Giving up the “Fame Game”

I’ve been hearing all the things I “should” do to promote my book and my new upcoming publications. Everybody seems to have their own ideas about how I should find the top marketer, a stellar agent, a glitzy webmaster, a renowned videographer, a world-wide distributor, etc. Unfortunately all of these wonderful suggestions cost money…our money (my husband’s and mine). We have no funders. We have no patrons. It’s just us.

So we have been paying for book editing, proofreading, printing and publishing out of our everyday budget and it is causing great strain. I was stopped dead desperate to decide not when to go forward, but if to go forward. I just quit writing, planning, scheduling and all manner of future-oriented strategy.

Instead I started paying attention to nothingness. I focused on simplicity, beginning in a most rudimentary way. I set aside complicated dinner menus that took a special trip to the grocery for intricate recipe ingredients.  I started concocting meals from whatever I had in the fridge, freezer and pantry. We had some really good meals that we’d love to replicate but can’t because we’ll likely never again have those same dibs and dabs of stuff.

I watched only TV comedy and read only uplifting articles. At the culmination of this active meditation, I happened to be watching Ken Burn’s documentaries on the U.S. National Parks. I learned how John Muir tried to do speaking engagements and lobby congress to set aside these beautiful expanses for the use of our nation’s people, their children, and their children’s children. When that failed, he decided to “take it to the people”. He wrote books, magazine articles, and pamphlets extolling the grandeur and the spiritually regenerative power of Yosemite’s promontories and Yellowstone’s compelling vistas. Muir invited his readers to take part in the glory of promise, to make it their own.

It dawned on me then that my message about saving lives from suicide requires that same people-oriented campaign. I don’t need fancy doodads, bells and whistles. I need to go directly to the people…to you and talk to you…invoke in you the desire to take action.

My job is not to spend time creating the perfect marketing devise. My job is to spread the word, person to person, standing shoulder to shoulder with the readers and the livers of life. My words need to empower any average person to know what to say, how to act, and how to support and follow through with anyone they know or suspect might be suicidal.

I need to give up the “fame game”. I need to quit clamoring for the ideal venue, to be like all the rest who vie for the perfect promotion. The way is right in front of me, at my very fingertips. I give the honor and duty to you.

If you will keep reading, you will develop the ability to save lives with your words and your actions. You will understand that all the doctors and clinicians and hospitals and drugs in the world cannot accomplish what you can. With your words and your will you can teach someone how to save their own life.

Keep coming back and I will teach you, one concept at a time, aspects that no one else knows and no one else has ever published. You have to live through this, like I did, to know how to deal with it. You can read ahead and learn them all in my book, “Just Because You’re Suicidal Doesn’t Mean You’re Crazy”, and on my website, htttp://www.jsp3.org.

But I am here. Now I know to give up the fame game means to put the knowledge and the power in your hands directly…no middleman and no gimmicks.  And I intend to do just that. Between you and I, we can turn around the terrible tide that is suicidality. We can make the change that will halt the 65% increase in the world’s suicides in the last 45 years. We can do it…together.

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“CPR” FOR SUICIDAL PEOPLE

I asked and a room full of counselors proudly indicated they all knew cardio-pulmonary resuscitation (CPR). All of them knew how to resuscitate someone who had quit breathing and whose heart had quit beating. They all knew how to save a life.  I then asked them if they knew how to save a life before they learned CPR.  “No”, was their response.

Next, a pall overtook the room when I asked if anyone knew how to save the life of someone who was suicidal. Faintly from the back of the room I heard one hesitant voice, “Call 9-1-1 and send them to the hospital?”

That’s when I thought of writing “CPR for Suicidal People”.  This information is for loved ones of suicidal people. But moreso, it is for those who have been or still are living with suicidal thought. It is the suicidal person that needs to know how to keep themselves alive.

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When you got up the courage to reveal that you wanted to kill yourself…were you told that you need to “get outside of yourself” and “quit thinking so much about yourself”? Have you been told that you need to go out and do something for someone else so you can quit thinking of “me, me, me”?

Join the crowd of suicidal people who no longer tell anyone that they have secretly held suicide as the ultimate “out” – exit from hopelessness and helplessness.  Join the rest who hear this repeated exhortation to release yourself from what is believed to be selfish suicidal thought patterns.

Volunteerism is a wonderful thing and my guess is you’ve already tried it.

When you volunteer to help someone, either for a cause or for a gesture of kindness, it does make you feel good and it does get you outside of yourself.  Question: What do you do for the rest of the time, when the thoughts return from nowhere, seemingly prompted by nothing?  Well, if you did what I did and what Veteran Clay Hunt (60 Minutes, 3/3/13) did to the nth degree, you know it does not solve the problem of hopelessness and certainly does not relieve you of suicidal thought.  What it does do is distract you and make you exhausted.

I agree distraction is essential for suicidal people.  And doing things for others is an excellent way to generate those “feel good” neurochemicals called endorphins.  But distraction to distraction is exhausting.  And that is what happened to Clay. What Clay did not know is that his brain had been hijacked. His brain was returning uncontrollably to the default pattern of suicidal thinking that in turn drove him towards the need for more distraction. Clay could not have known. I did not know.  No one could have known.  Even those who have been on that slippery suicidal slope for years could not have known instinctively. You must learn what is going on inside your head to be able to take the necessary steps to stop it.

