Suicide Prevention and Hope

with Pamela Morris-Perez

Here on the Everything Happens Podcast we don’t shy away from difficult subjects, and today’s episode tackles a topic we’ve been wanting to discuss for awhile—suicide among teens and young adults. My guest today, Dr. Pamela Morris-Perez is someone who approaches this subject with the heart of a grieving mom and the mind of a professor and practitioner who wants to make change possible and wants to teach us how we can help. This is such an important conversation on how communities can help prevent adolescent suicide.

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Pamela Morris-Perez

Pamela Morris-Perez is a Professor of Applied Psychology at the NYU Steinhardt School of Culture, Education, and Human Development and an Affiliated Professor at the NYU School of Global Public Health. Morris-Perez is an elected member of the National Academy of Education.  Morris-Perez launched her career at MDRC, examining the effects on children of welfare and employment policies, with profound impact on policy debates (with ~250 news articles), developmental science, and impact methodology. Morris-Perez’s newest research, borne from the loss of her 17-year-old daughter Frankie, addresses adolescent suicide from a developmentally-informed, population-health perspective as part of ARCADIA (A Research Center for ADolescent Interconnected Approaches) for Suicide Prevention. Our focus is to strengthen bridges, integrating prevention and intervention, within and across health and education systems, drawing from the “Swiss cheese model” for industrial accidents (described in a New York Times Op-Ed. With over $6M in funding from the William T. Grant Foundation and NIMH, she brings suicide prevention to the spaces that youth are to help more youth connect to care more quickly. She received a bachelor’s degree from Columbia University and a doctorate in Developmental Psychology from Cornell University.

Show Notes

988 is a resource for anyone struggling and those who love them.

ARCADIA is a research center, started by Pamela, for Adolescent Interconnected Approaches for suicide prevention.

Learn more about adolescent suicide prevention through the Alan Hu Foundation.

Stephanie Wittles Wachs wrote a beautiful memoir called Everything is Horrible and Wonderful about the death of her brother to an accidental heroin overdose when he was 30 years old. Kate got to talk to Stephanie about her book and her brother in the episode, When Life Gives you Lemons.

Jonathan Adler is a professor of psychology. He researches the narrative identity, which is the idea that the stories we weave together about our reconstructed past, perceived present, and imagined future helps us make meaning out of the things that happen to us.

Madelyn Gould is a professor at Columbia University, and leads the evaluation of the National Suicide Prevention Lifeline (Lifeline), the national network of telephone crisis services.

Kate DiCamillo book the Magician’s Elephant is a haunting fable about the unexpected and of hope and belonging.

Kate mentions a quote from bell hooks from her book All about Love: New Visions: ” The practice of love offers no place of safety. We risk loss, hurt, pain. We risk being acted upon by forces outside of our control.”

Chad Varah, an Anglican priest started a telephone hotline called Samaritans, after concluding that loneliness is the most heart-rending anguish.

For more conversations on suicide loss, Thomas Lynch describes the death of his daughter to suicide, Alexi Papas wrote Bravey and talks about the death of her mother to suicide, Liz Tichenor also lost her mother to suicide.

Another resource that Pamela hopes people will read is Stacey Freedenthal’s book, Loving Someone with Suicidal Thoughts.

Pamela is working on a memoir. Follow her for updates on Twitter and Instagram.

Discussion Questions

  1. This episode reminds us that talking about suicide actually is one of the most important ways of making it less likely. What does that tell us about the power of vulnerability and putting language around our emotions?
  1. Kate and Pamela invite us to hold on to simultaneous truths. Pamela says: “We were a good family and [our daughter] was a great kid and she died by suicide.” What simultaneous truths do you observe in your own life? If you had to form a similar sentence as Pamela’s, what truth-telling sentence might you form?

  1. Pamela’s insists that “when you see somebody’s pain, they’re not alone in it anymore.” Scripture tells the story of Hagar in Genesis 16, who has no support system to turn to but is found by God in the desert. Hagar speaks to God saying, “You are the one who sees me” (Genesis 16). When have you felt seen by God?

  1. Kate and Pamela remind us that one of the great lies of pain is that “this is never going to end.” How do you fight despair in your own battles with pain (whether physical or emotional)? What does it look like to “talk back” to the lies that our pain tells us?

Transcript

Kate Bowler: Just a heads up—today’s conversation is about suicide. This is such an important conversation on how communities can help prevent adolescent suicide. If you need to talk to someone, call or text 988. If you are worried about someone, you, too can call or text 988 to get resources. Remember you matter. Please listen with care.

Kate: Hello my dears. I’m Kate Bowler, and you know that here on the Everything Happens podcast, we don’t shy away from difficult subjects, and today’s episode tackles a topic my team and I have been wanting to discuss for such a long time: suicide among teens and young adults. Okay, I know this is a really devastating reality for so many, and immediately it can make us feel afraid or helpless or want to stick our head in the sand. We rarely talk about suicide loss, including parenting in that loss, or how to bridge the connection with friends who are grieving the loss of their kids. But my guest today is someone who approaches this topic with the heart of a grieving mom and the mind of a professor and practitioner who wants to make change possible and wants to teach us how we can participate. She’s the perfect person to learn from and listen to in a really important way. I just want to assure you that this episode won’t create nearly as much anxiety as you think. Talking about suicide is actually one of the most important ways of making it less likely. So let’s find better language together, shall we? And if it’s not something in your orbit, I promise that you’ll come out with better language to help other people. You’ll be the one who knows what to say, when to act, what to do, where to turn to for help. Thanks for being the kind of listening community who doesn’t shy away from hard things. You are my kind of people, and I feel so lucky to get to do this with you week in and week out. Without further ado, my guest, Dr. Pamela Morris Perez. Dr. Pamela Morris Perez is a developmental psychologist and a professor of applied psychology at New York University. Which, I don’t know if we all know, is an unbelievably big deal. Her 17-year-old daughter died by suicide, and this professor and mom has launched a center called Arcadia, a research center for adolescent interconnected approaches for suicide prevention. And she is a champion for honesty and courage and the need for us to learn to care. And carry one another. Pamela, I’ve been really looking forward to this for such a long time, and I feel my own inadequacy when I was even trying to come up with a question, so just like, I fully encourage you, this is a community of learners and you are so welcome to teach me as we go along now.

