When You Call a Suicide Hotline and Things Go Poorly

For a long time now I’ve wanted to talk about the problematic side of crisis chat.  I sometimes see my co-volunteers badly mishandle things, and it feels dishonest pitching crisis chats as resource without acknowledging the problems.  I held back partly because I would be violating two different people’s privacy if I gave any examples (one of whom is protected by HIPAA), and partly out of fear that I would discourage someone who needed it from reaching out.  But what I realized is that an overly rosy picture gaslights people who have had bad experiences at a hotline.  A lot of our callers believe nothing will ever help, or everything bad that happens is their fault, or a just punishment for their moral failings.  If you tell them the hotline always helps, and they catch a bad call, it reinforces the feelings the feelings driving them to suicide to begin with.

So what you need to know is: if you call a suicide or crisis line and feel worse afterwords, it’s usually their fault, not yours.  Suicide hotline volunteers are human beings with their own set of strength and weaknesses.  Every one of them goes into their shift hoping to make a difference, but on any given day you might catch a trainee, or someone for whom your story is too familiar and triggers projection from their own life, or your story is not familiar enough and they can’t work through the cultural differences.  None of these are reflections of you.

That’s not the only reason people feel worse after calling, of course.  Often the call is the first acknowledgement of how bad things are, after months or even years of numbness. There’s no way to make that not hurt.  But if your call deviates significantly from Hollis Easter’s description of a suicide hotline call, that is a good sign something has gone wrong on the specialist’s end.

What can you do in this situation?  Hanging up is certainly an option, and not one to be discounted.  But if you have the reserves, I encourage you to tell the specialist what is going wrong, as specifically as possible (“No, that’s not what happened”, “No, that’s not how I feel”, “Yes, I’m having thoughts of suicide but I’m not going to act on them in the next 24 hours so can we please talk about my mom”*).  If it works, great.  If it doesn’t, you can leave knowing you tried, and you’ve practiced asserting a boundary.  It’s not what you called for, and you shouldn’t have to do it, but it can be a surprisingly satisfying second best.

Or maybe that won’t make you feel better at all.  That could happen too.  But if it does, I hope that this entry lets you know that it’s not your fault, and leaves open the possibility of trying again later.

*This is a balancing act.  Some callers are genuinely pills-in-the-hand suicidal and we take a fairly aggressive stance at talking them out of it.  A lot of other people are having suicidal thoughts with no intention to act on them, and we want to be a safe place for them to acknowledge those feelings as we talk about the actual problem.  If a particular call is ambiguous, we have to default to suicide intervention.  But if you can promise us you’re not going to kill yourself in the next 24 hours, or even just for the duration of the call, we can relax.

In fact, figuring out what to talk about in general is a tricky problem.  Some people need to talk about the patterns in their life.  Some need to talk about a specific incident.  Some need to talk about feelings without regard to external events.  Some need to be walked through breathing exercises so they can stop chasing their feelings in circles.  If you know which one of these you are, tell us, we are overjoyed to act on the information.

Intelligence vs. Effort, Acknowledgement vs. Praise

Everyone knows you’re supposed to praise children for effort, not intelligence.  Praising intelligence makes them risk averse and fragile in the face of failure, praising effort makes them harder-working and resilient.  How could any caring parent or teacher do anything but change their praise to be 100% efforts-based?

