Let’s Talk About It: Suicide

By Rachel D. Miller, AMFT

Suicide remains a taboo topic in our society but failing to talk about it does not prevent it from happening. Instead not talking about it creates stigma for suicide survivors, their families, and those whose loved ones die by suicide. It also reinforces the myth that suicide should not be openly discussed. September is Suicide Prevention Awareness Month making it the perfect time to talk about it.

Let’s start by looking at its prevalence in the United States.

• Suicide is the 10th leading cause of death in the US for all ages (CDC)

• Approximately 123 Americans die by suicide every day (CDC)

• There is a death by suicide every 12 minutes in the US (CDC)

• White males accounted for 69.67% of suicide deaths in 2018 (CDC)

• In 2018, firearms accounted for 50.57% of suicide deaths (CDC)

• There were an estimated 1.4 million suicide attempts in 2018 (CDC)

• Lesbian, gay, and bisexual kids are 3x more like than straight kids to attempt suicide at some point in their lives (SAVE).

• 41% of trans adults said they had attempted suicide in one study. The same study found that 61% of trans people who were victims of physical assault had attempted suicide (SAVE).

• Lesbian, gay, and bisexual young people who come from families that reject or do not accept them are over 8x more likely to attempt suicide that those whose families accept them (SAVE).

What is Suicide?

The National Institute of Mental Health (NIHM) defines suicide as “death caused by self-directed injurious behavior with intent to die as a result of the behavior.” A suicide attempt is “a non-fatal self-directed injurious behavior with intent to die as a result of the behavior” (NIHM). It may or may not result in injury. The term suicidal ideation refers to the thinking about, considering or planning suicide.

Signs and Symptoms

Knowing the warning signs and symptoms is key to suicide prevention. Some of these are:

• Talking about wanting to die or wanting to kill themselves

• Talking about feeling empty, hopeless, or having no reason to live

• Making a plan or looking for a way to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun

• Talking about feeling trapped or feeling that there are no solutions

• Talking about being a burden to others

• Withdrawing from family and friends

• Changing eating and/or sleeping habits

• Talking or thinking about death often

• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy

• Giving away important possessions

• Saying goodbye to friends and family

A more thorough list of signs, symptoms, and risk factors can be found here on the NIMH website. If you or someone you know is exhibiting any of the above, please reach out for assistance as soon as possible and prioritize safety, particularly if the behaviors are increasing or have developed recently. Crisis hotlines and additional resources are listed at the end of this post.

Myths

Myths about suicide further complicate our ability to talk about and prevent it. The World Health Organization has complied a pamphlet debunking the most common. You can find it here.

What to do if someone you know is in crisis?

It can be scary to recognize the signs of suicide in someone you know. Being uncertain about what to do or being afraid of doing the wrong thing can lead us to doing and/or saying nothing. Despite the myth that asking about suicide increases the risk, expressing your concern, and inquiring about whether they have a plan can be helpful. It is vitally important to let them know you care and to encourage them to get professional help. Learn more about what to do and say here and here.

Additional resources:

National Institute of Mental Health: Suicide Prevention

Suicide Awareness Voices of Education (SAVE)

Teens and Suicide: What Parents Should Know

How to Talk to Children and Teens About Suicide: A Guidebook for Parents

How to Talk to Your Child About Suicide

Talking with Kids About Suicide

Talking to Kids About the Suicide of Someone Close to Them

Telling a Child About a Suicide

Speaking with Your Teen About Suicide

What to Say to a Suicidal Teen

If you or someone you know is in crisis call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the Lifeline’s website or the Crisis Text Line’s website. (https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml)

The Veterans Crisis Line connects Service members and Veterans in crisis, as well as their family members and friends, with qualified, caring Department of Veteran’s Affairs (VA) responders through a confidential toll-free hotline, online chat, or text messaging service. Dial 1-800-273-8255 and Press 1 to talk to someone or send a text message to 838255 to connect with a VA responder. You can also start a confidential online chat session at veteranscrisisline.net/get-help/chat.

The TransLifeLine is a peer support service run by trans people, for trans and questioning callers. Operators are located all over the U.S. and Canada and are all trans-identified. Trans Lifeline’s Hotline can be reached at 877-565-8860

Sitting In Your Impact

By Michaela Choy, AMFT

Our impact on others can be positive; it can look like encouragement, understanding, support, love, etc. Our impact can also feel negative; it can look like betrayal, hurt, ostracization, misunderstanding, etc. When the latter occurs, and someone has the bravery to share they have been negatively affected by you, it’s important to make space for their experience. This looks like honoring our impact before we share our intent.

