So, so great to talk w/@socworkpodcast today abt my book Loving Someone w/Suicidal Thoughts. We had a rich conversation abt different things friends & family experience, like fear & guilt, *feeling * manipulated, secrecy vs. getting support, hope & recovery, & also how to help. pic.twitter.com/H3oZ2MAvOL
— Stacey Freedenthal (@SFreedenthal) October 1, 2022
Bio
Stacey Freedenthal, PhD, LCSW is recognized nationally and internationally for her expertise in helping people who have suicidal thoughts. Her new book is Loving Someone with Suicidal Thoughts: What Family, Friends, and Partners Can Say and Do (New Harbinger Publications, 2023). Dr. Freedenthal also authored the book Helping Someone with Suicidal Thoughts: Tips and Techniques for Professionals (Routledge; 2018), and she created and maintains the website Speaking of Suicide. She has authored or co-authored more than two dozen peer-reviewed articles and book chapters about suicidal intent, youth suicidality, mental health service use, and other topics related to suicide. You can find her on Twitter
Dr. Freedenthal is an associate professor at the University of Denver Graduate School of Social Work, and a psychotherapist in private practice. She lives in Denver, CO, with her husband and their collection of cats.
Transcript
Introduction
Today’s guest writes about some other pervasive myths about suicide:
Myth #1: Everyone who dies by suicide has a mental illness
Myth #2: Suicide is always preventable
Myth #3: Once someone decides to end their life, there’s nothing you can do to stop them.
These are all myths. One of the myths my guest doesn’t include in her list, but one that she debunks all the time, is the myth that social workers don’t struggle with suicidal thoughts or behaviors, or that you can’t be a good social worker if you’re having suicidal thoughts, or have struggled with suicide attempts. Don’t let anyone tell you that you don’t have a place in social work. You do.
Today I'm speaking with Dr. Stacey Freedenthal. You might remember her from Episode 119 where she shared tips for professionals working with suicidal people. Or you might know Stacey from her blog, SpeakingOfSuicide.com, her 2017 New York Times op-ed where she came out as a suicide attempt survivor (https://www.nytimes.com/2017/05/11/well/mind/a-suicide-therapists-secret-past.html), or her work any of her academic contributions as an associate professor at the University of Denver’s Graduate School of Social Work. Today, she is back on the podcast to talk about her 2023 book, Loving Someone with Suicidal Thoughts: What Family, Friends, and Partners Can Say and Do, from New Harbinger Publications.
In today's interview, Stacey and I talk about how she drew on her personal and professional experiences to write a book for families, friends and parents of someone who is suicidal. She talks about why and how families can create support teams, when and why it might not be appropriate to reach out to others, and how to navigate reaching out even when the suicidal person doesn't want you to. We talked about how to find support on social networks like Facebook. She talks about how friends and family can feel manipulated by a suicidal loved one, even if the suicidal person isn't being manipulative. Throughout the interview, Stacey speaks to families AND social workers. For example, in her book she takes the classic therapy phrase "active listening" and suggests that for families we call it "brave listening." I love that. Active listening is so professional. If you're listening to your kid or your partner or your parent talk about how they don't want to live any more, you're brave listening... that's what it is.
Interview
Jonathan Singer: Stacey, thanks so much for being back on the podcast again. It’s so exciting to have you here!
Stacey Freedenthal: Thank you, Jonathan. And I’m excited to be here!
Jonathan Singer: So, what inspired you to write a book for family members?
Stacey Freedenthal: That’s a great question, and I think part of it is my website speakingofsuicide.com. Initially, I envisioned that website more for people who have suicidal thoughts, but there’s been so much interest from friends and family and so many comments and emails that I’ve received from people plaintively and poignantly wanting help with, “What do I say?” “What do I do?” “I’m scared I’ll make things worse.” “I’m scared I’ll say the wrong thing.” “I’m scared I’ll regret not doing something… or doing something.” And so, it just opened my eyes to… They say it takes a village, and there’s also a whole village needing help. And friends and family are part of that village.
Jonathan Singer: Well, and I know that you and I have talked about this, that we have had friends and family who have been suicidal, which is an interesting place to be as people who are sort of professionally associated with suicide prevention and suicidology.
Stacey Freedenthal: And mental health.
Jonathan Singer: Yeah, and mental health. Can you talk about some of the ways that your experiences kind of played into your decision to write this book?