Dr. Pamela Morris-Perez Thank you so much. Thank you so much for having me. I’m really excited to be here.

Kate: I wondered if we could just start with your beautiful kid and what she was like when she walked into a room.

Pamela: Yeah, well, thank you so much. Because she. I love talking about Frankie, I couldd do it all day, which I won’t, because I know we don’t have time. You know, she was this amazing kid, and I know, like, I’m completely biased because I’m her mom. But, she was just incredibly warm and generous and, actually, interestingly, I dreamt about her about a week ago. I almost never dream about her. And I told her I was going to be on this podcast. And I said, I’m going to talk about you. And she’s like, she looked at me, she’s got like her brown curly hair and big brown eyes and you know, like really cool sneakers matching her outfit. And she goes, what are you going to say about me? And, and, and I was like I’m gonna say how warm you are and how, like emotionally present she was, you are and you know, and that you’re so snuggly. You know, she used to like, walk, I would like, walk her to the subway on the way, to, you know, on her way to school, on my way to work. And she’d slip her arm into, like, crook of my elbow. And then, you know, and we’d get into this sort of really insightful conversation about, you know, I don’t know, something she had observed, like she was reading in school and then, you know, like the fountain would be on in Washington Square Park or there’d be snow, like, leftover from the night before. And she’d, like, run ahead like she was five years old again, like, jump on top of the pile and be like, there’s snow, and like, look at you to join her in that glee. She was like, both a like kid and a, like, wise adult. All in a teenage body in this sort of wonderful way. So, yeah, she was she was a great kid. And I could talk about her all day.

Kate: It sounds like she was very good at reading other people. And also that she had a lot of layers. That must have been hard to kind of be able. I just…with sensitive people, I imagine there’s just kind of… a lot going on on the surface and then so much more going on under the surface. How did you… I think a lot of parents worry that they’re not always sure how to interpret their kids. How did you feel like you were seeing all the layers, or not?

Pamela: So, so Frankie, I always thought was sort of, I used to say she was overly empathic. You know? She’d leave a movie, and partly it was, I think it was the sugar from the, you know, whatever. But, you know, she’d walk out the door of a movie theater and just, like, burst into tears. You know, she just felt things really deeply. And I think I didn’t… What I think I understood at the time was that that meant that she was so open to like, everybody’s pain and the world’s pain. What I didn’t realize until after, now, with sort of the grief side of this, is that when you are more open, you actually invite people’s stories. You must get this all the time, right? Where people come to me and tell me things, people I’ve known forever, telling me things that I didn’t know about them. Because when you’re empathic, people want a space to share. And so I think she got a lot of that. And yeah, I mean, you know, she was an easy kid to be around for so long, you know, until, you know, depression, anxiety really sort of hit her about six months before she died.

Kate: I had a conversation recently with a lovely author named Stephanie Wittles Wachs. And she described, after the death of her brother, like a a stage of when she called like manic investigation. I thought that was a really, I never thought of that as like a stage of grief, but the like, “I need to know. I need to figure this out. I need to be the detective.” Yeah. Is that an experience you went through?

Pamela: So yes. So I will say, so, there are no stages of grief. I’m just going to say that, sorry!

Kate: I know, I totally understand, no no,  I don’t believe in stages of grief, but maybe layers.

Pamela: There’s a lay-, or there’s a, so, what happens with suicide loss is that it’s tangled up in a whole bunch of other really negative emotions. So you don’t just feel the sadness of the loss. You also feel anger at the world that your, you know, loved one was taken from you too early. You feel a huge amount of shame. I remember walking outside to walk my dog and, feeling like I was wearing a big red letter S on my body. That really sort of here’s proof that I failed as a parent, right? My kid died by suicide. I felt, you know, you feel, you know, there’s the PTSD, obviously, the trauma of it all, but there’s so many other sort of negative emotions. And there’s the what happened. And I think what basically is happening is that I think, like we all have these narratives of our lives. So Jonathan Adler at Olin College talks about how we have, we build a narrative of our identity, and it’s related to a master narrative of the world, right? And it’s a reconstructed past, a perceived presence in an imagined future.

Kate: Tell me that one more time, because I love it.

Pamela: Sorry, reconstructed, past. Perceived, present. Imagined future.

Kate: I like that.

Pamela: And it makes sense. Right? And by age 50, like, I’ve got a story of who I am, and all of a sudden, this thing happens to you in the present, and then you’re like, well, now it doesn’t line up with who I thought I was, who I thought our family was, who I thought she was, right? Even though she was struggling you still don’t think suicide can touch you. And so what happens then is that to fill that space, to make sense, you pull on all these negative memories. So you remember really well all the things, you know, you didn’t say. The times you weren’t your best self, right? The, you know, even if you did it 2 or 5% of your time, it like balloons did make up 95% of your brain space. And you’ve gotta kind of sift through all of that. There was this moment, it was like, and I thought it was like 6 or 9 months after. And then I was looking in this journal where I write notes about sort of reflections on grief and reflections on suicide. And I realized it was 15 months after Frankie died, I had a day that was just pure grief. Like unadulterated, un-tinged with all this other stuff, no other emotions in it. And it was, it felt actually like a gift. And that was so weird. I was like, this is the curse of suicide. Because just missing her, just profoundly missing her, felt calmer than all the other swirling thoughts.

Kate: And noise.

