Welcome to Sheeper Assisted. I'm your host Sadie Sutton, a 19
year old from the Bay Area studying psychology at the
University of Pennsylvania. Sheeper Assisted is the teen
mental health podcast made for teenagers by a teen.
In each episode I'll bring you authentic, accessible and
relatable conversations about every aspect of mental Wellness
you can expect. Evidence based teen approved
resources, coping skills including lots of DBT insights
and education, and each piece of content you consume.
She Persisted offers you a safe space to feel validated and
understood in your struggle while encouraging you to take
ownership of your journey and build your life worth living.
So let's dive in. This week on She Persisted.
We know that connecting with people when we're depressed,
that's really helpful. And yet the nature of those
mental health struggles is that you want to avoid those things.
They seem like they're too much to even take on.
And so I think about that a lot with suicidal thoughts that that
hopelessness feels like there isn't any point in doing
anything. And when someone says to someone
who's hopeless, well, why don't you just do these things and
you'll feel better? Unfortunately, that can make
things worse because the person would feel ashamed for not being
able to do those things that might help them.
Hello, hello and welcome to She Persisted.
We're starting off with little trigger warning.
We are talking about suicidal thoughts and behaviors today,
which can be a heavier topic. We came at this from a really
intentional and evidence based approach.
We have a clinical psychologist on the podcast today who's been
involved in a lot of research on suicidal thoughts and behavior.
So we definitely come at this from a lens that is clinically
supported and not intentionally triggering or graphic or
anything like that. But this is the heavier topic.
And I know personally in my journey, there was a long time
where anything that related to suicidal ideations or behaviors,
I steered clear from intentionally because it was a
trigger that brought up those thoughts and engaging in those
in any capacity wasn't effective and was in some cases
maladaptive. So be mindful, decide if this is
for you. If it's not for you, if you're
someone who's listening to this episode to support someone else,
definitely recommend we talk a lot about how you can actually
support someone, what they're are going through, why they're
having these thoughts and feelings.
And I think from that perspective, this episode is
incredible. So if you're also listening and
you're like. This isn't.
Something I'm struggled with but like I have a friend or a family
member. You're going to love this, but
wanted to give that initial warning before we get into the
episode because it is a heavier topic and set your own
boundaries. But with that, we have Katherine
Gordon on the podcast today. She's a licensed psychologist,
speaker, and author. She specializes in cognitive
behavioral therapy, also known as CBT, and she's written
several books on using CBT skills to prevent suicide.
So we talk about a lot of different things in this
episode. We talk about why people have
suicidal thoughts, which is something which is really
misunderstood and not widely known.
We talk about how suicidal ideations and thoughts
progresses to behaviors. We talk about healthy
conversations about suicide and what you can do to promote those
healthy convos. We talk about Co ruminating and
setting boundaries, what to expect when you are in therapy
for suicidal thoughts or behaviors, which is another huge
point of anxiety for a lot of people.
So I hope that's helpful to kind of shed some light on.
We touch on CBT skills that are most effective for suicidal
thoughts, which I was really excited to touch on because
that's not not something that's widely known or accessible or
available in the mental health space.
You kind of have to dig for it. So I'm really excited for you
guys to hear that perspective. And lastly, resources for
someone when they are in a crisis or navigating really
intense suicidal ideation or behaviors.
So I hope you guys find value from this episode.
It's information that I wish I would have had access to earlier
on in my journey and provide so much insight and perspective.
If you know someone in your life who's struggling with these
thoughts and behaviors and again, listen at your own risk.
We again tried to be really, really intentional and come at
this from an evidence based perspective where we're not
doing anything that's known to trigger these thoughts and
behaviors. But be mindful and you know
yourself best. And if you guys do find this
episode, make sure to share with a friend or family member, post
about it on social media. This is information that can
really help and save lives. And so if you find it valuable,
if you find it relevant to your journey or others, make sure to
share and leave a review. So with that, let's dive into
the episode. Well, thank you so much for
joining me today, Catherine. I'm so excited to have you on
the podcast. This is.
