Episode 80 - Transcript - Suicidologist - Dr Tyler Black

By Michael Rhodes | September 22, 2022

This is a transcription of Episode 79.  The transcription was done by software, apologies for anything that seems out of whack. A link to the episode is below.

Michael 0:00
Hello, and welcome to the show. This is episode 80. Before we begin, I want to take a moment to dedicate this episode to Mr. John Taylor. John was a member of our divorce support for men group on Facebook. And recently John took his own life. I knew John I spoke to him on the phone several times and message with him quite a bit. So his death was definitely a shock to me. But I didn’t know John that Well, I didn’t know him outside of the sphere of divorce support. So before deciding to dedicate the episode to John, I reached out to his daughter, his oldest daughter and spoke with her and her sister, and got to learn a little bit more about John. And what I learned were some of the things that that I already knew was, he was a veteran of the United States Air Force. He served our country for 21 years. He was a father of six. And what I learned about John was, as described by his daughters, it was a man with a big heart. He loved the Eagles, he was from Philly, he loved golf, and he was a car guy. He was an animal person, though, wouldn’t admit to it, as described by his oldest daughter. He was more than anything. He was a man that worked hard for his family. He cared about others, he put others before himself and he would do whatever he needed to do to make sure that his family had before he had always John was loved. And John will be missed. So this episode is for him, and is in his memory. This episode is going to focus on suicide, I reached out to Dr. Tyler black, found him on Twitter, he is a suicide ologists he is an expert in suicide. So, that is the majority of the topic that is covered. And before I formally introduced this episode, I also want to say to you out there, if you are in crisis, if you are having these thoughts if you are lacking hope, please reach out to someone to anyone. And talk. There is hope after divorce, I promise you, there is so please just reach out and ask for the help that is out there. Here we go. Episode 80. Joining me today is Dr. Tyler black. Tyler, let’s just jump right into it. Who wants to tell us a little bit about yourself?

Tyler 3:21
Sure. So I’m a psychiatrist at the University of British Columbia. I specifically work more with kids. So I’m a ton less than psychiatrists. But really one of the reasons that we’ve connected and one of the things that I do a lot is research and suicide and suicide ology people probably aren’t aware of suicide ology, it’s not a much talked about specialty. But of course, suicide is a leading cause of death, and especially in younger people, especially in men. And, and so basically suicide. ology is the study of suicide. And I’ve talked about suicide, suicide risk assessment, you know, and my primary work is in emergency psychiatry. So I typically see people in crisis.

Michael 4:00
So sidebar, and this happens all the time, rabbit holes as a column, how did you get started into to that topic?

Tyler 4:07
Yeah, I mean, it’s, this is gonna sound out. So first of all, I’ll preface this so people are watching, I know that there is we’ve talked a little bit about that there’s, there’s been a recent event in your group, and people have varying contacts and thoughts and memories of suicide or suicidal thinking. I always say for something like this, I’m going to talk very frankly, about suicide, but really just the best the best time to, to listen to it, the best time to be a part of that is when you’re a good space to do so. Like it’s not generally a great idea to be thinking a lot about suicide when you’re down in the dumps. So I usually say wait for yourself to feel a bit strong and you know, I’m not going to censor myself, to be very to be overly sensitive, but I would say a lot of people tap out on these conversations and that’s okay. And then just return to it when you feel a little bit better. For myself. I as my first day of work, as a psychiatry resident, I arrived to a hospital and there was a man hanging from a tree. And I had never done a lick of psychiatry outside of my, my core medical student work, and a couple of electives. So it was quite a thing to see. And then the response to it within the organization was really varied. I got lots of different teaching, I had people teaching the opposite things like so and so it was more at risk, so and so it’s less at risk. And so I just did what I generally do, I went into the research, and I realized that a lot of the things that are taught about suicide aren’t true, and they haven’t been true for a really long time. And so the culture of suicide is still mired in a lot of stigma. Even in research, there are some medical truisms that have never been true and are continued to be taught. So it’s one of those things where I thought, well, I can become an expert in this, it’s really interesting to me. And like anything else, people think, you know, maybe it’s a morbid topic. But medicine in general is about death and dying. You know, if you’re an oncologist, trust me, it’s pretty forfeit if you’re dealing with cancer all the time. So. So really, I just want to try and be helpful.

Michael 6:08
Yeah. So let’s dive into the, the meat, the heart of the matter, as it were, and discuss the statistics do you have I think I have some, but I’m not the expert. So I’m going to rely on you. What what are the stats, it may be in the US or the world, but for men in particular, how many men it with the latest set of data are killing themselves? What in whatever metric you have daily, weekly, monthly.

Tyler 6:38
So it’s really, you know, we typically think about suicide, there’s a term that is often used called rates. So a rate is per population. And typically in death, we talk about mortality rates as being per 100 100,000 people. So, so So when a figure is expressed, it’s usually per 100,000 people per year. So for example, in the United States, for men, it’s about 22 per 100,000 per year. And so if you take the entire population, the United States, which is, you know, I think about 150 million men, or maybe 175 million men or so, you know, you you get to quite a high number of high number of raw suicides. But of course, suicide has a number of variables that affect it. So there’s a peak in midlife, for men, there’s a peak in later life, especially in the United States, much more so than other nations. And typically, in the Western world, we see about a three to one ratio from men to women dying of suicide, it you know, especially later adulthood, that ratio gets really distorted, it can be up to 13 fold, and at age 75. And women seem to have a bit of a decreasing rate of suicide after age 55. And men have an increasing rate of suicide after age 55. So there’s a bit of a gap there. But it’s important to also remember that that’s not like a genetic gap, because there are cultures like China, Bangladesh, where more likely women are dying by suicide, and, and, and so. So it’s not just a, this is a Y chromosome thing, or this is some pan thing, you know, it does seem to be more prevalent in Western society. So the ratio in Asian countries is about two to one, the ratio in North American countries is about 3.5, to one or so. So there’s a there’s a variance based off of where you live and what your culture is, too.

Michael 8:42
I’m shocked that there’s there are I’m not shocked that there, there are countries where the disparity is less, I am shocked that there is countries where you’re saying there are countries where females kill themselves at a higher rate?

Tyler 8:53
Well, you know, it’s difficult, you know, you think something as easy as what’s the suicide rate in a nation is easy to know. But for example, Italy reports 3.7 per 100,000 deaths by suicide and American reports, 14, and I’m sure that all entirely has to do with the Catholicism of Italy, rather than the rate of death by suicide in, in Italy. So stigma and cultural norms and the way that these things are investigated. And, and whether or not suicide is acceptable in the culture is something that a coroner can say, these all plan and of course, the statistics coming out of Bangladesh and China. You can wonder a little bit about, you know, if if you had access to the same data, would you come to the same conclusions, but it’s been relatively well held in China that it’s at least one to one. Some of the studies show that women die more of suicide and then in Bangladesh as well.