Stacey Freedenthal: Sure. Sure! Because personally, I have experiences from multiple angles, and professionally, I have experiences from multiple angles. And so personally, the one that’s most obvious is that I was suicidal in the past, and—I don’t know if you noticed, you may not have even gotten it in your proof but—the book is dedicated to my mother. And that’s because she went through this with me. And she loved someone with suicidal thoughts very, very well. You know? Like, I felt her love. And, by the way, she was a licensed clinical social worker.
Jonathan Singer: I didn’t know that!
Stacey Freedenthal: Yeah, she was a therapist for many years with an employee assistance program and then she went into private practice. And so, I had a good model for what to do, and then I also was the recipient of what she did. I know, for me, what worked and what really, really didn’t work. And obviously, I’m just one person, and my experience isn’t everybody’s experience. You know, I’ve been in this field now for almost 30 years, and over the years, I’ve discovered that a lot of the things that I cringed at when people said to me are kind of universal. You know? That others cringe at, too. And a lot of the things I deeply appreciated, others deeply appreciate, too. So, there are commonalities, and I was able to draw from that and my own personal experience. And then, also having had somebody in my family who had suicidal thoughts. And I mentioned in the book that my son did as a teenager. And so, then, that put me in this other perspective of… of, quite frankly, thinking some of the things that I didn’t like that people thought when I had suicidal thoughts. You know? So really, wearing multiple hats and being able to see now, more easily, another perspective and maybe even a perspective I didn’t like; that I was feeling worried about myself in ways that were at risk of preempting his needs. Like anyone, I think, who has somebody they know who has suicidal thoughts. They’re worried about the person with suicidal thoughts, and they’re also worried about themselves and how much it hurts and how much it would hurt if that person died.
Jonathan Singer: In chapter three, you talk about managing stress and guilt, and one of the things you recommend is to create a support team. What is that? And why is that so important for families?
Stacey Freedenthal: Yeah. It’s important because this is a terribly hard situation, first of all, and it’s even harder if you’re dealing with it alone. And it’s unfortunate that, I mean, obviously it’s unfortunate that there’s so much stigma around suicide, but it’s especially damaging in this context because people are, a lot of people, feel they need to keep it secret if somebody in their family has suicidal thoughts. And I understand that there’s a lot of different reasons why people might feel they need to keep it secret, but then it deprives them of the support of other people. And other people can help in tangible ways, like, “I’ll come over and I’ll walk your dog while you’re in the emergency room all night with your kid,” or, “I’ll bring you a meal because you’ve been up all night.” You know, that kind of thing. But they also can help in intangible ways, in terms of providing moral support. And another thing is, so many people are isolated and keeping things secret because of the stigma. But it’s astounding how many people that, when they hear that I study suicide, open up to me about somebody in their family who died by suicide or was suicidal, or they were suicidal, and then they haven’t told other people, and they’re only telling me because they feel safe to.
Jonathan Singer: And I think, for social workers, it’s such a good reminder that one of the things that we can do is to talk with family members about, “Well, who is your support?” Right? “What’s your team?”
Stacey Freedenthal: Absolutely. And, you know, we wanna be fired. We want our clients to not need us anymore, and part of that is working with them on where else they can have a listening ear or where else they can get emotional support. That kind of thing.
Jonathan Singer: So, who would you recommend people reach out to as part of their support team? And are there folks that you would suggest not reaching out to?
Stacey Freedenthal: Well, the thing is that there really are legitimate reasons why somebody may not want to share with others. And you know, there’s different layers. I mean, maybe the person with suicidal thoughts wants to keep it secret. And so now, you, as a loved one, feel like you need to protect their confidentiality. But I even think that there are times where you may decide that you’re gonna confide in other people even though the person with suicidal thoughts doesn’t want you to. Like, I think there are times where you may just decide, for my own well-being, I need to not be in this alone, and I’m gonna tell people I trust who will keep it secret. You know? Because I’m aware of situations where a teenager has confided in one parent and said, “Don’t tell the other parent.” And I’m also aware of situations where the one parent tried to keep it secret. And I’m not talking about the client here, by the way. So. I’m talking about situations I’m aware of personally and not professionally. So, you know, and then you’ve got people who work in professions where it could be damaging if others knew that they have suicidal thoughts. So, that might be another reason why someone feels like they need to keep it secret, and I’m referring to a loved one may feel they need to keep the other person’s suicidality secret. So, there are competing pressures and I want to acknowledge that. But I would say in terms of who to seek out for support group, again, people that you feel that you can trust to… to… Well, this sounds so trite, but people you can trust to help you! Like if there’s somebody that you worry that they’re gonna be judgmental and critical because they’ve been judgmental and critical in the past, then no, they’re not gonna be supportive. But if there’s just even one person can make a difference in terms of attenuating shame and isolation and giving hope, and different things like that.
