All posts by johnsommersflanagan

Advances in Suicide Assessment and Treatment . . . just published in the Jubilee Edition of Psychology Aotearoa

Ocean View

Here’s the view from New Zealand.

The professional journal, Psychology Aotearoa is the flagship publication of the New Zealand Psychological Society. Just yesterday I received a copy of the Jubilee Edition of the journal. I’ve got a brief article on pp. 76-80, but the whole journal is an interesting glimpse of psychology, psychotherapy, and counseling at an international level. Here’s the pdf: 2018 November JSF New Zealand Pub

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Why Kids Lie: The Podcast

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I still recall the first chapter of the first statistics textbook I ever read. It was titled, Lying with Statistics. Pretty cool title. At least I think that was the title. Is it still a lie if I think I’m remembering something accurately, but I get a few details wrong? Maybe it’s a partial lie. In psychology, we call that confabulation.

We all know first-hand about lying. Maybe we tried it out ourselves, in the past, of course. Or maybe we still engage in a little dissembling here or there. And, undoubtedly, we’ve likely been on the other end of a lie. Is that called being on the “butt-end” of a lie? If not, it should be, because that’s how it feels.

How about for you? How does it feel to tell a lie? Does it feel different when you get away with it versus when you get caught? How does it feel when someone lies to you? I can answer these questions from my perspective, but this post isn’t about me. It’s about you, your children, your friends, your colleagues at work, and obviously, it’s about American politicians. In particular, it’s about you and your children. If you’re like most parents (and humans), when your children lie to you, you might feel some flashes of anger. Although the anger is natural, in our Practically Perfect Parenting Podcast episode on “Why Kids Lie,” we recommend trying to follow the old Families First Boston motto of, “Get curious, not furious.”

Like everything, lying is developmental. Most of us lied about something, sometime, while growing up. But for most of us (I hope), the usefulness of lying started fading and was replaced by the usefulness and value of being honest. Our hope for you is that, if your children are lying, you can help them grow out of it.

Below is the blurb about this week’s PPPP episode. As usual, you can listen on iTunes (https://itunes.apple.com/us/podcast/practically-perfect-parenting-podcast/id1170841304?mt=2) or Libsyn (http://practicallyperfectparenting.libsyn.com/) and you can follow the PPPP on Facebook https://www.facebook.com/PracticallyPerfectParenting/).

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When it comes to boastful lying, there’s no better example than Penelope, one of Kristen Wiig’s characters on SNL. Penelope is incessantly popping up here and there, basically lying her ass off. The purpose of Penelope’s lies appear relatively straightforward. She seems to be insecure on the inside, therefore, she boasts and brags about her amazing accomplishments, constantly “one-upping” anything that anyone else says.

On second thought, maybe there’s another fictional-nonfiction character who does her one better in the lying department, but let’s not go there.

This Practically Perfect Parenting podcast on lying focuses on two key issues: (1) Why children lie . . . and (2) How parents can handle their children’s lying in ways that encourage honesty.

Sara and John review many different motivations for lying. These include, but are not limited to Penelope’s ego-boosting motivation. For parents, it can be helpful to understand the goals of your children’s lies. Obviously (or maybe not so obviously), if your children lie because they’re afraid to admit they did something wrong, then using harsh punishment with your children may make them even more afraid to tell you the truth and more inclined to lie and more likely to become even better liars.

Not surprisingly, in this episode, John tells a few lies. You’ll have to listen to see how Sara handles him.

Burning Out, Burning Up, or Just Singed: The Partnership Health Center Powerpoints

California Street FootbridgeThe powerpoints pasted below are from my educational workshop with the staff of Partnership Health Center in Missoula, Montana. In case you didn’t know, PHC provides dental, medical, and counseling services to about 16,000 individuals with limited incomes and who are facing challenging life situations. The people who work at PHC are inspirational. I was fortunate to spend several hours with them this afternoon.

Here’s the ppt: PHC Burnout and SM 2018

A Bonus Counseling LAB Activity: Person-Centered Problem-Solving

Riverbed and John

After having learned a bit about person-centered theory and therapy and then being exposed to behavior therapy, it makes sense to consider how you can combine the two. For me, the best first step is to integrate your person-centered attitude and skills into a behavioral problem-solving process.

