Reducing further suicide attempts

Suicide is the fourth leading cause of death for those under 65! A study in Philadelphia showed that recent suicide attempters treated with cognitive therapy (CT) were 50 percent less likely to try to kill themselves again within 18 months than those who did not receive the therapy. People were recruited for this study in the emergency room, following a suicide attempt. One hundred and twenty people were either assigned to CT or usual community treatment.

Seventy-seven percent had major depression and 68% a substance use disorder. About half of the participants in both groups took psychotropic medications and about 13% to 16% received drug abuse treatment. About 27% of those in the usual care group received psychotherapy outside of the study, compared to 21% of those also receiving cognitive therapy.

Over the year-and-a-half follow-up period, only 24% (13) of those in the cognitive therapy group made repeat suicide attempts, compared to 42% (23) of the usual care group. Although the groups did not differ significantly in suicidal thoughts, those who received cognitive therapy scored better on measures of depression severity and hopelessness, which the researchers suggest "may be more highly associated with a reduced risk of repeat suicide attempts."

One of the researchers reported, "We were surprised by the amount of energy and resources it takes to reach out to individuals who attempt suicide. This population lacks a positive attitude toward the mental health system and often fails to show up for scheduled appointments. However, the combination of cognitive therapy plus case management services was effective in preventing suicide attempts." He suggests that cognitive therapy's short-term nature makes it a good fit for treatment of suicide attempters at community mental health centers.

If you know someone that has made a suicide attempt, some psychotherapy follow-up should be mandatory.

Best wishes,

Mike

http://drmikemiller.com/suicide.html

Emotional fasting

We are now in the Lenten season. This is when Jesus went into the wilderness, fasted for 40 days, and resisted temptations. Many Christians have emulated this and give up chocolate and the like during this time. Most of the other religious traditions also have times of fasting. Many find this a meaningful spiritual. Regardless of whether you are Christian or an athesist, consider a fast in this season.

Rather than giving up chocolate (or in addition to it), consider working on giving up negative and catastrophizing thoughts. If your intent is to emulate Jesus (or Mohammed, Buddha, etc.), letting go of negativity will be much more spiritually cleansing than forgoing chocolate.

How would one do this? The first step is to become more aware of your automatic thoughts. Catch yourself saying things like, “Why even try. It won't work anyway!” or “What if everyone laughs at my efforts?” These automatic thoughts will generally fall into one or more of the following categories:

1.All/None thinking “It's perfect or it is crap!”
2.Overgeneralization “Nothing EVER works out!”
3.Mental filter You focus ONLY on problems and ignore the 99% of when there are no problems.
4.Discounting the positive Someone offers you a compliment and you deny it.
5.Jumping to conclusions “I KNOW that things won't work!”
6.Magnification and minimization “I mess up EVERYTHING.”
7.Emotional reasoning “I FEEL the test will show cancer, therefore, I HAVE cancer.”
8.Should statements “They SHOULD be competent if they work here!”
9.Labeling “I'm a loser.”
10.Blame Instead of problem solving, you blame yourself or others.

Once you identify that you frequently use any of the categories, begin to monitor yourself for those type of thoughts. For example, monitor yourself for “What if” thoughts, should worry be a problem. Don't be concerned that there is often overlap between the categories. Two good books that elaborate on this approach are Feeling Good and the Feeling Good Handbook, both by David Burns.

Best wishes,
Mike