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How does one deal with loneliness and suicidal thoughts?
This answer may contain sensitive images. Click on an image to unblur it.There are a lot of important answers on here. I am going to take a different tack for those who stumble on this post and have decided not to use the obvious skills of those trained in such critical matters.Having been suicidal a couple of times and having my brother intervene, I now know just being rational won't work. In addition, I have seen quite a few people who were suicidal in my practice now and used a number of processes others have posted on this site to help them. I am still in contact with the first guy I was able to help.Generally, suicidal thoughts come from an existential crises, because some event has brought a belief, so into focus, the person feels trapped. There doesn’t seem to be another way to see it, after running through all the options the person can come up with. Checking-out seems like the best option.Credit: Disney-Alice in WonderlandI have a model I developed when I was a probation officer to help the guys get a handle on their life before it completely slipped away to the prison system. A lot of them were saying, "I'm getting it together." I started asking about what getting it together was and did they know anybody who had it together?Most didn't and when they did, I'd ask them what the qualities were. They'd come up with stuff like; "He's rich", or "He doesn't have anyone telling him what to do. Of course, after walking them through known celebrities who had been in that predicament and failed, it came clear; they really didn't have very good handles for what "getting it together" was.I came up with what I called the "Together person diagram" to help visualize what was happening in their life. My wife never like the name, so I changed it to; “The Wheel of Life”.Eight items, each as a spoke in a wagon wheel. The person would rate each quality on a numerical value of 0 to 10, representing how well that item functioned in their life. 10 being excellent, out to the rim. We would put a dot on the spoke indicating how well that particular quality was operating at that time in their life.1. Work: is about being productive It is what you do for society, that society pays you for. It doesn’t mean it is fulfilling. It is enough to have a functioning lifestyle with. People see it for what it is. Most people in the world are not doing the kind of work they would prefer. It is the kind of work they can survive with. To be good at it; you need to be dependable, reliable, have veracity, follow through, and follow up. People need to have the pride in, I did it myself.2. Intimate: is about being vulnerable and lovingBeing open both physically and mentally, Naked. Someone to share the rainbow with and them you. Where you enhance each others joy and listen to their woes.It is being honest and treating them with dignity and respect even in times of conflict. This encompasses communication and empathy.3. Learning: is about your intelligenceIt doesn’t seem to matter whether it is formal or informal. After school, most people seem to educate themselves on their work, sometimes hobbies. But it would seem, few do on relationships, human growth, and even history. To grow intellectually in all areas of life is important.4. Creative: Is about using your talentEveryone needs to make things that didn’t exist. “I made it myself!” It doesn’tseem to matter what it is, just as long as it gives a sense of pride to its creator. Find your sense of innate gifts and shape them to express yourself in some way. At least get a hobby such as gardening, sewing, photography, model building, cars, computers, but something. Watching things and consuming things doesn't count. Getting through a computer game or crossword puzzle doesn't count. Those are other peoples creativity. Some people are fortunate enough to work at something that they can create too. It is a rarity in the world. I noticed from working with professional artist and musicians, they always have the consumer version of stuff and when they get the chance, they work on their own creations.5. Social Is about being popularIt is about friends, real friends. People who are willing to risk thefriendship to tell you, you are making a mistake. You can share who you are andthey with you. It is keeping a confidence. When friends trust you with theintimate details of their life, they are expecting you to honor that, even whenyou get angry, and not use it against them. It is Learning tobe aware of and empathies with other people.6. Physical: is about your Health in two ways.Our bodies are on loan. They all get factory recalls. Take care of it and it should last a hundred years. We have a friend right now who is a hundred and four,…. still works,…as a federal judge.What you ingest, turns into and becomes a part of you. Learn what food, drink, and mood alterants really do. You only need enough food to get to the next service station, otherwise you body stores it for the supposed coming drought. More than likely, it isn’t the last time you’re ever going to get to eat oneExercise keeps the energy flowing through so you don’t stagnate and putrefy. Similar to when water is dammed up and it sits. Medical says 20 minutes a day, every other day is minimum. The astronauts say they would have to exercise around 21 hours a day just to keep the muscle mass we get with walking around with one G. Learn a routine for aerobic functions to metabolize your intake and stabilize your output.7. Community: is about being ResponsibleWhen people connect with community, it is to expand their belonging to more than themselves and family. It is realizing they are a part of greater thing. They contribute and