Jonathan Singer: When you have a loved one that’s suicidal, it can be too late to do a whole vetting process. Right? And so, I think this is one of the reasons why, hopefully, as people read your book and this conversation continues, that you can have folks who are much more open about talking about suicide in general with friends and family. So that when it comes up, there’s already been this conversation about “so this person has this belief about suicide” or “this person has this judgment or this person” and so I sort of have a sense of who I can reach out to about that. Are you familiar with any online resources or technology resources for family members who might be looking for support around this kind of building an online team?
Stacey Freedenthal: Yeah, and that’s a great question, too, because one of the things that can be alienating for people who have loved ones with suicidal thoughts is that there are much more resources out there for people who have lost somebody to suicide than for people who are dealing with that right now. And I understand that. I’m not saying there shouldn’t be all those resources. I am saying, I wish there were more resources for people who are along different places on the spectrum. And so, I’m having two different thoughts about what you said and that’s… Somebody who has had a loved one attempt suicide, they often don’t get sympathy from people who have had somebody die by suicide. Because the person who is bereaved is like, “What are you complaining about?” Ya know? “You get another chance. I don’t.” But it still is terribly painful to have somebody you love attempt suicide. And yes, they survive. That’s fantastic! But it doesn’t mean that it wasn’t scary, that you’re not scared that it could happen again, that you’re not hurt or angry or whatever other emotions are weighing you down. So, there’s that person that I’m thinking of, and then I’m thinking of the person who has a loved one who’s thinking of suicide and hasn’t made an attempt. And then their situation may be minimized by others who have experienced something further along on the spectrum and something… I don’t want to say, “more severe,” because it’s all relative. You know? So, what I have found, it’s gonna sound weird, but Facebook groups. There are a number of Facebook groups for people who have a loved one who has suicidal thoughts or has attempted suicide. And some are specific to parents of adolescents, and some are more general. And, you know, that has its risks--to go on Facebook and talk about your family or friend or partner or some other loved one with complete strangers. So, I think it’s worth considering creating a new profile. Which, by the way, Facebook, don’t say I’m violating your terms of service for encouraging people to break your terms of service! But the reality is, sometimes people do need to have a persona that doesn’t reveal their true identity.
Jonathan Singer: Yeah, that’s really… I’m so glad that you brought up that point. Not necessarily about violating the terms of service for Facebook but acknowledging that when you have a support that’s out there for kind of one level of grief or bereavement (right?), it’s important not to mix and match. There’s this sense of, like, almost a competition. There’s a hierarchy of, like, what loss is worse. And what’s true is that all loss is loss, and in this spectrum, we know that there are far more people out there who are struggling with thoughts of suicide and attempts than have died by suicide. And so, sort of the number of people who are looking for support around that is huge. And if they say, “Well, my loved one hasn’t died by suicide. So therefore, I don’t really deserve this support.” Then that just shuts down the conversation in really awful ways.
Stacey Freedenthal: Yeah, and I find this is true in a lot of social work practice —that everything’s relative. I have clients who say to me, “I shouldn’t be this upset” or “I shouldn’t be depressed—other people have it worse.” And what I say to them is: If you’re sitting on a bench with somebody waiting for a bus, and somebody comes by and shoots you in the leg, and shoots them in the head, well, they’re in a lot worse shape than you. It doesn’t make your leg stop hurting, and it doesn’t mean you don’t need treatment. It doesn’t mean that you’re not losing blood… Your body doesn’t say, “Well, at least I didn’t get shot in the head.” No, it’s still excruciating pain and trauma to be shot anywhere. And that’s what I think about this. That if you’re in pain, or you’re distressed in some other way, it doesn’t matter if other people have it worse. You used the word “competition,” and I think another word that could be used is “disconnection.” That when people are hurting, it can be healing to connect with somebody else who understands or can listen and really can join with you. And when people are disconnected in that way, then there’s a lost opportunity.
Jonathan Singer: In your book, you also have a chapter that talks about feeling manipulated, which seems like a pretty loaded term. Could you talk a little bit about how you chose that term and what the point is in that chapter?
