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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

Position statement: Recent reporting in newspapers
2014-10-03

 

You may have read reports in two Afrikaans newspapers, regarding recent events at the University of the Free State (UFS). Sadly, those reports are inaccurate, one-sided, exaggerated and based not on facts, but on rumour, gossip and unusually personal attacks on members of the university management.

Anyone who spends 10 minutes on our Bloemfontein Campus would wonder what the so-called ‘crisis’ is about.

We are left with no choice other than to consider legal action, as well as the intervention of the South African Press Ombudsman, among other steps, to protect the good name of the institution and the reputation of its staff. No journalist has the right to launch personal and damaging attacks on a university and its personnel, whatever his or her motives, without being fair and factual. In this respect, the newspapers have a case to answer.

But here are the facts in relation to the reports:

  1. No staff member, whether junior or senior, is ever suspended without hard evidence in hand. Such actions are rare, and when done, are preceded by careful reviews of our Human Resource Policies, labour legislation and both internal and external legal advice. Then, and only then, is a suspension affected. A suspension, moreover, does not mean you are guilty and is a precautionary action to allow for the disciplinary investigation and process to be conducted, especially where there is a serious case to answer.
  2. At no stage was the Registrar instructed to leave the university; this is patently false and yet reported as fact. We specifically responded to the media that the Registrar does outstanding work for the university and that it is our intention for him to remain as our Registrar through the end of his contract in 2016.
  3. The Rector does not make decisions by himself. Senior persons, from the position of Dean, upwards, are appointed by statutory and other senior committees of the university and finally approved by Council. No rector can override the decision of a senior committee, and this has not happened at the UFS even in cases where the Rector serves as Chair of that committee. The impression of heavy-handed management at the top insults all our committee structures, including the Institutional Forum – the widest and most inclusive of stakeholder bodies at a university – which reports directly to Council on fairness and compliance of selection processes.
  4. In the case of senior appointments, Council makes the final decision. Council fully supports the actions taken on senior appointments, including a recent senior suspension. The fact that one Council member resigns just before the end of his term, whatever the real reason for this action, does not deter from the fact that the full Council in its last sitting approved the major staffing decisions brought before it. The image therefore that the two newspapers try to create of great turmoil and distress at the university, is completely unfounded.

Even if we wanted to, the university obviously cannot provide details about staffing decisions, especially disciplinary actions in process, since the rights of individuals should be protected in terms of the Human Resource Policies and procedures of the UFS. But that does not give any newspaper the right to speculate or state as fact that which is based on rumour or gossip, or to slander senior personnel of the university. For these reasons, we have been forced to seek legal remedy and correction as a matter of urgency.

Make no mistake, underlying much of the criticism of the university has been a distress about transformation at the UFS; in particular, the perception is created that white colleagues are losing their jobs. The evidence points in the opposite direction. Our progress with equity has been slow and we lag far behind most of the former white universities; that is a fact. More than 90% of our professors are white; most of our senior appointments at professorial level and as heads of department are still overwhelmingly white. Reasonable South Africans would agree that our transformation still has a long way to go and only the mean-spirited would contend otherwise. But based on the two Afrikaans newspaper reports, an impression is left of the aggressive rooting out of white colleagues.

In the past few years the academic standard of the university has significantly improved. We now have the highest academic pass rates in years, in part because we raised the academic standards for admission four years ago. We now have the highest rate of research publications, and among the highest national publication rate of scholarly books, in the history of the UFS. We have one of the most stable financial situations of any university in South Africa, with a strong balance sheet and growing financial reserves way beyond what we had before. We now attract top professors from around the country and other parts of the world, and we have the highest number of rated researchers, through the National Research Foundation, than ever before. And after the constant turmoil of a number of years ago, we now have one of the most stable campuses in South Africa. Those are the facts.

The UFS is also regarded around the world as a university that has become a model of transformation and reconciliation in the student body. The elections of our Student Representative Council are only the most visible example of how far we have come in our leadership diversity. Not a week goes by in which other universities, nationally and abroad, do not come to Kovsies to consult with us on how they can learn from us and deepen their own transformations, especially among students.

Rather than focus on what more than one senior journalist, in reference to the article in Rapport of 21 September 2014, rightly called ‘a hatchet job’ on persons and the university, here are the objective findings of a recent survey of UFS stakeholders: 92% endorse our values; 77% agree with our transformation; 78% believe we are inclusive; and 78% applaud our overall reputation index.  Those are very different numbers from a few years ago when the institution was in crisis.

This is our commitment to all our stakeholders: we will continue our model of inclusive transformation which provides opportunities for study and for employment for all South Africans, including international students and colleagues. We remain committed to our parallel-medium instruction in which Afrikaans remains a language of instruction; we are in fact the only medical school in the country that offers dual education and training in both Afrikaans and English for our students - not only English. We provide bursaries and overseas study opportunities to all our students, irrespective of race. And our ‘future professors’ programme is richly diverse as we seek the academic stars of the future.

We are not perfect as a university management or community. Where we make mistakes, we acknowledge them and try to do better the next time round. But we remain steadfast in our goal of making the UFS a top world university in its academic ambitions and its human commitments.

END

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