An Ethic to Live: Building Barriers to Suicide Around Ourselves & Those We Love

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. 

Bio: 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.  

Looking for Happiness and Finding Addiction

Our community is the epitome of mainstream America. We have deeply rooted family values, safe streets, moral standards, and most families stand guarded against outside influences that threaten our happiness. Recently, however, Utah achieved the 7th highest drug overdose rate in the nation. How can a community named Happy Valley have some of the highest rates of adult mental illness and teenage suicide in the country? 

Treating addiction is clearly a necessity. However, explaining these alarming and confusing statistics may also come down to understanding some myths, or assumptions, about happiness.  

Myth No. 1: I Should Be Happy All the Time 

Some aspects of our local community amplify and reinforce the well-intended message that “good people” or “my kid” should not or would not encounter pain. At times, we may even feel entitled to getting our way and therefore feel betrayed when we stress and we encounter unwanted but normal life struggles. These challenges show up as: loneliness, divorce, work stress, relationship issues, domestic violence, bullying, prejudice, low self-esteem, and chronic pain to mention a few.  

Myth No. 2: If I’m Not Happy, Something is Wrong with Me 

For decades, mental health symptoms have been twisted and misunderstood to the point that painful or overwhelming thoughts and feelings are now presumed to be products of weak, faulty, and unworthy minds. Labels like ‘Anxious’, or ‘Addict’ are now used so frequently and in such negative ways it distracts us from the real issue at hand. Those labels not only build a wall but also mask the reality that we all struggle in similar ways. Combine these objectifying terms with a competitive culture this myth grows more powerful and exponential.  

Myth No. 3: For a Better Life, I Must Get Rid Of Negative Feelings  

Every single one of us experiences self-judgment, fear, and shame of not measuring up. It can be overwhelming and discouraging. Unfortunately, we live in a culture that promotes numbing and hiding as the solution to any pain or discomfort.   

Anger, over-working, blaming, over-booking schedules, and isolation has been dependable sources of distraction for years. Some argue how safe and how little impact these behaviors have on themselves and others. Ironically, they assume that dependent or ‘addictive’ thinking and behaviors are only appropriate if describing illicit drugs and alcohol. Recently, more camouflaged options like sugar, caffeine, over the counter medication, smoking, power drinks, and trendy diets have become legal and justified ways to remedy unwanted thoughts or deal with social pressures. All of these behaviors, and others, are designed to alter reality, enhance social performance, and reduce stress. Unbeknownst to us, we end up trading one form of addiction for another.  

Everyone considers himself or herself an unwilling and/or unaware accomplice and each would avoid the road of undue suffering if possible. Here are three practical take home ideas that can help you start breaking yourself free from the shackles of these myths and identify and strengthen your core values so you can stay connected with reality.  

  1. Take time and energy to notice core values that you have and may share with others. Write down and/or share thoughts, feelings, and memories that help identify and strengthen your core values. Yoga, meditation, and other quiet activities will improve focus and self-awareness. 
  2. Compare less. Look for opportunities to learn about and accept the uniqueness of others. Admitting and accepting our weakness and vulnerability to others actually creates meaningful emotional and social bonds.  
  3. React less. Take a deep breath and refocus values that you can practice today.  

All of us long for acceptance, empathy, and connection from others but sometimes get stuck in the attractive web of addictive behaviors. If help is needed, reach out to others or professionals. Enjoy the search for happiness in the everyday pursuit of values, not distractions.  