give back for the betterment of that community. Most do it in a volunteer aspect but there are other ways. It is a sense of being able to respond to the needs of the community. My wife was run over by a drunk as a kid and spent a number of years in a handicapped school. She said one of the basic things taught was to help others and pay attention to how you could help. It was a big shock when she went to a regular school and it seemed it was everyone for themselves.8. Play: is about having FunHow to get off the clock and just play naturally. Down time, So many people Isee have learned to use artificial poisons to relax enough in order to havefun, They haven’t learned how to stop the harangue in their head and not feel guilty. Poisoning your rational-self with drugs to quit harassing you, says you have not learned how your internal systems work and they definitely are not working as a teem.Now connect the dots and it gives a visual as to just how well rounded a person has been running their life.The Rim. and Tire.These are where you use the resources of time, energy, money, and affiliations. Resources are all finite things which connect the outer part of the wheel, Where the rubber meets the road is where all the myriad of things are utilized in your life.such as decisiveness, cooperation, trust, respect, loyalty, discipline and others.THE HUB:.This is what keeps it all together, rather like the glue. It is who we believe we are. Our meaning in life, our purpose. It also creates our compelling future, why we get up in the morning, why bother with anything. This is our spiritual center. What we believe is our truth as to what it is all about. It feeds meaning to the spokes.No one can take your belief from you; you have to give it away. Your spokes, on the other hand, can be taken from you against your will. You can lose your job or your health. When people have a deep sense of who they are, they realize the event is a predicament or situation they are dealing with.You can lose a number of spokes and if your hub is okay, then you can weather it through. But if you lose the hub, then the whole thing (life) falls apart.Where it goes wrongCredit: Disney-Alice in WonderlandWhen people don’t have the hub identified and developed for them when they are growing up, one feels shame they are not good enough. They didn’t measure up to some standard for just being. They then learn they have to be liked to be loved. To be liked, they must behave a certain way. The hub has to be filled with something.Once the spokes tend to get identified as what will get the child liked, they start performing in whatever format that is. They have to get value by doing something, instead of being. When that occurs, the child tends to have shame if they behave otherwise. They can’t make mistakes because they now believe it will expose; they are a mistake. It becomes what we believe in our heart of hearts about ourselves.In order to fill the empty in their hub, the person tends to make what I have called a "Golden-Calf-God. That is, put a spoke in its place. They will sacrifice everything; friends, career, family, children, health, even their own life, to feed their form of security. It is a substitute reason for living.Performance becomes everything. For most men, it becomes work. That is, who they are. It can be a woman whose children grow and now she has empty nest syndrome. A sports figure blows out his knee, A man has his wife tell him she wants a divorce. A woman gets breast cancer. The company downsized and you lost your job. A large number of people have to be perfect (right) at whatever their particular spoke is.When this happened and the spoke was substituted in the place of who you are, you became vulnerable to having the rug pulled out from under you. Something has been taken against your will. It feels like it is who you are and you’re suffering a loss with out any hope of replacing it. Most people start obsessing as to ways to get the issue resolved. When it cannot be, despair can set in and it is a hop skip and a jump from suicide.All the people I have known to commit suicide had a spoke in place of the hub. They bet their life on something which could be taken away without their consent. Even people who said they had a deep religious conviction would commit suicide if say, their child died and they thought it was Gods punishment. Most religious suicides are from getting caught with sexual or financial improprieties, which betray their real behavior. Their shame is exposed and they have to leave.You are suffering as the great Buddha was suffering when he was in his own great depression.Suicidal Thoughts:Credit: Disney-Alice in WonderlandOnce the awareness sets in and concludes; “there is no way to get the old status back”, people get depressed. After all the other options are exhausted, most people’s minds start looking at "checking out", as a final solution. They can start using that as a purpose for awhile because it is a focus on the future and something one can work on. That is why when some people have been depressed and suddenly perk up, they convince people who notice, they are really getting better. The reality is, they have a door out of their predicament and are working on executing it now.When the obsessing starts and moves to depression, medication is almost always called for. The persons own biology is normalizing the process even though it is a negative one and can lead to death. It kind of reminds me of the movie “What Dreams May Come” when the Tracker tells Robin; “In Hell, the real danger is losing your mind. Hell will feed despair and you can’t think enough to get out.”