Pamela: All the noise. And it takes so long to get through that. You know, it took for me, like the first year and a half, two years to consistently not have that, the swirling thoughts. But, and you can’t like, you can’t rush it. It just needs its, it needs its time to process it. Eventually you get to the space where you’re like, I now can live in a world where I get that like, we were a good family and she was a great kid and she died by suicide. Both those truths can still exist now, but it takes so long to get there.

Kate: Yeah. I even really like the words that you’re using, that I wouldn’t have thought to put together, like, suicide loss is such a, I never hear that phrase. But that’s perfect.

Pamela: Yeah. So we, I call myself a suicide loss survivor, now. And it’s a word that some people use in the community. Sort of like. Like, you know, a survivor of trauma, right? Essentially.

Kate: What do you think that opens up for people when they can say that about themselves? Like what, what other labels does that kind of, like, scoot aside?

Pamela: I found it really helpful to have a label. When I remember when my therapist said something like suicide loss survivor and I was like, oh, there’s a word for who I am? Because there’s no, right? There’s orphans and widows. There’s no even word for a mother that lost a kid. Right. We don’t even have a label. Right. And then on top of it, like losing someone to suicide, like you need something to be like, this is who I am. Hello, world. So you don’t have to, like, go through the entire story every time.

Kate: Totally. You’re right, I hadn’t even thought of that. The entire purpose of the label is not to have to rehearse the whole story, and to get to the right conclusion together.

Pamela: Exactly. And it’s really important, that shift from, you know, the first, whatever year or two years, whatever it takes, three, four, five to moving from the death, the sort of perseverating around the death, to the moving to the life. Because once you can get through that and get the sadness up. Then you can start also remembering the good memories, and then you can start on this side of it, living not for why they died, but why they lived. Right? And you can pull that forward. And that’s why I love talking about all the good memories. And that’s why I don’t, you know, it’s much harder to talk about the end stage

Kate: Yeah. And it sounds like in a way, more appropriate to talk about the life than…

Pamela: Well, and, and then at least it’s not that suicide isn’t part of who she was. But it’s not the only part, right? It puts it back in the right perspective. She lived for 17 years, and so many of those years were really powerful and good and amazing.

Kate: And breezy and smart and funny.

Pamela: And smart and all this stuff. And then, yes, and she died by suicide. Like both of those truths are there.

Kate: Can you tell me that again too, about like “died by suicide” as opposed to “committed suicide?”

Pamela: Yeah, yeah. So, the suicide community, feels really strongly, I agree with this, so I feel really strongly that, to not use the word “committed.” And the reason why is that “committed” comes from suicide’s, you know, history as a crime and a sin, right? You commit crimes, right? And, and it came from, sorry to say, the church, right, was part of it. They then moved it into, you know, common law actually, where people it was against the law to attempt suicide and people that died by suicide, I have this picture that I show often in my talks because I saw it, and I was like, floored by it, it’s a church in England. And it has a line in the grass where there used to be a fence between the tombstones of everyone that died by every other cause, and the people that died by suicide. The tombstones. Because those are largely unmarked graves, you know, no last rites, etc.. And so that word comes from that. We say “died by” other diseases, heart attack, pancreatic cancer, what have you. “Died by suicide,” I sort of use it in the same language.

Kate: You have this beautiful way of describing like what suicide is as.

Pamela: Yeah. So it’s, it’s yeah. It’s not about wanting to die. It’s about wanting to avoid severe emotional pain. So just the same way that we are heart… Like, I think for a lot of people that look at suicide and they think that feels unfathomable, like it feels antithetical to what we understand about being human, right? We have a we have a basic instinct about living. And so what is this about dying? Choosing to die if it’s choice? And there’s a huge debate about that, so. But it really is just like you, the way in which we are hardwired to pull our hands away from a burning stove, we avoid physical pain. We are also hardwired to avoid emotional pain. And this is about deep, unrelenting emotional pain that feels like there’s no other way out. And so the trick is, is in the prevention side, you know, is really around how do we give somebody a way to, for other ways to relieve their emotional pain? But yeah, but it’s not about wanting to die, which is I think what we all think of.

Kate: I think people find that very helpful, too. Because, I mean, I just know from physical pain, I always have two thoughts: one, this is never going to end, and I’m convinced of it. And then two, it creates this real time wormhole. And then the… I’m absolutely certain of despair. And I want it to stop. And I can only make the analogy,.

Pamela: I think it’s very similar.

Kate: But I imagine that’s a lot less like choosing for me, or a lot less like. It’s just I, I it’s it’s hard to understand yourself. I feel like you lose the future. Just, it’s gone in a second.

Pamela: Yeah, yeah. So, yeah, it’s a very similar thing as I understand it.

Kate: Your ability to be the mom and the professor is really wonderful to hear you think because you have so much compassion for our emotional response are like the unfathomable-ness. Also just, I mean, all grief is this like love sickness in which it’s, it is very hard then, to like, apply an academic analysis. It sounds like really loving and understanding your kid caused you to grow into new parts of your academic expertise and a pretty amazing way.

Pamela: Yeah, so, I did, I started reading a lot about suicide, partly because I want to understand what Frankie was going through, I really wanted to understand what it was for her. I had almost no experience with loss, really no experience with loss. My parents are still living. My siblings are still living. I have not lost a close, close friend. So Frankie was my first loss, which was kind of a whammy, in a way. But it also meant that I really wanted to understand what she was going through. And so I started reading. And honestly, what made me at first kind of really angry was I couldn’t find her in it. And I couldn’t find our family. And it it felt, you know, I couldn’t find her empathy and her light. I just, I.. And so that felt really challenging for me. It’s not… I just want to say that, like the work part of it is not healing. Like it’s helpful and it’s useful.

Kate: Did you find you really need it, when, ’cause people were like “Isn’t this just like, therapy?” And like, “No! It’s really not!!

Pamela: No, it’ really not. Yeah, yeah, it’s really kinda hard. So, like, I think of it like that I’m on a seesaw and, like, there’s the grief, you know, and it helps. The work helps balance the seesaw so I don’t fall into the hole of grief and despair, right?