“CPR for Suicidal People” is much more than just one thing.  It is a combination of things.  It works.  I know.  I figured it out by pure chance and a lot of divinely inspired insight and self-dedicated education.

I was suicidal for 24 years.  From age eight to thirty-two I fought for my life and did not know why I was afflicted in this way.  It seemed to me that everyone else just lived their lives and I couldn’t.  I faked it a lot – so much so my life became a huge magnificent lie.  I laughed and made people laugh because I could not tell anyone the truth.  When I was flawless in performing my act, I could feel telltale chills of ingenuineness creep up my spine. I knew I was living a lie.  I knew there was something wrong with me to have this sucking black hole in my soul privately pulling me towards ending my life while I publicly displayed the opposite.  I did not understand it.  Now, I do.

I’m going to tell you why you have been plagued with these self-destructive thoughts and actions for as long as you have. By the way, it does not make any difference if you have been thinking this way for months or years – it begins the same way and if you do not learn your “CPR for Suicidal People”, it could end in you killing yourself.  But worse than that – and what could be worse than that?  Well, it is living your life in some suicidal tunnel where you cannot see nor enjoy the wonders of the universe because you are always secretly planning to leave.  You never truly love without desperation or hesitation.  You never truly feel without fear or longing deja vu. You never truly talk to anyone without reservation or feeling a need to defend yourself.  Life becomes an exercise in futility.  You are never genuinely nor completely engaged in it. You live on the periphery, in secret.

It started with you feeling like you were boxed in without a solution or escape from a seemingly insurmountable problem.  One of my clients remembers her first thought of escape was at four years old when she and her twin sister were being sexually molested by a family member.  Even at four years old, she knew what was being done to her and her sister was wrong in some way.  But she had no out, no way to defend herself or leave.  Her resourceful brain did a remarkable and wonderful thing.  It provided her with pain-relieving endorphins when she thought about “not being here”. Just the thought of “not being here” gave her the pain relief and the ability to stay alive.  Did you get that?  The thoughts that took her out of her pain also kept her alive.

Those thoughts of “not being here” were reinforced by pain-relieving endorphins and it was a brilliant, ingenious, and successful life-saving coping mechanism.  She remembered that relief.  She remembered that those thoughts were integral to that relief.  She subconsciously observed that she could keep herself able to operate in the world by continuing to think those thoughts.

What she did not know is that her brain was building and reinforcing a neural pathway each and every time she thought about “not being here”. That neural pathway became the default thought pattern any time she felt she had an unsolvable problem.  She went there and began feeling relief without needing to consider any other problem solving technique. Unfortunately this process works so well in the beginning that it also becomes the favored way of feeling better.  In addition, when it establishes itself as the automatic remedy, it also blocks all other methods of problem solving. Other methods might be obviously lacking in the production of “feel good, pain-relieving” endorphins, but not this one. It works every time.

Well, let’s qualify that.  Not EVERY time. At some point, those thoughts alone do not provide the same level of pain relief.  There is a stage where the thought pattern must intensify in order to supply required pain relief.  The thoughts go from “not being here” to “not being somewhere” to “not being anywhere at all”.

Let’s make one more thing perfectly clear.  No one realizes this is going on in their brain.  No one I know has ever awakened one day and said to themselves out of the blue, “Today, I am going to think about how to kill myself.”  It just does not happen that way.  It is subconscious, surreptitious and much more insidious.  What you must remember is no one is in charge here. No conscious effort can be made to stop this process because it is undetectable to the uneducated and completely covert.  You do not perceive any of this happening. It is completely automatic.

I can make this easier to understand if I compare it to something we have all seen and some have experienced.  It is easily compared to addiction and the pattern of neurochemical tolerance to a psychoactive substance (alcohol, cocaine, marijuana, opioid pain medication, etc).

We perhaps have noticed someone’s progression in their use of alcohol. We notice that a person often begins using regularly to relieve some kind of pain, maybe psychological or physical pain.  In any case, they continue drinking but soon you notice that even though they used to drink only 2 beers and seem buzzed and out of any perceived pain, they are now drinking 8 – 10 beers to get the same perceived effect. They are building a tolerance to the effect of the alcohol.  It no longer works at the same intensity as it did previously. The person drinking the beers may or may not take note of that. Regardless, they are not initially aware of the biological process in their brain that creates the need for a higher level of relief.

In the case of suicide, the unconscious biological mechanism of tolerance intensifies the thought patterns driving the progression from thinking about it to acting on it. It isn’t long before the wonderful and effective coping mechanism that kept you alive is now the mechanism that is compelling you to plan your demise.  How could this have happened when it worked so well initially?

Let’s go back to the addiction analogy.  No drug addict or alcoholic I know, including me, ever said, “I’m going to have this drink knowing it will someday kill me.” We did not know the wonderful thing we chose to kill our pain was going to turn on us.  People who take doctor-prescribed pain killers are absolutely amazed that those same effective, wonder drugs could kill them. The point is, someone who is desperately suffering cannot be blamed for using whatever works, especially if their coping mechanism was born shortly after they were.