“Every time you make a choice, you are turning the central part of you, that part of you that chooses, into something a little different from what it was before. And, taking your life as a whole, with all your innumerable choices, all your life long you are slowly turning this central thing either into a Heavenly creature or into a hellish creature -- either into a creature that is in harmony with Spirit, and with other creatures, and with itself, or else into one that is in a state of war and hatred with Spirit, and with its fellow creatures and with itself. To be the one kind of creature is Heaven: that is, it is joy, and peace, and knowledge, and power. To be the other means madness, horror, idiocy, rage, impotence, and eternal loneliness. Each of us at each moment is progressing to the one state or the other.”C.S. Lewis: The Chronicles of Narnia.A Native American elder was walking with his grandson around a lake and forest. They heard some wolves in the distance. The elder said to his grandson: "There are two wolves that live within me. One is content and happy, and roams around at peace with nature and its surroundings. The other is hungry and ravenous, never satisfied and always looking to destroy and conquer." The boy looked at his grandfather and asked: "Which wolf is stronger, Grandpa?" The elder answered: "It depends on which one I feed."Anonymous ancient Native American story.Sometimes people use affirmations as an attempt to heal themselves and although it can help a little, it never really works because again, rational mind can't access that unreasonable spot in your heart, in your hub. Some people just want you to pull yourself up by your own bootstraps but if you have what you considered your purpose in life taken from you, “what’s the point” can flood your mind. When a spoke has been put as a hub and has been taken against your will, all the sacred questions that the blessing was supposed to give you as truth, have evaporated. Those can't be fixed.... It has to be healed... Because we are living beings, not mechanical computers.Alice in wonderland.“Oh, Cheshire cat! It's you!Whom did you expect? The White Rabbit perchance?”Credit: Disney-Alice in Wonderland“Oh no. I'mthrough with rabbits I want to go home! But I can't find my way.”“Naturally. That's because you have no way.”“To get out of Tulgey wood, some go this way, and some go that way. But as for me, myself, personally, I prefer the shorT...cuT!”Credit: Disney-Alice in WonderlandGo find a Cheshire cat to get you out of Tulgey Wood. If you don't know one of your own, utilize ones posted on this site.Repair of an empty hubYou believe as you have been taught, you are a failure of some sort. That part of you has it as a truth. That part believes if you look into who you truly are, there will only be some kind of ugly. That part already feels ugly, so the fear is; it seems like confirmation. That is the problem with self diagnosis at this point. Touch the tip of your finger with the tip of the same finger. You can’t be subjective and objective at the same time.The spoke must get back to being just that, one of the supports for your life. It isn’t truly who you are, it just seems that way because of your background. You have to find something that is higher than you original parent-Gods messages which put it in there. The new message doesn't matter what form it comes in. It has happened for people in dreams and even a throw-away comment made by a complete stranger. Some people realize it reading a passage from a book and others from watching a movie.This is a basic existential crises and I have used all kinds of things for the individual to find their true personal self. I prefer transpersonal psychology for this because it is focused on the persons inner-truth. One of the better methods, Core Transformation, a delightful process created by Connie Rae Andreas from NLP Comprehensive in Colorado, addresses this beautifully. “To unstick yourself, organize your resources–spiritual, psychological, physical, sexual, emotional–so that they are in a balanced matrix.”Core Transformation by Connirae and Tamara Andreas"http://coretransformation.org/books_tapes.htmAnd a taste of the process:http://www2.hawaii.edu/~lady/archive/core-transformation.htmlOne other site for similar ideas:http://www.pathwaytohappiness.com/writings_falsebeliefs.htmAnd a couple of songs from Goose Creek symphony:Confusionhttp://mp3.xalo.vn/mp3new/85355/4e4ac6b7/094/confusion.mp3A Statified Mindhttp://mp3.xalo.vn/mp3new/85354/4e4ac796/e11/a-statified-mind.mp3Written by: Charles GearheartHow many timeshave You heard someone sayIf I had his moneyI could do things my wayBut little they knowThat it's so hard to findOne rich man in tenWith a satisfied mindOnce I was waitin'In fortune and fameEverything that I dreamed forTo get a start in life's gameThen suddenly it happenedI lost every dimeBut I'm richer by farWith a satisfied mindMoney can't buy backYour youth when you're oldOr a friend when you're lonelyOr a love that's grown coldThe wealthiest personIs a pauper at timesCompared to the manWith a satisfied mindWhen my life has endedAnd my time has run outMy friends and my loved onesI'll leave there's no doubtBut one thing's for certainWhen it comes my timeI'll leave this old worldWith a satisfied mindHow many timeshave You heard someone sayIf I had his moneyI could do things my wayBut little they knowThat it's so hard to findOne rich man in tenWith a satisfied mind
Do you think Steven Levenkron killed Karen Carpenter?