Michael 9:48
Do you think that in America and then the rest of the world you sort of alluded to it is suicide under reported?

Tyler 9:56
Well, it’s underreported and it’s hard to call so I’ll give a couple of examples. If if someone’s found that of a drug overdose, for example. And they clearly intentionally is drug, you know, it’s a drug of abuse like fentanyl or heroin or something. But they, you know, the question is like, what was their intent when they took it suicide is the intentional act of death. And, and a lot of people die of overdose without that. So you can imagine how hard of a call that is. For coroner’s, that investigate, they try and get to know pretty much all unnatural deaths in most western societies are investigated by a coroner service. And they get to know the family and talk to people who know the person and try to figure out what’s going on for them, and try and construct whether or not the death was intentional or not. And sometimes it’s very hard to tell. So there’s a group that we don’t know, I would certainly say there’s a tendency. For a while it was kind of reported that religiosity decreased suicide. But one of the big moderators for that is coroner’s, who are religious are less likely to call a death of suicide than coroner’s who aren’t religious, real, because you’re basically condemning that person to Hell say, in a Catholic country or something like that. So. So, you know, we think that the social connection of religious religiosity can be very helpful. But a lot of the country by country effects, you can directly plot it with the secularism of that country. You know, typically the more Roman Catholic the country, the lower the suicide rate.

Michael 11:31
Interesting, I would have never thought that I’m assuming we probably don’t have that trouble here in America in terms of, you know,

Tyler 11:37
well, it’s country, it’s county to county, we’d love to imagine that there’s this like, really robust way of doing things. But of course, every state every county often leads up to itself, how to how to adjudicate these things, how to report them, the CDC expects death reports for all unnatural deaths with a certain amount of characteristics. But a surprising number of things aren’t in that data. So for example, you know, we still to this date, don’t have a is this person gay or not? You know, and so for all of the, you know, we, we know, quite confidently that suicide, attempts suicide, thinking, we’re quite confident that suicide deaths are more common in people who identify as gay, but we don’t have any national statistics on that, because literally, there’s no box for is the person gay or not? And you can imagine that that, you know, America is a very divided country, there’s very different approaches to lots of things, you know, drug overdose deaths, in a very conservative state might be more often called suicides because of the pejorative way in which drug overdoses are viewed, and in and so, you know, there’s variability, you wouldn’t want there to be lots of variability. But there is,

Michael 12:58
well, coroner’s. Yeah, well, that aside, I mean, it’s still clear that, at least in America, that men are killing themselves at a higher rate. Why? Why is that? What Why do you think that is,

Tyler 13:09
I mean, there’s some tropes that they’re out there, and I challenged those a little bit like, I always feel like, there is a traditional form of masculinity that involves never admitting that you’re, you can’t handle something being too you know, any, any struggle is a sign of weakness. I do think that’s an issue. But I think that’s over called. And it’s a little bit simplistic because I have many male friends in my life. And we can talk about really emotional stuff. We don’t we don’t do it in a, we don’t do it in the same way that say women talk about their emotions. But you know, my friend could call me if he was having a hard time and we’d chat about it. And I’ve had my brother cry to me, I’ve had my, you know, my friend cried to me, you know, so I think there’s this kind of stereotype that men don’t open up about their emotions.

Michael 14:00
Yeah. Yes, no, yes. I believe that. I mean, I believe that,

Tyler 14:04
I think I think there’s some truth to it, because there is that kind of traditional, what in the research we call sort of hegemonic masculinity, which is basically weaknesses is, is what happened, like it’s a sign of weakness to need help, that that talking emotionally is a feminine trait. And there’s a lot of sort of that sort of, you can’t be feminine approach that some men have, but there’s also some other things that we have to put on the table men are much more likely to be involved in problematic drug use. Men typically bury themselves in work and responsibility and, and often men socially cast, one of their one of their identities is their role. So we see in a lot of Western societies, traditionally the feminine role as being one of within the family and that never retires. But when you’re someone whose role is I’m the sales manager or whatever, and, and then you lose your job. Unemployment hits men harder than it hits women, we see unemployment as a much stronger risk factor. In men and women for suicide the same for divorce. Divorce hits men much harder than it hits women in terms of a risk factor. Because again, men often see themselves as the ideal partner, and I’m so and so’s husband. And, and so loss of role can be a really big blow to men and men often put their roles functionally, if I’m not doing something, if I don’t have something to show for it. It’s not a role for me. So, you know, the, you know, the person who loses their job often finds themselves listless, the person who loses their relationship often finds himself without an identity. And that can be a real tragedy.

Michael 15:44
And it just hits me so hard, but it leads to so many, so many other types of questions. So, but then if, and I’m not saying you’re wrong, or or disagreeing, or agreeing, or whatever, but if if I think that’s true, by the way, I mean, 100% true in terms of losing identity, that’s something that I’ve talked my last podcast episode was just a solo one, I was talking about identity. Oh, thank you. I think thank you. I don’t know. Yes. So But if, if there if there’s not reaching out there, I mean, is that is that maybe maybe I’m jumping ahead in terms of the solution. But if it’s not that they’re not reaching out? Like if so if they’re faced with a problem, in part of the solution, at least, I think it is, is that you reach out for help. But you’re saying that that probably is occurring and probably isn’t as much of a factor?

Tyler 16:40
Well, I think it’s a factor. It’s just an overplayed factor, I think it plays into the stereotype of men, rather than it plays into the reality of men, I think there’s lots of men that would very happily speak. We know that men are a little bit more intimidated by professional help seeking. So talking to a therapist would be a lot different than say, someone just on the streets, and hey, how’s it going? You look, you’re looking like you’re having a rough day, you know? So So I think, you know, there’s this, there’s this kind of stereotype of men as not wanting to talk about their feelings, but I think it’s the mode of delivery, it’s when is it available, it’s reaching out early, rather than reaching out late, you know, a lot of men really hit, you know, it’s when the shit hits the fan that they, they, they reach out for help. And, and there’s, there’s just that culture of not reaching out early because I can handle this, or I got this. So I think some of those stereotypes have some truth, and some of them are exaggerated. So I certainly think it’s a factor.

