Published in the Bay Area Health & Wellness Magazine, Houston, Visit us at txhwmagazines.com
In cities throughout the world, notable high buildings and bridges increasingly have additional fencing built atop of them with the specific purpose of preventing suicides. Suicide fences tend to work because research has shown that suicidal actions are frequently impulsive, hence such fences serve to forestall that impulse and buy individuals precious time to further think about their decisions. In studies of suicide fences, it appears that individuals don’t leave such barriers to go look for another bridge or tall building to end their lives from, but instead return to the business of living for yet another day.
Presently suicide is the leading cause of death among young people ages 10-17 here in Utah, and over the last decade, it’s also doubled amongst adults in our state. As concerned friends, neighbors and parents, how do we help our community build more barriers to suicide; protecting and empowering those we love? Over the next year, I’ll be writing a series of articles in answer to this question; offering my perspective as both a therapist, who has stood on sacred ground in helping others walk back from suicidal thinking, and as one who’s felt and ultimately rejected the dark pull to end my life amidst heavy times.
Perhaps you’ve already noted that there’s no way to build suicide fences everywhere or to somehow block all of the endless ways in which someone might consider ending their life. Sound public policies on prevention and physical barriers like suicide fences are only some of the important ways to help. So in addition to these forms of prevention, the focus of my writing will be on how to build barriers to suicide directly into the thinking and values of individuals, and into the culture of our community as a whole. In this first article, I want to introduce how we help foster an ethic to live within ourselves and in others as a key barrier to suicide.
An ethic to live means valuing our lives and holding a commitment within ourselves to continue living — even when we’re unsure of how we’ll cope or move forward. In my experience, helpful conversations about consciously building an ethic to live, begin by first taking care to turn our attention to the reality that to live is to be vulnerable to an array of difficult life experiences, with the potential to evoke within us the thought to end one’s life to escape them. Throughout human history, individuals and peoples have had to confront extremely painful and unjust challenges which have overwhelmed their sense of being able to continue on, and it’s important to acknowledge that when we confront such considerable pain, it is the most human thing in the world to want relief from it. This is real; excruciating human suffering beyond one’s current sense of how to reduce or stop it is real, and in these concentrations of pain, we may find ourselves having suicidal thoughts.
When we acknowledge and honor that such excruciating life experiences do show up for many of us, it’s then that we can locate where we need to begin building internal fences to prevent suicide. It’s here that we recognize the need to develop a strong ethic to live even though there are times that we might not yet fully know how we’ll cope or be able to see brighter ways forward. It’s also here that we find the need to define as individuals what makes life worth living with specificity to our own life experiences, as well as the need to find a listener who we can turn to and voice what’s going on inside of us.
As you navigate life’s difficulties, no matter how hard things may get, make the commitment now to live and identify your personal reasons to do so. Additionally, identify suicidal thoughts as a sign to find a listener who you feel safe enough to talk to. It’s worth thinking about right now who it is you might feel comfortable turning to during your hardest times. By doing so, you’ll begin to build your own internal fence between you and suicide as well as have greater insight as to how to help others you care about to do the same.
* If you or someone you care about is currently having thoughts of ending their life, caring help is available 24/7 by texting 741741 from anywhere in the USA or you can call 1-800-273-8255 to speak directly with a Counselor from the National Suicide Prevention Lifeline.
About the Author: Laura Skaggs-Dulin holds a master’s degree in Marriage and Family Therapy from San Diego State University. She currently sees clients at the Spanish Fork Center for Couples and Families and at Encircle LGBT Youth and Family Resource Center in Provo
Divorce is hard. It is emotionally and physically draining for all people involved, including children. When a divorce becomes high conflict, children are caught in the crossfire and are treated as “prizes” to be won. Parents start pressuring their children knowingly and/or unknowingly to choose sides. These behaviors can escalate to “alienation”. Alienation is defined as a parent teaching their children to reject the other parent using fear (Templer, 2). Due to limited research, professionals often mistake alienation for estrangement. This misdiagnosis can have devastating effects on a family.
One misconception about alienation is that the alienated parent is responsible for being rejected by their child, whereas the alienating parent is considered to have little to no part in why their child is rejecting the alienated parent. Discerning whether a parent has been alienated or estranged requires specialized skills and knowledge. Unfortunately, many professionals who are assigned to such cases often have little to no training in this area.
Misconceptions about alienation prevent families from getting the help they need and can even have legal ramifications. Here are some examples of harmful misconceptions:
It is generally believed that if a child does not want to be with their parent it means they have done something to deserve it. However, the reason could be that the alienating parent programmed the child.
It is generally believed that the child would not align with the abusive alienating parent. However, children are vulnerable to manipulation. The targeted parent often tries to enforce appropriate discipline and fill the hole left by the alienating parent. In so doing, the targeted parent is looked at harshly and viewed as not respecting their child’s wishes and feelings.
Enmeshment (blurred boundaries between two individuals) can be confused with healthy bonding. When children feel that they are not recipients of unconditional love they can be manipulated into doing what the alienating parents desires.
