S03E04 Transcript: Rory O'Connor on Suicide and Prevention

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Gemma Styles [00:00:02] Hello, I'm Gemma and welcome to another episode of Good Influence. This is the podcast where each week you and I meet a guest who will help us pay attention to something we should know about as well as answer some of your questions. This episode features discussion of suicidal thoughts and behaviors. Please listen with care and put your mental health first. We'll be linking to some support resources in the show notes, so please do use them if you need to. This week we're talking about suicide prevention, why we should face our fear of talking about suicide, how researchers seek to widen our understanding and how we can look to prevent suicide deaths. So joining me this week is Rory O'Connor. Rory is a professor of health, psychology director of the Suicide or Behavior Research Lab at the University of Glasgow and head of the Mental Health and Wellbeing Group that he's a president of the International Association for Suicide Prevention, a fellow of the Royal Society of Edinburgh and sits on the Science Council for the charity MQ Mental Health Research, as well as many, many other accolades and board memberships I could list all day. Suffice it to say, Rory is a highly respected, highly experienced voice in the field of suicide research.

Rory O'Connor [00:01:15] You are really valued. The world is a better place for you and under the pain that you're experiencing is not permanent. Suicide is not the solution. And please hold on and reach out for help.

Gemma Styles [00:01:28] The first thing I kind of want to address right at the beginning is I'm really nervous about recording this episode. And the nerves mostly come from. Because it's such a sensitive topic. And I think the fear comes from the fear of saying something wrong that's going to be harmful. But I also think that is kind of the main reason that I wanted to do this episode, because it's one of those topics where the fear of talking about it, I don't think is probably actually helpful. To check, though, you obviously spend a great, great lot of your time talking about about suicide and about suicide prevention.

Rory O'Connor [00:02:13] Yeah, I think no, I think that's a really good place to start. And first of all, thanks, Gemma, for inviting me on. I'm really looking forward to our conversation. But I think I think you've just highlighted it's really a big challenge we still have in the field, which is because it is such a difficult subject to talk about and that we don't understand what is it that prevents people talking about suicide? And part of it is fear. And I think that fear comes from many different places. As you say, one of those places of fear is yet, as you've just suggested, that you don't want to say the wrong thing. And indeed, we know from lots of work that people do, there are some words that people struggle with loss using in the field. So one of them is talking about committing suicide even as a term, and that's a verb I try to not use my mainly because it harks back to a time when suicide was illegal. And so personally, I mean, I just try and talk about people dying by suicide, but usually I am try and I would never I would never tell anybody else how they should talk about suicide, especially if they are bereaved by suicide or have been suicidal themselves. For me, that advice on some of the terminology is more for people discussing it in the media or in other public forums where I know I've come across so many people who do find it. Do you find it really challenging to hear that their loved one, loved one's death described as as committing suicide? So I think that's but beyond that, I think for me, the conversations are so, so important and the work I've been doing over the last 25 years, I've done a lot of public engagement work and is really trying to get the message out there that it's okay to talk about suicide because there's research which shows that even just asking somebody whether they're suicidal, asking that question directly can really be the start of a life saving conversation, which could get them some of the help that they need. So although I totally get their totally understand the fear and it's and it's understandable, I think these conversations are so important because my advice would be, of all the years I've been doing this work, is that if you asked questions around suicide or mental health in a way which is compassionate, which is nonjudgmental, which is just common humanity, you're not going to say the wrong thing. And my experience of speaking to it a lot, I mean, countless people have been suicidal to brief. The challenge they often have is there's so much stigma still around. If you're suicidal yourself and somebody asks you, there's often you feel really shameful or a sense of shame that that you're are you are suicidal or or nobody's ever asked you that question before. And the sense of relief that that opens up this conversation, because I think often people who become suicidal, that maybe they've had a difficult childhood and that maybe their feelings and emotions haven't been validated or recognized. So you've just been asking that question. So I can just really have a sense of feel that individual feels held. And that's why my message I always say is, please always ask the question, always try and raise a discussion around mental health or suicide. Of course, you do it in a way which, as I said, already, is compassionate and non-judgmental. And only through having these conversations will we get more comfortable with having them. And so when I think about the conversations I've been having over the years, they do get easier and almost because I have lots, lots more experience of doing it.

Gemma Styles [00:05:42] I mean, yeah, as you've kind of said before, you've got a lot of experience in this field. You've been working in suicide research for, I think, 25 years. You said, how did you get into that field? Kind of what's led you to doing all of this work?