An episode and conversation I don't think is had on a lot of
podcasts even in the mental health niche, but I think it's
something that's really important for people to be aware
of, especially from an evidence based perspective and getting
that expert opinion. So I'm really excited to have
you on today and talk about your work and your workbook and all
things suicidal thoughts, ways to cope with that, different
interventions, how to prevent suicide.
But to get started, can you tell me a little bit about your
background and why you decided to go into psychology and then
specialize in this specific area?
Sure. Thank you so much for having me
on. I just think it's wonderful to
create more space for these types of conversations.
We know that they're really important and that also there is
a lot of fear and shame around suicidal thoughts.
So making it accessible like this is really important.
So thank you for inviting me on to focus on the background of
how I got into it. Basically, my father is a
therapist. And so I had kind of just grew
up with some awareness of mental health issues and also just
overtime, maybe especially as a teenager, knew a lot of people
who are struggling with different mental health
problems. And I was always really
interested in psychology. And so when I was an
undergraduate student, I was able to work with Doctor Thomas
Joyner and learn about eating disorders and suicide
prevention. And what I learned is that that
those two areas were really understudied at the time that
there was such a need for more research about what causes
suicidal thoughts and behaviors and how to help people with
suicidal thoughts and behaviors. So really that inspired and
sparked passion to continue pursuing that area.
And in addition to all of us know people in our lives or we
ourselves have struggled with different things.
And so those pieces pulling together are what really led me
down the path of focusing on suicide prevention and eating
disorders. Yeah, I really like that
framework you presented of like why people feel suicidal and
then what we can do to support and help.
And I definitely want to touch on the the piece of shame and
kind of different responses when you go to someone and express
that you're feeling suicidal. I was at ABCT this weekend and
we're talking about digital resources and ethical concerns.
And that's obviously like a big layer there, especially when
you're not interfacing with a therapist and so excited to get
all your thoughts. But to back things up a bit, I
think a lot of people either have never experienced suicidal
thoughts or they have experienced them, but they don't
understand why. Like even though this is their
only of experience and the emotions are coming up for them,
there's kind of that disconnect of like, why am I responding to
situations with these thoughts or why is this the way that I'm
coping with this? So to kind of give some
increased understanding for for both perspectives, why do people
have suicidal thoughts or suicidal ideation?
And then I'm sure we'll also get into behaviors as well.
It's a great question. I was at ABCT as well, so I wish
I would have had we could have we.
Should have connected, yes. Oh.
My gosh, yes. You know, it's a really, really
important question. And in terms of what causes
suicidal thoughts, there are two scientific theories in
particular that have helped me to understand what prompts
suicidal thoughts. And I found that one, it's
important that they've been scientifically tested and have
some empirical support for them, but also too, in my work as a
therapist, that they tend to resonate with people struggle
with suicidal thoughts. The 1st is the interpersonal
theory of suicide by Thomas Joyner and colleagues, and it
really focuses on the idea that suicidal thoughts tend to rise
when someone is feeling isolated and alone, like they don't
belong simultaneously, they're feeling like they're a burden on
others. And importantly, it's the
perception that they're a burden, that the people in their
lives are negatively impacted by them continuing living.
And so the idea is if you feel alone and like your existence is
a burden on others and you're hopeless about those being able
to change that, the idea of escaping that pain and finding a
way out makes sense. It's it's really hard to think
about, but it also makes sense when someone is in that much
pain, that suicide would come up as a way to think about escaping
that pain. So that's that's one framework.
The other framework, the three-step theory by David
Klonsky and colleagues, the three-step theory of suicide,
talks about that suicidal thoughts arise when someone is
in pain and they're hopeless about it.
And the pain can be emotional pain, physical pain, different
types of pain. But the idea is that the pain is
so strong and again, that belief that it's never going to change.
