Talking about Suicide
This morning our little community of Stone Oak in San Antonio, Texas was devastated by the news of an 8th grade boy who, last night, took his own life.
I am a trauma-informed trained crisis counselor who works with many of the youth in our community. This one hits particularly close to home. While I don’t know the family personally, I know many people who are connected with them or to them in some way or another. The kids in our community, whether they are ours or friends of our children, are all of our kids.
As our community grieves, I want to give parents and kids some resources and ways to open up dialogue and communication in your own home about this often-silent topic.
Here are some tips for parents to talk with your kids about suicide:
Use the word: When you talk about it, use the words “suicide” and “killing yourself.” Be direct with your child. Don’t circumvent the issue. Don’t say, “Have you ever thought about, you know, doing something to yourself?” Say it out loud. The words make it real for everyone.
Ask: The National Suicide Prevention Lifeline recommends the following questions be asked to address current suicide ideation or intent (commanly referred to as S/I): Are you thinking of suicide? Have you thought about suicide in the last two months? Have you ever attempted to kill yourself? As uncomfortable as these questions can be to ask, they are important ones. It’s also important to ask if they know of people or friends that talk about suicide or ending their lives.
Be prepared: If your child answers “yes” to any of the three questions, take it seriously. It is not a ploy or gimmick for attention. I can’t tell you how many parents I have had call me over the years tell me “I think they are just attention-seeking.” If your child tells you they have thought about killing themselves, believe them.
Check-In Often: Things change on a dime in a child or teenager’s life – friendships shift or end, romantic relationships go awry, pressure for grades can mount, peer-pressure, feeling like they don’t fit in or have a purpose…..there’s a litany of things that can pile on, and fast. Talk with your child about their goals, how they feel about the changes in their life, and what pressures or stress they are currently feeling.
Seek Help: If you think your child is depressed or has changes in behavior, contact a professional immediately. Don’t wait to see if it “blows over” or “is just a phase.” A counselor that specializes in depression, self-injury and one that has crisis and suicide experience is important.
Listen: Someone asked me today what the signs are for someone in trouble. The answer to that is……there is no perfect formula or way to know exactly. Sometimes there are whispers. Sometimes there are screams. Often there is silence. Watch for all three, along with the below warning signs.
The National Suicide Prevention Lifeline has the following list of warning signs to help determine if a loved one is at risk for suicide:
– Talking about wanting to die or kill themselves
– Looking for a way to kill themselves, such as searching online or buying a gun
– Talking about feeling hopeless or having no reason to live
– Talking about feeling trapped or in unbearable pain
– Talking about being a burden to others
– Increasing their use of alcohol or drugs
– Acting anxious or agitated; behaving recklessly
– Sleeping too little or too much
– Withdrawing or isolating themselves
– Showing rage or talking about seeking revenge
– Displaying extreme mood swings
I give my clients (teenage and otherwise) the following resources to plug into their phones:
National Suicide Prevention Lifeline: 800-273-8255
24/7 Crisis Text Line: Type “Hello” or “Hi” or “I’m Here” to 741741 and a Trained Crisis Professional will respond instantly.
Keep the dialogue in your home open. Let’s reach out to those that feel alone, hopeless and desperate. Talking about suicide is uncomfortable and painful, but necessary. And could save someone’s life.
Before You Go To Therapy……
So you’ve decided to go to therapy. Congrats on making such a big decision, and giving the gift of “you” to yourself! Of course I’m biased, but I believe therapy is one of the greatest things you can do for your overall health and wellness.
Finding a therapist can be daunting, and oftentimes people aren’t sure how to begin the process – or they give up before they make a first appointment. Here are some things to consider when searching for a therapist:
Shop Around – You shouldn’t make an appointment with the first therapist you Google. Ask around for reccomendations in your area, either from friends or your primary care physician. Research a few different therapy websites to read about what kind of client they serve and the type of therapy they offer. Talk to a few for an initial free phone consultation (I give a free initial 15 minute one).
Get the Deets – Does the therapist take insurance, or are they cash-pay only? Do they offer after-working hour and weekend appointments, or M-F, 8-5 only? Do they see children under 18 or only adults over 18? Do they have specializations or certifications in an area that you are seeking, such as addiction, play therapy or hypnotherapy? Do you have to travel into their office, or are they willing to come to you or do video/phone sessions? Find out as many details about the practice as you can so you can ensure a good fit for your needs.
Commit – Therapy is a process, and not always a quick, one-or-two session fix. Therapy takes time and money, so be sure you are willing and able to commit to regularly, scheduled meetings for a few months (or more, depending on the issues). Teenagers and children especially benefit most from consistently scheduled appointments.
