Suicidality: Talking About Suicide and Support

I want to preface this post by stating that the concepts and suggestions I’ve made below are my own thoughts, opinions, and suggestions based on my own experience working in the mental health sector and lived experience. There may also be numerous grammatical and logical errors. I know that you’re intuitive enough to understand what I’m attempting to describe and explain. Therefore, there will be no references section at the end. This is merely an expression of thoughts, a stream of consciousness (William James coined the term Stream of Consciousness).

Episodic, acute, and chronic anxiety can be miserable and debilitating. Individuals living with anxiety have generally experimented with many techniques to cope with anxiety symptoms, and they have often been practicing these techniques for months, years, or decades. Anxiety is life changing. Current treatment can be efficacious at reducing the intensity or frequency of symptoms for the vast majority of people living with anxiety, but only at best. I, myself, have tried the deep breathing technique commonly advised by mental health professionals, and it can be about as useful as taking a sugar pill. There is credible science that supports deep breathing exercises can improve symptoms and recovery rates for stress, anxiety and depression levels – but what about for an anxiety attack or a panic attack or intense chronic symptoms of anxiety?

Sometimes nothing is effective enough for immediate relief. It is my contention that building a relationship with a trained psychiatrist, specialised in this domain, is an essential first step. Your treating specialist(s) will need to have extensive experience and a comprehensive understanding of the debilitating impacts of anxiety, anxiety attacks, and/or panic attacks. I recommend psychiatry because you will need someone who can prescribe short-term medication, schedule 4 or greater, to alleviate the pain rapidly. All symptoms a person may experience from any condition in the anxiety family present a risk for searching for any immediate relief. This is true for you or me or anyone. Without prompt and effective medical care readily available, many people who do not have a plan for managing anxiety will potentially search for an unhealthy substitute to acquire relief.

These substitutes are often unhelpful long term but effective short term. We all know what they are: alcohol and other drugs, sexual promiscuity or sex addiction, love addiction, gambling, excessive or unhealthy eating habits, self-injury, addictive forms of gaming, impulse spending, co-dependent or dependent behaviours on people, people pleasing, running away (avoiding reality), raging, reckless driving and other criminal behaviour, and relying on pharmaceuticals (legally prescribes or otherwise) that will have long-term unhealthy side effects. People know how to “doctor shop”, and although this area of medicine is becoming much more regulated, it still occurs. Unfortunately, there are people who do require certain types of legal drugs, in a timely manner, to find relief as a means of not engaging in any of the previously mentioned behaviours.

Some people may not have much faith in the field of psychiatry or psychology – HOWEVER – you may find yourself in a situation one day where you will need a doctor who knows your history to increase the likelihood of prescribing medication to treat anxiety when you need it most. This medication usually has addictive properties. An ethical psychiatrist will usually be unwilling to prescribe more than a single repeat of potentially addictive medication to treat their patients. This is standard, regulated medical practice in Australia.

Anyone working in the drug and alcohol sector or has regular contact with a person living with anxiety, or any form of addiction, will know that patients – people – are not being seen in a timely manner top treat anxiety before the patient starts looking elsewhere. Even once the patient has accessed some type of medical care, the length of care is not long enough for the patient to be “well enough” after discharge or ending their hourly session, to be on their own in the community safely without becoming vulnerable to their condition in a short time and looking for more relief to ease their pain and improve their well-being.

If a person or a patient cannot depend on the medical system in the way they need to feel safe and well, they will almost certainly begin to lose faith and trust in health professionals, and ‘the system’. This perpetuates their internalised stigma being reinforced, yet again.

I am not saying the patient doesn’t have a significant responsibly of their own to make valuable choices outside of medical treatment. I quote what someone once said to me, “You may not have asked for this disease, but it becomes our responsibility to stay well”. That is our duty as the person living with a health issue of any kind. There are things we certainly must do (or not do) to stay as healthy as possible. The help make not be there in a timely manner the next time we need immediate help.

