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"Having Courageous Conversations About Preventing Suicide"

9/10/2016

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Today, I attended an excellent conference at USC Verdugo Hills Hospital: "Having Courageous Conversations About Preventing Suicide."  The presenters, panelists and participants provided insights on various facets of suicide prevention and mental illness, including the emotional, structural (policy/funding), "scientific"(evidence-based practices) and cultural.  In this post, I will highlight a few themes I found most compelling and also provide some guidelines if you or a loved one struggle with a mental illness and/or suicidality.

Almost needless to point out: Suicide and mental illness are complex.  Yes, we can identify risk and protective factors, but all speakers echoed the theme of complexity and mystery. We know this as therapists.  We assess the biological, psychological and social factors contributing to a diagnosis, but "there is no single cause."  Thus, while there are calls for evidence-based practices, greater research, and standardized measures, "science" is hardly sufficient to understanding and assuaging human pain.  Presence, love, acceptance and generous listening- from the person's perspective in his/her own language- are all helpful, as is getting professional help.  

Dr. Timothy Pylko described a "dissociative, trance like state" that some may enter into, where "relief from life suffering" is the motivation.  Keeping this in mind helps loved ones not attach blame to themselves or to the person who wants to take his/her life, or that has already committed suicide.  Dr. Pylko pointed out that "Suicide is not a selfish act." The blame and shame must really end for all impacted by suicide and mental illness.

Mr. Robert David Jaffee eloquently provided his story of transformation, from former experiences of psychoses and suicidality to stability and belief in his power of choice.  He invoked Freud's idea of work and love as foundations to wellness, which were instrumental in Mr. Jaffee's recovery.  Dr. Pylko noted that Freud added play as a factor.  I believe there is merit in Freud's idea, but I would expand the idea of work as not limited to the way the world has come to define it: paid work.  If there is purpose, raising children for example, avocations, and or other interests, these can count as work.  As for love and connectedness: Love is found through the relational self, and reaching out to others-especially when it appears they are not interested-is an expression of love.  Play is vital: laughter, silliness, hobbies and adventure.

Ms. Barbara Lang, RN, and Mr. Luke Jackson JD, BSN,  poignantly highlighted the human element and extension of dignity, especially as it relates to quality of care that patients receive.  For the health sciences field, the postmodern movement can provide a good dose of humility:  "Science" has its limits, funding has its interests, and there are experiences of healing that are found beyond the "knowledge" gained in our degrees and in "scientific studies."  The human/relational factor can harm or help...our grandmothers, maybe without the letters behind their names knew this.  In the extending of dignity to patients, it can buffer against our own secondary trauma as well.

Things to know/consider/do, if there is a life-threatening mental health emergency:
  • imminent threat, call 911
  • ask the person directly if he/she is planning to kill him/herself
  • if there have been prior attempts, risk factor is greater
  • do they have a plan
  • do they have access to lethal means: remove all lethal means
  • are they giving stuff away
  • does the person have a mental health disorder
  • some people may not say "I want to kill myself".  Speak their language: "I'm running out of gas.  I'd be better off dead."
  • Protective factors include: feeling connected to someone/something/group, good problem solving skills, and spirituality/religion.  
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    Nadia Brewart, Ph.D., is a student of life with an insatiable curiosity about what it means to be human, amidst encounters with the human condition. 

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