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06 September 2023 | Story Angela Vorster | Photo Andre Damons
Angie Vorster
Angela Vorster is a Clinical Psychologist at the School for Clinical Medicine, University of the Free State (UFS).

Opinion article by Angela Vorster, Clinical Psychologist at the School for Clinical Medicine, University of the Free State.

If you are reading this you may be interested in better understanding why there is a need for a World Suicide Prevention Day each year on 10 September. For some it may seem morbid, while for others it is just another awareness initiative. But for too many, suicide is personal. You may have lost someone you love in this manner. Or you yourself may be struggling with thoughts of ending your life. If you fall into the latter group you may want to skip over to the very last paragraph, because I know your attention may be waning and your energy may be low. Everybody else, please join me in better understanding the need for awareness of thoughts of self-harm and attempts at ending one’s life.

Mental illness can be fatal 

In most instances dying by ‘suicide’ is more accurately described as dying from a psychiatric disease. Mental illness can be fatal if left untreated and we need only refer to suicide-related statistics to realise the magnitude of this plague in South Africa. The World Health Organisation indicated that South Africa is ranked 10th on the list of international countries with the highest suicide rates, while The South African Depression and AFnxiety Group (Sadag) reports 23 deaths by suicide per day. For each person who dies by suicide in our country; 10 others attempt to end their lives. Up to nine out of 10 people who die by suicide in South Africa had a mental health disease such as depression at the time of their death. If we take a look at these facts, it becomes almost absurd that we still regard mental illness and thoughts of self-harm and the act of causing self-death, as shameful and abnormal. But that is still very much how mental illness and particularly suicidality are viewed in our communities. Perhaps if we are able to really understand what it feels like to feel so terribly sad, empty, hopeless, worthless and guilty that you would rather end your life than suffer through another hour; perhaps then we would be able to create safe spaces for those who feel suicidal to express how they feel. It is only through connection and communication that we can provide the right support at the right time in order to save lives.

The black dog

There are many descriptions of what it feels like to be so ill that death seems the only cure and these vary across cultures and countries. The Black Dog Institute in Australia derived its name from the description of depression as feeling as though a menacing dark dog-like creature is following you around and no matter how hard you try, you just can’t shake it. Winston Churchill used this metaphor to describe times when he felt melancholic, demotivated and down. Now I love dogs, so I imagine this particular type of canine as being almost monstrous, not leaving you alone, but also not giving you anything. Instead of the loyalty and companionship and protection that our pet dogs give us, this dog demands constant feeding, does not allow you any freedom and prevents you from making contact with other people. The moment you start to reach out to someone, this black dog starts growling in the background and you give up or scare them away with your dark mood. And the black beast has you all to himself once again. This type of depression sucks your energy and your motivation. It makes you irritable and tired and isolated. Difficult to like.

Another metaphor for depression is ‘feeling blue’, one which we use so frequently that we have perhaps not stopped to consider where it originates. There are many theories, and all of them quite bleak. One is that the description derives from the human body that turns blue after death; another that ships used to fly blue flags if their captain had perished at sea, and yet another, that Zeus, the Greek God of the sky and thunder, would make it rain when he was sad. Have you noticed how flippantly people comment on ‘the baby blues’ as though this were something almost endearing and expected that is associated with becoming a mother. This while the stark reality of post-natal depression has been highlighted in the recent trial of Dr Lauren Dickason in New Zealand. I cannot comment on the legal aspects related to her case, but what I found jarring was the number of times that she told the people around her that she wanted to die or that she wanted to harm her children. I have worked with many women diagnosed with post-partum depression who describe feeling as though they are drowning. Having nothing to stand on, being pummelled by waves, unable to catch a breath and with no sight of help or the shore. This type of depression is a torturous combination of distress, anxiety and hopelessness where you just cannot stop the negative fearful ruminations swirling in your mind. There is no calm, no silence and no peace.

