How to Talk About Feeling Bad (English)

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& community care mental health, suicide prevention

How Talk About Feeling Bad

A note to readers:

Every year, millions of Americans lose someone they love to suicide. Millions of others struggle with suicidal thoughts. And nearly all of us, at some point in our lives, deal with challenges such as depression and other mental illnesses, isolation, grief, and other kinds of profound loss.

But there’s a reason to push through these uncomfortable feelings and learn how to talk about feeling bad. Research suggests communication is central to treating mental illness and reducing the number of people we lose to suicide.

As I’ve worked on this project over the past few months, I’ve discussed suicide a lot. To my surprise, once people heard about what I was working on, many of them wanted to talk. They generously shared their stories of survival with me, formally and informally.

Sometimes that took the form of an on-the-record interview. Other times the conversations seemed to come out of nowhere, like the one in the pet food aisle at Dillons, where I leaned against my cart while I listened to an acquaintance talk about the ways she’s struggled with mental illness.

Everyone who spoke with me informed the outcome of this publication, as did my own history

Nearly 25 years ago, I experienced a period of suicidal ideation — a fancy way of saying I thought about dying a lot. But thanks in large part to supportive parents and the health care they helped me access, I’ve been able to stick around.

Think of this zine as a friend who knows more than you’d think.

The Story Behind

THE SUSPENDERS

Together with her colleagues, the chief psychologist at Wichita State has spent the past several years developing Suspenders4Hope, a comprehensive and researched-based suicide prevention strategy.

“I did what many loss survivors do — I threw myself into advocacy,” Provines said during a suicide prevention training she led last fall. “I wanted to try and make sure that nobody would have to experience the same pain I (felt).”

“It wasn't until then that we started to have a national strategy for suicide prevention and addressing it as a public health issue,” Provines said. “(Suicide) was just this hidden thing that happened that nobody talked about.”

In 2015, WSU received a Garret Lee Smith campus suicide prevention grant, which provided the initial funding for Suspenders4Hope.

Originally designed for the WSU campus, the initiative has expanded to other universities as well as organizations such as Via Christi St. Francis and Thrive Restaurant Group.

“My personal journey started back when I was an intern,” she said. “High-risk clients seemed to gravitate toward me. I felt like I had strong connections with them, and I needed to learn tools to help them.”

Those clients inspired Provines to pursue training in dialectical behavior therapy. The model involves helping patients learn how to build a personalized “toolbox” they can use to regulate their own emotions.

Provines also is passionate about training new therapists to work with suicidal patients. That’s necessary because 47% of students who seek care from Counseling and Prevention Services screen positively for suicidal thoughts.

But it hasn’t been easy, not least because Provines experienced more loss in the intervening years. The same month WSU received its suicide prevention grant funds, another patient of hers died by suicide. And last year, Provines again experienced what she calls “every therapist’s worst nightmare.”

“Suicide is no one's fault — not even the person who dies by suicide,” she said. “But as someone who's lost people I care about to suicide, I know that it can be hard to believe that.

“(If you’ve lost someone), you may not be ready to forgive yourself or your loved one now. But if you can set your mind on a path towards forgiveness, that is when I know I started to heal.”

—

The following pages are inspired by Suspenders4Hope and its “share, ask, support model.” Learn more about the initiative and take the free online training at suspenders4hope.com.

SHARE, ASK, SUPP ORT

But before we start: BREATHE.

“[Our] campaign is all about shifting our current culture of silence to a culture of shared responsibility, caring, and most importantly support. We are all connected as human beings, and we are responsible for taking care of each other.”

— Suspenders4Hope

A note about LANGUAGE

As our understanding of suicide evolves, the language we use when discussing it needs to change. Advocates believe that the use of direct, neutral language helps eliminate the shame and stigma associated with suicide.

OUTDATED language UPDATED language

“Committed” is how we talk about crime or sin, and it reinforces the false idea that suicide is a choice.

“Committed” suicide

Instead, use “died by suicide” or “killed themself.”

Describing a suicide attempt as “successful” or “unsuccessful”

Why would we frame a tragedy in positive terms?

Instead, try “died by suicide/survived a suicide attempt.”

Suicidal thoughts are scary.

Scary to experience yourself, and scary to hear that someone in your life is struggling with suicidal thoughts.

It’s important to remember that an overwhelming majority of people with suicidal thoughts do not attempt suicide.

What research tells us:

#1 Share

#2 Ask #3 Support

You know how sometimes something just

Maybe they have withdrawn from activities they once enjoyed.