Behavioral Health: Integrated Care and the Future of Whole-Person Treatment

The term behavioral health has gained exposure and popularity more recently, particularly among medical providers and those involved in healthcare reform in the United States. Burg & Oyama1 define behavioral health as, “the psychosocial care of patients that goes far beyond a focus on diagnosing mental or psychiatric illness… [encompassing] not only mental illness but also factors that contribute to mental well-being”. This is the first of a series of articles which will introduce essential concepts and goals for integrated behavioral health treatment.  Why is this important?  The correlation between comorbid mental health and medical issues has mounting evidence for impacting healthcare cost, treatment outcomes, and patient satisfaction.  Comorbidity in this sense refers to the presence of two co-occurring issues influencing the progression and prognosis of either condition.  Well researched comorbid conditions include diabetes & depression2asthma & anxiety/panic3, and chronic pain & psychosocial issues4.  The good news is we are learning innovative ways to effectively treat comorbid conditions concurrently, thereby increasing the likelihood of successful outcomes and improved quality of life for patients. 

The sustainable future of healthcare in the U.S. will likely require efforts to improve consultation/communication, cross-discipline competency, and collaboration among clinical teams.  Traditionally, mental health specialists (i.e. psychologists, LMFTs, LCSWs, LPCs, CMHCs, etc.) have operated in relative isolation from the medical community.  Aside from psychiatrists, who are primarily trained as Medical Doctors (MD), many practicing psychotherapists have minimal training in the biomedical model of treatment.  And the inverse is true as well, wherein medical practitioners often have limited understanding of psychotherapeutic theory, psychosocial problem etiology, and effective behavioral intervention.  This is exceptionally problematic for the patient because practitioners involved in treatment may have dramatically different, and often conflicting, beliefs about mental health problems and their respective solutions.  Sperry5  suggests, “the goal of health care integration is to position the behavioral health counselor to support the physician… bring more specialized knowledge… identify the problem, target treatment, and manage medical patients with psychological problems using a behavioral approach”.  The future of medicine may very well be found in systems which prioritize such supportive collaboration, encourage patient-centered policy, and deliver on whole-person treatment options.  

Hopefully this educational introduction to behavioral health integration can serve as a starting point for further interest and exploration of the topic.  While this is a relatively new concept, I predict we will see a dramatic increase of integrative efforts emerge over the next several years as clinicians, administrators, policy makers, and third-party payers (i.e. insurance companies) recognize the cost-effectiveness and clinical efficacy of interdisciplinary collaboration.  We do not live our lives in a vacuum, and our problems are rarely isolated conditions in themselves.  Therefore, we will need innovators across various disciplines to create efficient and effective systems which benefit all parties involved with the daunting task of healthcare reform.  As patients, we can empower ourselves with education about how the biopsychosocial model might positively influence our role and options in treatment.  So, the next time you are at the doctor’s office and they ask you questions about mood and/or behaviors, and you think, “What does this have to do with my medical problem?”, now you’ll know.   

References 

1.Burg, M.A., & Oyama, O. (2016).  The behavioral health specialist in primary care: Skills for integrated practice. New York, NY:  Springer Publishing Company.   

 

  1. de Groot, M., Golden, S.H., & Wagner, J. (2016).  Psychological conditions in adults with diabetes. American Psychologist, 71(7), 552-562.    

 

  1. Ritz, R.,Meuret, A., Trueba, A.F., Fritzche, A., & von Leupoldt, A. (2013).  Psychosocial factors and behavioral medicine interventions in asthma.  Journal of Consulting and Clinical Psychology, 81(2), 231-250.  

 

  1. Gatchel, R.J.,McGeary, D.D., McGeary, C.A., & Lippe, B., (2014).  Interdisciplinary chronic pain management.  American Psychologist, 69(2), 119-130. 

 

  1. Sperry, L. (2014). Behavioral health: Integrating individual and family interventions in the treatment of medical conditions.  New York, NY: Routledge.  

 

How do I Get My Husband to Come to Counseling?