 Person A: As usual, your job is to pretend that you’re a client who’s coming for counseling. You have a minor, but frustrating problem. It helps if the problem is concrete and best if you have a recent experience with it so you can describe it well.

When you sit down with your counselor, take about 5 minutes to describe your problem. Explain how bad it is, how difficult it is to change this problem, and share some of the strategies you’ve tried on your own. As the counselor listens and responds, do your best to respond genuinely back to the counselor and then go with the counseling flow.

Your counselor will engage you in a problem-solving process. Be yourself and participate as you would if you were with a “real” counselor.

Person B: You will be combining your person-centered attitudes and skills with a problem-solving approach. The basic steps to problem-solving [which you should always remember] are as follows:

  1. In collaboration with the client, identify the problem. When you do this, use your listening skills to try to operationalize it in a behaviorally specific way. Remember, you can ask questions, but if/when a person-centered counselor asks questions, the questions are centered on your client’s experiences and emotions. Remember also to avoid asking two questions in a row, because you need to paraphrase before moving to another question.
  2. Brainstorm (generate) a list of possible strategies that your client could use to solve or manage the problem that you’ve collaboratively identified. Remember to: (a) ask your client permission to start making the list, (b) tell your client that you’re only “making a list” to so that both of you can see all of what might be possible, and (c) therefore neither of you can criticize the alternatives/strategies on the list. In fact, you should let your client know that you’d also like to hear some bad ideas or strategies that have been tried, but that didn’t work perfectly.
  3. After you’ve generated 5-10 alternatives, share/show the list to your client and then ask if it would be okay to discuss the pros and cons and likely outcomes linked to each strategy. The purpose here is to collaboratively engage in a reflective process. You’ll want to know about obstacles that might make using some strategies more difficult and potential positive or negative outcomes/side-effects of each strategy. Explore your client’s thoughts, emotions, and reactions to each of the options, using your best listening skills. Behaviorists call this process “means-ends” thinking or “consequential thinking.” Engaging in this process can be naturally behaviorally inhibiting (meaning that it can decrease the chances of an impulsive behavioral response).
  4. Hand the list to your client. Ask something like, “Based on our discussion and on your feelings and thoughts, would you please rank these ideas from 1 to 8, with 1 being your first choice and 8 being your last choice (assuming there were 8 options).
  5. After your client has ranked the ideas, collaboratively make an implementation and evaluation plan. Your client might choose to use 1 or 2 or 3 different strategies. That’s fine. Ask questions like, “How will you remember to try this out?” and “How will you know if your strategy is successful?” You might need to help your client understand that the goal or outcome needs to be within your client’s circle of control. You also might need to provide psychoeducation on solutions often don’t fix things quickly and that it might take weeks to see progress. Let your client know that you’ll be checking in on progress at your next meeting and that although it would be very nice if the strategy has been implemented, it’s also a success to just be thinking about implementing the plan.

Close the session by thanking your client for engaging in this process with you.

Why Kids Lie and What to Do About It

Lucy in BedLying is in the news again today, as it was yesterday, and will be tomorrow.

The latest count (by the Washington Post) has Donald Trump at over 5,000 false or misleading statements on only his 601st day as president. This past September 7 was DJT’s new one-day high, at an astounding 125 false or misleading claims.

But today’s blog post isn’t about the president, it’s about parenting. Truth be told (and I’m not lying about this), children tell lies sometimes; lying, among children and teens (and adults), is a natural and normal act. However, even though lying is a normal childhood behavior, you probably don’t like it when your children lie—especially when they lie to you.

Relationships between parents and children are complex and multidimensional. You could probably say the same thing about any relationships that involve love and living together. One particularly complex dimension of parent-child relationships involves how selective children are when they watch, listen, comment, and copy their parents’ behavior.