Pain of any kind makes you very desperate. And our bodies naturally eschew pain.  Why do we instinctively cower and pull back from painful experiences? Why else would we have naturally built-in pain killers that work without us consciously beckoning them? Why do studies show that expecting pain relief brings pain relief? Why does meditating on the pleasant bring pain relief? When something works well to relieve pain, we are naturally going to refer to it repeatedly.  There is nothing shameful, guilty or heinous about that.  So if you find yourself blaming someone or yourself for suicidal thoughts, listen up.  You are in need of some serious education.  You need “CPR for Suicidal People.”

“CPR for Suicidal People” is only significant when someone realizes this is going on in their brain and chooses to do something about it.  Now that I have explained to you how you got this way and that it is most certainly not your fault and that you are not inherently flawed, let’s get to the rest of the CPR. Let’s learn how to save your own life.  Because, believe me, I know how desperate you are to find relief.  You are tired of living or half-living this way. You would not be in such torment if you did not want to live.  You just can’t figure out how things got this way and how to get out of it.  Listen up.

“I’ve asked for help before and they just slapped me in a hospital and I came out the same way I went in.”

Here’s the truth about asking for help.  You’re going to ask the wrong people like you have in the past.  You’ve asked the ones who you think should be able to help, like your parents or family members or spouses.  They may have blamed you, shamed you, and guilted you into saying no more about it. You scared them to death. If they were anything like my parents they accepted the blame for what they determined was my “mental illness” and did not want anyone to know that I was “unbalanced”.

Let me say something about the myriad of clinicians and lay people who commonly and firmly believe that suicidal thought is mental illness and/or emotional instability. I understand why they say that and treat suicidal people like they are mentally ill. It has been that way since we first knew that people killed themselves. But it is time to look at things differently. It is time to see things the way they really are. Not everyone in the world who is suicidal is Bipolar, or suffering from Major Depression, or has Borderline Personality Disorder.

I personally believe that just about any behavior can be pathologized, given a label and found to respond to some prescription drug.  And sometimes when you have been suicidal for so long, you do become clinically depressed and could use an antidepressant to help you think more clearly. But for the most part what the uneducated public doesn’t realize is that there is a plethora of suicidal people out in the world who hold successful jobs, support families and pay taxes. They are not emotionally unstable or mentally ill.  They have developed a maladaptive coping skill.  They have no idea their brain (and their problem solving skill) has been hijacked by an initially very effective but now default and inherently dangerous neural pathway.

And like I stated previously, a combination of actions need to be taken judiciously in order to provide recovery from the default use of suicide as a coping mechanism. My parents told me to shut up about it and go out and volunteer. That’s how I know volunteering until the cows come home will not, in itself, solve the problem. My doctors labeled me as Bipolar and gave me a boatload of meds.  That’s how I know medication might help, but also might do a great deal of harm. My hospital clinicians told me I had to cognitively raise my self-esteem and learn how to appreciate life. That’s how I know bibliotherapy and writing down how many ways I should be grateful for my life can be very damning, shaming, and ultimately painful.

So, what do you do? You ask your trusted peers to help you retrain your brain in very specific and prescribed ways. You learn to ask the people who actually have helped you in the past – not the ones who you think should.  Past experience predicts future success.

The difficulty comes in the fact that people you confide in often panic and call “9-1-1” and you do end up in the hospital.  That’s why you tell them now when you are not in crisis or in the attempt or post-attempt stage.  The sooner the better. Talk to them now.

“What do I tell them? How do I tell them I’ve been suicidal for so long?”

Here is what many have told me they did after they read my book, “Just Because You’re Suicidal Doesn’t Mean You’re Crazy: The Psychobiology of Suicide.” They handed the book to the people they wanted to support them in their recovery.  They said, “I need your help. This is me. If you are willing to help me in my recovery from suicidal thought, I want you to read this book.  It will tell you what is going on with me, then, we can talk.” They described giving them the book as easier than trying to explain the whole magilla to someone.  When their peers had the words in front of them they could reread them and understand them better.

After they finish reading it, sit them down and ask them if they think they could help you. If they hesitate, take it as that – not refusal, but hesitation.  Remember you will be asking help to form an advisory group called your “JSP3©” (Jensen Suicide Prevention Peer Protocol©).  This is new.  This is different. This could be really scary for them for any number of reasons.

The JSP3© is a coalition of individuals who are agreed to do certain things to help keep you alive until you can trust you’ve learned how to keep yourself alive.  It is a reciprocal group whose members act as a problem-solving alliance for each other.  You are not the only one who benefits, I assure you.

If one person says they cannot do it or they’re afraid, let them go and take no umbrage.  They are being honest with you and you with them.  This honesty thing will be new to you because, like I had, you have probably been living a magnificent lie.  You want people who are nonjudgmental and open-minded. Remind them it is not forever. (I will tell you though, my JSP3© has been in support of each other for forty years now.  These alliances can forge fierce, lifelong friendships.)

“What do I do if they still have questions about the JSP3©?”

