Finding Mastery with Dr. Michael Gervais - Dr. Mark Goulston, Suicide Prevention Expert

Episode Date: September 19, 2018

This week’s conversation is with Dr. Mark Goulston, a Board Certified Psychiatrist, a Fellow of the American Psychiatric Association and a former UCLA Assistant Clinical Professor of Psychiatry.Mark has specialized in psychotherapy for more than thirty years focusing on suicide prevention, death and dying, depression, anxiety, personality disorders, PTSD and marital therapy.After a recent string of high-profile suicides in America, death by suicide is a topic that's on a lot of our minds. Most of us are likely to know or love somebody who has been affected by a suicide.Since September is Suicide Prevention Month, this is a good time to seek understanding about these tragic experiences.You might be surprised by the global rate of suicide:According to the World Health Organization, "Close to 800,000 people die due to suicide every year, which is one person every 40 seconds. Many more attempt suicide. For every person who commit suicide, there's another 20 who attempted."My family has been impacted by suicide - I lost my uncle to this way of dying. Everyone who loved him dearly wishes we could have helped, but we couldn't.This conversation is about learning how to better connect with those in need - through listening, empathy and compassion._________________Subscribe to our Youtube Channel for more powerful conversations at the intersection of high performance, leadership, and meaning: https://www.youtube.com/c/FindingMasteryGet exclusive discounts and support our amazing sponsors! Go to: https://findingmastery.com/sponsors/Subscribe to the Finding Mastery newsletter for weekly high performance insights: https://www.findingmastery.com/newsletter Download Dr. Mike's Morning Mindset Routine! https://www.findingmastery.com/morningmindsetFollow us on Instagram, LinkedIn, and X.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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And by trade and training, I'm a sport and performance psychologist. And the whole idea behind these conversations is to learn. To learn the applied lessons and insights from people who are on the path of mastery. We want to understand much further, much deeper than their tactics. We want to understand what they're searching for, where they came from, the understandings that they've struggled with. And in doing so, we want to understand the mental skills that they've used to build and refine their craft. Finding Mastery is brought to you by LinkedIn Sales Solutions. In any high-performing environment that I've been part of, from elite teams to executive boardrooms. One thing holds true. Meaningful relationships are at the center

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That's linkedin.com slash deal. That's linkedin.com slash deal. For two full months for free, terms and conditions apply. Finding Mastery is brought to you by David Protein. I'm pretty intentional about what I eat, and the majority of my nutrition comes from whole foods. And when I'm traveling or in between meals, on a demanding day certainly, I need something quick that will support the way that I feel and think and perform.

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understated, not just for strength, but for energy and focus, recovery, for longevity. And I love that David is making that easier. So if you're trying to hit your daily protein goals with something seamless, I'd love for you to go check them out. Get a free variety pack, a $25 value and 10% off for life when you head to davidprotein.com slash finding mastery. That's David, D-A-V-I-D, protein, P-R-O-T-E-I-N.com slash finding mastery. All right, this week's conversation is with Dr. Mark Golston. He is a classically trained psychiatrist. He's no longer practicing that

form of medicine now. He's a fellow of the American Psychiatric Association and a former UCLA assistant clinical professor of psychiatry. He understands the craft and he's used that craft in his approach working with clients for many years and he's applied it in a variety of different forms to help people. And Mark has specialized in psychotherapy for more than 30 years. And one of the focuses that he spent a lot of time on is suicide prevention, death and dying, depression, anxiety, personality disorders, PTSD, and marital therapy. And after a recent string of high profile suicides in America, death by suicide is a topic that's been on a lot of people's minds for sure. And most of us are likely to know or love somebody who has been affected by suicide. And September is suicide prevention month. So the timing is eloquent for this conversation. or love somebody who has been affected by suicide.

And September is Suicide Prevention Month. So the timing is eloquent for this conversation. It's just a good time to better understand what is happening internally for people that are struggling. And it's not what you think. And we talk about this in the conversation. It's really that they've run out of choices because the pain is so bad. The internal pain is so bad for them that there's no way through it.

