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Loving Someone with Suicidal Thoughts or Self-Harming with Stacey Freedenthal, PhD, LCSW| 1.31.2024

In this episode, Kristen and guest Stacey Freedenthal, a psychotherapist, author, and educator specializing in suicide risk, dive deep into the complexities of loving someone with suicidal thoughts or self-harm. They provide a deeper understanding of how to effectively support and communicate with loved ones navigating these challenging mental health issues.

You'll Learn

  • How to recognize signs that a loved one might be at risk of suicide or self-injury.
  • How to approach and communicate with someone experiencing suicidal thoughts or engaging in self-harm.
  • Tips for creating a safe and non-judgmental space for loved ones to share their feelings and struggles.
  • The role of professional help in managing and treating suicidal ideation and self-harm.
  • Ways to take care of your own mental health while supporting someone going through such challenges.

www.staceyfreedenthal.com

Resources

 

For counseling services near Indianapolis, IN, visit www.pathwaystohealingcounseling.com.

Subscribe and Get a free 5-day journal at www.kristendboice.com/freeresources to begin closing the chapter on what doesn’t serve you and open the door to the real you.

Subscribe to the Close the Chapter YouTube Channel

This information is being provided to you for educational and informational purposes only. It is being provided to you to educate you about ideas on stress management and as a self-help tool for your own use. It is not psychotherapy/counseling in any form.

Kristen Boice

Welcome to the Close the Chapter podcast. I am Kristen Boice, a licensed Marriage and Family Therapist with a private practice pathways to healing counseling. Through conversations, education, strategies and shared stories, we will be closing the chapter on all the thoughts, feelings, people and circumstances that don't serve you anymore. And open the door to possibilities and the real you. You won't want to miss an episode, so be sure to subscribe. Welcome to this week's close to Chapter podcast. This is one of the most important conversations we can have right now. With suicide being an all time high, maybe you've struggled with suicidal thoughts, self harm, or a loved one has. This is an important conversation that I had today, we talk about how to have a conversation with somebody that you might suspect that has or is having suicidal thoughts or self harming. We talk about the myths and the do's and the don'ts. And if you've been having these thoughts, where did they come from? Why are we having them and what to do about it? It really is a powerful conversation. Let me introduce you to my guest Stacey Freedenthal is a psychotherapist, educator, PhD, LCSW, writer and consultant and speaker who specializes in helping people at risk for suicide. She has authored two books loving someone with suicidal thoughts, what family friends and partners can say and do and helping the suicidal person tips and techniques for professionals. She also created maintains the website speaking of suicide, she works as an associate professor at the University of Denver Graduate School of Social Work, and has a small psychotherapy and consulting practice. Dr. Frieden Thol lives in Denver, Colorado with her husband and their collection of cats. I love that I love it when people put little personal things in their bio. This is an important conversation. I could have talked to her for a lot longer because there was a lot more to cover, and we hit the important points pass this along to anybody you think might benefit from this conversation. Don't be afraid to ask somebody about their story to hold the space for them. And so without further ado, here is my conversation with Stacey Welcome to this week's close the chapter podcast. I am so excited for this conversation because we do not talk about this topic enough. And it has impacted almost every client I've worked with, and in some form or fashion friends, relatives, loved ones co workers. This is a topic that is relevant for every single person on the planet. So if you have ever struggled with suicidal thoughts, or suicide, and any form of maybe you've had a loved one, we've lost a loved one to suicide, or maybe you have lost somebody important in your life. This is a relevant topic. And I'm so excited to have Stacey join me today. Suicide ologists, author of loving someone with suicidal thoughts, right? This is an important topic. And so welcome to the close the chapter podcast, Stacey,

Stacey

thank you for having me on the podcast.

Kristen Boice

I'm so glad you're here because I think this is a topic people are afraid to talk about, they're afraid to bring it up, they're afraid they're gonna plant a seed in somebody. Tell me your story, as it relates to you feeling very passionate about the topic of suicide. Suicide

Stacey

is a big part of my life professionally, but also it has been personally suicide suicidality for various reasons. I mean, one is that a friend of mine died by suicide in high school. And that was really kind of formative experience in the way some of the questions that it raised for me are questions that have continued in my scholarship and studies on suicide. And then another reason has to do with my own personal experiences with suicidality, in that I've had suicidal thoughts, and I first had suicidal thoughts, even before my friend died by suicide when I was about 12. And then on and off, had them for many years, and then in my 20s, actually, things got incredibly worse. And I attempted suicide more than on to my 20s. And now here I am today, suicide elegist, which is a real word doesn't sound real, but it means someone who studies suicide. And I specialize in helping people who have suicidal thoughts, both in my writing and in my clinical practice and in my studying in my studies, that's what I specialize in. So

Kristen Boice

when someone comes to you, and Nick, does it come out right away? Typically does it unless they've had a hospitalization? How does someone start talking about their thoughts, their suicidal thoughts? How does it begin