Rory O'Connor [00:05:59] So it's funny or not funny, but it's more through serendipity or by chance. So many moons ago, in the 1990s when I did it, I did a psychology undergraduate degree and at Queen's University in Belfast and I'm Irish. It's important to be upfront. I got it hard and part of my identity is my Irishness. And but so I did I did work on depression there in my as an undergrad. I'm actually a clown to do a PhD on depression. And then it just so happens that sometimes things happen the somewhere. I think it was of 1994, I got this telephone call from the person who turned out to be my PhD supervisor and he said, There's this opportunity or for funding. I'm looking at suicide. So in that sense it was really fortuitous. So that's what brought me along my journey. And so although at that stage I'd never been directly affected by suicide, then this, then the sad reality in between has been two really important people in my life. Have lost their struggle to live. One was that person, Noel, who brought me in the field, my parents, the supervisor. He took his own life in 2011, and before that, in 2008, one of my closest friends, who we did our things together in Belfast, she took her own life. And so although I was always, always really passionate about mental health, even from a young as a young kid, I remember being really fascinated by psychology and mental health more generally than I suppose with my own personal experiences that really are home to me. The challenge of working in this field in terms of suicide and suicide prevention had really difficult to prevent sort of individual death by suicide and but also to just give me a sort of an added impetus to really every day I mean, almost every day for the last 25 years or more, I think it is now. I've been trying to understand suicide better and maybe do whatever we can to prevent it. And yeah. So it's yeah. So I never thought when I was 21, when I started this work that whatever my 48 so actually is more than 25 years. So that's that, that's what I would spend my life doing. But it's incredibly rewarding and incredibly humbling to do the work and people's like. People share their stories with me and my research team and it's just amazing. Amazing. It's difficult, but amazing.

Gemma Styles [00:08:31] Yeah. I mean, I'm really sorry to hear about those personal losses that you've experienced. And I think a lot of people listening will also have those personal connections to the topic. And, you know, that's why I want to do this as sensitively as possible.

Rory O'Connor [00:08:43] But yeah, but just just all that. Well, not just on that. Like. I totally agree that when we think about the number of people affected by suicide as well. It's really worth taking a second. Think about the scale of the impact of suicide. And so so when I started out in the field of suicide research and prevention, we used to think that for every person who died by suicide, there was maybe six people potentially affected by each of those deaths. Then there's a recent study in the in the United States published in just before the pandemic, well known suicides an 18. And while that showed that on average there's about 235 people will in some way have some connections with each of those deaths. And if you think about that and then think about, you know, listening to this podcast, the chances are we all know somebody either directly or indirectly. Yeah. And I did the calculation recently, and it was that we think there's about 703,000 people who lose their struggle to live every year somewhere in the globe or across the globe. And if you do that multiplication there between 135 times, 703,000, that's like 90 over 90, what, 95 million people potentially affected. And most of those people will not be bereaved in the traditional sense, but. So one of things I've learned over the years is you can never predict the impact of the death on in terms of like how close the person is. So yeah, of course family members and close friends will be affected, but colleagues or more distant friends can also be really adversely affected. Because what each death can do is resonate with you as an individual in the sense that maybe you've been having suicidal thoughts, maybe you've known somebody has attempted suicide or died by suicide. And another context, or then these other deaths really bring on the all of us, our own mortality mean our own fragilities and vulnerabilities. And certainly when Claire died, I mean, that really brought home to me my own personal vulnerabilities, my own personal fragilities. And and I think that's why when we think about having conversations like this and a podcast like this, reaching people in my case who don't read my academic papers, it's so, so important.

Gemma Styles [00:10:59] Yeah. I mean, so talking about the academic papers and kind of research that you do. So when we talk about suicide research, what is the kind of I mean, I'm sure there are many things, but what kind of areas are you and your teams looking at? What are we trying to understand? What do we not understand yet? Kind of where is that research going?

