance in the streets wherever I heard music. People would come around and watch me and I felt like I was bringing them God.

The last time I did LSD, it was very bad. That was the beginning of the suicidal stuff again. And when I become suicidal, it’s not over a specific event. The word “suicide” begins repeating in my head, like a ticker tape with the word “suicide” written over and over again. It feels like no oxygen going to my brain. I call it the vacuum state. I’d go to the library and pore over books about suicide. I started to write a suicide note, and there were pieces of paper hidden all over the house. I hid them in the couch and everywhere, notes about why I wanted to die. I never really wanted to die, I just wanted to stop the word in my head. In early 1980, I drove up to a mountain to jump. I wanted to die in nature, because I loved it so much. It wasn’t a straight drop, so I didn’t jump. I recall feeling immediate relief and then the frustration of not knowing what to do next. I came home and my therapist said, “If you don’t tell your parents, I’m not going to see you anymore.” I told my parents, and it was one of the scariest things I’ve done. They were loving and as supportive as they knew to be. I remember my father telling me he had once been suicidal. It was one of the closest moments I ever shared with him.

The therapist convinced me to go into a mental hospital. It was difficult. My mother was all about looking good to other people. But I needed to talk about it. Besides, I tend to be an open book. They told me I was bipolar, which fit. They gave me lithium, and within days I was feeling better. I don’t know if it was the placebo effect or what. I got out of the hospital two months later, and for the rest of the year the word “suicide” continued on and off. Finally I had a dream where my grandmother rose out of her coffin and said to me, “You are not to kill yourself, you have much more living to do.” It was such a lucid dream that I came out of my suicidal depression. It worked. So it was great. I was better for a while.

Throughout the ’80s I started doing self-help trainings like Lifespring and EST training, now called The Forum. I threw my medicine in the toilet because the trainings would say things like, “You don’t need medicine or psychiatry, just the training.” Then I’d get manic and in trouble again. Finally in 1987 I went to India with friends, and I had an evening where I had an insight, a very deep insight. I realized I needed to stop smoking pot. I went home and I kept smoking pot, until one night I just got it, that I couldn’t fit any more pot in my brain. I decided to go to rehab. And I’ve been clean and sober ever since, 25 years now. It was hard at first. I didn’t mind giving up pot, but I didn’t want to stop drinking. They told me you gotta stop them both for it to work. I finally got it. Also, I tried living in long-term treatment care. I didn’t want to burden my parents. Everywhere I went was terrible. I came home against medical advice, became suicidal again and ended up in the hospital.

I always put myself in the hospital. I’ve never been committed. While in the hospital in 1987, I would wake up naturally every night at exactly 3:20 a.m., and they wouldn’t let me leave my room or turn on lights. I did the only thing I could think of. I would get on my knees and pray that this would go away so I could help other people who were suicidal. When I got out of the hospital, I was going to meetings, AA, many kinds of 12-step groups. I’ve really been working hard on myself.

And in 1990 I had to address another problem. I was a self-injurer, but not like a cutter or burner. I went to Chicago to a program for self-injury, a special one I’d seen on TV. We were not allowed to talk about what we did, just about our feelings. While there, I saw myself rapid cycling, emotionally. In the past, the periods of mania and depression would each last for quite a while. This was new to me. At that point, I was off my lithium. I was now begging to take it again, and it worked.

Through the ’90s, I got really busy teaching drama. I had a very nice and prestigious job as an assistant drama teacher, eventually teaching my own class. Phil, my partner _ I call him my husband _ soon started teaching drama with me. We work well together. It was a tremendous amount of work, too much after a while. We stopped doing it this past year. But in the back of my mind was always stirring the wish to help people who are suicidal.

I got out of the hospital and stayed out for 18 years. I thought this was it. Then in 2007, it came out of nowhere. My mother died in 2005, and that may have had an effect. I started thinking about suicide again, and it freaked me out, so scary; it got faster and faster. I had to leave work to deal with it. And during that time, Phil started getting really depressed. There was a year in there, like 2009, we were both in and out of hospitals. He’d be a mess, and I’d be strong, I’d be a mess, and he’d be strong. It was unbelievable. That year, I was in the hospital three times, and they were giving me shock treatments, about 40 of them. I had already taken about 75 percent of the meds on the market. I could not talk about the fact that I was suicidal in groups, because I feared being sent to a state hospital. This is a big problem I hear from other consumers.