Stacey Freedenthal: Sure. It is a very loaded term. And I was very, very careful, semantically, throughout the chapter, to say you “feel” manipulated. You know? Because there’s that saying that just because you feel somebody’s manipulating you doesn’t mean they’re manipulating you. And yet, you can still feel manipulated. So, I give the example in the book of somebody who says, “If you won’t let me stay with you, I’ll kill myself.” And that can feel incredibly manipulative. It also may be that person’s truth, that if they have to go live on the streets that they don’t want to live anymore. I also give a variation of that example in the book where the person doesn’t say, “Let me live with you or I’ll kill myself,” but they do say, “Oh my God, I’m being evicted and I don’t know what I’m gonna do!” And “If I have to be homeless, I’m gonna kill myself.” And they’re not saying, “Let me live with you.” But naturally, their best friend is thinking, “Oh my God!” You know? “Live with me!” Even though they may not want to be sharing their house. But it’s such a rich topic because there’s the idea of, it's an insult. And I agree to say that some of these being manipulative. It’s an insult because it dismisses their very real pain and needs. And yet, there are times where somebody’s talking about suicide or using suicidal communications as a way to try to influence another person. And the most extreme example is someone in a in a case of domestic violence who in order to try to keep their partner from leaving says, “If you leave, I’ll kill myself, and it’ll be your fault.” But that’s even hard to say that that’s manipulative because that also may be that person’s truth. And it can be abusive to lay that on somebody when the when the intent is to control them. So, there’s just all these different angles from which to look at it. You know? Like, are you being manipulated? Do you feel manipulated? If you feel manipulated, it still sucks. (Pardon my highly technical term.) And then, what do you do?
Jonathan Singer: Yeah. So, first of all, I’m glad that you made the distinction about sort of being manipulated versus feeling manipulated. And yeah, as your book is subtitled like, so, what do you do?
Stacey Freedenthal: Right. And I just wanna say… Again, there’s multiple responses to everything, but… I think the first one is kind of to take stock internally with compassion towards yourself and see where this feeling is coming from. Is it that you feel manipulated by the person or manipulated by the situation? And that’s an important distinction. Because if you feel manipulated by the situation, so does that person with suicidal thoughts. You know? And it’s a way to join with the person. If you feel manipulated by the person, that can really create a distance between you when what’s needed in most cases—I’m not going to say in all cases, but in most cases—what’s needed isn’t distance, but connection and support. I want to say that this also applies to social workers professionally, because I hear people, a lot, say that a client is being manipulative. Marsha Linehan has written about the concept of phenomenological empathy, and that we need to recognize when we feel that we’re being manipulated: A.) That we might not be being manipulated. That the person may be doing the best they can. And that if we are being manipulated, it’s because it works, and they have found an effective way to get needs met because people aren’t meeting needs their needs in other ways or because they don’t have the skills to get their needs met in other ways. So, even though the book is intended for friends, families, and partners, I think social workers can take from that that they also need to look at when they feel manipulated by a client. So in addition to looking at one’s internal responses, I think it’s also important to look at what you can do if you feel manipulated to lessen the chance of that. And there are teenagers who will say things like, “If you make me go to school today, I’m gonna kill myself.” And if the parent says, “Oh my god! Then never mind.” Well, then that sets the path for more ultimatums in the future. And so, you know, this is kind of where behavioral therapy concepts come in; that people who feel manipulated can look at where they’re reinforcing those statements. It’s scary though. It’s dangerous. I’m not saying don’t give the person what they want, or they need. Because sometimes being manipulated is better than the alternative of not helping someone who needs help or not giving someone the connection they need. So, it’s very nuanced. And, you know, it required a whole book.
Jonathan Singer: [laughs] So, I really like that you end the book talking about fostering hope and recovery. What are some of the things that families can do?
[25:30] Stacey Freedenthal: Mmhmm. Yeah, there are quite a few things. Again, enough to fill a book. Some of the more kind of obvious, structured things were to talk about creating a Hope Box and to help the person think of things that they have to look forward to. You know, the things they want to do before they die, hopefully many, many years from now. The things that they may not be seeing. You know, the options they may not see, the other possibilities besides the worst possibility that is dominating their mind. We can create hope also by sharing stories of recovery. The thing about creating hope, though, or fostering hope that’s dangerous is, there’s often an urge to do it right away, in a way that can be very invalidating and dismissive to somebody who doesn’t feel hope. And that’s why there’s also a chapter what I call in the book “brave listening,” but what social workers tend to call “active listening” or reflective listening. Because it’s important before really actively trying to instill hope that we join with the person in their pain. Because otherwise, they may think you don’t get it… You can’t understand… You don’t wanna hear it… You don’t want to hear how hopeless they feel. And so, it’s a balance between listening and validation, and then also, not buying into their hopelessness, and holding in mind that everything’s dynamic, things change, nothing’s permanent. Even if the situation can’t change, a person’s feelings about the situation can change, or their ability to cope can change. Even in the worst circumstances, some people find meaning in terrible suffering. In the meaning that they find, whether it’s through helping others or writing about it, or spiritual growth or whatever it is, it sustains them.