Rory O'Connor [00:11:21] So the work that we do, because it's obviously to understand suicide is so complex. So the first starting point is that there's no single reason why an individual dies by suicide. There's no single risk factor. And the work that we tried to do using lots of different methods and I'll talk with some of them in a second, is trying to understand. So for me, it's all about trying to understand what it feels like to be suicidal. And then lots of people are suicidal, but thankfully most people don't act on their thoughts of suicide, don't engage in a suicidal act. So for me, it's about understanding what makes somebody suicidal. And then what is it that makes people more more likely to describe it as crossing the precipice from suicidal thoughts to suicidal acts? And then if we can understand both of those, hopefully we can have better interventions and prevention strategies and so on. So the work that we do to try and address those questions is we do lots of different sorts of work. We do large scale surveys with both clinical and non-clinical populations, with general population studies, which are trying to understand the scale of suicidal thoughts and other risk factors. We also do experimental based work. So for example, we do a lot of work on what happens if we. So in some of our studies we make, we might look at how people with different, different suicidal histories respond to stress or respond to a low mood. So we can. So it's a bit odd, but we can induce a low mood, negative mood briefly in the laboratory and then look at, say, for example, how people's psychological factors change. So the way they think about the future or the way the so we do our work on what's known as physical pain sensitivity. So we've had this this idea that people who attempt suicide may have a higher physical pain capacity so they can withstand higher levels of physical pain, which is often required to carry out a suicidal act. So that's an example of some of the experimental based work or or we do. We look at how the cortisol system, which is like the stress response system, works because we, we know know that people who are suicidal are when they encounter a stressful situation. So think any of us encounter a stress, a stressful situation that should activate our fight or flight response. And that fight or flight response is driven by, in part, this cortisol so that the stress hormone one of the stress hormones. So we need. Cortisol to be released by the body because that helps us then either decide what am I going to defend myself or how am I going to flee this situation? And it's also linked to, we think, to problem solving, to emotion regulation and to decision making. And so we've shown in some of our work and again, this is often done in collaboration with I have an identical twin brother, Darrel. He's a professor of psychology at Legion of our State and he's a stress researcher. And we so basically wherever he shows up that the stress system is what we technically describe as dysregulated are just not working as well and people here are suicidal. So we do that sort of work and we also then do clinical based studies with. So we do a lot of our work in hospitals and we work with people often within hours of a suicide attempt who maybe have gone through the emergency departments and and we do different sorts of work. Some of that is we might try and assess a range of sort of psychological and clinical risk factors to see can we better understand who's more at risk maybe to attempt suicide in the future or sadly, at risk of dying by suicide? And then we also do intervention based off. So in some of our clinical recent clinical studies, we we work with people in crisis to try and do whatever we can then to reduce the likelihood that they'll attempt suicide again in the future or sadly die by suicide. So as you can see, there's lots of different stuff going on. But yeah, and I suppose the last thing I'll just say on the types of work is it's so tough to all of it's usually guided by this sort of model of suicide I've developed. So a few years ago, it's a bit of a mouthful, but I, I published this sort of psychological model called the Integrated Motivational Volitional Model of suicide, which is like easier to say that I am v model. So the am v model. But mainly what it was my attempt to do was to understand why suicidal thoughts emerge in some people and not in others, and then why it is some people act on their thoughts. Some people cross a precipice, as I touched on already. And really at the heart of the model, though, is this idea that suicide is not usually about people wanting to die, is that their wanting unbearable pain to end and they feel trapped by that unbearable pain and that unbearable pain, that sense of entrapment could be driven by feelings of being defeated or humiliated, and that could be triggered by feelings of loss or rejection or shame. But for too many people, like for almost 6000 people in the UK, every year that pain becomes so overwhelming that they feel trapped by that pain and that they see suicide as the only option for them, the only way of ending that pain. So all that stuff I've just described previously is trying to write on package or on pack our understanding of what leads to that sense of entrapment. And then the Bentham is part of the model. This am v model is helping us understand. I've talk I talk about eight specific factors which we think are important and make it more likely that people who have suicidal thoughts will will carry out those suicidal thoughts and act on them and either by attempting suicide or sadly died by suicide. So it's a bit of a sort of a whirlwind tour. Jim, I apologize for that. Yeah.

Gemma Styles [00:17:04] No, not I mean, please don't apologize. This is the thing. It's obviously it's a lot of study and a lot of research, but it's also. A very complex issue. It's not the kind of thing that you're going to be able to boil down and say, you know, that's the only reason and that's the only thing to do about it sort of thing. But I think, you know, it's important to I enjoy learning about how this actually works with the people who are doing the work in this field. Yeah. So your book, if we look at that as kind of looks at the two areas of why people die by suicide and then what we can do to prevent. So I mean, obviously you've written a whole book about I'm not expecting you to read that to us right now. But when we look at prevention, what are the kind of areas that you're looking at in that respect? And what are the maybe more practical things that were done looking to actually prevent someone dying?