Or it almost seems as though their personality has changed — they’re more “down” or “up” than usual

There could be a very good reason why they’re struggling, such as the end of a relationship or the loss of someone they love.

The first step is to share your concern.

“I haven’t seen you around much. What’s up?”

“Tell me about what’s going on with you.”

“I know you’re having a rough time, so I wanted to check in.”

This is an opportunity to practice listening to understand.

Reserve judgment and focus on what the other person is telling you.

Most of us aren’t that great at this! The good news?

As with any other skill, it gets easier with practice.

Sometimes, you don’t need to go beyond this step. Maybe the person you’re talking to is going through a hard time, but they’re dealing with it pretty well. Maybe they aren’t struggling as much as you thought they were.

But what if the person you’re concerned about expresses feelings of hopelessness, or feeling trapped or in unbearable pain? What if they disclose that they’re struggling with basic caretaking tasks, such as bathing or getting enough to eat?

Let’s say your gut feeling was right, and this person you care about is in a bad place.

Step two is the scary part: asking about suicide.

There isn't a right or wrong (or perfect) way to share your concern for somebody and to let them know you see their pain and you want to be there for them.

Remember that the person you’re concerned about almost certainly grew up with the same stigma around suicide that you did. They may not realize they can talk openly about how they’re feeling.

Here are a couple of suggested questions taken directly from the Suspenders4Hope training:

“I’m sorry to hear how hard things have been lately. Have you had any thoughts about ending your life?”

“Thanks so much for being open with me, and I’m sorry you’re having to go through this. Has it gotten to the point where you’ve had thoughts about suicide?”

Avoid using indirect language such as, “Are you thinking about hurting yourself ?”

All evidence points to the conclusion that using neutral, specific language is helpful, not harmful.

And you can just come right out and ask — no need to work up to the topic.

If you don’t receive a clear, decisive “no” to your question, you might continue to check in. It’s possible this person doesn’t yet feel comfortable opening up. It might take some time to build trust.

*A note about nonjudgmental communication

“Don't tell me you're thinking about killing yourself, are you? Look at all the wonderful things you have in your life.”

are not listening, and in fact, you might be judging them. These are the kind of statements that can shut communication down.

Remember that the goal is to show love and compassion to people in crisis in order to accompany them in their pain.

How the heck do I do this?

Most things we aren’t good at feel uncomfortable at first.

If you haven’t had a ton of training, asking someone about suicide may seem impossible

It is hard. But one technique helps a lot.

Try role playing with a friend. Practice “share, ask, support” together, taking turns

Even reading the suggested “share” and “ask” lines out loud to yourself will help.

You might feel silly — but you will be more prepared to have these conversations in the future.

What if they say, yes , they are thinking about suicide?

Continue to ask about their suicidal thoughts, intent, and plans

so you know how to best execute the third step: SUPPORT.

REMEMBER: Suicidal thoughts are common, and they typically do not lead to a suicide attempt. Wanting to die does not necessarily mean a person’s life is in immediate danger.

However, it’s important to ask about and listen for signs of an emergency:

You hear that they plan to act on their thoughts soon

They have already taken steps toward a plan — for example, by obtaining a firearm

They are not communicating that they can or will be able to stay safe.

Any of these factors indicate the person is in crisis and may need timely intervention.

If they have acted on their suicidal thoughts already, call 911 immediately.

Reassure them that you are getting help and they are not in trouble.

If there are firearms, sharp objects, drugs or alcohol in the environment, see if there is a way to safely remove them.

If the person is alone, stay in contact with them.

Accompany them to an emergency room or crisis service if they are willing to go.

IN CASE OF EMERGENCY IF IT’S NOT AN EMERGEN CY

Let them know there is reason to have hope and that help is available.

Help them identify ways they can cope.

Recommend that they reach out to their support system.

Encourage professional counseling, and provide information about other resources.

Don’t be sworn to secrecy. If needed, you can say something like, “I care about you too much to keep this to myself. I need to let so-and-so know so we can help support you.”

A big fat myth ABOUT SUICIDE

Have you heard that one before? That one sentence sums up much of the prevailing attitude towards suicidal people.

Yet both parts of the statement are wrong in most cases. People experiencing suicidal crisis don’t want to die — they want their pain to end.

And intervention really does work, in part because suicidal crises are often so brief.

Are there times when intervention doesn’t work, or when it’s hard to tell that someone needs help?