The difficult thing is that there is no information out there that is not generated by me right now.  I am doing seminal work on treatment of suicide.  I liken it to Bill Wilson and Doctor Bob of Alcoholics Anonymous fame.  When they started AA in the 1930’s, no one was doing exactly what they were doing.  The Oxford Group was trying their best to provide an alternative to insane asylums and hospitals for seemingly hopeless alcoholics.  But no one but Bill W. and Dr. Bob were building a coalition of drunks to help other drunks stay sober.  They just knew it took peers to help – not hospitals and asylums.  (Although, they knew some medications were needed to help people think and operate on a healthy level, they recruited regularly from asylums and hospitals also knowing it took their peers to support each other.)

Like Bill W. and Dr. Bob’s grassroots efforts, the JSP3© survives not by research grants and journal articles touting it – but by lives saved. One by one, a life is saved because someone reached out and others answered.  They got the education they needed about the psychobiology of suicide, they learned how to help a friend problem-solve, and they followed the tenets of the JSP3©.

If they need more information, ask them to go to my website, http://www.jsp3.org. There they can read more and email me to ask any question they may have.

“What are the tenets of the JSP3©?”

It is easy to remember: “4-C HOPE”

The Four C’s: Commitment, Communication, Cooperation, Confidentiality

Commitment – following a specified plan

Communication – talking and conferring with each other

Cooperation – agreement in proactive action

Confidentiality – maintaining trust and boundaries

Retraining the brain and building new neural pathways is achieved through LEARNING,

which, in a JSP3©, is based on the following principles of HOPE:

Honesty – absolute and mutual truthfulness

Open for Reciprocity – mutual help between the members of a JSP3© which increases

self-efficacy, hope and reduces isolation

Problem-Solving – working out solutions together and proactive efforts to increase

endorphins

through enjoyable activities

Education – learning and explaining the psychobiology of suicide – understanding the

mechanism involved with a default neural pathway

These as well as the full instructions for forming your JSP3© are further explained in the book, “Just Because You’re Suicidal Doesn’t Mean You’re Crazy: The Psychobiology of Suicide.” (downloadable at  http://www.smashwords.com/books/view/209400. You can also order paperbacks online at  http://www.thirdplacebooks.com/just-because-youre-suicidal-doesnt-mean-youre-crazy-randi-j-jensen-ma-lmhc-ccdc)

“What can I do to help get the word out about “CPR for Suicidal People”?

Just like Bill W and Dr. Bob asked, reach out to others who need help and let them know how you recovered. Give them the strength to form their own JSP3. Give them the resource of the book and the website (http:www.jsp3.org). And each time you hear something familiar from your past coming out of someone else’s mouth, don’t turn away. Turn towards them and take the precious time to share your recovery. Give them hope. Give them the answer to life. Show them the way. Then email me and tell me about it. I need strength, too. I’m not an endless font of energy.

This is ground zero, my friends. Recovery starts here, now. Don’t give up and don’t let others give up either. Keep trying. Keep reaching out. Keep sharing your recovery.

God bless you all.  You deserve the very best life has to offer. Reach out and embrace it with a new knowledge and a new fervor. You know what to do. Now go do it. We need you.

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Knowing who to talk to…

The following interchange exemplifies what I mean by expressing yourself to individuals in your life who know intimately what you know or how, at times, you may feel because they may have felt likewise. They can gently remind you of principles you actually know to be true but have perhaps lost somewhere in your efforts to effect change in the world.

This woman and I are both crusaders for suicide prevention. Both of us work with the military. Both of us are therapists and educators. Both of us are God-directed. Both of us have been tested by limitations placed on us by an often resistant, unenlightened and intractable institutional atmosphere of varying degrees. We have commiserated about it and the taxing effect it has had on our resolve, which has been sorely tested but never wavered. We have never met in person.

I often address military battalions and squadrons on the subject of suicidality and talk about exactly what to do on a daily basis in order to actively help a battle buddy who might be struggling. I refer to my booklet “Suicide Prevention for Battle Buddies and their Families” available soon for free download at my website (http://www.jsp3.org). I speak honestly about my own 24 years of suicidality and how I came to successfully understand its origins and to manage it with the help of my dedicated and goal-directed friends. The intention of this cadre of friends for years was to carefully and insightfully keep me alive until I learned how to keep myself alive.

This was a message that I sent my east coast buddy on the eve before 2014 convened.

L, you are truly one of God’s gifts. Keeping going is one of the hardest things to do especially when it is difficult to see any changes happening and people suffering in the meantime.

I addressed a very young Stryker battalion this November where the mean age was 24 and two was the average number of deployments. I spoke earnestly and from the heart using as many examples that I thought they would find meaningful. Later on I overheard my husband telling one of the sergeants that he was miffed at the guys in the top rows laughing and giggling, although quietly, during my talk.

I tried to suck it up. Originally I thought I did a good job until we were at dinner that night and I realized how many “kids” in that battalion were goofing off, maybe making fun of me, but maybe (hopefully) deflecting the austerity and reality of the message.

However, while I was paying attention as I always do during my suicidality talks, I was astonished at the number of heads that were bowed and NOT making fun, but unable to look up and engage my eyes.

Later on I looked at husband John across the dinner table, and said, “I didn’t reach them. As much as I prayed I would and as hard as I worked on my talk, I did not reach them.” And then the tears began to flow. I couldn’t stem them and I knew the only thing to do was cry it out. 