Rory O'Connor [00:17:58] So in my book, when it's darkest called, when as dark as white people die by Suicide and what we can do to prevent it was my attempt to try and basically synthesize, bring together my experiences or personal experiences, my own loss to suicide, as well as my own mental health challenges, as well as the countless people I've met on my journey. People who've been suicidal. Those who've lost loved ones to suicide. Suicide note analysis. But bring all that together. All these different voices together with the research evidence to do those two things. One is to understand and then to try and intervene and prevent. Now, for one, that's sort of what's best in terms of prevention stuff that I think one thing that really tried to do in the book is Open the conversation ops, the books written for anybody with an interest in understanding suicide. And and that could be any member of the public. A young person that's a young person, a person with lived experience, a clinician, anybody, a tall, skinny, bereaved by suicide. And actually, it was a really scary experience right in the book because what I. Me because I put a lot of put a lot of myself into not many. I didn't want to write a textbook on suicide. There's too many of those. And just in the way of trying to reach out to others. So was really, really frightening an experience because I had no idea how it would be received. And there's stuff in the book and the night before the book was published, go on. I had this sort of really panic go on. Because all these things I all these self disclosures about myself, my own experiences. So my, my God, once tomorrow morning, publication day happened last year. They're all out there and I can't. It's like the tiniest level, so. But the reason part of the reason for doing that. The reason the reason I'm here is because I think we all have to lean into our own sort of fears and anxieties. And and that's how I will tackle suicide risk. And all of us are mental health challenges and all of us in it and in the book trying to bring together these my own personal experiences with the evidence, with also trying to tackle the myths surrounding suicide was to hopefully equip all of us with a recognition that suicide can affect any of us, any one of us. None of us is immune. There's no vaccine against suicide and there's no vaccine against or spin or even by suicide. And the only way forward is to have these conversations so that people as part of it, so we can all really move forward in discussing mental health better, but in a way which is safe and try to do it in a way which is safe but is personal and compassionate. And and so I think it's really important that we tackle issues math. So, for example, one of the mess I talk about in the book is. Asking somebody whether they're suicidal will plant the idea in their head. And that is a big fear. Lots of people still have as my God, they ask somebody whether they're suicidal and, oh, what happens that will make them that will make them take their own life. There's absolutely no evidence for that, that because we know that asking that question and as I said already, is a beginning potentially of a life saving conversation. And like another myth in the book is I talk about that. So one of the fears that many of us have, and sadly I've encountered this as well, is that when someone is in the midst of a depressive episode, say and and we know that although the relationship between mental health problems and suicide is complicated and most people, it's really important to highlight most people, for example, who are treated for depression will never, ever die by suicide, will never, ever attempt suicide. As about 4% of people. But but but again, one of the myth says it all that the reason people kill themselves is because they've got a mental health problem or mental illness. Yeah, that's part of the context in which suicide happens, but it's not the reason. And that's why this point I made earlier about suicide, not about wanting to die, is an unbearable pain, too. And and if we all can start thinking about it along those lines, thinking about it as this thing that any one of us can experience, this pain, we all experience different sorts of pain, physical pain, emotional pain and emotional pain is no different from physical pain in the sense that there's only a there's a limit. There's a limit to the amount of physical pain we can withstand. And the same way, there's a there's a limit to the might of emotional pain. And so what I've tried to do in the book is convey what that pain feels like and dispel, because part of the myths are and I'm part of the reasons why people are frightened. Go back to the very, very start of the podcast is because we think suicide is this thing that happens, like it's this abnormal thing which happens to other people. And then that sense of, Oh, there are people I remember as a kid, I remember as a child thinking that people who had mental health problems were different from me and that they were like qualitatively different from me. And it was this thing have happened over there, which of course is not it can and does affect any of us. And so one of the things that trying to do with the book is trying to have that people's understanding that what makes people suicidal is stuff that happens every one of us every single day. But for some, there's that perfect storm of factors that comes together. Some people might be linked to early life trauma. We've done a lot of work looking at the link between trauma and suicide risk and or could be linked to unemployment or body image problems or issues to do with struggle with your own mental illness or whatever social disadvantage. So a whole range of factors and I sort of get them around here a bit on the sort of soapbox, but part of it is to really try and. The cover that tallies all these mesmerizes and sorry. The myth I was going to highlight was when I got distracted by the sort of mental illness, mental health problems that she is. Yes. A suicide. Well, one of the myths is that are one of the things we need to be aware of is if somebody is in the midst of a depressive episode, say. And. There's no explanation for their mood lifting and they seem fine. That is sort of warning signs, alarm bells, because often we think what happens is that somebody is in the mood in the midst of a depressive episode. And I remember because, number two, suicide is the ultimate form of solving a problem. It's most ultimate problem solving and usually have a solution for some social problem. And it's in the midst, not the passive episode. The person goes, Actually, I find my solution. It's suicide. And then you're the witness because you find a solution to a problem. And then the reason that's a concern is that because as your mood lifts, you actually then maybe have the cognitive capacity and energy to plan the suicidal act and then carry it out. So what I try to do in the book is alert people to some of these sorts of signs and symptoms. And then also really then in terms of the comeback, back to your question then about the prevention is so the book takes us through this journey of looking at us, looking at what it feels like to be suicidal and really drawing on people's experiences. But then we move on to the interventions. And we know that if we just think about sort of psychological interventions, we know that there's psychological treatments work in reducing the likelihood that people will attempt suicide. So we know that they are like things like cognitive behavioral therapy, things like dialectical behavioral therapy. We know those are two psychological treatments which are helpful, but then the challenges are only helpful for some people. And then the other issue is not everyone can access those treatments. Yes. There's something about access to treatment is one thing. And I. Sorry, I've just been ranting. To. So.

