The Bill Zeller Suicide Letter

You can read his heart-wrenching suicide note here.

You know my take on suicide: it’s not a wish to be dead, it’s a wish for the pain to recede and not seeing any other viable way of making that happen. Bill Zeller was an exact embodiment of this mindset. He believed he had exhausted his options and was simply spent from the psychological pain he endured for over two decades.

A few thoughts: Mr. Zeller made reference to the mental health system failing him. While many clients unfairly put blame on their providers – whether that be to unreasonable expectations, a misunderstanding of a therapist’s take on a particular issue or even a belief that therapists can’t ever make a mistake – I could easily see his complaints being valid. His letter reads as if his experience and pain were never validated, that he was never told about the plenitude of anti-depressants available, that psychological treatments such as Prolonged Exposure Therapy were viable options to treat him or even what suicidal thoughts and feelings actually mean. And, although he was misguided on his beliefs about confidentiality and reporting of crimes as an adult, it’s not a stretch to think that a number of providers missed the boat on what was happening with Bill. A good diagnostician would be unlikely to do this.

Does Bill have the right to die? My profession doesn’t allow Psychologists to let this occur under their watch. Personally, though, the answer is an equivocal yes.

Shrinks are in both a legal and ethical predicament regarding suicide. We are required, by the law and our field’s code, to report imminent danger to self. This is based, at least in part, on the notion that we simply do not know how someone will feel in a week or a month or a year, with or without treatment. Mr. Zeller never really received adequate treatment so we cannot say with certainty that he would not have improved. Granted, depression can be a chronic, recurring illness, but there have been many people who have recovered. We can’t claim that Mr. Zeller would not have been among those fortunate people. In other words, absolute prognosis in mental health is virtually impossible.

Compare this to patients with terminal illnesses, or those with intense pain that doctors can provide very detailed and accurate accounts about prognosis. There’s no hope. It is in these cases that the right to die takes on a new stripe, because we can reasonably expect a certain outcome. You just don’t get that in mental health, which makes it such a fascinating yet frustrating field of study.

If your life, cognitions or emotions seem anything like the words Mr. Zeller wrote, please don’t take them as gospel as it applies to your future. Don’t give up. Maybe Mr. Zeller would never have improved, but we just don’t know. Independent of blame, he never got a viable chance to conquer the darkness to which he refers. Don’t be him in that regard. You might just be one of the many I’ve seen who got through it.

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15 Responses to “The Bill Zeller Suicide Letter”

  1. Catherine says:

    So sad. Thanks for your honesty.

  2. […] This post was mentioned on Twitter by James Hsiao, Celestine. Celestine said: RT @DrRobD The Bill Zeller suicide note and thoughts on a patient's right to die. Short and ultimately depressing. http://t.co/s8R8Z6M #fb […]

  3. David says:

    I’d read that note sometime ago and it crushed my heart. I’ve never truly contemplated suicide, but battling anxiety and depression there are times when you feel exhausted from the agony and the thought crosses your mind. I can only empathize. I’d read this on a link from fark and I was stunned (although I truly shouldn’t have been) by the lack of compassion and outright hostility. It served to reinforce the stigma associated with mental illness. In any case, I wish that he’d received better help, but I suppose that I’m happy he’s not in pain anymore.

  4. Rosie says:

    Dr. Rob, you say Zeller’s “experience and pain were never validated” and he wasn’t informed of treatments that could help with recovering from sexual abuse trauma. However, if you read the letter closely, you’ll see that Zeller never told any mental health professionals about the sexual abuse. He talked to “doctors” about “other issues,” and never found what they said to be helpful. How could they be helpful if he could not be honest with them about the root cause of his problems?

  5. Rob Dobrenski says:

    @Rosie: I might have missed something in the letter (if so please disregard the following), but given the nature of his distress, he should have been asked about sexual abuse directly. He, of course, could have lied, but most people don’t when asked in the right way.

  6. Rosie says:

    Zeller said in the note that he purposely did not tell the professionals he spoke to about the abuse because he believed one of them would make it known publicly. I think he was referring to mandated reporting laws. I didn’t tell anyone about the sexual abuse I endured as a child until I was in my 20’s. My therapist (who was actually a student in training) scared the shit out of me when she told me she might have to get the police involved. (No one in my family knew about the abuse at the time, besides the abuser himself.) Then after speaking with her supervisor, she told me that because the abuse was no longer going on, and because I was no longer a minor, the reporting laws did not apply. I don’t know if she was right. But that fear of the abuse becoming more publicly known seemed to be a big deterrent to Zeller coming clean with professionals about the situation.

  7. Rob Dobrenski says:

    This is a perfect example of the mental health system failing him. Everyone should be advised that if you are over 18, mandatory reporting is not relevant. Of course he couldn’t be honest if he didn’t know what would become of the information. Clinicians need to be clear about that, to provide the forum for honesty.

  8. UnSavioury says:

    @Rosie and Rob – true that the system makes it difficult to trust – I didn’t come clean until my 40’s because I’d heard varying degrees of action that would be taken. Largely because the perpetrator is family, has children of his own, etc. You just never know what the outcome will be. I believe that Zeller desired and felt the control of determining for sure his own outcome – death. For that, I am truly sorry, because he didn’t give himself enough time …it does take a LONG time, but the darkness does fade once other things in your life overshadow it.

