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Life-Saving Conversations: Tom Efird on Suicide Prevention
Episode 30 • 24th March 2025 • The Midlife Revolution • Megan Conner
00:00:00 00:46:05

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In this vital episode of The Midlife Revolution, host Megan Conner delves into the critical topic of suicide prevention with expert therapist Tom Eord. Learn about the myths and realities surrounding mental health crises, including the importance of direct communication about suicidal thoughts, the role of medication, and the power of building personal resiliency. Tom shares firsthand insights on how to support loved ones in crisis, the significance of therapy, and practical steps to foster healing from trauma. Whether you're seeking help for yourself or a loved one, this episode provides essential tools and understanding to navigate the path to recovery and hope.

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WEBVTT

::

Hello, beautiful humans.

::

Welcome to the midlife revolution.

::

I'm your host, Megan Conner.

::

And today we're going to be

::

talking about suicide prevention.

::

I normally don't do trigger

::

warnings because I believe

::

that our triggers are there

::

to teach us things about ourselves.

::

But today I just want to

::

mention that we have a

::

little crawl on the bottom

::

of the screen for the

::

suicide crisis lifeline.

::

And if any of you need it,

::

please reach out for help.

::

Today I am joined by the

::

illustrious Tom Eford.

::

Welcome.

::

Hi.

::

Thanks for joining me today.

::

Thanks for having me.

::

Would you like to tell the

::

people about your

::

credentials and where they can find you?

::

I am actually a licensed

::

clinical social worker and

::

an EMDR certified therapist

::

and approved consultant.

::

And I live in Texas.

::

I'm going to add to that

::

because that's a very boring description.

::

I think Tom is a,

::

is an excellent EMDR

::

clinician

::

He's a person who does not

::

suffer fools and proudly.

::

Yeah,

::

I come from a I come from a place where,

::

you know,

::

I'm not going to suffer foolishness.

::

And that's not I don't think

::

I think that's a skill set.

::

I think I think it builds resiliency.

::

And I think it's a great I

::

think it's a great asset to where,

::

you know,

::

we're just not I'm just not

::

going to play play with

::

fools because that's just a

::

waste of my time.

::

Just, I think, yeah,

::

that was a rather boring

::

description of what I do.

::

I've been in the field for 25 years.

::

I started in North Carolina

::

where I'm originally from.

::

Got licensed in North

::

Carolina and joined the

::

service at some point in 2012.

::

Served for five and a half

::

years and then ended up in Texas.

::

So I've spent the majority of, I mean,

::

I've spent my career,

::

I'd say since I learned how

::

to do EMDR in 2007,

::

I've spent the last 17 years,

::

18 years treating trauma.

::

I originally was a case manager in a small,

::

small,

::

small rural community where it was

::

probably the best training

::

I've ever had anywhere,

::

because you see everything.

::

But once I got licensed and

::

learned how to do EMDR,

::

I just that's just become my wheelhouse.

::

Yeah.

::

So I always tell people on

::

my channel that I am not

::

any kind of a mental health professional.

::

I am just an expert in my own trauma.

::

And you actually are an expert in trauma.

::

I try to be.

::

Yes.

::

So I'm going to go back and

::

talk a little bit about

::

some of my story and my

::

background for those people

::

who may be new to the

::

channel or don't know

::

anything about my story.

::

I survived sex trafficking as a child,

::

and I grew up in a very

::

toxic family of origin.

::

that sort of felt familiar to me.

::

And so I naturally was

::

attracted to those same

::

kinds of chaotic situations

::

as I got older and ended up

::

in some bad relationships.

::

And finally got to the point

::

where I had to address the

::

fact that my growing up was traumatic.

::

I had dissociated from it

::

for such a long time.

::

And I had an experience

::

around somewhere around 2014

::

where I had to wake up from

::

that dissociative state and

::

start confronting all of this trauma.

::

And I was in a really dark

::

place for a couple of years.

::

I love Christmas time.

::

I have six children.

::

Christmas is my very

::

favorite time of the year.

::

And in the Christmas of 2016,

::

I didn't take a single picture,

::

nothing of my kids Christmas Eve,

::

nothing waking up Christmas morning,

::

no presents or anything.

::

So that tells you a little

::

bit about what a dark place

::

I was in at the time.

::

And in January,

::

I decided to go on a girl's

::

trip to visit a friend who

::

lived in San Francisco.

::

And my phone must have been

::

listening to me and knew I

::

was visiting there because

::

I kept getting these news

::

stories and pop-ups about

::

things to do in San Francisco.

::

And one day a news article

::

popped up about a man who

::

had jumped from the Golden

::

Gate Bridge and lived.

::

And he talked about the fact that,

::

first of all,

::

that's rare for that to happen.

::

And secondly,

::

there's actually a group of

::

survivors that meet with

::

each other and they know

::

each other and support each other.

::

And he said one of the

::

things that all of those

::

survivors have in common is

::

that the second they jumped,

::

they immediately regretted it.

