Dr. Mark Goulston, Suicide Prevention Expert, Speaks On Teen Suicide and The Warning Signs

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The first week of April is Teen Health Week. As we take a moment to focus on teen health and wellness, it's important to acknowledge the second-leading cause of death for teens (after accidental injury) is suicide.

Suicide prevention expert Dr. Mark Goulston wants to help untangle the causes so we can stop the suffering and save lives.

"Modern life has helped create a perfect storm of problems in teens that can lead to depression, anxiety, and in some cases suicide. To stop the snowball effect, we need to understand where all their pain is stemming from," says Dr. Goulston, co-creator and moderator of Stay Alive, a new 75-minute video/podcast documentary serving at-risk populations, which is available here (#StayAliveNow). "We can't move the needle on teen suicide until we identify what drives this suffering. Once everyone can empathize with the isolation, pain, and fear impacting today's teens, we can offer them true understanding, and help them feel heard and far less alone."


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Stay Alive can help viewers get an inside look into what it feels like to be on the journey from despair to healing. The documentary, featuring suicide survivor Kevin Hines and suicide prevention advocate Rayko, delivers messages of education, compassion, and caring for those who are in deep despair, along with guidance for their families and friends who love them. The raw and intimate personal disclosures, paired with proven approaches to help those who are suffering, make this program uniquely valuable and unlike any other you have ever seen.

So How Did We Get Here? A Few Insights from Dr. Goulston...

Babies come into the world half-baked. When babies are born, nature has done what it's going to do, and how they are nurtured in the first six months is the other half of being baked. What happens during this timeframe wires them for life.

"All of us are born into this world helpless, powerless, and completely dependent on others to care for us," says Dr. Goulston.

On some level, babies are aware of their helplessness and look to their parents to provide security, comfort, and emotional support. When infants look into their parents' eyes, they are essentially asking, Can I trust you? If I'm afraid, will you make it okay? They are looking for security and comfort, both physical and emotional, a feeling that things will be okay.

For the last few generations, babies have not gotten the kind of deep connection they need with parents, and this has led to anxiety, insecurity, and fear later on in life. Our busy lifestyles have made it nearly impossible to tune in to what the baby is feeling and reassure them. Now we rush feeding time so we can get to our next activity.


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We've traded intimacy for excitement and turned into adrenaline junkies. As a society, we have always relied on emotional closeness, tenderness, and love to trigger dopamine, a pleasure chemical. We spent time together creating these bonds, the reassuring feelings we need to carry us through life.

But these things take time, and in the age of instant gratification, we just don't focus on them anymore. Now we rely on quick hits of excitement and adrenaline, which also trigger dopamine, to get our emotional satisfaction.

As we get more and more preoccupied and busy, we have even less time to spare. Closeness and tenderness take too long to manifest and so adrenaline wins out time and time again.

As parents, we've become preoccupied. Parents no doubt love their kids, but they also live in the modern world of distraction and busyness. Therefore, Dr. Goulston says many parents today are preoccupied, rushed, and unintentionally "neglectful." (He is not talking about neglect in the traditional sense; in this case, "neglectful" refers to emotional things like rushed feedings, spending less time bonding, and generally not taking the time to really connect with their child.) Parents are adrenaline junkies, chasing work and achievement, with little time for real emotional bonding.

When a baby looks up at their parents and gets a "busy signal," they internalize it for life. A preoccupied parent, craving adrenaline, literally can't tune in to where a helpless, powerless infant is emotionally. This sends the signal to the baby that they are on their own, and that can be terrifying. It creates a feeling of distrust and insecurity that stays with them later in life. They never internalize the feeling it will be okay. Instead, vulnerable, powerless infants internalize the vibe of a preoccupied parent, and it accentuates their helplessness. The insecurities planted at such a young age are hard to address later in life.

Kids are missing the everything will be okay feeling that comes when they get this closeness, bonding, and reassurance from parents. This bonding creates the feeling that everything will be okay, and is what sets them up for success and self-reliance later in life. They learn to jump into life without reservation and have confidence that they can handle whatever comes their way.