And so suicide arises as a way to think about escaping that
pain. And it's not something that
people are doing intentionally. It's something that our minds
and brains do in reaction to feeling that horrible.
It's really interesting because especially if people listening,
I've taken psychology classes or you like have some general idea
of evolutionary theory. It's not an adaptive response to
pain. Like it's not problem solving.
It's not seeking out support. It's really counterintuitive.
And I think that's what people struggle to empathize with when
someone comes to them and says I'm feeling suicidal or I've
been suicidal or this is something I've struggled with in
the past. Do you have any thoughts there
on kind of why there's this mismatch of how you would
intuitively cope with and experience or think about it and
then the way that people do, especially when they are feeling
like a burden or grappling with that hopelessness?
Thank you for asking that because I think you're exactly
right about that mismatch. But what that speaks to is not
that people who are struggling, not their unwillingness to do
things that are helpful, but what it speaks to is the cruelty
of mental health problems and the way that when we're
suffering and struggling, it's actually hardest to do the
things that would help us most. For example, we know that
connecting with people when we're depressed or anxious, in a
lot of ways that's really helpful.
We know that when we fear things, the thing that helps the
most is to face those fears. And yet the nature of those
mental health struggles is that you want to avoid those things.
They seem like they're too much to even take on.
And so I think about that a lot with suicidal thoughts that that
hopelessness feels like there isn't any point in doing
anything. And when someone says to someone
who's hopeless, well, why don't you just do these things and
you'll feel better? Unfortunately, that can make
things worse 'cause it can feel the person can feel ashamed for
not thinking about it that way or not being able to do those
things that might help them. And so I think that's a lot
where therapy certainly, but also our support networks, our
friends and family can help people to take those steps that
feel they feel impossible sometimes to take those steps
when you're in that level of agony and anguish.
Another question that I want to ask you is we have like this
idea of suicidal ideations with thinking about suicide.
And then obviously some people engage in behaviors based on
those ideations. And I would love to get your
perspective there, especially for people listening that don't
know how to support someone navigating that or they're not
empathizing from experience and they're like, I don't understand
why you're feeling this way. But also then why you would act
on these feelings. What are what are your thoughts
there? And kind of how that escalates,
I guess would be the the correct term.
I was actually watching a piece of a movie, a suicide
documentary earlier today, and Thomas Joyner's interviewed and
he says even if you haven't experienced suicidal thoughts,
all of us have been through painful experiences.
All of us have felt horrible. And so if you can imagine that
and multiply it by 10100 times, whatever it is, you get some
sense of how hard it is when you're feeling that bad to do
things that might help you because you might just you're
overwhelmed by it. And so I think that one of the
things that is very hopeful overall is that little things
that can support a person. So listening to them non judge
mentally and allowing space for them to talk about the suicidal
thoughts can actually make a huge impact because the opposite
where it's saying something judgmental or you have so many
good things in your life, why don't you look at the bright
side? Why don't you have some
perspective or why don't you just do this, this and this?
If a person is already feeling so bad, like they're burdening
others, there's something really wrong with them.
They're isolated and alone. Having someone say you should
just do this, that just prompts more and more shame because
often the person is already thinking that they're already
thinking, why can't I get myself out of this?
They're trying to get themselves out of it, so to have someone
respond that way, it kind of confirms that idea that they're
wrong and that they're not doing the right things and that
there's something that is unacceptable about what they're
experiencing and how they're responding to it.
You mentioned listening empathetically.
I'm sure you get this question all the time.
And it's also like a big general media question, which is how do
we talk about suicide and suicidal ideation?
Because it can be very triggering for for people.
And if you've been in therapy contacts, maybe group therapy,
DBT can sometimes be a little bit different.
But like you were saying, it can sometimes be discouraged to talk
about these things. And there is of course
literature supporting reasons why maybe certain settings
aren't the best place to bring these up.
But what are the best practices with having these conversations,
both from the perspective of someone that's looking to ask
for help or or be vulnerable, and then also people that are
wanting to offer support and not wanting to to trigger someone's
experience or bring attention to something if the person is like
moved through it or coped past it.