It can take weeks or more to enter a detox facility. It can take months to enter a rehabilitation facility. It can take months for an available appointment to open with a psychiatrist. It becomes our responsibility to know that even when we’re feeling well and back to “normal”, we must continue those relationships with medication professionals. It becomes our responsibility to try alternative medicines if that’s something you’re interested in. Let’s face it, psychiatrists cease their practice, our professional relationship has reached it’s potential for adequate, loving care, or we want to try something new.

Start the process of finding a reliable, qualified, and credible psychiatrist today. I would recommend finding a counselling psychologist or other mental health professional that you have a productive and friendly working relationship with – and if you want to practice Buddhism, or acupuncture, or hypnotherapy, or any other complementary and alternative medicine – do it. If you want to connect with God – do it. If you want to see a naturopath – do it. Whatever it is, this may very well be a lifelong journey for you. Based on my own experience, don’t stop because you think you’re “all better now”. The previously mentioned professions or treatment options or lifestyle choices can be extremely expensive, but I would encourage you to save for it, find less expensive options. Sitting in church is free, or listening to an online guru can be the price or maintaining your mobile service bill.

I once knew of a fellow peer in treatment alongside me who said he saved money for years to travel overseas to have a procedure not available in Australia at the time for this purpose. He wanted blood transfusions and heat therapy for chronic pain that didn’t doctors could not determine had physiological origins. The peer was sure it had to, and medical investigations in Australia come up negative. The peer explained the theory behind blood transfusions and heat therapy – he believed – were supposed to improve his blood circulation and blood flow to treat the chronic pain he’d been living with for years after a workplace accident. Even this procedure overseas proved ineffective in mitigating his chronic pain. So, next he tried the wim hof method. He changed is diet. He exercised differently. He tried hypnotherapy. Finally, he turned psychology to treat stress and process childhood trauma. He was being treated for this a private facility where I was a patient at that time. I lost contact with him after I ended my own treatment episode. I don’t know if he’s still living with chronic pain or not.

The following are some very basic and well-known strategies in the Western world of psychology that you can begin to practice today, and then practice every day after that too – even for 5-20 minutes:

– learning about anxiety – your specific “causes” and the conditions more generally

– mindfulness

– relaxation techniques

– correct breathing techniques

– dietary adjustments

– exercise

– learning to be assertive

– building self-esteem

– cognitive therapy

– exposure therapy

– structured problem solving

– support groups

My firm believe is this:

Strong, healthy, quality relationships are essential to treating anxiety and other psychological illnesses. This about your life today: are you lonely (romantically or otherwise), are you a stressed individual, do you regularly feel like you job is stressful or unfulfilling, do you feel sad a lot, are you feeling pointless a lot, or feeling helpless a lot, feeling shame a lot, getting angry a lot over considerably minor things? etc. etc. etc. I would strongly encourage talking to a professional and begin exploring what options you have available to you.

Try, explore, play with a few methods of treatment. However, this must take a priority in your life. It must balance will all the many other obligations and responsibilities people encounter daily.

Type alternative medications or approaches to psychology. There are so many. It can be fun to try out a few when your finances permit. Even planning a holiday every 3-6 months is taking care of your well-being.

Many blessings friends.

Finding Meaning: Masculinity in Crisis

Many young men seek counselling because they feel lost (Seidler, et al., 2016). This happens especially in today’s world, where the boundaries of how a man is supposed to behave are shifting rapidly. It’s a difficult time for young men to find their place in life as they struggle to adapt themselves to changing social attitudes and norms; there’s plenty of content in the media illuminating harmful male behaviours, but there isn’t a legitimate mainstream discussion of how masculinity ought to be propagated. As a result, many young men are growing into adulthood without a map – they lack a male voice of compassion and authority to guide them on how to integrate masculinity into their lives.

In our writer’s experience, men who have been referred for counselling often have a very strong underlying sense of purpose and a desire to be good people; their anxiety, depression, and harmful behaviours are often symptoms of feeling unable to actualise their potential. It’s a counsellor’s job to help men articulate this sense of purpose in constructive and positive ways, and offer guidance on enacting their perceived purpose effectively. 