In these moments it is most helpful to be curious, to listen, and to validate feelings. These moments can be tough. It’s challenging to hear the ways in which we’ve hurt others. When this happens, we are pulled to respond with our intention - “But you’re not understanding where I was coming from or what was happening for me…if you knew, you wouldn’t feel that way.” We need to resist the urge to respond with our intention first because this sounds defensive and therefore feels invalidating. Here are some helpful responses instead that make space for another’s experience:

- Thank the person for sharing with you.

- “I’m so grateful you told me, otherwise, I wouldn’t have known you were hurting.”

- Speaking to understand. Sharing your intention will come later.

- Be curious and ask questions

- What did you need from me instead?

- What else are you feeling?

- Is there more you need to share with me?

If you feel defensive, try the following:

- Remind yourself of your worth

- You are more than this moment and you are allowed to stumble. This is how we learn and grow.

- Slow Down

- The pull to defend is strong and automatic. Interrupt this by slowing down, take a breath, or restate what you’re hearing.

- Name it

- Share that you are getting defensive and notice that you need to shift modes. This keeps you accountable and will signal to others that you need some time to regulate. You can ask for a short time out if you need to gather yourself.

The appropriate time to share intention is after the hurt person feels understood. The easiest way to gauge this is to ask if they feel understood or if there is more you need to know. Once this is achieved, ask for permission to share where you were coming from. If now is not a good time, establish another time to connect.

Growing Your Self Awareness

By Michaela Choy, AMFT

This poem is a beautiful representation of how we grow and change. It acknowledges our pull to the familiar; we are patterned beings, the longer we’ve done something a certain way (manage conflict, date, etc.) the harder it feels to show up differently. And, good news, it’s also very possible to show up differently.

The path to growing our self awareness is winding and not linear. It’s common to have moments where you break harmful patterns and then moments of sticking to them. Just because you fall back into a pattern doesn’t mean you’ve regressed. It means that is a big pull for you that you will need to watch and take care of.

As we are confronted with our patterns, we build awareness of what we are doing. And we must give ourselves compassion in choosing the familiar path even when we see the alternatives. I have deep respect for where old patterns come from and how they’ve benefited us. At some point, your old pattern most likely served, protected, or helped you survive.

Too much compassion, however, can leave you stuck, so we must be accountable for our behavior. We must commit to building awareness of our patterns, find choice points, and do the newer, harder thing. When we deepen our self awareness, we must hold compassion AND accountability tightly.

How to Better Cope, Help, and Balance Your Needs in Our Political/Environmental/Emotional World

By Sasha Taskier, LMFT

As of September 1st, 2019, “which was the 244th day of the year, there have been 283 mass shootings in the U.S.” (source); we have experienced more shootings than days. As I type this, Hurricane Dorian is barreling its way across the Bahamas and towards the southeastern coast of the United States and families are still being separated at our borders and within our country. Between these catastrophic natural disasters and terrifying acts of terrorism, we are living in a climate of fear that can wreak havoc on our emotional wellness and mental health.

I know I have struggled to navigate my own feelings on these topics and the state of our political and environmental climate, but it comes up in my therapy sessions on an almost daily basis. I have cried with parents who cannot fathom the idea of their child being taken away from them and I have empathized with parents who are scared to send their kids to school or let their teenagers go to outdoor concerts for fear of yet another mass shooting. People are trying to understand how they can be more mindful of the environment and how that can impact some of their most intimate choices (like, should we have children if we do not know what the planet will look like in the next 50 years?).

Most of us are trying to understand how to live our normal, daily lives while we simultaneously fear for the safety of ourselves and our loved ones. It is taking an emotional toll, and it’s creating a spike in our collective anxiety.

Here are some topics to consider on the subject:

Media Intake

Limit your media; Either tune in occasionally in order to stay engaged and informed, or curate your intake very intentionally (ie. choose one podcast, or one newspaper), but do not feel bad turning off your twitter feed, turning off the news or closing your computer for some time. You are not disengaged or unfeeling if you decide not to watch violent footage, or become inundated with negative news cycles. It is imperative to create boundaries to protect your mental health and to respect your own limitations.