The third time I was hospitalized, I one day decided to trust my psychiatrist and said to her that when I’m depressed, I don’t want to hear anyone’s good news, just bad. She said at that point she no longer knew what to do with me and would have to put me in long-term treatment care. The only place that could take me with my insurance was a state hospital. I said no. She said I had two other choices: more shock treatments or go back on Seroquel. Apparently it was a medicine that had helped me in the past. I said fine, I’ll take it. And over the next few days, I convinced her each day I was getting better. I wasn’t. I was planning to kill myself when I got home. And they believed me, hook line and sinker. That’s how good an actress I am. That’s dangerous, when you can convince everyone you’re safe and are not. They let me go. The third day I was home, I had plans to kill myself because Phil would be away at work. I woke up that day with this thought in my head: “Suicide denied.” I said, “All right, I won’t kill myself today.” The next day I woke up and planned to kill myself, and I heard it again, “Suicide denied.” Day after day, this kept me from attempting suicide.

In the midst of these hospitalizations, I’d been in several day programs always thinking, “I don’t belong here.” It really humbled me, being with people with mental illness. One of the things it taught me was not to believe all those clichés that therapists repeat, like, “You have to love yourself to love others.” Because I hated myself, I used to force myself to walk around the hospital smiling at people. In being nice to other people, I learned to like myself.

There was a counselor in the day program who said, “You’ve got to get underneath this suicide stuff.” I said, “Just forget it. I’m an Aquarian, destined for greatness or madness.” I read that in the play “Hair.” I didn’t feel sad or upset about things. I was emotionally dead. I just felt my brain was going crazy. A lot of people in Suicide Anonymous say that. Then the therapist helped me to get in touch with my anger at my mother, and all my emotions started coming to the surface.

I started to hear guidance to do something about it all. I looked for a suicide support group for myself. I looked all over the country, but I couldn’t find anything for people who were suicidal. I could only find groups for people who lost someone to suicide. I couldn’t believe it. Come on, guys. If we had more groups for people who are suicidal, we wouldn’t need all those groups for people who lost someone to suicide. I couldn’t make sense of it.

At that point, I had found out about Suicide Anonymous in Tennessee. God bless America that I did. I was ready to move to Tennessee, I was so desperate for it. But I was too messed up to move. So I started my own group. I had to, to save my life, just for me. We had four people at the start. Then we started calling churches and libraries, handing out fliers. It’s been growing slowly. Even in Tennessee, it’s growing slowly. I think because it’s such a tough topic for people. Some people come and say, “Oh my God, this is the best thing since sliced bread,” but then they never come back. There have been a lot of miracles around it.

I finally started to feel well, but in 2011, I was diagnosed with borderline personality disorder. It was really hard for me to look at that, and I became suicidal again. The SA meetings helped me pull through that. And a few months ago, I started hearing the word “suicide” again, and I knew I wasn’t getting enough support. I started calling people more. I pulled out of it. I see how much this works. Now we have two meetings, one in Burlington County and one in Camden County. Anyone anywhere in the world can Skype or call into these meetings. We also started a meeting strictly on Skype. And I’m now the Outreach coordinator for the Suicide Anonymous World Service Organization.

I also went back to an old idea I’d had to design a workshop on suicide awareness and prevention using the arts and fun interactive activities. We now call it “Creative Crisis Care: Suicide Denied.”  I have a vocational counselor who loves me and whom I love like a mother. She said, “I believe in what you’re doing. Come to our self-help center and do your workshop.” We now do it for consumers and clinicians all over New Jersey and Pennsylvania. This keeps me sane, too.

What are your impressions of the people who come to meetings and stay?

I love them. They’re beautiful people, very committed and deep. I’ve seen people come who are desperate, and within three meetings they’re feeling such hope again. And the ones who come regularly are doing so much better. They all say the same thing; they can’t talk about suicide in the hospital, can’t tell the therapist because they’re scared of being put away. In these meetings we can’t report anyone, because it’s anonymous. But if someone is seriously suicidal, we don’t leave them alone. Phil and I are trained to assist people who are in trouble and know how to get them to a safety.

And I attribute a lot to Phil and I, we’re very honest in the way we share. I also think it’s because we’re talking about suicide. It’s as deep as you can get, one of the greatest fears there is, if not the greatest. My sense is, the thought of killing yourself is more fearful than the thought of killing someone else. It’s an act of murder, murder of the self, We get a lot of people who say they want to kill themselves because they’re so sad. I think if you look you will see a lot of anger there. I know when I stopped feeling suicidal, tremendous rage came up. I’m just now beginning to forgive in a natural way.

You say people can talk openly in SA meetings, but are there any guidelines, places you just can’t go?