Feeling nothing 

The metaphor I find most disturbing is when depressed patients describe feeling ‘nothing’. So often people will express feeling empty and their lives as grey. Nothingness. And I am always reminded of the 1980s movie ‘Neverending Story’ where everything that was magical and creative and hopeful had been swallowed up by ‘The Nothing’ – an empty energy that consumed everything in its way. How terrifying it must be to feel nothing. No hope, no joy, no excitement, not even sadness or fear. Just nothing. Blank. And no matter what you do or how hard you try, you just feel nothing. How horrifying it must be to hug someone you love, or have to get up each morning and go to school, or go to work and have to paste on a smile and chat about the weekend while you feel nothing. I can only imagine the desperation to feel something. Anything. This depression is you sitting on your bed and staring at the ceiling for hours. Waiting for it to end. 

Something that stands out to me as a common theme among all of these metaphors is this: if a monster is following you around, nobody wants to come near you. If you are gasping for breath and swallowing water drowning in the sea – there is nobody around to save you. If you float through your days in a bubble of nothingness – you are alone. The antidote to suicidality is connection. It is being willing to spend time with someone who has a growling, slobbering, and mangy stray dog following them. It is listening to someone who is struggling and thrashing, terrified of drowning. It is being brave enough to enter nothingness and to realise that you too could horrifyingly easily feel empty and grey too. Now we need to be cautious. It is dangerous dealing with an angry dog, or trying so save a drowning person or rescuing someone floating off into space. We cannot do it alone and we cannot do it without experts. But the first step is to shout, or speak or whisper: ‘Hello’. ‘I’m here’. ‘I’ll get help’. Without fear or judgement or discrimination. But with the deep understanding that being human is a treacherous thing. And recalling the times when a safe, strong hand reached out to pull us away from danger. Because you see, we are all vulnerable to being followed by a black dog. Or being washed away by a wave. Or being consumed by The Nothing. 

Grab hold of the stretched out hand 

What makes us human is our vulnerability. To diseases of the body. And diseases of the mind. And what makes us human is our willingness to see our own vulnerabilities in others. I will reach out and help you because I too have needed help. So this World Suicide Prevention Day let us tame black dogs and send life rafts out to stormy seas. Let us be the solid ground to tether those who are floating away into outer space. And when we find ourselves followed or drowning or adrift – let us too reach past the snarling and swirling and emptiness to touch the outstretched hands of those who are here for us. Because they are here. We are right here. But in order to be rescued from the attacking beast, or the crashing waves or the airlessness of space, you have to grab hold of the hand stretched out toward you. 

If you or someone you know are experiencing suicidal thoughts or feelings of depression please tell someone you trust how you feel and make contact with one of the 24-hour support lines such as The South African Depression and Anxiety Group (Sadag) (+27 800-567-567) or LifeLine (+27 861-322-322).

Also take a look at these websites:

News Archive

Media: ANC can learn a lesson from Moshoeshoe
2006-05-20


27/05/2006 20:32 - (SA) 
ANC can learn a lesson from Moshoeshoe
ON 2004, the University of the Free State turned 100 years old. As part of its centenary celebrations, the idea of the Moshoeshoe Memorial Lecture was mooted as part of another idea: to promote the study of the meaning of Moshoeshoe.

This lecture comes at a critical point in South Africa's still-new democracy. There are indications that the value of public engagement that Moshoeshoe prized highly through his lipitso [community gatherings], and now also a prized feature in our democracy, may be under serious threat. It is for this reason that I would like to dedicate this lecture to all those in our country and elsewhere who daily or weekly, or however frequently, have had the courage to express their considered opinions on pressing matters facing our society. They may be columnists, editors, commentators, artists of all kinds, academics and writers of letters to the editor, non-violent protesters with their placards and cartoonists who put a mirror in front of our eyes.