Michael 17:37
Yeah. So that jumping around a bit. But that’s, that’s why I create an outline. So when you say that, men are a little bit more intimidated by professionals a little less likely to reach out. And I see it in here, sometimes they reach out in here. What the hell should we do when that happens? Because and people are on my case about this, but we we fucking failed. We had a guy in here, and he’s not here. And I get it’s not my fault. It’s not their fault. But the system that I have in place here, the ecosystem, it failed, it failed. It did. Now I’m not saying it’s my fault. But what are what are better ways then, like whatever I’m doing? It didn’t catch this one. And maybe it is one. And it’s an anomaly. But I would rather not rest my head on that. I’d rather take action. So what what are we to do as, as as a peer and not a professional for a man that is on the brink? So to speak? Yeah,

Tyler 18:36
yeah, I’ll start. And I don’t mean this as a platitude. But I’m used to the feeling of people who survived suicide is feeling like they somehow failed, or that they missed something. Of course, we use unfortunately, in suicide prevention work, we use a lot of talk about warning signs and mental illness. And what that ends up doing is that makes in all the people who survived a suicide a sense that you missed the warning signs, and you missed the mental illness. And, and that’s really unfortunate. It’s one of the reasons why I’m not a fan of Zero Suicide campaigns are that every suicide is mistake, because we don’t actually get to see what’s in the the hearts and heads of every single person and the ability and there’s many people who you couldn’t tell that the next moment they’re going to die by suicide. They don’t have a diagnosable mental illness that’s only about 60% of people who die by suicide 50 to 60%. And, and warning signs aren’t just while they’re weather while they do occur. They’re so generic that you can miss them for anything. So if you look at some of the warning signs, and you really think about it, it’s like a change in personality. Well, my goodness, if someone gets a girlfriend, they have a change in personality. If someone you know, has a rough night, they have a change in personality, you know, like, so some of these warning signs. You know, they’re there. They can be helpful, but they also set up kind of what you expect. Last year, this this sense of we were there, but we failed. I’d really like to make sure that you and your community and people listening to this, recognize that, you know, you do what you do what you can, but you can’t be responsible for everyone’s life or death. This is something that as a physician I’ve had to tackle very early, when patients who should have survived it into and patients who shouldn’t have survived it. I don’t get to control as a physician who lives or dies. And I have lots of knowledge and lots of expertise. So so people who kind of go through this, they often are left with that sense of what did we do wrong? And here’s one of the kickers, it could be that you didn’t do anything wrong, you did everything, right. The outcome can still suck when you do everything, right. So you know, that person having an outlet to go to that person reaching out all of the responses that receive could have been, you know, exactly what that person needed. But the circumstances or if they got some other hint, or they got a phone call, or who knows what else happened? So, so I would like to get Emily relieve you. Well, can I

Michael 21:09
just say, I, I hate that fucking answer. I’m not saying no,

Tyler 21:13
right? No, I’m

Michael 21:14
not saying you’re wrong. You’re the X. We all hate it. We all have, but it’s just it feels it makes me feel powerless. It makes me feel like then. Yeah, I don’t know, what’s the what’s the fucking point is what I feel. Because it, I don’t know, man, it’s fucking

Tyler 21:31
frustrating, you come to a place. And you know, a lot of physicians go through this, a lot of people who work in suicide risk assessment go through this, and I certainly went through it, where you transition yourself from my job is to prevent all suicides to my job is to improve the lives of the people around me. Every person who comes in contact with me, I want them to leave contact with me in a better position than when they start out. I want to tip the scales in favor of them surviving. So if I identify a problem, I want to correct it, if I identify something that would help their life, I want to add it. But I don’t actually get to see the final score. And man, that’s frustrating. There was a I’ll, I’ll really drive it home in a very analytical way. There was a there was a study where they had big, deep blue IBM’s, big supercomputer that beats all the chess masters had a crack at 9 million electronic medical records from the state of California, trying to predict suicide, they had access to every bit of information that was ever written about that patient. Going back far, the best the model could do was a positive predictive value of less than 1%. And this is big blue with 9 million EMRs. So you with limited information and the person sitting across from you, you’re, you know, the idea of predicting, and knowing whether or not someone’s at risk is is really infinitesimal. So so I tried to take this universal approach, instead of being defeated by it, it gives me a mission, every person will see, I can make their life a little bit better. I there’s something I can do to make something in their world better. And, and that becomes your motto when when you’re trying to prevent suicide.

Michael 23:11
Yeah. It’s, I’m not surprised by the answer, I guess. In some ways, but it’s just yeah, I don’t know. It’s so so so being analytical, right? Talk about analytical, that’s, that’s my jam. Tell me Tell me Give me the numbers. Give me the data. And now Now, it seems like there isn’t a way and so on. But But with that said, though, Arthur, are there things, but I mean, should I be looking for certain things? Is there a certain or is it just,

Tyler 23:43
I always think when again, when you approach warning signs, don’t do it from the I will catch everyone who is suicidal point of view, do it from the really basic humanistic point of view. And I’ll demonstrate it right now. Like if I was talking to you right now, and I felt like something was off, I would just pause and I’d say, hey, you know, we’ve been talking for awhile, but today seems a little bit different is something going on for you. Like that is a real question with real care. Or I could just say how you doing today, and whatever they say, Okay, anyway, so I was calling about what, like, we can treat people superficially, or we can treat people, you know, with a genuine concern and interest for their life. And when you notice something, when something’s you know, seems off, you know, some of the warning signs, quote, unquote, warning signs of suicides are things like people seeming sadder than normal, or people giving away their possessions or, you know, these some, some range from the blindingly obvious, like telling them, hey, if I die, please take care of my cat, to the not so obvious change in personality. But if you notice something, I always say, model, the type of communication that we wish for. And we can all think of a time where we were struggling with something and we didn’t bring it up. And it wasn’t because we didn’t want to talk about it is because there was a barrier. And so if you imagine what were those barriers, just to tackle those barriers, I just needed someone to reach out to me. So reach out to people, you know, I just, I just needed someone to, to not make it like a big deal I wanted, I didn’t want to really make a big deal out of something. So don’t make it a big deal. Hey, we all go through stuff. How are you doing today? I just wanted to check in on you. It’s been a while since we chatted, you know, these, these seem like really basic things, but they’re super helpful.

Michael 25:26
So it’s, it’s a matter of, I mean, staying in touch, right? Just just trying to reach out and not wait for

Tyler 25:33
your group has gotten quite large, right, you said 6500 people. So you know, you know, you, you run the stats on, you know, divorced men in a group 6500 of them. And, you know, it’s not surprising that there’s a suicide in that group.

Michael 25:50
I always knew that. I mean, I always expect it. And that’s why I always push so hard to prevent it in some way. And like, let’s be conscious of it. Let’s not post dumb shit about how can I get laid tomorrow? Like not, you know what I’m saying? Like, these are these are real, verifiable facts. And that means, therefore, that it’s more likely that this is going to happen. So let’s try to do our best. Yeah. So let’s, let’s on that sort of note, what are some of the things that you in a group like this or in any kind of setting, what are some things you should not do? Like, what is it? I don’t even know if that’s a

