I rarely go to movies, maybe once a year. Inception (2010) was an exception largely in part of the fantastic reviews and I'm a DiCaprio fan. However, I was also curious as a psychologist. The movie was about levels of consciousness and memories. Memory formation has been a controversial area of research for decades with implications from the law to abuse to your own memory (check out the TED Talk "The  fiction of memory").

As I reflected on the movie, my mind kept returning to the therapy process. There were many themes in the movie that I experience in the therapy room. Initially I thought my narcissism was kicking in. Is it a bit much to compare working with a patient to a blockbuster mind bender? Set aside the process of inception or extraction. Reflect more on the underlying process of entering someone's mind, circumnavigating their and your own defenses, and uncovering raw, genuine experiences. Read below and you be the judge.

A major theme of therapy is the patient protecting the unconscious. Dom Cobb (DiCaprio) offers a service to Saito (Ken Watanabe) of training his mind to protect its secrets from extractors when in a vulnerable mental state. In Saito's case, the vulnerable state of dreaming.  People protect their emotional world by gaining distance from real feelings by utilizing defense mechanisms such as repression, rationalization, and humor. These mechanisms offer protection from the power of our emotional world. 

Therapy is the process of extracting. Extracting that memory or experience that lies deep within the psyche. An emotional experience that's difficult to reach. In the real world, we present differently than we do in the privacy of our home or a therapy room. We work to maintain our composure in public, counting down the minutes until you can finally be yourself. Our public and private experiences are different levels of consciousness. Therapy is the plot of Inception, gaining the combination to a personal safe.

Enter the character of Robert Fischer (Cillian Murphy). Saito has asked Cobb and his associates to enter Fischer's subconscious. This is mantra the role of psychoanalytically informed therapy; bringing the unconscious to conscious. Freud posited that people have developed simple and complex mechanisms to keep unconscious thoughts, feelings, and experiences from entering consciousness. Freud utilized a number of strategies to bring the unconscious to the conscious including hypnosis, free association...and dreams. 

The process of entering deeper into the mind has a sinister feel in the movie. For therapy, the belief is the opposite: if emotions are brought from the unconscious to consciousness, experiences can finally be resolved, leading to psychological relief and growth. During the process of exploring the unconscious, the therapist will regularly encounter resistance in the form of the patient's defense mechanisms. 

The projections in the movie are the defense mechanisms that are present in therapy. The role of projections were to block Cobb's team from completing their extraction mission, much like a defense mechanism blocks a therapist or even you from accessing experiences and feelings in the unconscious. 

To illustrate, let's use a therapy example. A patient conveys a story where a family member forgets the patient's birthday. The patient dismisses the forgetfulness as a non-issue because the family member has a busy life. The patient may then state birthdays are blown out or proportion, and actually express relief that their birthday was forgotten. 

However, at a deeper level the patient may actually feel hurt and disappointed. At an even deeper level, the patient may feel dismissed and unloved by family. The deep, core issue here is feeling dismissed and unloved. However, the rationalization (e.g., busy family member) and intellectualization (e.g., debate of birthday value) of the situation  serves as a defense against the realization of deeper, more profound emotions. 

Each "kick" represented a different level in the dream state, with its own world and sense of time. The same applies to the different levels of consciousness for each person. In the birthday example, each level of consciousness came equipped with it's own defense mechanism as well as a unique sense of time. Just as in the movie, as you move to deeper levels, the laws of time are compromised, and more signals or markings are needed to keep perspective. 

Yusuf kept a sense of time by playing music in the van. In therapy, a sense of time may occur by recognizing the context of the memory (e.g. the physical location of the experience, who you were with, etc.). Just like the kicks, moving from one conscious state to another with a patient can be smooth or violently jarring. Just like a kick, therapy is finite, each session is limited to 50 minutes. 

