Why Lifesaving Conversations Matter

We’re here to bring attention to the elephant in the room. The conversations we’re having this season aren’t always easy. Topics like emotional pain, self-harm, and feelings of hopelessness can feel uncomfortable, heavy, or difficult to talk about openly. But avoiding these conversations is often what keeps people struggling silently.

Season Two of Let’s Talk About It With OhioGuidestone is focused on breaking stigma through honest, approachable conversations that help people feel seen, supported, and understood. Because lifesaving techniques start with a conversation, and every interaction has the potential to make a difference. 

In the season two premiere, host Derek Rader sits down with Kathleen Kern, Ph.D., Chief Clinical Officer at OhioGuidestone, for a broad overview of lifesaving prevention and the role we all play in supporting one another. Together, they discuss common myths and misconceptions, warning signs, how to start conversations with someone who may be struggling, and practical lifesaving techniques that anyone can use to offer support. Dr. Kern also shares why connection, listening without judgment, and knowing how to respond can make a positive impact. 

This episode lays the foundation for the season ahead, introducing the concepts that will be explored in greater depth as we examine lifesaving prevention across every stage of life, from early childhood through older adulthood.

There are things we all think, but don't always say out loud.
Is this normal?
Why am I feeling so overwhelmed?
Shouldn't I be able to handle this?
If you've ever wondered, "Am I the only one feeling this way?" You're not, let's talk about it.

OhioGuidestone's Promise Run is back! Join us at Wallace Lake in Berea on Saturday, September 22nd. 

Questions about our podcast? Email podcast@ohioguidestone.org to get in touch with us. To learn more about OhioGuidestone, visit ohioguidestone.org. 

Transcript

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SPEAKER_01 0:16

Before we begin, we'd like to take a moment to share a content advisory. This episode contains conversations about suicide, mental health, and emotional well-being. Some listeners may find the topics difficult or triggering. We encourage you to prioritize your well-being and seek support from someone you trust, a mental health professional or crisis resource. For listeners in the United States, the Suicide and Crisis Lifeline is available by calling or texting 988. If this topic feels overwhelming, feel free to pause or skip the episode. In 2024, approximately 14.3 million adults seriously thought about suicide. 4.6 million made a plan, and more than 2 million people attempted suicide. These numbers remind us that this touches far more people than we realize. And that is why these conversations matter. This season on the Let's Talk About It podcast, we're going to talk about suicide, suicidal ideation, and self-harm. I'm Derek Rader, and this is the Let's Talk About It Podcast with Ohio Guidestone. Hi, I'm Derek Rader, and this is the Let's Talk About It Podcast with Ohio Guidestone. Today I'm here with Dr. Kathleen Kern, Chief Clinical Officer. Kathleen, thank you so much for being here today.

SPEAKER_00 1:57

I'm so happy to be here, Derek, and so excited about our conversation today.

SPEAKER_01 2:02

Great, great. Well, I'll jump into things. What do we mean when we talk about suicide, suicidal ideation, self-harm, and prevention?

SPEAKER_00 2:12

It's a great question. And, you know, part of the reason why I'm so excited to be here is because I'm happy for the opportunity to talk about it. And I feel like that might sound a little strange sometimes. Like, yeah, she wants to talk about suicide. But the truth of the matter is the more we talk about it, the more we get comfortable with it, um, the more benefits that people who we love are gonna have, and the more likely we are to be able to reduce the number of suicides. So, you know, you talked about what is ideation versus behavior. And I think that's a really critical point because the truth of the matter is a lot of people think about suicide. And I'm gonna say something a little controversial. Um, it's okay to have thoughts about suicide. What we need to be able to do is to understand that thoughts don't have to graduate to behavior. And the way that we can stop that from happening is having these conversations.

SPEAKER_01 3:11

Right. Yeah. So when we use the phrase death by suicide, what does that mean? And why is that language important?