::

And after I read that article,

::

I made a decision that I

::

was going to live.

::

I wanted to live.

::

And despite the dark

::

thoughts that I had and the

::

dark place that I was in,

::

I decided that I didn't

::

want those thoughts to take

::

over and I didn't want to

::

leave my kids without their mother.

::

And so I came up with a plan to

::

get help for when i was in

::

those really dark spaces

::

and i wrote a book about

::

all of my healing

::

experiences it's called i

::

walked through fire to get

::

here and in the book i talk

::

about my plan and i had a

::

group of friends and i

::

referred to them as the

::

suicide squad and these are

::

the rules of the plan

::

Number one, when I'm in crisis,

::

I will send a text message

::

to the group with just a

::

number on a scale of one to

::

10 with one being suicidal

::

and 10 being euphorically happy.

::

I was never a 10.

::

I had never been a 10 at the

::

time I lived my life in the

::

three to five range.

::

Three was barely able to get

::

out of bed and pretend like

::

everything was okay.

::

So I could pretend to work

::

and pretend to be there for my kids.

::

It usually took several hits

::

to knock me down to a two

::

triggers trauma or more abuse.

::

This was before I had good, reliable,

::

unbreakable boundaries,

::

so I was getting hit often.

::

Once I was at a two, the assessment became,

::

am I about to spiral down

::

farther or will I be stable

::

enough to do some self-care

::

or get in to see my therapist?

::

If the answer was a spiral,

::

it was time for a text to the squad.

::

rule number two.

::

When I'm in crisis,

::

I'm not allowed to decline

::

any offers of help.

::

My usual behavior in crisis

::

was to shut down,

::

put the walls up and lock myself away.

::

I didn't want to tell anyone

::

how I was feeling.

::

I didn't want to reach out.

::

I didn't want to accept

::

phone calls or answer texts

::

or admit that I needed help

::

or allow people to help me.

::

The abuse and neglect I

::

suffered taught me not to trust anyone,

::

not to rely on anyone,

::

not to ask for anything from anyone ever.

::

The only person I could

::

really trust was me.

::

And even I wasn't very

::

trustworthy most of the time.

::

Rule number three,

::

the squad's job is to check in.

::

I was only required to

::

respond if my one to 10 number changed.

::

They were to offer encouragement,

::

we're here for you, you're not alone,

::

reminders like drink water, eat something,

::

practice self-care,

::

and help me keep track of

::

medications and dosages.

::

Rule number four.

::

If the episode lasted more

::

than a couple of doses of meds,

::

they had my permission to

::

contact my psychiatrist.

::

They all had his number and

::

he had a list of the names

::

and numbers of everyone in the squad.

::

And if necessary,

::

they had permission to call 911.

::

rule number five someone in

::

the squad would make

::

face-to-face contact within

::

a few hours and report back

::

to the rest of the squad

::

what the situation looked

::

like in person the most

::

important thing about this

::

plan is that all these

::

rules and plans were made

::

when i was not in crisis

::

with the help of my friends

::

and therapists i made a

::

list of self-care items i

::

could and would practice i

::

made a list of things that

::

would be encouraging to

::

hear and what i did not

::

want to hear the last thing

::

in the world i wanted was

::

for people to rush to my

::

side offer to bring me

::

cookies or a casserole

::

or sit there and bite their

::

nails with a worried

::

expression and ask trite questions like,

::

how are you really?

::

This plan,

::

this squad was put into place to

::

make sure that never happened.

::

When all was said and done,

::

I only needed the squad

::

three times over the course of a year,

::

and we never got to the

::

point where 911 was needed.

::

Just knowing that I had a

::

plan in place kept me from

::

going down the spiral at

::

least eight more times.

::

I found a way to end the

::

pain without ending my life.

::

So Tom,

::

I brought you here today to get a

::

clinician's perspective and

::

to hopefully assist some

::

people out there who either

::

are dealing with suicidal

::

feelings themselves or who

::

have a friend or a loved

::

one who are going through this as well.

::

So what advice do you have

::

about people putting a plan

::

in place similar to that?

::

I think any plan to prevent

::

suicide is a good plan.

::

Any plan is a good plan to prevent it.

::

And we'll be clear about that.

::

To prevent suicide,

::

any plan is a good plan.

::

Suicide is not part of our

::

natural instincts.

::

Our natural instinct is to live.

::

And you said that so eloquently,

::

survivors of suicide have

::

said they jumped and

::

immediately regretted it.

::

so I think that any plan to prevent it

::

is a good plan.

::

Uh,

::

and I think the other thing to remember

::

for that,

::

I think that gets overlooked is

::

that our brains are hardwired to heal.

::

The brain is always trying

::

to return to a state of

::

natural balance and healing.

::

Um,

::

now going through things like you went

::

through as a kid is

::

certainly going to leave a mark.

::

Yeah.

::

But if we give ourselves the

::

time and the space to heal,

::

we're gonna heal.