Stories SURVIVAL of

Survivors // Kelly Rio

Kelly Rio’s husband Joe died by suicide in 2018. With the exception of her job, Kelly says “everything else crumbled to the ground” in the wake of his death. She credits therapy, her relationship with Joe’s daughter, and a supportive community for helping her survive the worst thing that’s ever happened to her

Even as I look back on it now, I feel like I was meant to be with him for the rest of his life.

I was dating the singer in his band when we met each other again. We’d bumped into each other over the years, but timing was never on our side.

He just decided he liked me. Didn't come near me — I was with the singer. But as soon as we broke up, Joe and I went out. It was pretty much understood that we were together from that point on.

He was so unapologetic about who he was, really charismatic and honest. It was refreshing. And he was hilarious, and I like to laugh. It's hard to make me laugh, but I do love it. He was a breath of fresh air to me every time I saw him.

He was on big-boy drugs for about the last year and a half of his life. Some of those drugs we now know can cause suicidal thoughts if taken in excess or on a daily basis. There are so many contributing factors. But ultimately, I have to remember that even though it feels like total and utter betrayal, it really wasn't personal.

A couple of people have told me about interviews with people who tried to commit suicide but lived. Their family and their loved ones were the last thing they were thinking about. Getting rid of the pain was number one.

Afterwards, I lost a lot of weight. People would take me out to eat and take me out on walks. My friend Kali was huge. She and I met through Joe, and I really liked her, she had cool energy. We would talk every now and then, but when he died, she started to ask if I wanted to go out. I would say, yeah, let’s go to a park. After a while, I noticed I would reach out to her because I trusted her, and I have a very small group of people I trust.

My stepdaughter has also helped a lot. Every week, she comes over and we hang out. It’s been helpful to put my energy into that relationship instead of utter despair. I’ve also had a lot of therapy. I was diagnosed with complex PTSD because of everything that happened that night. That’s not something you just get rid of, although I’m working on it as best as I can. After the second year, I felt like I had made progress, but it took two years. Because I lost everything that night, except for my job. Everything else changed. Everything else crumbled to the ground. So I’ve spent a lot of energy rebuilding my life.

Survivors // Bryan Raymundo

Bryan Raymundo was born in Wichita to Mexican parents. As an undergraduate, he changed his major from physical therapy to studio art after taking a printmaking class. Some of his work explores his personal history with mental health, which includes suriving suicide attempts. Bryan will graduate from Kansas State this spring with a Master of Fine Arts in printmaking. You can view his work on his Instagram page, @raymundo_printmaker

I just submerged myself in printmaking. I hid away from a lot of things, and with printmaking there’s so much to learn. My whole personality was printmaking. Every single day, I’d put on my apron and get to work.

After a while, I started partying more. I was still in the print shop every day, but I’d go out Thursday through Sunday night. I started drowning a little bit. My friends showed love to me, and they showed they cared about me, but I didn’t feel it. I noticed that I wasn’t feeling a lot of things. I started questioning what happiness is and why I didn’t feel it, or why I couldn’t appreciate the love I had, why did I feel I didn’t deserve it, why did I feel like I should push people away The questions just got louder and louder

When I was growing up, I learned real quick that expressing emotions or dealing with emotions is a luxury in a household of immigrants. My parents didn’t have the time to slow down and think about why they felt a certain way, they didn’t have time to process death and grief. They always had to work.

I was the first person I know of in my family who has been to therapy or tried medication. At first, I didn’t understand why my parents didn’t see mental health problems as an illness. My friends were like, it’s totally fine to acknowledge that. It was one of the first times I felt this weird battle in my own head about my feelings, and it just got heavier and heavier.

One thing I tell people. I’ve been to a lot of therapy, and one thing I’ve noticed They either tell themselves it could always be worse, or it’s not that bad.

But whatever you go through, trauma is trauma, and it feels heavy as f---.

It’s important to find that help and to find your people who can be there for you. Just having one friend, a true friend, goes a long way.

Survivors // Kate Radley

I started seeking treatment mainly because I was just so depressed and didn’t know what was going on. I got a therapist, and that was when the hospitalizations started happening for suicidal ideation and (suicide) attempts.

I turned to writing when I was in eating disorder treatment. I started taking my journal entries from when I was so low and turning them into poems. I feel like my poetry helps me to tell my story in the most authentic way I can. Because when I write it down in an artistic way, I feel like it just doesn’t have the same sting that it did before.

A lot of times, the people who bring stigma don’t understand the traumas that bring people into dark places. That’s what keeps me talking about it, is that trauma wants you to remain silent and keep things in the dark.

