Archive of ‘Suicide’ category

Suicide Prevention: Conversations to Have with Your Teen

Conversations with our teenagers are vital in keeping them healthy and safe. CDC has reported an increase of adolescents who have had a suicidal attempt since 2020, the beginning of the pandemic (CDC, 2021). As a previous school counselor who did a lot of crisis counseling and worked with students who had suicidal thoughts, I want to encourage adults, parents, and educators to have these important conversations with your teens.

Ask the teen how they feel.

This sounds like a no-brainer, but this is the most important thing we can do for our adolescents. Instead of asking about how their day went or about if they finished their homework, ask them how they feel today. You can ask questions like this: “How do you feel about what happened today?” or “How are you feeling today?” or “What are some emotions you feel regarding ____?” Middle and high school students would always tell me that they wish more adults would ask them how they feel instead of only asking them about tasks they need to get done.

Don’t be afraid to ask the teen if they are suicidal.

Many people believe that if they bring up the word “suicide” it is going to suddenly make the teen curious about it. Nope! It’s a myth. Research has proven that bringing up the word will NOT increase the level of suicidal thoughts in a teenager (NAMI, 2020). If a teen is thinking about it, their thoughts about it won’t increase just because someone asks about it. Parents, educators, and adults, please do not be afraid to ask your teen if they are suicidal. Many adolescents just need to be asked this question – so many adults in their life are afraid to ask, so the teen may not have a space to open up about their suicidal thoughts.

If your teen happens to say yes, ask if they have a plan. If they say they have a plan, consider seeking treatment and support, and do not leave them alone. If there are any items that they can use to hurt themselves, remove those items from their reach. During this process, encourage open communication and don’t be judgmental. Immediately reach out to a therapist and/or treatment center and ask for support. For an additional layer of protection, reach out to their school counselor and inform them of this too, so that they can keep an eye out at school. Since adolescents spend most of their time at school, it is important to have an adult at school who is aware of their suicidal thoughts and/or plan. The more eyes we have on our teen, the more we can protect them from doing anything rash.

Ask the teen about any protective factors.

The more hobbies and people the teen cares about, the more likely they are willing to stay alive. Ask about the adolescents’ hobbies, social circles, and values. See if there are any factors that may light up their interests or passions. If they talk about a hobby they enjoy, ask about it often and ask about their thoughts and emotions regarding it. As a therapist, I always start off my conversations with my clients about their protective factors. It helps me to better understand what they enjoy and what keeps them interested in living life. 

Protective factors to ask about:

  1. Hobbies: What do they like to do in their free time? What clubs/sports/extracurriculars are they involved in?
  2. Social circles: Who do they spend time with? Who do they trust? Who would they turn to if they were going through a hard time?
  3. Physical health: Are they eating well? Are they drinking enough water? Are they spending an adequate amount of time exercising?
  4. Purpose/Values: What do they believe in? What do they value? What are some topics that get them stirred up? Do they believe they have a purpose in life?
  5. Self-esteem: What do they think about themselves? Do they believe they have the strength to overcome challenges?

If you have a teen who is having suicidal thoughts, please reach out to a therapist immediately. You can find a therapist with immediate openings at Austin Family Counseling by emailing [email protected].

Additionally, there are resources available that can offer immediate support: 

  • Call 988 (suicide hotline number)
  • Call 512-472-HELP (Integral Care Mobile Crisis Team) 
  • Chat with a crisis counselor: https://988lifeline.org/chat/ 

Citations:

https://www.nami.org/Blogs/NAMI-Blog/September-2020/5-Common-Myths-About-Suicide-Debunked

https://www.cdc.gov/mmwr/volumes/70/wr/mm7024e1.htm?s_cid=mm7024e1_w


The Giftcurse of Grief

Fall is often associated with grief. Celtic tradition has built rituals around the recognition that the veil is thinner this time of year. There is a cultural multiple-discovery of rituals during this specific season, one chosen to honor the dead and ancestors’ past, as well as to pay homage to grief itself. The Aztecs had a ritual that pre-dated and inspired Mexico’s Día de los Muertos, and the holiday continues to include Catholic influence around All Saints Day. Celts had Samhain, the Romans, Feralia; South Koreans celebrate in September during Paju. The Hungry Ghost Festival occurs a bit earlier in China, in August. 

This varied, yet overlapping ritual space that both honors and mourns is generally aligned during a time of the season where leaves die, fall, and reintegrate back into the earth’s biosphere. This fall, of 2021, grief seems particularly potent, with many of us either deeply exhaling, or holding our breath, after a long 20 months of pandemic living of varying scales. Many have experienced losses of magnitude and cadence that are out of the ordinary for this last eon. Grief has been experienced in both direct and indirect ways, as shared worry, depression, anxiety, insomnia, even studied as collective shifts in dreamlife.