With each "kick" into a deeper dream state, stability and predictability were compromised. Cobb's team experienced a loss of control as they descended into deeper levels of the dream state. In therapy, as you venture deeper into a patient's psyche, there is the risk of destabilizing the patient. It's one thing to process a family member missing your birthday, it's an entirely different thing to process feeling unloved and forgotten by family. 

It's a very delicate process to venture deeper into someone's mind. Now add the time constraint of 50 minutes. It's not often talked about but there is a psychic pressure similar to the experience of deep sea diving or climbing a mountain. If you ascend from a sea depth or ascent a mountain too quickly, the body and mind sometimes have difficulty transitioning which can result in a sickness, shock, or even death. If you move quickly in and out of the unconscious, the patient can suffer a similar experience of sickness, shock, or even psychosis. It's imperative to bring a patient out of a deeper psychological state, and help them recover toward the end of the session. When the session is finished, that's the "kick" back to reality, the return to the world outside the therapy room. 

The underlying subplot of Inception is Cobb's unresolved trauma of his wife's, Mal, psychosis and subsequent suicide. Cobb feels responsible for her death, and his own psyche proves to be a complex web for the inception team. Ariadne, the dream architect, repeatedly questions whether Cobb can keep his own projections contained during the dream extraction and inception. 

This subplot is quintessential countertransference. Countertransference is the therapist's feelings that are stirred and brought to consciousness by the patient's experience. Entering Fischer's dream state stirs Cobb's own dream experience with his wife. A patient talking about abuse, loss, or fear can stir the same emotions in a therapist. Like Cobb, the therapist has to be vigilant and set aside their own experiences to work with the patient and their psyche. Countertransference is a powerful experience and should be addressed whether in a therapist's own therapy or in peer consultation. 

Inception concludes with Cobb returning home to his children. He spins his totem, his reality check mechanism, and the screen goes black leaving the viewer wondering if this last image is in fact reality, a dream state, limbo, or all of the above. 

Memory and the patient's reality (whether accurate or not) is the foundation of therapy. I often encourage patients to journal or talk to their parents, if possible, about early childhood experiences that we process in therapy (I encourage you as well). Sometimes we are sure of a memory, then are surprised by how we are our own inception team. Each person decides how they are going to encode an experience into a memory, without the guarantee of accuracy.

For example, I was sure of a decades old memory until a year ago. I remember riding my bike home as a kid and seeing my mom pull out of the driveway with a child in the passenger seat writhing in pain. I remember feeling confused and wondering what happened. According to my memory bank, I found out the injury details hours later when everyone returned from the hospital. 

I revisited this memory with my mom last year and her recollection floored me. She recalled sending me out to find this child as she feared something bad had happened. I found him injured in the woods, carried him from there into the house, and my mother took him to the hospital. 

Two incredibly different stories for the same experience. Only one of us can be right. So if my mom and I both spin are totems, which spinner will continue to spin?

Take a moment and ask someone about one of your memories. Ask them their experience and compare notes. You might learn something about yourself.


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Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

I get two basic questions when a parent sets up an appointment for their child:

1) What should I say to my child about their appointment?

2) What happens during the first appointment?

Let's go one at a time and assume that we are talking about children under the age of 12. Most kids over the age of 12 actually ask their parents if the can talk to someone. Of course there is a significant difference between a 12 year-old and 5 year-old so you adjust your conversation to an age appropriate level.

What should I say to my child about their first appointment?

This is a question I address during the phone consultation. First, tell your child about the appointment at least a day or two before the appointment. If your child is anxious and you feel that it will exacerbate their anxiety, go with what works. I've found in most instances that kids actually feel relief and curiosity when they learn that they are going to talk with someone about their emotional issues.

Especially for young children, make clear that they aren't seeing a medical doctor, they are seeing a “feelings” doctor. It's okay to be more specific, especially if your child has opened up to you about complex, confusing issues like depression and anxiety. Also make sure that your child knows that there are no shots or medications involved in this appointment, only talking. You would be surprised by how many kids assume a shot or medicine is involved when they hear “doctor appointment.”

