Tag Archives: suicide

Feeling Happy About (and a little jealous of) Craig Bryan’s New Book, “Rethinking Suicide”

While engaged in a little late-night Twitter scrolling, I came across a fascinating post and thread questioning the utility of suicide screening for low risk populations (e.g., schools). Having been mildly opposed (along with the UK and Canada), to general population suicide screenings, I felt validated, especially upon discovering that Craig Bryan was author of the Twitter thread. Dr. Bryan is one of the best and most authoritative resources on suicide in the world. As of two nights ago, I was only familiar with his professional book with David Rudd (Brief cognitive-behavior therapy for suicide prevention) and his excellent work with military veterans, suicide, and lethal means management. I also knew he had recently published a new book titled, “Rethinking Suicide.”

Then, today, I checked out Rethinking Suicide online. I was gob smacked. It’s fantastic.

This post is mostly to pitch Craig Bryan’s book.

Among other gems, Dr. Bryan frames suicide prevention as a “wicked problem” and tells us about the origin of the term, wicked problem. What’s not to love about that.

Here’s a quote from his introduction: “Consistent with the perspective of suicide as a wicked problem, I will argue in this book that we need to replace our solution-based approach to suicide prevention with a process-based approach focused on creating and building lives worth living” (p. 7). Wow. That’s like music to my ears.

Dr. Bryan also weaves in “confirmation bias” (more music) as part of his critique of using so-called “mental illness” as an explanatory mechanism in suicide (I know if you know me and this blog, you know I don’t even use the term mental illness unless I’m explaining why I don’t use the term mental illness, and so I’m destined to love Dr. Bryan’s deconstruction of that concept).

Anyway, you can find Rethinking Suicide through your favorite online bookseller. I recommend it highly. I’ve ordered my copy.  It’s about time we all started rethinking suicide.  

How on Earth Could Suicide Rates Go Down Along with the Onset of the Pandemic in 2020?

Last week I got to be part of an amazing conversation with Paula Fontenelle and Stacey Freedenthal. Paula and Stacey are experts in suicide prevention, postvention, and treatment. You can easily find them and some of their great work online using your favorite search engine. They both have books out. Paula’s is: Understanding Suicide and Stacey’s is: Helping the Suicidal Person.

Paula invited Stacey and I onto her podcast (which is also a video production). We all sat in separate rooms in three different states (Oregon, Colorado, and Montana) and talked about, “How on earth” it could be that pandemic-related mental health stress and distress is up (the research says so), and yet suicide rates in 2020 dipped, for the first time in two decades? What a great question!

Between the three of us, we had many answers. That’s good, because death by suicide is always influenced by many factors (in the scientific world, we like to say that suicide is multi-determined). Our answers are speculative, but I think it’s good to be speculative, as long as you admit to the fact that you’re being speculative.

The most fascinating of many fascinating explanations for the recent reduction in suicide rates was our “in real time” discovery that the pandemic relief checks went out in April of 2020. That was important because, year-after-year, the CDC reports that April is nearly ALWAYS the month with the highest suicide rates and in 2020, it was the LOWEST. Why is April always linked to high suicide rates? No one knows for sure, but Paula, Stacey, and I talk about potential explanations for that too. As T. S. Eliot wrote:

“April is the cruelest month, breeding lilacs out of the dead land, mixing memory and desire, stirring dull roots with spring rain.”

If you’re interested in suicide-related phenomena—not everyone is—you should listen or watch Paula’s “Understand Suicide” podcast. You can watch any of the episodes for great info, but for our episode, here are the links.

To watch: https://youtu.be/fPrDdQg7G_E

To listen: https://bit.ly/3KrJILO

Have a great weekend.

Who Wants a Two-Day Professional Workshop on Strengths-Based Suicide Assessment and Treatment?

I’ve got a friend who writes to me in acronyms. TBH is “To be honest.” LMK is “Let me know.” IMHO is “In my humble opinion.” FYI is “For your information.” YSKAT is “You should know about this.”

When I read my friend’s emails, there are always more letters than words, if YKWIM (you know what I mean).

This leads me to my PP (promotional point).

TBH signing up for a two-day SBSASTW (strengths-based suicide assessment and treatment workshop) isn’t everyone’s COT (cup of tea). TAI (think about it). That’s like 13 hours of suicide-related content. If you TAI, it CBYD (could bring you down).

That’s why, we will weave some PDC (pretty damn cool) EBHIs (evidence-based happiness interventions) into our 13 hours. This will be the MFE (most fun ever) two days of suicide training on November 19 and 20. YCBOI (you can bet on it).

But IMHO, woohoo. Really YSKAT. IMHO signing up for a two-day strengths-based suicide assessment and treatment workshop is TRTTD (the right thing to do).

YAMBWing (You also may be wondering), when John writes “we” is he going with the singular “we” or is he indicating there will be other presenters. TBH, John doesn’t know, but he’s hoping to recruit some of the amazing participants from this summer MHP (Montana Happiness Project) retreat to join in on the FUN (fricken unbelievably nice).