According to his daughter, yes:How My Father Steven Levenkron killed Karen Carpenter My father is a very bad man. Gabrielle Levenkron Copyright © 2017 by Gabrielle Levenkron. All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means including information storage and retrieval systems, without permission in writing from the author. This book is a work of fiction. Names, characters, places, and incidents either are products of the author’s imagination or are used fictitiously. Any resemblance to actual persons, living or dead, events, or locales is entirely coincidental. For Dad I hope you rot in prison till you die Karen Carpenter Was Killed by An Over-the-Counter Drug that was given to her by my father Steven Levenkron. My father Steven Levenkron is an American psychotherapist and writer known for his research into anorexia nervosa and self-injury. He lives in New York, where his practice is based . Steven Levenkron American psychotherapist IMC'IC IX PMV77 l h# imtini w^wl ii> rW bf« wllmg novel I Kt BfcSl urtu c.mi is the world Tl»» motto* *<• •n«|Mrin« iM a toang wnnun tirnggling ig«MM he* iltvfwil Cttrt and ilk* wh w w iu a ikil I was on cover on one of his books. At the point when Karen Carpenter crumbled at 32 from heart disappointment in a closet storeroom of her folks' Downey, Calif, home two years back, the acting Los Angeles coroner, Dr. Ronald N. Kornblum, said she kicked the bucket of difficulties from anorexia nervosa, particularly "cardiotoxicity" expedited by the substance emetine. What he didn't indicate was the means by which the emetine arrived. Specialists now concur there was just a single way that could be available: She had abused a typical, over-the-counter medication called ipecac. A noxious, golden shaded medication, syrup of ipecac has been sold in drugstores for a considerable length of time to actuate spewing in harm casualties. General experts have since quite a while ago prescribed having a container in the solution chest as a shoddy antitoxin; a one-ounce bottle costs just about $2. In any case, the truth of the matter is that ipecac, in vast measurements, may make irreversible harm the heart, and if taken more than once, is a deadly toxic substance. One month after Carpenter's passing, Deborah Mae Mellon, 32, a mother of two, kicked the bucket of emetine harming. Two Philadelphia legal advisors, Thomas E. Mellon Jr., Mrs. Mellon's brother by marriage, and Michael B.L. Hepps, have recorded a claim charging the various producers of ipecac with inability to caution people in general about the medication's dangerous threats. The suit, started in the interest of Mrs. Mellon's domain, looks for $5 million in compensatory harms and $10 million in reformatory harms. "Nobody can know from taking a gander at this toxic substance remedy that it is a toxin itself," says Mellon. "Like Karen Carpenter, Debbie thought ipecac was safe. She was a cheerful, solid lady who essentially was urgent to get more fit." Mellon says if the reason for Karen's passing had been uncovered promptly, it may have spared Debbie's life. "What's more, it would have prevented other ladies from taking ipecac, as well. They would have said to themselves, 'This is the thing that slaughtered Karen Carpenter. I'm not going to take it.' " Presently a few specialists fear a pandemic of ipecac abuse among an expected 150,000 anorectics and two million patients who experience the ill effects of bulimia, gorging and cleansing. A gathering of psychotherapists who have some expertise in treating the two sicknesses has chosen to announce the genuine reason for Karen's passing. Boss among them is Steven Levenkron, a psychotherapist and creator. It was Levenkron who treated Carpenter for anorexia— effectively, he thought— for right around a year prior to her passing. "Similarly as Karen snuck past our fingers, so are numerous other ladies," he says now. At a hearing later this spring in Washington, D.C., Levenkron and his partners will request that the FDA pronounce ipecac a physician recommended medicate. "Ipecac ought not be promptly accessible," he says. "It ought to be controlled instantly." When she kicked the bucket, Karen had been experiencing anorexia for a long time— evidently since perusing a passing reference to her tubbiness in an audit. In the wake of seeing a few advisors in California, she moved to Manhattan to start working with Levenkron. He in the end place her in the healing center, where she raised her weight from a skeletal 83 to 108 and defeated her dependence on diuretics. In November 1982 Karen concluded that she could go home. Before long, as indicated by Levenkron's reproduction of her last months, she more likely than not started gulping a few teaspoonfuls of ipecac consistently after supper and in the long run expanded her admission to a jug or two. The medication, which causes sharp spasms took after by vicious regurgitating, bit by bit debilitated her and drove, on Febuary 4, to her sudden demise. Levenkron says he was stunned to discover that his patient had kicked the bucket from ipecac harming. "I contemplated her." During telephone discussions, he reviews, he had asked her, "Would you say you are shedding pounds? Are you taking purgatives?" and she had dependably replied, "No." "Ipecac was something that never jumped out at me to get some information about," he says. "I accept Karen thought this was a safe thing to do," to eat consistently yet keep up her weight at 108. In an official statement for his post-mortem examination investigate Karen, the L.A. coroner neglected to say ipecac. The discharge in truth expressed that "research center tests had precluded medication or pharmaceutical overdose as a reason for death." Says Dr. Kornblum now, "It never struck me to specify ipecac. In my brain, emetine and ipecac are a similar thing." Since Karen passed on, Deborah Mellon's has been the main revealed demise from ipecac harming. However, a few spectators presume that many eating routine fixated young ladies may have passed on from abusing the medication. "We believe that numerous anorectics and bulimics who've kicked the bucket of baffling heart disappointment may have