Counseling, if done right, is husband friendly! Find the right therapist and you’ll understand. The problem is that many husbands worry that the therapist is going to take their wife’s side and gang up on him, or that therapy will be uncomfortable. While the latter may be true, the former isn’t. A good therapist doesn’t take sides or act as a referee. I have had many couples want to hash out an argument in front of me in counseling so that I can tell them who is right. I stop them, and explain that even if one of them ended up right, that they would be so wrong in their rightness – their marriage would suffer because they insisted on being right instead of compassionate and forgiving. A good therapist, rather, is able to foster healthy interactions between spouses so that they both feel safe and are able to be vulnerable and genuine with each other. When husbands understand that what they feel and think is important, then they are more willing to make this uncomfortable leap with their spouse. Women are more likely than men to initiate therapy, but without buy-in from the man, it is difficult to be successful in therapy. My suggestion to women who want to initiate counseling, but have a reluctant spouse is to recognize that this is scary for your spouse. They may feel as if they will be attacked, or worse yet, that they will lose you. Help them understand that your desire for counseling is because you love him and because you want this to work – but aren’t sure how to make fix it. Ask him to give therapy at least 3 sessions – after that, if he still feels reluctant there might be another counselor or approach that you could try. Most men feel better about therapy after at least 3 sessions if you have the right therapist for you.

 

Originally published on www.tristonmorgan.com

 

The Secret of Pornography

Secrets fuel addiction. As I’ve mentioned before in previous posts, addictions, such as pornography addictions, are a shame-based experience. This means that when someone uses pornography they feel as if they are a bad person, rather than feeling that they are a good person despite making a mistake. When someone feels shame, they often compartmentalize what they have done – they hid it and separate it from who they think they really are, or, think that that mistake totally defines who they really are.

This is where secrets come into play. Over time, a man (or woman – I’ve worked with both in therapy for pornography issues) who has been using pornography and feeling shame because of it will gather many secrets. He won’t want to tell anyone what he is doing, or won’t want to tell them all that he is doing. He might only present the best parts of himself or just tell enough about his mistakes to others to appease them or to feel like he is being open. But, in fact, he is keeping secrets. These secrets start to bury him and make him feel more shame. They take an effort to maintain and keep hidden. They cause him stress and to feel disconnected from others. All of these things can lead to more addictive acting out.

Being transparent is key. This, in part, is why in the 12-step model of recovery (for alcohol, sexual addiction or substance addiction) addicts are asked to write a fearless moral inventory and to share it. Being open with others can feel uncomfortable and embarrassing. Many would say, “It’s in the past – let it stay there” or, “I don’t want to hurt her, so I’m not going to tell her about it”. These mindsets only make things worse for someone using pornography and their spouse/family. Telling others and being transparent is on the path towards recovery.

Pornography counseling offers a venue to be transparent and honest with yourself and with your loved ones. A good therapist will help you through this process in a way that might be painful, but certainly not shameful.

Originally published on www.tristonmorgan.com

 

When the Holidays Hurt

For many people, the holiday season is a time of joy and magic, a time where people relive and create happy memories. They are moments of joyous gatherings filled with love, laughter and crowded tables. But if you are not one of those people, the holiday season can be very difficult to endure. For individuals who have experienced the loss of a loved one, abuse in childhood, or another tragedy or trauma, the holidays just remind you of that loss and pain. Your days may not be merry and bright. Your days may feel more gloomy, more isolating, and you may feel more disconnected from the world around you.  

The holidays are here, and the holidays can hurt. 

Maybe it’s because of the chairs that will be empty or the phone calls that won’t come. Maybe it’s the time off from work that allows you to think about your life and feel the pain. Maybe it’s the reminder that all of your holidays your whole life were negative and filled with dysfunction and abuse. And maybe it’s the perception that everyone else has the picture perfect holiday gatherings with all their loved ones. Whatever the reason may be, a heavy sadness can take hold of you and you don’t know how to shake it off.  

For many of us, depression, grief, and sadness are constants and we get used to fighting them off and keeping them at bay. There’s nothing like the holidays that make you feel like you not only have to have it all together, but you have to wrap it up with a bow and display it for the world to see.  

If you happen to be hurting this holiday season, I’d like to offer some helpful advice. 