The best advice I can give is to keep going and never to give up on yourself. Don’t give up just because it isn’t getting better. It might seem like it’s never going to get better, but it’s going to eventually. That glimmer of hope, that glimmer of light, it’s going to come. You just don’t know.

Survivors // Amelia Phommachanh

I think it's important for me and my generation to remove the stigma around mental health, to step out and be a voice for those who feel voiceless.

My platform for Miss Kansas is “HEAR for you suicide prevention.” The “H” means help, the “E” empathy, the “A” is awareness, and the “R” is real.

I want to have real conversations and share my real, vulnerable story about my challenges with mental health and suicide. When I was around 14 years old, I started to develop mental health issues that I didn't know what to do with. My parents were going through a divorce at this time, and I had lost hope in a lot of things.

I didn't know about the resources available at that time. I grew up in a home where suicide prevention, mental health — anything of the sort — was not mentioned. Growing up in an Asian and biracial household, it's hard to talk about that type of thing with my parents. I just didn't know what to say.

Around that time, I tried to end my life.

At such a young age, I didn't fully know what that meant, but I knew that I didn't want to be here. I felt hopeless, like there was nothing left for me.

Through social media, I talk about things like mental health and suicide prevention. I've made videos showing the glamourous sides of my life and also the sides of my life where I’m crying and struggling.

And it's really important for me to remember that the emotions I felt in that moment (when I tried to end my life) aren’t eternal. Now I work with kids in the community, and I talk like this and I become vulnerable. I share my story so that they can feel like they have a space to share their own. Because nobody should feel victimized by the mental health issues that are going on inside their head.

At the end of the day, I am a survivor and I wear that proudly across my chest. I am not here to be ashamed of my story, but to share it to bring awareness and hope to others who struggle just like me — just like all of us.

The day Jess bought one

TOO MANY HATS

“Shannon, I just wanted to let you know Jess was in the shop today.” So began the call “Hatman” Jack Kellogg placed to his friend Shannon Littlejohn.

Jack wouldn’t normally call Shannon to report that her husband had stopped into his regular storefront on Douglas Avenue in Wichita’s Delano District. He had already purchased a handful of hats not long before, including a sombrero — all from the shop’s substantial inventory. Now he wanted to place a special order.

“Jack said, ‘I knew there was something wrong when he inquired about ordering another sombrero,” Shannon recalls.

Shannon already knew her husband was struggling. He had not yet been diagnosed, but Jess would go on to be treated for bipolar disorder. Through his treatment and recovery, Shannon advocated and cared for Jess. She had her “hands on him,” is how she puts it.

“It's one of my favorite stories from that time,” Shannon said.

“Someone else had his hands on him, too.”

Wichita Journalism Collaborative

Partners have reported numerous stories about mental health over the past year. View all the coverage online at wichitajournalism.org.

“Through friends and social media, I finally found that there is help that I can get and I am finally getting back to my normal self.” — Heidi Lane, Derby High School sophomore, from a story in the Derby High School Panther’s Tale

https://bit.ly/heidilane

“My whole life I’ve always struggled with like being forgotten or being lost. I have a hard time connecting and thinking that when people are coming to me to want to talk they’re not at the end of the day going to leave as well.” — John Kirk, from a story in The Sunflower

https://bit.ly/johnkirk

“As adults, we too often discount the mental health struggles of our youth. We call it teen angst. We call it a mood. A phase. And yet, the CDC maintains statistics on suicide in those as young as five years old.” — Eric Litwiller, director of development and communications at the Mental Health Association of South Central Kansas, in a commentary for KMUW

https://bit.ly/ericlitwiller

“I encourage parents to talk about mental health with their children like they would have the ‘birds and the bees’ talk,” said Nicole Fenoglio, the founder of Stop Suicide ICT. “‘You’re gonna change and at some point, you are going to have these feelings, blah blah blah.’ Talk about mental health that way.”

Fenoglio also recommends regular mental health check-ins with a professional, as you would with a primary care doctor, and being open about how you are feeling. “Suicide prevention is way more than just helping someone in a crisis,” she said.

From a story in the Wichita Beacon about the importance of community in the healing process

https://bit.ly/nicolefenoglio

“Help is out there. It’s just making the phone call to have the conversations to learn

How to find a therapist

(when you don’t know what you’re doing)

You’ve decided you want to try therapy … but how do you go about that exactly?

Here are a few options to get you started:

1.

2. 3.