SPEAKER_00 3:19

So yeah, I think it's important to recognize we used to use the term commit suicide, and that brings with it a whole lot of baggage. It brings a lot of guilt and shame about things that people would commit, right? We think about people getting committed to jail or committed. It's really got a negative connotation. So the change in language is really to help people understand that death by suicide is not to be stigmatized. We don't need to call it out as something different, wrong. Um, what it is is the way that someone ended their life.

SPEAKER_01 3:53

So, what is the difference between having thoughts of suicide and being at immediate risk of suicide?

SPEAKER_00 4:02

It's a great question. Um, the the major difference is that those thoughts have graduated to the point where someone is actually thinking about how am I going to do this? They want to do it, right? And, you know, it's like anything else. To the degree that we keep our thoughts to ourselves, sometimes we make bad choices. Um, and you know, when I talk about suicide with people, I want to make sure that we have a way to understand it. And I think one of the best ways to think about it is to think about other decisions that people make that sometimes aren't the best. And if they feel like they have to keep it to themselves, they're more likely to take action on it on a thought that isn't positive. So I'll give you an example. If you had a tough day at work and you're thinking, like, I want to quit, I want to quit this second, I never want to come back here, right? You have that thought. It doesn't necessarily result in you taking that action, right? Why not?

SPEAKER_01 5:03

That's really true. I don't know.

SPEAKER_00 5:06

So part of it is when we have thoughts like I want to quit my job or I want to travel to Florida on a whim, basically we don't have that judgment on it, right? So we're not telling ourselves as soon as we have that thought, you can't have that thought. When we kind of police ourselves around the thoughts we're allowed to have and not allowed to have, we actually increase the likelihood we're gonna perseverate on them because our brain hasn't come to peace with it, right? We're having that interaction. So the more that we kind of identify thoughts as a bad thing, the more we're likely to keep those people who are having them from communicating them. And the thing that helps most of us not make a bad choice is being able to talk about it with somebody we care about, right? If I'm saying I'm gonna quit my job today, um, somebody who cares about me wants to understand why I'm thinking that way or feeling that way. And then they want to help me figure out are there other solutions? But to the degree I keep it all to myself and I feel bad about how I'm thinking, then it's just gonna cause that thought to get more and more intense until it graduates to the point where somebody wants to take action.

SPEAKER_01 6:18

Wow. That's really impactful because I can see with a lot of the stigmas surrounding suicide, people might hold that in.

SPEAKER_00 6:25

For sure.

SPEAKER_01 6:26

And I can imagine that's you know, so unhealthy to carry that around.

SPEAKER_00 6:30

Absolutely. And it's, you know, it's part of their own kind of shame that is part of our culture that I shouldn't be having this thought. But the other part, and the thing that I'm most happy to talk about with you today, is the fact that it's essential for the people who are around them to be able to communicate about it. So if they do have the courage to identify that they're thinking about suicide, it becomes really important that people receiving that message aren't sort of in implicitly telling them, like, stop, shut up. That's I I don't want to hear about that, right? So having these kind of conversations and being able to be open about it is a big part of the solution.

SPEAKER_01 7:11

And people often hear the term suicidal ideation. What does that actually mean in everyday language?

SPEAKER_00 7:18

Yeah, it just means thinking about suicide.

SPEAKER_01 7:20

Wow, it's that it's that simple. I mean that's what it is.

SPEAKER_00 7:23

And I mean, it's on a continuum. There's people who have brief thoughts about suicide every once in a while, and there's people who cannot get the thought out of their mind. So it's not as as simple as it is, it does look different in different people.

SPEAKER_01 7:38

So this season, as you know, we're exploring uh suicide prevention across all the different stages of life. While every age has its own unique challenges, what is one thing that stays true no matter how old someone is?