Let it hurt. Allow yourself to feel the pain and allow it to come fully without altering or inhibiting it. Life is difficult and painful sometimes and it is okay that you are not okay during this time. You don’t need to pretend that you are. Emotional reactions are expected and there are no right or wrong feelings.  

Don’t hide it. Be as authentic as you can with the people you are closest to. Allow people who love you to be there for you and support you in your time of pain and distress. Let them see you and know you–not an edited, “better” version of yourself.  

Today is really just another day. Don’t fool yourself into thinking that it must be the most wonderful time of the year. It doesn’t have to be, and it clearly isn’t that this year.  

Practice self care. Be aware of yourself and what you’re feeling and if something is triggering and overwhelming.  Allow yourself to disengage or leave a painful situation and attend to your pain. Only you truly know how you are feeling and what your boundaries and limitations are. Be true to yourself.  

Embrace this holiday as-is. You may feel overwhelmed and in pain, but there is still goodness to be experienced, even in the pain. There will be holidays in the future that are lighter and happier, and these difficult days are part of the healing path to get there.   

New traditions. New traditions can be healing and can help you create better connections to the loved ones in your life. If you have survived the loss of a loved one you can start a new tradition that symbolizes letting go, such as sending balloons or floating lanterns in the air. 

Above all, know that is okay to be blue during the holiday season.  

If you need someone to talk to you can contact the Center for Couples and Families at (385) 312-0506, text  HOME to 741741 to reach the crisis hotline or call the suicide hotline at 1-800-273-8255. 

 Originally published on Utah Valley Health and Wellness Magazine

CCD Smiles: One in a million

I am the only one in my family with CCD (Cleidocranial Dysplasia), which was a random mutation. Having CCD influenced my studies and career choices. I have always been fascinated by the body, genetics, and helping others with physical or emotional health problems. I started my career as an emergency room registered nurse. I did my Master’s thesis on CCD and then went on to obtain a Doctorate in Nursing Practice (DNP) degree. I have been a nurse practitioner for the past 14 years, working in family medicine and mental health. My background in medicine helps me better understand CCD. I want to share my experience and medical understanding with others.  

I was born in Reedley, California in 1975. When I was born, it was obvious to my parents and doctors that something was wrong. My body, mostly my head, was shaped differently than a “normal” baby’s. At 3 months of age, I was diagnosed with Cleidocranial Dysplasia. 

I grew up knowing I was different. The most difficult part of CCD was all the oral and facial surgeries. My baby teeth never fell out on their own, my permanent teeth didn’t grow in on their own, and I had several extra teeth which had to be surgically removed. Everything in my mouth had to be done manually. I started having oral surgeries at age 7 and I spent most of my Christmas, Spring, and Summer breaks undergoing surgery. My last major surgery was when I was 19 years old. 

 CCD dental treatment was not easily navigated. My dentists, orthodontists, and oral surgeons had never treated anyone with CCD. Everything they tried was experimental. 

Medical insurance and dental insurance did not cover the cost of my surgeries. Medical insurance considered my teeth problems to be dental. Dental insurance considered the surgeries cosmetic. My parents were paying for my surgeries until I was in college. 

When I was growing up, I didn’t know anyone with CCD. In 2001, technology helped me to connect with other people with CCD for the first time. I heard about other people’s experiences as I conducted phone interviews for my Master’s thesis “CCD: The lived experience.” Eight years ago, I met Steffani and her daughter Hally, who have CCD, for the very first time. 

 CCD Smiles 

I felt inspired to create a nonprofit organization to help others with CCD. I started working on the foundation in 2013. In 2016, Gaten Matarazzo’s dad contacted me. Together, we made CCD Smiles an official IRS approved nonprofit organization in January 2017. Since it’s official beginnings, we have had gatherings and fundraisers across the country. I have met 38 other people with CCD, which has been a tremendous blessing in my life.  

 Gaten Matarazzo, from the series Stranger Things, is a huge part of bringing awareness to CCD. As his popularity in Hollywood has grown, so has familiarity with CCD and CCD Smiles.  