On the one hand, parents often feel like their children aren’t listening to them (“that darn kid doesn’t listen”). On the other hand and ironically, children’s observational powers seem to be at their peak during those moments when parents engage in less positive behaviors, including the parental exaggeration, fib, or outright lie. Then, and especially then, children’s ears perk up and, no big surprise, they catch you in your lie!

In addition to the irony of your children’s selective attention to your moral and ethical missteps, having a president like Donald Trump makes preaching the virtues of honesty all the more challenging. After all, he’s publicly telling many lies every day, and he’s attained his success, in part, because of his self-professed philosophy of lying, never admitting he’s wrong, and never apologizing. He shapes reality around what he thinks, which I would guess, is exactly the opposite of what parents want to teach their children.

Consider this excerpt from an essay titled “Fathers” by Alice Walker.

I recall a scene when I was only three or so in which my father questioned me about a fruit jar I had accidentally broken.  I felt he knew I had broken it, at the same time I couldn’t be sure.  Apparently, breaking it was, in any event, the wrong thing to have done.  I could say, Yes, I broke the jar, and risk a whipping for breaking something valuable, or No, I did not break it, and perhaps bluff my way through.

I’ve never forgotten my feeling that he really wanted me to tell the truth.  And because he seemed to desire it and the moments during which he waited for my reply seemed quite out of time, so much so I can still feel them, and, as I said, I was only three I confessed.  I broke the jar, I said.  I think he hugged me.  He probably didn’t, but I still feel as if he did, so embraced did I feel by the happy relief I noted on his face and by the fact that he didn’t punish me at all, but seemed, instead, pleased with me.  I think it was at that moment that I resolved to take my chances with the truth, although as the years rolled on I was to break more serious things in his scheme of things than fruit jars (you can find this essay in Alice Walker’s book of essays titled, “Living by the word,” p. 12; see, https://www.amazon.com/Living-Word-Selected-Writings-1973-1987/dp/0156528657/ref=sr_1_2?s=books&ie=UTF8&qid=1541802856&sr=1-2&keywords=alice+walker+essays).

Alice Walker sensed, at a very young age, that her father wanted the truth, she gave it to him, and he provided her with positive reinforcement (and no punishment) in response to her honesty. That’s a powerful sequence, and one way that parents teach children to value honesty.

Just yesterday, Sara Polanchek and I recorded a Practically Perfect Parenting Podcast episode on “Why Kids Lie and What to Do about It.” The podcast isn’t available yet, but it will be soon. In the meantime, here are some highlights.

Because all children lie and lying is a natural part of child development, we encourage parents to “be curious and not furious” about children’s lies. That doesn’t mean you should accept their lies; it does mean you should try to understand your child’s motivations for lying, before reacting (or overreacting). Here are some of the most common reasons why children lie and ideas about how to respond.

  • Young children (typically 2 and under) will lie because they don’t understand the differences between fantasy and reality and/or because they’re experimenting with fantasy and reality. This might involve, “the monster broke my toy” or “that’s my doll!” If you think your young child can’t quite make the distinction between reality (what happened) and fantasy (what the child wishes or thinks might have happened), a little empathy, mutual exploration, and limit-setting might be in order: “Darn. It’s upsetting when toys get broken. How can we make sure the monster doesn’t break any more? And, I hope it doesn’t happen again, because we only have so many toys.”
  • For children and adults, many lies are a product of self-defense or self-protection. As in the Alice Walker essay, children may be scared of or be avoiding negative consequences. One way to help your children through their fears of telling the truth is to do what Alice Walker’s father did: Communicate how much you value honesty, and sometimes, when your child is honest, let them out of the natural consequences.
  • Ego-boosting is another reason why kids (and adult) lie. Most people want to look better than they are or to have more than they have, and that can result in bragging or boasting. One way of dealing with this motivation is to focus on the real and true things that you value about your children. Additionally, it’s important to let children know that you love them—even when they’re imperfect.
  • As they say, imitation is the sincerest form of flattery. Your children will notice when you lie and when you tell the truth. If you really want to instill values of honesty—that means making a commitment to being honest yourself—at least in front of the children. One powerful way of modeling honesty is to honestly share with your children times when you wanted to lie about something, but chose to tell the truth instead. Children can benefit from understanding (and seeing) that telling the truth isn’t always easy and that it’s natural to feel the temptation to deceive others for protection, gain, or self-promotion.