::

Yeah, I think for me,

::

that was the hard part

::

because having confronted

::

all of the reality of all my trauma,

::

at the time that that came out,

::

I felt like I was never

::

gonna feel differently.

::

I felt like it was

::

impossible to confront all

::

of those different kinds of

::

abuse and come out on the

::

other side and be happy.

::

Well, if we look at it this way,

::

you're 15 years old and you

::

have your first boyfriend

::

or girlfriend breaks your heart.

::

You feel like you want to

::

die because that's your

::

first real heartbreak.

::

And then, you know, time goes on 10, 20,

::

30, 40 years later.

::

Now you just got a funny story.

::

Because in the immediate aftermath of that,

::

you don't sleep good for a few days.

::

You might have some weird dreams,

::

you don't eat good.

::

But eventually what happens

::

is the brain takes that

::

event and it puts it in its

::

proper context.

::

Like you just got your heart broke.

::

You're not going to die over this.

::

Yeah.

::

And you're going to move on.

::

Something like chronic

::

sexual abuse or exposure to

::

violence in childhood

::

that leaves a mark that

::

determines really what ends

::

up happening is you end up

::

in these patterns of

::

behavior until really you

::

get the help that you need.

::

And that help can come, you know,

::

sometimes it takes a while

::

to find the right help because we just,

::

you know, if you don't know,

::

you don't know.

::

And hindsight is always 20, 20.

::

But when you find that help

::

and you do the work,

::

things do get different, different.

::

And I think the important

::

thing to remember is that once,

::

once you kind of recover from something,

::

then it becomes the lesson

::

and you get the experience

::

and the wisdom.

::

So when some, if somebody, you know,

::

if you get out of,

::

if you were raised in a

::

violent home and you get

::

into violent relationships

::

and then you realize this

::

isn't good for me and you end up,

::

going to therapy or getting

::

the help that you need.

::

And then you start dating

::

again and you start seeing

::

those red flags.

::

Those red flags are not the circus.

::

That's not the entry you want.

::

You're going to look at

::

those red flags and go,

::

I've been down this road before.

::

I know how this ends.

::

That's a hard pass.

::

Then you end up having

::

better relationships

::

because you're not running

::

towards the circus with the red flags.

::

Yeah, of course.

::

Yeah.

::

And I did get to the point

::

where I became allergic to

::

disrespect and I became

::

allergic to volatile temperaments.

::

And, you know,

::

I just have zero tolerance

::

for any of those things now.

::

And it's it's easy to see

::

how that evolution happened for me.

::

And, you know,

::

now being on the other side of it,

::

I just think that so many people,

::

you know,

::

we all have some kind of a

::

trauma that we are that we

::

need to work through.

::

Some of it can be helped with talk therapy,

::

which is where I started.

::

Some of it needs more intense help,

::

different kinds of healing modalities.

::

But I think when people

::

think about the idea of

::

going to therapy and

::

confronting their deep,

::

dark secrets and their demons,

::

it feels overwhelming and

::

you don't want to do it.

::

And that's why most people don't.

::

Well,

::

When you ask for help,

::

if you have somebody who

::

you're worried about,

::

and I'll start there.

::

If you have somebody that

::

you're worried about,

::

I'm a fan of asking direct questions.

::

I think most of my patients

::

will tell you that I don't mess around.

::

I'm going to ask the direct question.

::

Are you thinking about killing yourself?

::

Yeah.

::

And if they say yes,

::

I'm going to ask some

::

follow-up questions because

::

if you ask the question and

::

you're not a clinician,

::

because me asking that question,

::

somebody says, yes, well,

::

it's nine o'clock on a Tuesday.

::

You know,

::

that's not something that's

::

necessarily going to keep

::

me awake at night.

::

If they have plan and if

::

they have the plan and the intent to die,

::

that will keep me awake and

::

I'm going to do what I need

::

to do to make sure that they're safe.

::

But if, if I wasn't a clinician, um,

::

Am I asked the question?

::

And then I have to be

::

prepared for the answer.

::

What happens if they say yes?

::

Well, I think the next thing,

::

because we're talking about

::

your loved ones and

::

everybody's got different

::

ways of handling these things.

::

But I think the most humane

::

thing to do is ask the question, well,

::

what can I do to help you

::

so you don't feel this way?

::

And if they say, well, I don't know,

::

well...

::

That's when you do the follow up thing.

::

Can we get you some help?

::

Yeah.

::

Yeah, thank you for addressing that.

::

I think a lot of people are

::

afraid to ask the direct

::

question because there's

::

sort of this myth out there

::

that if you ask someone if

::

they're suicidal,

::

you're going to make them worse.

::

No, because if that was the case,

::

as much as I talk about

::

wanting a new guitar,

::

nobody's bought me a new guitar.

::

You know,

::

that's like listening to blues

::

music is going to, you know,

::

you're selling your soul to

::

the devil if you listen to

::

blues or rock music.

::

That's a myth.

::

It's not going to make anybody worse.

::

It's actually going to shine

::

a light on that shadow.