And it seems like a good solution for many of them. Now there's twists to that. There's many layers and nuances and textures to how complicated suicide is. But some of the twists we get into this conversation, which makes this a charged conversation for sure. And I think if you haven't been affected by suicide, you might be surprised by the global rate of it. According to the World Health Organization, close to 800,000 people every year die to suicide, which is one person for every 40 seconds. And many more attempt suicide. And the thought behind that is for every person that does commit suicide, there's another 20 people who have attempted.

And so my family has been impacted by suicide, losing my uncle to this way of dying. And everyone who loved him dearly wishes that we could have helped and we couldn't, we were not able to do that. So this conversation is important. It's important for me. It's important if you know someone that has been affected and is either attempted or has committed suicide. And maybe more importantly, because we can do something about it, this conversation hopefully is about you being armed if you're thinking about suicide or are in a dark place, you being armed with some insights and processes that might help you and or someone that you might know that's struggling. So there is nothing more important than saying, hey, it's all right, I'm screwed up.

I'm a mess right now. And that is the beginnings of us to be able to have conversations with other people to help us get to a place where we can find professional help. You don't have to do it alone. There's thousands and millions of people across the globe that are classically trained in this form of struggle. This conversation is about living and listening and relationships and empathy and compassion, and it's bundled in a conversation that is challenging around suicide and suicidality. So with that, let's jump right into this conversation with Dr. Mark Goulston. Mark, how are you? I'm great. Glad to see you, Mike. It's been a while. It's been too long.

So what happens when two shrinks walk into an office? They get shorter than all the people else who come in there. Hopefully they don't bore the heck out of each other. This, I'll bet the farm that there's nothing boring about this conversation. I've been fortunate enough to know you for a long time. I've watched what you've done and the significance you've had in people's lives that I know, the care you've taken to spend dinners and conversations with me about love and life and relationships and professional growth. And it's about freaking time we finally got together. That's the way I think about this.

And as a background, you're classically trained as a psychiatrist is that right yes and let's just do for some folks don't know the difference between psychiatry and psychology so I'm classically trained as a psychologist with a specialization in sport you're classically trained as a medical provider as a as a physician, if you will, prescribe medication. I could prescribe medications. And it was interesting because I was kind of a dinosaur in the sense that I focused more on psychotherapy than medication. In fact, a lot of psychiatrists would refer me to their suicidal patients. UCLA would refer me to their suicidal patients.

One of my earliest mentors was a psychologist who was the pioneer in the field of suicide. His name was Dr. Ed Schneidman, and he was the founder of the American Association of Suicidology. He co-founded the Suicide Prevention Centers in Washington and L.A. And he referred me the beginning of my practice. And so this is triggering things. Can I just go into it? Yeah, yeah. So Ed was this sort of this amazing, caring, eccentric person who was tolerated at UCLA because he just published so much.

And he had an interesting background. What happened is he got into the study of suicide because he was at the VA hospital in West LA. And he ran into the coroner for LA and said, I got about 5,000 suicide notes. You want them before we throw them out? So he made a study of suicide notes to see if he could really detect, you know, things about their personalities. And so he became this suicide specialist. And by the time he mentored me, though, what would happen is he would do consults in the inpatient wards at UCLA, and there were some highly suicidal patients who were still suicidal but needed to be discharged. They weren't acutely suicidal, and you can't keep them there forever,

but the residents didn't want to see them as outpatients, so Ed would go up to a consultation, and he would call me, and this would be exactly what he would say each time. Mark, this is Ed. I'm here with this lovely young woman. I'm here with this handsome young man. They're in a lot of pain, Mark. You could help them, see them, and then you put them on the phone and then they could be discharged. And so early on, I had a fairly suicidal practice. But what I learned early on is that when I started sounding pedantic or academic, I'd look into their eyes, and their eyes would say, nice try, doc, you missed.

And since I was fortunate that I didn't have to check boxes or report to a clinic, I just threw away everything I'd learned, and I just learned to listen into their eyes. What does that mean? Well, I'll give you, here's an example of the difference between listening to someone and listening into someone, and I'm going to do it with you right here, right now, real time. I love when you do this to me. It's so good. So when I listen to you, you know, you've asked the appropriate questions.