Lastly, frame the appointment with concern and care. It's okay to say that the school or family has concerns and this appointment is to help. In many cases, the child has raised the concern and the desire to see a therapist, so it might be welcomed with open arms. You can also add that it's up to the child if they want to meet alone or would feel more comfortable with a parent in the room. The choice is theirs to make.

What happens during the first appointment?

The first appointment is an opportunity for the child psychologist to help the child feel comfortable with the idea of therapy. I usually spend the first part of the session reviewing patients' rights, my responsibilities, office rules, and other details like the length of sessions and who I am. I also try to mix in some humor or silliness to help the child feel more relaxed and playful.

How the first session progresses is up to the child. Especially in play therapy, the goal is for the child to feel like they have a safe, nonjudgmental space. Sometimes a child will want a parent or caregiver to accompany them for the entirety of the session. In other instances, a child might walk in and say “see you whenever we're done” and leave their parent(s) in the waiting room. It depends on the child and neither approach is wrong. The goal is to make sure the child feels that therapy is a safe space where they are respected and valued. That's the foundation of any healthy relationship.

Certainly there are exceptions to the rule, but this is a fairly accurate impression of how I encourage informing a child about an upcoming therapy session and how most first sessions go in my office.


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Someone I know has an addiction. How do I approach them about it? 

-- Anonymous October 2013

Addiction is a challenge to overcome. There is a reason why it can take multiple attempts to kick an addiction. You hear about people who stopped smoking cigarettes cold turkey, or conquer an addiction after (re)committing to their faith. These stories happen, but more common is the personal struggle and loss of what is important in life due to an addiction. How do you handle someone struggling with addiction? First, let's understand the underlying process of addiction.

For me, all addictions have the same psychological underpinnings. Whether we are talking drugs, alcohol, porn, or any other vice, they all have the same root. Addiction is a mixture of a biological predisposition + a void in one's life + inadequate and inefficient coping skills and resources. Before I say more about this addiction mixture, there is a great presentation on TED Talk about addiction and the brain. It's a an excellent resource.

Biological predisposition. I believe people have a predisposition to everything. Whether it's depression, obesity, or artistic ability. There is a potential within us for anything. Factors (e.g., environmental, family, biological) in our lives moderate the maturation and expression of a predisposition. These factors over time can lead to a sensitivity and affinity to certain predispositions.

Personal void. Every person I have worked with who is struggling with addiction has a personal void. Whether it's a chaotic childhood, loneliness, attachment issues, or a failure to manage daily stress, there is a glaring void in their lives. An addiction serves two purposes: 1) it superficially fills the void and 2) it pushes personal inadequacies out of consciousness, for that moment.

Ineffective coping skills. You can argue that any psychological issue is the result of having limited coping skills. With addiction, the same applies. The specific, unhealthy behavior gains an addictive quality because it is helping the person cope with something that had been unmanageable. This is what makes addiction so hard to overcome, it's difficult to let go of an effective coping mechanism, even if it's unhealthy. A major component of addiction treatment is understanding triggers and how to cope with these stressors..  

So how do you talk to someone with an addiction?

In a previous post, I wrote about how to have a difficult conversation with someone you love. Similar rules apply to addiction, but there are differences.

1. Speak gently and non-critically. You are talking to someone with limited coping skills and an inability to manage daily life. Keep the stress level low.
   
   
2. Be consistent and honest. You don't have to be critical to say the person's choices have negatively impacted their life and yours.
   
   
3. Speak with love. Make sure it is clear that you are approaching them out of love. “I'm talking to you about this because I love and care about you.”
   
   
4. Ask for honesty. It may not work, but it's worthwhile to see if the person is in denial or wants help.
   
   
5. Listen. Allow the person to talk. Ask questions that are open-ended, that allow for dialogue.
   
   
6. Have resources ready, and be prepared. If the person has a specific addiction, do some research and see what supports are available in the area.
   