Stacey

with For me, it tends to come out right away with my clients. Because when they call to make the appointment, I say on my website, it says, I specialize in helping people who have suicidal thoughts. Is that a reason that you are interested in seeing me? And so that provides a very concrete opening for somebody to say, yes, they have suicidal thoughts, and sometimes they don't. And they say no, but I figure if you can handle that you can handle me. So it's not exclusively people who have suicidal thoughts. But more generally speaking, it tends to be that the person shows that statement, Shadow don't tell, it tends to be that somebody shows rather than tells that they're struggling. And one of my big soap boxes is that we need to ask the question, and not rely on the person to tell us for many reasons, and one being that it's so hard to talk about, it's so hard to ask about. And it's so hard to disclose for many people, not all people, but for many people, there's just this, it's laden with taboo and fear, anxiety, there's the topic of suicide is, and so there's a lot of kind of social pressure sort of conditioning to not explicitly talk about suicide or suicidality. So by directly asking somebody, we're showing that we aren't colluding with that taboo, and that we are willing and able, and maybe eager is not the word that we want to know if he has suicidal thoughts. That makes sense.

Kristen Boice

What would be the question when you say, ask them? Because some people are like, well, I don't know what to say. What would you say, would be the key question?

Stacey

Well, the key question would be the most direct question, which is, are you having thoughts of killing yourself? Or have you been thinking of suicide? Or are you saying that you want to end your life? Those are all direct questions about suicide, and there can be ways to lead into it. So you're not like, Hi, my name is Stacy freedom fall? Are you having thoughts of suicide? I did once volunteer very briefly at the crisis hotline, where that was the way they answered the phone. They said, Hi, my name is Stacy. And I'm wondering if you're having thoughts of suicide, and I couldn't continue volunteering there. Because that goes against my own approach so strongly, which is to meet the person's needs not to meet our needs to get that information. And they had a lot of hang up costs. And I don't think that was a coincidence. But there are ways to lead up to the question. And one way could be with everything that you're describing sounds like you're under a lot of stress, or it sounds like you're really struggling, whatever the situation is, a lot of people who go through things like this, they have thoughts of suicide, do you or you know, I'm wondering if you're having thoughts of suicide, do you is kind of blunt, I'm wondering if that's true if you choose. And then by asking it that way, you're kind of normalizing that many people do have suicidal thoughts. And you're also conveying that you've heard it before that you're not going to freak out that you're not going to be judgmental. So it's a good invitation. And it's something that a psychiatrist in Shan che writes about where he talks about validity techniques, and not validation, but validity, where you're asking sensitive questions in a way where you're trying to get valid, truthful information about an often stigmatized topic. Yeah, I

Kristen Boice

like that. I'm wondering as it sought, it feels gentle and the tone of voice like you're softening me think that's your natural tone. But I think it's so important, like, Are you suicidal? Like that feels very jarring and uncompassionate and not empathic? How much does that play a role? Someone's tone someone's facial expressions and body language in asking the question,

Stacey

it definitely plays a role. I mean, I don't want to convey the message that you have to do it just right, that there's one way to ask, because people already have anxiety about asking, and that's something I say to my students. You don't have to ask perfectly, but you do need to ask, but I think tone and expression and all that are very important. And I think they also often get missed because so often, like in a clinical setting, the clinician is asking for their own needs for information and then for the other person's needs for empathy and understanding in so the question can be asked in a formulaic way, and I'm saying some people ask in a formulaic way, I'm not encouraging people to ask in a formulaic way, but they'll say, Do you have thoughts of suicide? And then a person says, yes, and then their immediate next question is, do you have a plan, and that's not empathic? There's no acknowledgement and an error of what person just said, of what there is. Experience saying of what their own inner thoughts and feelings are, it's more okay, now I need the next bit of information. So I know whether to worry or not.

Kristen Boice

That's such an important point. Because you miss that point of attunement and connection with the person in front of you. If you jump to do you have a plan, because you're trying to cover your bases? So what would be the next question? If someone says, Yes, I am struggling with suicidal thoughts or suicide?

Stacey

Yeah, I think the first would not so much via question is a reflection, like, you must be going through a really hard time. Or if you're having suicidal thoughts, something's going on what's going on? So I think the first would just be some kind of empathetic statement or empathic statement, and then the next would be an invitation for them to tell you more, in their own words, not Do you have a plan? Do you have the means? Do you have the intent? Do you have access to the means? All those different questions, but just like I said, what's going on? Or can you tell me the story of how you came to have suicidal thoughts? Or have? Can you tell me the story of how suicidal thoughts came to you something that's an open ended invitation for them to say more on their own terms?

Kristen Boice

Yeah, I like that. Because you're really trying to get the story. You're trying to understand this person's story in front of you. And if you can understand that, and the person feels heard and understood that then you can go into that empathic validation, understanding the story, and then what let's say they share their story. And then where do we go from there someone that's listening that doesn't know what to do next?