Kate: That makes complete sense to me.

Pamela: But it’s not the warm blanket thing, right? But we all are like purpose, right?

Kate: I thought it was the warm blanket, they do! And think, in a way, I don’t know. I think if… People love to imagine that as you’re telling them the story, it’s not as much of a gift as it is because it’s helping you. No, it’s gift.

Pamela: Right. We love this redemptive narrative, right? You know that, like, exists in the world.

Kate: “And it was part of my healing.” You’re like “mehhh…”.

Pamela: Kind of not. But that’s okay.

Kate: I don’t know, the ability to then… I guess one thing in which I find that the both sides helps, is it does radically change your worldview. I wouldn’t say it’s like making my heart glow to know things I wish I could unknow it, but it has really changed my worldview.

Pamela: Yes. And I will say that what I bring from the grief side into the prevention side is I have so much empathy for parents of kids who are struggling with suicidal thinking, which I don’t I, I don’t think we recognize the sort of trauma that’s happening to families when a kid, when they realize their kid is suicidal and that is traumatic and difficult and it’s different than grief, but it is, you know, that is really important. It’s rough. So that and the compassion for kids who are struggling, you know, and, you know, and sort of still hope in for all of them, you know, and all of that.

Kate: One of the things that I have noticed about being on the sadder side of things in terms of topics, is that I, I think people worry that the more they engage with like… You tell someone you’ve had a diagnosis, and then there’s kind of a concerned trying to find the reasons, and this is in the most uncharitable version, why it’s me and not them.

Pamela: Yes, yes, of course. The othering thing. Yeah, yeah.

Kate: And then there’s the, you know, and then there’s also the desire to learn. But I imagine that with suicide you have that times a million of like, “please don’t tell me more about that…”. What do you think people are most afraid of when they engage with your work?

Pamela: Yeah, so there’s lots of the othering and I think especially around suicide and especially in anything that we don’t understand the causes of actually, if you, if you read the history, like Susan Sontag stuff about cancer?

Kate: Yes. Which cancer you have determine’s people’s compassion.

Pamela: 100%. And and, you know, the ways in which we used to write in the newspapers back in the, you know, 70s that, that depression caused cancer? Because people that had cancer were also had been depressed before they got the cancer. So it must have been the causal frame. And again, I think it was all the way to say, like this thing that I don’t understand and I can’t predict, how do I make it not happen to me, right?

Kate: There’s another version that sounds, that I think is equally… Like it’s so rampant right now. But there’s a real repression theory about how if you have any kind of negativity, that it will create physical symptoms and then they apply kind of like a freudianism…

Pamela: Positive thinking.

Kate: Plus positive thinking. But the language is so, I mean, it’s a it’s a real grab bag of like once I know this information, then it’ll somehow be in my body, which is genuinely not true. It’s just kind of a… but then therefore I should not learn about difficult topics.

Pamela: Right? And I think suicide in general, like everybody’s scared to say the word, right. You know, we’re scared to talk about it. We’re scared to think about it. We’re really scared of somebody thinking about it near us, we don’t want to touch it.

Kate: It sounds to me like one of the most comforting things that you say to people, though, is that talking about it does not, in fact, increase the likelihood of it.

Pamela: Yeah. So but the sad thing is that was research that was done 20 years ago, right? In 2005 Madelyn Gould, she’s from Columbia, did a randomized trial, like, nice study, right? Randomized one set of kids to ask the question. One set a quiz to ask a different set of questions. Followed the kids. No more thinking about it, and in fact, the kids that were more depressed, actually, there was a reduction in distress. And then it was, you know, there’s been meta analyses and this, that, and the other thing. And the way I think about and I think the crime of the suicide field is that we’ve not figured out how to get that out into the public. And I think the reason is we haven’t given people a frame for believing those findings. So as an early childhood researcher, the way I think about it is… So most of my work has actually, had been in early childhood and preschool. You walk into a preschool classroom and I’ll say, like, you know, you hear a teacher say something like, “Hey Johnny, I see you’re really angry” or, “Oh, you must be really frustrated.” And teachers do that because we believe that if you label an emotion, you can regulate it better, right? And we know that for two and three and four year olds. But somehow when kids get to be teenagers, we’re not explaining the difference between sadness and depression. Stress, anxiety, panic attacks, those are different emotional experiences. And suicidal thinking, right? And so we don’t talk about it and then they have no space to explore it. Like, why am I feeling so shitty right now and then, and they’re not differentiating their emotions and they don’t know when they’re starting to come on. Right. All of the stuff that we know how to do with little kids, we like forget. When when kids are all of a sudden like, presented with a thousand different emotions.

Kate: That is a great argument. We’re going to take a quick break to tell you about some of the sponsors of the show that bring you great content like this. Don’t go anywhere. We’ll be right back.

Kate: For parents who are starting to try to tease out some of the distinctions between like complicated, unhappy emotions, what are some red flags, or what are some signals of distress that you might identify?

Pamela: I can tell you the warning signs, but I’m also going to say that the truth is you can’t really we, we as researchers, in 50 years of research we can’t predict suicidal thinking. So, and, most of it just looks like regular teenage angsty behavior. So I don’t know, I like I said, there are some telltale signs, which is like, you know, kids saying like, I don’t know why this matters. But, you know, kids say that too, right? Giving away your possessions. Like if kids are saying, like, I don’t need this anymore, something that’s really special to them. They say disengaging from social activities, but you could have a kid like Frankie who doesn’t disengage, who still is able to have really close friends. So, like, there are kids that are able to present without and really keep that suicidal thinking to themselves. So I tell parents, that they should ask the question directly. And because if we don’t know who’s thinking about it, the only way we can really get into it is to ask and talk about it. You can say like, hey, I’ve noticed you’ve, you know, stopped going to soccer practice, you know, and I just have to ask, are you thinking about suicide? At all? And then you want to stop. Because the next thing you don’t want to say is, “Of course, you’re not” or,  you know, “I didn’t, I’m so sorry I asked.” My my, you know, I was at the doctor for regular checkup thing, and they were like, I’m sorry. Because I said, yeah, I lost my daughter to suicide and they said, “I’m sorry, I have to ask you, but are you suicidal?” And I’m like, don’t be sorry. You have to ask. Like, just ask the question.