OK. I’ve had it with all these letters. And so, if you want to sign up, check out “Session three” on this link: https://www.familiesfirstmt.org/umworkshops.html

If that doesn’t help, send me an email (john.sf@mso.umt.edu) and I’ll see if I can help you figure out how to sign up. Just LMK. The session is also Zoomable.

The ACA Town Hall is Tomorrow

Rita and I get to be the guests for tomorrow’s online ACA Town Hall. The topic for the day is suicide, but more generally, the Town Hall, moderated by ACA President Dr. Kent Becker, is designed to be a community event for ACA members. The suicide discussion will be brief and there will be several other break-out groups in the Zoom format.

To participate, you’ll need to be a member of the American Counseling Association (ACA). As ACA members, you can attend for free, but you need to register in advance. Here’s the link: https://imis.counseling.org/store/events/registration.aspx?event=DOH2021SEP

My apologies for the late notice on this.

I hope everyone is well and thriving as much as possible.

John

Early Birds and Two Upcoming Strengths-Based Suicide Trainings

On September 24, I’m doing a full-day online-only Strengths-Based Suicide Assessment and Treatment Planning workshop. The workshop is on behalf of the Association for Humanistic Counselors . . . a cool professional organization if there ever was one.

I’m posting today because today is the last day for the “Early bird rates” for this AHC workshop. Just in case you want to be an early bird, this link will give you that chance . . . at least for a few more hours: https://events.r20.constantcontact.com/register/eventReg?oeidk=a07eibjc7x5afb40bd4&oseq=&c=&ch=&fbclid=IwAR2mwGRA6UgOtrTXBdWlS8ZlQAArlPlQR3LGOZigxdIeyodKcIBtY1yovXs

Just in case you want two-days of Strengths-Based Suicide Training or you want to come to the U of Montana or you need some college credit, we’ve got a full two-day version of the workshop happening in Missoula on November 19 and 20. In addition, if you’re wanting a continuing education smörgåsbord, this link also includes two day trainings with the fabulous Dr. Kirsten Murray (Strong Couples) and the amazing Dr. Bryan Cochran (LGBTQI+ Clients). Here’s that link: https://www.familiesfirstmt.org/umworkshops.html

There’s more happening too . . . but for now, this is probably enough for one post.

Have a fantastic week, and don’t be afraid to be the early bird.

Coping with Suicide Deaths

A recent smoky sunrise on the Stillwater River

As most of you know, I recently published an article in Psychotherapy Networker on my long-term experience of coping with the death of a client by suicide. In response to the article, I’ve gotten many supportive responses, some of which included additional published resources on coping with client death by suicide.

This blog post has two parts. First, I’m promoting the Networker article again to get it more widely shared as one resource for counselors and psychotherapists who have lost a client. Below, is an excerpt from the article. . . followed by a link. Please share with friends and colleagues as you see fit.

Second, at the end of this post I’m including additional resource articles that several people have shared with me over the past two weeks.

Here’s the excerpt . . .

The Prevention Myth

I’d worked with Ethan for about 20 sessions. Stocky, socially awkward, and intellectually gifted, he often avoided telling me much of anything, but his unhappiness was palpable. He didn’t fit in with classmates or connect with teachers. Ethan felt like a misfit at home and out of place at school. Nearly always, he experienced the grinding pain of being different, regardless of the context.

But aren’t we all different? Don’t we all suffer grinding pain, at least sometimes? What pushed Ethan to suicide when so many others, with equally difficult life situations and psychodynamics, stay alive?

One truth that reassures me now, and I wish I’d grasped back in the 1990s, is that empirical research generally affirms that suicide is unpredictable. This reality runs counter to much of what we hear from well-meaning suicide-prevention professionals. You may have heard the conventional wisdom: “Suicide is 100 percent preventable!” and, “If you educate yourself about risk factors and warning signs, and ask people directly about suicidal thoughts or plans, you can save lives.”

Although there’s some empirical evidence for these statements (i.e., sometimes suicide is preventable, and sometimes you can save lives), the general idea that knowledge of suicide risk, protective factors, and warning signs will equip clinicians to predict individual suicides is an illusion. In a 2017 large-scale meta-analysis covering 50 years of research on risk and protective factors, Joseph Franklin of Vanderbilt University and nine other prominent suicide researchers conducted an exhaustive analysis of 3,428 empirical studies. They found very little support for risk or protective factors as suicide predictors. In one of many of their sobering conclusions, they wrote, “It may be tempting to interpret some of the small differences across outcomes as having meaningful implications, . . . however, we note here that all risk factors were weak in magnitude and that any differences across outcomes . . . are not likely to be meaningful.”

Franklin and his collaborators were articulating the unpleasant conclusion that we have no good science-based tools for accurately predicting suicide. I hope this changes, but at the moment, I find comfort in the scientific validation of my personal experience. For years, I’ve held onto another suicide quotation for solace. In 1995, renowned suicidologist Robert Litman wrote, “When I am asked why one depressed and suicidal patient dies by suicide while nine other equally depressed and equally suicidal patients do not, I answer, ‘I don’t know.’”