A study from the University of Connecticut has identified three major factors that determine whether men believe their lives are meaningful (George & Park, 2016):

1. They feel that their lives make sense, and have continuity
2. They are directed and motivated by meaningful goals
3. They believe their existence matters to others

Researchers discovered that sources of meaning tend to fall into two main categories: meaningful relationships and a meaningful profession (George & Park, 2016).

There is no doubt that this generation of males is developing a unique relationship with masculinity, and it’s not necessarily for the betterment of their relationships or professions (Black & Westwood, 2012); men’s desire for professional success can be interpreted as a validation of the patriarchal system, while their pursuit of romantic relationships can be perceived as misogynistic (LeanIn, 2019). While some men are certainly exploiting systems which privilege them, often times the prevalence of this attitude discourages “good” men from progressing and developing themselves (Hoff, 2016). This article is not making a stance on any social/political issues: it is merely articulating some causes and concepts that can assist counsellors in understanding this very nuanced issue, so they can help men find meaning in the modern world.

What even is masculinity?

Masculinity and femininity denote sets of attributes that most people can intuitively identify – for example, it doesn’t take a discerning anthropologist to tell the girls section of the toy store apart from the boys section. But regardless of the value of this distinction, what exactly is the nature of it? Defining masculinity and femininity is a little more nuanced than simply referring to their apparent differences; not all people have the same understanding of what masculinity and femininity are, and how they manifest themselves. For example, conceptualisations of masculinity and femininity vary vastly across cultures and historical periods (Reeser, 2010); as such, there can be confusion about what these terms mean, and how we can embody them effectively.

Across time, however, typically agreed-upon standards for masculine conduct involve strength, courage, and leadership (Kimmel, 1994); these traits reflect a desire for meaning – you only inhabit strength and courage when a compelling reason to do so arises. Young men today, knowingly or not, are crying out for responsibilities that offer this type of meaning in their lives (Frankl, 2006). They want to know what it means to be who they are in the world right now – what can they do, and how can they best live? It’s time that we help them find the answers to these questions.

Currently, there is a lot of heated discussion about whether masculinity – or any kind of gender categorisation – is a genuine natural occurrence, or a mere social construction that we can/should dispose of; the question of whether masculinity is inherent in biology or if it arises through socialisation has been debated for hundreds of years (Martin & Finn, 2010). This is a question that does not have a black-and-white answer; studies on prenatal androgen exposure – among other developmental events – have shown biological links to expressions of masculine or feminine traits (Martin & Finn, 2010), however, it can be argued that these differences are exaggerated and articulated further by social influences (Wharton, 2012).

Whichever perspective you align with, an often unacknowledged aspect of these conversations is that while some forms of masculinity are harmful, some are also powerful forces for good. It’s possible (and advised) for men to have a productive and integrated expression of their masculinity (Jung, 2009) – one that allows them to use their strengths to achieve fulfilment. Unfortunately, the current culture is lacking in content which identifies what these strengths are, and thus fails to encourage men to embody them; as detailed above, many young men feel lost because of this.

It should also be stated that masculine traits are not exclusive to men; masculinity and femininity are not synonymous concepts to gender or sexual identity (Butler, 2006). That being said, this article is specifically addressing the mental health of men with masculine attributes. 

Why is masculinity in crisis?

There are a variety of reasons why young men feel uncertain about how to navigate the contemporary world. These include, but are not limited to, the following 3 observations:

1) The increasing separation between traditional male roles and the reality of modern life

The roles of men in the traditional household and workplace are changing. Men are becoming more inclined to be actively involved in child-rearing and housework. However, there is still often an expectation for them to maintain the traditional breadwinner role (Martin & Gnoth, 2009). Men are finding themselves stuck in limbo between the past and the future. Discerning one’s purpose thus becomes difficult, leading to feelings of emptiness (Rogers, 2010); men without a  defined mission will generally find themselves feeling a tremendous sense of lack (Deida, 1997). In this day and age, young men are extremely worried about what they will do after college, and the answer is likely “Go overseas for a few years, then come back.” This reflects a lack of encouragement to make powerful decisions towards meaningful futures.