really passed on of ipecac mishandle," says Levenkron. Dr. Alan Adler, a Philadelphia doctor who in 1980 treated the principal revealed casualty of ipecac passing, a 26-year-old lady, clarifies, "Individuals don't confess to taking ipecac, most doctors aren't mindful that it's cardiotoxic, and as far as anyone is concerned just a single lab in the nation tests for emetine harming." Ipecac originates from the base of the ipecacuanha plant, a bush that develops in South America. It is the main nonprescription medication known to contain emetine. Until the late '70s, when investigations of ipecac harming began appearing in therapeutic diaries, many specialists never considered that ipecac may be abused. "None of us had taken the inconvenience to research this medication," says Levenkron, "in light of the fact that who might mishandle a medication that produces awful agonies, queasiness and retching?" Dr. John Adams Atchley, a Manhattan specialist who is leader of American Anorexia/Bulimia Association Inc., answers the inquiry: "In the event that you heard [bulimics] discuss the considerable euphoria they get in wiping themselves out, you'd comprehend why they're willing to take ipecac. They'll endure a wide range of things to get that practically otherworldly high." Anorexia is self- starvation coming about because of one's very own irritated feeling self-perception. Bulimia is repetitive gorging, trailed without anyone else actuated spewing or cleansing by intestinal medicines and diuretics. Bulimics are sticklers and fanatical compulsives, with exclusive expectations and low confidence; they are fleshier than anorectics, whose squandered look marks them as casualties of an odd illness, and their number is developing. "In eight years I saw our gatherings in New Jersey change from gatherings of gaunt young ladies to gatherings of field hockey sorts who were gorging their heads off, taking intestinal medicines and tossing it up," says Dr. Atchley. However, on more intensive look there are indications: puffiness around the eyes and a swelling of the organs on the sides of the jaws. Endless vomiters once in a while have facial rashes, harmed teeth and untimely cheek wrinkles— like columns of brackets on the sides of their appearances. Despite the fact that bulimics appear to be sturdier than anorectics, they are frequently in reality less strong. Gorging itself can be lethal. As of late a 23-year-old model, who had starved herself down to 84 pounds, passed on in London in the wake of picking up 19 pounds amid one fling. As indicated by a letter in the British medicinal diary, Lancet, the lady's lethal admission comprised of liver, kidneys, steaks, eggs, cheddar, bread, mushrooms, carrots, an entire cauliflower, 10 peaches, four pears, two apples, four bananas, two pounds of plums, two pounds of grapes and two glasses of drain. A few vomiters end their gorges with a few containers of eating routine pop. This influences the sustenance to buoy to the highest point of their stomachs and sparkles the stiller reflex. Some basically will themselves to hurl. Others— 300,000 by a few appraisals— take ipecac. Regardless of the awfulness of Karen Carpenter, not every person concurs that ipecac ought to be made a physician endorsed sedate. Dr. John Schlegel, leader of the American Pharmaceutical Association, recommends that rather, "We embrace naming changes on the item that will all the more enough caution customers about the potential perils of utilizing ipecac mistakenly." Says Ron Williams, APhA's executive of expert undertakings, "Consistently ipecac spares 150,000 lives. Everybody ought to have a container in the pharmaceutical chest if there should arise an occurrence of inadvertent poisonings." To balance certain toxic substances, ipecac must be taken inside a half hour. Dr. Atchley contends that requiring a remedy won't risk harm casualties. "A mother could approach her pediatrician for a remedy and keep a jug in the pharmaceutical chest," he says. His position is supported by previous clients of the medication. One of Levenkron's patients, a 14-year-old young lady, said she purchased ipecac at a drugstore subsequent to perusing about it in a book about bulimia. She took it a few times despite the fact that it influenced her regurgitation to blood and bile. "Would you have utilized it regardless of the possibility that it had a skull and crossbones on the name?" Levenkron asked the young lady. "Truly," she stated, she would have. Returning to Los Angeles in November 1981, Karen filed for divorce. Leaving behind the pieces of her broken marriage, she set out on a year-long recovery mission, relocating to New York City's Regency Hotel in January 1982. Manager Jerry Weintraub arranged for Karen and Itchie Ramone to share a two-bedroom suite. Cherry O'Neill, the eldest daughter of singer Pat Boone who had herself recovered from anorexia, had recommended Karen consider coming to the northwest and seeing the doctor who helped her. But in Karen's world, one name was synonymous with anorexia treatment, and that name was Steven Levenkron. He was a psychotherapist specialising in eating disorders and his successful book The Best Little Girl in the World had become a highly acclaimed television movie, which aired in May 1981. Levenkron agreed to treat her. He received £100 for each hour-long session five days a week, totalling $2,000 a month. "I liked Levenkron, at least in the beginning," Itchie Ramone says. "No one really knew why someone would get the disorder or how to treat it, so we were really looking to him to 'save' her." Arriving at Levenkron's office at 16 East Seventy-Ninth in Manhattan, Karen weighed in at an alarming 5st 81b. A week into their daily sessions, Karen admitted to Levenkron she was taking a