You got a little bit of my background. You know, hopefully that passes the sniff test a little bit. But when I listen into you, and we're doing this looking into each other's eyes, this is a calling for you. It's not just a job. And you really care about what you do. And you're always listening for things that will make your listeners' lives better, hopefully immediately. I hope this goes well because you're also listening for the crappy experts where you're thinking, I can't broadcast this. I got to protect my listeners. And I don't know what I say to this person. It didn't come up. We can't use it.

So you have a calling where you're really protective of the trust that your listeners and your clients have in you. And it's not just your credibility. It's, it's your calling. So is that, is that true? Yeah. And how do you do that? How the S you know, uh, here's, I'll play it back to you is that I I'm compelled to follow the trail that is in thin herd right now. So I'm in the thin herd is what it feels like. And I'm compelled to carve it and follow the thin herd as best as I possibly can. And, and that's not for any other reason other than curiosity. And I do feel a responsibility in the broadcasting, you know, and the broadcasting is like a new part of my life, but then the same is true for people that are sitting across from me in a chair one-on-one or, you know, a handful of people in a locker room.

Like there's that same responsibility that I feel. And I don't know if you know that because you feel that or you're just have looked into my soul through my eyes and that's where it comes from. That's a little bit of both. Did it feel different when I said this was my listening to you and this was my listening into you? Complete different. What was the difference from your point of view? head, and hopefully a little bit of my heart. And when you're talking about listening into you, it's as my heart thumped a little bit like, Oh, what's he going to hear? And what am I going to give away? Because I know I'm always giving away. I'm not a good poker player. I'm always giving things away. And most people, you know, speak through their micro expressions as much as they

do within the words that they choose. And so I just wondered what you're going to see and hear. Then what it felt like, though, is that it was something far deeper than the cognitive and intellectual aspect of the person that I am. And so what did you internally feel in terms of, did it spook you? Did you hold back? Did you lean into it? Did you, or did you check the box and say, damn, Mark, you nailed it. I mean, yeah, it was more of that. It was like, I was watching you work more so than I was watching me work. Well, we'll see if we can fix that during the interview. Yeah, that's great. Okay. So you had early days with suicide and I can't imagine a more stressful practice and a more honest practice. So the relationships that I've had with people that are on the edge of, um, or have taken a run at it and it didn't work out the way they wanted or they wanted to be rescued.

Like it's complicated. It's an honest, deep, rich, intense conversation slash relationship with these men and women. And I can't imagine having, you know, almost a full practice of them. How did you do that? And we'll get to this as it unfolds. What have you learned? So first, how did you do it? Well, as I was saying, as people came out, and these were often multiple suicide attempters, the more that I tried to check boxes, the more that I asked them questions, the more I could see them disengage in their eyes, and they would nod, and the nod would

tell me, you missed. You're a professional. You'll probably put it in your medical record, and you'll need that when my family sues you when I frickin' kill myself. So you can recognize that look. Oh, yeah. Can you paint that picture? I'll tell you what happened, because in my book, Just Listen, Just Listen is about listening into people. It's about helping people to feel felt.

And feeling felt is much different than feeling understood. When you feel felt, you feel less alone. There you go. And when you feel less alone and you feel felt, your oxytocin goes through the roof, your cortisol goes down, your amygdala goes back into your holster, the blood flow goes from your lower primitive brain because it was all cortisol and amygdala up. And what happens is when people bond and they feel felt, they start to cry

because they feel less alone. When they cry and they feel less alone, what happens is, as I said, their oxytocin goes up, the blood goes more from their primitive brain to their upper brain, and you let them cry. You don't make them cry. And then if you stay with them, you can feel them heal into the conversation. And probably the most dramatic example of that was a woman that I'll call Nancy. So Ed had referred her to me, and she'd made multiple attempts, had been in the hospital three to four months every year for the previous five, six years. And I was seeing her, and I felt I was making no progress.

She would come in. She would hardly look at me. She would look 20 to 30 degrees to the left or right. She wasn't catatonic, but she wasn't engaged. And I didn't think I was helping her. And I was seeing her for six months. And that's the longest she went without a suicide attempt or hospitalization. And I used to moonlight at one of the state hospitals.

