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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 24 to 48 of 67. Go back in thread:
Posted by cubic_me on March 6, 2005, at 5:58:22
In reply to Re: immediate concerns » Dinah, posted by alexandra_k on March 6, 2005, at 1:10:17
I think that if the system of people being able to notify ISP providers was in place, I would hardly talk at all on these boards for fear of the police knocking on my door.
I don't post suicidal intent on these boards, however I can completely understand why people do. Many people have few people IRL who know them as well emotionally or who they trust as much as babblers. It is not true that we can do nothing to help - sometimes words alone can be enough for people to hang on a few more days until things seem bit brighter. Of course we want to stop people killing themselves, but in the end it is THEIR choice, it will not be our fault if they kill themselves. If this system was opperating I think that it may stop people posting who could have truely been helped by some support from babblers.
I don't think that babble has ever explicitly stopped me from attempting suicided (however even recently I can think of one person it has), however it has made me feel less alone at those times. I would not have posted, and therefore felt less alone if I'd have thought that the police may come knocking. I am a very private person, and people knowing about my depression would have severe concequences for me. Also, I ofen post from the university computers - would the police be able to find me there?
I'm sorry for the length of this post, I just feel strongly about this. I think that the idea of some kind of crisis centre is good, but may be impractical (but I don't know). Perhaps more prominant links to the crisis pages would be good, as I didn't even know there were any unitil I read about them on Admin a few weeks ago.
Posted by Dinah on March 6, 2005, at 9:08:16
In reply to Re: immediate concerns, posted by cubic_me on March 6, 2005, at 5:58:22
I agree with everything you say. I would hate for people to lose Babble at the point they most needed it. Perhaps it's a situation where trigger warnings would be a polite gesture. But I don't think it would be right for Dr. Bob to shush people for expressing the ultimate of despair.
I know there are times when people feign suicidal intent, for various reasons. I try to be understanding of the fact that I have no way of knowing if that's true in any particular case, and that whatever reason they have is vital to them. I sometimes fail to keep that in mind.
Oh, this brings back so many old feelings.
Right now, Dr. Bob does contact the ISP if he feels there is an immediate threat, and if he is available. But he's conservative, and he has experience in determining whether a situation calls for that drastic intervention. In fact I contacted him once about a situation that I thought fell into that category, and he disagreed. I trust him in that position.
I'm also not sure it's a burden Dr. Bob should place on the Babble population at large. If he's willing to accept volunteers and give them some rudimentary training, that might be different. Or accept volunteers who already are credentialed in some way.
Posted by Phillipa on March 6, 2005, at 9:27:11
In reply to Re: immediate concerns, posted by cubic_me on March 6, 2005, at 5:58:22
Maybe our crisis center could offer the services of fellow Babblers trained to "know what to say". Then if it was in agreement with the potential suicidal person, a list of places or people they could call for help in their area. Asking them if there was a loved one whom we could help them contact to go to their location. With their permission of course. Sometimes you just have to talk someone through the necessary steps to available help, as they are so stressed at the time that they can't do it by their self. Fondly, Phillipa
Posted by Dr. Bob on March 6, 2005, at 14:49:36
In reply to Re: immediate concerns, posted by Phillipa on March 6, 2005, at 9:27:11
> Another thing that might help is very clear guidelines very prominently postes. Something along the lines of "if you express clear suicidal intent, your ISP will likely be contacted, but do not rely on that and please seek help in real life".
>
> DinahI'm not sure how prominent I'd consider it, but the FAQ does already say:
> I ask for email addresses (and the server logs IP addresses) so that if there is any abuse or serious danger, I can notify the person's Internet service provider (or other authorities).
http://www.dr-bob.org/babble/faq.html#privacy
--
> May be farfetched but how about our own crisis center.
>
> Phillipa> Is there some person, group of persons, or organization with experience in assessing intent that would be willing to review posts that were sent to their attention?
>
> Dinah> Maybe our crisis center could offer the services of fellow Babblers trained to "know what to say".
>
> PhillipaWhat if Babblers who were interested obtained training from the Samaritans or someone?
--
> The consequences of making a good call…
> Even if a life is saved as a result I worry that a poster won’t be happy that another poster called the police on them.OK, thanks, I see.