I decided to go out to the car and wait for John to pay the bill. As I left the restaurant, three kind young men opened the door for me. I had my head down but raised it just long enough to hide my tears while thanking them. One of the guys said, “Hey, you’re the lady that spoke to our battalion today. You were great. You were the best speaker we’ve ever had and we really heard what you had to say.”

Huge tears rolled down my cheeks. I looked up and said, “Thank you, but I was convinced of just the opposite.”

They asked if they could help me out to the car and I agreed realizing I needed some guidance. They put my walker in the backseat and asked what else they could do for me. 

With tears still pooling, I replied, “Take care of yourself, but most of all, listen and take care of each other.” Then I gave them each a hug and we went on our way.

I cried all the way home.

I still don’t know what to think about that day.

I don’t know if I am too old to talk to and be heard by the majority of young people today or am I asking too much of them?

I know I must do what I can and if it helps one person I need to be able to endure the derision of a hundred in order to make that one miracle happen. And ego be damned, eh?

So you keep going. We’ll all keep going. You are blessed. And you’re a precious child of God.  Everything we do to reach out to help someone anywhere, anytime is important.

Love, Randi J.

This was her enlightened response.


Dear wonderful Randi,

 

You touch people so much more than you know, and though your awareness of your effect on others didn’t seem helpful – it absolutely was.  The military culture as you know better than me is one of stolid fortitude and resistance to vulnerability.  Many learned as children that being vulnerable meant they gave others a “weapon” to hurt them.  The walls they build up, you pulled down.  Those chuckling in the top rows were listening, even as they felt they were conveying their machismo and barriers.  Do not doubt this; He is well pleased with you.

 

There isn’t a service member or vet alive that hasn’t been affected by someone (or themselves) who wants to end their own life.  I can say with assurance that you reached many more than those three young men at the door.  We’ve never met in person, but we already know more about each other than we imagine.  Your talk was a gift to them, and my belief is that your words come back to many of them at the oddest times; your words don’t just dissipate into the ether; they stick with people.

 

God brings people together for a reason, and He doesn’t make mistakes.  You’re right, keeping going when we don’t want to do so is what makes us different.  But I don’t think I know how to not help people, and neither do you; it’s why we live every day.  I have never been in the emotional space you have, but I’ve been mightily challenged.  We wounded healers are the sustainers of His will, and we bow to that will, knowing He will give us what we need, even when we sigh and weep and wonder.  It’s what we DO.

 

With great care and His love, peace, my friend, in 2014, L.

 

That’s what I mean by knowing who to talk to and who to keep close to you in days of questioning and times of challenge.

 

We cannot be afraid to have tender underbellies. There is no one who does not have one. If we are wise in whom we confide, we could know that vulnerability can be expressed without fear of exploitation. The question to ask yourself is, are you someone who can be confided in? Or more expressly, are you someone who can be fearless enough to be the one confiding?

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What have you done in 2013 to help prevent suicide?

The American Association of Suicidology asked about new things that have been done to prevent suicide in 2013. This was some of my response.

You ask, “What have you done in 2013 to help prevent suicide?”

I just saw a client who had recently been discharged from a well-known local private psychiatric hospital. She is the second suicidal patient who told me the same story. They both experienced condescension and judgment from the staff. Essentially they were told to “get over it” and “quit belaboring their problems”. They were told they both needed an antidepressant and to try to stop dwelling on the past.

There is nothing wrong with taking an antidepressant if it can help the brain’s information processing and provide some uplift and/or clarity by increasing the necessary neurochemicals that the brain in question is lacking. But to rely on medication as the most significant solution is not going to make the patient feel they have any more control over their condition than they had before their hospitalization. They both felt like they were warehoused until willing to say they were no longer suicidal…whether they were or not.

A hospital truly devoted to preventing suicide could do it by creating a discharge plan that included educating and forming a support team of the friends and/or family members identified by the suicidal person. To release a suicidal patient without obtaining releases to talk to and educate the concerned others in how to support the patient is unconscionable. There are no confidentiality or HIPAA (Health Insurance Portability and Accountability Act) violations involved with forming a JSP3© support team. The patient is the one who actively plans, approves and leads their own support team. Forming an educated support team for a suicidal patient should be routine.

I provide free 3 hour sessions to form JSP3© (Jensen Suicide Prevention Peer Protocol) support teams for suicidal people who want to retrain their brain and learn a new way of being. I help suicidal people get into and stay in the driver’s seat of their lives. They realize they can’t do it alone because most have tried unsuccessfully for years. When introduced to the JSP3© support team method of retraining their brain, the suicidal person begins to feel agency and self-efficacy sometimes for the first time in their lives.