   
7. Establish boundaries by taking care of yourself. Support the person, but not at the expense of you. This will be the first exercise for the person to learn about healthy boundaries.
   
   

Being there for someone who is struggling with an addiction is difficult. Find your own support to ensure you remain healthy.  

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This is the 3rd post in this series on communication. The first post (here) focused on what to do prior to a conversation. The second (here) centered on tips to consider while communicating. This post is how to fight fair, specifically how to have healthy communication during a argument.

Fighting is healthy. Disagreeing is healthy. What is unhealthy is when fighting and disagreeing turns into emotional, verbal, and/or physical abuse. You have two responsibilities during a conversation: 1) be aware of your own actions 2) be aware of how the other person's actions are impacting you. If these seem overwhelming, try being aware of what is manageable, especially during an argument. Here are some suggestions for how to fight fair.

Focus on one issue. Have one argument at a time. If you are talking about finances, talk about finances. Don't throw intimacy or other issues into one conversation. If there is a repetitive pattern of a behavior (e.g. dishonesty, forgetfulness, insensitivity), have the conversation about one instance. It's usually not productive to recall something that has happened months or years ago.

You might be thinking that you have to bring up other examples of the behavior to show that it's been a problem for a long time. There are instances where this might apply. If you feel it is necessary, bring it into the conversation as a way of showing a pattern, not as a way of punishing the person repeatedly and endlessly for past mistakes. If this is difficult for you, read my previous posts about letting go and grudges.

If you find yourself bringing up specific instances from the past, it may very well be you are presenting these issues to show a pattern of behavior. However, it may be these issues are still memorable because you have unresolved feelings about what happened. If there are unresolved feelings, then set a time to talk about them after reaching a resolution about the current issue.

No name calling or insults. Name calling and insults happen when you have been hurt. If you are tossing insults, it's usually to hurt the other person.  Once insults and sharp criticism enter the conversation, the actual issue is lost in the back and forth. Also, you might use a name or insult that you really regret later. I've worked with many couples where one person had a very difficult time healing from a specific insult that happened years ago.

Listen. Listen. An argument usually intensifies when there is a breakdown in listening and message comprehension. If you find yourself preparing your response before the other person has finished speaking, then you are probably more interested in debating your perspective than listening to theirs. If someone has ever told you, “You'd be a really good lawyer”, then this might apply to you. 

Take a break. If things get too heated or unproductive, take a break. If you are feeling overwhelmed or unable to express yourself, say so. When you take a break, set a time or day to come back and reengage. Many people feel dismissed and angry if someone asks for a break without a timetable for returning to the issue. So when you say, “I need a break”, add a “let's talk about this after dinner or on Wednesday after my presentation.” Setting a time shows that you are still invested on solving the issue. Taking a break isn't giving up, it's being human. 

Find what works. Not to undermine what I just wrote, but find what works for you and your relationship. I always recommend having the conversation in person. If that's too difficult, try email, a letter, phone call, or even including another person. Those aren't ideal but if they are more effective than talking in person, go with what works. Relationships are complex, sometimes there is no black and white solution.

Again, it is healthy to disagree and fight in your relationship. I'd be weary of a relationship where there is never a disagreement. Fighting can strengthen your relationship as it shows that you trust the other person to engage in something that might be uncomfortable, as long as you fight fair. 

The final part of this communication series will focus on being aware of who you are talking to.  


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

One of the first questions someone asks when they come for therapy is, "How long is this going to take?" It's a interesting moment as there really isn't an answer. For a lot of people, this is where setting goals is important. It's a way for people to track progress. It's measurable. Am I less depressed? Do I have more friends? Have I been better at coping with daily stress?

These questions are ways to assess the frequency of presenting symptoms (e.g., feeling sad, lacking energy, discomfort in social situations). The symptoms are what bring people to therapy. However, the cure for symptoms is examining the root causes. Getting to the root of a problem is complex, and it's the reason why it's difficult to answer, "How long is this going to take?" In my work, successful therapy is defined by attaining 3 goals.

