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To hear and be heard: ideas for meaningful conversations for nurturing life

The month of September is celebrated globally as Suicide Prevention and Awareness Month. To learn more about suicide and how we can support each-other, see this article. If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or proceed to the end of this article for the contact numbers of various local 24/7 crisis lines.

Stereotypes aside, as an organization providing psychological care, We Thrive’s work admittedly has a lot to do with conversations. It is something we take for granted, not always realizing that this very peculiar human capacity is one of the building blocks of human civilization (Crystal et al., 2023). Conversations are also one of the building blocks of human life: as psychologist Lucy Foulkes puts it, when conversations “allow us to learn something important about ourselves, about the other person, or about the world” (Foulkes, 2021), truly remarkable things happen. Such conversations, when they are “meaningful”, can turn even otherwise mundane chatter (what we label “small talk”) into subtle gateways for deeper interactions (Macquire, 2023). They make possible the flourishing of all those aspects of being human: sensing and holding our emotions (Lieberman et al., 2007), articulating the various aspects of the self (McLean and Morrison-Cohen, 2013), developing new behaviors and perspectives (Albright et al., 2016), relieving and easing painful experiences (Kardas, Kumar, and Epley, 2021), making sense of life as a whole (Tarbi et al., 2021), and much more. Speech of this kind has a literal healing effect, hence the well-earned stereotypical predominance of “talk therapy” methods in clinical psychological practice (Lindberg, 2023).  As social beings, as author Arthur Dobrin puts it: “With conversation, we find a place where we belong” (Dobrin, 2011).

In our ongoing observance of Suicide Prevention and Awareness Month, we want to offer some practical points for reflection for having meaningful conversations, particularly those you want to check in on and support through difficult experiences.

The look and feel of a meaningful conversation

The main feature of a meaningful conversation is the experience of being “heard” — an experience which is, without exaggeration, “one of the most basic, yet potent needs we have as social beings” (Fowler, 2022). Most of us know from personal experience how painful not being heard can be, and how influential it can affect our own ability to hear others. Not being heard can have many precipitating factors: maybe there are basic differences in communication style (Khiron Clinic, 2021); or maybe the capacities of one or both people in the conversation to hold big or uncomfortable feelings are limited (Brosch, 2015). It could be some other factor, like adverse childhood experiences (Zlate, 2020), which are not within our present control. Whatever the case, when we are not heard, some of our most fundamental needs — the needs to feel that “we are taken seriously, that our ideas and feelings are acknowledged, and that we have something to share” (Nichols, 1995) — cannot be met.

So how do we get to meaningful conversations where we feel taken seriously, acknowledged, and feel that what we share has value? We may be tempted to offer advice right away or resort to offering affirmation.

But “problem-solving” is not the same as “hearing”, and our impulse to give instructions or shoo away difficult feelings with aspirations of pleasantness, while usually very well-intentioned, may not reflect the other person’s true needs. This is what is often meant by “toxic positivity”: when the resolution to be quote-unquote “happy” is not grounded in the present reality which might demand more emotional complexity.

So having said that, what does “hearing” actually look like? Thankfully, a few scholars have looked into this. In a series of studies, the concept of being “heard” — described by the authors succinctly as “a key variable of our time”, given our modern propensities for distractions — was operationalized according to five components (Roos, Postmes, and Koudenburg, 2021). Here, we will present how these were understood and some points for reflection to guide how we apply these to making our conversations truly meaningful. 

  1. Recognizing our “voice”. This is about “being able to express myself freely, that is, being able to say what I want to say.” In meaningful conversations, there must be that sense that, while some social filters might be appropriate in any given situation, we are able to say what we think or feel without fear of being criticized, demeaned, or thought poorly of. It is the sense that, right or wrong aside, what we say is welcomed.

Reflection: In our conversations, do we offer a sense of security that allows the other person to say what they need to say, and that we are willing and able to welcome what they say — even if they’re about something difficult and uncertain?

