The man France proclaimed “Best Chef” just committed suicide. He had just been informed that he still had his third Michelin star, the pinnacle of achievement among chefs. You can’t achieve any more than Chef Benoît Violier has in a life spent cooking. And according to one of the people interviewed for the story, Chef Violier gave every appearance of happiness and being self assured. And why wouldn’t he be. His restaurant apparently had no financial troubles and his clientele was world renowned. Food critic Francois Simon said of chefs: “All these great chefs have a bipolar side. They often have hidden weaknesses and wounds, and fame, stress, work and overexposure can bring these to the fore.”
I have seen similar situations. A successful middle aged person (usually men) commits suicide for no discernible reason. When we see a successful person, we aren't likely to consider they might be suicidal. I certainly didn’t believe that two 50-year-old men I knew well were suicidal. But the signs were there, particularly battles with depression. One had multiple ACEs as well. I don’t know about the other’s trauma pattern.
In Alaska, policy for reducing suicide includes efforts to reduce alcohol use in our villages through prohibition, promoting use of gun locks and teaching recognition and intervention techniques. The Tribal community has focused on cultural restoration. I have taken a different approach, one more specific to identification of behaviors and a demographic that characterize the higher risk group. Success in education, career and family does not, in my model, play any role for excluding someone from the higher risk group. The accolades earned by Chef Violier would not remove him from concern.
While alcohol plays a role in many suicides in Village Alaska, I read a persuasive research paper written by Dr. Matt Berman from the University of Alaska that stated that alcohol controls had no significant impact on suicide reduction. In fact, the rate of suicide in villages that prohibited alcohol was higher, but not significant when controlled for other factors. Instead, I view alcohol use as an identifier. Someone with alcohol issues may be struggling with ACE issues and adopting different behaviors in their effort to heal. As Dr. Vincent Felitti, co-principal investigator of the ACE Study, wrote:
“Our findings indicate that the major factor underlying addiction is adverse childhood experiences that have not healed with time and that are overwhelmingly concealed from awareness by shame, secrecy, and social taboo. The compulsive user appears to be one who, not having other resolutions available, unconsciously seeks relief by using materials with known psychoactive benefit, accepting the known long-term risk of injecting illicit, impure chemicals. The ACE Study provides population-based clinical evidence that unrecognized adverse childhood experiences are a major, if not the major, determinant of who turns to psychoactive materials and becomes ‘addicted’.”
There are two points I would like to make here: It is my belief and observation that many behaviors actually benefit someone who is suffering from the many problems caused by ACEs; and many behaviors that are viewed as positive are among those that become compulsive because of the benefit provided.
Here is an example of what I mean. A successful professional with a stellar education and a long history of leadership comes home after work and after hanging up his jacket heads to there refrigerator and opens a beer. Six to nine beers later, he is essentially put to bed by a wife who knows that he must be sober for work the next day. On weekends, beer consumption increases. His wife suffers from anxiety, is a smoker and also drinks significantly. Depression has been an earlier factor in their lives. Emotional abuse exists in the relationship, but no physical abuse. If this couple has children, the door is open to passing on their trauma.
If you add a couple of additional factors in, the prospects for having someone who is in the risk pool for suicide increases. Males from 15 to 34 and in their mid 50’s are at higher risk for suicide than the rest of the population. Men with 7+ ACEs have a very high chance of attempting suicide, according to the ACE Study results. Those with 5 or 6 ACEs are also at high risk; within the population studied at Kaiser Permanente, about 6% had 5+ ACEs. Someone who fits this profile is someone worth talking to about suicide potential. It doesn’t matter if they are successful in their career and education.
Not everyone in this risk profile will attempt suicide. And some may be offended if you discuss the topic with them. That’s human nature. We hide behaviors that we become convinced the people we deal with don’t want to see. We put on masks. We hide our behaviors. We explain and justify them. The conversations we have are tough ones, but they may be conversations that matter in more ways than one. Why is that? It’s because having that conversation opens the door to imparting knowledge about the impact of ACEs on ones life, and brings up not just suicide, but many of the behaviors we become addicted to, and the way we process our threat response. We can start to identify some reasons for behaviors that the victim knows are destructive, but can’t stop doing.
I had never heard of Chef Violier before the report of his suicide. But he was living a life worth living, and his death removes beauty and joy from the world. And I am not saying that he was a victim of ACEs. But if he was, and if an early conversation means he might have avoided the feelings that drove him to suicide, that conversation would be worth it.
So my approach is different than the one followed by others. We need to start thinking about how we recognize the behaviors (positive, neutral and negative) that ACE victims adopt to help themselves feel better. Then we should develop an approach that doesn’t offend the victim further and is more likely to help them remove the masks and start on a path to healing.
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