It is important to note that epidemiological research shows that the greatest risk for suicide is in the first few weeks following discharge from the hospital.In fact, in Britain, researchers discovered that 41% of the suicides after discharge occur before the first follow up mental health appointment.2 In addition, it is estimated that nearly 1% of inpatient discharges result in suicide within the first year following discharge.3 

I am doing everything I can as a suicidologist (who specializes in and teaches treatment of suicidality) to convince hospitals they need to form JSP3© (Jensen Suicide Prevention Peer Protocol) teams for those who are dealing with suicidality. I have provided free counseling and free formation of JSP3© teams for clients and their families and concerned others and it works. By explaining the psychobiology of suicide, the entire team including the suicidal person realizes that the patient’s suicidality is not their own fault. They understand that it is an enduring coping mechanism that formed a neural pathway and requires retraining the brain to atrophy that long-term neural pathway. The JSP3© team provides the support in this process while a licensed therapist helps resolve the underlying trauma that produced the helplessness and the hopelessness where the need “not to be here” began.

More information is available in my book,” Just Because You’re Suicidal Doesn’t Mean You’re Crazy: The Psychobiology of Suicide”, where I reveal how I retrained by brain with the help of a dedicated team of friends. After 24 years of suicidality and my daily struggle to stay alive, with the support of my peers, I came to know a new life.  I now do this for my clients and it is the most empowering thing they have experienced in their lives.

When I teach “Recognition, Assessment and Treatment of Suicidality”, a course now required for all mental health therapists by Washington state Department of Health, I currently include the importance of peer support. More information is available at http://www.jsp3.org.

During my 24 years struggling with suicidality, I spent three long hospitalizations in psych wards, each after suicide attempts of ever increasing lethality. Never did any of those ward clinicians suggest that a support team of my concerned others could make life easier for me battling suicidality on the outside. Instead my friends stepped up on their own and remained determined that they were going to work together in an organized way to keep me alive until I could keep myself alive.

It was through this process developed through intuition and dedication that underpinned my recovery. Now I form those teams for others who want to climb into the driver’s seat of their lives and begin retraining their brains.

I will never give up forming JSP3© support teams. Although I sometimes gave my team plenty of opportunity, not one member ever gave up on me. If not for them, I doubt I’d be here.

 

1   Crawford, M. (2004) Suicide following discharge from in-patient psychiatric care. Advances in Psychiatric Treatment 10. 434-438.

2   Appleby, L., Dennehy, J., Thomas, C., et al (1999a) Aftercare and clinical characteristics of people with mental illness who commit suicide: a case–control study. Lancet, 353, 1397–1400.

3   Goldacre, M., Seagroatt, V. & Hawton, K. (1993) Suicide after discharge from psychiatric in-patient care. Lancet, 342, 283–286.

 

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Knowing who to call

Knowing Who to Call –  Commiseration with the Right People

 

Four weeks ago I met with a patient who told me that the night before she met with me she was an “11” on a scale of 1 to 10, with ten being the highest degree of suicidality. She was trying to do it all alone. And she has severe chronic pain.

We talked about the psychobiology of suicide1 and how she can start being in the driver’s seat of her life. In order to do that she needs to ask for support from the right people, hopefully from peers who can relate to what she is going through.

The following is a definition of peer support paraphrased from the article, “Peer support: A theoretical perspective” by Meade, Hilton and Curtis2.  Peer support is reciprocal empowerment achieved through giving and receiving help from those sharing respect, responsibility, and mutual agreement of what is helpful. There is no basis in psychiatric taxonomy, labels or diagnostic treatment. It is the shared empathic experience of emotional and psychological pain that creates the therapeutic connection. The mutual affiliation affords an equality in status without the constraints of traditional (expert/patient) relationships. As trust develops over time peers are able to challenge each other’s old behaviors and encourage new ones. There is more information about peer support at www.jsp3.org.

 

Understanding that this patient needs to develop peer support is vital to retraining her brain and creating new behaviors based on those new concepts. We discussed how she needs to realize who in her life actually supports her and who does not. But, more importantly, at pivotal times in our lives we all need to figure out who in our lives might want to support us but simply can’t because they don’t know how nor do they have the capacity to learn how. And the hardest lesson of all is realizing the people we think should be able to help us (like our blood kin or long-term friends) are either overwhelmed in their own worlds, living in fear of anything shaking their beliefs or holding on to their own preconceived notions that prevent them from opening their minds and hearts to new information.

Hard to know what really stops people from having compassion for us when we need them. But it sure hurts when you need it and don’t get it or worse get derision, shame or blame instead.

So we talked about how you actually figure out who might be supportive. The best indicator is past behavior. If a person has been supportive of you in the past or if you know someone who might be supportive of you if you build a relationship based on mutual honesty, you have a good prospect.

But probably the most important aspect of finding supportive people is finding people who have been through what you have or have some intimate knowledge of a similar situation.

Research indicates that peer support from troops who have had similar combat stress  or other trauma can provide for each other mutual compassionate support that can actually prevent post-traumatic stress disorder3.

So it seems if you can find someone who personally knows something of what you have experienced, you have a better chance of receiving “emotional support, informational advice, practical assistance, and help in understanding or interpreting events” (p.14)3.

I know this for a fact. I have certain friends I call for certain kinds of support. I emailed a colleague last week after I worked diligently on a conference proposal for 5 days. I thought I had 2 hours leeway in submitting it. But after I entered it into the proposal portal, the date/time stamp on it revealed it was 2 hours too late. I had not noticed that the proposal deadline was midnight EST, not PST. All that work seemingly for nothing. I could only tell that to someone who had been there and knew what that kind of research and prep really meant. Few others would have fully understood how disappointed I was in my own stupidity.  