::

And, you know,

::

if they say they don't know and they say,

::

well, can we get you some help?

::

You know, then what do you do?

::

Well, if you have commercial insurance,

::

Blue Cross Blue Shield, Aetna, Humana,

::

United, most of these insurance companies,

::

and I know that people

::

complain about insurance companies.

::

I don't like to complain

::

about the people that pay me.

::

I think that's out of bounds.

::

You know, nothing's perfect.

::

But one of those insurance companies,

::

the things that an

::

insurance company will do

::

is when you call that 1-800

::

number and say, hey,

::

My kid,

::

my loved one is having suicidal thoughts.

::

This is their insurance policy, blah, blah,

::

blah.

::

I need to get some help.

::

Typically what that

::

insurance company will do,

::

and I'm going to knock on wood,

::

is that they're going to say, well,

::

let us help you find somebody.

::

And some insurances will

::

actually help you make

::

phone calls to providers

::

who are in network.

::

I know that people worry

::

about their insurance

::

companies knowing about

::

their mental health.

::

It's no different than going

::

to a doctor and being

::

diagnosed with diabetes or

::

heart condition.

::

Insurance companies are going to know.

::

And one of the things that

::

has happened over the last

::

dozen years is that when

::

the Affordable Care Act was passed,

::

I can't remember the year,

::

but when the ACA was passed,

::

they eliminated

::

pre-existing conditions and

::

they made mental health and

::

substance abuse,

::

they gave it parity with

::

medical conditions.

::

So you don't have to,

::

typically you don't have to

::

pay any more than what you

::

would pay your provider for

::

a doctor's visit.

::

But calling your insurance

::

company and using your

::

in-network benefits,

::

and finding a provider that

::

way is a great resource.

::

The other thing is check

::

with your employer because employers have,

::

especially if it's a big company,

::

employee assistance programs.

::

Sometimes they have mental

::

health benefits that are

::

extended to family members.

::

And those things are usually free.

::

And I'm a big fan of free.

::

I like free.

::

So, you know,

::

and you get a certain amount

::

of sessions for free.

::

Can you talk a little bit

::

about confidentiality and

::

sort of the myth that if

::

you call the suicide crisis line,

::

if you call 988,

::

that they're going to send

::

police to your door or, you know,

::

something like that.

::

I've had a lot of people ask

::

questions about that.

::

I will always and forever

::

reserve my right to be

::

wrong about things.

::

I'm a married man.

::

I can either be right or I can be happy.

::

I don't get to be both.

::

My understanding and things

::

that I've read about 988 is

::

that that rarely happens.

::

If somebody is that

::

concerned that you've got

::

the plan and the intent to die,

::

somebody should call 911

::

and have them do a safety check.

::

I would rather that happen

::

and have somebody be angry that, well,

::

they called the police on me.

::

Well, were you suicidal?

::

Yeah.

::

Did you have a plan?

::

Yeah.

::

Did you have intent?

::

Yeah.

::

Well, they did the right thing.

::

I would rather have you

::

alive and angry than dead

::

and having to do that work

::

with grieving parents or a

::

grieving spouse or kids.

::

You know,

::

just because you call 988 doesn't

::

mean that, you know,

::

the police are going to

::

automatically show up.

::

They're going to walk you

::

through it and they're

::

going to give you resources to help you.

::

So I want to talk a little

::

bit about what you said

::

about plan and intent,

::

because there's a

::

difference between suicidal

::

ideation and then having plan and intent.

::

So can you explain to us

::

what those differences are?

::

Well, you know,

::

going to bed at night and

::

praying that you don't wake

::

up in the mornings,

::

And then you wake up and

::

you're disappointed.

::

Then you roll out of bed and

::

you go on about your day.

::

That's depression and hopelessness.

::

You can work with that.

::

Yeah.

::

Having brief fleeting suicidal ideation.

::

Well, sometimes I think about this thing.

::

Okay.

::

Are you going to?

::

No.

::

Why not?

::

Well, I've got kids.

::

Well, I've got this thing to live for.

::

Okay.

::

I want you to keep living for that thing.

::

You know, if it gets any worse than that,

::

let me know.

::

We'll talk.

::

But having a plan is when you're preparing,

::

you're giving things away,

::

you're practicing what it's

::

going to be like to do the

::

act that you're how you're

::

going to end your life.

::

And the intent to die is when you are like,

::

well,

::

today's the day this is happening

::

and it's going to happen at this time.

::

Yeah,

::

so those are some good warning signs

::

for those of us who have

::

loved ones who have

::

struggled with depression.

::

If your loved one starts

::

giving away meaningful things,

::

or if they start writing

::

letters that sound like

::

their goodbye letters,

::

or if they start talking

::

more and more about not being around,

::

those are the times to

::

intervene and start asking the questions.

::

Yeah,

::

and this is the other thing that I get,

::

because you were talking

::

about confidentiality.

::

And it's, you know,

::

confidentiality laws are

::

confidentiality laws.