Stacey

Yeah. And I just want to clarify, are we talking about the lay on the answer? flooded?

Kristen Boice

lay audience? Lay AUDIENCE Yes, somebody that has a friend or a loved one, or maybe even themselves, like, but let's talk about, let's say, a loved one. They're talking to somebody they care about? Yeah.

Stacey

So I think as much as you can invite the person to tell you on their own terms, what's going on with the feather? There's a quote, it's often miss attributed to Maya Angelou, but at Zora Neale Hurston, she says, There's no greater agony than having an untold while I didn't, I'm not quoting a verbatim because now I can't remember the exact words, but it's basically there's no greater agony than having an untold story and sign a few. Yeah, I love that, quote, someone may not come to you and say, hey, I want to tell you my story. But often that is what people ate, to do, to tell their story to be heard. To have some effort of understanding, I know that we can always completely understand and to connect, and to not feel alone. And sometimes even just having that conversation with somebody can give somebody hope, like, Oh, someone can understand. Or maybe there is someone who can help me. So it's a very precious opportunity to plant the seeds, if not grow the actual planets, she and then for change that us something else that I was going to answer. And that was, oh, what next? After you've invited the story. I mean, it's gonna depend on what they tell you. I mean, sometimes when they're telling you their stories, they answer a lot of the questions you would have anyway, like, they may say, I'm just going to make something up, my girlfriend broke up with me, and I feel so helpless, sometimes and hopeless, I'm never going to meet anybody, again, I'm going to be alone forever. And then they may say, like, and so then that makes me feel like I want to die. But I'm not really going to do anything, I have the thought of off, I'm going to kill myself, because I'm going to be along the rest of my life. But I also know that I'm not going to do it. So then you've had that answered, you still may want to ask again. Because sometimes people say that to reassure the listener more than to reflect their own truth. But the next thing, then I would say is to try to get more information. And it's a fine line, because on the one hand, they say we need to meet the other person's needs for connection, not our own needs for information. But then we do also need information, whether you're a friend or family member or the person's therapist, you want to know if that person is planning to kill themselves in the next day in the next hour in the next week. And there's very different pathways to take if somebody has a specific plan to kill themselves. And actually, I try to avoid the word plan, because most people don't like most lay people don't talk that way. They don't say, Oh, I have a specific plan for suicide. I mean, they may say, I've been thinking about how I would do it. I've been thinking of when I would do it, but you want to know is the person intent? Are they intending to act on any suicidal thoughts? Or is it more that the suicidal thoughts are a symptom or illustration of the despair or suffering or whatever that they're experiencing? What's

Kristen Boice

underneath suicide? For people that don't understand it? They don't. Maybe they haven't struggled with that. What's underneath suicidal thoughts in considering suicide for people to help kind of comprehend what This really is about

Stacey

Yeah, I mean, I don't think we completely know, I think there's a lot we don't know, we probably there's a lot more we don't know than what we know about suicide. But my own observations, both personally and on other people is that there's some kind of acute intense pain or anxiety of the agitation. Sometimes it's numbness, but the person is agitated by the numbness. But more often, it's some kind of psychological pain, whether from trauma or mental illness or grief loss, different things can feed it. So that I would say, is the first ingredient. And then typically, there's also a feeling of being trapped of this is never going to end, I'm going to be this way the rest of my life, or there's no way out, or the only way out is in my life. And I mean, this is my own unique thought. There's been things written about suicide, originating in pain, plus entrapment. And I think that can be hard for people who have never felt suicidal to understand is that feeling of being trapped in having no way out. But the other thing is, is there's also there's some kind of genetic or neuro chemical or physical component to suicidal thoughts to beacons. For some people, they just have these intrusive, suicidal thoughts, and they don't have a reason. They haven't been through anything awful, or they're not experiencing anything awful in the moment. And they have the thought, if you should kill yourself, or you're worthless and don't deserve to live, and these intrusive thoughts, I mean, where do they come from? And that's why like, for me, as a therapist, I try to tell my clients that recovery isn't necessarily not having suicidal thoughts again, because that may be out of your control. I mean, it often is out of your control, recovery is learning to deal with them in a way that doesn't hurt you or hurt your life. Yeah, cuz some

Kristen Boice

clients feel very afraid. They get scared. They're like, where are these thoughts coming from? It's very scary and jarring, especially if they're sudden, like all of a sudden, they have these thoughts come through, how do you help people through that?