Tyler 26:24
Well, I think you probably experienced this man who go through divorce often get treated like they’re, they’re going through a funeral. You know, divorces are, especially when you don’t want the divorce that happens to you, which I believe is kind of the, the group that you’re about is kind of this unexpected, unexpected divorces. But if you try to give lay advice to someone, the best thing that can happen for you is when someone who doesn’t love you leaves your life. Like it’s actually a really good thing. And, and so, I think we can be a little bit overly negativistic. About, you know, if someone’s in a black hole, you don’t want to be like, and here’s a few more things to suck about what you’re going through. You don’t want to be superficially glib, but I do think that you can take a tone. That’s very hopeful, because one of the one of the, you know, when we think about the keys to suicidal planning and thinking, it usually resolves around a stress that we can’t manage, and hopelessness that it won’t get better. And, and so, you know, some like, there’s nothing a lot of us can do about some of people’s life stresses, we just have to like, man, that sucks. But the hopefulness, I’ll always be here for you, you know, you can spend time with me, if you can add hope to that person, you’re going to amputate a lot of that suicidal drive, which we do feel sort of comes from that combination of an overwhelming stress plus, the idea that it won’t get better. So when we see men who are facing a criminal sentence, and then they hang themselves in jail or something like that, they do that because they know they’re going to jail. There’s no hope for them whatsoever. And so if you can, if you could tell that person tomorrow, oh, there’s a technicality. You won’t go to jail. They’re not hanging themselves. And so if you can, if you can add hope to someone, you can really amputate their suicidal drive. And so so it’s it’s not about being glibly hopeful, it’s about being realistically hopeful. This is a process we’ll get through it. You don’t have to do this alone. You know, I’ll be here every time, you know, you have a bad moment, just let me know those types of things. And when you create a community like you’ve created, it would be hard. You know, we’ll never know we don’t get to get the numbers of of everyone who touches your group. But it’s hard to imagine that a group of people coming together and talking about such a life altering thing. Could not be anything but suicide protective. So, you know, I think there’s lots that we can do. Yeah,

Michael 29:01
what does it feel? I feel like I mean, I’m sure it’s childhood shit and whatnot, but like, I feel like such a fucking disappointment because of this one guy. And I knew I knew John not not well, but I talked to him on the phone. We messaged like, I knew his story. And I keep fucking coming back to but I was just thinking, Well, did he get that? Maybe we maybe didn’t do enough of that. Maybe he didn’t get enough hope. Maybe I was Dick one day or you don’t I mean, like that, that fucking regret that won’t leave me the fuck alone.

Tyler 29:36
Well, you know, you know, grief. And the way that we process loss also involves a little bit of denial of reality, like you don’t have the level of direct control over someone else that you wish you had. And that’s why it’s the whole group. You know, but, you know, we don’t have that level of direct control. roll in. So I always come back to whatever whatever you did for that person, were you doing your best to make their world better, where you’re doing the best to help them? And if the answer to that is yes, then that’s what you’re doing. You don’t get to see the final score, I’ll give you a really concrete example. I could give someone with non Hodgkins lymphoma, the perfect chemotherapy, and they could still die of non Hodgkins lymphoma. So it doesn’t have to be that I made a mistake in treatment, it doesn’t have to be that I had a bad approach or that I missed the early warning signs, it could be that things are just not in my control. And I do the best I can to improve someone’s quality of life

Michael 30:39
is that something as a doctor that you probably have to wrap your head around at some point, right?

Tyler 30:44
You You always sort of imagine and TV does this quite a bit that you know, you do heroic measures, and the person survives, and have to say, I’ve seen a lot of heroic measures, and I haven’t seen a lot of people survive. And and and so, you know, the realities, for example of CPR, rescue rates are pretty, you know, pretty, pretty low compared to what it looks like on TV. And, and so you do get used to this idea that that we don’t get to control that that grand arbiter decision of whether what someone’s health course looks like, but we have really good tools that improve the quality of life for people that we work with and give people a better shot. So if I give someone aspirin, who’s at risk for stroke, like a baby aspirin or something like that, I could be increasing the risk of other things, but I’m improving the risk of stroke, I don’t get to turn off their ability to get a stroke, you know, I just don’t get that ability. So, you know, it’s just one of those medical factoids that that you encounter, that really drives home when you have patients who you really care about pass away? What about people?

Michael 31:48
I see it in here, sometimes people that reach out, and almost all they say is like, you know, I don’t I don’t want to be here anymore. Like, I found that typically are not typical. Every time someone does that. I don’t, they don’t. I don’t want to say follow through because that sounds pretty fucked up. But you know what I’m saying? They don’t. Right. So is that when people say things like that is that again, it was probably hard to

Tyler 32:17
there’s a large scope. So so my world child and adolescent, you know, 16% of kids in any given year, think seriously about dying by suicide, and 0.0048% die by suicide. So the there’s a huge vast swath of people who seriously think about suicide who don’t die. And I think one of our one of our liens that’s often counterintuitive when someone says things like that is like, oh, no, it’s not that bad. It’ll be like, almost quickly invalidating experience. And I’ve always found that when someone’s expressing that much suffering, the best move is to sit alongside them and talk about Yeah, that sounds awful. I totally get what you’re saying. It must feel like there’s just no way out of this. So you know, talk to them about what’s going on. And then, you know, gently push them towards hope. I think, like I said, you can you can really do it on a very, almost like, I don’t, I’m not listening to you. So someone says something like, I just can’t take it anymore. And you’re like, Oh, well, you know, the weekend is coming. You’re just, you’re, you’re doing it like this person is saying I don’t think I can survive tonight. And you’re saying Don’t worry, the weekends coming. But if you said, Man, that must be such an awful feeling. You call you’re telling me about this, tell me why you call me today, tell me what we’d like to talk about what can we do? Let’s get to go in and let’s get to doing something. I do find that men respond really well to activity. A brooding man can get real down on himself. But if once you start doing something whether, you know, within your abilities, you know, to emulate to get some movement, going to do something with your hands to distract yourself. You know, when we’re in a culture that makes media seem very negative, I can tell you through the one very traumatic breakup I’ve had in my life, three seasons of South Park probably saved my life, and just binge watched it. Until I, you know, until I got through the initial chakra stuff. So you know, whatever it takes, but the don’t reject that feeling. It can be scary when someone says that, but we have a quick, you know, we want to resist that tendency to say no, you don’t really think that you kind of brought up this idea that they don’t sort of follow through with this idea of attentions, attempts versus completions or ideation versus completion. I take a very humble position of I don’t get to know what’s in someone’s heart and soul. So whatever they’re saying, I’m just going to accept it at face value. And I’m going to say okay, thank you for sharing that. What are we going to do from here? You know, if if, if dogs like like in my area Risk Assessments I’ll use the word attempt that’s defined has a very specific, you know, definition. But it doesn’t mean, they weren’t serious about it, you could do something that, you know, has very little authority, but you were in a real dire state when you did it. And so, and in the same way, some people, you know, end up in the ICU, and they’re really regretful that it was a total mistake. So, I’ve met many people in the ICU, who the moment I see them, like, Oh, my God, it was just a relationship, why would I do that? But I’m just glad they survived.

Michael 35:34
What about messages, like, you know, you know, your children, you know, the, you know, in terms of like, you know, don’t they’ll, you know, they’ll miss you, though, you know, you can’t leave them like, are those kinds of good messages because I see that a lot and hear from guys get that message. I don’t, I don’t know if it’s good or not.