::

There's a reason why we have HIPAA.

::

It's a federal law that

::

protects people's privacy

::

and confidentiality when it

::

comes to the healthcare.

::

If I get referred a patient,

::

And they want me to talk to

::

their loved ones, their spouse, their mom,

::

their dad or whoever.

::

They have to sign a release

::

of information and we have

::

to discuss what information

::

I can talk to their loved ones about.

::

And I've done this where, you know,

::

somebody I used to work

::

emergency services early in my career.

::

and somebody is bringing

::

their loved one in,

::

and you really have to convince,

::

and it's really just a lot

::

of convincing the person,

::

sign the release of

::

information so we can bring

::

your parent in,

::

we can bring your loved one in,

::

because you're getting them

::

to buy into the process,

::

buy into getting help,

::

because it makes them feel

::

like they have some locus of control.

::

Even when I was in the

::

military and we'd have to

::

hospitalize somebody,

::

there's rare occasions where

::

it's involuntary because I

::

want them to buy into this process that,

::

you know what, it's bad right now.

::

It's going to get different.

::

We're going to get you through this.

::

But the confidentiality laws

::

means that as long as you

::

sign that release of

::

information as a clinician, I can talk,

::

I can talk to you.

::

If they say, no,

::

my hands are effectively tied.

::

There's nothing I can do.

::

You know,

::

if they're telling me that they

::

if they're suicidal,

::

they have the implant and

::

the intent to die.

::

I can call 911 and have 911

::

have the police do a safety check.

::

And that's what I can do.

::

You know,

::

there have been a few times since

::

I've been out of the Air Force that.

::

I've missed having the

::

ability to hospitalize

::

people that I think needed

::

to go because they just

::

weren't buying in and I had

::

to escalate it to a, to a higher level.

::

Yeah.

::

Yeah.

::

And, but the important thing is,

::

is that getting somebody to buy into,

::

there might be a better way to do this,

::

be a better way to get help

::

So I think I remember you

::

saying that the only times

::

that you needed to contact

::

someone on the outside and

::

involve a third party is if

::

somebody is planning on

::

hurting themself or someone else.

::

Well,

::

typically it's with if they're going

::

to hurt themselves.

::

Yeah.

::

And they've got a plan or the intent.

::

know,

::

I think there's this myth out there that,

::

well, if I say yes,

::

I'm going to be hauled off

::

to the psych ward.

::

And that's not necessarily how that goes.

::

Yeah.

::

You know,

::

somebody having brief fleeting

::

suicidal ideation that that's Tuesday.

::

It's like I said, it's not going to get my,

::

it's going to get my attention.

::

That's something that's

::

going to be on my radar,

::

but it's not something that

::

I'm going to get too worked

::

up about because, okay, they're just,

::

they're in pain right now.

::

I think it's a lot more

::

common than people think, you know,

::

and I certainly thought

::

when I was going through it, I was like,

::

I'm probably the only one

::

who feels this extreme about this.

::

You know,

::

I'm the only one who's having

::

these thoughts,

::

but I think it's pretty common.

::

It,

::

It can be,

::

but I think the myth of being

::

placed on a psych ward,

::

I think it's overrated.

::

If you end up on a psych

::

ward that is for stabilization purposes,

::

you're gonna be there for

::

24 to 72 hours typically.

::

It's a rare occasion,

::

at least since I've been

::

out of the emergency services

::

arena if when i was working

::

emergency services uh

::

doctors would do an

::

evaluation and say that

::

they need to be

::

hospitalized the patient

::

doesn't want to go and they

::

fill out the form for in

::

they do an involuntary

::

petition to have that

::

person committed to a psych

::

unit for observation

::

And typically, at least in state,

::

every state is different

::

about how this process goes.

::

But you have to go, you know,

::

the clinician has to

::

contact the magistrate and

::

swear out an affidavit and say, hey,

::

this person is suicidal.

::

We cannot guarantee their safety.

::

They need to be committed.

::

They need to be a 24 to 48

::

hour commitment and the

::

police will go pick them up,

::

which is why it's always

::

better to get the buy in

::

Because if it's voluntary, it goes better.

::

But there have been times

::

where I've had to go down

::

to the magistrate and say,

::

I swear this person is

::

doing this and this needs

::

to happen for their safety.

::

Yeah.

::

They usually get mad, but they're alive.

::

Well, yes.

::

And as you said before,

::

we'd rather have them be

::

mad at you or mad at us for

::

making the phone call than

::

to have to deal with the

::

consequences of completed self-harm.

::

But again,

::

it doesn't happen as often as

::

people think.

::

It usually happens when

::

people are really in a bad

::

way and they are refusing help.

::

Yeah.

::

So basically,

::

if you want to avoid getting committed,

::

buy into your own healing.

::

You know, I would recommend that.

::

Yeah.

::

And, you know,

::

this is the other thing is

::

that when you're when

::

you're looking for clinician,

::

everybody wants a doctor,

::

everybody wants a psychiatrist.