There are many more motivations for lying that Sara and I discuss on the upcoming podcast. We also discuss some additional ideas for promoting honesty. Here are a few quick points:

  1. Gently inquire with your kids about what’s wrong with lying (or cheating or stealing, etc.).
  2. Keep your ears tuned for signs of your kid taking personal responsibility, having empathy for others, and principles such as trust . . . and celebrate those when you notice them.
  3. Whatever your child says, accept it, note that it’s interesting, then share your perspective.
  4. Avoid preaching.
  5. Avoid extra harsh punishment because it can promote the use of lying out of fear.
  6. Make a practice of being truthful yourself. As a parent, you set the standard.
  7. Don’t play detective. Keep in mind the old saying, “Ask me no questions and I’ll tell you no lies.” Apply natural and unpleasant consequences when there’s available evidence, but don’t set your child up to tell a lie.  Instead, tell your child what you know and let your child expand on it.  Schaefer (1995) uses the following example: If you know your child did poorly on a test at school, don’t ask, “Did you pass your exam?”  Instead, make a statement: “Your teacher called and told us that you failed the test.  We are worried.  We wonder how to be of help?”
  8. Let your children know that if they’re honest about misbehavior you’ll do what you can to be helpful. On the other hand, if they lie about misbehavior, the natural penalty will be double (one consequence for the misbehavior and one consequence for the lie).
  9. Use books and stories to teach moral values.
  10. Let your child know, repeatedly, how much you appreciate honesty and openness. And be prepared for times when you will be disappointed.  When appropriate, share your disappointment rather than your anger.
  11. If, after using the previously mentioned suggestions, the lying persists, family counseling or counseling for your child might be a good idea.

No doubt, lying will continue to be in the news. It appears that there’s not much we can do about that in the short term. However, as a supportive, limit-setting, and positive role model, you can reduce the amount of lying that happens in your own home. And when it comes to building a truth-telling society, promoting honesty in your home is a great place to start.

 

 

 

My Closing Argument: Take a Breath, Check Your Moral Compass, and Vote for Checks and Balances in Government

California Street FootbridgeTrust me.

As the election closes in, I’ve been obsessed with perusing the literature on mass hypnosis. Trust me happens to be a rather common phrase among stage hypnotists and used car salespeople.

Then, this morning an unusual word popped into my brain.

Demagogue

Believe me, really, I thought of demagogue first thing this morning. Funny coincidence, did you know that Donald Trump used the words, “Believe me” 40 times in the 2016 presidential debates?

Here’s what Wikipedia says about Demagogue:

A demagogue (from Greek δημαγωγός, a popular leader, a leader of a mob, from δῆμος, people, populace, the commons + ἀγωγός leading, leader) or rabble-rouser is a leader in a democracy who gains popularity by exploiting prejudice and ignorance among the common people, whipping up the passions of the crowd and shutting down reasoned deliberation. Demagogues overturn established customs of political conduct, or promise or threaten to do so.

I can’t help but wonder, maybe every century or so, a natural-born demagogue comes along. It’s possible.

You already know I’m referring to Donald Trump. He is, unarguably, a talented, master manipulator. We can all agree on that. Go ahead and match up Mr. Trump with the preceding definition of demagogue. See what you think. You’ll see a match like you’ve never seen before.

Tomorrow, the democrats will mostly vote for democrats and the republicans will mostly vote for republicans. The question, for those in the middle, is whether you believe and trust that Mr. Trump is employing his vast skills of manipulation for the good of America. I doubt it, but maybe that’s just me.

My Montana connections tell me that the Trump played “Sympathy for the Devil” to crank up the crowd at his October 18 Missoula rally. The lyrics begin, “Please allow me to introduce myself, I’m a man of wealth and taste.” You can find the rest of the words online. But just in case you don’t have time, I’ll share this: when Mick Jagger sings the lines, “Just as every cop is a criminal, and all the sinners saints. As heads is tails . . .” it gets hard to break free of the song’s powerful grip. But at the same time, somewhere, down deep, it’s also hard to imagine that Mr. Trump is looking out for the welfare of the average American citizen.