  1. Receiving “attention”. This is about feeling that the other person “focused their attention on what I said”. In meaningful conversations, there is a conscious effort to home in on the details, verbal or otherwise. It is the sense that what we say merits curiosity, and that there is a richness in what is being said that is worth patiently drawing out.

Reflection: In our conversations, do we offer expressions of interest that communicate to the other person that what they have to say is important, and that we really want to understand them?

  1. Receiving “empathy”. This is the perception that “the other tried to take my perspective and emotionally understand me.” In meaningful conversations, the affective contents of what we say — not just the words, but the conditions that led us to say what we say — are appreciated. It is the sense that the other person is resonating with us at a level that is deeper than the dictionary definitions of our statements, and that we are allowed to speak with more vulnerability, confident that, at the minimum, our vulnerability will be cared for.

Reflection: In our conversations, does our presence invite the other person to let their guard down, even a little, so that what they say communicates more truthfully what their hearts dictate? (At least to the extent possible, given the circumstance. Emotions are complex, after all!)

  1. Receiving “respect”. This is the feeling that the other person “valued what I said (my voice) and me as a person”. In meaningful conversations, while all human activity is prone to human errors of misunderstanding, we are taken and honored as we are. It is the sense that whatever prejudices there may be are set aside — or at least owned up to, honestly — and that the interaction is grounded in a commitment to the fact that we are human beings deserving of compassion.

Reflection: In our conversations, does our approach show the other person that we accept and honor them as they are, however and whatever they may be?

  1. Experiencing “common ground”. This is the perception that we can “understand each other’s point of view”. In meaningful conversations, there is a kind of exchange that allows both people’s perspectives to be influenced in a constructive way, allowing not just greater understanding of the nuances of these differences, but a greater appreciation of how such differences can lead to the same goals of cultivating a more meaningful life. While there may be significant divergences in the way we come to our conclusions, these conclusions are ultimately grounded on a desire for the greatest good — and that our conception of the “good” can be deepened and strengthened by one-another.

Reflection: In our conversations, do we communicate an openness to hearing the other person’s views, and an openness for our own views to be positively influenced by them?

Being able to initiate and sustain such a potent human activity is one of our best means for promoting healing for ourselves and one-another. By cultivating these five components, we can be better placed to leverage the power of conversations to cultivate human flourishing both within and beyond our difficult experiences.

For mental health support services, email us at resilientteams@wethrivewellbeing.com or contact us to sign-up for sessions with our mental health clinicians.

If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or call these 24/7 crisis lines:

DOH-NCMH Hotline

0917-899-USAP (8727)

0966-351-4518

0908-639-2672

(02) 7-989-USAP (8727)

1553

Hopeline PH

0917-558-HOPE (4673)

0918-873-4673 (HOPE)

(02) 8-804-HOPE (4673)

2919

In Touch Crisis Line

0917-800-1123

0922-893-8944

(02) 8-8937603

References (in order of appearance):

  1. https://wethrivewellbeing.com/world-suicide-prevention-day-responding-to-suicide-with-resilience-and-compassion/ 
  2. https://www.britannica.com/topic/language 
  3. https://psyche.co/guides/how-to-have-more-meaningful-conversations 
  4. https://carolinemaguireauthor.com/how-to-make-small-talk/ 
  5. https://www.healthline.com/health/mental-health/talk-therapy#how-effective 
  6. https://pubmed.ncbi.nlm.nih.gov/17576282/ 
  7. https://www.tandfonline.com/doi/abs/10.1080/15283488.2013.776498 
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344154/ 
  9. https://www.apa.org/pubs/journals/releases/psp-pspa0000281.pdf 
  10. https://www.sciencedirect.com/science/article/abs/pii/S0738399121003335 
  11. https://www.psychologytoday.com/intl/blog/am-i-right/201112/conversation-makes-us-human 
  12. https://thedmcclinic.ie/blog-the-importance-of-being-heard/ 
  13. https://www.goodtherapy.org/blog/listen-up-why-you-dont-feel-heard-in-your-relationship-0810154  
  14. https://www.pacesconnection.com/blog/adverse-childhood-experiences-and-interpersonal-relationships 
  15. https://www.compassionate.center/docs/Why-listening-is-so-important.pdf 
https://psyarxiv.com/73jgn/
Categories
General News & Events

Thrive! A Parent’s Journey to Resilience, out now!

