Jack Klott – Suicide & Self-Harm: Stopping the Pain

Outline

The Guiding PrinciplesThe Guiding Principles

Research on Suicide and Research LimitationsResearch on Suicide and Research Limitations

• Research on numbers/methods/treatmentResearch on numbers/methods/treatment
• Limitations of a “psychological autopsy”Limitations of a “psychological autopsy”
• No causality in researchNo causality in research

The Neurobiological Basis of SuicideThe Neurobiological Basis of Suicide

Who Is At Risk?Who Is At Risk?

• Mental Disorders Mental Disorders
  • DepressionDepression
  • AnxietyAnxiety
  • TraumaTrauma
  • PsychosisPsychosis
  • AddictionsAddictions
  • Personality DisordersPersonality Disorders
  • Other DSM-5® ConsiderationsOther DSM-5® Considerations
• Social Stress Factors Social Stress Factors
  • Adults FactorsAdults Factors
  • Adolescent FactorsAdolescent Factors
  • Childhood FactorsChildhood Factors
• Psychological Vulnerabilities Psychological Vulnerabilities
  • Performance AnxietyPerformance Anxiety
  • Emotional ConstrictionEmotional Constriction
  • Defenseless PersonalityDefenseless Personality
• Adaptive Suicide ProtectorsAdaptive Suicide Protectors
• Maladaptive Suicide ProtectorsMaladaptive Suicide Protectors
• Fueling Emotions to Suicide and Self-HarmFueling Emotions to Suicide and Self-Harm

Non Suicidal Self Injury (NSSI) – The Self-Harming PopulationNon Suicidal Self Injury (NSSI) – The Self-Harming Population

• All Behaviors are Purposeful!All Behaviors are Purposeful!
• Relief from: Relief from:
  • Dissociative ConditionsDissociative Conditions
  • Self-HateSelf-Hate
  • Emotional ConstrictionEmotional Constriction
  • PsychosisPsychosis
  • Anxiety and/or DepressionAnxiety and/or Depression
  • Loneliness, Isolation, Abandonment, RejectionLoneliness, Isolation, Abandonment, Rejection

The Suicidal PopulationThe Suicidal Population

• Suicide Rehearsal – The Seventh Goal of NSSISuicide Rehearsal – The Seventh Goal of NSSI
• The IdeatorThe Ideator
• Suicide Threats for Secondary GainSuicide Threats for Secondary Gain
• The Attempter/CompleterThe Attempter/Completer

Assessment of RiskAssessment of Risk

• When to Hospitalize the IdeatorWhen to Hospitalize the Ideator
• Six Week Warning Signs for the Suicide CompleterSix Week Warning Signs for the Suicide Completer
• Six Day Warning Signs for the Suicide CompleterSix Day Warning Signs for the Suicide Completer

Treatment Considerations for NSSI and Suicidal PopulationsTreatment Considerations for NSSI and Suicidal Populations

• Identify the Locus of PainIdentify the Locus of Pain
• Empathic RegardEmpathic Regard
• Provided AlternativesProvided Alternatives
• The Role of Motivation The Role of Motivation
  • Reasons For LivingReasons For Living
  • The Continuous Hope Providing RelationshipThe Continuous Hope Providing Relationship
• MindfulnessMindfulness
• Relationship Effectiveness Relationship Effectiveness
  • Opening Up Your Emotional DoorOpening Up Your Emotional Door
• Emotional Regulation Emotional Regulation
  • The Safety PlanThe Safety Plan
  • The Crisis PlanThe Crisis Plan
• Avoid “Contracts”Avoid “Contracts”

The Therapist as a Survivor of SuicideThe Therapist as a Survivor of Suicide