large number of laxative tablets - 80-90 Dulcolax a night. This did not surprise Levenkron. In fact, it was a common practice for many anorexics. "For quite some time, I was taking 60 laxatives at once," admits Cherry O'Neill. "Mainly because that was how many came in the box... I would ingest the entire contents so as not to leave any evidence." What did stun Levenkron was Karen's next casual disclosure. She was also taking thyroid medication - 10 pills a day. He was shocked, especially when she explained that she had a normal thyroid. Realising she was using the medication to speed up her metabolism, Levenkron confiscated the pills. This was the first case of thyroid medication abuse he had seen in his dozen years in the field. According to Levenkron's 1982 book, Treating and Overcoming Anorexia JVervosa , the patient must become totally dependent upon the therapist. Once the patient has transferred their dependence on to him, he tries to teach them how to create their own sense of identity, and he helps them disengage from their dependence on him with new behaviours, habits, and thought patterns. Karen took advantage of the beautiful spring weather and began a new exercise routine - to and from her sessions with Levenkron - a brisk two -mile round-trip walk. This was yet another method to burn extra calories. Outwardly Karen seemed committed to the idea of therapy, but as evidenced by her daily walking regimen, she was not as committed to making actual changes that would result in real progress. "She was still walking a lot, and she was exercising," Carole Curb says. "And then she was into throwing up and taking pills that make you lose water-weight. Debilitating things like that." Several months into his sessions with Karen, Levenkron began to suspect that she had fallen off the wagon. He invited the Carpenter parents and Richard to a 90-minute family therapy session at his office. "They did come to New York -finally," Itchie Ramone recalls, "and only after a lot of nudging. By then, Karen seemed to be starting to turn the corner a bit emotionally." The stigma surrounding mental illness and a need for therapy was frightening for the family, especially Agnes, who felt Karen was simply going overboard as far as dieting was concerned. If only she would stop being so stubborn and just eat. Over the years the family tried every possible approach to get through to her and make her eat. "Everyone around her did everything that they could have humanly done," Richard said in 1993. "I tried everything - the heart-to-heart, the cajole, the holler... It can just make you crazy. Obviously it wasn't about to work, and I was upset." Levenkron explained that the family's attempts to threaten or bribe Karen out of her behaviours would never make them go away. According to his book, "Failure of the family to understand this produces division within the family that in turn results in feelings of anger and guilt. The family atmosphere is chaotic, reinforcing the anorexic's belief that she and no one else knows what is best for her." Levenkron suggested to the family that Karen was in need of a more tactile, demonstrative kind of love. Karen cried uncontrollably during the meeting. She told them how sorry she was for having put them in a situation where they felt a need to defend her upbringing, and she went so far as to apologise for ruining their lives. "I think Karen really needs to hear that you love her," Levenkron told the family. "Well, of course I love you," Richard told her unreservedly. "Agnes?" The therapist tapped the mother's shoe with his own. Rather than address her daughter, Agnes explained how she preferred to be called Mrs Carpenter. "Well, I'm from the north," she continued. "And we just don't do things that way." "Agnes couldn't do it," says Itchie Ramone, who discussed the meeting with Karen and Levenkron after the family left. "She couldn't do it... In therapy you're basically stark naked. Then your own mother can't reach out to you? And the way she doted on Richard. Most children would try to dance as fast as they could to make their parents love them, but it was at that point that I think Karen decided it was time to take a step back." After the meeting with Levenkron, Richard became angry with the treatment plan, which he thought to be worthless. He was upset that Karen had not checked herself into an inpatient facility as one would do to conquer substance abuse. He and his parents returned to California and chose to keep their distance after this painful encounter. They made no further attempts to contact Karen's therapist. "What I find interesting," Levenkron stated in 1993, "is that in the entire time Karen was in New York, I got zero calls from the family. I have never treated anyone with anorexia nervosa whose family didn't call regularly because they were concerned." Likewise, Richard claimed to have never received a call from Levenkron. Karen and Itcliie were surprised to learn that Levenkron was not an actual doctor. "We used to call him Dr Levenkron’ all the time," Itcliie explains. "Then we found out that he wasn’t even a real doctor. Any medical issues she had, we had to go see this other doctor at Lenox Hill Hospital." According to Evelyn Wallace, "Karen picked the wrong guy to go to. He wasn’t even a doctor. It seemed like Levenkron was simply trying to talk Karen out of having anorexia, but she’d talk to him and she’d go hack to the same routine." By the autumn of 1982 Karen showed no real signs of progress. In fact, her walks to and from sessions with Levenkron kept her body weight beneath the six stone mark. Itchie Ramone called Levenkron and voiced her concerns. "Look, Karen's getting thinner and thinner," she exclaimed. "Plus, it's obvious she doesn't have her usual energy