Gemma Styles [00:25:45] No, no, you really help. This is the thing. When you were obviously trying to do a limited time podcast episode and try and get everything in, but this is good. This is what I want to get in. I mean, I suppose what I also want to ask, you know, if it's something you are able to answer, I know that there will be people who will listen and be thinking, okay, in that situation where there's someone I care about and I think that they are at risk of dying by suicide. What do I do in that situation?

Rory O'Connor [00:26:19] Well, in that situation, I would I would ask them directly whether they're thinking of having of ending their life or having thoughts of suicide. Be direct. Now, some people start that conversation off, off by asking, are you okay? And and and I think that's a really that's a good way to start it. But then be asked, ask directly. Each of our biggest fear is when I ask that question, the answer comes back is yes. And so somebody responds and says yes. And I talk a little bit of provide tips about how you do this in the book. Is it so if somebody responds? Yes. Well, part of that is you're trying to validate, hear what they're saying and say, that sounds awful. So you're trying to validate and and acknowledge what they're saying. Don't try and minimize it. Don't try and explain. It's not your your you don't have to solve their problems. Fix it. You're just there to hold them, have a conversation, and then try and encourage them to seek help. Because obviously, most people they ask has asked that question to our friend or colleague. You're not a mental health professional. And so it's open the conversation up and then hopefully encouraging them to seek help. Now, if somebody is at imminent risk of if you think they're going to attempt suicide imminently within the next couple of hours, of course, always go with try to the emergency services, obviously that final point of call but try and encourage them to speak to the GP, their GP or phone the GP with them or as I say, all else fails. Definitely contact the emergency services. Now the other thing again, I described it in the book is you can also help them think about how they can keep themselves safe, because one of the things that we know works noise is it's a thing called a safety plan. And a safety plan is just a way in which you help somebody think about what are the sort of warning signs that a crisis might be escalating. So and then just ask me to think through that. So you're so what a safety plan tries to get somebody to do is to plan ahead for maybe a next crisis so that the next time a crisis comes that they feel better equipped to deal with it. And so with that safety plan are six steps and the safety plan and the first step is just looking at what are your warning signs? Ask them somebody talk through what are the warning signs? That crisis might be escalating. And then there's things that things you can do to keep yourself safe. So some of those might be just distraction techniques. Like some people, mindfulness works for them, although others it doesn't go for a role less than the music. What's in a movie, whatever it might be, something you can contact. And then the way the safety plan works, it goes through. Then sort of distraction techniques within. Internal and external. And then maybe people you really somebody you can contact if you're really concerned about yourself, like an emergency contact that can be a family member, a friend or somebody else, as well as maybe then listing your key professionals. Like if they all feel they they don't intend to continue, you still think you're safe. That's right. And don't like would you phone Samaritans would be phone your GP, would you form some other person or organization and professional. And then the last bit is and the way in which we it's called keeping your environment safe is trying to help the person that they are if they thought of particular method of how they'd end their life trying to ensure that they that to maximize the distance between that person on their and the method. But the key thing is it's having these conversations. And again, a safety plan is normally co-created with a professional. But I think willingness is really important, encourages all of us having these sorts of conversations of how we can keep ourselves safe as well as other safe. But of course, ultimately, if we're really concerned, it's it's an obviously contacting the emergency services and I know that these things are scary to do. But again, a of of tips in the book of how you can do that and also just having those conversations in a humane compassionate sort of sort of accepting way.