No question, Mr. Trump is fantastic at conjuring up fear, division, and hate. He’s also a master at giving his listeners permission to think and act on their least morally upright and most unhealthy thoughts and emotions. Believe me on this too. After all, this is the guy who, at one of his rallies, said, “I’d like to punch him in the face.”

Often I’ve heard Trump supporters say, “I like him because he says what everyone is thinking.” The problem is that although Mr. Trump’s extreme and judgmental statements may resonate with his audience, embracing a philosophy where acting on or sharing all of our thoughts is encouraged is nearly always a very bad idea. In fact, I think it might be the opposite—along with shooting refugees who throw rocks—of what Jesus might recommend.

The truth is (and you should trust me on this because I’m a psychologist), some thoughts (and some emotions) are simply not ready for prime time. Convincing listeners (as Mr. Trump does) to follow their coarse, uncensored thinking toward action is a common magic trick of someone who’s goal is to produce a mass trance or hypnotic state.

He might as well be telling people, “Trust your thoughts. and trust me. You know in your heart and mind there are many things to fear, but I will keep you safe. I know your thoughts, your thoughts and my words are as one, bring them together and all will be well. Trust me, I will keep you safe. And you will keep me safe. Because you feel anger and fear and because I’ve so helpfully pointed out the enemy, we know what we need to do. Maybe some of you 2nd amendment supporters will take care of it for me. We share common fears and anger and thoughts and actions and we can move forward together and you can let me take care of the rest of what’s important. Trust me. Trust me to do that for you. I can do it better and bigger than anyone else has ever even thought of doing it.”

The big question is, how to break the demagogue’s hypnotic spell?

Unfortunately, the big answer is . . . it’s very difficult.

Step 1: Hang on tight to reason and rational analysis. A hypnotic state requires suspending rational thought, therefore, it’s essential that messages from the demagogue not be accepted without critical analysis. Seek input from alternative viewpoints. Don’t just trust me. Don’t just watch MSNBC and Fox News. Find content from the middle . . . and then fact check that too.

Step 2: Get out of the heightened and focused state of arousal. Hypnotic trances are states involving hyper-focus. If you’re feeling activated all the time, take time to meditate, reflect, walk around the block, and talk to your neighbor about life and death and health (instead of politics). The truth is that you don’t “need” the demagogue on either end of the political continuum. What you need is balance.

Step 3: Listen for the “Trust me” card. Right now, in this state of questionable news and Russian bots, it’s tough to determine who to trust. If you’re feeling that, then get out your favorite moral guidelines—it doesn’t matter whether your favorite moral guidelines include the Dalai Lama or the Sermon on the Mount or the Eightfold Path or the Ten Commandments or the Koran. Take your moral guide and then place what Trump is saying right next to it. Is Trump saying something consistent with what’s in your guide? Does your moral guide say anything about holding children in cages? Or does it say something like “Let the little children come to me.”

This brings me to my closing argument.

Now is a good time to stop and take a breath. Break free from the aroused state of hyper-focus. Consult alternative views.

If you do, you may recognize that most democrats are not members of an angry mob. You may also recognize that most republicans are not White supremacists. Democrats, republicans, independents, (and yes, even libertarians) are your neighbors. Love them.

Now is a good time to shake yourself free from someone (anyone) who tells you what you should fear, how you should think, and for whom you should vote. After shaking yourself free, embrace your moral guide.

If you need a more obvious voting tip, consider voting for a balance of power. Right now, we need the checks and the balances to do what they do—to provide checks and balances so one person cannot wield too much power. This is especially true when that one person keeps repeating the words, “Trust me,” because . . . and you know this in your heart . . . that’s never a good sign.