Stacey

Yeah, and there's two sides of the coin. For some people, they're intrusive, and jarring and scary. And for other people, they can be comforting. So I just want to acknowledge that I'd like to talk with clients about the way I view suicidal thoughts is kind of like weather, and that we don't control the weather. And there can be a storm that moves through your head. And some clients, this really resonates with not all but some. And the idea that you can have these really destructive thoughts of wanting to be dead, and then a few minutes, an hour or a few days, you may not love them at all. And that can be disorienting to like how can those thoughts come and go. And that's where thinking of it, like the weather in a hurricane or tornado can be useful for some people. And something else I've been reading and hearing about more often lately than when I first started in this field is that sometimes intrusive suicidal thoughts can be a form of OCD. And that's something I don't think that we had as much awareness of before. But for some people understanding then at learning that has helped them to not feel as helpless about their suicidal thoughts. It's more like, and that's where when I say learning to manage the suicidal thoughts is key because one of the ways to manage them is to observe them as sort of phenomena of the mind and not as truth because I think for a lot of people, they have the thought, Oh, this is never gonna end I should kill myself. And then it's true to them. In its there's a way to be kind of an observer of yourself, and to say, Oh, I just said the thought that this is never going to end I should kill myself under what's going on. And we can respond with curiosity or with compassion. Oh, I just said this thought and had is so unsure. I absolutely have a lot to live for and have wants, well, maybe they don't want to keep living. So maybe the thought is right now I don't want to keep living. But I don't know that that's going to be true tomorrow, or the next day or the next on my website. Speaking of suicide.com I have an article that somebody else came up with this idea about the three day rule that whenever they have suicidal thoughts, they tell themselves, okay, the clock starts now. And I'm gonna start over the clock every time I'm not thinking of suicide and after three days now, they say after three days, they'll kill themselves. I don't recommend that. That's not my recommendation. My recommendation is after three days if you still have suicidal thoughts, even before get help, there's many things you can do besides kill yourself. But her point is that she's never made it though. Three days without things fluctuating. And so then she starts over with the clock and Mako two days and then realizes right now I don't really want to kill myself. And then she starts over the clock. And there's so much fluctuation that people may not be mindful of until they really try to observe the dynamics of their suicidal thoughts. Let's

Kristen Boice

talk about self harm. There's many ways of self harm versus suicidal thoughts, and help people understand the difference because we're seeing an uptick. I mean, I don't know if you're seeing the same thing and suicidal ideation, self harm over the past, I'd say since COVID, even before COVID It was on an uptick, help people understand what self harm is versus what suicidal thoughts and when do they coincide. And when don't they

Stacey

sure there's a lot of overlap, they're not the same because somebody can have thoughts of hurting themselves, not only without intending to die, but maybe they're having thoughts of hurting themselves as a way to cope with wanting to die or to avoid killing themselves. I mean, I've heard people say, I cut myself. So that said, They'll obsess about suicide. And because there can be physiological changes that come from hurting oneself. This is by no means an advertisement or advice divert oneself, but there can be physiological changes, like the release of endorphins, or the distraction, or the release of anger, whatever the function may serve for people. So in some ways, self harm can be a coping mechanism, not what I would consider to be a healthy coping mechanism, because it hurts and it puts your life in danger. There are healthier ways, but it still is, it still can be for some people a way to avoid acting on suicidal thoughts. But there is overlap that a lot of people who do have self harming, who do self harm, also have suicidal thoughts. And the danger will there's several dangers with self harm. But one danger is that it can desensitize the person to the pain and danger. And like with any kind of coping, or coping habit, we can build tolerance in need more and more of the same thing to get our need more and more something to get the same effect. And so that's one of the biggest dangers. And then of course, there's the very obvious danger of you could accidentally kill yourself, for people who cut they could accidentally knit an artery, and they weren't intending to die. But that can happen. But that's not the only danger. The decency in this station is a bit problems.

Kristen Boice

So how does someone address someone that might be cutting a loved one, a child, a friend, somebody they care about? How do they address the conversation about self harm? If they're noticing some scarring, or noticing some wounds? How do they bring it up?

Stacey

Yeah. And that can be really hard to because the person who's asking may I have so much fear and anxiety and hurt that the person they love is hurting themselves, when they obviously don't want the person to hurt themselves. But if you come at it purely from that angle, you might shut the conversation down. So I would say try to ask with me, I'm sure I'm not the only person who's used this phrase ever. But like with compassionate curiosity, and just heavy, I notice you have these marks on your arm, and kinda looks like you might be cutting yourself, have you been doing that? And if they say yes, or they start crying, or too sensitive, or whatever, you know, taking it from there. But and again, you could also normalize it in the way I talked about before, you could say, you know, a lot of people when they're under a lot of stress, so when they're feeling just that they're having difficulty sitting with something really painful or agitating, they may cut themselves, is that what you've been doing? And then again, inviting the person story instead of like town to that, instead of oh, it hurts me to see that you're hurting yourself saying like, well, what's going on? Or can you tell me what's going on or inviting the person to tell you in something that can be useful here? And I should have said this earlier to around asking you about suicidal thoughts is it can be useful to if the person says no, to ask them, if in the future, they were thinking of suicide, or they were hurting themselves in some way? Would they feel comfortable telling you because that can be a really revealing question. If they say no, and then that opens the door to will what would make it hard? Tell me in the future, because it actually may be in the present that you don't want to accuse the person of lying to you. So by saying it as a hypothetical, you could say in the future, if you were feeling that way, what would make it hard for you to tell me and very often the response will be something like you would freak out. You would call 911 You would say done crazy. You judge me. So very often, those are the kinds of responses that then can be talked about, and to allay the person's fear. And the other thing to hold in mind is that it's not a one off conversation, like, the person may not tell you now, but how you respond now may plant the seed for them to tell you later that if you are freaking out, and if you are healed, ting the law or doing something else that is imposing your own needs on them. And that kind of shuts them down. If you aren't doing that, well, maybe next week, they'll think, Ah, I'm feeling that way again. And when I talked to Crystal, she seemed understanding, so I think I'm gonna tell her, like he just you never know.