I think that this is something that is on a lot of people's
minds when they're feeling the complications of helping and
supporting others. So I'm glad for the opportunity
to talk about it in general. And it's there are individual
differences depending on and what people need and how they
feel supported. But in general, I'm in favor of
being direct, open and honest because anything else just
confirms that idea that it's unspeakable and that the person
can't talk about it. And so I think just starting
with open-ended questions, how do you feel?
What do you think LED you to feel that way?
That sounds really hard. Simple, empathic, non judgmental
statements like that are helpful.
I think that's really hard to do because it's uncomfortable and
painful to hear that people are in those situations where
they're feeling suicidal. So often the urge, which is
totally understandable, is to jump in and problem solve or to
kind of push away the conversation.
So being direct is really helpful.
To your point about not wanting to make the suicidal ideation
worse by talking about it, in the vast majority of cases, what
research we have that exists suggests that if someone is not
thinking about suicide and you ask them about it or they listen
to music about it or whatever it is, that they aren't going to
start becoming suicidal. And so that's something we can
kind of rest assured about. On the other, there is evidence
that if you talk to someone about suicide and they are
struggling with suicidal thoughts that even talking about
can reduce some of the distress and intensity surrounding it.
And I think that one area, you know, you mentioned DBT that it
that is worth mentioning and group settings there are rules
about. I'm not going into details
surrounding methods. I think that's a controversial
area about how much that matters, but I think it makes
sense. And I don't think it's necessary
to go into details about methods if you're trying to understand
why someone's experiencing that. I do think it is important to
understand what people are thinking about in terms of
methods for the next piece, which is making sure they're
safe. So if someone has specific
methods in mind or past methods they've used to try to end their
lives or kill themselves, then actually it is important and
helpful to know what those are so that you can help create a
safer environment. Because the research really
strongly points to the fact that if you, if someone has firearms
in their home or they plan an overdose, or they plan whatever
their plan is, that if you can restrict that, that can be life
saving. And so there's a, there's some
nuance to it, but the general rule is it's better to talk
about suicide than not. And keeping it open and non
judge mental and expressing compassion tend to be helpful.
What about peers and Co ruminating?
Because we have a lot of young adults that listen to the
podcast and often times with young adulthood comes your peers
being the people you're leaning on the most.
Maybe there's more fear and shame about going to parents or
counselor, a trusted adult to try and be vulnerable.
And especially with mental health challenges, that can be a
double edged sword because you just don't have the training and
expertise and emotional bandwidth and all the things at
at that point in life. And it's also not in like a
negative connotation, but it's not your responsibility.
Like you're not their caretaker or guardian or parents or school
counselor and all the things. So especially with young adults
and and Co ruminating or if there's multiple people that are
struggling, is that kind of like an outlier to the the rule of
thumb? Have you seen the Netflix series
Heart Stopper? No.
The recent series, the main star, the main character of it
has eating disorder symptoms and also some self harm issues.
And it's actually really nice depiction of it because one,
it's realistic, it's and two, it shows the friends and the
character's boyfriend both feeling like they don't know
what to do to help him. And so there's a nice scene
where the the boyfriend happens to have a psychiatrist who's an
aunt, which is handy. And she says your job is to ask
him how he's feeling, be willing to spend time with him.
And then you gently urge him to seek help, to talk to his
parents, to talk to a therapist. But your job is not to intervene
and, and change it. You can't do that.
And also your mental health could deteriorate if you think
you can and you're unable to change that.
And so I was impressed by that because you don't see that a
lot, but there are much better mental health depictions than
there used to be. But that really shapes, to
answer your question, the boundaries around what we can do
as as peers. Even I'm, I'm a psychologist and
I'm psychologist friends and even though I have the training
as a therapist and the capacity as a friend, I don't approach it
the same way at all. It's very much listening support
and also knowing my own limits. So are there things that are
that I don't have the bandwidth for that you mentioned?
