SUICIDE AND THE IMPACT ON THOSE LEFT BEHIND

Suicide continues to increase in the United States. I have no doubt that this is directly related to increased stress in the lives of those who have died by suicide. I also believe that a major factor in their decision to harm themselves was feeling alone and isolated. So, they felt disconnected from others and yet afterwards a lot of people are left distraught as they grieve for the who is tragically gone. So, how come they didn't feel this? 

Well, sadly, people often withhold their caring and affection for a variety of reasons: it is too painful to care for someone who is talking about hurting themselves; not wanting to enable or unwittingly encourage negative behaviors [make the person more suicidal]; cope with their sadness about the person's hopelessness by giving advice over and over which only serves to make the person feel more isolated and lonely.

What can we do to help those who we love and who are suicidal or at risk to become suicidal so they are more likely to feel our caring about them? 

• We can listen! Listening is an effective way to demonstrate caring for someone...especially if we are able to listen without having our own reactions. When we listen without reacting we are being present with that person and they can feel that. Their own feelings and thoughts will be clearer and if we need to say anything to them our brains will provide this for us [really!].
• We can tell them that we are worried about their safety and remove any lethal means of suicide that are available to the person.
• We can encourage them to talk with someone about how they are feeling and even suggest specific people that the person can call, as this is one way to help a person who is feeling depressed and it is estimated that 90% of people who attempt suicide are depressed.
• We can call 911 if we feel that the person is still at risk to attempt suicide and tell the 911 dispatcher that we have a mental health emergency and give details of what is happening. 
• We could also offer to take them to the emergency department of a hospital so that they can be evaluated and have a chance to talk about how they are feeling. 

Taking the steps outlined above can help us to maintain a feeling of connection to the person who we are worried about. This can help us to feel that we are with them, as we are encouraging and supporting them. This way of supporting others can help the person we are worried about to feel connected to us and cared for even if we have to call 911.  

If the person that we are worried about [and likely love] dies by suicide, we are less likely to feel as overwhelmed and less likely to have a prolonged recovery period. I did not call this a prolonged period of grief because I believe that grief gets blamed for stressful emotional states that are not part of grief. These emotional states can actually delay the opportunity to grieve for the lost loved one and for us to realize that we they are part of us and we can then give ourselves permission to participate in our own lives again. 

GRIEF...SHRINE OR NO SHRINE?

I've had several requests to write another blog about grief.  A number of my patients have lost pets, mostly dogs.  Some have had to make the decision to euthanize their pets.  We have had discussions about how to prepare for the death of a pet.  This includes whether to create a shrine to their pet.  The need for a shrine seems related to worries that we will not be able to remember those that we have lost.  This worry starts before our loved ones die and we seem to worry more the more things we accumulate to remind us of the loved ones, the more worried we become.  So, why does this happen?  It might be that the focus on trying to remember makes it harder to remember.  When we are worried our brains automatically make this a priority.  When this happens it is harder for us to access stored information and this is where we access our memories, including those of our loved ones. Therefore, if we start worrying about our loved ones we can have a difficult time remembering them because of our worrying about them, including worrying about being able to remember them.

You can then imagine what can and often does happen.  Our worries lead us to signal our brains that we are stressed and our brains respond to this stress and then we can't access memories about our loved ones so this intensifies our worries and it is even harder to access memories, etc.  This is one reason that some people decide to make shrines to their loved ones as a way of holding on to memories.  These may help cue some memories and yet this cueing is not needed if we are calm and trust our brains to supply the memories, and they will.  If we trust our brains we might also be able to discover that our loved ones are still with us.  Worries and shrines get in the way of this.  Of course, keeping some photos and a few items can be comforting unless you do this to try to reduce worrying. This is not comforting.  

So, try not worrying and see what happens.  Of course, it is ok to let yourself have feelings and then move on to what is next.  However, it is not ok to use feelings as a way of worrying becauses you know what can happen then.

LISTENING, REALLY LISTENING...WHY IS THIS SO IMPORTANT?

Over and over recently I have seen how listening can reduce stress in our lives and help us to be more confident.  So, how can listening help reduce stress and improve our confidence?  My initial awareness of the significance of listening came when some of my patients talked about trying to help their friends deal with grief.  My patients felt bad that all they could do was listen to their friends. When we discussed their friends response to being listened to, it seemed to be positive. Another patient indicated that when she responded emotionally to her friend who was experiencing grief and said that she knew what her friend was experiencing, her friend became angry.  We then wondered if listening was really being empathic and saying how you feel or that you understand, is not empathic but really being sympathetic.  So sympathy seems to be more about the person who is trying to console the other and actually may separate themselves from the one they are trying to console.

Maybe listening is really like meditation, like being present with ourselves and the person we are listening to. if listening is a way to be empathic then does that mean that being empathic is like being present with someone [and with ourselves]?

Another benefit associated with listening without our own agenda is that when we do this our brains seem to be working optimally as we realize that we remember everything that we are hearing and then we are able to respond without worrying or feelling stressed.  

So, does that mean that listening to others and ourselves is like being present with others [and ourselves] and is a very good way to us our brains?

GRIEF REVISITED

I have continued to wonder about why grief is often so crippling and difficult to resolve. It seems that many people get stuck focused on past memories of the loved one who has died.  I keep wondering why the memories have to be so painful.  As I thought about this I remembered that I have seen a lot of people who seem stuck in the past but have actually seemed to bring the past up to the present.  I then wondered if people who are experiencing grief can bring their memories of their loved one into the present and it is like having them with them.  

So, how does someone bring past memories into the present time? Recently, one of my patients told me how she looks through photo albums of loved ones who have died and feels like they are with her now as she experiences these memories like they are happening now.  This is very soothing for her. Maybe whenever we have memories we actually are experiencing them in the present. If we become aware that our memories of loved ones are in the present, can this allow us to trust that we can continue to feel our connection to them? What do you think?  

REVISITING GRIEF

I have previously blogged about grief and wondered if our ability to reach a level of acceptance about our loss is important as the acceptance will keep us from continuing to experience the absence of our loved one.  This continued feeling of loss can occupy our brains and keep us stuck in the past.  So, being able to accept the loss may be important but how is that accomplished?

It seems that getting beyond (past?) the sense of loss may allow for acceptance. If we can shift our focus from our feelings of loss and even abandonment, we will be able to remember our loved ones and feel their presence attached to these memories.  If we remain stressed our brains will focus on trying to reduce the stress and this will block our access to memories and a sense of the presence of our loved one.  

Since we are our experiences and our relationships to others, just being ourselves will help us to know that our loved ones are still with us.  Now, being ourselves requires that we trust our memories and allow them to be alive in the present moment.  This means not trying to force memories but trusting that they are there.

This sounds kind of spooky, doesn't it? Still, you might give it a try.