One thing that makes my chronic pain patients (and me, too, because I have chronic pain) frustrated is doctors that eschew the psychological effects of unrelenting pain. They treat the physical pain the best they can but usually spend no time dealing with the devastating mental effects of intractable pain. This is sometimes obvious when the patients gets the blame from the doctors who are relegated to just treating the symptomatic pain because they cannot successfully solve the causative health problem.

I’ve learned when fibromyalgia lays me out for days, unable to walk but haltingly on my walker, there is nothing I can do. Day follows day and upon awakening each morning perhaps after a disturbed, pain and fit-filled night, comes the realization this day is no less debilitating than the day before.

I do everything I can to mitigate the effects of unmitigated pain. I switch around my obligations as best I can, reschedule patients, ask for favors from husband and friends, reassess priorities, and accept this is how it is. I handle it the best I can by myself but sometimes I need help from others who know what this is like.

I call my friend in Florida who has Chronic Fatigue and Fibromyalgia. She is one of the funniest people I have ever known and can make me laugh even when we are both in serious pain. We’ve known each other for 45 years. We’ve had our ups and downs and we’ve both gotten over disappointments in each other over the years. In contrast and in testament to our enduring friendship, we still celebrate moments of hysterical insanity from years of sharing work hours and the goofing off hours in between.

But moreover, we can rely on each other for compassion in dealing with our chronic pain. I’ve been struggling all week with “through the roof pain” and broke down today, angry because I had to cancel another day of activity. I called her and make no mistake about it – this was not then nor is it at any time wallowing in distress. This was not misery loves company. This was and is vital mutual support for mutual suffering.

When I call, she reminds me I’m not alone and that I do have much to be thankful for – but it’s the way she does it that makes it perfectly healing.

I told her, “I’m exhausted from not being able to do anything.” This is what E told me. “I haven’t been in this much pain in years either. I think it could be the weather, but either way, this sucks. My house is a mess. There is so much crap on the coffee table I can no longer see the other side of the room nor the body from which my husband’s voice is emanating. I want to clean it up but I really only have the energy to think about it. When I’m watching our gigantic TV and I can no longer read the news crawl on the bottom of the screen, I know I have to start lowering the stack of crap in front of it.”

We went on to talk about how we distract ourselves using different TV shows. I use stupid 60’s sitcoms. E uses true crime shows. She says, “whenever I start feeling really bad I watch a murder on ‘I’d kill for you‘ and then feel glad that’s not me.”

She reminds me how grateful she is that she’s retired and does not have to work.  She and I agreed that even in all of our pain, we need to be thankful that we do not have to spend our precious remaining days standing all day saying, ‘Hello, Welcome to Walmart’ or asking, “You want fries with that?”.

See what I mean?

P.S.: E called me the next day and asked me, “You didn’t think I was trying to “out pain” you, did you? Because I hate people when you tell them how much pain you’re in hoping to get some understanding, and they ‘one up you’.” She wanted me to know she heard me and that she wasn’t dismissing my pain with hers. She made me laugh again and really guffaw. I was grateful. The pain disappeared out of my consciousness for a few seconds more.

There’s something special about knowing who to call.

 

References:

1                 Jensen, R. (2012). Just Because You’re Suicidal Doesn’t Mean You’re Crazy: The Psychobiology of Suicide. Smashwords.

2                 Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical perspective. Psychiatric Rehabilitation Journal, 25(2): 134-41.

3                 Defense Centers of Excellence. (2011). Identifications of Best Practices for Peer Support Programs: White Paper. Retrieved from www.http://dcoe.health.mil

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How Suicidal People (and Others, too) Ask for Help, or not…

Why is it so dang hard to ask for help?  What has happened in this world that we have become so self-sufficient that we no longer allow our friends or anyone to do for us?

Well, I think there are 2 sides to this peculiar coin. “Heads” says we should be our own determiner. We should be independent because true independence means you’ve “made it” in this world. You don’t need anyone’s help. You can make it on your own. But all you need to bust that bubble is a situation where suddenly you can no longer “do” for yourself. You can’t zip up your pants, you can’t even get them on in the first place. You need help. And there you are at “Tails” – you are flipped in need on the other side of that coin. Now you have no choice but to ask for help or founder by yourself.

Why is it that most of us feel shy in asking for help? Could it be that we fear looking weak, stupid, inadequate, incapable, or less than? Or maybe we fear being refused and thus looking vulnerable and embarrassed that we even asked in the first place? Perhaps even though doing it ourselves causes huge inconvenience, we still think no one can do it better. Sometimes former experience has created the fear that asking for help will lose us any control over the matter. In those cases you end up with someone who won’t stop helping you and you end up buried in obligation.

One thing that suicidal people do seemingly routinely is ask the very people for help who cannot give it. We have a tendency to ask those who have never been helpful in the past but who we think should help either from familial obligation, reciprocation or some other duty or debt. We forget or refuse to acknowledge that past performance is the best predictor of future results. We habitually repeat the same hopeful yet humiliating routine expecting there to be a change in the people who continually shame and blame us. It’s uncanny but I’ve discovered it to be a universal pursuit among suicidal individuals.