Kate: You’re like, do you know my job?

Pamela: Right? And I know it’s really scary and like, practice it in the mirror. But you do want to ask the question directly because if you just say are you feeling really sad? You know, first of all, you can be anxious. And I mean, depression and suicidal thinking are not the only two things that are paired together. Lots of times, suicidal thinking can exist without depression, without anxiety, right?

Kate: I didn’t know that.

Pamela: Yeah, so it does co-occur with a whole slew of other mental health challenges sometimes. But it is its own thing all by itself.

Kate: You need to be able to say, are you are you thinking about suicide?

Pamela: Then you just want to listen and hear what the kid has to say. Because what you’ve done then by asking the question directly, even if they’re like, no, mom, like, forget it. You know, a month from now, six months from now, maybe they are struggling. They know now that you’ve broken the ice, you they can come to you. Yeah. On top of it, if you end up, if they end up, you know, wanting to help a friend, you’ve now modeled for them, how do you ask the question? Right? Because they’ve got friends who they’ve probably seen these signs from before. And it’s why I actually think we need to start with sort of the kid generation in particular.

Kate: How early is too early to ask that question?

Pamela: You know, we’re starting to do things with younger and younger kids now to understand their, you know, sorry to scare you, I don’t want to scare people, but, you know, they’re, you know, more and more 10 to 14 year olds are dying by suicide now than had been before. It is… It can be… it’s, first of all, kids do think about death early. Can I just say that? Like, it’s not unusual to have a conversation about death and what’s basically… And there are and that’s a good thing, right? We actually think that it’s appropriate to think about existential questions in adolescence. Why am I here? You know, the fact that we’re mortal is why we like, lean into life, right? So there’s that, too. And the way I talk to parents about doing it is, imagine your kid came to you and said, I have a headache. You would know how to ask a set of questions to decide whether they are, you know, they just didn’t drink enough water that day, whether they, needed glasses, you know, because they’d been reading too much or whether you need to bring them to the pediatrician because they need to see a neurologist and you would say, like, how much does it hurt? How often has it hurt this way? You know, last time you felt this way, what were doing right before? What did you do after that happened? What made it go away last time? It hurt like this, what did you do? And what’s nice about that is you’re allowing the kid to articulate the things that they’re already doing that is easing that emotional pain. And we were back in the emotional pain a while ago. We’re helping to sort of bring that all out.

Kate: That sounds so much more curious than the way I think people imagine that conversation would go.

Pamela: And and the truth is, it’s okay—it’s not okay to think about suicide—but it is okay to explore thinking about suicide in that kid isn’t definitely at risk because they’re thinking about it. The kids that are most at risk that we have to be the most concerned about is if they’re thinking about suicide, they have a plan to attempt, and they have access to that plan. Those are the kids we are most worried about. So just because the kid is thinking does not mean they need to be hospitalized today. And in fact, that’s why they’re worried about talking to grownups about it, because they’re scared they’re going to land in the hospital and and all their clothes are going to be taken away from them, and their phone is going to be taken out like everything’s gonna—they’re going to lose all agency. And the truth is, you just need to like, sit and talk. And actually, the way to think about it is exactly the same way. Like when you want somebody to talk to you about, you know, all the things you’ve been through, you don’t want somebody to tell you what to do, right? You don’t want somebody to, you know, you have all these people on your show, right, that always have had really hard things happen to them. And I like as a grief, as someone who has experienced grief, like, I didn’t want people telling me like, you should go do X. Right? Or this is why it happened or anything, right? You want someone just to listen. So. One of the things I found really useful is, and it’s a fiction, so you’ll bear with me for a second, but, Kate DiCamillo has this book, The Magician’s Elephant. Do you know that story.

Kate: No, tell me.

Pamela: So it’s about a little boy. A fortune teller tells him to go see this elephant, to be able to find a sister. And the elephant is, deeply depressed because it’s been conjured into this town by a magician, and, and all of a sudden, it’s being held in the castle, and all the townspeople are traipsing to see this elephant. And so the elephant’s deeply depressed and says, like, I don’t want to live, which is essentially being suicidal. The boy lines up to go see the elephant gets to the front of the line. He says, elephant, open your eyes, I have to ask you something. Please open your eyes. And finally the elephant opens its eyes and he sees the deep despair in the elephant’s eyes. And what Kate DiCamillo writes is that in that moment, the elephant felt like, he felt known and understood, and he felt something akin to hope. And what I love about that is that the boy didn’t do anything. He just saw the elephant and its pain. And when you see somebody’s pain, they’re not alone in it anymore. Like, as humans, we deeply need to be seen and understood and with people. And I think if you can sit with your kid in their pain and see that pain and not try to understand it with them and say, like, I don’t, you don’t have to have all the answers. You can just be like, I don’t understand this either. We’re we’re going to figure it out together. You know, there’s something about sitting with someone in their pain that’s like a really valuable… processing.

Kate: It goes to that deeper place and you can feel it.

Pamela: Right? And I think there’s this way in which—someone wrote on a listserv once that I thought was sort of brilliant. She’s like, you know, in the end, the only person that can save somebody is themselves. But if you can sit with them for a moment in their emotional pain and feel—they feel helpless and hopeless. And if you can feel helpless and hopeless with them, then for that moment, they’re not alone. And that may help them find their reasons for living. Right? It’s just the, like, little bit of help, right?

Kate: I can also hear how much. The formula idea like breaks down. There is not, there is not a magical five set of criteria that makes everybody feel safe again. And don’t worry, they didn’t meet that criteria. And then there’s not the magical… Because it sounds to me like you’re saying relationships are so embedded in a form of listening and love, that if you don’t get to there, there’s not like a formula that makes it magically protected.