Am I having a really hard week and I need all the resources I
can? Well, then I you can tell the
friend, is there anyone else who can call or can you call the
crisis hotline 988? Have you tried to talk to your
therapist? Can I help you by identifying a
therapist? So finding something to do while
not taking on the full responsibility for it because
you want to check in with yourself and your own mental
health and understand really what you can do is very
powerful, which is to show that you care.
But what you can't do is control someone else's behavior or
something like that. And if it helps at all to think
about it this way, by you modeling that you have certain
boundaries around mental health and that you're taking care of
yourself, that can be helpful for your friend too.
It might not immediately feel good to them, but they're
getting the message that OK, my friend, when they're struggling
or want to prevent struggling, they are doing things to take
care of themselves. And so they're observing that as
well. And I do think that model can be
helpful. Yeah, I, I think that was one of
my biggest learnings and I think it caused me a lot more struggle
than I needed to experience was by surrounding myself with
people that were feeling the same way.
And it's instinctive, like we attract the energy we put out
and getting our feelings validated is is really
important. And also like an innate need.
We look for that from people around us.
And in this situation it just adds a whole nother layer to the
situation and it can hurt it rather than help it.
And I think even now, same thing where like when I think about
how I could help and support my peers, it wouldn't be like
listen to this podcast or like, this is how we're going to walk
through this and even like making a situation more safe
because that's not my role in their life.
But being someone that they know they can have a fun night with
and watch a show together or laugh and just call when they're
not doing well. I think that you're adding like
a great deal of positivity and support their life that they can
count on. And I think people underestimate
how much that's valued. And even if they feel like they
could do more, I think that is an incredible position to be in
as a friend if you know that they can count on you and you
know that you can be an outlet for them to feel better and get
out of their head and just connect.
That's exactly right. It can mean the world to someone
who thinks that they're a burden and they're alone to be with
someone who likes being around them and it will do things with
them. And the other part that you
said, which I think is really important is that often in
therapy, we're trying to not avoid things, we're trying to
really not distract, we're trying to process things.
But as you know, with suicidal thoughts, actually it's it's
very important, especially during a crisis to have that
skill and tool of distracting and tool that intensity
decreases. And the research supports that.
And that's certainly present in a lot of therapies that we do
that that actually is not a good time to just keep.
You want to eventually get back to the causes.
But while you're in a crisis, distraction may be the best
thing to do. Yeah, I just recorded an episode
on anxiety and I was like, let's not distract too much, let's go
towards that thing. This time we're like distract,
distract, distract. Watch as much office as you
want. Listen to like do whatever you
need to do. And I, I think that's very true.
Shifting gears a little bit and kind of expanding on how you can
work through these thoughts. Well, I'm sure we'll get into
identifying the the core issues. You have a workbook which we'll
put in the show notes about how people can work through suicidal
thoughts, especially from the CBT framework.
But can you give us like a 30,000 foot view of kind of what
this process looks like? Because that's the other thing.
If you haven't been to therapy for navigating suicidal ideation
before, you really have no idea what to expect because it's not
a natural skill in life to be like, oh, I intentionally
changed the way I think about things because it has really
detrimental impacts on my life. So overview, what can people
expect? And I think it's also helpful
for parents and peers to understand the work that their
friends and family might be doing.
The, the kind of behavioral therapy model kind of zoomed out
and at its basic level is that a thoughts, emotions and behaviors
all influence each other. And when someone's in a suicidal
mind state, often the thoughts are about being alone, about
being a burden, that nothing in life matters, not feeling
connected to it and their perception, even though it's not
their fault. Often it has some flaws to it
because the, again, the cruelty of struggling with suicidal
thoughts is that you're so can be so hypercritical of yourself
and you can be unable almost to see reasons to believe that
things can change or that you can help to affect that.
So with the cognitive behavioral therapy model, really the work
that's being done is finding ways to be aware, first of all,
of suicidal thinking patterns and how they tend to increase
pain, increase hopelessness, and look for evidence that prove
you're not worthy, things like that.
