In your book, you share how you lost your brother to suicide. How did his loss impact you?
I was gutted when David took his life. Like many traumatic events, I can recall every detail of that day. I lost my closest brother and my longest friend. It was an irreplaceable bond. My life’s trajectory shifted seismically that afternoon, and every meaningful decision that I have made in the past seventeen and a half years has been impacted by his absence.
How did this experience impact your thinking?
My last response stated that I have been impacted by his absence. Truthfully, that absence is an enormous presence. Presence and absence are the same thing if we pause and absorb the concept. My loved one is absent yet I can find him in any moment of my life (I’m talking about him right now). I cannot share an experience with him, but I can insist on a meaningful interaction with whomever I am spending time with. This includes spending time with myself. His absence has sharpened my attention to life and I am flooded with the opportunities in front of me.
How is your approach to suicide prevention different from other models?
I think that many well-intended survivors of suicide loss try to attach meaning to their grieving process, and my approach began as a massive projection of my experiences. I was quite irritated at the research and programming that was geared toward recognizing signs and symptoms of suicide. It simply didn’t resonate with me. Does a person have thoughts and behaviors that can be described as suicidal? If so, what happens next? I see most symptom reduction models as an extension of a medical model where we identify symptoms and then try to reduce/eliminate/treat them. Paradoxically, I believe that the medical model is stigmatizing and reinforces the notion that suicidal thoughts and actions are aberrant.
Living Ideation is a philosophical approach that is deeply rooted in Constructivism and Existential thought. If we recall the concept of presence and absence, suicidal ideations are a dearth of living ideations. Perhaps the expansion of living ideations can reduce the existence of suicidal ideations. Please know that Living Ideation is not meant to be a Pollyanna approach that says “just look at the bright side!” Not even close. Look at the dark side and get to know it. It exists because of the duality with the light side. It simply acknowledges that dark and light coexist. Both suicide and life have presence and absence.
Living Ideation is a suicide prevention and intervention model that acknowledges pain and non-pain. Having empathy for pain and despair can illuminate the rooted feelings of love and hope. The complimentary emotions can promote cognitive dissonance; at least love and hope have a fighting chance to compete with an abundance of pain.
Can you share what you’ve learned about the various mindsets people have when they are experiencing suicidal thoughts?
For the sake of this interview, I am oversimplifying a suicidal mindset to be pain. Life has varying degrees of pleasure and suffering, and if a person was dominated with perceptions of emotional/physical pain, then eliminating that pain seems logical. Western civilization and thought have not done many favors to those who experience pain; the stigmas associated with suicide are absolutely brutal. Selfish, cowardly, weak, sinful, etc.
Consider this: if your loved one was immersed in pain, if they could only perceive darkness, and if they were certain that the future would be more of the same, wouldn’t you hope for their peace? I can’t think the injured are trying to cause anyone else pain as much as they are trying to bring silence to their own.
What do you believe is most important for behavioral health providers to keep in mind when it comes to working with someone who has suicidal ideation?
I really want to remind all of the behavioral healthcare providers reading this that they are the right people for the job. If you have made it this far in your education and career, then you must have a beautiful desire to help others. Please keep honing your natural skills for connection and service. Be congruent while being curious.
Carl Rogers was spot on with the concept of Accurate Empathy. As health providers, we have the opportunity and obligation to connect with heartfelt intent. We want to know as much of our client’s pain as possible so that we can get into the experience with them. Connectedness is a possible way out of pure pain. Foxholes are built for two soldiers to reside in; so are counseling relationships.
Quick example of work with a person who has been through too damn much:
Client: “I’ve seen and done so many awful things, and nobody understands it. I can’t escape the pain. I’m cursed.”
Therapist: “I want to try and understand as much of your experiences as possible. If you think that you’re cursed, please know that I’m not, and I want to work on this with you.”
That quick example is intended to remind us all that we have opportunities to connect with the living. We can help others find their way through pain and reinvent non-pain.
In your personal and professional experience with suicide what have you learned about grief?
Grief and love are the same thing. It wouldn’t hurt so much if you didn’t miss them so much. You couldn’t miss them so much if you didn’t love them. Here in lies love’s curse; if you can love with great ability, then you will hurt with equal ability.
When I think about my brother, or anyone else I have lost, I ache. I also smile knowing that I still love them very much. This translates to the present moment where I have limitless opportunities to experience newness. My appreciation for my memories fuels the present moment.
In that same vein, what have you learned about family dynamics after a loss by suicide?
I learned first hand that such a loss imposes new roles and responsibilities within a family or system. Recognition of the new roles can create opportunities for intentionality. I was the youngest of four boys, and after my brother’s death, I found myself in more of a patriarchal role. I was decisive with protecting David’s reputation. I also reexamined my newer opportunities to be a husband and a father. This is in step with Living Ideation. I consciously search for meaningful interactions that would create a future filled with substance.
My research and professional experiences revealed that there are some productive pathways for those grieving suicide loss. These families had peaceful intentions, open-minds, and an insistence of unity. Simply, these families wouldn’t quit trying to find a new normal. Conversely, when family/systems hold grudges, withdraw, and maintain stigmas, they deteriorate quickly.
In what ways do you think we can improve prevention efforts?
Prevention. Prevent what? Suicide, pain, despair, death? We forget that we get to work with the living. Imagine assessing and focusing on the promotion of living. I believe that we all have basic needs and desires in life; we can foster those and compete with the deficits. Consider wildfire prevention for a moment. There are plenty of ways to prevent and suppress wildfires. The best approach is to promote a healthy ecosystem. Why not do the same with human beings?
Obviously, I am biased. I think that before we insist on ruling out darkness, we should assess for light. I think that our helping professions have over-corrected in our efforts to reduce suicide, and I think that we have neglected so many opportunities to promote growth and wellness. The illness reduction models focus on signs and symptoms of depression, trauma, anxiety, etc. We assess for the presence of diagnoses well before we assess for protective factors that can be expanded upon.
As you look at current data on suicide, what do you think is important to focus on when it comes to treatment and prevention?
I believe that prioritizing connectedness within the various levels of our community is paramount. This translates to a focus on:
- family groups
- peer support networks
- funding and programming for health and community agencies
- government (local, county, state, federal) initiatives to promote social programs that help those in need.
Is there anything else you feel is important for our readers to be aware of?
Please remember the duality of pain and non-pain. Embrace them both so that they can freely blend in to a full experience. Suicide awareness and prevention is as important to consider as the awareness and promotion of living.