Kristen Boice

Yeah, I like how you're like, you're really emphasizing that to make it about you. So like, how could you do this to me? You know, that hurts me. I don't understand why you would do this to me, like those types of things. That's a GE lease link. How could you leave me that is such a big? Yes. And when you turn it back on you, you're going to lose the person potentially in front of you. Is that?

Stacey

Yeah, I mean, I say I wouldn't say lose effort, then. Yeah. Lose the guy. Yes, yes. We just took let

Kristen Boice

me specify thank you for that. The connection can be severed at that point. Yes,

Stacey

you can lose the connection, and you can lose the opportunity, the opportunity to help. And because again, there is so much stigma, so much taboo, so much fear of judgment and hurting others and things like that, that it can confirm the person's fears.

Kristen Boice

And this idea that they're like, Well, I'm a burden, like the shame of I'm a horrible person. I'm not lovable. I mean, these kinds of thoughts can get then even more intense, sometimes, based on how someone responds, I mean, they're not responsible for the other person's feelings, necessarily, but what it can activate the other person?

Stacey

Yes, it can. And I appreciate that you're saying they're not responsible, because I would never ever want to convey that somebody's to blame for another person's suicide, unless, of course, you know, it was a very extreme situation. And they provided the person with the means. And they said, Do it, do it, they may bear some responsibility. But generally, how you respond is going to make or break whether the person lives or dies, that it's suicide, this chick complex to be attributed to one single response to that conversation, but it can result in like we were saying, losing that opportunity and that connection to help

Kristen Boice

that make sense. So let's walk through the do's and the don'ts. If someone's having suicidal thoughts, like these are the things to do. These are things to not do. And then I have some myths that I kind of want to bring up. So let her go through the do's and don'ts of talking to cite an

Stacey

ethical chat. That's the subtitle of my book. Yeah, yeah. What to say and what's what friends, families and partners can say and do, which I

Kristen Boice

love. And if you have anybody that is struggling right now, please go get Stacy's book. I mean, loving someone with suicidal thoughts is imperative that you have support. And no, it's kind of a serves as a guide. And a way to say this is so if you want more than this conversation, please go get the book because this will give you more hit the highlights for those that might need just a high level do's and don'ts short,

Stacey

while I would say the first don't is don't make it about yourself, which we've already spoken about a little because often, I understand why people make it about themselves. Because you don't want the person you love to die. And you don't want the person you love to be suffering. And we just kind of have an instinctive response. I've been thinking about this a lot lately, because in the book, I have something I talked about briefly listening. And I've been thinking about why it's so hard to really listen to somebody. And I think it's because we don't like seeing somebody hurt, and we want to immediately help them to feel better. So like if you see somebody crying, often the immediate response is still cry, don't cry, it's not that bad. It hurts to see someone cry, and that sometimes what they need to hear is what's making you sad, and not false reassurance. Like it'll get better or that it'll pass. Because those are very well intentioned things to say, but we don't really know. And that's not what the person is feeling right now. Or else they wouldn't be crying. So just trying to gain an understanding. So I would say rewinding a little, the first thing is not making it about you and your discomfort and your fear and your hurt feelings because sometimes it can feel like a rejection. If someone that you care about is thinking of ending their life, like you may, understandably at the thought of how could they want to leave me Why aren't I enough for them to stay alive? But now is the time to voice that right now. It's about the other person and about what they're experiencing. And so one of the things that I talked about out with my students because I teach a class on suicide assessment and intervention is I talk about things that can open up the conversation versus shutting them down. And if someone says, I'm having thoughts of killing myself, and you say, How could you think of doing that you have so much to live for, that's shutting the conversation down. Again, well intentioned, I'm not faulting people for thinking that or for wanting to say that, and it may not be the most helpful thing to say, when I've

Kristen Boice

got a shame. Why am I even thinking this? I'm like, it takes you into shame. It can

Stacey

definitely especially like a song as a really good life. And you say, How could you think of killing yourself? Look at all you've got into I can't speak for the millions of people who have suicidal thoughts. There may be some people, for him that works. But overwhelmingly what I've encountered both in my work as a therapist, and as somebody who has experienced suicidal thoughts, those kinds of things didn't help me either. So if somebody I mean, that was my thing in my 20s, was, I felt like I got a good life. I've got a good job. I've got good friends, I've got good family, and I'm having thoughts of killing myself, what's wrong with me like, and then I would have thoughts like you're so ungrateful, there are other people dying of cancer, and they would do anything that lives and you're, you've got a healthy body, and you're among thoughts of killing yourself, you're a horrible person. Those were the kinds of thoughts I've been have to myself, and sometimes with much harsher language that may not be appropriate for a podcast. Well, where was

Kristen Boice

the beginning of this? The beginning is to do says, nope, make it about yourself. Yes, like not salary do and so you keep the conversation open, rather than closing the conversation. And you kind of give your students ways to do that, and what to say and kind of hear some things maybe to steer away from.