Tyler 35:50
I think there’s, there’s good aspects to it. And there’s bad aspects to it. So don’t use it as a guilt weapon, don’t leave your kids is probably a little guilt inducing. However, one of the things that comes with suicidal thinking, and depressive thinking generally, is the idea that people would be better off with how to my kids would be happier if I wasn’t around, or, you know, life would be easier for them. If I wasn’t around. That is never true, I will tell you straight up that one of the downsides of my life and the career that I’ve taken is I’ve met so many families who’ve lost people due to suicide. And it doesn’t matter how much conflict there was in the family, it doesn’t matter how much dislike and hate and whatever there is going on the family, when someone dies by suicide, everyone’s harmed by that. And so countering that idea that people would be better off without you usually requires a direct conversation. I do this with kids all the time. I said, Who told me Oh, my parents would be better off without me. I’m like, you know, I’ve met a lot of parents who die by suicide, and not a single one of them has ever benefited from their child dying by suicide, it’s always a devastating thing, even in some families that fight all the time. So So I would say careful not to use it as a guilt weapon. Think about your kids how much they’d miss you, if you did that, and how disappointed they they’d be in you, is just adding pressure and guilt. But do recognize that this idea that they’d be better off without you is a complete distortion, that can’t be true. We know that kids need their dads, we know that for a fact. So of course, there’ll be better with you. Of course, we want you better of course, we want you feeling better. But there’ll be better with you than without you

Michael 37:33
can on that sort of same topic. Can we categorically say that telling a man to stop being a bitch is not a helpful way?

Tyler 37:41
Without question, this this idea that crying, be feeling weak. Seeking help, is somehow a feminine action is is part of the reason why I still subscribe to some of that masculinity, that toxic masculinity talk because it’s definitely something you’ll hear, you know, Oh, yeah. Especially online where it’s a little bit easier to be crass and crude. And I even see it sometimes as like a, I’m a tough love type of person, like, you know, stop, stop being a bitch and hit the gym or whatever. Like I get it. You’re an alpha male, I promise you that just drives like a nail into that person. And it’s, it’s totally counterintuitive. People respond really well to here’s what I did when I was struggling. So if you ever want to kind of try to introduce a different tactic than the one the person is doing, just do it from the here’s what I did type of vantage point rather than here’s what you should do.

Michael 38:52
Right? Yeah. Hey, guys, I don’t know how it feels like maybe I’m getting towards the end. But I could be totally wrong and find out a rabbit hole if you got any questions. Throw them up. I don’t know if anyone’s gonna have any Tyler

is are there any other countries like America in terms of the male disparity and suicide? You kind of talk Western, but like pretty

Tyler 39:17
much all of that, like all of the Western nations, everything from Australia to the UK to to Canada. You know, the ratio is between three and four men to women. And, you know, the, the, there’s a couple of like myths out there that adolescents are more at risk for suicide, when in fact you’re actually most protected when you’re an adolescent from suicide. It’s mid life. We see a peak at around 4040 to 50 for both men and women. And, and anytime you’re talking in large pool of statistics on on suicide, it’s really important to mention in in any area that has indigenous People, indigenous males, especially young Indigenous males, that the rates are astronomical. Yeah, like the rate of Indians, right? Yeah. Yeah, the rate of Inuit suicide in Canada, for males, remember, I was giving the number of 22 per 100,000, is 260 per 100,000. So more than 10 times the rate, and it’s not because of any genetic factor, again, it’s just the systemic issues that, that and the impacts of colonization so. So yeah, it’s, it’s, it’s quite a, there’s quite a risk added by by being exposed to systemic things like indigenous people face.

Michael 40:41
How much do you in a psychiatrist, how much do you believe pharmacology should should play a role in these things?

Tyler 40:53
Well, the pharma call, if you have a diagnosis that pharmacology helps, pharmacology has a role, you know, as a pure, we can stop suicide with a pill, probably not. There is some signal that maybe lithium in the groundwater is related to the rate of suicide and, and you’d have to have a huge randomized control trial that would somehow have the path ethics, because again, we’re talking at rates of, you know, per 100,000. So you need gigantic people in the study. But the evidence on that is pretty contradictory. Certainly, lithium seems to have a protective effect for people with mood disorders, for suicide. But I’d say if you have a depression, treat your depression, and, you know, I am a psychiatrist. And I certainly think that pharmacology tools are useful. But that’s not the only way to treat depression, there are excellent psycho therapies for depression, there are somatic therapy, some people choose to do neither. And they do things like AC T. I mean, it’s a very, it’s a very stigmatized treatment modality, but a very effective treatment modality. And, and then, you know, from mild to moderate depressions, we have tons of evidence that adding exercise, changing diet, there’s lots of things that you can do for yourself, that that improve almost as well as most psycho therapies. Real depression. Yeah. Once the depression starts getting to the moderate to severe category, you don’t want to be relying on exercise or diet, you really do want evidence based therapies. But I think in that space of mild depressions, where you’re functional, but you’re feeling down and low, there are lifestyle changes you can make that can really improve things.

Michael 42:32
Oh, yeah. How do you how do you Boy, that’s a nice, like, how do you know? Like, how do you know? I would say, self assessment? Yeah.

Tyler 42:41
Like, how would you be one of the there’s two big questions of whether or not my depression is severe. And number one is connect function. So there’s three main areas in our life that we function, there’s our occupation, there’s our social world, and then there’s our health. And if, if we’re failing in any of those three categories, it’s probably not a mild depression. You know, if you can’t get out of bed and go to work, because you don’t have motivation and you lose your job, you’ve got to at least a moderate depression, right. And on the same hand, if you’re someone who like you feel a malaise things, you don’t enjoy things as much, but you have your friends, you’re enjoy things, occasionally, you’re able to hold your job, you might, you might have a mild to moderate depression and lifestyle changes could be really helpful for you, but the best way to know is always to, to talk to your physician. You know, depression is a very treatable problem. treatments work. If people who choose medication, first round, it’s about 66% likely to be effective by by medication, two or three, you get that into the high 80s. Psychotherapy is exactly the same psychotherapies are and medications performed evenly. And the combination of the two is superior to either by themselves. And so using a real evidence based treatment for depression can really improve the outcomes of depression.

Michael 44:00
Well, I’m familiar with Cymatics. I did a little bit of somatic therapy myself. Yeah. Buck loved it. I recommend everybody. I don’t know what EC T is. What is

Tyler 44:10
that? electroconvulsive therapy so if you ever seen movies and one over the Flew Over the Cuckoo’s Nest to the electricity to the brain, it’s done very punitively in most movies, it looks really inhumane. The reality of AECT is it’s it’s using an electric current to induce a seizure in the brain for depression extremely effective. You usually we use it when people can’t for some reason do psychotherapy or medications and so it’s often used in in people who, for contraindications can take medication but have a severe depression. There’s there’s there’s a mode of brain stimulation called repetitive transcranial magnetic stimulation that’s actually done in office, you don’t need anything and the psychiatrist or the treating professional would be using a magnet tack Sleep reverse polarities in your in your brain. And, and it’s a somatic treatment that showing good, good evidence. Probably not as strong as AECT. But, but but good. And so there’s lots of developing therapies. Yeah.