If you’re not insured, look into low- and no-cost resources in our community. If you need guidance, call the 211 community help line or make an appointment with a behavioral health consultant at GraceMed.

Look through an online directory for therapists. The largest one is operated by Psychology Today, and it allows you to search by location and lots of other factors, including cost, gender, and type of therapy. There’s even a way to contact each therapist through the website, a bonus for those who don’t want to pick up the phone.

Or ask your primary care physician. 5. 4.

Resources for the LGBT community

But is that possible in the Wichita area?

“There are providers around here who are informed and trained to work with this population,” says Ragan Snyder-Smith, an Andover-based therapist who has specialized training in working with LGBT patients.

These local and national resources focus on meeting the needs of the LGBT community:

The LGBT National Help Center provides peer support in multiple formats, including online chat and national hotlines. Call 888-843-4564 to reach the main hotline, and visit lgbthotline.org for information about peer support for youth, seniors, and coming out.

The Wichita LGBT-Friendly Provider Directory includes a list of mental health providers in Sedgwick County who are committed to delivering competent services to LGBT patients. Find it at wichitalgbthealth.org

The Trevor Project is a national organization dedicated to supporting LGBT youth. Its initiatives include an online community and 24-hour crisis services. To reach someone, text START to 678-678, call 866-488-7386, or exchange messages with a counselor at thetrevorproject.org.

Resources for income-based mental health care

Other options for low-income residents of the Wichita metro area:

Cana Counseling Services (Catholic Charities)

316-263-6941

The clinic also has interpreters who can speak Spanish, and access to interpreters for languages other than Spanish and English. Call 316-866-2000 to schedule an appointment.

Guadalupe Clinic provides counseling for patients who do not have insurance as well as patients whose insurance plans don’t cover mental health care. Services are free, although patients may elect to donate $5 per session. The clinic schedules therapy appointments two nights per week: one in English and one in Spanish. Call 316-264-6464 to schedule an appointment.

COMCARE of Sedgwick County describes itself as the “safety net for individuals who need mental health services.” The county-run organization provides services regardless of ability to pay.

catholiccharitieswichita.org/ cana-counseling

Counseling Center at the Mental Health Association of South Central Kansas

316-652-2590

counselingcenteratmha.com/services

Wichita State Psychology Clinic

316-978-3212

wichita.edu/psychologyclinic

Find more information on local resources from the Wichita Journalism Collaborative: wichitajournalism.org/ mindful-solutions

THANK YOU

Many people contributed their reporting, professional expertise, and personal experience to “How to Talk About Feeling Ba d.”

Kelly Rio, Amelia Phommachanh, Bryan Raymundo, Kate Radley and Shannon Littlejohn recounted their personal experience on the record. Allison, Mary, Jenny, Amanda, Beth, Lori, Lisa and Kali experience, ideas, resources and encouragement.

Jessica Provines and Ragan Snyder-Smith shared their expertise as mental health professionals. "Share, Ask, Support" is based on the Suspenders4Hope suicide prevention campaign developed by Provines and her colleagues at Wichita State.

CityArts and the Ulrich Museum of Art have been enthusiastic institutional supporters of this project. Both have hosted events in collaboration with the Wichita Journalism Collaborative

Jenny Venn designed and managed the production of this publication, which includes illustrations by 12 Wichita-based artists and designers:

German Andrade

Geli Chavez

Danny Echo

wichitajournalis m.org to learn more about our distribution partners.

Reporting by Megan Stringer and Celia Hack informed the resources listed in this guide.

Genna Gehring

Paris Jane

Lindsey Kernodle

Honeybee O’Gee

Carlos Palomino

Brittany Schaar

Dale Small

Austin Storie

Allison Stucky

WJC Project Manager Maren Berblinger of the Kansas Leadership Center and WJC intern Jordan Plowman were instrumental in planning events and spreading the word about this project.

Translation by Claudia Yaujar-Amaro and Ahida Velasco of AB&C Bilingual Resources, LLC; Fidel Serrano; and edited by Michael Roehrman.

Finally, “How to Talk About Feeling Bad” is the brainchild of Chris Green, editor of The Journal at the Kansas Leadership Center and project manager for the WJC.

Funding for “How to Talk About Feeling B ad” was provided by:

by:

Emily Text Christensen

JennyVenn Design by:

Featuring art by:

German Andrade, Geli Chavez, Paris Jane, Danny Echo, Lindsey Kernodle, Honeybee O’Gee, Carlos Palomino, Genna Gehring, Brittany Schaar, Dale Small, Austin Storie

and Allison Stucky