Increased awareness of the self.

Before making real changes in your life, you have to better understand what changes need to happen. Part of that process is better understanding you. Everyone has their own behavioral patterns, relationship tendencies, stress management preferences, and a style in relating to others. Therapy helps the person gain insight into personal patterns.

Increased awareness of the other.

It's great to know why you do the things that you do, but life doesn't exist in a vacuum. Your behavior has an impact on others. The next step after increasing awareness of your behavior is making the connection to how your actions affect others. I'm talking about empathy again. I've written extensively about empathy, read a more detailed description here.

Understanding relationships.

Seems natural. Gain awareness of yourself and others and you'll be good to go with relationships. Right? Not necessarily. Relationships are Gestalt-like, the whole is greater than the sum of the parts. Understanding relationships is more than understanding yourself and the other. Relationships are a source for psychological well-being. Unhealthy relationships are usually associated with increased stress and psychological problems, whereas those with healthy relationships tend to be happier and more confident. For a more in depth read on relationships, click here.

Increased awareness will inevitably lead to a decrease in presenting symptoms, which is what most people want. However, increased awareness leads to a fundamental change in our core self, which is what most people need.

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I’ve been asked this question by friends, strangers, aspiring mental health professionals, and even patients. It’s an interesting question, but I always find myself surprised when it is asked.

I also give the same response every time. In my years of being a clinical psychologist, I’ve never come across the same type of person twice. I have worked with many people who have presented with depression, anxiety, family conflict, etc., but each person had their own unique background and story.

Yes, common themes do arise in therapy: grief from losing a loved one, anxiety related to control, reoccurring relational problems, poor self-esteem due to a chaotic, neglectful home life. However, each person has their own experience, and the same experience can have a different impact from person to person.

Even the loss of a loved one can impact people differently. One person could be grief-stricken for months or years, while another may process the loss by becoming more active in personal pursuits as life isn't limitless.

People are complex, and it’s immensely rewarding and actually energizing to be able to work with people from different backgrounds. It’s a privilege to be allowed access to others’ experiences.

To be completely honest, sometimes there are moments of feeling disconnected during a session. Some might describe this moment as boredom or disinterest, but it's different. It's more about the interaction being superficial versus meaningful. It's getting caught up in the minor details instead of focusing on the central issue.

The disconnect during a session refers to the emotional connection between the patient and therapist. The patient or therapist can feel disconnected in a moment, the feeling isn't exclusive to either. Part of the therapy work is verbalizing and exploring this emotional distance, and recognizing if and when the same disconnect occurs in other relationships.

So for those who have that friend who only wants to talk when there is a problem, or only shares their own successes, take a moment and reflect on the relationship. Consider your perspective, but also connect with the perspective of others.

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Bad things happen in life, they just do. If they keep happening, it might be worthwhile to ask yourself, “Why does this keep happening to me?” “What is my role?” It’s one thing to be dealt a bad hand or have bad luck, it’s another to actively play a part in your own demise.

Self-destructive behavior can be a conscious effort, but in many instances it’s driven by unconscious forces. Why would someone actively sabotage their life? Why would someone seek out unhealthy relationships? Why are you chronically late to work or short-tempered? There are actually quite a few explanations for self-sabotage.

Self-destructive behavior is seen as normal. For some people, self-destructive behavior has been happening for so long it feels normal. A common theme in therapy is assisting an individual in realizing how their way of living might be maladaptive. It’s not easy to change unhealthy behavioral or cognitive patterns, especially if there is some degree of benefit. Part of the therapeutic process is gaining awareness of the beneficial and/or harmful aspects of behavior. 