Here’s the link to the full article: https://www.psychotherapynetworker.org/magazine/article/2565/the-myth-of-infallibility

Here are the additional resources people have shared with me:

Ellis, T. E., & Patel, A. B. (2012). Client suicide: what now?. Cognitive and Behavioral Practice19(2), 277-287.

Jorgensen, M. F., Bender, S., & McCutchen, A. (2021) “I’m haunted by it:” Experiences of licensed counselors who had a client die by suicide. Journal of Counselor Leadership and Advocacy. DOI: 10.1080/2326716X.2021.1916790

Knox, S., Burkard, A. W., Jackson, J. A., Schaack, A. M., & Hess, S. A. (2006). Therapists-in-training who experience a client suicide: Implications for supervision. Professional Psychology: Research and Practice, 37(5), 547-557.

Ting, L., Jacobson, J. M., & Sanders, S. (2008). Available supports and coping behaviors of mental health social workers following fatal and nonfatal client suicidal behavior. Social work, 53(3), 211-221.

As always, thanks for reading, and have a great day!

Montana Conference on Suicide Prevention — My Powerpoints

Good morning. I’m listening to Dr. David Jobes talk about innovations in approaching suicide assessment and treatment. I’m struck by the breadth and depth of his knowledge . . . and also discouraged by him acknowledging how difficult it is to change people’s mindsets regarding suicidality and its treatment. At this point we ALREADY have many effective psychosocial treatments, but disappointingly, the media and public knowledge still leans toward profiling hospitalization and the potential of medication (both of which show very mixed results).

I’ll stop with my rant here and post my ppts. Thanks for reading . . . and be sure to get the word out on innovations in suicide assessment and treatment (aka psychosocial treatments).

Tomorrow – Another Suicide Prevention Conference with Free CEUs

The second of two consecutive suicide prevention conferences with free CEUs is tomorrow! Just in case you didn’t know, this conference, the Montana Conference on Suicide Prevention, has two full hours of David Jobes–the creator of CAMS–in the afternoon. How often do you get to listen to Dr. Jobes for two hours, for free, and get CEUs? Not often, I suspect.

Here’s the conference link. Go to the bottom to find the registration button: https://www.montanacosp.org/

In related news, I just got an email from the Association for Humanistic Counseling about an upcoming all-day conference on Strengths-Based Suicide Assessment and Treatment (with me presenting!). The date is: 9.24.21. This one has a small fee for CEUs . . . but it’s cheaper if you become an AHC member. Here’s the registration link for that one: https://events.r20.constantcontact.com/register/eventReg?oeidk=a07eibjc7x5afb40bd4&oseq=&c=&ch=

Have a great evening and I hope to “see” you tomorrow at the Montana conference.

Mental Health Academy Suicide Summit PowerPoint Slides

Good morning! The 2021 MHA Suicide Summit has started (see below) and I’ll be up in less than an hour.

Sometimes I think the hardest part about doing workshops is writing the workshop blurb. My problem-and maybe it’s just my problem—is that the process of writing workshop blurbs nearly always impairs my judgment. I start out writing like a sensible and rational person, but eventually I decompensate into displaying delusions of grandeur. For the Mental Health Academy Suicide Summit, I completely lost touch with reality and claimed that I would,

  1. Describe strengths-based principles for suicide assessment and treatment
  2. Be able to implement three strengths-based assessment tools (and recognize the limits of risk and protective factor assessment)
  3. Identify suicide drivers (and goals) linked to seven common life dimensions
  4. Describe at least one wellness and mood management positive psychology strategy for patients and practitioners.

Of course, all of this is great, but, here’s the catch. I’m only presenting for 45 minutes!

If anyone out there can help me become more realistic, I would appreciate the input.

In the meantime, here are the ppts for the presentation today.

John

This Month’s Psychotherapy Networker Magazine and the Myth of Infallibility

Hi All,

In this post I’m sharing a link to an article I just had published in Psychotherapy Networker. Although I had hoped it would be the Networker’s “lead article,” instead, they put Shankar Vedantam first? And then a bunch of other people, like David Burns and Martha Manning? Seriously? All jokes aside, the truth is, I’m humbled to be included.

The article—titled “The Myth of Infallibility”—is about my immediate and ongoing emotional reactions to the loss of a client to suicide. I hope the article provides useful information and emotional support for counselors and psychotherapists who have experienced—or will experience—a similar loss.

You can use the following link to bypass the paywall and read the article for free.

https://www.psychotherapynetworker.org/magazine/article/2565/the-myth-of-infallibility/f576ab48-e662-46f0-b122-06ab19d35e28/OIM

Thanks for reading this. Please share the link if you feel so moved. One of my counseling colleagues shared it with all her students, which seemed great to me, mostly because IMHO, we don’t talk much or get formal training on how to cope when or if we have a client who dies by suicide.

Today, I’m especially grateful for all the people in my life who have supported me in one way or another, over so many years.

Thank you and have a great week.

John S-F