Michael 45:16
What what are you? I mean, you’re primarily children, so you’re probably just psychotherapy than right.

Tyler 45:23
We always prefer psychotherapy for kids. You know, my neck of the woods is emergency tertiary psychiatry. So I kind of see the most crisis and worst of cases. So often, there’s times that I’m relying on pharmacology, you know, in for some of the major mental illnesses like schizophrenia, bipolar disorder, psychotherapy alone usually doesn’t cut it either, usually is has to be some medication that goes with it. But in kids, we typically try psychotherapies first, families are a huge part of how kids function schools are a huge part of how kids function. So we modify environmental factors as well.

Michael 45:56
Speaking of that, and again, rabbit hole. If you don’t address some of these things, and maybe they’re mild or whatever, it just not an ideal childhood, whatever the hell that means. But don’t you don’t you need to address those things? Maybe maybe not good as a bad childhood? I don’t know. address those things, right? Ultimately, like, isn’t that sort of the source and the heart of a lot of the least, you know, in older,

Tyler 46:27
you’re describing sort of the impact of what we call adverse childhood experiences. Yeah. In the medical industry call those aces in later in life.

Michael 46:35
Yeah, I got like six of them, I guess. There are

Tyler 46:39
forms of therapy that are really keyed into understanding the why and going deep and those, if you imagine like a classical on the couch type of therapy. It’s called psychodynamic therapy, it literally created by Freud and his colleagues, but it’s much more advanced. It’s not Freud’s old ideas. It’s a very advanced therapy. It’s a long term therapy with really the goal of understanding yourself better and where things come from. A lot of modern therapies for depression are very functional, like cognitive behavioral therapy is a little bit less about the why and about what to do. It’s very manualized. A lot of people find some real benefit from working with a therapist to go back in their life. I think we’d be really remiss if we didn’t talk about this, you know, you brought up that you had a number of adverse childhood events in your life. We know that men far underreport the amount of sexual and physical abuse that occurred in their life, we often play off physical abuse that happened early in our life as just growing up, you know, I had a rough childhood. And that’s the euphemism for I suffered physical or sexual abuse, you know, it’s like, you know, so so, you know, we should be you know, physical abuse, emotional abuse, sexual abuse, these are things that are done to children by abusers that cause long term psychological harm. And certainly exploring those with a professional especially if the ramifications of it echoing your head. So, you know, a lot of the a lot of the cruel things said during physical abuse, often replay in our head as adults or kind of harddrive and narrative as an adult,

Michael 48:13
all the fucking time. I mean, I know the source I can, sometimes I’m like, shut up, Mom, go fuck yourself, you know, that’s that negative, you know, you’re never gonna amount to nothing type of voice and I was able to identify that after many, many, many, many, many years, I think, I don’t know how many. But but it was psychotherapy. It wasn’t you know, I didn’t stumble upon it. And it was also the will the desire to go alright, something’s not right here. What do I do what I gotta do something. I want to go I want to shift to something that I wanted to bring up. But I kind of forgot. When when someone makes the make that decision to end their life? Is there a couple questions around that that moment? Is there anything you can do once? And maybe maybe there’s no info on this? But once they decide, Is it how long from they decide to they do it? And in that window? Is there an opportunity to talk someone off the ledge so to speak?

Tyler 49:17
Absolutely. There is. It’s not, it’s not the same for everybody. I think you’re in the United States. You live in the gun capital of the world. And one of the downsides of guns is when you decide to use them for suicide, there is no coming back from it. So there’s many other ways that people attempt suicide where we can intervene either during or after the attempt. If if a gunshot occurs, it’s usually quite fatal. And and so the ability to intervene usually is quite limited after the fact. So it’s all about what can you do to before the fact there’s some alarming you know, I don’t want to get too much into gun control stuff though. I’m a Canadian, and I think There’s way too many guns in America, I will say that a lot of guns are purchased by men for the purpose of suicide. And that sucks to know but states that enact waiting laws 30 days before you can buy the gun or something like that show pretty, pretty significant decreases in suicide and, and so gun control is definitely going to be a part of one of the larger evidence based ways to intervene, which is means restriction. So making it making it so that you have to use your brain to die is really important. Because we often when someone has a suicidal thought, it is fleeting. For some people, it’s fatalistic, and it’s well thought out, and there’s no changing it, you diagnosed with me, we mean with Alzheimer’s, I love my brain, I promise you, at some point, I would be like, I’d rather not be here. And there’s no there’ll be no convincing me otherwise. But for a lot of people, they have a type of suicidal ideation that we call the anomic suicidal motivation, which is basically, I got overwhelmed by stress, and I couldn’t figure my way out of it. And in those in those conditions, 99% of the time, it’s temporary. And there was a great old documentary called, I think it’s called jumpers. It was about Golden Gate, bridge jumpers, and, and how they had to install all these things, because it became such a famous bridge. And they interviewed people who had survived and universally that to a tee, there’s actually a follow up study of 100 people who survived, they all report regret while falling, you know, it’s a long way down. And while falling, they really, really like Man, it was really clear to me that this was a bad idea. So if there’s some way to add a pause between action, and thought, or sorry, thought and action, you’re probably going to really benefit that person. So anything that reduces means is really good. So in, in America, right now, you can go to any pharmacy get an over the counter version of a pain medication in enough quantity to die. Something as simple as having that in the UK. They’re in blister packs, and you can only get 20 at a time. You know, it’s restrictive, like Sorry, it’s encroaching on a freedom. But again, if you’re going to impulsively pop out 20 pills to take, it’s probably not impulsive right? Now, that’s where it’s taken, taking a bunch of pills is quite quick. So means restriction is a way. And if you if someone’s like, really in a moment, it is one of those things where you do kind of have dropped everything and make sure you help them access to professional, hey, let’s get into a hospital, you need to talk to someone, you know, I’ve been in this situation, I have this thing where all of my patients get my email address. And I’ve been in this situation where I get an email and I’m like, Oh, shit, tell me where you are. Right now. We’re getting. So yeah,

Michael 52:49
I can’t imagine what that said How effective are and I know, we’re hope you’re okay with time. If you’re not just, you know, you know, how effective are things like suicide lines, suicide chats, suicide websites, and like, you know, we’ll help you dial 888 or whatever.