Pamela: Yeah, and I wish I could say that everyone’s kids would be protected, and there was only one kind of suicidal kid, and you’d know it if you had it. But there’s not, you know? And I think we create visions of these because it’s, you know.

Kate: Because it’s because it gets to that unthinkable thought.

Pamela: And then I don’t have to let it have to touch my family. You know? And I wish it didn’t touch anybody’s family anymore. You know, I really do.

Kate: There’s this quote from, I think i’s a bell hooks quote, about, like, there’s all kinds of things in love, but there’s no safety in love. But someone was like, oh, that’s so depressing. And I thought, oh no, I think that just feels like there’s a, there’s a, there’s a hook. There’s like a fish hook that goes directly into my heart, to theirs, and because of that, there will be a million things, but there won’t be safety in that. There will just be desperate, beautiful, exhilarating, exhausting love. It just struck me the way you were describing the importance of, like, practicing asking questions about suicide is that it does feel… it feels like you’re bubble wrapping them to say that stuff doesn’t like, that will never touch you. Of course you want to say that. But it sounds like that is not like a, that’s not the protective kind of love that we always imagine it is.

Pamela: I think it’s that, and I think the protective kind of love also makes you want to fix it, right? Yeah. You want to pick them up and put the Band-Aid on the knee that you could do when they were two. And the problem is, is that for them to feel agency, you need to not. So it’s like, it’s it’s just like the tight rope of a normal adolescence, but like in extremes, because the danger feels so much bigger, right? And that’s why I call this a trauma for the family. It is so scary. For the family.

Kate: I find so much of parenting literature sounds a lot to me like self-help literature, which has a really sometimes, like easy peasy lemon squeezy attitude toward human suffering. And I, I just find the way you’re describing it really real, and the more real it is in a way, the more comforting it feels. Because there’s all the trying, and then there’s the all this stuff that lies beyond our ability to try. And that is like, that’s intense wisdom there. Knowing that distinction when it comes to the most important life and death issues.

Pamela: That, and and to be honest, like it makes you… Suicide really, in some ways, like took the wind out of my sails as a parent, and in some ways that was terrible. And in some ways it made us pause, like with our son, like it made us pause and do this sort of step back with him that honestly was really, I think, helpful for him as he was sort of grieving also as well.

Kate: What did that step back look like? We you like, I can’t control every part of your life?

Pamela: Yeah. It’s the like, I used to believe that… Not that everything would be perfect, but that there was always a do over, you know what I mean? Like, you know, like, you could always redo and, you know, death, there’s no redo over. Right? You know, and it made me like, okay, like, I, I, you know, I always felt like I could figure everything out. Eventually.

Kate: I’m just thinking of the number of brands that is entirely predicated on that idea. So I, like, what you’re saying is so countercultural, which I really appreciate.

Pamela: And it really like made us just pause and look and watch. And for him, like, you know, he was 17, you know, they were so close as twins. They, they were really two halves of a whole. So like, she, I described, right, was this sort of, you know, outgoing, like bubbly, you know, she was the humanist, she was the pixie. He was the lanky engineering quiet kid, right? You know, like they were the pair. And, you know, and as I said, like I hadn’t experienced loss. So I had no playbook for parenting him through this. And I didn’t know what it would be like to lose your twin, who he’d been with since the womb. Like he didn’t know life without her. And we just like let him lead, which turned out, he was also 17, but it turned out to be really good for him. He, you know, he had decisions he had to make. Like it was just three weeks before their high school graduation. So, you know, he had to decide. Did he still want to go to prom and senior track or not? Which he decided to do. And we scaffolded, you know, like, we made sure if he was going to go on senior trip, he could talk to his school counselor every day. And he had an out clause, he could, like, leave. But the other thing that happened was because we took a step back, other people stepped forward. So I remember after the funeral, we were standing on the, like, grassy area outside the building, and he was, like, in a clump of kids, you know, teen clump. You know how they are? And, and he’s like, I want to go off with my friends. And of course, the adults were all going back to our apartment, but they he had lived through like the day before, we had done the whole open apartment thing, and like, hundreds of adults had, like, traipsed through and hugged him. And it was rough. And I didn’t want to, but I was like, okay, that’s fine, I said, but I need to know you get home okay. And one of his friends, this kid, blond hair, blue eyes like steps forward, looks me straight in the eye, and was like, I’ll make sure he gets home.

Kate: That’s so touching.

Pamela: And I was like, okay. It was like this really sweet thing. And Iwas like, ok, I trust. I’m entrusting in the world. You know, in the same thing, we dropped him off to this, you know, trip to Costa Rica for his senior trip, at the airport. And this girl, like, not even like that close, a friend of his is like, chatting with her friends, and she just, like, sticked her arm around him. And I was like, he’s going to be taken care of. And, you know, of course, we got him a really good therapist and the whole thing and watched really carefully. But the result of that sort of stepping back meant he eventually came forward and like, I’d be hanging out at dinner, like after dinner, washing the dishes or something and he’d come to get ice cream or something. And we get into this conversation about, you know, regrets or about a Frankie memory or whatever, but like, you know, standing there in our kitchen. But not because I like when we like. We have to talk right now.

Kate: Dragged it out of him, nag nag nag.

Pamela: Like it was a few weeks or months after, I don’t know when.

Kate: Yeah. But letting it bubble up.