> On a slightly different note I wonder if letting people do this would escalate or reduce those kinds of posts on the board.
>
> alexandra_k> I think that if the system of people being able to notify ISP providers was in place, I would hardly talk at all on these boards for fear of the police knocking on my door.
>
> cubic_meWhat about me already being able to notify your ISP?
If you aren't really suicidal, you can just say so, and that would be nice for everyone to know...
Thanks for thinking this through with me,
Bob
Posted by alexandra_k on March 6, 2005, at 15:01:59
In reply to Re: immediate concerns, posted by cubic_me on March 6, 2005, at 5:58:22
I think that there is a difference between posting suicidal ideation and suicidal urges. Well, the border can be fuzzy at times to be sure, but my understanding is that it would be clear cases of the latter that would warrant someones internet provider being contacted.
I post ideation quite a bit. I also say that I will be okay. I don't want to worry people but I do want to vent what is going on for me. Nobody has had a problem with that (that I am aware of) but people did express concern and I got some supportive posts which helped me.
But when someone posts something saying that they are going to do something or they have just done something or saying goodbye to everyone then that is when something needs to be done. It is that kind of stuff that I wish people wouldn't post here because a) It is a gamble as to whether Dr Bob can do something so they receive intervention in time and b) The rest of us have to deal with being very concerned (possibly triggered) and helpless and powerless to do anything. I don't think it is fair to the posters here. We are not trained to deal with suicide intervention. With respect to getting supportive posts you don't need to post the latter kind of claims to get support. The rest of it is unnecessary and there are much more appropriate alternative places with trained staff that people can turn to.
If we can get someones ISP provider to contact the police then Babble becomes something of an emergency service. If that is acceptable then I would request that the latter kinds of urges be prefaced with a special trigger warning. In fact, why not just hook it up to 911 directly ???
> I think that if the system of people being able to notify ISP providers was in place, I would hardly talk at all on these boards for fear of the police knocking on my door.
Yes. I can see it now. Police phone the manager at the hostel: some of the residential assistants are informed etc etc. Then they want to know whether I post on this board and what I post and why someone called the cops on me etc etc. Humiliating. But I do think that there could be measures around this. We would need to know what kinds of things warrant a call to the ISP provider (to make sure we don't say them) and that calls are made only on the basis of our having posted such things.
I apprecite that I will probably get jumped on again... But I do think that it is possible to express yourself in a way that is true to your experience AND considerate of posters and their position here at the same time.
Posted by alexandra_k on March 6, 2005, at 15:14:49
In reply to Re: immediate concerns, posted by Dr. Bob on March 6, 2005, at 14:49:36
> > On a slightly different note I wonder if letting people do this would escalate or reduce those kinds of posts on the board.
> What about me already being able to notify your ISP?
But that is fairly inconspicuous...
(Though not anymore not anymore)
Also it is a great gamble.
Who knows when you will be able to do that.
And how long the ISP will take to notify the cops.
And how long the cops will take to find someone.
If posters can do this too then there is much faster intervention.I guess my experience with suicidal peoples is the people I knew in DBT group. That is probably impacting on my thoughts about this quite a lot.
One expresses urges or has an attempt and then by next week almost everyone has expressed urges or had an attempt. Catchy. For people who have a tough time dealing with crisis services the police being called by a third party might be what it takes for them to be taken seriously. But then Babble becomes a routine way of getting services they need in their area.
So be it I suppose.
It is not that I am so very cold and heartless.
But their has been something of a spate of this on the boards recently...
Also people saying they need to reduce their emotional involvement with Babble...
Catchy?
I worry that it will significantly change the tone of the boards...But all that being said...
I would prefer to interveane rather than be powerless.
And people do insist on expressing their urges.Sorry.
I have felt quite affected by some of the posts here recently. I don't think I am the only one. I'll just try to think of it as a 'bad patch'.
Posted by Tabitha on March 6, 2005, at 17:47:41
In reply to Re: immediate concerns, posted by alexandra_k on March 6, 2005, at 15:14:49
From a technical perspective I don't think Dr Bob can necessarily trace each poster's location. He probably won't want to share specifics, but I suspect his ability to locate a poster isn't fool-proof. So even if he extends this "notify the ISP" power to us posters, it still might fail to provide that person's physical location to the police. This makes us uniquely helpless here in cyberspace.