There's a state hospital called Metropolitan Hospital here. And so on weekends, I would cover for other psychiatrists. I'd admit patients, you know, pick up a few extra bucks. But sometimes you wouldn't sleep for 36 hours. So on one weekend, I hadn't slept for 36 hours. And in comes Nancy on a Monday. And I'm seated with her about the same distance that you and I are, except she's not looking at me the way you're looking at me. And I'm seated with her, and suddenly all the color in the room as I'm looking at it turns to black and white. So I'm looking out, and the room is black and white. And I'm sleep-deprived, and I thought, well, that's kind of interesting. And then the room got very cold and chilly. My skin just

started to freeze on me, and I thought I was having a stroke or seizure. I'm a medical doctor, so she wasn't looking at me. So I did a neurologic exam on myself. I was tapping my knees, tapping my, you know, looking at my finger from side to side, and she's not looking at me because I thought I was having a stroke or seizure. So I'm doing this. And I thought... And you're trying to play it cool. I'm trying to play it. Well, she's not looking at me, but I want to see if I'm having a stroke or seizure. So I'm doing a neurologic exam on myself. She, you know, I'm sneaking it. She's not looking at me. And so I do it and I say, wow, I'm all here. It's not a stroke or seizure. And then I thought, I don't know how it happened, but I am looking at the

world through her eyes. And so I thought this and then it turned out that I blurted it out so I thought I was in big trouble so what came out of me because I was sleep deprived is Nancy I didn't know it was so bad and I can't help you kill yourself

but if you do I will still think well of you. I'll miss you. Goodness. And maybe I'll understand why you had to, to get out of the pain. And I thought I'd just given her permission. And that's the first time she makes eye contact with me. And she looks at me and she looks right through me. And in the moment she looks right through me, kind of like I'm looking at you, I realize that I had seen the world through her eyes. And she looks at me, and she says, if you can really understand why I might have to kill myself to get out of the pain,

maybe I won't need to. And then she smiled, and her suicidality went away. So I listened to her from her inside out. I helped her feel less alone in pain, in hell. And with that, she found hope. So one of the reasons I do it, and this is why I'm trying to retrain suicide hotlines, and give them some empathic skills, because what I've learned to do is instead of classifying people out of my own anxiety and professionalism, I just dive into their eyes. And I'll share something that I've come up with, which I'm going to be teaching to suicide hotlines.

And if anyone's listening in and they know of a connection to a suicide hotline or conferences where they get training, I hope you'll put in a good word because one of the problems is I'm an outlier. I'm a little bit like you. And so what happens is it's tough to break through. I've been trying to share what I've now learned because what I was able to do with Nancy, I've now made scalable so other people can do it with other people. So I wasn't scalable. So after 25 years, I did get compassioned out. And then I went into the business world. And after about 15 years in the business world, what I realized is it was all up to me unless I made something scalable, unless I came up with a process that other people could

do. So after hearing that over and over again, and I've syndicated columns and multiple business journals, I blogged for the Harvard Business Review. 460,000? Yeah, copies of my books. But what I've learned to do is scale things. Here are processes. Here are the steps that you can follow so that it doesn't have to be me.

So what's happened with the uptick in suicides, and I have a special passion for veterans, and the number is 20 or 22 veterans kill themselves every day. If you drill down into that, 20 or 22 veterans kill themselves every day, that must mean 10 times that try and don't succeed. That must mean 100 times that think every day, what's the point? What's the point of going on? So we're talking tens of thousands of veterans every day who think, what's the point? They just haven't gotten to the low point. And so I'm very excited.

And one of the programs that I've developed is something called The Road Back from Hell. And it's how to talk and walk veterans through their life to the point where they're looking down the barrel of a gun, to the point where they surrender and then come out of it. But here's the tip I want to give to suicide hotlines if I can. So here are some tips and approaches that you can use if you're worried about someone who's depressed or suicidal in your life. But I'm wanting to give it to suicide hotlines,

and they don't have to hire me because I'm going to give you the whole thing in about five minutes right now. That's what I'm talking about. That's not good business strategy. Well, I'm not a business person. I just try to save lives here. Anyway, anyway. But if you want the full enchilada, you'll have to bring me in.