Professionals who have these or other misconceptions may come to the conclusion that the alienating parent is stable, whereas the targeted parent is not; this instability, real or perceived, is often the result of depression, anxiety, and anger that’s developed from the trauma of being alienated. Another example is if the targeted parent is falsely accused of abusing their child; the parent may exhibit instability due to the fear being jailed, losing their children, or financial pressure. The unfortunate reality is that even strong, emotionally stable individuals may become anxious, depressed, and angry when under the pressures of alienation.
Mental health professionals play a critical role in high conflict divorce cases and have the power to make things much worse or better. Given the high stakes, families are encouraged to carefully select a professional with the proper skills and training.
About the Author: Carol Kim is a Licensed Marriage and Family Therapist who has spent the past 6 years practicing in several cities across the United States, including Boston, San Francisco, and now, American Fork. She is passionate about applying the principles of therapy to improve lives and relationships, and is committed to creating a safe, comfortable, and supportive environment. Carol specializes in individual, couples, and family therapy, and has extensive clinical experience treating depression, anxiety, ADHD, addictions, domestic violence, trauma, children/adolescents and relationship issues. She has also utilized her deep understanding of parenting and marriage to teach and facilitate community parenting and marital enhancement groups. Carol received her Master in Marriage and Family Therapy from Brigham Young University, where she was clinically trained and conducted extensive research in improving marital satisfaction. After graduating and before dedicating herself full-time to therapy, she was awarded the prestigious Kaiser Fellowship and worked for the San Francisco Bay Area’s most popular news station, KTVU, as a broadcast journalist focusing on mental health related issues. She is a member of the American Association of Marriage and Family Therapy and the Asian American Journalist Association.
Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.
If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.
Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.”
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed.
Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.
What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.
About the Author: Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing. Alberto has been been working as a Nurse Practitioner since April of 2013. In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program. He is currently working at the St. George Center For Couples & Families.
Adolescence is often described as a period of storm and stress – where children begin separating from parents, establishing their own identities, and discovering their sexuality. This development into junior adulthood coincides with myriad hormonal, physical, and emotional changes. In short, adolescence is difficult, overwhelming, and taxing. The fact that most kids make it through this critically important developmental period to be better human beings than when they entered is remarkable.
The fact that parents of adolescents make it through this period is nothing short of miraculous. And as if this period wasn’t hard enough, we now have to deal with smartphones – at the dinner table, on vacation, while they’re sleeping. Now we worry about cyberbullying, online predators, hundreds of dollars of in-app purchases from Clash of Clans to…SEXTING.
Sexting is defined as sending or receiving sexually explicit messages or images/video via electronic means (usually phones). My team at the University of Texas Medical Branch published some of the first studies on this relatively new behavior. While research in this area is still new, we and others have consistently shown that teen sexting is common and that it is often associated with real life sexual behavior.
Between 15% and 30% of adolescents have participated in sexting, with higher rates reported by older adolescents or when the sext is limited to just messages (no images). In my study of nearly 1000 teens, 28% of boys and 28% of girls had sent a naked picture of themselves to another teen. Nearly 70% of girls had been asked to send a naked picture.
Like all studies published on the topic, my research also shows that teens who sext are substantially more likely to be sexually active. Indeed, in a study published in the journal Pediatrics, my colleague and I recently found that teens who sexted were more likely to be sexually active over the next year, regardless of prior sexual history.
These statistics will alarm any parent. But should they? The short answer is “maybe.”
Let me begin by saying that I don’t want my kids sexting. That being said, most sexts are harmless in that they are seen only by the intended recipient and not the entire school, they do not end up on the internet, and they do not land the teen in jail. “Normal,” well-behaved kids sext, and accumulating evidence suggests that, when not coerced, sexting is not likely to have psychological consequences.
Furthermore, more teens are having real sex than are sexting. Thus, our priority should be promoting healthy relationships and teaching teens evidence-based and comprehensive sex education. Sexting education should be a part of this, but not at the expense of valuable information on the importance of delaying sex, and the prevention of unwanted pregnancies and sexually transmitted infections.
However, sexting can have disastrous consequences. So what should we do? Most importantly, we should talk to our kids and we should do so in a fully informed and honest manner. Approach this like you would a conversation about something as mundane as seatbelts. You probably would not tell your children that if they don’t wear their seatbelt they will likely die the next time they drive. You would probably say something like, “You’ll probably be fine if you choose to not wear a seat belt, but ‘what if?’” or “It only takes one time.” Similarly, we should not tell teens that their future is ruined if they sext. Instead, we can say, What if it does end up on the internet; what if someone forwards it to your teachers; what if your coach finds out; what if the college you’re applying for learns of this?” Adolescents are impulsive and moody and irritable and weird; but they are smart. We should treat them as such.
But what do I know? I have a 12 year old at home who knows everything and thinks I’m stupid. Wish me luck.