Stacey

Yeah, and so like, sometimes, I think this is more in a professional setting than in a personal setting. But sometimes the students response will be thank you for telling me that, which is a nice thought. It's kind, but it doesn't invite the person to tell you more, it kind of fits a period at the end of the dissonance. Thank you for telling me that. Now I know. And really, what we want is to invite the person to say more. So that's where I think that it can be so useful to either reflect like, Oh, you must be feeling overwhelmed, or you must be feeling whatever the person has given you indications of you must be hurting so much, or this must be so hard from you, sometimes just reflecting like that is enough for the person to keep sharing. But if not, then just an open ended question can be slow, like, what's going on? What's happened? What are your thoughts telling you? What is your mind telling you? That's something that I like to ask people, and the possibilities are endless. When you do take that stance of compassionate curiosity.

Kristen Boice

Yeah, I love the Peter Levine, quote, something like we heal based on whether we've had an empathic witness. I like that a lot. I love it. It's like how, like, if you can just hold the space of being an empathic witness to someone's story in their pain, that can be the pathway to healing. That's so powerful. And that's kind of what you're saying, just hold this space. And it's hard, because our own fear, like you said, can get stirred up. And so we can't fix it, we want to fix it, we want to rescue the person out of their pain. That's not what they need. You're saying they need us to hold the space to get compassionate curiosity be that empathic witness. That's really what it's about. Yeah.

Stacey

And sometimes what I encounter, especially in like friends and family is they have a fear that well, if I ask questions like that, they have a fear that, well, if I ask questions like that, or if I reflect the pain they're in, then they may think I agree with them, or that I think it's hopeless to or in. So if that's the fear, I mean, you can be transparent and say, Hey, I don't want you to think that I think this is the solution. And I want to know more about why you think it is. And I may disagree, but I want to understand why you feel that so that if you feel uncomfortable, and you feel like silence equals endorsement. I don't necessarily think it does. But I can understand how that fear can arise, it's fine to say that, gosh, a part of me feels like I should try to talk you out of it. And that if I don't, then you'll think that I don't hear. But I also really want to understand,

Kristen Boice

yeah, I love that. And when it comes to this concept, this is one of the myths that gets brought up like suicide. And I know this can be triggering for me to even say out loud. So I want to put a little disclaimer, this is not what I believe this is what I've heard people say and I think it's important. Let's get it out there and kind of address it. Suicide is selfish. Yes,

Stacey

that's another one of my soapbox is I've got a lawless soapbox who's

Kristen Boice

let's hear it. Let's hear your thoughts on that because I feel like we need to address it. Yeah,

Stacey

suicide, the selfish boy talk about shutting down the conversation. There's so much that is hard about that. And one thing that's hard about it is that if you've lost somebody to suicide, you may feel that it was selfish of the person To die by suicide in, you're entitled to your feelings. So while I do have a soapbox where I disliked that judgment, and that phrase, I also don't want to invalidate people who do feel that way. Because I mean, I could see how if you're married, and you've got four kids, and your hands are completely full, and your partner has been fully participating parents, and now they've left the scene, whether by suicide or for any other reason, that could feel selfish, like, now I have to do this all by myself. And now I don't have the help. Now I'm going to become homeless, or I'm going to pass to live in poverty, or whatever the situation is, I don't think it's invalid, to have the feeling that it's selfish, and I think it is Miss attributing the cause of suicidality. When somebody dies of cancer, we don't say they're selfish. And that's the tricky thing about suicide is it can seem volitional. I mean, really, with many aspects of mental illness or distress, things can seem like someone's making a choice to do something. But really, the circumstances or whatever forces behind it are what are pushing the person to take action. So that's one thing is that often, and what seems like the person's choice may not be their choice, and often is not their choice. One of the really powerful metaphors I've heard for suicide, I think David Foster Wallace, I know he were the bad and I don't know if he was the first person, but you've heard about that somebody who's acutely suicidal, it's like they're in a burning building. And they can either experience the excruciating agony burning alive, or they can jump out the window. And we actually saw that with 911, that some people jumped from the buildings, rather than die an even more painful death. And I'm sorry, if I'm activating anybody, because that's a really, really sad and depressing thought. And it can help put perspective on the fact that suicide often is not about anyone who's been poof, feel slighted, you know. And I mean, so that cancer example, and I actually have on my website, a blog post, that's called the title is it selfish to die in a tornado. And again, here's where I'm comparing suicide to a storm. And I wrote this because there was this horrific story in the news in Dallas, this man went jogging. And he was attacked by somebody who had a machete and killed him. Again, very, not uplifting conversation, and also still important, and his wife think it was few days that might have been a couple of weeks afterwards, killed herself. And a newspaper columnist wrote a column saying how selfish she was. And I was so angry reading that column, how could you call her selfish, like she was in pole, you know, I mean, we do things boudoir and painting that aren't selfish. They may seem selfish, but they're really just an instinctive response to not feel so much pain. It's how we're wired, you're