::

And there's nothing wrong with that.

::

The psychiatrists,

::

at least in my experience,

::

they don't do that kind of therapy.

::

They do medication

::

management and medication

::

management for depression,

::

for mental health issues.

::

It's a wonderful asset.

::

It's a wonderful tool.

::

I know people say, well,

::

I don't want to take medications.

::

Well, you know,

::

Diabetics don't want to take insulin,

::

but there they are taking insulin.

::

There are medications there

::

that are supposed to help

::

alleviate those symptoms.

::

It doesn't necessarily mean

::

that you're going to be on them forever,

::

but to get you through, it helps.

::

Yeah, when I when I first started therapy,

::

there just was nothing that

::

was making me feel better.

::

And I didn't want to get on

::

medication either.

::

There's all of the stigma

::

around it and side effects

::

and all those kinds of things.

::

And when I did finally get on medication,

::

I was able to get above that, you know,

::

three or four on a scale of

::

one to 10 for the first time in years.

::

And I was able to get out of

::

bed in the morning and function normally.

::

And I always said that

::

depression for me felt like

::

there was a filter over my

::

brain and none of the bad

::

thoughts could get out and

::

none of the good thoughts could come in.

::

So I was just stuck in this

::

place all the time and

::

medication helped get rid

::

of that filter so that I

::

could finally start feeling

::

hopeful about things again.

::

Right.

::

And so I'm not a prescribing provider.

::

So when patients ask me

::

questions about their medications,

::

I'm like, one, two, three, not it.

::

Call your doctor,

::

because if you're having these issues,

::

you should be talking to

::

your doctor about this.

::

If I think that you need medications,

::

I'm going to tell you,

::

I think you need a second opinion,

::

because even in my work,

::

I may be an expert, considered an expert,

::

but I can still be wrong.

::

And I'm a fan of getting a second opinion.

::

A lot of people don't

::

realize that you can get, um,

::

depression medication from

::

your regular primary care doctor.

::

You don't have to go to a psychiatrist.

::

You can, you can get your,

::

you can get psych meds from

::

a nurse practitioner or PA,

::

or just a regular, uh,

::

general practitioner.

::

but that's for medications for therapy.

::

i'm a licensed clinical

::

social worker so i have a

::

master's degree in social

::

work i've been licensed

::

since 2003. so i am

::

sanctified and certified by

::

the state of texas that i

::

can provide assessments do

::

treatment planning provide

::

outpatient therapy services um

::

and do discharge planning

::

and case management.

::

I cannot prescribe medications.

::

So a few years ago,

::

my wife and I were at a

::

social work conference here in Texas,

::

and we were standing in

::

line to get lunch.

::

we were standing behind some

::

students some young

::

students and me being the

::

smarter like that i am i

::

overheard one of them say

::

how do you tell the

::

difference between a

::

master's level provider

::

psychologist and a

::

psychiatrist and without

::

thinking i said level of

::

arrogance and my wife

::

immediately just does this

::

number and start shaking

::

her head like why

::

I don't know.

::

It's a true statement.

::

I mean,

::

if you spend any time with providers,

::

you'll be like,

::

and I have the same problem.

::

But the difference is, is that LCSWs,

::

licensed professional counselors, LPCs,

::

licensed marriage and family therapists,

::

LMFTs,

::

there might be another license I'm

::

missing, but we can assess,

::

we can write treatment plans.

::

we can diagnose, we can provide therapy.

::

And depending on like social workers,

::

we're trained a little

::

differently because a lot

::

of our work started in the community.

::

So we go from a systems perspective.

::

It's not only that individual,

::

but what societal factors

::

are impacting that person.

::

Do they have food?

::

Do they have a roof over their head?

::

Are they in a safe environment?

::

I can't tell you how many

::

times I've done evaluations

::

where I'll ask the questions, well,

::

do you have food in your refrigerator?

::

And if they say no and they're cranky,

::

well, they might be hungry.

::

If they're having financial issues,

::

if they're having...

::

marital if there's marital

::

conflict there might be

::

something else impacting

::

those symptoms that i need

::

to be aware of but we're

::

all trained to do therapies

::

whether it's and it's

::

usually basic stuff in grad

::

school and then we go on

::

and get other training um

::

psychologists and psyd's

::

they're trained to do the

::

same thing the only thing

::

that the bare bones of what they do

::

is the only thing they do

::

additionally is IQ and

::

personality disorder

::

testing and testing for

::

learning disabilities.

::

And they do those things beautifully.

::

They're great at it.

::

I've worked with a lot of

::

great psychologists over the years.

::

So those are kind of the differences.

::

What else do we need to

::

cover about suicide prevention?

::

What haven't we asked yet?

::

That is important to know.

::

Well,

::

Best way of preventing suicide.

::

Build resiliency.

::

The R word resiliency.

::

Heard that a lot in the Air Force.

::

Build resiliency.

::

And I always kind of chuckle

::

at that because service members,

::

when we join the service,

::

we're typically a little healthier.