No, I don’t think so. One of the guidelines is, don’t talk about events. In other words, how you tried to kill yourself, just about the experience. We don’t usually stop people if they discuss how they did it unless it’s very gory or weird and we think people are getting triggered. We say just stick to the experience. Sometimes we get people who talk a lot, a long time. A lot of 12-step meetings time you. But we like to let people get it off their chest. If they’re really going too long, we stop them gently.

What can you do to grow the groups and create more groups elsewhere?

Well, word of mouth is the way 12-steps work. You’re not supposed to promote. I had an article in the Philly Inquirer and one in the local paper. I don’t care if we’re breaking 12-step tradition. We want to get the word out. We hang fliers up, talk to people at hospitals about it. We present at conferences. We’re just doing everything we know how. We just maintain anonymity when we do this.

What are some of the questions people ask when they hear about it?

We get people who are not actively suicidal. They just don’t want to wake up. They’re not planning to kill themselves, but they want to die naturally by disease, heart attacks, etc. They think they don’t belong at meetings. We say yes, that’s a form of suicide. At meetings, they say their name and “I wish for death” instead of “I’m a suicide addict.” Another issue that comes up for everybody with a 12-step group is, “I don’t believe in God, can I come?” Absolutely. We don’t talk about God as much as a higher power. Your higher power could be a dog, anything or anyone. My higher power was my dog when I was too far gone to even imagine God.

The group talks in terms of addiction. Do you think everyone who thinks about suicide is addicted?

No. I don’t think everyone who thinks about suicide is an addict. That’s another big question that comes up. It’s up to you to decide whether you’re an addict or not. Many people have fleeting thoughts of suicide. But if the thoughts are making life unmanageable, then I’d say that’s addiction. We have people attend who never attempted it, like me, yet know they are addicted.

The man who started this is a psychiatrist. He attempted it seven times. Then he got it. He was an addict. He did a study about suicide addiction and found it follows all the same steps as any other addiction: fantasizing, rituals like saving pills, collecting ropes, withdrawal when an attempt fails, etc. We’re not finding a lot of people in the mental health field who get it as an addiction. But they will. It will come. I’m convinced that SA will be the next big thing, because suicide is the next big problem.

What do you mean, the next big problem?

People are killing themselves right and left. The numbers are going up for people who are middle-aged because of the economy being difficult, and the numbers are going up for teenagers. They can’t make sense of things on this planet. The numbers are increasing terribly. Phil and I are tracking the statistics.

Ken Tullis, the founder of SA, what does he think about what you’re doing?

He’s very grateful. He’s hard to get. We’ve talked to him a couple of times. He’s quite busy now, travels the world talking about this, which I’m thrilled about. I just wish he were a little more available. But it is what it is.

You hear a lot of personal stories in the groups. How are you holding up? How do you protect yourself?

Oh, I love it. I was born for this. My theory is that Spirit wanted me so much to do this that I had to go through it one more time in 2007 to get it. I wake up and come to life when people start talking about this stuff, because I crave truthfulness and this is about as truthful as one can get. I’m a helper, I like to help people. Also, it’s what I was sent to this planet to do. I’m very excited to be involved in this. But I am learning to set boundaries to take care of myself. If someone is relying too much on me for help I either have to end the relationship and/or send them in the direction of more help.

Suicide still has such a stigma. How to break it down?

I talk about it like people talk about making dinner. I make it easy and comfortable. People do our workshops and say it’s the funnest thing they’ve done in a long time, mostly because it’s using the arts. Anything can be made creative and fun, I don’t care how bad it is. A lot of love, a lot of compassion and constant willingness to look at myself is the key. It helps to remember that whatever I see going on outside of me is because it’s going on inside of me.

The portrayals of suicide in the arts and media, do you feel they’re accurate?

I haven’t seen a whole lot out there about suicide, so I don’t know. I think “Girl, Interrupted” was a great movie about this stuff. But I haven’t been able to watch a lot about it because it’s too painful and scary. It triggers me.

What have I not asked that you’d like to add?

It’s just that I never dreamed I’d be sitting here talking about this, no way. Three years ago I was too ashamed to even utter the word “suicide.” I urge people not to give up. It takes a lot of work. You just need a little bit of willingness to start. It’s easier to do the work than to hold it in in the long run. And talking about it really helps.

I often ask the question, “Who else are you?” but you’ve answered that well already. Is there another side of you to mention?

I’m kind of like a fairy-princess type, very down to earth, and also playful and childlike. When I’m around kids, I get right there in the sandbox with them. That’s what keeps me happy. I’m willing to be silly. People have to give up this intense desire to look good.