And then exploring evidence that suggests you are worthy and that
things can change and you've been through hard things before
and you can get through them and there are ways to cope.
So that's a big piece of it at a, at a zoomed out level.
And then there's a lot more details in between.
But that's the main idea is looking at those what thoughts,
behaviors and emotions, what can we do to impact those to
basically disrupt the suicidal crisis and system?
If we can like kind of go through the cycle and get
detailed on thoughts and then the behaviors and then the
emotion shift as well. And I'm sure there's, we talked
about shame earlier, sometimes guilt, like these emotions that
can really 'cause this cycle to continue.
The thoughts piece of it, I think is really interesting.
And like you said, the the data doesn't support that engaging in
these thoughts or going down that that line of thinking, it
doesn't have a positive impact on your mood, even though people
sometimes do, like you said, use this to cope with feeling
hopeless or like a burden or these other emotion.
So in the thought piece of thing, what's arising?
How can people rewire that? All the things?
So one piece that I want to mention is that I think it's
part of the complexity. It's not helpful to, for
example, continue to think about suicide as an escape and that it
can increase suicide risk. However, it's really important
to be compassionate with yourself and recognize one that
that's not completely in your control.
Your thoughts can kind of do all kinds of things and, and just
approaching yourself, yourself with warmth.
And So what a thought might look like is something like, I'm not
going to get through this. I'm going to be in this pain
forever. And a way that you might address
that with kind of behavioral therapy is dig a little bit
deeper. Well, why is that?
Well, it's because I'm incapable and it's because the world is
cruel and nobody wants me around and all of those thoughts.
And so then once you've identified what those thoughts
are, you can look and see, do they fit certain patterns?
Often the patterns that we tend to see are all or nothing
thinking. So the person is thinking about
all the things, the mistakes they've made and they don't
they're, they can't think without some help about the
things that they have contributed and how they've
connected. They can't think about building
confidence by looking at what they've done in the past.
They can't think about, well, I feel like a burden.
So maybe if I change the behavior and start intentionally
contributing more, that might reduce the emotions.
And so the the process is identifying the thought,
identifying what the pattern is. Is it all or nothing?
Is it disqualifying the positive things that are coming up?
And these are all from Aaron Beck's kind of behavioral
therapy and David Burns also his Feeling Good book has a lot of
these common patterns in them. And so I I found in therapy that
even introducing those patterns helps people so much because
they relate to them and they realize it's not just them.
If someone's written a book and there's a list of them that's
really helpful. And then the next piece is
helping go through evidence against those thoughts and then
coming up with a new reframed thought that's more accurate.
And it's totally different than positive thinking because you,
you aren't just saying, OK, you think you're a bad person, just
think you're a good person. That's that's, that doesn't work
that way, right? That would be nice if it did.
It doesn't, though. So rather what you're doing is
you're building a case by examining evidence that supports
that they're not a bad person and then coming up with a
reframed thought that's more accurate and then acting as if
that's the truth. And so that's part, a big part
of what it is. And then the behavioral piece is
very much adding in those things that connect to person, that
tether them to life. What's meaningful to them, What
are their values? How can they amplify those?
Because under the crushing weight of suicidal thoughts, not
everyone, but a lot of people withdraw, give up, and all of
that. And so it's also finding things
that feel doable with that energy level or whatever it is
for creating a little more joy and connection in the person's
life. So that's the main gist of how
to build a hopelessness and to soothe some of the pain that's
driving the suicidal thoughts. I really like what you mentioned
there where you have to have that self compassion with the
first thought because it's you can't necessarily control that,
just like you can't control like an emotion as it rises or if
you've coped with something behaviorally a certain way for
years, it's not immediately going to shift even if you set
that intention. But the next thought or how you
respond to it or the evidence you collect against that initial
thought, you do have that autonomy and choice and power
there, which I think is really important.