Here are some things that bother me about that framing:
  1. It’s an absolute, rather than relative to our current position.  It’s entirely possible that kids need a mix of both kinds praise, and we’re just swinging the pendulum from too much of one to too much of the other.
  2. As evidence for this, I present the fact that when East Asian kids despair-quit, they often frame it as “I’m not hard working enough”, which I’m not convinced is any better than “I’m not smart enough”
  3. Which brings up the important point that the parallel of “you are smart” is not “you must have worked very hard” but “you are so hard working”, so the comparison is not just intelligence vs. effort but innate characteristic vs. conscious choice.  I have no problem believing those have very different effects on children.
  4. What if the child didn’t work hard?  They either believe you, in which case they won’t understand what is happening when they are faced with something actually requiring hard work, or they won’t, in which case you’re eroding the child’s trust in you in the name of increasing achievement.  Good job science.
  5. More generally, framing everything as a result of effort is gaslighting above- and below- average children alike.  Some children get things faster than other children.  Refusing to acknowledge that could easily be interpreted as being smart or dumb is taboo, which is incredibly destructive on many levels.
  6. One of which is that it denies you and the child information that should inform their schooling.  All kids do need to learn to work hard, and that is better achieved by increasing difficulty until they find something they struggle with, rather than insisting they pretend whatever is in front of them is challenging.  It’s almost cargo-cult.
  7. This has the faint whiff of my mom’s ban on coloring books, because they limited creativity.  It is true that coloring requires less creativity than drawing, but that very factor makes them better for practicing hand-eye coordination.    Given that I’ve always overflowed with creativity but at age 13 got state-funded occupational therapy to make my handwriting legible to myself, I think a little coloring would have been okay.  Hell, there’s a trend right now for adults to color because life is hard and coloring is soothing.  Not everything needs to be about bringing out a child’s potential.
What I would rather see is success at school de-emphasized, all children exposed to a wide variety of activities so they experience being great and terrible at things,  and adults accurately reflect back what they did.  Sometimes that will be “you worked really hard”, sometimes it will be “you were really creative” and sometimes that will be “looks like you got that one really quickly.”  Curriculum would be adjusted so that all kids experience a range of challenges, without the level of activity that challenges them being given any moral weight.

I Swallowed A Bug

Here are the arguments in favor of bug eating:
  1. Relative to traditional meats (chicken, cow, pig, sheep), bugs require many fewer resources. (This and all future comparisons will be done on a per unit edible protein basis, rather than per unit animal weight)
  2. Bugs have more trace nutrients and less fat.
  3. We care less about bug suffering than chordate suffering.  Possibly we don’t care at all.
Here are the arguments against bug eating:
  1. Bugs are gross.
Here is where 28 years of being unable to digest food becomes a super power.  Most food and essentially all protein sources strike me as gross.  So bugs aren’t that much worse than any other source, and I have a lot of practice overcoming disgust in order to eat.
My friend Brian held a bug eating night.  He explains the rationale and practicalities pretty well, so I’ll restrict myself to talking about my personal experience, which can be summed up as “a million times better than I thought it would be.”
For background: I’m trying to train myself to eat meat.  This quarter I’ve taken to cutting off slivers of salmon (for the omega-3s) and more recently duck (which is a wonderful combination of delicious when dead and malicious towards conspecifics while alive, which makes it feel a little more moral) and sauteing them until they’re charred through.  When I say slivers, I mean slivers.  I’ve been working on duck for a week and I eat at most two fingernail-clipping sized bits, prepared and eaten separately.  For salmon I might do as much as 1/2 the volume of my pinky. I have small hands.
I pre-committed to eating at least one cricket, but that was all.  The other bug was supposed to be waxworms, and waxworms are squishy.  I don’t do squishy even when it’s not bugs.  And I was going to be extremely proud of myself for just that one cricket.  Eating a new anything is a big deal for me, and it takes time to adjust.
When the moment came I ate several (along with some HCl pills), and walked away, supremely satisfied in myself for trying a new thing and not freaking out about it.  And then I started getting that itch to eat more, that means the thing in front of me has some trace nutrient I’m short on.    So I did.  And I asked for some to take home.
I got off easy on the waxworms because they were burnt so badly they ended up not serving them.  But there were mealworms.  Mealworms were served as taco fillings, but as it turns out I’d rather eat a bug than a taco (the variation in textures freaks me out).  Mealworms were wetter and more fibrous, so you had to chew them more (although don’t skimp on chewing crickets, catching a leg in your throat feels gross).  The had their own taste, which I didn’t care for at first but could probably grow to be okay with.  I think I like it better than chicken (aka bad tofu) and beef, but not as much as duck or pork, and by pork I mean bacon.
At the end of the night I had a slight stomach ache.  I’d brought HCl but no digestive enzymes, and my stomach was clearly struggling to keep up.  But I get that with all new foods and any significant amount of protein, so I don’t hold it against the bugs.
Some of ease of eating was undoubtedly the environment.  Brian, John, and their blogless roommates have a pre-existing tradition of communal meals that I love, and that makes eating easier.  it was also supremely gratifying to have other people share my attitude that the food in front of us was gross but we were going to eat it anyway.  Constantly being the only one that thinks that gets really lonely.  I flinched a little bit when I went to eat the cricket leftovers this morning.  But then I ate them, and it was fine.  Definitely better than duck, and duck is delicious.
Honestly, the biggest down side is that for all that bugs take many fewer resources than chordate meat, they are currently much more expensive.  One pound of edible cricket is ~$13/pound, which is as much as the grass fed free range humanely cuddled duck I get at the fancy grocery store.  I could probably grow them at home at essentially no cost, since they can live on food waste I would otherwise toss, but I’m not yet committed enough to deal with the noise.  But even at this price I plan on eating more bugs.

