06 January 2011

Why I'm not surprised that no-one helped Simone Back

You've probably read about Simone Back by now. It seems there's a global wondering of how people could possibly ignore a suicide note. The world seems stunned that no-one helped her as she lay dying after so publicly declaring that she'd ODed.

I think it's so desperately sad that no-one came to her aid, but I can't even feign a bit of surprise that people bitched about her rather than saving her because I know what it's like to be unwell and for people to become desensitised to you mentioning it. For the most part my own health problems are physical rather than mental but I think the principal is the same across all illnesses of whatever type.

When Simone posted the words "Took all my pills be dead soon bye bye everyone," one of her "friends" replied with:

"She ODs all the time and she lies."

Now I don't know Simone, I've never met her. I only know what I've read in a few news articles. But that cold, unfeeling sentence from one of her "friends" would suggest that Simone has attempted suicide in the past and was quite open about it.

When you talk about your ill health all the time, be it mental or physical, people seem to stop giving a shit after a while. Like you're a broken record and the disjointed tune will remain the same no matter what intervention so people just ignore that track and wait for the next one. Except in the online worlds of Twitter and Facebook it's not like you've got to wait for the dodgy track to play out to get to the next song like you did with vinyl or tapes: Twitter and Facebook are more akin to mp3 players and you can just scroll past the corrupt song onto the next one.

So when I mention feeling unwell my online friends don't respond with concern anymore, they just scroll past onto the next update; me mentioning my shitty health is the TwitBookSpace equivalent of that corrupt file in your iTunes library.

I've been having a bad day today. Earlier in the week I had a reminder of what my life used to be like when I had that precious thing called health. While I had a fun evening out on Tuesday it has since got me contemplating all the things I've lost and the things I had the potential to be which are now dreams that'll never be realised. That contemplation made me cry. My body is constantly on the lookout for any excuse to hurt and via a couple of degrees of separation the emotional upset ended up causing me physical pain.

My tweets are set up to automatically update my Facebook status. So this morning when I tweeted that I was having a bad day that fact was broadcast to my 407 Twitter followers and 376 Facebook friends. The number of people that replied? 3. Two Facebook friends I know IRL and one Twitter follower who's only just started following me so is therefore presumably not sick to the back teeth of me moaning yet.

A couple of hours, one nap and many drugs later I tweeted that I'd managed to cry myself into physical pain. This time it warranted even less of a response: Just the one person who I only met last month said that she was sorry to hear I was having a sucky time. Again, I'm sure that once she's known me for more than three weeks she too will lose interest in me feeling rough.

I think stereotypical British stoicism is part of the problem. We're not supposed to talk about negative feelings, whether they be physical or mental. On Tuesday I had a brief conversation with someone I haven't seen for over 5 years: Since before I became "ill" (I've always had a shitty skeleton but there's a difference between "illness" and "impairment". Until 5.5 years ago I was mobility impaired but free from illness). She's doesn't know anything about me other than that I have a very loud laugh, but in the polite and conversational way that you do she asked on Tuesday "how have you been?"

I actually had to pause for a minute. "Do I answer honestly or do I just say what you're supposed to say which is 'fine'? She doesn't know me so doesn't need to hear my shit. But on the other hand I hate lying..." I opted for just shrugging because I couldn't bear to deviate from the social norm enough to say "not at all well actually." Except I did then explain that I'd been ill because I suck at keeping my trap shut.

With social rules dictating that we're not even supposed to answer "how are you?" honestly unless the answer is positive it's not entirely surprising that there is such a backlash against people like Simone who'll publicly state "I hurt" rather than keeping their British stiff upper lip.

I'm not going to pretend that I'm above the social rules and desensitisation. I have Twitter and Facebook friends with painful diagnoses and I don't reply every time they say "sneezed and broke a rib" or "dislocated my shoulder relocating my knee." I've rolled my eyes at friends who always cry when they're drunk because with inhibitions lowered the stiff upper lip falters and their sadness slips out. I'm not proud of it, but sometimes you don't want to listen to that dodgy mp3 and you want to listen to a new song you've never heard before. Or at least you want to listen to a song that'll play without scritching.