Gemma Styles [00:30:21] Yeah, definitely. I feel like in kind of trying to prepare myself for this episode recording, I've done some kind of, you know, research online about how to speak about these topics. And there were a few things that I maybe hadn't come across before, but I thought maybe we could discuss a couple of them. So that was one thing that I thought was interesting in terms of if you have lost someone to suicide. I found something that was talking about is, of course, understandable and fine to post tributes about people who've died, but try to emphasize that their death was preventable and don't use language like that in a better place now. So I feel like these are just small things that maybe I wouldn't have considered, but it's kind of, I don't know. Ironic because even having this conversation, it's obviously putting more things out into media. But then. Yeah, just the small kind of ways that we can as you know, everyone with social media, for example, the ways that we can talk about suicide in a way that is the most. Not even helpful, but just. I don't know. Do you know what I'm trying to say?

Rory O'Connor [00:31:34] Yeah. Not really. It's such an important such an important topic. And so couple of aspects that one is dealing with memorials after a suicide death. And that is always really challenging and ends a fine line because family members and friends, of course, want to honor their loved one. But we know from the research says you have to be really careful because we glamorize suicide. And if you talk about suicide as a sort of the solution to problems and like the idea of in a better place, what what you're doing then is that there's a risk that somebody who is already vulnerable may be more likely than to think of suicide themselves as an option. And so there are media reporting guidelines that the organization, which I'm president of the International Association for Suicide Prevention, Samaritans, the National Union of Journalists, all have on talking about suicide in the media. And it's about safe reporting. It's not about censorship. And it's the same applies to social media. Yeah. So basically talk about suicide, highlighting that suicide shouldn't be there. I mean, for all we should live in a world in which suicide is not the option, that there should be a solution, we hope to somebody's pain. And so what you're trying to highlight is suicide is not caused by a single factor, but many factors. And that more and more things we know for certain about seasonality is that's not suicidal thoughts are not permanent. Mhm. We know they come and go, they wax and wane and and they come up with periods of high intensity and those moments of high intensity it can often be difficult to see, hope to see a future, but we know from all the research and all the clinical work is that that those suicidal thoughts do recede and that and so what and when we're talking about suicide prevention in the media, we're trying to convey those messages of hope and that by reaching out, I reckon that there is support out there and that we need to do more than when we're talking about it in the social media way of highlighting that that's that there are alternatives to suicide and that these suicidal thoughts are not permanent. And I'll just say one last thing, and that is that I've lost track of the number of people I've met over the years who have been acutely suicidal, have thought that their suicidality would never pass and they would never recover. And then many years later, meeting them and they're recovered, loving, completely fulfilled lives, and they're so pleased that they were able to keep themselves safe for adult. I mean, it doesn't matter how they were kept safe, really, but they were kept safe that they didn't end their life. And they are so grateful. So my message to anyone listening to this podcast is Film in Crisis are vulnerable. Please. You are really valued for so many values that the world is a better place with you in it, and that the pain that you're experiencing is not permanent. Suicide is not the solution. And and please hold on and reach out for help.

Gemma Styles [00:34:29] I mean, I would echo that. And this is it's not you know, I didn't want to make this a very personal thing, but I will say if it will help anyone. I have experienced suicidal thoughts in my life. I have been in that place before and I remember at the time thinking that I was just nothing that would fix it. And I personally know that's not true. And even when, you know, this was years ago for me, you know, luckily, and even if I've had subsequent depressive episodes, I never again felt that way. So yeah, that was not a very well worded attempt at that. But just as a very human to human thing, if you're listening to this. It's happened to me. I've been there and it doesn't last. And I know that because it didn't. And I'm here, and I want you to stay.

Rory O'Connor [00:35:17] Yeah, I know. I think it's. That is such a powerful message. And it's even it's even more powerful because it's not scripted in a way. And, I mean, that's what makes it is a human experience. And human experiences are not scripted. And but I think what you just described there is that tunnel vision that people often feel and those are kids suicidal crisis. You can see all turn. Does he think that things will be fixable and that's why, for example I mentioned a safety plan are so important because that those moments of crisis are so people also have like hope boxes which things like hope box who may have photographs or memories or our music would say concerned in those moments of crisis and social importance. So I, for one, am so appreciative of you, Sharon, that gem, I'm sorry you went through it. And I'm so pleased to hear that all these things are better for you and. And a great story of recovery.

Gemma Styles [00:36:08] Thank you. Yeah. Every week my guest and I will be answering your questions on the first one comes in from Tanya. So Tanya's question is actually about a friend of hers who has lost someone to suicide. So recently my best friend lost a friend due to suicide. I really want to help her and maybe just understand what she's going through because I've never lost anyone close to me and I want to help her the best way I can. I know I can't heal her in any way. We're both just teenagers and not medical professionals, but I want to help.