2) A lack of positive masculine role models in society

For many children, fathers are either absent or not present enough, and this has lasting impacts on the way males view themselves and their sense of meaning/purpose in the world (Single Mother Guide, 2012). Men who grow up without an emotionally involved father has been correlated with long term effects including increased likelihood of dropping out of high school or college, and increased likelihood of substance abuse (McLanahan, Tach, & Schneider, 2014). These problems are exacerbated by the fact that many young men are searching for their place in the world and attempting to figure out what it means to be a man in today’s society – there is not always an adult male figure for them to look up to. 

The men who are often placed in the media limelight are there by way of some transgression or moral failing. While the modern world is rightly campaigning for positive representations of identities in media, it seems as though this effort circumvents men (Tarrant, et al., 2015). It is understood that men have historically tended to see themselves in positions of power and dominance, but this is not a reason to avoid exposing men to genuinely positive role-models in our current time. It is to the detriment of the mental health of many young men that we do not see more positive representations of masculinity (Tarrant, et al., 2015); ones that represent the compassionate and purposeful core of the masculine ideal.

3) Social media content either teaches men harmful ways of interacting with others, or degrades the concept of masculinity in general

The following two types of social media content are tough for today’s men to navigate. Firstly, there is a large online community of content creators calling for men to be ruthlessly successful; young men are bombarded with images of ‘alpha-males’ and are expected to adopt this image into their own definitions of masculinity. This makes it more difficult for boys to embrace their sensitive sides, leading to a lack of emotional literacy (Stratford, 2020). Content creators rarely offer antidotes to this effect, and are failing to provide helpful insights into the psychological reality of becoming a good man with a meaningful life. These online figures often try to convey an image that their life is perfect, when in fact this is often far from the truth; men are being encouraged to strive for false images of fulfilment (Stratford, 2020). This is a major concern for both men and women. 

Secondly, while some men are being plagued by the alpha-male image, others are being exposed to content that degrades masculinity in general. The conduct of certain men has been the object of fair scrutiny over recent years, and there are arguments to be made for how this conduct has been an expression of masculinity. There is, however, no grounds for suggesting that masculinity in general is problematic. This view has created a culture in which masculinity is demonised; while this might be a perceived course-of-action for eradicating its more toxic forms, the more immediate effect is that good men are feeling alienated and ineffectual (Rogers, 2010). Rather than encouraging men to be better, we are constantly reminding them that they are harmful; a result of this is a generation of men who are unmotivated and aimless (Salter, 2019). A study has found that male respondents who have experienced gender-based cyberbullying feel compromised in how they feel they are permitted to exist in society (Chen, et al., 2015). Men are seen as less attractive and less desirable to women when they post images of themselves on their Instagram account, as it is seen as the promotion of male dominance rather than a harmless expression of an individual (Fox & Rooney, 2015). This phenomenon leads to a significant decrease in men’s self-esteem, which results in paralysis and stagnation in their professions and relationships.

So, how can counsellors help men find purpose and meaning?

As counsellors, we can offer strategies to help men identify and organise the meaningful facets of their lives. Viktor Frankl, the author of Man’s Search for Meaning, created logotherapy, which is based on the presumption that a man’s main motivation is to find meaning in life, as opposed to the pursuit of pleasure or power (Marshall & Marshall, 2012). Some techniques he used were dereflection (focusing on high-level goals instead of on themselves) and Socratic dialogue (open-ended questions to uncover dormant aspirations). If, for example, a client is passionate about saving the environment, this type of therapy can assist them in finding a practical way to focus their time and efforts on realising their potential in doing so.

