The False Equivalency of Numbers
If suicidal ideation were a temperature, there would be a number that marked the danger line. It could have some grey zone on either side, but everyone knows that a temperature of 100 you are sick. At 99 you may be fighting something but you're probably fine. At 104 you are probably headed to your doctor or urgent care. It's clear. There are lines. There are treatments. There are expectations for when schools should send kids home. It makes sense.
Therapy for suicidal ideation can offer numbers, but they are so much fuzzier. Are you a 2 today or a 3? How do you tell? There's no equipment that can measure it. There's no impartial arbiter that can smack a metaphorical hand to your forehead to tell if you're "warm". And besides, how much difference is there really between a 2 and a 3, or 2 and a 4 for that matter? In my family, we tend to describe a 0 as everything is fine and dandy while at 5 the world is on fire. But if you feel like just you are on fire - is that a 3? a 4?
And even assuming that we can somehow with any degree of accuracy tag the numbers, what would you do with them? There's no Tylenol to bring the numbers down to "healthy". Coping and distress skills... well we're learning about them, and I sincerely hope that they are more effective than they feel in this moment. In my heart of hearts, though, I just wish that the mind was as (relatively) straightforward as the body. Have issue, get issue diagnosed, execute treatment plan, issue is gone.
Maybe it's in my framing. Maybe instead of thinking of this as a temperature I need to think of it more like cancer... or AIDS. Have issue, get issue diagnosed, identify hopeful treatment plan and begin treatment... see if it works, measuring constantly... adjust treatment plan.... Best case scenario is that treatment works as well as treatment can work and the issue is beaten back to something you can live with... and that's the point: you live. There are no Star Trek magic pills, it doesn't go away, but you live.
Therapy for suicidal ideation can offer numbers, but they are so much fuzzier. Are you a 2 today or a 3? How do you tell? There's no equipment that can measure it. There's no impartial arbiter that can smack a metaphorical hand to your forehead to tell if you're "warm". And besides, how much difference is there really between a 2 and a 3, or 2 and a 4 for that matter? In my family, we tend to describe a 0 as everything is fine and dandy while at 5 the world is on fire. But if you feel like just you are on fire - is that a 3? a 4?
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| At some point the numbers start swimming and lose all meaning.... |
And even assuming that we can somehow with any degree of accuracy tag the numbers, what would you do with them? There's no Tylenol to bring the numbers down to "healthy". Coping and distress skills... well we're learning about them, and I sincerely hope that they are more effective than they feel in this moment. In my heart of hearts, though, I just wish that the mind was as (relatively) straightforward as the body. Have issue, get issue diagnosed, execute treatment plan, issue is gone.
Maybe it's in my framing. Maybe instead of thinking of this as a temperature I need to think of it more like cancer... or AIDS. Have issue, get issue diagnosed, identify hopeful treatment plan and begin treatment... see if it works, measuring constantly... adjust treatment plan.... Best case scenario is that treatment works as well as treatment can work and the issue is beaten back to something you can live with... and that's the point: you live. There are no Star Trek magic pills, it doesn't go away, but you live.
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