Self-destructive behavior is beneficial. This might be a head scratcher, but sometimes there is a benefit to self-destructive behavior. Whether it is to elicit compassion, pity, or sympathy, self-destructive behavior can serve as a way to gain attention from others or a connection to someone. For some, any attention (even negative) is better than no attention, and there are plenty of people who are drawn to the emotionally wounded.

The fear of change. Change is uncomfortable and scary. Even if your behavior is self-destructive and unhealthy, if it has been your standard behavior, it’s comfortable and predictable. Comfort and predictability are highly valued, and in many cases, well-being and quality of life are compromised for comfort and control. Many people in unhealthy relationships are caught in a common conundrum: stay in a harmful, yet predictable, relationship or leave and be left with the unknown.

The fear of success. Self-destructive behaviors are typically associated with maladaptive, unhealthy experiences. After enough time, individuals can embrace a self-view of being inadequate and worthless. When failure is perceived as inevitable, even the idea of being successful is anxiety provoking. Shifting from a negativistic to an optimistic mindset is a challenge. Part of that challenge is letting go of a current identity and opening yourself to a new way of living. It can be an intimidating proposition but it's certainly doable.

Self-destructive behavior is common. If you find yourself wondering why the same bad thing continues to happen to you, partake in self-reflection and see if you can recognize patterns in your behaviors, relationships, and experiences.

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If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville facebook group by clicking here. Thanks for your support!

In a previous post titled "Letting Go",  I briefly commented on grudges within the process of moving on from relationships. You can read that post here. In this post, I want to say more about the idea of a grudge and how it may speak more about your coping and communication style than anything someone has done or said to you.

What is a grudge? A grudge is the resentment of another for a past harm. Psychologically, a grudge is what remains when an emotional injury hasn't healed properly or completely; essentially, an emotional wound or scar.

A few weeks ago, I wrote about how your body sends your mind signals when you are feeling specific emotions (to review that article, click here.). A grudge is your mind sending the following signal to your consciousness:

I continue to have thoughts about that person because of what happened, and because I still have unresolved feelings about the person and experience.

If you find yourself preoccupied with resentful feelings toward another person, you are holding a grudge. You have three options: continue to hold the grudge, address your feelings with the appropriate person, or decide to actively move on with your life. You could also do some sort of combination of the three.

Option #1: Hold on to the grudge. The benefit of this is you get to focus all your anger and resentment at this person inside of your head. The downside is chronic angry and resentful feelings puts your mental and physical health at risk. The other downside is you learn (or continue) to suppress your feelings, which will feed the cycle of being hurt and not advocating for yourself.

Option #2: Address your feelings. The purpose of sharing your feelings with the appropriate person (the perpertrator) is not to get that apology or for the person to grovel for forgiveness (though that would be nice), the purpose is to find your voice, to advocate for yourself. This value is sometimes lost in the process. Advocating for yourself is taking ownership of your life, it's saying that I can't control what other people do but I have power over my actions and how the actions of others affect me.

Option #3: Move on with your life. Many choose this option, but be careful. At face value, moving on and even learning from your experience sounds like a healthy, well-adjusted way to live. This option may very well work, but be aware that for some, continuing to be the "bigger person" may result in emotional and relationship issues later in life.

Why do some experiences result in grudges while others are resolved and released? That's a great question to reflect on. Is it simply because you have fully expressed your feelings and have complete understanding of the situation or are there other factors?

Many hold grudges because of the fear of what may happen if their true feelings of anger, sadness, and resentment are expressed. Expressing your feelings in a healthy way usually won't result in the catastrophic damage you imagine. It will result in a personal sense of accomplishment and mastery of one's environment.

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Hey Salmaan, I wanted your opinion regarding conversion therapy considering you are in the field. Particularly because you are a Muslim, what's your opinion about conversion therapy and what role do your religious beliefs play in working with someone who is gay.