There is a remarkable story of how Moshoeshoe dealt with Mzilikazi, the aggressor who attacked Thaba Bosiu and failed. So when Mzilikazi retreated from Thaba Bosiu with a bruised ego after failing to take over the mountain, Moshoeshoe, in an unexpected turn of events, sent him cattle to return home bruised but grateful for the generosity of a victorious target of his aggression. At least he would not starve along the way. It was a devastating act of magnanimity which signalled a phenomenal role change.

"If only you had asked," Moshoeshoe seemed to be saying, "I could have given you some cattle. Have them anyway."

It was impossible for Mzilikazi not to have felt ashamed. At the same time, he could still present himself to his people as one who was so feared that even in defeat he was given cattle. At any rate, he never returned.

I look at our situation in South Africa and find that the wisdom of Moshoeshoe's method produced one of the defining moments that led to South Africa's momentous transition to democracy. Part of Nelson Mandela's legacy is precisely this: what I have called counter-intuitive leadership and the immense possibilities it offers for re-imagining whole societies.

A number of events in the past 12 months have made me wonder whether we are faced with a new situation that may have arisen. An increasing number of highly intelligent, sensitive and highly committed South Africans across the class, racial and cultural spectrum confess to feeling uncertain and vulnerable as never before since 1994. When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. It must have something to do with an accumulation of events that convey the sense of impending implosion. It is the sense that events are spiralling out of control and no one among the leadership of the country seems to have a handle on things.

I should mention the one event that has dominated the national scene continuously for many months now. It is, of course, the trying events around the recent trial and acquittal of Jacob Zuma. The aftermath continues to dominate the news and public discourse. What, really, have we learnt or are learning from it all? It is probably too early to tell. Yet the drama seems far from over, promising to keep us all without relief, and in a state of anguish. It seems poised to reveal more faultlines in our national life than answers and solutions.

We need a mechanism that will affirm the different positions of the contestants validating their honesty in a way that will give the public confidence that real solutions are possible. It is this kind of openness, which never comes easily, that leads to breakthrough solutions, of the kind Moshoeshoe's wisdom symbolises.

Who will take this courageous step? What is clear is that a complex democracy like South Africa's cannot survive a single authority. Only multiple authorities within a constitutional framework have a real chance. I want to press this matter further.

Could it be that part of the problem is that we are unable to deal with the notion of "opposition". We are horrified that any of us could become "the opposition". In reality, it is time we began to anticipate the arrival of a moment when there was no longer a single [overwhelmingly] dominant political force as is currently the case. Such is the course of change. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than ones that seek to prevent it. This is the formidable challenge of a popular post-apartheid political movement.

Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it currently is and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest itself in different articulations of itself, which then contend for social influence.

In this way, the vision never really dies, it simply evolves into higher, more complex forms of itself. If the resulting versions are what is called "the opposition" that should not be such a bad thing - unless we want to invent another name for it. The image of flying ants going off to start other similar settlements is not so inappropriate.

I do not wish to suggest that the nuptial flights of the alliance partners are about to occur: only that it is a mark of leadership foresight to anticipate them conceptually. Any political movement that has visions of itself as a perpetual entity should look at the compelling evidence of history. Few have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early 1990s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. It is not a time for repeating old platitudes. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed up to the adoption or our Constitution?

Morena Moshoeshoe faced similarly formative challenges. He seems to have been a great listener. No problem was too insignificant that it could not be addressed. He seems to have networked actively across the spectrum of society. He seems to have kept a close eye on the world beyond Lesotho, forming strong friendships and alliances, weighing his options constantly. He seems to have had patience and forbearance. He had tons of data before him before he could propose the unexpected. He tells us across the years that moments of renewal demand no less.

  • This is an editied version of the inaugural Moshoeshoe Memorial Lecture presented by Univeristy of Cape Town vice-chancellor Professor Ndebele at the University of the Free State on Thursday. Perspectives on Leadership Challenges In South Africa

 

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