Meaning therapy (Wong, 2010) incorporates aspects of cognitive-behavioural therapy and positive psychology, and helps people take on more meaningful responsibilities in their lives while encouraging them to pursue goals that serve others. It advocates psycho-educational approaches that equip men with the mental toolkit necessary to create a vision of an idealised future for them to begin moving towards.

Similarly, self-authoring is a process by which people organise their lives into a narrative structure, making their past, present, and desired futures more easily understandable (Peterson, 2005). By creating a map of one’s life, it can become far simpler to identify who you are, what you value, and what you need to do to be of most service to yourself and your community. As with most approaches that attend to creating meaning, it is based on reflection and awareness. 

A culture of masculine content creation must be encouraged to counter the fear of being construed as ‘too emotional’, or ‘not manly enough’. It’s time we begin working together to help young men find meaning, and develop a culture which is focused on stopping the cycles of toxic masculinity, whilst encouraging healthy expressions of masculinity in its stead.

In summary… 

Young men today are having a difficult time finding their place in the world. The current cultural climate surrounding masculinity – as well as the absence of positive role-models for younger generations – is leading to a decrease in the quality of mental health. Men must be taught how to integrate their masculine dispositions into their lives; how to lead, how to care, and how to love with purpose and commitment. There is an urgent need for discussion to take place around what masculinity means, and how we can encourage healthy expressions of it; it is my hope that this article has encouraged us all to begin engaging with this conversation. 

Recommended Links: Men In Mind Program (by Movember), Men and Emotions: From Repression to Expression (Article), Men, Emotions and Alexithymia (Article)

References:

1. Butler, Judith (2006) [1990]. Gender trouble: feminism and the subversion of identity. New York London: Routledge. 
2. Cunningham, C. E., Chen, Y., Vaillancourt, T., Rimas, H., Deal, K., Cunningham, L. J., & Ratcliffe, J. (2014). Modeling the anti‐cyberbullying preferences of university students: Adaptive choice‐based conjoint analysis. Retrieved from webpage.
3. Deida, D. (1997). The Way of the Superior Man. S.I.: Sounds True.
4. Fox, J., Rooney, M. (2015) The Dark Triad and trait self-objectification as predictors of men’s use and self-presentation behaviors on social networking sites. Personality and Individual Differences
5. Frankl, V. E., Kushner, H. S., & Winslade, W. J. (2006). Man’s search for meaning. Boston, MA: Beacon Press.
6. Hoff, C. (2016). Five Ways Patriarchy Affects Men and their Relationships. Retrieved from webpage.
7. Jung, C. G., Shamdasani, S., & Hoerni, U. (2009). The red book = Liber novus: A readers edition. New York: W.W. Norton &.
8. Kimmel, Michael S. (1994). “Masculinity as Homophobia: Fear, Shame, and Silence in the Construction of Gender Identity”. Theorizing Masculinities. Thousand Oaks: SAGE Publications, Inc. pp. 119–141. 
9. LeanIn.Org and SurveyMonkey survey (2019)
10. Maria Marshall; Edward Marshall (2012). Logotherapy Revisited: Review of the Tenets of Viktor E. Frankl’s Logotherapy. Ottawa: Ottawa Institute of Logotherapy. 
11. Martin, Brett A.S.; Gnoth, Juergen (2009). “Is the Marlboro man the only alternative? The role of gender identity and self-construal salience in evaluations of male models”. Marketing Letters. 20 (4): 353–367. 
12. Martin, Hale; Finn, Stephen E. (2010). Masculinity and Femininity in the MMPI-2 and MMPI-A. University of Minnesota Press. pp. 5–13. 
13. McLanahan, S., Tach, L., & Schneider, D. (2013). The Causal Effects of Father Absence. Retrieved from webpage.
14. Peterson, J. (2005). Self Authoring. Retrieved from https://www.selfauthoring.com/
15. Reeser, Todd W. (2010). Masculinities in theory: an introduction. Malden, Massachusetts: Wiley-Blackwell. 
16. Rogers, Thomas (November 14, 2010). “The dramatic decline of the modern man”. Salon.
17. Salter, Michael (2019). “The Problem With a Fight Against Toxic Masculinity”. The Atlantic. 
18. “Single Mother Statistics”. Single Mother Guide. (2012)
19. Seidler Z. E., Dawes A.J., Rice S. M., Oliffe J. L., Dhillon H. M. (2016). The role of masculinity in men’s help-seeking for depression: A systematic review. Retrieved from webpage.
20. Stratford, H. (2020). ‘Be a man’ – toxic masculinity, social media and violence: Innovation Unit: Creating impact – reducing inequalities – transforming systems. Retrieved from webpage.
21. Tarrant, A., Terry, G., Ward, M., Are Male Role Models Really the Solution? Interrogating the ‘War on Boys’ Through the Lens of the ‘Male Role Model’ Discourse. (2015). Retrieved from webpage.
22. Westwood, M. J., & Black, T. G. (2012). Introduction to the Special Issue of the Canadian Journal of Counselling and Psychotherapy. Retrieved from webpage.
23. Wharton, Amy S. (2012). The Sociology of Gender, second edition. Hoboken, NJ: Wiley-Blackwell.
24. Wong, P. T. (2009). Meaning Therapy: An Integrative and Positive Existential Psychotherapy. Retrieved from webpage.