It is this time of year where clients cite dreams that feel vibrant and potent, some report wanting to sleep more (daylight savings weirdness does not help this, does it?) And seasonally, grief seems more at the surface than in other months. Grief is often described by those experiencing it as a fog, a film, a visible haze that separates or delineates. CS Lewis defined grief as “a sort of invisible blanket between the world and me” after the death of his wife. Somatically, grief can show up in the head, gut, and chest. Grief can physically feel heavy. This is even noted in our idiomatic expressions of the blues, depression, sadness, loss. I feel down, it reduced me to tears, I have a lump in my throat, I am holding my breath. Unprocessed grief can compound and show up as a malaise, a depression, at times it can mirror PTSD symptomology. The DSM 5-TR has created a new diagnostic path for prolonged grief (Prolonged Grief Disorder) to give credence to the impacts an elongated, or multiple-event grief process, has on the brain and body, including sleep disturbance, substance use, and immune functioning. This addition is timely, and necessary, to witness the incredibly demanding time in which we are living.

James Hollis has described grief, or one of the giftcurses of it, as a “mythological disorientation.” At times when we encounter a loss, an earthquake in our senses of selves, the narratives we have built or lived under without question can be aptly rocked by grief and its preceding events. A false self, born under the desires of the family of origin, untapped unconscious material, or just the waves of societal norming might now be proven as outmoded based on what the more concrete situation of grief has unveiled. Therein lies the opportunity. Rather than attach yourself to the other common idiomatic mechanism we humans tend to pursue with grief: get over it; this invitation is instead to sit in it, move through it, let yourself be rocked, create some room for the ferns that grow from the char.

Here are some meditations and considerations on how you might sit with, experience, honor, express, or otherwise cool down from grief:

Stay With It

I adore Tara Brach and have gotten the chance to experience her silent meditation retreats. I often use one of my favorite tools of hers, RAIN, with clients and with myself- here is a 20-minute meditation that features this tool.

Breathe With and Through It

Try alternating nostril breathing (hold left nostril closed, inhale through the right; clamp right nostril and exhale through the left; switch/repeat) which can calm the mind and reduce stress.

Or box breathing which activates the parasympathetic nervous system – exhale for 4 seconds, pause at the bottom for 4 seconds holding your lungs empty, inhaling for 4 seconds, pause at the top, holding the air in your lungs before repeating the pattern.

Create a Ritual Space

Take a page from the aforementioned ritual book and create a space for offering. This could be a section of a table, a shelf, truly anywhere you’d like to place objects, visual reminders, remnants, and notes to a person, a pet, a part of self, a season in your life that has passed.

Open Your Chest

When we are cold we tend to turn inward, when we are grief-stricken we do the same. Doing chest- and heart-opening stretches and poses can help regulate breathing and offer a somatic pull of energy into a space we may be unconsciously holding or tightening.

Stimulate the Vagus Nerve

If you work with me you know I am obsessed with this wild gut-to-brain neural circuit. Here’s a video from the @the.holistic.psychologist demonstrating just one vagal stimulation pressure point.

Cool Off From It

Distraction can be a defense, but it can also be a great tool when grief turns to overwhelm. Get grounded and go for a walk, listen to a favorite album, draw, paint, dance the feeling out of your body.


Growing Through Grief: You Will Never Feel the Same Again… But You May Become Better

Losing a loved one may shatter your life. You may feel numb. You may feel that you can’t think straight. Every heartbreak that you have suffered previously may hit you full force, simultaneously. At times, the pain can almost paralyze you. 

Be patient with yourself. Healing from grief is a slow process. It moves, not at the tempo of technology, but at the tempo of agriculture, as slowly as plants grow. But as you heal, you may discover in yourself new strengths that were not there previously. 

In my case, my mother’s death forced me to re-examine my identity and my purpose in life. This exploration eventually led me to seek a master’s in social work. I discovered that my interests include caring for older adults, persons who are nearing death, and persons who are grieving. 

Each experience of grief is unique, as unique as you are, and as unique as your relationship with the person you lost. But there are some patterns that humans share. It helps to learn these patterns, as they will help you understand yourself and other persons.  

Elisabeth Kubler-Ross’s 5 Stages of Grief

This was the first research model of grief, and it is still used. People do not go through the stages in a neat, sequential way. But they usually experience all 5 emotions, and move in a gradual, bumpy way from shock toward healing. 