 

The Case Against Zero Suicide

SunsetI’ve been trying for the past year to find a way to say this nicely. Finally, I discovered a recent article in the Journal of the American Medical Association (JAMA) that says what I want to say—at least in part—in a more professional tone. The articles is “Implications of Zero Suicide for Suicide Prevention Research.” Spoiler alert, the authors, Dominic Sisti, Ph.D. and Stephen Joffe, M.D. end their article with the following sentence: “To demonstrate which interventions are effective for reducing the suicide epidemic, it is necessary to let go of the belief that every suicide is preventable.” For their whole article, go to: https://jamanetwork.com/journals/jama/fullarticle/2706416?utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=etoc&utm_term=102318

I have no doubt that my views are more extreme that Drs Sisti and Joffe. They’re medical researchers, publishing in JAMA. But I was heartened by their article; it helped me feel less alone in my dislike for Zero Suicide. They inspired me to share some of my thoughts and writing on the topic.

That said, now I’m sharing an unpublished rant about Zero Suicide. Keep in mind that I’m in favor of suicide intervention and suicide prevention. I’ve even started a trade book proposal on the subject. But I’m not in favor of Zero Suicide. Here’s why:

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Last month I entered into a Twitter debate about Zero Suicide. It started and ended like most Twitter debates. We disagreed in the beginning. Then, after several passionate exchanges, we disagreed even more in the end.

The issue was Zero Suicide. Zero Suicide is a national suicide prevention campaign, healthcare philosophy, and comfortable delusion. In case you haven’t yet heard of Zero Suicide, there’s a Zero Suicide Academy, Zero Suicide ToolKit, Zero Suicide Community, and several websites orienting people to the Zero Suicide Initiative. As a pragmatic mental health professional and sentient human being, I’m completely in favor of suicide prevention. I’m in favor of suicide prevention because many people who think about suicide are in great psychological pain, and if that pain can be addressed, then their suicide wishes often can abate. I also support much of what the various Zero Suicide Initiative involves. However, as a behavioral scientist and someone who has regular contact with other humans, I consider Zero Suicide to be a ridiculous philosophy and a DUMB goal.

Zero Suicide is a DUMB goal, principally because it’s the opposite of a SMART goal. You can find definitions of SMART goals all over the internet. SMART goals are commonly attributed to Peter Drucker—a renowned management consultant, Austrian immigrant, and author of 39 books. Drucker is commonly considered one of the most important thought leaders in business management. Using Drucker’s principles, back in 1981, George T. Doran published a paper in Management Review titled, There’s a S.M.A.R.T. way to write management’s goals and objectives. Although many variations exist, SMART goals are typically defined as:

S =  Specific

M = Measurable

A = Achievable or Assignable

R = Relevant or Realistic

T = Time-bound

Drucker and Doran were writing from a business management perspective, but smart goals are also intrinsic to psychotherapy. I won’t be going into the details here, but William Glasser and Robert Wubbolding, two renowned reality therapists, describe important variations of smart goals in psychotherapy. Put simply, the philosophy of Glasser and Wubbolding is simply common sense: “A goal should be within your control.” Put differently, if individuals or agencies identify goals that are dependent on other people’s behavior, then frustration and other problems will inevitably ensue.

Online resources for Zero Suicide are impressive. The breadth and volume of information will provide healthcare professionals with an excellent foundation for working with suicidal patients. For the most part, I have few objections to the quality and quantity of their online suicide prevention resources. Having these resources for healthcare professionals and the general public is important and fantastic. With a foundation of knowledge and informed action, it’s possible to prevent some, but not all suicides.

Despite its impressive array of information, Zero Suicide also has several shortcomings. For example, nowhere on their 66 item Zero Suicide Workforce Survey do they ask a question about having or holding empathy or compassion for suicidal patients. Empathy and compassion needs continual re-emphasis in suicide prevention. Why? Because patients, clients, and citizens who are suicidal, are also often experiencing depressive symptoms. All helpers and healthcare professionals should understand that empathic responding is the foundation of suicide intervention and prevention. Even further, one common depressive symptom is irritability. If irritability is present (along with depression and suicidal thoughts, when healthcare workers or others try to intervene with suicidal people—or persuade them to get help—the following pattern might emerge.

Gloria: I’m concerned about you and how you’re doing. “Have you been thinking about suicide?”