If I tell my therapist or pdoc I'm going to kill myself, they can take action to get me hospitalized. If I call a crisis hotline or 911, they can trace my call and locate me. This forum might be the only place I can announce my intent to kill myself without any consequence. I don't think such a situation is healthy for the suidical person or for the other members.
I also question whether allowing group members to provide suicide intervention makes any sense. Would any real life support group have its members able to or responsible for intervening in other members' suicide attempts? Just does not seem like good boundaries to me. In fact it seems really messed up. I think Dr Bob should discuss this idea with some other psychiatrists or mental health professionals and get their input.
Posted by Phillipa on March 6, 2005, at 19:22:34
In reply to Re: immediate concerns, posted by Tabitha on March 6, 2005, at 17:47:41
Good Idea. Fondly, Phillipa
Posted by Dinah on March 6, 2005, at 19:58:17
In reply to Re: immediate concerns, posted by Tabitha on March 6, 2005, at 17:47:41
That posters would rather have a poster just quietly disappear than post anything suicidal?
I'll remember that.
Posted by alexandra_k on March 6, 2005, at 20:08:36
In reply to So the consensus is, posted by Dinah on March 6, 2005, at 19:58:17
I never said that Dinah.
I don't think anybody said that.
Posted by Dinah on March 6, 2005, at 20:49:16
In reply to Re: So the consensus is » Dinah, posted by alexandra_k on March 6, 2005, at 20:08:36
If it's inappropriate to post suicidal intent on the board, what else is there but to slink off quietly and die without bothering anyone?
So if I'm missing something, let me use examples.
1) Say I've decided to go through with killing myself, but there's a small part of me that wants to be talked out of it, or given a reason to live. Is it inappropriate to post?
2) I'm on my way out the door to carry out my plan, and I want to say goodbye. Is it inappropriate to post?
3) I've already carried out my plan, and am waiting for it to work. Ok, this wouldn't apply to me, so never mind.
Posted by Phillipa on March 6, 2005, at 20:55:40
In reply to Then I'm missing something, posted by Dinah on March 6, 2005, at 20:49:16
Very good points. You need a place to Post, and hopefully be talked out of carrying out your plans, or convinced to call 9ll if you have let's say ingested pills. Fondly, Phillipa
Posted by alexandra_k on March 6, 2005, at 22:12:00
In reply to Then I'm missing something, posted by Dinah on March 6, 2005, at 20:49:16
I think the difference between expressing despair / ideation and expressing intent is tricky. A little like the difference between expressing an accusation and expressing ones feelings.
> If it's inappropriate to post suicidal intent on the board, what else is there but to slink off quietly and die without bothering anyone?
Well there is 911. There is the emergency room. There is the samaratins. There is lifeline or the equivalent. Perhaps there are other people in ones life. A therapist. A p-doc.
> 1) Say I've decided to go through with killing myself, but there's a small part of me that wants to be talked out of it, or given a reason to live. Is it inappropriate to post?
I don't see anything wrong with expressing that one is finding it hard to come up with reasons to live. But that is different from saying one will kill oneself if someone can't come up with a reason for you. There are other people that can be contacted.
> 2) I'm on my way out the door to carry out my plan, and I want to say goodbye. Is it inappropriate to post?Same as above.
> 3) I've already carried out my plan, and am waiting for it to work. Ok, this wouldn't apply to me, so never mind.But it may apply to others.
What do you think.
Is it fair on the posters here?
Asking for support is one thing...
Telling people you are going to kill yourself is another.IMO
Posted by Dinah on March 6, 2005, at 22:20:11
In reply to Re: Then I'm missing something » Dinah, posted by alexandra_k on March 6, 2005, at 22:12:00
Well, I was more likely to post here than I was to contact 911 or the Samaritans. In fact I'm unlikely to do either of those. Won't you sort of notice I'm missing though? Especially if my posts have been increasingly distraught?
Oh well, I suppose as long as you can imagine I might be all right, you can not be distressed by it.