anymore. When do you expect this turnaround? She's just skin and bone." The therapist agreed that Karen seemed extra tired and was not responding as quickly as he had hoped, and vowed to try another approach. After her next session with Levenkron, Karen asked Itchie if she could borrow a swimsuit. "What?" Itchie asked. "There's no pool in the hotel. Besides, it's cold out!" "No, I have to wear it tomorrow for Levenkron," Karen answered. The two stopped by the Ramones's apartment to pick up a size 2 light green bikini belonging to Itchie. Karen changed into the bikini and emerged smiling. Itchie was mortified and unable to hide her reaction. "What's the matter?" Karen asked. "It fits." "Uh, yeah, it fits," she said hesitantly. "You can use it tomorrow, I guess." Returning to Levenkron the following day, Karen was asked to change into the bikini and stand in front of the office mirror. He urged her to survey and evaluate her body. "She didn't really see any problem with how she looked," Itchie recalls. "In fact, she thought she was gaining a little weight. But she was 791b." In mid- September Karen phoned Levenkron and told him her heart was "beating funny". She was quite upset, anxious, and confused. She complained of dizziness to an extent that she was unable to walk. Despite not being medically qualified, he recognised her symptoms as those of someone suffering extreme dehydration. Karen was admitted to New York's Lenox Hill Hospital on 20 September 1982 to begin hyperalimentation, or intravenous feeding. The next morning she went into surgery to have a small-bore catheter implanted within the superior vena cava (right atrium of the heart). An unexpected complication was discovered later that day when she complained to the nurse of excruciating chest pain, and X-rays revealed the doctors had accidentally punctured one of her lungs in their attempts to insert the tube. As her lung began to heal, Karen's body quickly responded to the artificial means of feeding. The hyperalimentation process completely replaced all of her nutritional needs, and a precise daily calorie intake was dispensed through the catheter. This loss of control was known to often spark fear in patients, and doctors who oppose hyperalimentation argue that it does not teach the patient to eat properly. However, Karen went along with it and gained i2lb in only a few days. Solid foods were slowly reintroduced as the level of assistance from Karen's IV lessened, and she continued to gain weight steadily. Unlike many other patients she seemed pleased and excited to show visitors her progress. Richard flew in to visit on 25 October and, like most who saw her there, was shocked and saddened. She was still horribly emaciated and barely identifiable by this stage. "You see how much better I look?" she asked. Richard nodded in agreement but only to appease his sister. In an attempt to divert the attention away from herself, Karen told him of other patients who were much worse off. But he was not sidetracked. "Karen, this is crap," he said suddenly. "Don't you understand? This is crap! You're going about this all the wrong way. This guy isn't getting anything accomplished because you're in a hospital now!" By November Karen was eating three meals a day at Lenox Hill, and trying to stay positive about the weight gain, by then approaching the 3olb mark. The return of her menstrual cycle, which had ceased during the previous year, seemed to signify an improvement in emotional and physical wellbeing. On 16 November Karen visited Steven Levenkron for the last time and presented him with a farewell gift, a framed personal message in needlepoint. The large green-threaded words "you win - I gain" served as tangible proof of the long hours Karen had spent alone in the hospital. Learning of her plan to leave, Levenkron reminded Karen she was abandoning the program much too soon, and that treatment takes at least three years. He suggested a therapist in Los Angeles so that she might continue a routine of some sort upon her return home, but she declined. She promised to call him and swore she would not take any more laxatives or diuretics. Agnes and Harold (Karen's father) met up with her at Levenkron's office that day. The couple had flown to New York City to bring their daughter and her 22 pieces of luggage home. It was obvious to most that Karen's treatment was inadequate and ending too soon. "She tried to get help," says her longtime friend Frenda Franklin. "She went to New York to try. It just wasn't the right way to do it. If this had happened in today's world I think Karen would have lived. I think we would have had a good shot. They know so much more. We were dancing in the dark." Karen ate heartily on Thanksgiving Day, much to the delight of her family, and she even called Itchie Ramone that night to tell her of all she had eaten. "She said to me, 'I ate this and that and all my favourite things,'" she recalls. "She was very proud of herself then. We were all very proud of her. It seemed like progress." In the weeks following her return to Los Angeles Karen went back to shopping and socialising without delay. Although others felt she was still quite fragile and thin, Herb Alpert, who had first signed the Carpenters to A&M, saw Karen shortly after the New Year and recalled her looking terrific. She bounced into his office saying, "Hey, look at me, Herbie! What do you think? How do I look?" Alpert agreed that she looked happier and healthier than he had seen her in some time, and felt she appeared to have won the battle. "I am so happy," she told him. "I'm ready to record again, and Richard and I have been talking about getting the group together and performing." Despite her high spirits, she was taking more naps than usual and sometimes lying