Pamela: Letting it bubble up. Yeah. And then because my wife and I grieved really differently and because we articulated that difference, I think it gave him permission to grieve in his own way. So he found his own way through it all. And then he taught me things also. So I mean, he took, he took. so he went on the senior trip and he packed up. He took out of the closet, he didn’t, you know, we were packing, like, the night before, and he didn’t have a raincoat that fit him, you know, 17 year old boys, like, you know, they grow out of stuff, right? Like, we didn’t have a raincoat. And he grabs Frankie’s raincoat and puts it in the suitcase. And I’m thinking, like, what if he loses it? Like wouldn’t that…? I was like, doing all this, and he, like, folds it up, puts it in the suitcase. And I was like, I’m just not going to say anything. It was interesting. I texted a friend after and she was like, it makes perfect sense. She goes, she’s going to be hugging him the whole time. I was like, oh, thank you for that because I needed the reframe because I’m freaking out right now. And he said now, like, he took really good care of it. He like, there was stuff in the pocket he left there to like, preserve. And he really, like, gave me permission to, like, I wear. I mean, I’m wearing Frankie’s earrings, and I do that now…

Kate: You’re wearing her earrings? Awww.

Pamela: Yeah, you know, because I feel like…

Kate: To like fold it into your own life instead of only just like amber, like that feeling we have when we love someone to lose them, but we kind of want to preserve them. Just to, like, fold that love into life. Sounds so beautiful.

Pamela: Because then she keeps and actually she keeps growing with, I mean, so with me, she fills me, but she’s still 17. What’s been fascinating, like, he channels her, he like is still him, you know, we’re almost five years out now and he, like, carries her in this really beautiful way that’s like totally beautiful and heartbreaking all in the same breath. And then her friends who we’re super close with now, like, they, we talked to them and they’re like, yeah, she’s still growing with us. And I feel like they, she gets like the pieces of her that are in all of them. Yeah, I don’t know.

Kate: “She’s still growing with us” is such a beautiful…

Pamela: It’s like the, it’s like the love she sent to them, like ricochets to others… like it’s…

Kate: That’s really beautiful. Oh my gosh.

Pamela: It’s so pretty. And as a parent who loses a kid, but you lose, you lose the ability to see your kids still have impact, right? You know, you don’t get the chance to see, you know, for the teacher to be like, they were such a great presence in the class or they did this. And what instead I get now to see is sort of the way that she impacts them and they carry her. And that is at least some, you know, it doesn’t replace her. It never will. But it certainly helps. It softens a lot to see that.

Kate: Yeah. Love becoming love, becoming love.

Pamela: Love becoming love. Yeah.

Kate: When I was so sure wasn’t going to make it till the summer, I had this thought that I would step back a little bit in terms of my desire to aggressively over parent. And I thought, now is probably the right time to practice other people having a relationship with my son. And I’ve seen it. That part feels like such a miracle to me, because I can see how much that love became more love. That didn’t require me…

Pamela: Doing it.

Kate: Yeah. It’s like this, whenever you get to see somebody else, somebody else love your kid. And then their love multiply. It’s a pretty beautiful, it’s just, it’s a really beautiful thing.

Pamela: It’s a beautiful thing.

Kate: It always feels like a little miracle.

Pamela: Oh my gosh. And it’s what, you know, part of the reason we opened our house up to her friends was Frankie loved her friends so much.

Kate: Aww, that’s so nice.

Pamela: And we felt like she wanted us to take care of them. She would have wanted that. But now we get these gifts. What is that, it’s the multiplying love thing that just feels so, like, amazing. And sometimes these kids show up. We ended up, we adopted a bench for, at the cemetery because we could do a tombstone, it just felt too…

Kate: I love a bench.

Pamela: Yeah, next to a tree. But it also is this little oasis by water. And so now and I go, I go to braid flowers on it often, like every week or two because it’s like my centering space. And I find things that the kids have left there. And even things that, kids that I didn’t, that don’t go through us? So last May was year forur. Frankie died in early June. And I arrived and there was this little Ziploc bag on the back attached to the bench. And I opened it up, and I actually thought about it for a time, because we have this thing of like, should we open things that are left there? They’re for us, they’re for Frankie? We decide if things aren’t sealed, it’s okay to look at, and they open up this like ladder that’s in there. It’s actually a little note to the family, too. So I was like, okay, it’s legal, I’m allowed. And this, this kid described how, you know, Frankie taught them that friends could hug. And it was like, so sweet. And it’s not signed by a name, like, it’s, like, anonymously signed. But I’m pretty sure it’s a kid that hasn’t been through our apartment before. And I love that. Some kid found this bench. It’s like, I’m like, so happy.

Kate: We’re going to take a quick break to share about the sponsors who make everything happen at Everything Happens. Don’t go anywhere. We’ll be right back.

Kate: Will you tell me some of the like fact facts about like how people should… helplines, like ,some of the kind of basic things that I don’t think that I would know if I didn’t, like, go out of my way

Pamela: Yeah, yeah. So, there’s lots of things now. So, 988 is this is a three digit number people can call, if they’re struggling, if they’re suicidal, and a parent can even call the number to be like, I’m really worried about my kid. They’re not going to get to be the first person in line, right? They might have to be on hold for a little, but they are there. What’s interesting, actually, about helplines is, they were a really interesting history that I think is helpful to understand what happens when you call. Yeah. So they were started by a priest, actually, Chad Varah, in the 1950s. He had presided over the funeral of a young girl, 13 year old, who had died by suicide when she took her life when she got her first period. And there was 17 years later, he was like, I’m, you know, it’s like, I’m never going to forget you. I’m going to do something right by you. He and he started accepting people. He was like, people should have someone to talk to when they have questions, when they’re stressed out. And so he started inviting people to come. He was really good at what he did. And, this is a story that actually a, colleague, a junior colleague of mine, tells, Zezhen Michael, that he was so good that he hired volunteers to sit with the people in the office to, like, serve them tea or whatever. And then one day, he opens his door. He says half of them are gone. And he realized that it wasn’t him that they needed to see. They needed somebody to talk to. And the volunteers were doing just fine. And so he created this thing called befriending. And the early lines were called befriender lines. And in fact, I wish our 988 line was called a befriender line.

Kate: It’d be so much less scary.