Meaningful tips on media consumption, from Brené Brown.

Seek Support

If you notice a rise in your fear and anxiety, or you’re struggling to manage your emotions as these tragic events continue to unfold, it might be worthwhile to seek some additional support. You can search for a therapist by zip code and/or specialty through Psychology Today.

Collective Healing

Reach out to friends and family. We are creatures of connection – and in times of threat and despair, we sometimes need to embrace our inner ‘pack animal.’ Put down your phone, and spend time with your people IRL; presence can be healing. Additionally, if you know someone who may not have family or friends nearby, reach out to them: invite them for coffee or have them over for dinner. Even something as simple as a text to tell someone you are thinking of them and hoping they are ok, means more to them than you realize. No one should have to feel alone during such a scary and uncertain time.

Get Involved

There is nothing worse than the feeling of helplessness that follow these horrific events; No, we cannot change what has taken place, but there is enormous healing in engagement and collective action. You can turn towards your local community and find a volunteer opportunity nearby. Connecting and helping in person may feel especially rewarding.

• If you’re in Chicago, this is a great resource: https://www.chicagocares.org/

If you are feeling compelled to turn your attention towards gun reform, these organizations have opportunities both to donate and volunteer. There are numerous events and meetings around Chicagoland - just search below:

• Every Town for Gun Safety: https://everytown.org/

• Moms Demand Action: https://momsdemandaction.org/

Red Cross - you can donate directly to those who have been impacted by Hurricane Dorian

[Unfortunately, I felt inclined to write a similar blog post almost two years ago after the Las Vegas shooting, which occurred right on the heels of a shooting in Texas, and the horrific earthquake in Mexico City. You can read my thoughts and many recycled tips from October 2017, here]

Strategies to Move Through a Breakup

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By Michaela Choy, AMFT

Around Valentine’s Day, I’m reminded of beautiful ways we can honor our loving relationships, and I’m mindful of those who feel alone and hurt – particularly those who have recently ended relationships. Breakups are profoundly painful phases that drain our emotional and physical states, and they will most likely impact you at one point or another. The following list includes strategies to implement at any point during a breakup process. Incorporating some of these ideas will restore your energy and help you create a new normal.

1. Kindness

Do one good thing for yourself each day. This can range from a small gesture of kindness to something larger. Getting a special coffee from your favorite coffee shop, cooking yourself a nourishing and delicious meal, going to the movies, or getting a massage are some examples.

2. Connect with Your Greatest Support Systems

Set up time to see friends or family and schedule at least one or two of these get-togethers each week. This can be helpful for a few reasons. One, surrounding yourself with supportive connection can feel healing. Two, it gives you some structure in the week and forces you to get out into the world. There are open pockets of time that you and your past partner once spent together, and this is one way to fill that time meaningfully. If family and friends are far away, consider setting up phone calls or trips to see them.

3. Reflection

At times, you may want to create a list of reasons why the relationship didn’t serve you. Be honest with yourself about the ways this relationship impacted you. It’s normal to think of both good and bad impact.

If you are ready to take a step further in your reflection, notice the ratio of good to bad. Ask yourself if you had awareness of this picture while you were in this relationship and begin think of ways you can you build greater awareness going into your next relationship.

Reflection with this list can be particularly helpful if you hoping to get back together or stay apart.

4. Physical Movement

Go for a walk or try a new workout class. Joining a sports league or a weekly fitness class can not only help your body feel better but also add structure to your routine.

5. Distraction

Create a list of go-to, feel-good things when you have inevitable moments of emptiness. Think of activities you can do when you’re alone and activities you can do with friends or family. Moments of intense loneliness and pain can appear out of nowhere. A premeditated list of activities will give you options in moments where your thought energy is lacking.

How To Better Cope (And Help) In Today’s Climate Of Tragedy And Fear

By Sasha Taskier, AMFT

In the wake of Sunday night’s shooting in Las Vegas, we are reminded (again) of the fragility of life and the senseless acts of hatred and violence that plague our country and our world. It feels overwhelming to wrap our heads around another tragedy, especially just on the heels of the devastation in Texas, Mexico City and Puerto Rico (and beyond). Between these catastrophic natural disasters and terrifying acts of terrorism, we are living in a climate of fear that can wreak havoc on our emotional wellness and mental health.