So imagine this. Someone calls in, says, I feel like hurting myself. I feel like killing myself. What you want to do is build rapport. And the way you build rapport, and you can use this with anyone, is you focus on four things that have emotional juice on them. Hyperbole, which is awful, horrendous. Inflection, I'm not sure I can take this much longer.

And people really get into this if you focus on adjectives, that embellishes a noun, adverbs embellish a verb, you know, makes them more powerful. So hyperbole, inflection, adjectives and adverbs all have emotional juice, and they are invitations into more. So if someone calls in and they say, you know, I feel like killing myself, I don't know if I can take it anymore, you let them vent that. Pause for a second, at least, because you want them to feel that you've considered it, that you're not giving them a by-the-book answer. Pause for one to two seconds, and then you go, say more about the killing yourself.

Or say more about, I can't take it anymore. And in my book, Just Listen, I have things called conversation deepeners, and that's one of them. You focus on the emotional word or phrase, and they say more about that. And what you'll notice, and if you're doing it with someone in person, you'll notice that they start to say even more because you're inviting them to say more. And then when they finish that, another conversation deepener from just listen is you say, really? Not really, but really? And that's inviting them to say more. And they say, oh, yeah, I can't take this anymore. I mean, I've tried everything, and I'm a big fucking loser,

blah, blah, blah, blah, blah. And then you can say, say more about that. So you use that to build rapport. But then what you want to do is you want to break the stranglehold they have on suicide as the only way out of their pain. Suicidal people don't want to kill themselves. They want a way out of the pain, and nothing else works, and they have a stranglehold. They fixate on that, and so you want to break that. So you build a rapport.

And then at that point, here's the pattern interrupter. You say seven words. And they're going to say, what? You say, yeah, seven words. And they're going to go, what? And so what's happened? They say, what? Because you've broken it.

You've built a rapport. You've broken into them. And then you say to them, yeah, seven words, hurt, afraid, angry, ashamed, alone, lonely, tired. Pick one. Some of these people say, I got them all. All of them. All of them. Great. Now, the reason you do that, that's what I call interventional empathy. See, that's different than saying, do you feel angry? Oh, the guy's checking the box. He wants to be able to click on the buckets. Do you feel lonely? Oh, he's doing that again. And the point is when you ask questions, it doesn't invite someone semantically into the relationship with you. But when you already know they feel those things and you say those words, pick one,

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You spell it F-E-L-I-X-G-R-A-Y.com and use the code Finding Mastery 20 at FelixGray.com for 20% off. That's a really thoughtful strategy, right? Because one, I love the pattern interruption. And I didn't know that that was really a thing until I was in a crisis. I was in a crisis with an athlete in a consequential environment. And he and I partnered up on having a rock solid psychological framework to deal with a very consequential environment. And it was on. And his eyes turned as big as saucers. His heart rate was actually fine. We're measuring his heart rate. He started to have some beads of sweat. And so there was a disconnection, right? His heart was fine. He was sweating and his eyes were huge and he's looking for help. And it's like, I made it

up. I'm sure somewhere, somewhere like this is taught to us at an early age, but you're reminding me or reminding all of us in the importance of an interruption of the story. And so I said, how tall is yellow? He said, what, what? Like I'm dying over here is what he's saying. You're asking me about, he goes, and I said, yeah, how tall is yellow? And he says, what are you talking about? I said, okay. All right. And so I just want you to do some simple math actually to help us get through this. The math was not necessary. And so he did some simple math. So I kind of got that system on board and away from the amygdala into some thinking, but it was simple, simple, simple strategies. And it just interrupted the whole cascade of neurochemical, neuroelectrical psychobabble that he was working through internally. And so what you've just done is introduced the same thing, seven words. And what I love is that you

