connection: the key to prevention...5/7/2019 1 connection: the key to prevention psw 9 th annual...
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5/7/2019
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Connection:
The Key to Prevention
PSW 9th Annual Conference
Wisconsin Dells, WI
May 3, 2019
Mark A. Meier, MSW, LICSW
Objectives
1. Describe and understand the associations which
exist between social isolation and suicide
2. Describe the role subjective feelings of loneliness
have on suicidal thoughts and actions
3. Describe and utilize two strategies to help others
develop resiliency skills and build connections to
address isolation and loneliness
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“What do we live for if not to
make life less difficult for
each other?”
Roger Bannister, MD
Let’s Start Here
“There is no single cause to suicide. It most
often occurs when stressors exceed current
coping abilities of someone suffering from a
mental health condition.”
https://afsp.org/about-suicide/suicide-statistics/ Accessed May 8, 2017
My Own Experience…
shaped by 2 critical components
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Face It Foundation
Our Mission
“Leveraging the power of Peer
Support, Face It works with men
to confront the epidemic of
suicide and help them recover
from depression and anxiety.”
Face It Provides
(All Services are free)
• Men’s Groups
• Men’s Retreats
• 1:1 Support
• Peer Support Network
• Monthly Social Activities
• Education
• Online Tools
• Texting/Telephone support
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What Really Shaped Me…
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5000
10000
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35000
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Num
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Death by Suicide Death by Homicide
47,173
17,284
Centers for Disease Control
Suicide vs. Homicide - 2017
My Personal Narrative
• “Get over it”
• “My childhood was perfectly normal”
• “It’s not like anything bad happened to me”
• “I have so much, I shouldn’t complain”
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My Personal Narrative
• “I’m a loser”
• “I’m unworthy of love”
• “Nobody cares about me”
• “The world would be better off without me”
What was “really” happening
• Loving, supportive spouse
• Happy, healthy kids
• Friends…lots of them
• Good job with bright future
• Master’s degree, awards, promotions…
What I was struggling with
• Depression
• Anxiety
• Substance Abuse
• Unresolved Trauma
• Lack of Coping Skills
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And I….
• Shut others out of my life
• Develop my mask of “happiness”
• Turn to substances
• Developed my sharp wit and ANGER
• Lived what appeared to be the “Good Life”
despite profound ISOLATION and LONELINESS
Objectives
1. Describe and understand the associations which
exist between social isolation and suicide2. Describe the role subjective feelings of loneliness have on suicidal thoughts and
actions
3. Describe and utilize two strategies to help others develop resiliency skills and
build connections to address isolation and loneliness
Social Isolation and SI/SA
Linked with…
• Employment Status
• Marital Status
• School settings
• Prison settings – disciplinary isolation
• Perception of not fitting in
• Quality of relationships
Calati R., Ferrari C., Brittner M., Oasi O., Olie E., Caralho A,. Courtet P., 2018. Suicidal Thoughts and behaviors and social isolation:
A narrative review of the literature. Journal of Affective Disorders 245; 653-667
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Assessing Social Isolation
• Number of individuals with whom a person
interacts with in a given period
• Number of qualitatively different types of
relationships the person has
• The degree of intimacy involved in his/her
interactions
Trout, D.L.. The Role of Social Isolation in Suicide. Suicide Life Threat. Behav 10 10-23
Consider This…
“We (men) have been trained to choose surface
level relationships or no relationships at all,
sleepwalking through our lives out of fear that
we will not be viewed as real men. We keep the
loving natures that once came so naturally (in
our youth) hidden and locked away.”
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Num
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Male Female
36,794
10,379
Centers for Disease Control
By Gender- 2017
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Men Are Taught
• Avoidance of emotional expression
“Why Are So Many Men
Dying By Suicide?”
“So what gives? Being a man in the U.S., and around the world,
too often means learning to suppress our emotional experience,
so much so that we as men often lack even the language to
express or understand our emotions. Some psychologists have
called this alexithymia—the inability to connect with and
communicate one’s emotions—and identified it as more
prominent in males. Quite simply, if men can’t recognize
negative or troubling emotions, and can’t or don’t seek help or
talk about them, we don’t know what to do when we face
them.”
https://slate.com/human-interest/2018/06/are-we-socializing-men-to-die-by-suicide.html Accessed November 1, 2018
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Alexithymia
• is a personality construct characterized by the
subclinical inability to identify and describe
emotions in the self. The core characteristics
of alexithymia are marked dysfunction in
emotional awareness, social attachment, and
interpersonal relating.
"Experiments show that when people are
primed to feel high levels of distress, the
quickest to recover are those who can identify
how they are feeling and put those feelings into
words. Brain scans show that verbal information
almost immediately diminishes the power of
those negative emotions, improving well-being
and enhancing decision-making skills.”