When they don't get it, it sets them up for a lifelong feeling of insecurity, distrust, and anxiety. This becomes problematic when they start hitting trauma later in life and things don't go their way.

When things go south, people should be able to reach inside themselves and tap into that feeling that everything will be okay. With proper nurturing, this feeling becomes part of the DNA of their soul.

Instead, when children and teens don't have this it will be okay feeling in their soul, they fall apart at the first sign of trouble. When they don't receive the approval they crave from teachers or other authority figures, they often feel hurt, resentment, anxiety, and anger, which can eventually lead to depression. (Remember, Freud famously said that anger turned inward is depression.)

They feel this resentment, because, again, they are looking for love and comfort in all the wrong places. This resentment fuels anxiety, because deep down the child wants to actually do something defiant to get back at the teacher. The resentment makes the child scared because it flirts with being out of control. The real desire is to do something destructive, because they feel hurt.


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Kids aren't learning the coping skills they need. Part of life is learning to take hits. Dr. Goulston says that people who can take the hits reach into themselves when things get hard and come up with heart. People who can't take hits reach in and they plummet.

"What you find when you reach deep inside has a lot to do with what was poured into you when you were vulnerable and your personality and resilience were forming," says Dr. Goulston. "Teens who find heart are the ones who received the maternal empathy and comfort that children need, followed by the paternal reassurance that everything was going to be okay."

Modern teens seem to be reaching in and coming up short. Not only are they missing that initial bonding experience, but when parents are all-consumed with achievement and adrenaline, they often end up pushing children in ways they might not normally have done. Messages get poured into children such as, It's your own fault, or, You can do so much better than this. This perpetuates the feeling in the child that they are all alone and not good enough.

They look for relief in all the wrong places. Sadly, the parental preoccupation doesn't get any better. As these children grow up feeling unable or unworthy of attracting their parents' attention and approval, they throw themselves into anything that distracts from this feeling or alleviates the pain.

Sometimes it's achievement, as they know that's what makes their adrenaline junkie parents smile. They make themselves crazy to achieve, as they think maybe then their parents will connect, says Dr. Goulston. But Dr. Goulston says this is like fool's gold—it doesn't really satisfy their need for approval and connection. The parents aren't paying attention to who the kid really is; they're just getting an adrenaline buzz off of their child's accomplishments. Sometimes, they even become super achievers, constantly searching for approval.

For some it could be drugs and alcohol as an escape, or video games and other distractions. They start to suffer from what Dr. Goulston calls "disavowed yearning." This happens when kids who didn't get the warmth and support they needed in infancy convince themselves that they don't need that connection from their parents. Sometimes it can lead to behavior like drug use. The teen's underlying thought is, See, I don't need any of you because I can just take drugs.

The adrenaline rush transfers to the next generation. Kids, too, become fully indoctrinated into the adrenaline junkie culture, focusing on achievement, still trying to get approval. In many instances, kids are able to figure things out and achieve without the emotional support of their parents. To that, preoccupied parents say, "Good for you," and then take credit for being an awesome parent. This pushes the child ever further away and deepens the chasm.

Adrenaline not only makes you feel excited, but it makes you feel powerful and invincible. You no longer feel that terrible vulnerability. Adrenaline lets you put lipstick on the pain, and you no longer feel powerless and alone.

Enter social media (the pain multiplier and false prophet). Social media says, Don't worry about all the things you aren't getting in the world. We are going to give you something that excites you. It makes kids feel they don't have to feel powerless, vulnerable, frustrated, and angry. Suddenly they feel invincible, focused, confident, and in total control. (Again, all this excitement creates adrenaline, which masks the pain.)

Social media also perpetuates the problem by creating a lack of emotional bonding. Instead of forging real relationships, teens bond with influencers and fake personalities. In addition, it allows them to be anonymous and create their own alternate identity. Furthermore, it exacerbates the feeling that they are not good enough (compared to everyone else's great life). It also discourages social relationships and the ability to bond with others.