Sean: Yes. I think about it all the time.

Gloria: I want to tell you that there are some excellent resources available for people who are feeling suicidal.

Sean: I know that.

Gloria: Can I get you connected with a counselor here in town?

Sean: Not interested.

Gloria: But I want to be of some help to you, in some way.

Sean: I don’t want your pitiful help. I’m depressed and I’ve been thinking about suicide. I’ve been to counselors. Nothing helps.

Gloria: How about friends? Do you have some friends who might help and support you?

Sean: None of my friends care anymore.

Gloria: How about family?

Sean: My family has disowned me and I’ve disowned them.

Gloria: How about a church or community center? Lots of people get support at those places.

Sean: I can’t hardly get myself out of the house, so those are stupid ideas.

Gloria: Have you tried medications?

Sean: Medications just make me feel worse.

Gloria: How about exercise?

Sean: Seriously?

At this point in the conversation Gloria probably feels frustrated. She’s trying to help, but she can feel Sean resisting her efforts. Gloria is problem-solving, but Sean is feeling hopeless and isn’t able to engage in the problem-solving process. Sean has been through all these ideas in his head and in his depressive state of mind, he’s already rejected all these ideas as completely ineffective.

Next up, Gloria might up the ante by trying to get Sean to engage in logical thinking. She might say something like, “Suicide is a permanent solution to a temporary problem.” Having heard this logical ploy several times, Sean will be ready, “I’ve been living in misery for years. You might see the world as all happy and shit with your fancy shoes and Polly-Anna glasses on, but what I’m experiencing doesn’t feel temporary. I hate my life and I want to die.”

Even if Gloria is more saint-like than most, it will be difficult for her to sustain a helpful attitude toward Sean. She might try encouraging him to go to the hospital, but many suicidal people abhor the idea of hospitalization. Eventually, as Sean continues to insist that he’s suicidal, she might call for a county mental health professional to conduct an evaluation. If so, Sean may lie to the evaluator and say that he’s not imminently suicidal or the evaluator may decide Sean isn’t suicidal. Or, in the best case scenario, Sean may be hospitalized, but he also is likely to become very pissed off at Gloria, because he views her as usurping his personal rights and freedoms. In nearly every case, people like Sean are not likely to pause and thank Gloria for her suicide prevention efforts.

I could go on, but I’d probably just head further down this dark road. Instead, I’ll try to end with a few hopeful comments.

Suicide prevention is important, but it’s part of a strange dialectic. Sometimes, if we try hard to connect with someone and save them, we are fabulously successful. However, other times we try to connect and the person rejects us and suicide becomes even more likely. What’s the difference? I don’t know the perfect answer, but I’m pretty sure it involves collaboration and not coercion. I wish I had thought this up myself, but it’s something that suicidologists, researchers, and philosophers have known for millennia. On top of being fantastically unrealistic, zero suicide also smacks of coercion.

One of the best and forward thinking suicide intervention researchers is Marsha Linehan. You may have heard of her because she’s a University of Washington professor and developer of Dialectical Behavior Therapy. I’ll end with a rather amazing piece that she wrote. Take some time to read it and try to absorb the message. I think her story is all about being empathic and collaborative. Let me know if you think so too. Here are Marsha Linehan’s words, from the Foreword of a book titled, “Building a Therapeutic Alliance with the Suicidal Patient.”

I always tell my students a story about what it is like to work with suicidal individuals. In the story, I describe the suicidal person as trapped in a small, dark room with no windows and high walls (in my mind always with stark white walls reaching very, very high). The room is excruciatingly painful. The person searches for a door out to a life worth living but, alas, cannot find it. Scratching and clawing on the walls does no good. Screaming and banging brings no help. Falling to the floor and trying to shut down and feel nothing gives no relief. Praying to God and all the saints one knows brings no salvation. The only door out the individual can find is the door to death. The task of the therapist in this situation, as I always tell my clients also, is to somehow find a way to get into the room with the person, to see the person’s world from his or her point of view; to get inside the person, so to speak, and then together search again for that door to life that the therapist knows must be there.