down by seven in the evening. Richard did not believe she was well, and he told her so. On Thursday 27 January Florine Elie drove to Century City for her weekly cleaning of Karen's apartment at Century Towers. There the housekeeper made an unnerving discovery. "When I was working up there I found Karen," Elie says. "She was lying on the floor of her closet." She gently shook Karen who awoke but was groggy. "Karen, is there something wrong?" she asked. "No, I am just so tired," she replied. "Maybe you better go lie on your bed," she said, helping Karen up and tucking her into bed. Florine checked on Karen again before leaving. By then she was awake and adamant she was OK. Tuesday 1 February found Karen dining with her brother, this time at Scandia on Sunset Boulevard. They were joined by stage producer Joe Fayton, and the trio discussed plans for the Carpenters' return to touring. Karen ate with enthusiasm and after dinner returned to Century Towers. This was the last time Richard would see his sister alive. The next day Karen spoke with Itchie Ramone, who was pregnant with her and Phil's first child. Karen shared her plans for the week. She would sign the final divorce papers on Friday and then prepare to leave for New York. "That weekend, 6 February, she was going to hop on a plane and be there for the birth," Itchie recalls. Shortly after midnight, staying overnight with her parents, Karen went over her to-do list with Frenda Franklin by phone, and finalised plans for the next day. "OK, I am going to drive in. There shouldn't be a lot of traffic," she said. According to Frenda, Karen enjoyed keeping up with traffic reports. "Then we're going to go get the red fingernail polish." The two had a noon appointment for a manicure in celebration of her divorce. On Friday morning, 4 February, Karen awoke and went downstairs to the kitchen, where she turned on the coffeepot her mother had prepared the night before. She went back upstairs to get dressed. When the coffee was ready, Agnes dialled the upstairs bedroom phone, but its ring, heard faintly in the distance, went unanswered. Agnes went to the foot of the stairs and called to her daughter but there was no response. Entering the room, Agnes found Karen's motionless, nude body lying face down on the floor of the walk-in wardrobe. Her eyes were open but rolled back. She was lying in a straight line and did not appear to have fallen. "She had just laid down on the floor and that was it," Agnes recalled. The autopsy report listed the cause of death as "emetine cardiotoxicity due to or as a consequence of anorexia nervosa." The finding of emetine cardiotoxicity (ipecac poisoning) revealed that Karen had poisoned herself with ipecac syrup, a well-known emetic commonly recommended to induce vomiting in cases of overdose or poisoning. Levenkron claimed to know nothing of Karen's use or abuse of ipecac. In their phone calls she assured him she was maintaining her new 7st lolb figure and had completely suspended use of all laxatives. He never suspected she was resorting to something much more lethal. In a radio interview taped shortly after Karen's death, Levenkron discussed the autopsy findings: "According to the LA coroner, she discovered ipecac... and started taking it every day. There are a lot of women out there who are using ipecac for self- induced vomiting. It creates painful cramps, tastes terrible, and it does another thing that the public isn't aware of. It slowly dissolves the heart muscle. If you take it day after day, every dose is taking another little piece of that heart muscle apart. Karen, after fighting bravely for a year in therapy, went home and apparently decided that she wouldn't lose any weight with ipecac, but that she'd make sure she didn't gain any. I'm sure she thought this was a harmless thing she was doing, but in 60 days she had accidentally killed herself. It was a shocker for all of us who treated her." In one of Levenkron's most recent books, Anatomy of Anorexia , the author boasts of his above-average recovery rate in working with those suffering from eating disorders. "In the last 20 years I have treated nearly 300 anorexics," he wrote. "I am pleased to state that I have had a 90 per cent recovery rate, though tragically, one fatality." That was Karen Carpenter. I have read most if not all of Steven Levenkron's books. I used to admire him a lot because he seemed very insightful and caring. But as I've gotten older and had my own experiences with a therapist and in getting social work training myself, I started to see him as condescending and egotistical. I have no doubt that he's helped many people with eating disorders, but I no longer see him as a "guru". Maybe Richard was turned off of him because he saw the same things in him that I see. As to whether or not Karen got substandard care from Levenkron, I would guess she didn't. I think there's a good reason why Levenkron is so successful. In fact, Karen had set a goal to "kick" anorexia in a year. Levenkron reportedly told her that it would be impossible to do that, even if she got therapy every day. Karen went back to L.A. after a year in New York anyway. Even if she hadn't done that, I doubt Levenkron would have been responsible. She died of medical issues— she didn't purposely take her own life. And even if she had committed suicide, any therapist will tell you that a person who really wants to kill themselves will find a way to do it eventually. I think it's my father Steven Levenkron's fault that Karen died. He was working a lot of things with a client who was used to getting her own way. And he was in charge of the medical side of her treatment. Full text of "How My Father Steven Levenkron Killed Karen Carpenter"
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