Do the Work – Anyone that comes into my office will be told this: I’m one hour of your week. There are 167 others. So if your therapist gives you readings to do, assignments to compete, or activities to participate in – do them. It’s all part of the work that needs to be done out of the therapy appointment time, and to maximize the overall success of your therapy.
Change – Much like a doctor, lawyer, or hairdresser, sometimes the therapist you try simply isn’t the right fit for you. That’s ok! Therapy will only work if you feel you can work with that person, so don’t be afraid to stop services with one and get referred elsewhere.
Give Feedback – Some of the best work I’ve done with clients were the ones who were truthful when I asked them, a few sessions in, how they thought therapy was going. Your therapist wants your feedback and honesty to ensure your are getting the most out of your therapy time. If your therapist isn’t working on the things you want or need, or you feel stalled – tell them! The best clients I have give me feedback on what they think is or isn’t working for them during our sessions.
I hope this helps in your search for a therapist. Best of luck!
Blog Post: Happiness isn’t a Goal…It’s a Mindset
It’s 2018 and everyone is talking about their New Year’s Resolutions. Regardless of the time of year, I always ask clients to tell me a few goals they want to work on in therapy. Of all the goals people state, one of the most common ones I hear is this: “I just want to be happy” or “I want my kid/spouse/marriage/parents to be happy.”
When clients say that, I know therapy most likely will not give them what they need. Because happiness isn’t a goal. It’s a mindset.
I think a lot about happiness. I talk at length about it with my clients ranging in age from 10 – 91. What differentiates happy people from ones that are not? How can we be happy when we are in the midst of a personal crisis? How can depressed people be happy? What is happiness and how can we measure or judge it?
While the answer to happiness is far from simple, and it’s different for everyone, there are a few things to think about regarding happiness….and how to make it a mindset, not simply a goal:
1) Manage expectations – Remember Prom? Or Homecoming? Or New Year’s Eve? Probably wasn’t as great as you thought it was going to be, right? Sometimes, we need to manage our expectations. Focusing on the small, funny, happy moments even if a night or big event goes awry can put a positive – and fun – spin on things.
2) There’s no Magic Happy Pill – Many clients expect happiness to appear out of thin air. I hate to tell them this, but it doesn’t. That’s not how happiness works. I recently had this discussion with a client who told me she was “waiting to be happy.” My answer to her was, “You’re going to be waiting a long time if you think happiness is just going to show up.”
3) Look for the Small Things – Often there is happiness or joy all around us. We just sometimes miss it because we are too wrapped into our own thoughts and our state of mind gets in our way. For instance, at the airport in California where I began writing this post, I observed an elderly couple holding hands. I saw a young child wearing his Disneyland sweatshirt and clutching a stuffed Mickey Mouse, his eyes still wide with the wonder and excitement of his magical vacation. I could have chosen to focus on the traffic and crowds and other common annoyances of traveling, but I was too busy focusing on the positive things all around me.
4) It’s Not Up to Other People – Rule number one is that happiness needs to come from within. Expecting others to be that source is simply setting yourself up for failure. Of course, we derive great happiness from our personal interactions and relationships, but those cannot be the sole source. Being happy with ourselves means accepting the good, bad and ugly of ourselves, and realizing that at the end of the day, our state of “happiness” is up to us – and only us.
5) Not Every Moment of Every Day is Happy – and That’s OK. We live in a world where we literally have a front seat to everybody’s lives on social media. And I always, always remind my clients that no one posts the bad stuff. Case in point: a client told me about a friend that was posting amazing holiday pictures – family at church, everyone in matching pajamas on Christmas Eve, opening presents, everyone smiling and happy. When she spoke to that friend, she learned about some of the fighting and things going on all while those “picture perfect” photos were being snapped and posted. We carefully edit and delete the bad pictures, the imperfections, the out-of-focus shots. No one is happy 100% of the time. No one.
6) Focus on the “Happy.” – One of the exercises I utilize in my clinic is asking clients to state the “highs and lows” that occurred since our last session. I usually ask for at least three each. When clients tell me “there were no highs” I don’t let them off the hook. I ask them if they saw any friends, did anything fun, at at a restaurant they like, had a text from someone that made them laugh. Focusing on the positive, no matter how miniscule it may seem, can slowly, over time, help shift our mindset.
7) Surround yourself with Happy People – Let’s face it – hanging out with Debbie Downers all the time can have a domino effect. Think about the happiest friend or family member or co-worker you know. Be around them more. Pull back from the people in your life that constantly emote negative energy.