When to Fake It Till You Make It (and When You Shouldn’t)

Faking it for the right reasons can change you for the better. Here’s why.

Posted Jun 27, 2016By Amy Morin

One day, a client came to see me because she felt socially awkward. She knew that her inability to make small talk was holding her back both personally and professionally. As a shy person, she hated going to networking events. But making connections was vital to her career.I asked, “What do you usually do when you go to a networking event?” She said, “I stand awkwardly off to the side and wait to see if anyone will come talk to me.” I asked her, “What would you do differently if you felt confident?” and she said, “I’d initiate conversation and introduce myself to people.”

Right then and there, she discovered the solution to her problem: If she wanted to feel more confident, she had to act more confident. That wasn’t quite what she wanted to hear. She’d hoped for a solution that would immediately make her feel more confident. But the key to becoming more comfortable in social situations is practice.Her instinct was to wait until she felt more confident, but that confidence wasn’t going to magically appear out of thin air—especially if she was standing around by herself. However, if she started talking to people like a confident person, she’d have an opportunity to experience successful social interactions, and each of these would boost her confidence.

Acting “As If”

Acting “as if” is a common prescription in psychotherapy. It’s based on the idea that if you behave like the person you want to become, you’ll become like this in reality:

1. If you want to feel happier, do what happy people do—smile.

2. If you want to get more work done, act as if you are a productive person.

3. If you want to have more friends, behave like a friendly person.

4. If you want to improve your relationship, practice being a good partner.Too often we hesitate to spring into action. Instead, we wait until everything feels just right or until we think we’re ready. But research shows that changing your behavior first can change the way you think and feel.

The Biggest Mistake Most People Make

Faking it until you make it only works when you correctly identify something within yourself that’s holding you back. Behaving like the person you want to become is about changing the way you feel and the way you think.If your motives are to prove your worth to other people, however, your efforts won’t be successful, and research shows that this approach actually backfires. A study published in the Journal of Consumer Research found that people who tried to prove their worth to others were more likely to dwell on their shortcomings. Ambitious professionals who wore luxury clothing in an effort to appear successful, and MBA students who wore Rolex watches to increase their self-worth just ended up feeling like bigger failures. Even worse, their attempts to project an image of success impaired their self-control. They struggled to resist temptation when they tried to prove that they were successful. Putting so much effort into faking it used up their mental resources and interfered with their ability to make good choices.

How to “Fake It” the Right Way

Acting “as if” doesn’t mean being phony or inauthentic. It’s about changing your behavior first and trusting the feelings will follow. As long as your motivation is in the right place, faking it until you make it can effectively make your goals become reality. Just make sure you’re interested in changing yourself on the inside, not simply trying to change other people’s perceptions of you.