Posted by alexandra_k on March 6, 2005, at 22:31:02
In reply to Re: Then I'm missing something » alexandra_k, posted by Dinah on March 6, 2005, at 22:20:11
> Well, I was more likely to post here than I was to contact 911 or the Samaritans. In fact I'm unlikely to do either of those. Won't you sort of notice I'm missing though? Especially if my posts have been increasingly distraught?
> Oh well, I suppose as long as you can imagine I might be all right, you can not be distressed by it.Ouch Dinah, ouch.
I am really worried about SmokeyMadison truth be told. If anyone knows whether she is alright or knows how to contact her to find that out I would appreciate that.
Posted by Phillipa on March 6, 2005, at 22:43:40
In reply to Re: Then I'm missing something » alexandra_k, posted by Dinah on March 6, 2005, at 22:20:11
Are people in that amount of pain really thinking of "what is fair" to other posters? No, they have reached their limits and now they just want out. I would like to think that I at least tried to stop them. I would personally sleep better. And sleeping is a problem for me. Fondly, Phillipa
Posted by Dinah on March 6, 2005, at 23:10:27
In reply to Re: Then I'm missing something » Dinah, posted by alexandra_k on March 6, 2005, at 22:31:02
I didn't mean to poke you, Alexandra.
Part of what I was saying is literal. I will feel less able to post here, the only place outside my therapist that I'm likely to say anything at all, if I think that people will be annoyed with me for doing it. And if, God forbid, the reason I'm suicidal is that something, God forbid, happens to my therapist, then this is the only place I'm likely to say anything at all. So if I don't think I can say anything here, my thought processes would be that it would be better to just... Oh well, you get my point.
I was also trying to say that people don't have to post suicidal messages for others to be concerned about them. It's possibly not true about posters who are newly arrived on the boards, so that people don't know it's uncharacteristic for them not to post, but it almost definitely is true about people who post consistently then suddenly stop. Gracie springs to mind.
The distress level here can cause pain sometimes. There's no doubt about that. And people need to be able to judge what they can and can't handle for themselves, and skip over what they can't handle. I can't visit the grief board. Maybe you need to skip suicidal messages. Probably there are times when everyone needs to skip them. That's why it's good to have a big board.
With suicidal messages, perhaps the best way to disengage is to truly accept our own powerlessness on an ultimate level. We can try to help others, and we may or may not succeed. It isn't up to us.
(Unless Dr. Bob makes it possible for posters to contact ISP's)
I haven't heard from Smokey Madison, Alexandra. Maybe you can post on Social or Psychology and she or someone she's been in contact with can tell you more.
Posted by alexandra_k on March 7, 2005, at 0:01:14
In reply to Re: Then I'm missing something » alexandra_k, posted by Dinah on March 6, 2005, at 23:10:27
> but it almost definitely is true about people who post consistently then suddenly stop. Gracie springs to mind.
Well Smokey is springing to my mind right now. She was a fairly consistent poster and she hasn't been around at all for a while. She has also turned her babblemail off (assuming it was on before)
> I haven't heard from Smokey Madison, Alexandra. Maybe you can post on Social or Psychology and she or someone she's been in contact with can tell you more.Done that already.
Nobody had any info.I don't know what to say...
It is true that people who are feeling suicidal typically aren't thinking very rationally...I have said what I think already in the posts above. There really isn't anything I have to add. But to draw your attention once again to the distinction (which may well be fuzzy) between ideation and urges. If you need support then sure, that is what the boards are about. If you want to inform us of your impending death then it is just my personal preferance that you place one hell of an obvious trigger warning on that thread.
BECAUSE THERE IS NOTHING WE CAN DO
and also
BECAUSE THERE ARE THINGS THAT PEOPLE CAN DO IRL
and unless you need help getting up the courage to do that WHY POST IT HERE. How can that really be anything other than distressing to other posters?I don't know.
It isn't that I am heartless.
But sometimes there is only so much that one can listen to without getting infected with the same bug.
I personally find it to be contageous.
And the trouble is you have to read it to figure out what it says and it is only once you have figured out what it is saying that you know you shouldn't have read that.