::

We have to be a little

::

healthier than everybody else.

::

So we've already got some

::

built in resiliency.

::

I work with a lot of parents.

::

I don't work with kids.

::

I think I've kind of aged

::

out of working with kids.

::

No longer cool.

::

I'm an old guy.

::

But I tell parents who are

::

worried about their kids, it's like,

::

when have you allowed them to fail?

::

When have you taught them how to fail?

::

Because the best way that

::

you're gonna prevent this

::

stuff in the future is if

::

you teach them how to fail.

::

And it's gonna stink.

::

When you watch your kid fail, it stinks.

::

Now,

::

my mom was one of those old Southern

::

women who did not play games.

::

And she did not suffer

::

foolishness like a lot of

::

moms of that generation.

::

And she made it very clear

::

that if we failed at school,

::

there were gonna be

::

consequences that we didn't want.

::

Now, we would, you know,

::

grow our hair as long as I

::

had hair at one point.

::

We would grow, we had long hair,

::

holes in our jeans, you know,

::

listening to rock music,

::

doing just dumb things.

::

But my mom set her limits.

::

She goes,

::

I don't care what kind of music

::

you listen to,

::

but if your grades are not good,

::

we have a problem.

::

And she was a great believer

::

in teaching object lessons.

::

You know, four years old,

::

we were standing in my

::

grandmother's living room.

::

She was ironing her clothes and she said,

::

honey, don't touch that iron.

::

It's hot.

::

And I didn't believe her.

::

Put my finger on that thing,

::

started hollering.

::

And she looked at me and said, well,

::

I told you it was hot.

::

What'd you learn?

::

Which was normally the, you know,

::

after the lesson, after the,

::

after I learned the lesson, well,

::

what did you learn?

::

You know?

::

I think that's such a great way to handle,

::

you know, children's failure or children,

::

you know,

::

being disappointed about

::

something is to just, just say,

::

what did you learn?

::

Because that's a very

::

nonjudgmental way to say

::

you and I both know that didn't go well.

::

And the important thing is, yeah,

::

what did you learn and what

::

are you going to do

::

differently next time?

::

Right.

::

if there's violence in the

::

home that's something

::

different but if you're in

::

a house where you know

::

there's a mix of discipline

::

and love and we know from

::

studies after studies that

::

parents just who give their

::

kids are permissive with

::

their kids and let them do

::

anything well they end up

::

getting spoiled little

::

brats if on the other hand

::

you have strict

::

disciplinarians that they

::

have to toe the line and

::

you know, all that, well,

::

they're just going to get

::

better at hiding.

::

They're going to get better

::

at hiding bad behaviors.

::

But what we found is that in, you know,

::

at least the last time I looked at it,

::

parents that give a mix of, you know,

::

setting limits and

::

consequences and boundaries

::

and rewards when they've

::

earned it typically end up

::

with with fairly decent kids.

::

You know, notwithstanding,

::

we're all you know, when we're all kids,

::

we're all stupid.

::

I don't mean that in a bad way,

::

but we're all kids.

::

We do dumb things.

::

That's just life.

::

Putting your finger on a hot

::

iron taught me don't touch a hot iron,

::

you know.

::

But it is really, well,

::

what did you learn?

::

And being nonjudgmental about it.

::

And sometimes as, you know,

::

working with kids,

::

sometimes it really is.

::

Here's the thing.

::

I'm not okay with that behavior.

::

Don't do that again.

::

And here's the consequence.

::

But the other thing is,

::

and I really do kind of

::

feel sorry for kids

::

nowadays is because there's

::

social media and

::

everybody's got a cell phone.

::

And it's hard to build relationships.

::

But I think that some of the

::

things that protect us over

::

time is having people that

::

we can count on, friends.

::

And the thing that I hear from patients,

::

which I will always and

::

forever reserve my right to

::

be right about this, is when they say,

::

well,

::

I can't burden my friends with this.

::

And I'm like, no,

::

that that's not how this is

::

going to work.

::

As a therapist,

::

I get you for one hour a week.

::

I get that's it.

::

And we have work to do.

::

And I'm going to structure

::

that time so you get your needs met.

::

Because you coming in and

::

talking to me about your

::

feelings is not going to be

::

ineffective because

::

essentially what you're

::

doing is you're just

::

stirring a pot of soup.

::

You're stirring everything up.

::

You walk out.

::

You feel like crap.

::

And then you have to deal

::

with that the rest of the day.

::

Mm hmm.

::

And so what I want to do is

::

stir the pot in session,

::

make sure that you've dealt

::

with what you've had to deal with.

::

So when you leave my office

::

or leave telehealth,

::

because that's what I'm doing now,

::

when you log out,

::

you feel better because

::

that's kind of the point of therapy.

::

Because if you're doing the

::

same thing with your

::

therapist every week and

::

nothing's changing, to me,

::

that would be a problem.

::

Yeah, time to get a new therapist.

::

Yeah, it's time to get a new therapist.