Any straw that doesn’t break your back must be weightless.

Toxoplasma gondii is a single-cell parasite usually associated with cat feces, although undercooked meat is the more common form of infection.  For years, everyone knew that T. gondii was totally harmless unless a pregnant woman caught it at a very particular stage in the pregnancy, at which point it caused miscarriage or devastating birth defects.  I probably learned about this younger than most because this was my parents official reason for not letting me have a cat while they were trying to conceive.  But eventually I got my cat and never thought about it again*, because I was not a pregnant woman.  While the concept was gross, 20% of the US and 30-60% of the world has it, so clearly it’s harmless.

Then science began to poke around a bit more.  Toxoplasmosis causes pretty drastic behavior changes in rat, as demonstrated by this adorable video of rats attempting to cuddle a cat…

…which is actually a video of a paramecium attempting to get this cat to eat the rats so it can sexually reproduce in the stomach.  Enjoy that mental image.  If it can have such a strong effect in rats, might it have some measurable effect in humans as well?


First, T. gondii was always considered dangerous in immunocompromised individuals (e.g. AIDS patients). But it gets worse. Research revealed associations between T. gondii and lower IQ in children (which may reverse with treatment), suicide attempts, decreased novelty seeking, car accidents,  lower IQ  in men, greater friendliness and sexuality in women , and perhaps 20% of all schizophrenia.**

Here is what I think is going on.  The human body is incredibly robust.  It can take a number of hits and show only a very minor decrease in function.  But if you already have enough hits against you (HIV, age, genetic predisposition to schizophrenia), it can have a big effect.  Or maybe it will do nothing, but it uses up one of your hits, so when the next blow comes, you don’t have the energy to fight it.    This is why the phrase “only dangerous in immunocompromised individuals” bugs me so much.  First, everyone who doesn’t die of trauma lives at the mercy of their immune system.  Second, immune function is not bimodal.  There’s lots of people that don’t have AIDS, but do have, I don’t know, multiple chronic complex infections in their jaw requiring extensive surgery to remove.  Or they’re poor and have substandard housing and nutrition.  Or they pick up a second parasite while camping.

Telling these people- who don’t have AIDS or leukemia, but aren’t functioning at optimal either- that T. gondii, or any other aggravator, can’t affect them is like telling a working-poor person that ATM fees can’t hurt her because she’s not homeless.  It’s great that the fees are a rounding error to you, but don’t discount the cost they impose on others

*Which turned out to be totally justified.  Owning a cat is not a risk factor for toxoplasmosis, and I happen to have been tested as part of a larger parasite screen last year and am certifiably toxoplasmosis free.

**A lot of these studies are associational, which I usually frown upon.  I find it more valid in this case because causational studies in animals show similar effects.