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Parents and kids collude to avoid feeling the pain. Parents may also be suffering from a lack of bonding. Everyone's collective solution is to just stay busy. The idea is that if we all stay busy, the feelings will go away. We keep pushing the envelope to keep the adrenaline high, because when you go into an adrenaline crash, you start getting ADD and you lose your focus. You lose everything. So you'll do anything to maintain the adrenaline high and avoid feeling those negative feelings. But these feelings don't just go away.

And then comes the crash...it's an adrenaline crash. Suddenly, they aren't focused, powerful, or in control. They crash and are back to feeling powerless, vulnerable, frustrated, helpless, and angry. They get behind. Parents are disappointed. People are yelling. They start to cut corners to get by. They cheat on tests or do other things in response to the pressure they feel to succeed, and things start to plummet.

Suicide occurs when everything comes crashing down. At some point, a person feels as though they are falling apart. They think, I'm coming unglued; I'm losing my mind. And there is a visceral feeling that they are falling apart. They decide that before they fall apart and never come back, they will die by suicide.

Where Do We Go from Here?

Staying distracted from our feelings is not a long-term solution. We can't just gloss over them and move on with our lives; we have to take a step back and really process them in order to actually get better. "Feelings must be felt all the way through, in the same way that you need to drain an abscess in order to heal," says Dr. Goulston. "Staying busy as a way to avoid feelings isn't a healthy solution for parents or their children."

In the long run, we have to get off the adrenaline high and return to bonding. Excitement can't take the place of real intimacy, and on some level, we know that. We have to stop fooling ourselves into believing that everything is okay when it's clearly not.

As the old Chinese proverb says, "The best time to plant a tree was 20 years ago. The second best time is now." We have to start somewhere on stopping this dangerous trend.

"Understanding the complex factors that are leading to increased mental illness and suicide is the first step to helping stop this crisis," says Dr. Goulston. "We have to understand what's wrong before we can change it. Then, we can respond with empathy and understanding to save the lives of teenagers everywhere."

If you or someone you love needs help, call 911 or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or visit www.suicidepreventionlifeline.org.

About Dr. Mark Goulston: 
Dr. Mark Goulston is the co-creator and moderator of the suicide prevention documentary Stay Alive. He is a former UCLA professor of psychiatry, FBI hostage negotiation trainer, suicide and violence prevention expert, and one of the world's foremost experts on listening. He is the author of the best-selling "Just Listen": Discover the Secret to Getting Through to Absolutely Anyone, which became the top book on listening in the world. Dr. Goulston'sHBR IdeaCast episode Become a Better Listener is ranked number one of all their podcasts. He is also host of the My Wakeup Call podcast. Dr. Goulston is on the Board of Advisors for HealthCorps and will be receiving the Dr. W. Mark Warfel Resilient Heart Award in April 2019.

For more information, visit Dr. Goulston's website at www.markgoulston.com.

About the Producers: 
Producers Frank Kilpatrick (www.frankikmusic.com) and Linda Kilpatrick, along with director Paul Emami (www.storytellerz.tv), partnered with Mark, Kevin, and Rayko to create Stay Alive to express the purpose of helping you or someone you love to find their way out of despair. We hope this video is a helpful catalyst for having conversations about those at risk or even with yourself. If you or anyone you know has been touched by suicide and is feeling isolated, we hope you find the video valuable and share it with others.

About Stay Alive (#StayAliveNow): 
Stay Alive is a 75-minute video/podcast documentary serving at-risk populations. The program's two sections, Understanding and Helping, deliver messages of education, compassion, and caring for those who are in deep despair, along with guidance for their families and friends who love them. Stay Alive is recommended for individuals, families, schools, communities, social services, and churches—anywhere there is a need. Moderated by Mark Goulston, MD, participants in Stay Alive's intimate and disclosing discussion also include Kevin Hines, best known as the man who jumped off the Golden Gate Bridge and survived (www.kevinhinesstory.com), and suicide prevention advocate Rayko (www.rayko.com). #StayAliveNow

Stay Alive is available here on YouTube, and will be available on Amazon Prime Video and other distribution channels free of charge.

For more information, please visit www.stayalivevideo.com.

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