-- Anonymous, August 2013

I openly admit I do not have first-hand experience with conversion therapy, I have only heard stories from those who were willing and unwilling participants. The stories I have heard have been negative; however, I know there are positive stories out there.  I am not sure if a “conversion” to heterosexuality makes the therapy a success, or if the goal of conversion therapy is to manage homosexual desires in a heterosexual manner. It's certainly controversial, and therapy in general is usually a failure if the participant has been coerced into therapy.

In my professional work, when someone who is confused or struggling with their sexuality enters my office, I focus on the struggle and confusion. I never have and never will push someone to one orientation or another. That's me speaking as a psychologist and a Muslim. Maybe I'm doing my faith a disservice, but I don't think so. In my life and work, I believe it’s not my place to judge; my role is to increase understanding and awareness in your life.

Part of therapy with me is having a conversation about what would it be like to be straight and what it would be like to be gay. This allows for a genuine analysis of how the person feels and may bring clarity regarding their sexual orientation. If someone wants to talk about the role of their faith, that conversation is certainly explored. Many do struggle with balancing their religious beliefs and their orientation.

In my experience, people know their sexual orientation upon entering therapy. Therapy is usually more confirmation and supportive than analytical. A major part of the therapy is how to manage current relationships, especially family relationships. For many, the major stress is how to tell family, especially if the family is opposed to the lifestyle. The fear of being ostracized and disowned from their family is very real for many.

For those who have been adamant that homosexuality is a choice, I always say your political/religious affiliation is a choice, so spend the next 5 years genuinely being of a different political mindset or different religion. That might provide perspective into what it is like to pretend to be something that you are not. That’s my personal belief.

As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

Suicide is a mostly avoided topic, but there is a good chance you will be impacted by a suicide in your lifetime. More than likely, you will personally know someone or know of someone who has taken their life. Here are some sobering statistics (courtesy of the National Center of Health Statistics, 2010):

Suicide represents 1.6% of all deaths in America.

Suicide is the 2nd leading cause of death among teens.

Suicide ranks 10th in causes of death in America. Homicide is 16th.

Men are 4 times more likely to carry out a successful attempt than women.

Women attempt suicide 3 times as much as men.

There are approximately 1 million suicide attempts/year.

So what do you do if feeling suicidal? It’s important to know that as lonely and hopeless as you feel, many people from all walks of life have suicidal thoughts. Feeling suicidal is scary, but it’s not uncommon. Suicidal thoughts are the result of being overwhelmed with feelings of sadness and pain. You feel like you can’t cope and there is no other option. What’s important to know is with time and healthy choices, suicidal feelings can pass and you can regain control of your life. Here are some things that help if feeling suicidal:

Talk to someone.  Don’t keep suicidal feelings to yourself. Talk to someone. Feeling understood will decrease the loneliness and hopelessness.

Avoid drugs and alcohol.  Some feel that drugs and alcohol numb the pain; however, drugs and alcohol can actually exacerbate suicidal thoughts and feelings.

Make your home safe. If you have thoughts or a specific plan of how to hurt yourself, remove household items, weapons, and/or medications from your home. If you can’t, then go to a safe place or have someone remove the items for you.

Exercise and get outside.  Try to exercise for 30 minutes. Go for a walk outside. Even 10 minutes of activity can result in an improvement in mood.

Keep yourself busy.  Staying busy keeps you from thinking about suicide and keeps you productive. It also gives you time to gain perspective on your situation.

Focus on what keeps you from attempting suicide.  You are alive and that is for a reason. Focus on what keeps you alive (faith, family, friend, hobby, anything that helps).

You may be thinking that everyone will be better off, or even happier, if you aren't around. That is never the case. A suicide leaves a path of pain and sadness behind for those left to deal with the aftermath.

If you are feeling suicidal, there is always someone to talk to. In the U.S., you can call:

The National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

The National Hopeline Network at 1-800-SUICIDE (1-800-784-2433)

Outside the U.S., you can search for a resource in your country by visiting the website below:

http://www.befrienders.org/directory

If you know of someone who is suicidal, you can call 911 or take the person to the nearest emergency room.


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Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!