Kristen Boice

trapped in your pain. I mean, there's the word trapped again, that's really what it is, you're trapped in your pain, and don't see away feel trapped

Stacey

in your pain feels trapped in your pain. Yeah. And that's the goal of treatment, or other kinds of help is to help the person find other options, or to see places where they are trapped, or to see where their mind is lying to them. Because often that's what's happening is the mind can be telling them things that aren't true. Like, you'll feel this way forever. We don't know how you'll feel forever, nobody knows. That's one thing

Kristen Boice

I love about EMDR if there's something that got stuck in time, a trauma of abuse, something that got frozen, there's almost a trapped feeling. So it's almost like we can work through it was EMDR there's other modalities, but that's just one to free that thought to feel that feeling in the body. Because it lives in the body as we know, there's many ways but that like you're saying that's one option to kind of move through it to get to the other side. And then there's other times where it doesn't clear right it just kind of that might be a reoccurring thought is that the case? I mean for many people that it just does no why does it just disappear?

Stacey

Yeah, for some people, they may have a baseline of always having suicidal thoughts but they kind of like a song playing in the background that they hear but they go about their luck go on about their life regardless and that for other people it may be that whenever they're under a lot of stress or in pain that their mind these to the same place in their some thinking and I think also evidence that it can become a habit, a habit of the mind that like neural pathways can be forged. And what's come out in more recent research is that there's a reward to it and our mind craves reward our minds crave us gait relief. And the reward is that it can be comforting to know that you have a way out and comforting to feel in control like, well, if this does continue, then I can put it into it. And so if that creates some kind of mental relief, well, then the mind is going to go there. Again,

Kristen Boice

it's trying to protect you in a way. I mean, if you really think about it, it's trying to, and the best way we know how mean at that point until we learn other ways, but it's almost like it's trying to protect you. So what are the signs of someone's going okay, now, what do I look for? If I have a loved one? Like, what are the signs that someone's suicidal so I can know what to look for? Well, there's

Stacey

the obvious signs that if they're talking about suicide, take it seriously. And I don't mean, take it seriously call 911 or go to the emergency room. But at some about, hey, you've mentioned a couple of times that you wish that you weren't alive, what's going on? What's behind that? And sometimes people joke about suicide. And this is hard, because a lot of times people who joke about suicide, why don't they admit that they really are thinking about suicide, and a lot of people who joke about suicide arcs thinking about suicide. But it's also well known that oftentimes people joke as a way, whether consciously or unconsciously, not even necessarily as a way of conveying to others what they're thinking, but just that it kind of leaks. A really incredible example of this is Anthony Bourdain, after he died by suicide, somebody went through his interviews and found something like 25, or even 30 examples of where he's said, in a way, that seems like a joke, like, Oh, if I'm at the airport, and I have a bad hamburger that I just want to kill myself by, and then give us the method that he ended up using got in littles. I know there were dozens, and this was over a period of years, like a period of I think, like eight or 10 years. So it's not like in one week period, he made 30 references. These were things over time, and if asked about it, he probably would have just laughed it off and said it's hyperbole, but then the fact that he acted in the same way that he had pre sage set the word pre sage presage, I'm not sure that is revealing. And there's, I'll give you two other examples. One is that there's a woman who and I quoted her in the book, she had suicidal thoughts and worked in in the emergency room. And people would say to her, how's that going? And she'd say, nothing, that X amount of insulin could impure, and that would kill her. And they would laugh. It was funny. And then the other example, I'll give it to myself that in my 20s, nobody knew I had suicidal thoughts. I mean, until I eventually told them, but for a long time, nobody knew. But I made jokes. And one time somebody did pull me aside. And in this particular instance, I said, somebody had said to me, what happens if we never get out of the Bureau's I was a newspaper reporter, and we were in the bureau in a suburban bureau. And I said, Well, if that happens, I'll just lie down on the freeway, it just came out. And not that I even was ever thinking of lying down on the freeway, but it was just that was an illustration. And this person took me aside and sent you several statements about suicide. And are you thinking of suicide? And I was like, No,

Kristen Boice

did that make a difference in your life, that they pulled you aside and asked you, because you remember it? I

Stacey

know, I was gonna say, that's a really good question. Because on the one hand, it didn't. But on the other hand, that was 32 years ago, I had like, remember, for