I'm curious, are there any behaviors or coping skills or
activities that clients have found really helpful across the
board? A few that you consistently
recommend that people can try out if they're like OK, I like
the idea of increasing meeting but I don't know where to start.
Sure. So I think about a couple of
different types of behaviors and one one thing that my workbook
really focuses on as a framework and then I use as a therapist is
the idea that there have to be a menu of options because
different things work for different people.
So if one thing doesn't work, OK, well we have nine other
things or 10 other things. And that in itself can build
hope getting through it. So one category I would say is
self soothing. And when someone's struggling
with a mental health problem and feeling suicidal, they often are
punishing themselves. They don't even think, oh, now's
the time to actually soothe myself.
So I think about if you have the flu or you're sick, at least
some part of you knows that it's not your fault.
It's just something that happens and you kind of have to go easy
on yourself. You have to have comfort foods,
you you can't do the things you normally do.
Hopefully you can call out of work.
And so I try to make that analogy that when you're
struggling in a lot of pain, that is the last time for more
punishment and self criticism. So things that tend to soothe
people. I think a lot of it, a lot of
people go to music. A lot of people go to, I like
stand up comedy because it's kind of the opposite of feeling
bad when you're laughing. And I think the other part of it
is that actually there's so much comedy now about mental health
stuff, so kind of have like a 2 functions where it's funny and
you can resonate with it. So those are a lot of them.
Getting outside, like just changing the perspective and
going for a walk, taking a hot shower.
Anything that captures your attention and feels positive can
be helpful. So watch a horror movie that was
one of the big go to ones that I heard a lot because you cannot
feel like deeply sad and hopeless and jump scare at the
same time. So any of those where it's like
it's just that all-encompassing emotion being evoked.
It's really effective as an intervention.
Exactly because what you're doing is your mind is kind of
like a magnet when you're suicidal.
And it's it's everything that confirms your negative views
kind of sticks. And so it takes something to
jolt out of that. So that's, that's exactly right.
And you it's trial and error too.
So you see what works for you and you try other things.
And then the other piece I would say with the behavior, just
trying not to isolate. And one way to do that is to
reflect on your values. And my workbook, I talk about
Viktor Frankel's Man's search for Meaning that he wrote, he's
a Holocaust survivor and as a psychiatrist and talked about
how even in the worst situations, I mean, he was doing
suicide prevention and a concentration Campbell, he was
held captive there. There is still a way to find
meaning. And so a lot of it, boiling down
the basics is spending some time to reflect what are my values
and what am I doing in my life that connects me with those
values. And the other theme I've
mentioned a few times, they don't have to be huge things.
If you value being compassionate or charitable or educated or
whatever it is, you can find something, something to do that
just kind of connects you with that value.
And then life doesn't feel so empty.
And so it's worth thinking about those types of things and making
action plans for what something I might do to enhance that
meaningful feeling. For sure.
The last thing I want to touch on is what people can do in a
crisis because I know people are like, we know 988.
We did an episode a while ago and I'll put it in the show
notes with Adia Fedai and she is a 988 operator.
So we like went through exactly what happens when you call and
what they'll say and how you can still be anonymous and all the
things. We did a similar one with Crisis
Text line and what people are commonly talking about.
And we had a a young adult volunteer on the podcast and she
went through kind of like how she typically responds and what
people can expect. So generally those are our
resources, but there's still anxiety and apprehension about
utilizing those. We talked about distraction.
Is there anything else that you would recommend in crisis that
people can utilize? I am almost positive people are
listening to this not in crisis. They can write it down, maybe
take a photo of a sticky note, whatever it is to come back to
this as a crisis survival plan. But what other tips do you have
for crisis? Or 988, I would go to their
website and they have safety plan templates and I would look
there and and fill out one. It's worth having a safety plan
like you said, when you're not in crisis, but the main things
that it has on there are one. What is your main reason for
living? Because when you're suicidal,
it's hard to remember. Wait, why do I want to hang on
anyway? And that that can make it more
salient again, that idea that you're kind of shining your
attention and spotlight on something else.