Then there are those who will criticise you for being open about how you're feeling. Those who'll attack you for complaining about feeling crappy. You wouldn't believe the number of times as a child I was told to shut the fuck up screaming about my broken bones because my distress would upset other people. The TwitBookSpace equivalent I guess would be unfriending/blocking someone for being honest about how they feel, giving a bitchy remark as a parting shot. Or deleting that corrupt file from your iTunes library.

When it comes to mental health we, as a culture, want to hear about it even less than physical health. If people are going to ignore me moaning about being in physical pain you can be sure they'll steer well clear of someone moaning about being in emotional pain. And if people can react with hostility to a cute small child screaming because they've got 3 freshly broken long bones and no painkillers in their system is it really surprising that people are hostile to someone saying "I'm killing myself"?

When it comes to talk of suicide we typically have 2 responses:

  1. Disbelief
  2. A desire to not get involved in case we make matters worse
On disbelief: In both those Telegraph articles they quote "a spokeswoman" from Mind as saying

It is a myth that people who talk about suicide don't go through with it.

I find it greatly alarming that we get a lot of anonymous commenters on WtB talking about how they plan to kill themselves if/when they lose their benefits. Sadly we have heard from people who don't believe those people actually are planning to kill themselves because of the myth that genuinely suicidal people don't talk about it.

As for point 2, I have an example in mind. Just before Christmas the wonderful Incurable Hippie read this article and started begging people in the Oxford area via social networks to go down to Wolvercote lock and take Mr Payne warm clothes and food and a puncture repair kit because being in Sheffield she wasn't in a position to physically help him herself.

Someone she asked refused to retweet the link because Mr Payne was suicidal and he felt that Mr Payne's aid should only come from The Professionals. I'm pretty sure that a thermos full of Heinz soup reheated by an amateur would've been satisfactory and that Payne didn't really need any food to be prepared by Jamie Oliver.

Yes, I do realise that the gentleman in question wasn't referring to pro chefs. But are we really that afraid of mental illness that taking hot soup to a cold depressed person is too scary? But taking soup to a cold person who's full of joie de vivre would be OK? Isn't it conceivable that if Mr Payne was treated like a human being instead of a social problem that he might not actually have been feeling suicidal in the first place?

We have a cultural thing about not talking about how we feel unless our feelings are all rainbows and sweeties. We ignore people who break that rule or are sometimes even hostile towards the social deviators. As a culture we have a big problem with people who'll speak out about feeling suicidal. Yet people are somehow still surprised that no-one rushed to Back's aid? Saddened, of course. But surprised? Really?

Edit: Just wanted to clarify that I don't think it's an internet problem; people have the same reaction in real life towards people who talk about illness regularly. I think it's more that ill people are supposed to be stoic about their pain and so those who do talk about it are castigated. If anything I think the problem is worse in real life: In my experience people actively avoid those who moan about their health all the time. Online people tend to just avoid the health-related updates rather than avoiding the ill person completely.

I also wanted to touch on the fact that every article I've read about Back quotes Graham Bell from the Brighton and Hove Depression Alliance as saying:

“People need to be friends in the real world as well as in the online world.”

Really? Funny thing about illness is it makes you ill. When you're in too much pain to get out of bed, or when you're too depressed to get out of bed, or when you're too stoned on medication to get out of bed how the hell is one supposed to get out there and maintain real-life friendships? I frequently go weeks and weeks without talking to friends in person. If it weren't for my online social life I'd have no way of keeping in touch with people at all. In person friendships are great for those with the health to manage them but who am I going to forge RL friendships with from the confines of my flat?


  1. I think part of it is to do with the "generality" of twitter updates and facebook statuses.

    If I am having a crap day and I phone any one person who is on my Twitter list and who also knows me in real life, and I tell them I'm having a crappy day, chances are they *will* listen, and sympathise, and do their best to make me feel better in whatever way they can.

    However I suspect if I posted it as a twitter update, addressed to the world at large, no one would respond. And that's not because of the callousness of the online world, it's because (1) no one knows if *they're* the person who's supposed to pick up on it, (2) if it's got better in the 45 minutes since I posted, am I going to want to be reminded of it?