The much awaited book “Thrive! A Parent’s Journey to Resilience” has recently been published!

Written by We Thrive clinicians Cherie Lo, Dr. Jabby Herrera, Malyn Domingo and Rhoanne Ramas, together with We Thrive co-founder Mel Tan and former We Thrive consultant Karyl Abog, “Thrive!” tackles the neuroscience of stress, how it affects parenting and gives concrete strategies for parents to navigate the ever-changing landscape of childrearing.

“Stress is a common experience in our lives. It affects us in different ways depending on our background, our vulnerabilities, and our strengths. Most of us can cope. Stress can even lead to growth. But what happens when stress becomes chronic, unpredictable, and intense?”

A group of clinicians breaks down the science of stress in simple and accessible language. They have compiled valuable insights on mental health practices from years of experience and research. Complete with tools necessary to develop self-care and compassion, this book will help readers navigate their road to resilience and, in turn, raise resilient children”

Here are some of the photos from the book signing at the Manila International Book Fair where the signed copies of the books were sold out!

Copies of Thrive! are available at the We Thrive Clinic in Tektite and online through Lazada and Shopee.

Categories
General

World Suicide Prevention Day: Responding to suicide with resilience and compassion

Trigger warning: this article discusses sensitive topics related to self-harm, suicide, and other similar experiences. If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or proceed to the end of this article for the contact numbers of various local 24/7 crisis lines.

In We Thrive, our work is embedded with the assumption that life is inherently meaningful and worthwhile. In the process of learning to regulate, relate, and reflect, we also develop a sensitivity to at least three underlying intuitions about our lives: first, that it “make sense and has continuity”, and that the logic of life, while not always completely clear, eventually unfolds; second, that it is “directed and motivated by meaningful goals”, whether or not we have fully grasped these goals; and third, that it “matters to others” — saying not just that the outcomes of our life’s work has value, but that the presence of our life in and of itself is valuable (DeAngelis, 2018).

Sadly, this intuition of life’s purposefulness is not always immediately apparent nor secure. We can be met by challenges so intense that they disturb or even completely discredit it. For many, how life unfolds can lead to the perception that life simply may not be worth it, and can lead further to the conclusion that the only way out is to take one’s own life. And the great tragedy of human experience is that these conclusions are acted on too often. Among young people in particular, suicide is the fourth leading cause of death globally (WHO, 2023). And based on recent national studies, Filipinos are not exempted from this pain: as deeply worrying data from the Young Adult Fertility Survey 5 (YAFS5) has recently shown, 17% of young Filipinos reported suicidal ideation, 7% have attempted suicide, and more than half reported that they have not reached out to anyone about these experiences (UPPI, 2022).

To honor World Suicide Prevention Day on September 10, we wish to briefly discuss some facts about the nature of suicide, and to raise awareness about how we can effectively respond to this issue with greater wisdom and compassion.

First, let’s address some MISCONCEPTIONS  about suicide:

  1. People with diagnosed mental health conditions are NOT the only ones who think about attempting, or try to attempt, suicide (Fuller, 2020). It is true that psychiatric illnesses such as depression, substance use disorders, and related conditions are found in a large number of cases (Brådvik, 2018). That said, estimates of people living with such conditions who actually attempt suicide quite low, with one study putting lifetime risk at just 4% (Bostwick and Pankratz, 2000). Even in the case of depression, the most commonly assumed cause in the popular imagination, “a large percentage of severely depressed patients never think about suicide” (Pompili, 2019). Non-psychiatric health problems (e.g. type 2 diabetes, see Gómez-Peralta et al., 2018), socioeconomic inequalities such as poverty (Bantjes et al., 2016) and immigrant status (Forte et al., 2018), or experiences of discrimination such as on the basis of sexual orientation and gender identity (Henry et al., 2021) are also well-known risk factors.
  2. Talking about suicide does NOT make someone more like to attempt suicide (Dye, 2022). This idea draws from a phenomenon commonly called “suicide contagion”: the uptick in cases after a report of suicide in mainstream media, such as of a celebrity figure; or in one’s immediate communities, such as of a friend (Poland, Lieberman, and Niznik, 2019). There is ongoing work towards reducing these risks, such as through evidence-based guidelines for responsible suicide reporting (Gould and Lake, 2013). But we know that simply talking to someone about it does not make it more likely that they will do it (Dazzi, Gribble, Wessely, and Fear, 2014). And the key word here is “responsible”: suicide contagion emerges when conversations about suicide are mishandled, such as excessive focus on the means of death, or failing to include accessible resources for seeking help (Utterson, Daoud, and Dutta, 2017).
  3. Thinking of, or attempting, suicide is NOT a sign of weakness or of moral failure (Sharma, 2021). One of the most difficult things about responding to suicide is that, while there is an abundance of knowledge about potential vulnerabilities, “no risk factor, including classification of diagnostic subtype, has been reliably shown to predict suicide” (Bostwick and Pankratz, 2000). So when we hear about suicide, what we are witnessing is an ultimately incomplete picture of a long and difficult journey, whose roads could have led to any other path, and whose particular tragic conclusion we can only ever speculate. To make assumptions about personal integrity, ulterior motive (e.g. seeking attention), or anything else about a person’s suicide assumes a level of understanding that we simply don’t have. If we want to be of any help, the first step would be to exercise some restraint on our own personal prejudices, so we can approach the question with more humility, curiosity, and kindness.

Misconceptions aside, the next question is about what we actually know can alert us to the risk of suicide. Of course, any such “warning signs” must be understood within a person’s context of adversity, and why they might experience such adversities as unbearable or insurmountable. Such contexts can be individual (e.g. a debilitating physical or mental conditions), relational (e.g. serious family conflicts), communal (e.g. unstable access to basic needs), or cultural and systemic (e.g. discriminatory attitudes towards particular groups) (CDC, 2022). Keeping these in mind, there are some potential warning signs which can alert us to such intense distress:

  1. Taking more interest in suicide than what would normally be expected (e.g. looking up information about different methods of ending one’s life), or making preparations as if one’s life will end (e.g. giving away prized possessions) (Sharma, 2021).
  2. Increased withdrawal or isolation from one’s significant relationships such as loved ones and other social groups (Dye, 2022).
  3. Increased statements which are self-deprecating (e.g. “I am useless”), express a serious sense of hopelessness (e.g. “There is just no way out”), and/or explicitly concern ending one’s life (e.g. “It would be better if I were gone”) (AFSP, 2023).
  4. Negative changes in one’s routines, such as reduced enthusiasm or commitment to hobbies or other interests; as well as disruption of regular bodily functions, such as eating habits, sleep, and hygiene practices (Ellis, 2019).
  5. Intense and unusual dysregulations in mood (e.g. increased agitation, lethargy, sadness) and accompanying shifts towards more dangerous and reckless behavior (e.g. substance use, violence, risky sexual activity, and self-harm) (Cleveland Clinic, 2021).

Lastly, whether you are someone whose loved one has attempted suicide, or perhaps you yourself live with thoughts of suicide, what is important is not just the apparent “causes”, but the “capacities” we have cultivating resilience in such difficult and complex situations. This can include ensuring access to urgent care after an attempted suicide (BeyondBlue.Org, 2022); creating a “safety plan” to help recognize triggers and coping techniques (Samaritans, 2023); and understanding the unique recovery process with the help of a professional (Raypole, 2019). Admittedly, this process of building resilience, with all its steps and caveats, can be confusing and overwhelming. But we can organize our approach within the framework commonly referred to as “suicide resilience”, described by five defining attributes (Wang, Lu, and Dong, 2022):