CCD Smiles is still in its infancy, but you can go to www.ccdsmiles.org to learn more about us and watch us grow! Currently, the website is a place for donations, purchasing CCD swag and education about CCD. In the future, the website will be a place where those with CCD can connect, share pictures, exchange stories, and find hope. I want others to know they are not alone. It will also provide current and accurate medical information, written in plain English. Doctors, dentists, orthodontists, and surgeons can come together and discuss treatment, research, and options for their patients. 

As CCD Smiles grows and donations are made, we can help cover the costs of oral/facial surgeries. If insurance isn’t going to help, then we can. I don’t want the medical/dental expense to keep parents from being able to provide beautiful smiles for their children. 

My ultimate dream is coming true. July 13-15, 2018 will be the first national CCD conference in Salt Lake City.  Watch the website for more information. If anyone is interested in donating time, money, or talents to this event, please email me at kellywosnik@ccdsmiles.org. 

CCD Smiles Mission Statement: We bring global awareness, provide assistance for dental care, and support research to improve outcomes and quality of life for individuals with cleidocranial dysplasia. 

CCD Smiles can be found in the media and on social media— Instagram, Facebook and Twitter (@ccd_smiles, #ccdsmiles) 

Originally published on Utah Valley Health and Wellness Magazine

Now That My Teen Has Come Out – WHAT DO I DO NOW?

Ive told my son that nothing changes, that I still love him, but I expect him to live the same standards as the rest of the family, and yet he seems more and more depressed. Why isnt this working? 

I dont want my daughters ideas about being lesbian to influence the younger kids in the family, so Ive told her not to talk about it at home. 

I think if my son is going to wear makeup, hes going to get made fun of at school. I cant stop that. 

In the September/October issue of Utah Valley Health and Wellness, I talked about parental self-care. It’s important for parents to have people to talk with who understand and don’t blame them for what they are feeling and experiencing. In the July/August issue, I talked about how to keep lines of communication open when a child “comes out” as lesbian, gay, bisexual, transgender, etc.  In this issue, we’re going to talk about how to keep you and your teen connected. 

Some families consider that their main responsibility to a child that comes out is to continue to teach truths about sexuality and gender, and to make sure their teen does not misunderstand or ignore these teachings. In my experience with hundreds of teens from good homes, this emphasis generally results in a disconnection that makes communication feel tense and difficult. Because teens need a good relationship with parents in order to navigate the experiences of being a healthy teen, I recommend that parents: 

  1. Consider that your child may not be choosing to rebel against your teachings and beliefs as they learn new things about themselves and want to share them with you. 
  2. Recognize that your child knows where you stand with regard to teachings about sexuality and gender. 
  3. Learn to be open to hearing from your child what internalizing these ideas has been like (both recently and in the past). 
  4. Find out what your child’s hopes and dreams for themselves are, and how they may be changing. 
  5. Show respect for your child, especially as your child’s experiences are different from yours. 

These five things will make a dramatic difference in your child’s interest in re-opening a relationship with you. The most important thing is that you – as a parent – remain a steadfast connection with the world of respectful and loving relationship with your child. Children who do well – that is – avoid risky sex, drug abuse, alcohol abuse, and suicidal behaviors – have parents who show respect for their childrens sense of what is true about them. (For details about the retrospective studies of families who demonstrate accepting and rejecting behaviors and the outcomes for teens, see http://familyproject.sfsu.edu/) 

If you want help navigating how to support your teen while making sure they are safe and mentally healthy (especially if identifying as a gender or sexual minority goes against your beliefs), you may want to:  

  1. Meet with other parents who have found peace in this journey ( the last issue listed several groups that meet in Utah County) 
  2. Meet with a therapist who can help you and your teen navigate issues of safety and mental health. 

Many families have found their way through this journey with greater love and appreciation for each other and for their relationships, which strengthens everyone, including parents and the younger children in the family. 

Originally published on Utah Valley Health and Wellness Magazine