  2. That's a great post. I too am unsurprised that no-one helped her, but it is very upsetting indeed. I think the second reason you mention above is a big factor, i.e. worrying you'll make matters worse, worrying you will offend somehow, etc etc- also that sometimes people feel a bit helpless to make others feel better, not realising that a kind word would help. Like you I've been on both sides of the equation, posting myself and getting little response, and sometimes wondering how best to respond to other people.

    Regarding the nasty person who posted that "she lies" comment, I know that no amount of guilt will bring her back but I nonetheless sincerely hope they feel completely awful and that they learn never to be such a prick again.

    Finally, I'm sorry you've been feeling so awful and I really hope you feel better soon. Sending you hugs in any case. xxx

  3. You see, it's the generality that I like.

    I'd never phone a friend and say "I feel like shit." I could never dump that burden on someone.

  4. I'm really sorry you've had a crap day, Lisy and I didn't see it (I glanced at Twitter once today, and too late in the day at that). But this is a brilliant post.

    I will add one thing though. Elizabeth has often written about people slipping away or not commenting, and her life is as about as extreme as it gets before life itself gives up. But like lots of other people I guess, I frequently struggle with what to say, and especially what to say which is not exactly what I said the last time. And that applies to everyone I know who experiences pain of any kind.

    A friend of mine lost her husband, who had been ill for a very long time, just before Christmas. I am acutely aware that by now, the intense support she initially received will be waning off as folk get back to work. And after the funeral next week - even though grief sometimes hits hardest once the funeral is done - it is likely to get even quieter. So I want to make sure I stay in touch, keep dropping a line to let her know she is being thought of.

    But that's a challenge. Not an insurmountable challenge - it would be better to repeat myself, and risk hitting the wrong note than to say nothing - but still. I think in on-line worlds, especially where we have *lots* of contacts, and every other day is somebody's bad day, this searching for the right thing to say can be half the battle.

  5. I think part of it is when things are so unimaginably awful for you it is difficult to know what to say. I'm sorry things are so rubbish for you healthwise, but thank you for letting us know about what it is like. The pieces that you have written here and on the disability blogs have given me a much greater understanding of the issues involved with the government cuts,

  6. Well, no, I don't exactly phone my friends and go "I feel like shit". That would be pointless. After all, they can't make the actual pain any better because that's what chronic illness IS. I suspect this applies with mental health too.

    But there's at least five people who are quite content for me to phone them and ask them to distract me from the feeling-like-shit-ness. Which is, for me at least, all I'm really looking for - not so much active help, as a reminder that I'm not existing all on my own with this ball of pain, something to draw my mind away from the "this hurts this hurts this hurts" cycle and reassert that there are many other wonderful things in the world, including friends who are happy to spend twenty minutes of their day sharing their life with me.

    It doesn't make it hurt less but it makes it easier to deal with the hurting, if you know what I mean.

  7. Anonymous9:24 am

    @ the goldfish - do stick by your friend - although in my experience it's the 6 month point, when reality kicks in and you need support most, that the friends really drop away. There are organisations you could point her towards who will understand (WAY is widowed and young for example, but however her husband died there will be specific support and self help groups.)

    Another point to consider - is it fairer, when our own lives are stressful, that we admit we realistically can't take on the distress of another? How do we ask about others and support them, when we are completely worn down ourselves? I think this will become more critical in the months ahead. As we all feel the effects of cuts, queues for services etc, will we have even less time and energy to listen and react to the stresses of other people?

    Lisy great post - thank you

  8. Anonymous6:38 pm

    I reached the point of not responding to two friends who repeatedly said they were going to kill themselves but didn't. In the end, you stop being willing to be manipulated. I have absolutely no idea whether Simone did make repeated threats, but if people believed that she did, maybe they were just weary of it.

    I have responded to an awful lot of cries for help, but there comes a point at which you say "I'm not playing this game any more." If you don't, they carry on threatening and in the end they succeed. I think that not responding to repeated threats can often be the safest thing to do, and if sometimes one person dies, it's probably fewer than will die if they keep taking melodramatic overdoses that aren't actually intended to kill but just might.

    That won't stop me responding to many cries for help, just exercising judgement as to when enough is enough when I think that someone is playing games.