Jonathan Singer: I think it’s so important to be able to listen and to validate the person for where they are, right? And if they’re in a place of hopelessness, validate them. While at the same time you, as the family member, as the loved one, are able to hold hope. And I remember hearing suicide attempt survivors talked about how they didn’t know what their reasons for living were, they weren’t in their life yet, but they stayed long enough for those reasons for living to be in their life. And sort of holding hope, but not saying, “Hey. Look. You will have this someday! Just trust me.” Right? Which could be very disconnecting and is not meeting the person where they are.
Stacey Freedenthal: Right. And I think the phrase “it gets better” got a lot of… What’s the word I’m looking for? Pushback. When the It Gets Better campaign started, it was almost glorious. Like, oh my gosh, this is so important to tell kids. It gets better. This isn’t permanent. Hold on to hope. You know? Stick around. But then the pushback was, it doesn’t always get better. And even if it does get better, if I’m in a state of mind where I think it can’t get better, it doesn’t matter. And this is where, Jonathan, I’ll be honest, I think my experience of having been suicidal informed my writing. I was constantly thinking of, like, how I felt when somebody said a cliché to me when I was in a suicidal place. And I think another important thing for friends and families and partners to hold in mind is that recovery can look different than what they may think. Like, they may have perfection in mind. This person is recovered only if they never again, for the rest of their life have a suicidal thought. But the reality is, many people think of suicide and still have full lives. It’s a paradox. It’s estimated that fifteen million people in the United States, every year, seriously consider suicide. Fifteen million people. And of those, almost fifty thousand end their life. And that’s tragic. I in no way want to minimize the devastating effects of even one suicide death, let alone almost fifty thousand. But I also find hope in the fact that means that there’s fourteen million, nine hundred and fifty thousand other people with serious suicidal thoughts who live. And so, having suicidal thoughts itself doesn’t need to be an emergency or—I’m only gonna use this word because I’ve heard it from other loved ones. I, myself, don’t use it, but they view it as—a failure if the person they care about is still thinking of suicide. And obviously, it’s not ideal. You know? But people can’t control what thoughts come to them. And thoughts don’t necessarily constitute action, but they also don’t determine the future.
Jonathan Singer: That’s great. Stacey, thank you so much for, first of all, for writing the book, and for taking all of your years of accumulated wisdom as someone with lived experience, as someone with a parent, as a parent, as a professional. And I appreciate you talking through all of these various pieces which you wrote for non-professionals, but I do think that there’s a lot of value in this for professionals who are supporting clients. And also, recognizing that professionals are people, too, and professionals will have loved ones who are suicidal, and we have to take those hats off. We can’t be the social worker to our family, right? So, we’re the person that you wrote the book for. And I think that’s really powerful. So, thank you so much for being here and talking with us about this.
Stacey Freedenthal: Well, thank you, Jonathan. It’s my pleasure to be here, and I’m grateful for your interest in helping suicidal people.
Jonathan Singer: I’m Jonathan Singer. And thank you for being with us today for another episode of the Social Work Podcast. If you missed an episode or have suggestions for future episodes, please visit socialworkpodcast.com. If you’d like to support the podcast, please visit our online store at cafepress.com/swpodcast. To all the social workers out there, keep up the good work. We’ll see ya next time at the Social Work Podcast!
Transcript donated by the amazing Grace Durbin
Resources
- Speaking of Suicide (Stacey's blog): https://www.speakingofsuicide.com/
- Freedenthal, S. (2023). Loving someone with suicidal thoughts: What family, friends, and partners can say and do. New Harbinger Publications.
- Freedenthal, S. (2018). Helping the Suicidal Person: Tips and Techniques for Professionals (1 edition). Routledge.
- 988 Suicide and Crisis Lifeline: https://988lifeline.org
APA (7th ed) citation for this podcast:
Singer, J. B. (Producer). (2022, December 25). #131 - Loving someone with suicidal thoughts: Interview with Stacey Freedenthal, PhD, LCSW [Audio Podcast]. Social Work Podcast. Retrieved from http://www.socialworkpodcast.com/2022/12/Freedenthal2022.html
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