And also the idea that it doesn't have to be something
huge. Some people say their family and
members are what keep them going or their pets or whatever it is.
But it whatever it is that's acceptable.
So it's a reminder of that. The other piece is of course,
the emergency numbers, but people don't always want to call
that, you know, I encourage it, but if you don't want to, you
don't want to the distraction and coping strategies.
And then the thing and I'll add is a piece about making your
environment safe, as we were talking about earlier, that's
super important when you're in a high risk situation that you put
distance and time between yourself and the lethal methods,
whatever they are, that is life saving.
There is there is research looking at how long the typical
intensity like very intense suicidal thoughts can last and
at their highest peak, often they diminish within hours.
And so if you can get through that without having access to
the lethal methods, having some support people that you can
contact, having some coping skills and remember your reason
for a living, that can be really life saving.
And I'll mention an app called the Virtual Hope Box, which has
a lot of these ideas in them and includes distraction things in
there like games that you can play and inspirational quotes
and emergency numbers. And so the goal is to have this
plan in place so that when you can't think clearly about it,
you can access that and that gives you the steps to take.
And so those are those are the main pieces.
Separation from lethal means support people, emergency
numbers, and your reason for a living.
Yeah, there's like you mentioned, there's so many.
Different ways that we apply double standards to mental
health and I think the like giving yourself an environment
that you can be successful in is a great example of that.
Like if you have celiac, you don't buy 12 loaves of sourdough
when you go to Trader Joe's because no one has that level of
self restraint. Even if you know there's going
to be a negative consequence, if you're struggling with
addiction, you don't spend 3 hours at the bar after your work
day. Hopefully these are things you
don't do because you know, you're just setting yourself up
to be in a situation you have to use willpower and humans don't
have a lot of willpower, whether you're looking at them taking
grit lab right now. And so we're talking about
achieving your goals and like deliberate practice with
instruments like willpower doesn't get you there.
It's these contacts you put yourself in.
And that's absolutely true for mental health and, and suicidal
ideation. And I, I think that's really
important to remember because I think again, it could, it comes
back to the shame piece of like, why can't I just get through
this thought? Like, why would I have to adjust
the environment? But we adjust our environments
for everything, and it's really, really key in allowing us to be
successful. It's simple things like putting
your alarm across the room so you can't get back in bed.
Like all these things we do, because as humans, we're very
susceptible to our environments. We don't have a lot of willpower
and unfortunately that works against us in this context.
You're absolutely right, and I think the analogy of other types
of medical emergencies is correct too, in that if
someone's having a heart attack, you don't expect them to figure
it all out on their own. You people that can support you,
you contact emergency services, you have someone else drive you
to the hospital. So when you're in a suicidal
crisis, you why in that emergency situation, would you
not want to reach out except, as we mentioned, knowing the shame
that comes with it and feeling like no one cares.
So it can be helpful, just like you're saying, to think about it
when you're not in crisis, so that when you're in crisis you
already have the plan laid out and don't even have to think too
deeply about what you need to do A. 100% Well, if people want to
get your workbook or I know you have another book coming out as
well, where can they do that? My book is available on Amazon
and a bookshop and basically most places where books are
available, it's usually at least a copy or two at Barnes and
Noble. So it's it's not too hard to
find if you're looking for it. And I think the other, the
guided journal I'll mention, which is just another format it
it's much shorter, but I found that journaling people find
really beneficial for a variety of things.
And so the guided journal for Suicidal thoughts workbook kind
of to your point, it's not ruminative, it's guided and it
has a lot of these cognitive behavioral therapy practices
that will be out in July 2025. And that'll be available Amazon
Bookshop, Barnes and Noble, all, all of the same types of
websites. Amazing.
Well, I'll put that in the show notes and thank you so much for
joining me. Oh, thanks so much for having me
on. It was my pleasure.
Thank you for having me on the talk about this important topic.