Pamela: So much less scary! If I had like a wand, I would call it the befriender line. So it’s based on active listening, empathizing. No giving advice, no counseling. They do do a full risk assessment to figure out how much the person is in imminent risk. To figure out whether they need to do something to keep somebody safe. But beyond that, then they are there to just listen. And the idea is having somebody just to listen to actually eases that emotional pain, right? It’s  back to that, what we were talking about before.

Kate: That makes it sound like the word commiserating is exactly the right word.

Pamela: Yeah, commiserating. Yeah, yeah, commiserating. I never thought about that. I like that. So yeah. So their helpline is there and people can call, people can make their home safer.

Kate: Tell me about that.

Pamela: The analogy I use often a seat belts. Right. So we all put a seatbelt on. Most of the time, none of us get into an accident. So we can all suicide proof our home, which means get lock boxes for medications, lethal over-the-counter stuff. Things, leftover medication from the last time you were at the orthodontist. Obviously, for, you know, firearms. It turns out that, I used to think that if somebody wanted to die by suicide or somebody, that they, that they would seek, that if you stopped one way, they would immediately go to another way. And I think our strong will to live means that when we can pause that for longer, for most people, not for everybody, it can, and give them more chances to find their reasons for living. We delay it longer. It can help. And so that’s why the safety stuff matters. Nicely, they’re starting to do a lot of things sort of in communities now. You know, barriers on bridges and things like that as well. The Golden Gate Bridge finally, now has a netting. Just needed for people who’ve been fighting for, for an inordinate number of years and finally has now netting, so that. And then there are, you know, programs in schools that are increasingly happening now, too. We work with a wonderful nonprofit in Southern California that has kids make films in suicide prevention, like one minute films in mental health awareness and suicide prevention. And then it means that they’re talking to their friends, because often the first person that will notice what’s going on with a kid is probably a friend, right? You know, they’re and they’re in schools. Kids are in schools a lot of the day and more often more in school than they are at home. So there’s ways in which schools are a really important place for really supporting, you know, prevention, even though teachers are doing way too much already. But it’s another space, you know, to really talk directly to kids about… They’re supporting each other already. And the trick is, I think as adults, we’re not giving them the chance to know what to do with that information. Right?

Kate: Yes. Yes. What a good argument. I feel like every time you say something, oh my Gosh. What an unbelievably helpful argument!

Pamela: Like, they’re already talking about it. They’re already struggling. What we’re not doing is telling kids what to do. When do you break a code of silence? When is it too much? Like you can’t keep this secret. You know what, where, who’s the adult that you can bring the kid to in the school building that’s going to, not immediately, you know, once you say the word suicide, hospitalize you, you know? Can you call nine, eight, eight together? Right? Or there’s team lines out in the West Coast and where a kid will answer the phone overseen by clinicians. You know, older kid. Overseen by clinicians, teen line and youth lines out in California and, up in Portland. And but 988 works everywhere.

Kate: Pamela, you’ve given me so many kinds of ways to think about why more language and like softer language is going to open up a lot of possibilities for connection with people. Like that makes it both less like of this than that and so much more like, how can we include suicide in the way that we talk about our belonging to each other, how we love each other better, how we have maybe a lot more honesty around like when we see people creeping up to the edge of despair. And I feel so grateful. This was a very emotionally expensive thing for you to do with me, and I feel incredibly grateful you chose to do it.

Pamela: Thank you, thank you. I you know, it’s, you know, obviously a really important topic. And, Frankie would want me to do this, so. Feels like the right reason to do it.

Kate: What a gift. Friends, if you are struggling, call or text 988. If you are worried about someone, you can call or text 998 to get helpful resources. You don’t have to like meet a magical threshold of things being hard enough. Just call or text 988. Remember, you really matter. And hey, we have lots of links for you in the show notes of today’s episode. Just head over to KateBowler.com/podcasts and you’ll find all the links there. Pamela gave us some recommended reads for ways that you can learn more about loving people through suicide loss, as well as ways to stay connected to her work and her center at NYU. As a way to close today, I thought we could use a blessing for these feelings, the fear and the grief and the hope that we can learn to better support one another. So here’s a blessing for you who know the depths of sorrow that few understand.

Kate: Blessed are you who see it all now. The beautiful, terrible truth that our world, our lives can seem irreparably broken. And you can’t unsee it. The anxious, the exhausted, the stretched too thin. The person who wonders if any of this is worth it. And all the loneliness and despair and helplessness and grief. Blessed are you who glimpse this reality and don’t turn away. You who walk the delicate path of supporting others through their darkest days without the ability to fix it for them or rescue them. Even though I know you would if you could. Blessed are you who’ve wrestled with questions that have no answers for you, who have dared to seek understanding in the face of so much pain. May you find peace in the midst of uncertainty, knowing that your presence itself is a language of love. Terrible. Beautiful. Fragile.

Kate: Look, my loves, I know this one was a big ask, but for all the people who are going through it, they’re going to be so glad that you did. And thank you so much for the generosity of our partners who make things possible. Thank you to the Lilly Endowment, the Duke Endowment, and Duke Divinity School. We are so grateful to get to make things alongside of you. This episode in particular is the result of the fact that my team has heard from so many of you and knew that you wanted this episode, so thank you. Thank you to Jess Richie, Harriet Putman, Keith Weston, Gwen Heginbotham, Brenda Thompson, Iris Greene, Hope Anderson, Kristen Balzer, Jeb Burt, Sammi Filippi, and Katherine Smith. Thank you. And we do it because of and for listeners like you. Yes, you worried about your kids, or you on a mission to do better for the kids in your life? You are our absolute favorite and we are so grateful to get to make something that we hope is useful for you. Leave us a review on Apple Podcasts and Spotify. It will help us so much and it only takes a few seconds. Or call us and leave us a voicemail at (919) 322-8731. Okay guys, I will be back next week with the hilarious and endlessly entertaining comedian Samantha Bee. You will not want to miss it. Until then, this is Everything Happens with me, Kate Bowler.

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