Tyler 53:09
They’re, they’re helpful, I don’t want to say they’re not helpful. But when you really think about it, they’re catering to a group of people who clearly have some ambivalence about wanting to die. Why would you call a lion if you wanted to die, you call a lion, because you don’t want to die. You call a line, because you’re looking for help you call a lion, because you’re looking for someone to talk to you, you think that you’re heading down a pathway, you don’t really want to go. And so in some ways, they’re framed as suicide prevention devices, really their suicidality, intervention devices, great for that purpose. But if we really wanted to look at suicide prevention, I would guess there’s a whole bunch of people who know the numbers and just for whatever reason, decide, you know, what I’m not calling, of course, the they can’t be effective for those people. So I certainly am not in the camp of they shouldn’t be open. But I think we need to be very cautious in saying that the way we the way we prevent suicide is by having a national hotline. Because you’re almost always catering, those types of things to people who will reach out and you’re in a, you’re in a much more advantageous person pointed, you know, prospective if you’re already one of those types of people. And we really actually have to think about the people who don’t reach out. Now for some not knowing the number. Maybe that was a barrier. But for many, it’s not what the number is, it’s it’s not wanting to call.

Michael 54:28
Yeah, because I was thinking about how to find somebody to integrate that within this group somehow. So make it easier. But

Tyler 54:35
yeah, I think in a large group, you should always have content moderation. You know, you do want to make sure that, you know, someone really goes, it really goes south. We know that there’s a contagion effect. And so you really want to shut down those posts quickly. Put up numbers for people to call if they’re in distress and those types of things. And it’s not about the censoring or whatever. It’s about literally, if you’re in a bad space and you’re worried about someone else dying by suicide, it can be a contagion for yourself. And so you know, we do really do want to twin that content moderation.

Michael 55:13
Yeah, I wonder Yeah. Yeah. In my haze of dealing with this in I hate to. It’s not about me. It really isn’t. But when it had when I found out I was like, Okay. I gotta I gotta tell the group, right? Yeah. And then I found out and Eddie, I’ll get to your question, bro. And then I saw his daughter had a GoFundMe and I posted that. It’s also partly because Facebook algorithms are algorithms fucking suck. So I posted a shit on that thing. Because I wanted to say let’s, let’s, let’s get let’s get this contributed to but I also put in the message that you know, he lost his lead by suicide because I also wanted to drive the point home that we this happened, these things happen. We can’t let this happen like and so maybe maybe if I fucked up, I’ll be the first one to say it.

Tyler 56:07
Well, I was already seeing the direction your brain was going on that one, I’ll say, I’ll say if you’re having a caring, nuanced discussion about a human being, that’s okay. What we could what we worry about in contagion is lack of lack of protection in there. So So an example is, if all of a sudden newspaper was like 13, people jumped off the bridge yesterday. And here’s some pictures of their gory bodies. You know, that’s definitely going to have a contagion effect. But if if there’s like an article that’s talking about the realities of men dying by suicide, that’s new ones to that, you know, and so in the same way, you’re expressing grief, you’re using altruism, you’re talking about raising money. There’s a pull together effect that’s anti suicidal when people work together for a common cause. So we see after suicides, for example, many people who are touched by the suicide create societies are nonprofits based around that person’s debt. And no one would ever say, Oh, you’re creating contagion. They’re, you’re adding altruism to this world. So you know, as long as you’re adding nuance, as long as you’re, you’re treating it with respect, you’re not being salacious about it. Nobody needs to know method of death. That’s really Yeah. But that, that gets a little bit too specific. But I’ll tell a funny story about that. Right. But I was on the I was on the news after Robin Williams death. And they were interviewing me about mental illness. And it was, by the way, it was later revealed that Robin Williams had an advanced form of a rare form of dementia. That was one of the things that was really affecting his mental health. It wasn’t his alcohol or bipolar disorder, it was dementia. That was really negatively affecting him. But right after, right after they had me on, I was talking to the newscaster and I said, Whatever you do, please don’t mention the cause of death. Like this is just a basic suicide contagion thing. I go home, my wife’s watching it right after my segment, I would live to California and there’s this dude holding up a necktie saying like, I kid you not, it was like, just so so pretty, and salacious. You know, salaciousness is part of suicide. It’s it’s an interesting topic. It’s compelling topic. People always want to know how people always want to know the details. And and it is it is important when you’re affecting a large group of people to be effusive about the details to be to really include messages of help and how to reach out

Michael 58:44
a couple a couple more, and then I’ll let you go, my friend, I really appreciate you doing this. Sure. How much of a factor is alcohol and suicides?

Tyler 58:53
Well, it’s because alcohol, being acutely intoxicated makes you more impulsive, almost certainly, if you’re down and you’re drinking, that’s a recipe for increasing your suicidal risk. So if you’re drinking as a way to cope with depression as a way to numb your feelings, because things are really going poorly for you. You know, alcohol is going to be a big risk factor. You know, if you’re out partying with friends and having a good time, probably less so. But certainly alcohol plays into it and then we know that overall, and this stinks, I wish it wasn’t the case. Alcohol is a depressant. Like it literally long term use of alcohol makes us more depressed. It’s a It’s alcohol is a classic poison, it destabilizes the membranes of our brains, it’s not good for our bodies or brains. It’s a socially acceptable way to harm yourself, but it is harmful. And one of the ways that it poisons our brain is is increasing our chance of developing depression. So some people do sort of follow their feelings into the bottle and and that that goes against one of my principles. I’m very non judgmental about substance To use, but I’m always like with kids, I always say, seven C’s is supposed to be recreational. It’s not supposed to be therapeutic. If it was therapeutic, we’d be prescribing it, you’d be getting your oil, you’d be coming to the alcohol dispensing center, and I’d be writing a prescription for alcohol. But we know that it doesn’t help. It hardens you. So if you’re using alcohol, if you’re using drugs of abuse as ways to cope with distress, you’re likely harming yourself more than helping yourself.

Michael 1:00:27
A couple questions, Eddie is asking, would you say people prefer a gun over other methods of suicide? And I guess the question is around modality, like, how do what’s what are the percentages like what’s the

Tyler 1:00:41
most leader most suicides are by hanging? And and then, in the United States, there’s a much higher proportion of gun suicides? I would think in the United States, maybe gun suicides are number one, I’ll quickly I’ll quickly check.

Michael 1:00:57
Yeah, because I was wondering about that, because Canada doesn’t have as many guns and so I was wondering, I myself was gonna be like, Well, yeah, they’re out of

Tyler 1:01:04
firearms are number one in in America. 53%. So not even close. In the rest of the world. It’s not Spyros usually number two or three. But of course, there’s so many guns in the United States. Males are more likely to own guns than females are. So we see a higher percentage in in men than women of dying by firearm. Yeah.

Michael 1:01:32
And is that’s a whole other podcast. I think. He said, Ed, he’s asking another question. Thanks, Eddie. You said contagious, I think you might get a sick contagion. What do you think people learn this behavior as a means to cope with the pain, for example, school shootings, meaning that kids think, Oh, look, that other kid was pissed off and went on a shooting rampage? Do you think people learn this behavior?