  1. Denial (shock)—This is the emotional equivalent of an airbag in a car. It protects you from feeling the impact all at once, which could be overwhelming. 
  2. Anger—You may protest and feel, “This is terrible! This shouldn’t have happened!”
  3. Bargaining—You may think, “I’m trying to regain some control of my life, when I feel so out of control. If I change my life in such-and-such a way, then I should feel less bad.” A religious person may make deals with God, such as, “Dear Lord, if I start teaching Sunday school, You should make me feel less awful.” 
  4. Depression—This stage is not well-named. It’s not depression, but it can look that way. There is a general withdrawing from activities and social life, a conserving of energy. The person may feel powerless, but not hopeless. They are starting to come to terms with the loss.
  5. Acceptance—At this point, you may feel, “This situation stinks. I don’t want it this way. But it’s reality, and I am going to acknowledge it and deal with it as best as I can.”

William Worden’s 4 Tasks of Grief

Again, people don’t go through these tasks in a neat, sequential way. There may be setbacks and cycling. But there is a gradual movement toward healing.

  1. Acknowledge the reality of the loss. State that the person is dead. Describe how it happened, how you learned, and what you saw.
  2. Experience the pain. Face it. Don’t try to pretend that it doesn’t hurt much. It does. Don’t try to dull it out with alcohol.
  3. Adjust to an environment without the person there. The longer that people are in relationship, and the more closely their lives are intertwined, the more adjusting needs to be done.
  4. Withdraw some emotional energy from that relationship and invest it in another relationship. Be careful! You can’t replace one person with another. (We all know a grieving widow or widower who remarried out of loneliness, but chose altogether the wrong person.) Some marriages and other relationships aren’t happy. In this case there may not be much emotional pain after the death. Or there may be intense pain, as the person grieves for a relationship they craved, but never had. Sometimes a loss leads to a new project. A mother whose child was killed by a drunk driver started MADD (Mothers Against Drunk Driving), to try to prevent this tragedy from happening to others. 

Corr & Doka’s 5 dimensions of grief

  1. Emotional
  2. Physical—You may feel cold. (When we feel threatened, blood flow goes to our inner organs, and we feel cold.) You may get sick, since grief weakens the immune system.
  3. Spiritual—Grief may impact your belief system.
  4. Social—It may be hard to socialize, as some people may misunderstand you, or say clumsy things.
  5. Cognitive—You may have poor attention, poor concentration, or difficulty learning new material. Some children who are grieving are diagnosed incorrectly as having ADHD. When these children heal from grief, they do not show ADHD behavior. (This research study was my professor Dr. Helen Harris’s doctoral dissertation.) Some older adults who are grieving fear that they have dementia; but when they heal from grief, they can think just as well as they did before the loss. 

Alan Keith-Lucas’s study of children’s resilience after a loss

Shock and denial: After a significant loss, every child experiences shock and denial. Then there are 2 different paths:

  1. Protest: If the child is allowed to have and express the feelings, “No! This is unfair! This can’t be!” then the child can achieve “mastery,” becoming stronger than before the loss. The key is for the child to learn to express their feeling of anger in a way that doesn’t hurt themself or anyone else. 
  2. Despair and Detachment: If the child is not allowed to protest, the child falls into despair and detachment. These children are not troublesome. However, as adults, they may not function very well. They struggle to keep a job or stay in a relationship.  

Books—Some of my favorite books about grief are:

  • Doka, Grief is a Journey 
  • Neeld, Seven Choices: Finding daylight after loss shatters your world 
  • O’Brien, The New Day Journal 
  • Wings of Change Publications, The Nature of Grief: Honoring and Healing the Seasons of Loss. 

Are you currently grieving? 

We experience grief not only when a loved one dies, but also when we lose anything that is important to us, such as our health, a job, or a treasured relationship. If you are grieving, it would be my honor to share your journey with you. Grief is too hard a journey to travel alone.

[I wish to thank Dr. Helen Harris and Dr. Richard D. Grant, Jr., for teaching me the above material.] 

Written by: Catherine C. Stansbury, LMSW, supervised by Melissa L. Gould, LCSW-S. Catherine is a therapist here at Austin Family Counseling. She is an EMDR Trained Therapist specializing in trauma therapy for adults. She has a Master of Social Work from Baylor University, where one of her internships was in a hospice agency. She is a PAC Certified Independent Consultant, trained by the Positive Approach to Care organization; a Certified Practitioner of the MBTI, trained by The Myers & Briggs Foundation; and an associate member of the Aging Life Care Association.




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