Rory O'Connor [00:36:40] I think that's such an important topic. Gemma And what I'm often asked is how can we support people who are bereaved by suicide? And the first thing to say, I suppose, is that it doesn't have to be. You don't have to be a medical professional or mental health professional to provide support. Everybody's experience of grief and bereavement is unique, but there are some common features the individual could be experiencing anger, shame, regret, guilt, lots of really complicated feelings, especially a young person. As a teenager, our emotions are often really complicated anyway. We're still trying to make sense of who we are in the world, but my advice is just often be there as a sign and board be listening. Or we often talk about active listening, and active listening just simply means just listening to what the person says, maybe reflecting back to them that you've heard them, and then recognize that the one certainty about grief is its unpredictability. So there's periods in which a person can feel absolutely fine, but then completely overwhelmed. And it's just. Going along with that person and their and their pain and their grief, but also is really important, looking after yourself and looking at yourself in your own mental health if you are supporting somebody who's been bereaved. And so also it's important to reach out. But I think the Pepto also the last thing I'll say that is and relates to the sort of stuff we talked on earlier about saying the wrong thing. I think, again, most of it just treats on an on a human to human level. We're unlikely to say the wrong thing. So please try and just be there for people if you can.

Gemma Styles [00:38:23] Perfect. Thank you. So next question. And I wonder what you'll think about this, because you and I on a on another podcast and have spoken. You've got strong feelings about social media. But Michelle asks, I think suicide has been normalized to a point where a lot of people make fun and jokes around the terms of using, you know. Quote unquote, kill you as a phrase when someone on social media doesn't like them. Do you think social media is responsible for people not taking seriously how important suicide is?

Rory O'Connor [00:38:55] I think the relationship between social media and mental health is complicated in the first instance, and this relationship with our attitudes towards mental health is complicated. I think on balance, social media has been positive in terms of providing a forum for people to express themselves, hopefully in a safe and supportive way. And before I answer to the question about the attitudes to suicide, there's lots of evidence out there that people who are vulnerable, who are feeling in crisis have got incredible support from others on social media. So so when we hear this debate about social media, mental health. Too often the story has been social media bad and and of course for some people who are vulnerable if they're experiencing bullying or having negative experiences in exactly the same way as an in-person face to face, that could impact on their mental health, of course. So vulnerable people absolutely will have an impact. But if we look at the research, the research on the relationship between social media and mental health is it's a small relationship because all of our mental health is not affected by one single factor. It's multiple factors. So I think what we need to be doing is getting better and smarter at using social media, harnessing the benefits of social media to be a even better place for people more more resilient place or a place where you can feel safe. And I think that's really, really important. Well, dance the question directly. I mean, I don't know. I wonder whether this sort of similar minimization of mental health was happening when I was a kid. But it was happening not on social media, it was happening elsewhere. So I think for me, yeah, we should be trying to promote conversations which do not minimize the impact of mental health. But I think we have to keep these things in perspective. That's that. And social media is definitely engaging and censorship. It just doesn't work. So what you need to do is promote community. Social media are social communities in which the norms are. Let's talk about this respectfully. And if somebody still can touch on that, we there is a place for joke and joviality. But as long as it's in the context of recognizing that for so many people, mental health is painful and sadly, the most devastating outcome is suicide or self-harm.

Gemma Styles [00:41:28] Yeah, absolutely. Last question is from someone who wanted to remain anonymous, who says I had a best friend die by suicide in 2020 and still struggle with grief from time to time. I want to know if it's okay of me to feel anger and guilt because of what she did. Even though I know it's not a selfish act, but I still feel those emotions. What can we do to save someone from suicide? Because I feel like I really tried.