Tyler 1:01:55
We often put things like school shootings under the guise of mental illness, but but really, you know, there was a FBI report looking at like mental illness rates in school shooters and things like that. And it’s not as much of a factor as we’d commonly believe it to be. You know, there’s a lot of, we know that shooters are disproportionately male. We know that there’s a lot of disaffected young youth. So disaffection is one of the main things they’re not fitting in with a group or feeling ostracized from a group. But not necessarily mental illness. Is that a learned behavior? I mean, self injury is definitely a learned behavior. One out of six kids in high school age will use self injury as a way from coping from their distress. So that involves involves cutting or scraping or scratching or burning are those types of things one in six, one and six. And it’s, it’s socially spread, because it works. And there’s a portion of people in population that when they inflict injury on themselves, it makes them feel better. And of course, we we know that it’s short term, that really, there’s better ways to handle our problems. But again, one of the non judgmental things I do is I say, Well, I get it, you were you were desperate, and this worked for you. So you’ve continued to use it. Kids have definitely started to teach them teach each other cutting. So we see, cutting is the primary the primary way that young people experience self injury now, and it’s way more common than it was, you know, 20 years ago.

Michael 1:03:28
I keep adding things. I promise I’ll stop. Would you? I’m trying to figure out which one I want to ask first. Yes, is this what if there’s one thing, and I hate to do that to pin you on to one thing, but if there’s one thing that you could do that you could change to prevent suicide? What would that be?

Tyler 1:03:49
Without question, it has to be, like a, like, if it was up to me, it would be everyone that I encounter leaves me feeling better than when I encountered. And, and if you make it, you know, be genuine, be yourself. Don’t be fake. But if you care about people, make sure you let them know be explicit about your care. Like, it is not easy to say, hey, just to let you know, I really love you like I would be really, really lost without you, man. Like, really, that’s a hard thing to just open up and say, but if you’re not explicit about it, when that person has the thought in their head, they don’t have that explicit counter message to it. Their brain says Oh, they’d rather you not be around. So, personally, I would say be genuine, be authentic, reach out and try to make people around us lives better. From a systems point of view. We have to treat suicide seriously. You know, there are so many campaigns about talking and my goodness, the number of politicians who talk about mental health, just astronomical. But suicide is is one of the top causes of death under the age of 50. Like usually one, two or three pounding on the nation and get compared to cancer. It’s like 1/20 of the research money. It’s it’s, you know, we got our suicide data, a year and a half after the years that occurs, you know, we need real time reporting, we need active measures. There’s a famous what there’s two famous nations for suicide, Japan and Korea, Japan in 2008, created a national policy for Suicide Prevention, the suicide rate was about 27 per 100,000. So way higher than America’s and over the last 10 years, over the next 10 years through a number of things, improving jobs, putting barriers in train stations, adding lots of work returned to work people for retirees, because they were having old people dying of suicide a lot. They reduced their number from 27 per 100,000 to 16. Per 100,000. Still slightly higher than America, but way closer, and, and so when a nation makes suicide a priority, we can actually reduce a number of deaths. And I never want to make it seem like all suicides are preventable, but a number of them can be intervened on, by simple things, like means restriction, making sure that we have safe communities, making people sure that people have access to health care. It always blows me away that I’m talking to someone in the richest nation in the world where there is no universal health care. Like it just blows me away.

Michael 1:06:26
I’ve traveled the world, my friend, and I’ve been in many places, and I did everywhere else has i You’re preaching to the choir,

Tyler 1:06:35
from the from the larger point of view, you know, it will require large systemic changes, like America definitely needs universal health care, there has to be a serious conversation about firearm firearms in the United States, because death by suicide is one of the commonest forms of fatality by firearm in the United States. You know, it’s it’s one of the big reasons that people die of guns in the United States. And so there’s some real conversations that are well beyond what you were I can do. But I always say, you’re in a local environment, you know, there’s a big difference to passing someone in the street and saying, Hey, how’s it going? And if they’re looking rough, saying, hey, no, really, it looks like having a rough time? Is there anything I can do to help just be one of those people be a helper, and the more helpers we have in this world, I think the better will be

Michael 1:07:19
is is hope, the antidote that sounds cheesy hope,

Tyler 1:07:23
hope is an anecdote for sure. But you never want hope to be saccharine. Like, bad things happen to good people. And, you know, some people’s don’t have easy fixes or easy solution. So just make sure hope isn’t saccharine? You know, if I’m working with someone who has, you know, I work in, in a lot of neuro psychiatric conditions where they have a degenerative course they’re gonna die very early, I’m working with young kids who are depressed who are going to die in their 30s. And, or even sooner, you know, I’m not gonna be like, Oh, things will be okay. It’ll be let’s, I want your life to be as good as it can be. And so as long as your hope isn’t saccharine and superficial, I think it can be really helpful.

Michael 1:08:07
Well, Tyler, Dr. Black. You clearly earned that title. Sir, I thank you for doing this. I really, really appreciate it. The last question I asked everybody is what words of wisdom would you impart to a man who has just started his divorce process?

Tyler 1:08:26
I mean, this is going to sound trite, but it’s not. And that’s that, you know, there is a new identity to find when you go through a divorce. And that identity is always going to be better than the identity of being in a relationship where the person didn’t love you the way that you wanted them to. And it you know, it’s always going to be that way. Losing your identity is challenging, but finding who you are, is the goal. That’s what we’re here to do. You know, we are human beings on a tiny ball of rock circling this vast universe, there is no grand scheme to anything except we really need to enjoy our lives, find out who we are, and make a positive impact on our world. And, and so divorce is really a challenging change in life, but it is one where you have the opportunity to to rediscover your identity.

Michael 1:09:23
Yeah, excellent words, my friend. Thank you very much. How can people find you? Are there any books or Yeah,

Tyler 1:09:31
I don’t, I don’t have anything really to plug. I I’ve generally found on twitter at at Tyler black 32. You know, I do suicide prevention talks and things like that and published a few articles but nothing to sell. So feel free to find me on Twitter and I hope you know, I can’t I can’t mention it enough. You know, before I hadn’t heard of, obviously the podcast pyre, you know, not divorced then. And lucky, you lucky, I dove into it. I’ve listened to a few episodes. I’ve I’ve scoped things out, you know, I did my due diligence before coming on. Because there are a lot of spaces where it’s quite bitter, and the masculinity has turned into a sort of, you know, you know what I mean? Oh, I

Michael 1:10:18
do see it,

Tyler 1:10:20
I will say that, that I really feel like you’ve done a really good job in fostering a caring and supportive and, and dare I say loving environment for for men who are going through what you you’ve been through. And if there’s one really healthy way to process a life, it’s through a loss. It’s through altruism. It’s one of the highest forms of defense mechanisms we have in this universe. And it helps, it really does help when you do things to help others it helps yourself so I just wanted to thank you for doing what you’re doing.

Michael 1:10:50
Thank you, sir. I really appreciate that. I try my best that’s for sure. Thank you again for joining us, Tyler. We will definitely do it again. And and we’ll definitely stay in touch.

Tyler 1:11:00
Thanks so much.

Episode 80 – Suicidologist – Dr Tyler Black


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