Pre-Hotline Suicide Prevention


Pre-Hotline Suicide Prevention

With the recent tragic deaths by suicide of Kate Spade and Anthony Bourdain, the topic of suicide has been trending on social media. This is both good and bad, because talking about suicide in a direct, open way can open doors for people contemplating it to seek help, but it is also true that a suicide can trigger clusters of other suicide attempts. I have seen many posts on social media recently in which brave, compassionate people are sharing their own struggles with mental illness and thoughts of taking their own lives. This is refreshing to see, and forges connections between people in a way that the commonly portrayed “highlight reel” of people’s lives does not. This is a start to the many things we can do to address one of the leading causes of death in the US, which is suicide.

I started my career in psychology conducting research for renowned suicide researcher and psychology professor Dr. Thomas Joiner at Florida State University. I completed an Honors thesis about suicide in people with anorexia because I was struck by the fact that this population has the highest rate of completed suicides of any mental illness and I wanted to know why. Dr. Joiner has written several books, including Why People Die By Suicide, about the components of this cause of death, which are 1) perceived burdensomeness- thinking others are better off without you, 2) thwarted belonging- feeling like you don’t fit in or have support from others, and 3) acquired capability- having experienced physically or psychologically taxing experiences that make you more likely to be able to go through with a suicide attempt.

During this time, I also worked for the National Suicide Prevention Lifeline, and learned techniques such as exploring the side of a person that wanted to die and the side of them that wanted to live. I also learned the basis of the counseling skills that I use today- reflective listening, empathy, and validation; skills which show that you can truly hear and understand a person’s pain, express that they are not crazy for having those feelings, and that they are not alone. I also learned that those who call a hotline are usually not those that are truly in danger of dying by suicide- it’s the people who never reach out. Suicide is often an impulsive act that is carried out when a person is at the depths of their negative feelings about themselves and about life, and they have the means to kill themselves readily available.

I believe that suicide prevention starts before the Lifeline phone conversation, the 911 call, or a stay at the psychiatric hospital. It starts with seeing someone alone and reaching out to them, telling people how much they matter to you, listening to people without thinking about yourself or what you’re about to say, and asking someone you’re concerned about in a direct way if they have ever thought about taking their life. It also starts with recognizing that depression is a presence that isn’t who you are, but rather a state of being that distorts reality by telling you that you have no one, you are worthless, and life is too much trouble. Prevention starts with confronting the depression by seeking support from family, friends, a support group or a therapist.

I have been listening to Kevin Hart’s book, I Can’t Make This Up: Life Lessons, about his difficult childhood and path to success, and came across this quote that feels relevant to anyone who feels hopeless, worthless, and bogged down by life’s tragedies. “Life is a story. It’s full of chapters. And the beauty of life is that not only do you get to choose how you interpret each chapter, but your interpretation writes the next chapter. It determines whether it’s comedy or tragedy, fairy tale or horror story, rags-to-riches or riches-to-rags. You can’t control the events that happen to you, but you can control your interpretation of them. So why not choose the story that serves your life the best?” It sounds delusional in a way, but that is the power of the human mind to create its own reality.

It also helps to have a purpose, a reason for living this life. Even people who have been through the worst hardships can turn that suffering into purpose, like Garrett Greer, who broke his neck in an accident and became paralyzed, then used his injury as motivation to become a professional poker player and create a platform to inspire other quadriplegics. The creator of a life-changing therapeutic technique called DBT, Marsha Linehan, used her own suffering from Borderline Personality Disorder to help others with similar problems. Singer Demi Lovato had a severe eating disorder and now uses her music and social media to spread body positive messages. Your purpose doesn’t have to be grand or overly ambitious; it can be as simple as helping just one person, finding what you’re good at and giving that talent away, or seeking happiness in your daily life.

4 Steps to Making 2018 Yours


NEW YEAR, NEW YOU: 4 Steps to Making 2018 Yours

As we get further into adulthood, the markings of time become fewer and further between. We aren't in school any longer, and most years don't seem to bring a noteworthy event (new job, move to a new city, illness, end/beginning of a relationship). We often feel like years blur one into the next, without separation to mark change. This makes it important to utilize the markers of time we DO have, one being the end of a current and beginning of a new calendar year. 


I like to utilize this time to recognize and honor the events and experiences of last year, and consider what changes float up as of utmost priority. My clients and I do this work together at the end of December and beginning of January, to really set the tone and theme for their change narrative. One of my favorite quotes is from the philosopher Plato, who said “The beginning is the most important part of the work”. This is when we set the tone for what we pay attention to, and what we pay attention to grows. Setting healthy narratives and habits early on can help them become lasting throughout the year, and lasting positive change that is aligned with our values and needs is what makes a fulfilling life. So let’s consider the four steps you can do to help move further towards fulfillment in 2018:


1) VALIDATE FIRST: Recognize What Has Worked well

All my clients hear this from me ad nauseam. The FIRST step to getting to any new truth is to validate what you've been through. This means, we need to reflect on 2017. The highs, the lows (and we know there have been some lows). And the gratitude for what went well and what we accomplished, even if it's just "Surviving" with some semblance of sanity. Validate FIRST before anything can happen next. It was a hard year, and you got through it.


2) REFLECT on What You Didn't Accomplish

What do you wish you had more of last year, and what could you stand to have less of? When a year ends, the weight and gravity of the negatives can often outweigh the triumphs. Instead of ruminating and sitting in the distress, feel it to learn from it. This is our body’s way of providing data to us. If it felt bad, this is something you would like to change (be it your weight, your lack of progress at work, not speaking up enough, your toxic relationship, or just dressing better). 



Divvy up your goals into smaller steps that you can write in a planner. Instead of “Lose 30 lbs”, consider “Work out 3 times per week (with a focus on losing 1 lb per month).” Instead of “Stop Fighting with my Partner”, consider “Attend weekly couple’s therapy and go on one date night per month”. Research shows that smaller goal-setting and goal-achieving creates small surges of dopamine in our brain that excites us and makes us eager for more. Those attainable goals give us the energy and confidence to achieve another small, attainable goal. Remember, “attainable goal” means a goal you can realistically achieve within a single number of days or weeks.

4) ENACT CHANGE via small Steps:


Plan what you will do by writing it down. I highly encourage getting a planner to create a plan of action and set yourself up for success. The weekly portion helps with the small steps, and the monthly view allow us to see trends and themes. Get creative with it – use colored highlighters and stickers to organize tasks, anything that gets you more hyped to use it! You can be accountable to yourself when you have a place and space to write, reflect, and plan. Electronic apps and calendars help you sync those goals and plans with a friend or partner, and allow you to set reminders, which are KEY to any system of planning for change (Loop Habit Tracker and Productive are apps that allow you to keep track of your goals, and even offer statistics on how you’re doing, if you’re into data to help create real lasting change). If it’s not something that’s currently part of your life, you will likely need a multitude of reminders to keep from neglecting your new goal.


And once it is written down, start DOING. This is obviously the most important part of the process. Most of us wait for the perfect time, when we are finally “ready”, but the sooner you start, the sooner new routines will become integrated into your life. Start meditating 5 minutes every morning. Sign up for and attend a fitness class you've been meaning to take. Apply for that job that will take you to the next step in your career, even if you feel you "aren't ready yet". Call that friend you’ve been wanting to reconnect with for years. Make an appointment with a Therapist to help sort out your difficulties with forgiveness. Do the things you planned to make this year more in line with your needs and desires. Your future self will thank you.