Rory O'Connor [00:41:53] So, I mean, that's such a heartbreaking question. And so to that person, your feelings are completely understandable. And one of the common like like the emotions surrounding suicide, it does matter if you're a family member or a friend are complicated. Anger can be and guilt and regrets. And all these things are always in the mix. So. So your feelings are important to acknowledge and validate. So. So your. And your response is. Is to be expected. So the second bit of that question, though, on what can we do? It's really nice speaking to somebody who's lost two people in my life to suicide. And I met with this suicide prevention expert. So I find this a difficult question to answer on one level because. Individual suicides on an individual level are often difficult to prevent. But my message is if we try and understand suicide better and provide. So that's my sort of mantra of trying to understand the pain that some is experience and helping them recognize that there are alternatives. And then on an individual level, each of us can do small things like reaching out to our friends and letting our friends know. That you're there for them when when you need them or when they need you. And that and that those small acts can be really, really important in interrupting suicidal thoughts or just suicidal thoughts do not become suicidal acts. But but the stark reality is that not no one, no one individual. I can't be held responsible for somebody else's decision to end their life. I may talk. Wait. Decision that I don't mean they've chosen to end the life because suicide, this overwhelming pain I have just described and the person feels that they've no alternative. And also member. Sadly, too many people who die by suicide think that they're a burden on their loved ones or their self esteem and is so low that they think that others would be better off if they died. So so that in terms of the guilt that we all will inevitably feel when we lose a loved one to suicide, it's really trying to remember that we can't be held responsible for for their death. And the point that that person made as well about suicide not being a selfish act. So it's really important to reiterate that because in that moment of a crisis, that tunnel vision, that not being able to see alternatives, not being able to see the devastating impact, or if you did see the impact, feeling that you're doing your loved ones a favor. So please hold on to glasses that it's not it's not your fault. And then maybe one last thing. Sorry Jamma is as a maybe nice way to sort of and on a sort of message of hope is that first of all, most people who are suicidal will recover. And I know that doesn't help the countless people here bereaved by suicide. But what we all can do is work through these conversations and in reaching out and asking those difficult questions of loved ones around us, we hopefully can save, save more lives.

Gemma Styles [00:44:54] Thank you. I mean, I really appreciate your, you know, grace in answering that question and especially because of your personal experience. I wanted to ask it because it also wasn't the only similar question. And what I want to make sure is through this conversation and talking about suicide prevention is I want to make sure that I'm talking in a way that really honors the feelings of people who have lost loved ones to suicide.

Rory O'Connor [00:45:21] And I think it is important when we think about suicide prevention, we think about the impact of these conversations around suicide on those people who have lost loved ones because it's so, so difficult. These conversations are helpful. They're helpful to people who are bereaved. Hopefully provides some hope that although with the people who are buried by suicide, we'll never be the same again. But it's a different sort of we life life moves forward. It's not moving on. It's moving forward. And if you move forward in a way, in a different way, but hope in a way, which certainly for me, I think has made me hopefully a more compassionate and. Sensitive person, I think. I don't know. I'd like to think that I'm but I'm hoping that that all of us who've been bereaved, we bring this energy. And I know that all the people I've met prior, even by suicide, who've lost so many people, have started foundations and have been really instrumental in moving government policy on energy. And that personal experience is social powerful. And so although it's so difficult for us to accept the pain, hopefully there is some some some good, some positive that can come out of it.

Gemma Styles [00:46:32] If you want to know about opportunities to send in questions for upcoming guests, then follow us on Instagram or Twitter at good influence us. Or you can email me at good influence pod at gmail.com. Before you go, I've got three things I ask every guest. That's if listeners want to find out more about what we've been talking about today. Could you please recommend does something to read, something to listen to and something to watch?

Rory O'Connor [00:46:58] Well, maybe if I'm a bit cheeky for the first recommendation, what you read as my book. That maybe sounds a wee bit cheeky.

Gemma Styles [00:47:07] Yeah, not not cheeky at all.

Rory O'Connor [00:47:09] So it's when it's dark, when it is darkest, why people die by suicide and what you can do to prevent it. And you can it's available everywhere. And as I think I said earlier in the podcast, it's me trying to bring together personal and professional. So we all have a better understanding of what we can do in terms of understanding, and then also what we can do in terms of preventing it's preventing suicide and lots of stuff I didn't get a chance to talk about today in terms of prevention and inequalities and early life trauma and all these other things are covered there as well as myths and so on. And then in terms of what to watch too, documentaries I would recommend which are available I think on YouTube one, and I was involved in both of them and they're really powerful experiences. And one was Life After Suicide, which was presented by Angela Samata and Angel Samatha lost her partner to suicide. And it's a BBC documentary in which she travels the country meeting other people who've been briefed by suicide. And it's really, really powerful, really, really powerful. And I'm involved I was involved in that and actually was BAFTA nominated and that won the London Mind Media Award. Oh, wow. And then want to listen listen to maybe a song, which means a lot to me in the context of suicide bereavement days. Is a song called Angel Flying Too Close to the Ground. I think it was originally a Willie Nelson song. I don't if he wrote it, but he certainly popularized popularized it. But the version I love really means a lot to me is there's a Beth Riley version of Angel flying too close to the Ground. And it's just such a powerful, powerful, emotional song. So I suppose that would be my lesson.

Gemma Styles [00:49:01] Thank you for listening. And as a reminder, if you feel you need support after listening to this conversation that are resources linked in the notes to the episode. See you next week.