The Happiness Advantage: How a Positive Brain Fuels Success in Work and Life
Assessing Social Isolation
• Number of individuals with whom a person
interacts with in a given period
• Number of qualitatively different types of
relationships the person has
• The degree of intimacy involved in his/her
interactions
Trout, D.L.. The Role of Social Isolation in Suicide. Suicide Life Threat. Behav 10 10-23
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Objectives
1. Describe and understand the associations which exist between social isolation
and suicide
2. Describe the role subjective feelings of loneliness
have on suicidal thoughts and actions3. Describe and utilize two strategies to help others develop resiliency skills and
build connections to address isolation and loneliness
My Personal Narrative
• “I’m a loser”
• “I’m unworthy of love”
• “Nobody cares about me”
• “The world would be better off without me”
The Evidence
“the lack of feeling of belongingness is one of
the main risk factors associated with suicide.”
Joiner, T.E. 2005. Why People Die by Suicide. Harvard University Press, Cambridge MA
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“Loneliness is killing millions of American men.
Here’s why.”
“research shows that boys in early adolescence express deeply
fulfilling emotional connection and love for each other, but by
the time they reach adulthood, that sense of connection
evaporates. This is a catastrophic loss; a loss we somehow
assume men will simply adjust to. They do not. Millions of men
are experiencing a sense of deep loss that haunts them even
though they are engaged in fully realized romantic
relationships, marriages, and families.”
https://www.upworthy.com/loneliness-is-killing-millions-of-american-men-here-s-why
Accessed November 2, 2018
The Journey of a Lifetime
“Rick”
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“David”
To Be Lonely…
• I am all alone…regardless of who is around me
• I am not understood
• I don’t matter
• I carry my pain in silence and shame
• I never share
• I never connect
• I act out
The Behaviors
• Drug/Alcohol Issues
• Gambling Issues
• Porn & Sex Addiction/Affairs
• High Risk behaviors
– Speeding, seat belt play
– Gun play
• Anger…lots of it!
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How Do They Get There?
Adverse Childhood Experiences
“ACE’s”Adverse childhood experiences (ACEs) are stressful or
traumatic events, including abuse and neglect. They
may also include household dysfunction such as
witnessing domestic violence or growing up with family
members who have substance use disorders. ACEs are
strongly related to the development and prevalence of
a wide range of health problems throughout a person’s
lifespan, including those associated with substance
misuse and mental health issues.
My Personal Narrative
• “My childhood was perfectly normal”
• “It’s not like anything bad happened to me”
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My ACE’s
• Childhood memories/Environment
• Multiple life disruptions due to brother’s illness
• Shy, isolative in nature
• Lack self-confidence
• Lots of anxiety
• High expectations of self/Perfectionist
• Significant 8th Grade bullying experience
• Demanding/shaming home environment
My ALE’s(Adverse Life Experiences)
• College
– Didn’t fit in
– Nearly failed out
– Held at gunpoint
– Survived serious truck accident
– Physical assault (80+ stitches in face, broken bones)
– Recurrent thoughts of suicide and risk-taking
behaviors
The Men We See
• Physical, Sexual, Emotional Abuse
• Other Traumas
• TOXIC SHAME!
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The “Voice” of Shame
• I am defective (damaged, broken, a mistake,
flawed).
• I am dirty (soiled, ugly, unclean, impure, filthy,
disgusting).
• I am incompetent (not good enough, inept,
ineffectual, useless).
• I am unwanted (unloved, unappreciated,
uncherished).http://www.bhevolution.org/public/overcoming_shame_based_thinking.page
The “Voice” of Shame
• I am weak (small, impotent, puny, feeble).
• I am bad (awful, dreadful, evil, despicable).
• I am pitiful (contemptible, miserable,
insignificant).
• I am nothing (worthless, invisible, unnoticed,
empty).
http://www.bhevolution.org/public/overcoming_shame_based_thinking.page
So How Do We Help Them?
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Address Trauma
• Trauma is not reserved for a war zone
• Trauma is embedded in us
• Approaches
– EMDR
– Brain-Spotting
– Accelerated Resolution Therapy
Address Trauma
• Hypnotherapy
• EFT (Emotional Freedom Technique…aka
psychological acupressure)
• Breathing exercises
• Visualization
• Yoga
Teach Them
• Challenge/replace the irrational thoughts that
drive them
• Build relationships
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What is Intimacy?
“IN-TO-ME-SEE”
Connect Them!
• You may have to take an active role in this…
Peer Support
“The pooled results from randomized controlled
trials indicate that peer support interventions
improve depression symptoms more than usual
care alone and that the effects may be
comparable to those of group cognitive
behavioral therapy.”
Efficacy of peer support interventions for depression: a meta-analysis. General Hospital Psychiatry 33 (2011) pp 29-36
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We Push Ourselves
• Take risks to build new programs
• Collaborate with others
• Look beyond “the way we do it here”
mentality
What I Know
• People die by suicide for a multitude of
reasons…the destruction it leaves behind is
painful
• ACE’s are real, they’re prevalent, and they
follow us through life…until we make peace
with them
What I Know
• Trauma and it’s co-existing realities are
complex and helping others navigate them is a
big job
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Does Any Of This Work?
• 7 Years
• Hundreds of high risk men
• 20,000+ hours of peer support
• 0 lives lost to suicide
“What do we live for if not to
make life less difficult for
each other?”
Roger Bannister, MD
Thank You
Mark Meier, MSW, LICSW
651-200-4297
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