Kristen Boice

you do not remember like a vivid memory, I can tell just by you sharing it,

Stacey

I remember clear as day and then what eventually transpired was that a month or two months after that, this same person came back from covering a story because again, we were new skip reporters, in it had been a funeral. And he was so shaken up on another stage, why I'm so upset. And it was a funeral, someone who didn't know he was there to cover the story. And in talking with him, it became clear that he had experienced the death in his family. And it was a sibling who had died by suicide. So then I realized that was why he was so sensitive to my statements. So it clearly on the one hand, in the moment, it didn't have an impact. But I remember it so vividly. I even messaged the person a couple of years ago on Facebook, because I'm already in the process of writing a personal account of my experiences. And I asked permission to put that in. And he said, as long as you don't use my name, so very, very vivid memories.

Kristen Boice

That's powerful. I mean, it stuck with you. Yeah, I mean, all these years. 32 years later, here you are, it's still with you that he noticed and he asked multiple times, it sounds like I mean, he did not just once he didn't he asked multiple times. Yeah. even one person noticing and paying attention makes a difference. I mean, we don't know how, but sometimes it might, we might not be able to see it. This is 32 years later, and you're writing a book about it. And you remember this. I mean, I think that is so impactful. Thank you for sharing that. I feel like I could talk to you for hours. Is there anything like we didn't cover that you want to make sure that you share?

Stacey

Well, I've already mentioned asking and not relying on the person that telling you I mean, there was a study that came out last year, that among people who had suicidal thoughts in this particular study, 40% had not told their therapist, they were all in therapy and 40% had hidden it from their therapists, which I find that incredibly sobering as a therapist. Yes. And I know a big part of that for many people is fear of being hospitalized.

Kristen Boice

Yeah, actually, they're like, you're gonna put me in the hospital? I don't want that.

Stacey

Exactly. And there's this myth that if you so much as say, you have suicidal thoughts, then you'll be hospitalized, which I mean, of course, there are exceptions. And you know, someone will have a story of someone who was, but overwhelmingly, you can't get into a hospital when you want to see you know, so if you have suicidal thoughts, overwhelmingly, that's not going to land you in the hospital. So I would say to be brave, I mentioned earlier, brave listening, to be brave to sit with your fear, but still ask, you may be afraid, but don't let that stop you. Because look, 32

Kristen Boice

years later, you remember someone asking to come full circle. I mean, this is what matters. Notice the people in front of you notice if something seems or joking about something or mentioning something, you notice something compassionately, inquire in that and ambient empathic witness. And you never know what could happen as a result, you don't need to be attached to the outcome. It's just noticing people's 110 into your own pain and to noticing other people's and their lives can be changed. So if you are struggling, or you know somebody struggling, what's the next step for somebody? Well, the

Stacey

big thing that I need to say and sort of a public service is that we do have 988, which is the mental health equivalent of 911. And so if you're ever in doubt about how to proceed with somebody, or if you yourself are having suicidal thoughts, and you aren't yet to the point where you want to tell a friend or a family member or go to a therapist about it, you can call 988. It's a 24 hour hotline, the former title for all title was something like the national suicide and crisis lifeline, something like that. And it's everywhere. So 988, but but I would say talking about it, trying to connect with others, both if you're experiencing suicidal thoughts, or if you've observed that the person is experiencing suicidal thoughts, connection is so important. Not Being alone is so important. I don't mean just not being alone, physically, I mean, emotionally, and again, you know, responding with compassion and empathy and the desire to help Oh, so but if you are experiencing it, or if you're helping someone who's experiencing suicidal thoughts, trying to get them help, of course, is important. But it's not the only thing. Like one of the one of the little pieces of publicity I made when my book came out, said you don't have to be a therapist or psychiatrist to help someone who has suicidal thoughts. It's not only for mental health professionals, and in fact, people go to mental health professionals less often than they go to their family and friends about suicidal thoughts. So we need to not have this kind of knee jerk reaction of, oh, you have suicidal thoughts? Let me send you to the emergency room that is also losing an opportunity to help unless the person is in immediate danger. Yes,

Kristen Boice

Stacy, thank you so much. Go get the book loving someone with suicidal thoughts, fleas, this needs to be a nationwide conversation share this episode with someone that just you feel like would benefit from learning more about this topic, or they have loved ones that are you know, struggling in some form or fashion which most people have something going on right now. Most of us have some hurt something going on. Let's start normalizing talking about it. Let's start normalizing offering empathy and compassion and having open conversations about it. There's nothing more healing than really having that space to do that. So thank you for the work you're doing in the world, Stacy, and I loved our conversation. Thank you so much for listening to the close the chapter podcast. My hope is that you took home some actionable steps, along with motivation, inspiration and hope for making sustainable change in your life. If you enjoyed this episode, click the subscribe button, too. Be sure to get the updated episodes every week and share with a friend or a family member. For more More information about how to get connected visit kristendboice.com. Thanks and have a great day.