About the Author: Dr. Temple, a licensed clinical psychologist, completed his undergraduate degree at the University ofTexas-San Antonio and his Ph.D. at the University of North Texas. In 2007, he completed a postdoctoral research fellowship at Brown Medical School. Dr.Temple is an Associate Professor and Director of Behavioral Health and Research in the Department of Obstetrics and Gynecology at UTMB Galveston. He is a nationally recognized expert in interpersonal relationships, with a focus on intimate partner violence.
I’m often asked WHY cutters cut. For those that do not cut, they have difficulties seeing how something that appears to be so painful can cause a relief? It’s beyond their mind’s capacity to understand why someone would do this to themselves. The hardest part about trying to answer what appears to be a simple question is that there is not a simple answer. I’d like to take a moment to share with you what I have experienced as a clinician, what I have read from books, collected from research, and have heard from the mouths of my clients. Secondly, I’d like to share some basic tools or coping skills to gather and use as a lay person, a parent, a friend or a therapist. My greatest goal is that you build an ability to be open-minded to help those that are hurting.
Cutting is a form of communication. At the basics of cutting, self-harmers live in a world where they are either afraid to speak their true emotions, will be criticized if they do, or lack the ability to articulate their emotions. Our job as clinicians is to help bridge the gap. We must help our clients find a healthier coping skill, build verbal communication, and help mend emotional turmoil.
1. First, we must assess the cutters. Most cutters cut to avoid suicide. This is a very important concept we must teach the parents’ of cutters. However, there is a small number that actually have suicidal ideation while cutting, and an even smaller number (4%) that have actually died from self-harm. If this is the case, it is important that we refer our clients to the nearest hospital and make sure that their families are aware that they must be under greater supervision than one-hour a week therapy sessions.
2. We start to help our clients to build a vocabulary list of emotions felt before, during and after conflict-cutting.
3. We help them go over coping skills that can be traded for cutting. We need to help our clients heal the internal and external pain. We must be compassionate for each client will have a different reason for cutting. ‘I want to feel alive’, ‘ I want to stop the bad feelings’, I want to feel numb’, ‘It makes me feel numb’, ‘It’s my way to avoid people, punishment, consequences’, ‘It’s my way of control’, ‘I’m bored’, ‘It’s my way to punish myself’, and/or ‘I want to be paid attention to’. If we can understand their pain, we can help our clients communicate that to those around them.
For parents, some basic tools include opening lines of communication, listening to your child, not judging, not giving ultimatums/threats/punishment, help aid their cuts and provide medical assistance if needed, and help them find professional help to process their pain/emotions. Most importantly, for a parent to remind their child that they deserve to be happy and that you are trying to be there for them, not against them, could be most beneficial.
For the therapist/clinician, starting off with an impulse-control log, can help your client start to document how often, where, when, with what tool, and emotions attached to the behavior. You can also help start to identify some healthy coping skills including writing, drawing, music, physical activity, art, meditation, etc. One of the greatest tasks as a clinician is to help the client vocalize their emotions to their parent and to get a response that will not only verbally and emotionally be a safe response, but physically. Most of our clients lack a relationship of verbal comfort or even physical comfort (hugs). It can be a long process for clients that are fearful to open up. We must instill safeness again and remind our clients that their current level of coping is not healthy for themselves or their families.
Cutting is a topic that some clinicians stay far away from and that parents are highly fearful of. I want to remind both clinicians and parents that suicide is not the ultimate goal for cutters. I want to demystify the behavior and build a sense of clarity and compassion for those who are fighting the battle and those that watch the fighting battle. For ‘self injury is a sign of distress not madness’. – Corey Anderson
Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Mental Health of America: www.mentalhealthamerica.net
Cornell Research Program on Self-Injurious Behavior in Adolescents and Young Adults: www.crpsib.com/researces.asp
S.A.F.E. Alternatives (Self-Abuse Finally Ends): www.selfinjury.com
Self-Harm: Recovery, Advice and Support: www.thesite.org/healthandwellbeing/mentalhealth/selfharm
Self-Injurious Behavior Webcast: www.albany.edu/sph/coned/t2b2injurious.hmt
Christianity Today: www.christianitytoday.com/cl.2004/005/29.18.html
American Academy of Child and Adolescent Psychiatry: www.aacap.org
Strong, Marilee (1998). A Bright Red Scream. New York, New York: Viking Press.
Conterio, K. and W. Lader, Ph.D. (1998). Bodily Harm. The breakthrough Healing Program for Self-Injurers. New York, New
The Prevention Researcher. Parental Guidelines for Preventing and Constructively Managing Inevitable Self-Injuring Slips, 19, February 2010
About the Author: Jamie Porter has a Master’s degree in Marriage & Family Therapy from UHCL. She has worked in non-profit settings working with women, adolescents, children, families, couples, and equine assisted psychotherapy. She is currently the Sugar Land Center for Couples & Families office manager, and an AAMFT approved supervisor.
NETWORK OF THERAPISTS
Our network of effective, friendly & credible therapists is unparalleled. Each specialist has been individually selected & approved by our team of therapy & training experts.
We’ll prove to you that the results, our ethics & our standards for exceptional therapies & services will go above and beyond your expectations. Guaranteed.