The author is Susan Rose Blauner, and her book is How I Stayed Alive When My Brain Was Trying To Kill Me. (William Morrow). The scene above describes the aftermath of her second of three suicide attempts, but the term is misleading, Susan contends, because, one, there is no such thing as a successful suicide attempt, and two, acting on a suicidal impulse is not necessarily the same as wanting to kill yourself.

The author refers to her three close calls as "suicidal gestures." Yes, she could have killed herself or have survived with permanent serious injuries, she admits, but at no time did she actually attempt to close the deal. Quite the opposite. In analyzing her second display of brinkmanship, she notes that she called for help soon after overdosing and that she was found kneeling in front of the toilet, fingers down her throat, trying to get the pills out of her system. And on awaking in the ICU, when she thought she was going to suffocate, she fought to breathe.

Obviously, there is a difference between a true death wish and behaving dangerously, though all too often the result is tragically the same. Suicidal is not a feeling, says the author. Anger is a feeling, along with sadness or loneliness. According to Susan: "Suicidal thoughts, I learned, were an indication that some deep feeling or need was being triggered or stirred. I had to figure out what the feeling or need was and address it." Driving a wedge between your feelings and your suicidal thinking creates the breathing room that allows you to put all your coping skills to work. One of these is "faking out the brain." For instance, if the brain says don't call Sam, call Sam.

Other strategies range from affirmations to journaling to spiritual practice to not being afraid to ask for help. Over the long haul, talking therapy is recommended to work through personal issues and perfect one's coping skills. In Susan's case, she had to contend with the trauma and depression from early childhood abuse, as well as a diagnosis of borderline personality disorder.

Four years ago, however, Susan's brain played its trump card by convincing her to in effect unilaterally disarm. No affirmations, no faking out the brain, and so on. A busted personal relationship and a meds change had combined to give her brain the upper hand, and as sure as night follows day a third suicidal gesture took place, an act made far more hazardous this time by the fact that the hospital released her the next day. (Why does this not surprise us?)

From this emerges the strongest lesson from this book: Although Susan acknowledges suicidal thinking is an addiction for her, like alcohol to an alcoholic or heroin to a junkie, she also has an array of coping skills that would put most of us to shame. Yet, she almost became a statistic, such is the nature, persistence, and sheer power of the beast we are all forced to deal with. Which begs the question: How good - how really, really good - are your coping skills?

Suicide Facts