Here are a few thoughts and recommendations for how we can better navigate this difficult time:

ACKNOWLEDGE YOUR EMOTIONS

It may feel like the only option right now is to push through and ignore your thoughts and reactions to recent events. Often, when we ignore our feelings, they get worse, or they can manifest elsewhere in our lives.

Take stock of how you are feeling; it may be easy to identify the emotions you’re experiencing, but it may also be really difficult. It is common to experience multiple feelings at once, a constant switch between emotions, and even an overall sense of numbness. There is great power in naming our emotions – once we have a name for them, we can identify them more readily when they surface and then we can more calmly and better manage our symptoms.

If you have experienced a trauma or loss in your life, this news might be especially triggering for you. There is a particularly higher risk of feeling a sense of despair, helplessness, anger and grief– even if this event is in no way connected to your own experience. (There are links to both the disaster distress hotline and crisis hotline at the bottom of this post, should you need them.)

Other symptoms you may be experiencing around this event are increased irritability, loss of sleep, reduction in appetite and loss of focus. Pay attention to yourself and your body – if these are happening to you, it is your body’s way of saying you may need to seek professional help, and take some time to take care of yourself.

MANAGE YOUR MEDIA INTAKE

Many of us may feel guilty turning off the news, or choosing not to watch the footage of the most recent shooting. We may feel obligated to stay informed and force ourselves to see what is happening; in doing so, we hope to increase our understanding of the situation and our compassion for those who were affected. While I think it is a worthy effort to remain engaged and continue practicing empathy for those who are suffering, overdoing this media exposure can lead to increased anxiety, traumatization, and even a re-triggering experience.

Limit your media; tune in occasionally in order to stay engaged and informed, but do not feel bad turning off your twitter feed or closing your computer for some time. You are not disengaged or unfeeling if you decide not to watch this footage; (there are plenty of ways to remain engaged without exposure to such horrific visuals.) It is imperative to create boundaries to protect your mental health and to respect your own limitations.

(I so appreciate these wise words on consuming media, from Brené Brown.)

EMBRACE CONNECTION

Reach out to friends and family. We are creatures of connection – and in times of threat and despair, we sometimes need to embrace our inner ‘pack animal.’ No, you do not need to talk about the event if that feels un-welcomed – but you can share your feelings, share good news and continue to focus on joy. Remember, joy is an act of resistance, especially in the face of hatred.

Additionally, if you know someone who may not have family or friends nearby, reach out to them: invite them for coffee or have them over for dinner. Even something as simple as a text to tell someone you are thinking of them and hoping they are ok, means more to them than you realize. No one should have to feel alone during such a scary and uncertain time.

HELP OTHERS

Helping others counteracts the stress hormones in our bodies. There are countless ways to help and they do not necessarily have to be related to the shooting in Las Vegas. You can donate to relief efforts in Houston, Mexico City and Puerto Rico.

Donate to the Red Cross and Other amazing relief organizations to consider

You can turn towards your local community and find a volunteer opportunity nearby. Connecting and helping in person may feel especially rewarding.

If you’re in Chicago, this is a great resource: https://www.chicagocares.org/

If you are feeling compelled to turn your attention towards gun reform you can check out these organizations to see how you can become involved:

      -  The Coalition to Stop Gun Violence: https://www.csgv.org/

      -  Every Town for Gun Safety: https://everytown.org/

      -  Moms Demand Action: https://momsdemandaction.org/

And of course, you can contact your representatives to tell them your feelings about passing comprehensive and common sense gun reform in the wake of Sunday’s tragedy.

       -  Here is a useful script to help guide your words and guide for reaching outI’ve used the ‘ResistBot’ and found it to be an unbelievably                easy and fast way to contact mySenators and Congressmen about issues I care about. Text RESIST to 50409.

Additional Resources & Articles:

Disaster Distress Hotline:  1-800-985-5990 – Text: TalkWithUS to 66746 – Website

Crisis Hotline: 1-800-273-8255 - Website

Psychology Today

Huff Post Blog

Mashable

Grief & Resilience

By Sasha Taskier, AMFT

Grieving is a universal action, one that we embody as the result of a loss. Humans all over the world grieve through different customs, ceremonies and traditions (TED Ideas). We’ve even learned that certain animals grieve when they’ve loss a member of their family or pack (BBC).

Most commonly when we speak about grief, we are referring to the death of a person; yet, I have found that we grieve when there is loss. That loss may be a person, but it could also be the end of a relationship, the loss of a job, the loss of our health, or the realization that our dreams and wishes for our future can no longer be reached.