How to Choose a Counselor for your Child
School is out for the first semester, and maybe your child is struggling with a transition or an issue that needs some outside help. That’s when a counselor might be the answer. A good counselor can help someone work through challenges, problems and sorting out life’s pressures.
There are some important things to consider when choosing who will work with your child. Make sure you have an initial phone consultation with any potential counselor and find out the following:
1) Availability – Some counselors book appointments only during work hours, and others offer weeknight and weekend hours to accommodate school, sports and other activities. Some counselors offer in-home or distance counseling options as well.
2) Specialization – Make sure the counselor is adept in the specific area you need. Does your child have anxiety, depression or a substance use issue? Do you need someone with experience with eating disorders? Children under age 10 usually benefit from someone who is a Registered Play Therapist. Ask a counselor upfront about their area(s) of specialization.
3) Payment – Find out about the payment options offered by the counselor or counseling practice – do they take insurance or are they cash-pay only? And what payment types are accepted? Some counselors (such as myself) offer discounts for military or first responders. I also offer discounts for multiple, pre-paid sessions. Don’t be afraid to ask if there are options for discounts.
4) Consistency – The therapeutic process is maximized when there is consistency. Make sure you are willing – and able – to commit to a regular appointment schedule. Oftentimes, people make the mistake of thinking that one or two appointments here and there are enough. A lot happens in the weekly life of a child or teenager! Regular, scheduled appointments will help bring the best results.
5) Credentials – Be careful with this one. Vet the credentials of any potential counselor. Some people take “online certification” courses and call themselves a counselor. Make sure yours holds a minimum of a Master’s Degree and is licensed to practice in in the state where you live. You can verify credentials at any Department of State Health Services’s website.
Above all, make sure your child is comfortable with the counselor they visit. The therapeutic relationship will work only if your child feels the counselor is someone they can work with and confide in. Good luck with your search!
Blog Post: A Letter to My Addiction Clients
Dear Addiction Client,
I am writing to tell you a few things that were on my mind after our last session – actually, things that have been on my mind since the first time you walked through my door.
I can always tell when you are lying to me. Believe me, I’ve heard it all. You’ve been lying to yourself for so long that I know at this point, even you may believe the stories you tell. But I don’t. And the people around you that know you even better than I do better don’t believe you either. Beginning with the truth is a first and crucial step on your journey to recovery.
Show up for your appointments. You are wasting money if you don’t show up. And show up consistently, and on time. The only way you are going to get better is with consistent and continual therapy. Showing up for appointments holds you accountable, and forces you to be responsible.
Oh, and besides the importance of showing up for appointments……don’t show up high. Truly. Just don’t. It’s not funny, or cute or anything else. It is disrespectful to me and my time. And it is disrespectful to you and your time. You’ll never get anything done in that session – anything that you remember. Plus, I’m not going to let you drive home so besides the money you waste on the hour of therapy….you’ll also have to have an Uber to drive you home, or someone come pick you up.
If you were voluntold to come to therapy, that’s ok. Don’t be angry about that. Someone in your life loves you and is desperately trying to get you the help you need. Be glad there is someone that still cares enough about you at this point to try and get you some help. Because trust me: soon, if you don’t get serious about your recovery, they will get to the point where you will lose them forever. And they’ll be gone. Think about that while you complain about them to me. Picture your life without them for a
No one is going to do the work for your recovery. That comes from you. Not me, not your mom, dad, grandma, grandpa, aunt, uncle, daughter, son, girlfriend, boyfriend, cousin, neighbor, Pastor, Rabbi, partner, friend or spouse. You will most likely have the support of one or more of those people I just named, but you and only you are responsible to do the actual work. Period.
Do I sound like I’m being hard on you? I am. I want to help you, and I want you to get better. I wouldn’t be doing my job if I don’t call you out from time to time. I know you are hurting. I know addiction is a beast to overcome. But you can fight it. I’ve seen people fight tooth and nail for their recovery. It’s possible. Anything, anything you want….it’s possible if you want it bad enough.
Recovery can happen. It can. I know you don’t think that now, and it feels like everyone is against you and the world is a hopeless place…..but stick with me. I believe in you. I know you can do it, you just gotta dig down deep and do the work. I have seen nothing short of many miracles in the time I have been working with people in addiction. I’ve seen people hit rock bottom and come back stronger and better and totally opposite of how they were before.
I can’t wait for you to re-read this letter once you’re in recovery. Do me a favor, and let’s read it together. It will be the biggest gift to me as a therapist, to see how far you’ve come.
Thanks for listening. You mean a lot to me, and I know you mean so much to the people in your life. We all want the best for you. Nothing more, nothing less. Just the best.
I’ll see you next session.
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