SPEAKER_00 7:56

So one thing that's true and does tend to put people at risk for suicide is a feeling of being alienated or alone. And and it it's really important to understand that as a feeling, because it might that's not sometimes how it looks to other people, right? So sometimes people look like they're the life of the party, they're engaged, they're popular, but if they are feeling alone and like no one else understands them, that can put somebody at great risk for suicide. That and the feeling of being kind of a burden to other people are the two risk factors that we see when we look at people who've had serious suicide attempts.

SPEAKER_01 8:39

One thing that I found really interesting uh as my team and I were doing research for this podcast and talking to other clinicians, we found that CDC data shows that adults ages 80 and older had the highest rate of suicide, which really surprised me. Um, and maybe some listeners who associate associate suicide with younger people. Uh, why is it important to understand that suicide can affect people at every stage of life?

SPEAKER_00 9:09

It's it's incredibly important. And I think part of what we're talking about is that thoughts of suicide can impact anybody at any time. And if we think about people who feel alienated or might feel like a burden to others, our senior population is at higher risk, right? They're they're more likely to maybe have lost some people who they loved and are left to feel alone. And maybe they've lost some independence and now have to depend on people more. And so it does elevate the risk. I will say part of what you're talking about reflects that it's a smaller population of people over 80. So the number of people who die by suicide rate makes that percentage look large. If we think about it in just general terms, actually, middle-aged men are at highest risk.

SPEAKER_01 10:03

Um, I'm glad you talked about that because, you know, while we were doing research, I did find that suicide doesn't affect every population in the same way. Why is the um the rates among adult males four times higher than females? What can what are some of the factors that contribute to those differences?

SPEAKER_00 10:24

Well, I want to say first that really anybody who dies by suicide does it because of a complex assortment of reasons, right? And so we're not going to identify a particular one thing that would be causal, right? It's about your biology and your experiences and your social support and a whole host of other things. But one of the reasons that we know that men are more likely to die by suicide is that they tend to use more lethal means. Um, so things that can't be reversed. And as a result, they have a higher likelihood of death as a result of an attempt.

SPEAKER_01 11:03

What can we learn about those differences when it comes to prevention?

SPEAKER_00 11:07

Well, it's really important to understand when we go from having thoughts about suicide to taking action, if we can put some barriers in the middle, right? So if between the time I'm thinking I want to die and the time I can actually take action on it, there's a whole bunch of obstacles in the way, then that gives my brain more time to consider other alternatives besides dying by suicide. So one of the things that is really important is to reduce ready access to lethal means, right? So if I have to um, let's say that I'm a gun owner, right? And I know that I'm at risk, especially if I'm drinking and I know I'm gonna be drinking on Friday night, one thing that can be done is to ask a loved one to hold that gun for a while or to ask them to hold the ammunition. And it's not to say like it's not your gun anymore, you can't have it. It's it's about saying, like, if that feeling becomes so intense and I feel like I can't take it anymore, it will be harder for me to act on it if I have to call my buddy, ask for the ammunition back, have them bring it over, right? So anything that we can do to just put space between the thinking when it gets really intense and the actual behavior is a life-saving action. But we have to do it ahead of time, right? Because once somebody's in that state, it can be challenging to then say, like, okay, now's a good time to put distance between yourself and means. We have to do that on the front end to prevent the risk later on.

SPEAKER_01 12:45

So, in terms of prevention, it sounds like it doesn't look exactly the same for a child, a teenager, or even an older adult. Is that why is that?

SPEAKER_00 12:57

So it's specifically because people at different developmental phases have different risk factors, or maybe those risk factors manifest themselves a little bit differently. When we think about our young population, it's so important for them to feel that connectedness and that belongingness. And yet they don't quite have the neural connections that allow them to understand that as immensely painful as something is at this moment, it will not always be so. So in the young population, they really have a harder time understanding that they can tolerate a certain amount of distress and they can still be okay. Once we get to middle age or older, we've probably had some experiences of terrible, awful things happening, and we've lived through it and we've been okay. So in the um kind of middle-aged population, adults and you know, younger adults all the way up to middle-aged folks, it really is about um the prevention is around being able to communicate your feelings and your thoughts. And it's, you know, that can be harder than it seems sometimes for a lot of people who um kind of grew up burying their thoughts, not wanting to acknowledge that they had emotions, um, talking to them about really the connection between how their body is feeling and how their emotions are feeling. It can be a challenge, but it's absolutely required if people are going to have the kind of support that they need to keep them safe. And on the adult side, really, the intervention is about reducing loneliness and helping people, maybe people who have lost somebody that they love, find new connections, whether that's at a community center or doing some volunteering, like making sure that those people don't feel like they're completely alone in the world.