  1. Social support. Who can be trusted and turned to in times when life seems too much to handle, and when life seems to have no other reasonable options? Who can provide the necessary guidance, presence, and sense of security so that responding to life’s immense difficulties can be done with more efficacy, more compassion, and less crisis? 
  2. Coping strategies. What can be done, as an individual and with others, that allows for building up the ability not just to more effectively tolerate distress, but also more effectively relish and take pleasure in life? What allows for more awareness of, and more compassionate responses to, the experiences that heighten the risk for suicide? 
  3. Psychological capital. What resources are available, within oneself and within one’s many different roles and relationships, which can help grow one’s inner resources of optimism, hope, gratitude, and even forgiveness? Within one’s limitations, and doing the best one can given these harsh circumstances, how can wellbeing be strengthened?
  4. Meaning in life. One’s experiences can lead, with a terrible but clear logic, to the conclusion that suicide is the best solution. But what else might there be in the experience of life that might allow a person to seriously reconsider the possibility that living is also a viable option — not just viable, but even necessary, for pursuing one’s ideals, values, and goals? If one chose to live, what sense of purpose can encourage a person to persevere, and even joyfully accept, what life has to offer?
  5. Sense of responsibility. What obligations would a person leave behind, not just to loved ones but to themselves, if suicide is chosen? And is the person willing, given the things that are important to them, to give up on such obligations?

For mental health support services, email us at resilientteams@wethrivewellbeing.com or contact us to sign-up for sessions with our mental health clinicians.

If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or call these 24/7 crisis lines:

DOH-NCMH Hotline

0917-899-USAP (8727)

0966-351-4518

0908-639-2672

(02) 7-989-USAP (8727)

1553

Hopeline PH

0917-558-HOPE (4673)

0918-873-4673 (HOPE)

(02) 8-804-HOPE (4673)

2919

In Touch Crisis Line

0917-800-1123

0922-893-8944

(02) 8-8937603

References (in order of appearance)

  1. https://www.apa.org/monitor/2018/10/cover-search-meaning 
  2. https://www.who.int/news-room/fact-sheets/detail/suicide 
  3. https://www.uppi.upd.edu.ph/sites/default/files/pdf/YAFS5_National_Dissemination_Slides_FINAL.pdf 
  4. https://www.nami.org/Blogs/NAMI-Blog/September-2020/5-Common-Myths-About-Suicide-Debunked 
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165520/ 
  6. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.157.12.1925
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025580/ 
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454768/ 
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068754/ 
  10. https://www.mdpi.com/2673-866X/1/3/13 
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543655/ 
  12. https://heartlandhealth.org/2022/09/suicide-fact-vs-fiction/ 
  13. https://www.nasponline.org/publications/periodicals/communique/issues/volume-47-issue-5/suicide-contagion-and-clusters%E2%80%94part-1-what-school-psychologists-should-know 
  14. https://www.ncbi.nlm.nih.gov/books/NBK207262/ 
  15. https://pubmed.ncbi.nlm.nih.gov/24998511/ 
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376723/ 
  17. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/8-common-myths-about-suicide 
  18. https://www.cdc.gov/suicide/factors/index.html 
  19. https://afsp.org/risk-factors-protective-factors-and-warning-signs/ 
  20. https://www.bridgestorecovery.com/blog/5-warning-signs-of-suicidal-behavior-that-are-easy-to-miss/ 
  21. https://my.clevelandclinic.org/health/articles/11352-recognizing-suicidal-behavior 
  22. https://www.beyondblue.org.au/mental-health/suicide-prevention/after-a-suicide-attempt 
  23. https://www.samaritans.org/how-we-can-help/if-youre-worried-about-someone-else/supporting-someone-suicidal-thoughts/creating-safety-plan/ 
  24. https://www.goodtherapy.org/blog/when-life-continues-recovering-from-suicide-attempt-0215197 
  25. https://www.frontiersin.org/articles/10.3389/fpsyt.2022.984922/full