Probably the next most universal thing that happens, not exclusively with suicidal people but with almost everyone, is the use of sideways comments when requesting help. Sideways comments are ways of saying things without actually verbalizing them precisely. You hint yet circumvent the real meaning by making cryptic or euphemistic comments. I’ve asked for help from a supervisor before by saying, “I’ve had all I can take”; “I can’t do this anymore”; “I’m at my limit”; “I just don’t care anymore”; “I’ve had it”; “I can’t take it anymore”, and many more like that. Simply because I could not say, “I need help, please help me.”

This supervisor did not recognize as true supplication my trite statements made in desperation. I explain in Just Because You’re Suicidal Doesn’t Mean You’re Crazy: The Psychobiology of Suicide that suicidal individuals most often ask for help in a particular sideways offhand way. We make comments that sound like extreme frustration but do not confirm true dilemma. People write off our statements also because we are more than willing to let them do just that. Almost at the very moment we release the words, we feel like we might have made a dreadful mistake. Letting the words out is opening yourself to shame and blame. The doom dawns immediately and while wanting to suck the words back in, we let you believe they were said in off-handed hyperbole.     

When people ask for help using sideways comments, they really can’t achieve the help they want because no one recognizes the request. This is the sad part. No help is forthcoming because the appeal is essentially written off. In this way the suicidal person unknowingly contributes to the conspiracy of denial around suicide. In addition, the veiled comments that scratch at the surface of hope for relief from suicidality also obscure the chance of it.

Those who have never contemplated suicide develop a pervasive denial that anyone actually could. Compounding that, it also seems that people are not willing to hear more than what is explicitly said for fear of what might be asked of them if they do. Until the development of the Jensen Suicide Prevention Peer Protocol (The JSP3), aside from conveying the person to a mental health facility, no one knew on a day to day basis expressly what to do for someone who is suicidal.

 

In other blogs, we discuss how to defy and overcome the conspiracy of denial and pick up cues to the real meaning behind suicidal sideways comments.

 

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Suicide and Don Quixote

I just this week watched on TV the film, “Don Quixote”. I remembered in strange reverie that this was one story I could relate to in my struggle to stay alive in the early 70’s – the height of my suicidality. I would sing along with the movie’s song lyrics desperately in search of my own destiny, something faithful and worthy to follow. “I am I, Don Quixote, the Lord of La Mancha, my destiny calls and I go”.  I longed for the knowledge that something besides death would call to me. 

 

I felt like Quixote did, alone on a quest that had no real discernible future. That music gave me something to focus on though, some knowledge that out there was a story punctuated by compelling melody written by someone who knew a deeper truth, a deeper yearning in the human soul. I was drawn because somehow I knew I could find solace there. I have found many of my patients find certain songs express the pain inside better than they could ever verbalize it. They listen to a particular song repeatedly, memorizing every word and inflection. I did exactly the same thing. And I felt a tremendous comfort in knowing someone had found a way to express my torment – that there might be someone else out there who felt my same way. Suicidality is so isolating. It seemed maudlin to any unsuspecting eavesdroppers but music and story always played a part in my slow path towards my healing and my destiny to heal others.

 

I realized that the reason I spent 24 years in agonizing suicidality was to be able to discover the means to help others through my research and my own personal experience. Why it has taken so many decades for me to get here pains me because I feel the urgency of Quixote. I feel the loss of every spent moment and am compelled to jealously garner every second in retribution for that lost time.

 

I’m going on vacation next week and I know how badly I need it.  I’m going to a local quarry for 5 days to learn how to sculpt.  I want to go and I need to go. I’ve always wanted to work with stone. It is a powerful healing metaphor. I’m looking forward to it. Yet, I feel precious moments ticking away. There are more things I could be doing to save lives perhaps in a more demonstrative immediate way.  I wrote the book (Just Because You’re Suicidal Doesn’t Mean You’re Crazy, 2012) and I add to and am revamping my website (http://www.jsp3.org), but I am perpetually thinking, “What more, what more…”.

 

In my meditation this morning the Lord spoke to me and told me my continued mission of preventing suicide in the world is at the quarry. “GO and wait on me”, was the clear and poignant message.

 

So, you see, in watching Don Quixote this last time through new and enlightened eyes, I realized fully that my ministry is not necessarily in what I do, the deeds I accomplish.  It is in who I am as a person – the essence of benevolent intent. The blessed entity that is who any of us are in the world surpasses all we could ever do.

 

Today I am renewed. 

 

UPDATE: An unfortunate misunderstanding prevented me from continuing my sculpting plans. I spent only one day at the quarry, felt totally extraneous, unwanted and in the way… and left.  I was overwhelmed with loss of expectation for most of the remaining week. I found myself in deep reverie and meditation, wondering what that experience was all about. I can only think of rare occasions when I have felt so disrespected and disparaged. Expecting the opposite, the reality hit me twice as hard.

But life is filled with little disappointments and griefs like this. The best thing to do is put your big person pants on and move on. It took a while and I’ve moved on. I’m not worrying about deeper meaning or lessons learned – just movin’ on. Only thing that drives me crazy is that one of my most unfavorite sayings fits perfectly here: “It is what it is.”

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