SPEAKER_01 15:24

Is self-harm always connected to suicide?

SPEAKER_00 15:28

I'm so glad you asked that question, because there is so much confusion about that. And no, it is not always connected to suicide. Self-harm often happens when people don't have the ability to tolerate their emotions and they're looking for any escape or release from feeling that intense emotional pain that they have. If the person who is self-harming is doing so to stop a really intense emotion, but doesn't actually want to end their life, then you can see the distinction between self-harm and actual suicidal ideation or desire to die by suicide.

SPEAKER_01 16:07

So if someone discovers that a loved one is engaging in self-harm, what is the most important and helpful first response?

SPEAKER_00 16:17

It's always the most important to let somebody know that you care about them, right? Because pretty similar to suicide, I think when people are self-harming, there's a certain degree of shame and embarrassment. So starting with an acknowledgement that the reason you're even asking about it is because you love them and you care about them. And I think also understanding that people self-harm because they're in pain. And if we react to people's pain emotionally in the same way that we do physically, we'd be much better off, right? So if somebody who we care about was, I don't know, fell down, rolled their ankle, um, was bleeding, we wouldn't hesitate to go approach them and say, something's wrong, like I want to help you. Sometimes when it comes to that emotional pain, people are they hold back, right? And they're like, well, I'm not exactly sure what to do about that. I'm not sure if I'll say the right thing or do the right thing. But if we think about it as if somebody has a physical injury, like if somebody's on the ground, I don't need to know how to set their bones. I don't need to know what medication is going to be helpful to reduce their pain. All I need to do is be with them and say, I see that you're hurting and I want to help. And oftentimes that's connecting them with somebody who has that medical expertise, right? It you don't have to solve everything, but I think that sometimes slows people down because they feel like if I don't know exactly what to do to make this symptom go away, then I'm not gonna say anything.

SPEAKER_01 17:48

And I think that's so important as someone who has had family that that had struggles with self-harm. I remember personally thinking, what do I say? I don't want to say the wrong thing. You know, you know they need help. Um, what is one thing you could say or you want everyone to know about talking with someone who may be struggling?

SPEAKER_00 18:09

I think the most important thing is to identify that I care about you and I will be with you as we figure this out together, right? So you don't have to have every answer. You just have to help them understand that they're not alone in their battles. And I think the other piece that goes along with that is reducing the degree to which somebody feels shame. Because if they feel shame, they keep it quiet, it stays hidden. If you can allow them to understand that you see it as a reflection of the fact they're in a ton of pain and they don't know yet how else to deal with it, right? It's just a lack of ability to cope differently. But we can help with that.

SPEAKER_01 18:50

And is it okay to ask someone directly if they're having thoughts about self-harm or suicide if you're concerned?

SPEAKER_00 18:58

Absolutely. In fact, that's the number one thing that we can do. When we talk about reducing shame, so many people struggle to get that question out of their mouth to say, are you thinking about suicide? And it's because we're afraid, probably in two ways. We're afraid we're gonna hurt the person's feelings and make them feel misunderstood. Sometimes we're just worried about feeling embarrassed ourselves, like the person's gonna look at us like, you know, that's crazy. Why would you think that, right? So there's that kind of like social anxiety that occurs when we come to the place where we recognize we should ask the question. And I really do try to encourage people to think about the consequences of not asking, because those are consequences we can't walk back from. If we recognize something's wrong and we are too scared to hurt somebody's feelings, um, we also have to recognize that not doing something can have consequences, right? So remembering that even though it's uncomfortable, it's important to ask the question and to ask it directly. And, you know, if somebody thinks that you're a little off because you're asking and they're like, no, why, why in the world would you ask me that? Right? It's it's fine to say, hey, I listened to this awesome podcaster, Derek, and he let me know that there's that people think about suicide a lot. And so now I'm just kind of looking out and making sure that if that was on your mind, you knew that I'd be here to talk to you or listen.