I recently read Sheryl Sandberg and Adam Grant’s new book, Option B: Facing Adversity, Building Resilience and Finding Joy. Sandberg, most notably known as the COO of Facebook, tragically lost her husband in 2015. She, with the help of psychologist Adam Grant, share a very personal lens into her grief story and process of recovery. They examine the impact of loss (in its many forms) on depression, resilience and growth.

“We cannot control what happens to us, but, we do have some influence over how we respond to the events and hardships in our lives” – Adam Grant

If you or a loved one has experienced a loss, or are even curious about this topic – I highly recommend this book. It is not only a king of memoir, but also a collection of stories from resilient people around the world, and a self-help platform with the latest research from psychologists in the field.

In the meantime, here are 3 of my favorites takeaways from Option B:

1)    Grant present Martin Seligman’s theory of the Three Ps, which can help determine our ability to deal with ‘setbacks’ in our lives

• Personalization: “This is the lesson that not everything that happens to us happens because of us”
• Permanence: “refers to whether you see negative experiences as global or specific, or as Sandberg says, whether "an event will affect all areas of your life."
• Pervasiveness: “explains whether you see an event as stable or unstable, or how long you think the negative feelings will last.”

Sandberg describes this idea as our brain’s psychological immune system – we can heal and recover, but sometimes we need steps to kick into gear. Noticing when we feel one (or more) of the three Ps can be a helpful first step to challenging our mindset around grief, or feelings of ‘stuckness.’

2)    Self confidence and self compassion

Sandberg shared how after the death of her husband, she felt her self-confidence plummet; she was apologizing to everyone around her at home and work. She felt guilty – that everything was her fault. One of the most important components of recovery is self-compassion.

Kristin Neff defines self-compassion as: approaching yourself with the same kindness you would show to a friend.

Sandberg felt that her internal experience (where she was falling apart) matched how she presented herself to the rest of the world. Adam Grant suggested that before bed, she write down three things she did well that day. It may take some time, but focusing on ‘small wins’ builds confidence.

3)    Its important to talk about loss and hardship

We have a really hard time talking about loss and adversity. Even if it is on our mind – we may not say anything to that friend whose parent is sick, or to someone we know is dealing with the loss of a job, or a recent death in his or her family. We’re scared to say the wrong thing, or perhaps we fear that by bringing it up, we’ll be ruining that person’s day. (Psychologists coined a term for this, called The Mum Effect.)

Sandberg talked about the feeling of isolation she experienced after she lost her husband. She would be amongst friends or coworkers and while she knew everyone knew what she was going through, they never said anything. It became the elephant in the room that fueled her sense of isolation and despair.

Just ask; if you know someone is going through a difficult period, ask him or her: “how are you, today?” This acknowledges that every day is different, and some days may be better than others. It is simple and it may give the person who is grieving the opportunity they have wanted (or needed), to share.

If you are interested in learning more about Option B, and/or lessons about grief, resilience and growth, Sandberg and Grant have created a platform to explore these themes and hear stories from real people who have overcome unbelievable hardship and adversity.

https://optionb.org/

The Power of Reminiscing

The Short north, columbus ohio

I recently returned to Columbus Ohio where I had spent three years of my life post college.  During these early twenty-something years, I can look back to some amazing memories, tough challenges, relationship building and self discovery.  Columbus was where I started the beginning stages of my career, built a strong support system of close friends and met my husband.  It was where I first experienced full independence and allowed myself to dream big and push through fear of failure and change.

As I drove through the city with my closest girlfriend Jaime, we found ourselves completely emerged in our memories of that exciting and terrifying time.  Not only did we reflect on our memories, but we also shared new awareness of the present as it is connected to our past. 

Research shows that reminiscing can be a very valuable tool towards healing and growth.  John Kunz, founder of the International Institute of Reminiscence and Life Review states “each time an individual tells part of his/her life story, those who listen are like a mirror, reflecting and affirming their lives.”  This experience of nostalgia does have its painful side, yet research continues to show that by reminiscing, life can seem more meaningful and death less freighting.  It can counteract loneliness, boredom and anxiety.

So the next time you find yourself with this opportunity of reminiscing remember that this experience strengthens relationships, creates more meaning in life, increases feelings of contentment and links our past to the present.