  9. T.J. says:

    I wondered if / when you were going to weigh in on this. Well done, Rob.

  10. An_Irish_Brit says:

    Like you, Rob, if I had to come down to a decision about Bill’s right to die I’d give an equivocal yes too. The right to die is really where the debate about assisted suicide should come in, but mental health patients should never be assisted in taking their own lives, their vulnerability means they should always be protected from harming themselves in such a way. Though what’s really sad is that when someone is resolutely determined to go through with suicide they are forced into doing so in ways that can terrify them, lack dignity, or, worse still, in isolation… alone. The solitariness of suicide is what’s most heartbreaking.

    An inability to access appropriate care is at the crux of this, for whatever reason Bill appears to have been failed. Whether this was poor practice or the help coming too late or a combination of the two, who knows? Perhaps we’ll never know. What I do know, though, is Bill should have had clear discussion about the rules of confidentiality. It’s difficult to know if this was ever fully explained to him or if he even understood it. If he had done he would definitely have felt he had more control of his situation and ultimately empowered (and possibly even hopeful). I didn’t get a sense of that from what I read.

    I agree, if anyone reading this has the same mindset as Bill, please seek professional help. It can be hard work, but people work in the helping profession for a reason, namely their dedication to your success. They will be determined to work alongside you to get you through it. You deserve to get through it. You at least owe it to yourself to give it a shot. The ultimate goal being a better sense of contentment and happiness and who wouldn’t want that? Sometimes the hardest bit can be picking up the phone. Accessing help isn’t a weakness either, it’s a strength. Saying “I need help” is the first step to recovery, we all need help at different times in our lives. Go on, pick up the phone, do it!

  11. nikolina says:

    Everytime I hear one of these stories it breaks my heart. To hear him talk the way I used to when I was suicidal makes me wish I could have been there to talk to him. Parts of this letter are like reading my own old diaries and I wish I could have helped him wake up the way someone else helped me.

  12. katie says:

    this was a beautiful and touching post, made all the more so by the funny and sometimes caustic humor in most of your posts. i so appreciate the sincerity and depth in this post, and i suspect i will read easier with your other posts now that this one is here.

    thank you.

  13. UnSavioury says:

    This has been stewing around in my head the last few days, as things like this often do. This is only the second time in my life that I have read a suicide note, the first was a friend of mine, found by his roommate, that simply said “I give up”. I think Bill’s letter differs, in that he really gave us a glimpse into his world in great detail and made us each truly feel his pain. While I was reading it, I kept thinking “STOP, don’t DO IT!” even knowing that it was too late for him. I could so relate to his fog-like darkness, his longing-yet-fear of emotional intimacy, the fear of hurting those around him, his inability to trust, the secret wish to die, and the frustration of not being able to talk about it. In a way, I felt more connected to Bill Zeller than I have to many, and I never knew him personally.

    As a computer science graduate student myself, I knew of Bill’s work, and was floored that he was strong enough to accomplish so much while enduring so much pain…he had no idea how strong he really was to keep all that inside. To techies, he was a star, and we’re saddened not only by his pain, but that the world has been deprived of what would have been an important and innovative body of work. Now his legacy will be the still-impressive work that he did in his short life, those around him that he inspired, and his gut-wrenching ending.

    My hope is that anyone reading his letter with similar experiences realize that they are not alone, and can choose not to suffer Bill’s fate by seeking out help. That anyone reading who does not have a similar experience can better empathize with those who have, understanding the paint that seems to permeate every aspect of life, even if not on a consious level. And to know that many victims can look as “normal” ajusted, happy, and determined as Bill. We are not all cutters, drug addicts, or prostitutes. A survivor could be your boss, your mailman, even your best friend.

    I always hear of suicides described as “senseless”..in this case, I am not certain of that. This was obviously not done on a whim, but carefully thought out and planned, and his letter said so much. Not the words of a man “copping out.”

    People have questioned Bill’s motives to both take his own life and publicize his suicide letter. I can only think that a theory is that he needed to get his story out, but did not want to live with the shame of it. Being a somewhat public figure, he also wanted us to know why he did what he did, so that he would be forgiven.

    I believe we SHOULD forgive him, no matter our takes on suicide.

  14. Addison says:

    As someone who has both had suicidal thoughts and attempted suicide in the past, I can relate so much to his words. The mental health is not expected to be perfect, but it would help if it would be better than it IS. It’s expensive and a lot of times, I even wonder if it’s worth. I pay a therapist $280 a week. It’s a struggle, but I need the help and truly can’t afford it. I’ve had one serious attempt and two that were probably some kind of cry for help. The suicidal feelings never are far from my mind, though. Do I blame the mental health system? No. I have borderline personality disorder, though…Google it. We’re the “hardest to treat” clients and a lot of mental health professionals run the other way when they say you have BPD. As I read his letter, I couldn’t help but feel the same as he did and wonder if he was BPD too.

    I’m not suicidal NOW, but again, I’m in therapy and I do worry about what my future holds.

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