SPEAKER_01 20:26

What is happening emotionally or psychologically when someone begins to feel that suicide is the only option?

SPEAKER_00 20:33

That's a great question. One of the things we know about suicidal thinking, because generally it's left to be what the person's left alone to think. They don't get any kind of external perspective because they're ashamed to talk about it. And one of the things that happens over time is that they lose their ability to problem solve, right? So going back to the example of quitting work, if I'm just like, oh, I'm just gonna quit today and not look back, right? To the degree that I'm not articulating that to someone else who might say, well, like what about a 30-day notice? Or what about a different way to manage the stress that you're having? I don't pull in any alternative solutions, right? So I'm stuck with I have pain, I have a solution, and I don't have any ability to get other perspectives on it. So it's it ends up being such that you believe that that's the only way to end your pain. And when people die by suicide, generally speaking, it's not a desire to be dead, it's a desire to not feel the excruciating pain that they're experiencing at the time and an inability to understand that there are other solutions that I I can get through this.

SPEAKER_01 21:52

I think it really does take a village, you know, and talking about removing stigmas and having those initial conversations, even if they're uncomfortable, is so important. Um, you know, in in your opinion, it's it's it's you know, in in terms of suicide prevention, it's not only mental health professionals that have a role there.

SPEAKER_00 22:13

You're exactly right. I mean, you are so right because over the last decade, we've learned a lot more than we've ever known about how to prevent suicide. But the problem is if the if non-clinicians are not talking about it or open to that discussion, we never get the opportunity to bring people to the professionals who now know more about how to help, right? So many, many people, about 50% of people who are thinking about suicide, don't tell anybody. And it's only in us being active and asking the questions, um, demonstrating that we're open to listening to it, that we're gonna have some change and our ability to really arrest the increase in suicide rates.

SPEAKER_01 23:02

If you could change one thing about the way uh our communities talk about suicide, what would that be and why?

SPEAKER_00 23:11

I would really love for there to be a thousand discussions like the one that we're having right now, where people understand that, yes, this is a hard thing you're being asked to do. It's uncomfortable, but it is so necessary. If we don't start openly talking about suicide, we are on a path to just see it get worse and worse. And all of the good work, all of the good research, all the good clinical skills that we now have, we won't be able to benefit from them because people aren't like their first call isn't to talk to a clinician. Their first call is to talk to their friend, their teacher, their aunt, their mother, whoever it might be. And we need for everybody who is in those positions, who loves somebody, to be able to have that conversation without inadvertently sending a message that says, no, don't talk to me about that. That's scary.

SPEAKER_01 24:08

So as we wrap things up, Dr. Kern, if listeners only remember one message from today's conversation, what do you hope that that message is?

SPEAKER_00 24:19

I hope the message is that we all need to be able to talk about suicide. We all need to be able to ask about it. That's the only way we get past this.

SPEAKER_01 24:36

I think that's so important. Removing those barriers, removing that stigma. I think you can save lives. You know, if more people could hear that and know that. Well, I want to thank you, Dr. Kern, for being here today. I'm Derek Rader, and this is the Let's Talk About It Podcast with Ohio Guidestone. Have a great day because you deserve it. If you or someone you care about is struggling, call or text 988 to connect with a trained crisis professional at any time, day or night. For immediate, life threatening emergencies, call 911. Talking about mental health can save lives, and every conversation matters.