::

And I tell all of my patients,

::

if what I'm doing isn't working for you,

::

we're going to have a

::

conversation about it

::

because there was a time I

::

probably would have tried

::

to stick it out with them.

::

But if it's not working, it's not working.

::

And frankly,

::

it just gets really hard to

::

write those notes after a while,

::

plus wasting that person's time.

::

And that's that's not that's

::

not great for for for helping people.

::

But there are things that I

::

think one building those

::

friendships that and, you know,

::

women communicate very

::

differently than guys do.

::

It's just it's just our nature.

::

I'm not going to go to my

::

friends and tell them all of my feelings.

::

I'm going to say, dude,

::

you ain't going to believe this.

::

And my friends are going to be like, dude,

::

And they're going to be there for me.

::

Like, is there anything I can do?

::

Nah, dude, I just need to say it.

::

I, if there's something I can do,

::

let me know.

::

Gotcha.

::

Um, because we,

::

we communicate differently.

::

We just, you know, we do.

::

It's neither bad nor good.

::

Just is what it is.

::

Um, but I think other,

::

just like keeping life really simple,

::

getting off of social media, phone down,

::

um,

::

Practice daily routines.

::

Getting out of bed is a daily routine.

::

Brushing your teeth is a daily routine.

::

Drinking a good cup of

::

coffee is a good routine to have.

::

Don't drink coffee at

::

midnight unless you're a

::

third shift worker.

::

Exercise.

::

If you're not moving, get moving.

::

Try something new.

::

If you've stopped listening

::

to the music that you grew up with,

::

just because you, you know,

::

you've stopped listening to it.

::

Revisit those songs, revisit those albums,

::

because they are going to hit different.

::

Be okay, get okay with failing.

::

And over the age of 50, I can tell you,

::

I failed at things.

::

I can't remember who said this,

::

but I love this quote that

::

the definition of success

::

is moving from failure to

::

failure without a loss of enthusiasm.

::

I think that was Winston Churchill.

::

Might be, yeah.

::

I think it was Churchill.

::

And it's just the

::

acknowledgement that life

::

is a series of failures.

::

And if you think of it that way,

::

then you appreciate the

::

things that happen well

::

because they're rare.

::

Yeah, you know, I had a...

::

I was talking to a friend of

::

mine who's a vet and he's

::

retiring and we were

::

talking about our

::

experiences in the military.

::

And, you know,

::

some of my experience was

::

amazing and some of it was

::

just creptacular in an epic proportions.

::

And we were talking about it and I said,

::

you know,

::

even with all the even with all

::

the bad stuff,

::

I wouldn't change any of it.

::

And he's like, why?

::

I was like,

::

because I wouldn't have ended

::

up where I am.

::

I mean,

::

it literally the worst some of the

::

worst moments of my life

::

occurred when I was in the military.

::

Just due to bad leadership,

::

because leadership is key

::

to preventing mental health

::

issues in your in your troop or in work.

::

So, you know, I told him, I said, you know,

::

I would do all I would do

::

it all over again.

::

Yeah, because it made me exactly who I am.

::

And I got those lessons that

::

I can pass on to other

::

people if they want them.

::

And if they don't want them, that's OK.

::

The other thing to remember,

::

because I find myself

::

saying this a lot lately.

::

Feelings are not facts.

::

Your feelings are going to change.

::

And I know that there are

::

people out there who would

::

disagree with me about this.

::

And hey, Kitty.

::

um it's time for her treats

::

uh my goal is to help you

::

move past those yucky

::

feelings if you've got a

::

lot of trauma that you're

::

hanging on to there's work

::

to be done we can get you

::

through that and you're not

::

going to feel the same way

::

but that said there's no

::

therapy on this planet that

::

is ever going to make you like something

::

didn't like broccoli as a

::

kid probably not going to

::

like broccoli as an adult

::

if you didn't like being

::

sexually abused as a kid

::

probably not going to like

::

it as an adult and that's

::

okay what therapy is going

::

to do is it's going to take

::

out the emotional sting of

::

those issues and so that

::

way you're not having those

::

same reactions because if

::

you keep having the same

::

reactions over and over

::

again that's a problem

::

But I just, you know,

::

and I say this to a lot of people,

::

you know,

::

our feelings aren't facts and

::

our feelings are going to change.

::

And we're going to grow through them.

::

They're going to be different.

::

So the next time, you know,

::

somebody tries to pull the

::

wool over your eyes,

::

you're going to be sitting there going,

::

I've seen this movie before.

::

I know how it ends.

::

I'm good.

::

No, thank you.

::

Yeah, for sure.

::

Miss Pris here is demanding her treat.

::

What is her name?

::

We need to know.

::

Her name is Callie.

::

Her Majesty.

::

Her Majesty the Queen.

::

Well,

::

thank you so much for spending time

::

with us today.

::

And I appreciate all of your

::

helpful commentary.

::

And I hope this helps some

::

people out there to get the

::

help they need.

::

Yeah.

::

Yeah.

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