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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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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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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

MMeier@FaceItFoundation.org

651-200-4297

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