Posted by alexandra_k on March 7, 2005, at 0:07:36
In reply to Re: Then I'm missing something » alexandra_k, posted by Dinah on March 6, 2005, at 23:10:27
But anyway we have become distracted from the issue here.
It doesn't matter how I or anyone feels in response.
People will post what they will post.
And some people may be in a position to be helpful while others may not be.
(By posting support)
(By getting intervention)
Hell, I can go either way depending on how I am in myself.
I wish people wouldn't post that.
But then I wish people didn't feel like that.
But given that they do feel like that
What are they supposed to do?It would be nice if people could post about how they are feeling.
Rather than about what they are going to do
Or what they have done
(So support is appropriate rather than intervention)
But people will post what they will postYes, I think we should have the option to contact someones ISP.
Time could be of the essence
Posted by alexandra_k on March 7, 2005, at 1:45:00
In reply to Re: Then I'm missing something, posted by alexandra_k on March 7, 2005, at 0:07:36
Somewhere that could be kept safe (well, as safe as possible) for people in a fragile state.
Posted by cubic_me on March 7, 2005, at 5:25:38
In reply to Re: immediate concerns, posted by Dr. Bob on March 6, 2005, at 14:49:36
>> I think that if the system of people being able to notify ISP providers was in place, I would hardly talk at all on these boards for fear of the police knocking on my door.
>>
>>cubic_me>What about me already being able to notify your ISP?
I think I was more saying that if any one (or two) people could cause the ISP to be contacted, I would feel much more vulnerable to it than if just you (Dr. Bob) had the authority to do it, as you, I am presuming, have had more training in assessing risk than many of the posters here.
>If you aren't really suicidal, you can just say so, and that would be nice for everyone to know...
If I only have ideation, I am always sure to put that - one of my pathologies is that I don't like to worry people! However someone could use this in a manipulative way, by saying for example 'I think I'm going to kill myself tonight, so just incase I do I want to say goodbye and thanks to x, x and z etc, but actually I'm pretty sure that this is ideation and I'm not going to do it'. In any case they have managed to say their intent and their goodbyes, without having the ISP contacted.
Posted by cubic_me on March 7, 2005, at 5:57:18
In reply to Re: immediate concerns » Dr. Bob, posted by cubic_me on March 7, 2005, at 5:25:38
I would certainly prefer someone to come here and say what they are about to do (or have done) than leave them completely alone in those awful feelings. Alex suggested that people would call 911 if they weren't allowed to post here, but many people's reason for posting here rather than anything else is that it is anonymous. I have never even thought about calling anyone IRL when I have been in that position - sometimes you are so confused you want someone here to suggest it to you, so that you know it is a valid option.
I think that trigger warnings should be mandatory on such posts, however. It is important that other posters/readers of the boards can protect themselves if they feel vulnerable.
Posted by Shame on March 7, 2005, at 9:37:37
In reply to Re: possibly being able to do more to help, posted by Dr. Bob on March 5, 2005, at 9:28:17
Maybe I am alone here, but if someone is SERIOUS about bowing out, they do it. No questions, no cry for help. Cry-for-help type attempts are usually advertised somewhat more broadly than an anonymous message on an internet message board.Then there is the issue of how to tell if someone is suicidal over the net. Are we talking about an ourtight decleration, or a pattern of behavior?
Posted by Dinah on March 7, 2005, at 9:52:36
In reply to Re: possibly being able to do more to help, posted by Shame on March 7, 2005, at 9:37:37
I think you're underestimating the importance Babble plays in many people's lives, myself included.
I don't really think of Babble as being anonymous at all. People may know me as Dinah, not by my real name, but a fair number of people here know me very well indeed.
And I'm not sure you're right about not crying for help first. At the very least, physical cries for help can often lead to damage.
Posted by Shame on March 7, 2005, at 10:05:28
In reply to Re: possibly being able to do more to help » Shame, posted by Dinah on March 7, 2005, at 9:52:36
Well, I am new here and don't have a good feel for who is here, and what they are all about. I just know that when I was serious about taking my life, I certainly didn't share it with anyone, even my best friend of 25 years. Its when I get moody that people might think that I am in danger of hurting myself, when in reality I'm just coping with things. Suicide is somewhere WAY past that.
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