give them the choice to tell you where to go. To recap, you build the rapport by focusing on emotionally charged words, hyperbole, inflection, adjectives, adverbs, you build a rapport. So you're saying those back to them? No, you're saying to them, say more about the horrendous. Okay. So you're picking up on their adjectives, their adverbs, their hyperbole. And then, so you're saying, say more about one of them. Say more about what you're saying. So what you're saying is that's the tip of the iceberg. Instead of my rushing in because I'm anxious and I want to give you a solution, why don't you give me more of the iceberg? And as they begin to tell you more of the iceberg,

if you watch them, you're going to see them relax. And as they relax, they're building rapport with you. But in my area, which is saving lives, you want to go into the dark night of the soul. And the dark night of the soul, and I wrote a piece which went viral called Why People Kill Themselves, It's Not Depression. And what I wrote about is that hundreds of millions of people are depressed. They don't all kill themselves. It contributes to suicide. But one of the things almost all suicidal people feel at the moment they do it is they feel despair. And if you break the word despair into D-E-S-P-A-I-R, it means unpaired with the

reasons to live. Hopeless, helpless, worthless, meaningless, useless, pointless. And they pair with death to take the pain away. So this approach is pairing with them to break their pairing with death, and they'll pair with you. See, the death ends the pain. It doesn't relieve the anguish as compassion and empathy. So when you then give them the seven words and they repeat them, they're again expressing their feelings. And then you want to go even deeper and say, pick one. Give me an example of when it was at its worst. Now, there's an interesting thing when you ask someone to granularly go back to an event

because what happens is they immediately go back there. See, you sense that when I shared my story, you sense, Mark, you're back there again. And so when you get someone to share their, their worst memory of when they felt ashamed or angry or alone or tired, as they're sharing it with you, they're reliving it. They're reliving it with you when they felt it all alone. So when you're reliving it, when they're reliving it with you, instead of feeling alone, the oxytocin goes up. And that is the cuddle chemical. That's the chemical that we release to bond with people. Right? Yeah. So just so we're clear on that. Yeah. And so when you do that and they relive it, they have the chance to change their relationship to the event.

See, I wrote a book called PTSD for Dummies, and I've been trying to change the diagnosis. I've been trying to kill the diagnosis PTSD because I think it's useless. What people really live, and I think you're going to like this, people don't have PTSD. What they have is a re-traumatization avoidance, what I call RTA. You ask anyone who's been deeply traumatized and you look at them and say, good for you, you got over it.

How much courage? You look them in the eye and they say, I didn't get over it. What do you mean? I got past it, but I didn't get over it. What do you mean? I got past it, but I didn't get over it. I'm not the same. What do you mean? I don't fully step into anything with two feet anymore.

I'm cautious slash paranoid. I don't go near fill-in-the-blank situations. I don't go such and situations. I think about those things and it's scary. And yeah, there you go. So you're calling it re-traumatization avoidance? Yeah, because all... That's exactly what it is. Because what they think is, I don't know how I survived it the first time. If I go back again, or if I re-experience it again, it'll take me down for sure. So I do everything I can to avoid it. I numb it. I drink. So when you think of veterans, when they're driving in their pickup truck and they're feeling

relaxed because they're not around people, because all the people at home don't understand them. And so they're relaxed. And then there's a, and then a car backfires. They get re-traumatized. But they organize their life to avoid it. That's right. Yeah. And then are you working at the APA level to get that change? Or is this a quiet mission that you're on? I'm on a quiet mission because what happens is I get a lot of pushback by the not invented here.

But here's how I've broken through it. Oh, those people. You know them. Oh, those people. You know them. Oh, yeah. See, what I'm finding is internal champions who've had a son or daughter kill themselves, or they themselves have been suicidal, and all the conventional approaches, which are great, but they don't reach that core. They help you cope, but you don't heal. In fact, I'm putting

together a webinar at my site called Why Cope When You Can Heal and Thrive the Road Back from Hell. So you've used that title twice, being in hell. And I're the image that i have is when somebody has such lonely despair right the the deepest the where they thought the end of abyss might be that they're they've gone past it and they feel completely alone that you're bonding with them you're building rapport out of respect rapport first you're connecting with them they're having a neurochemical exchange you're bonding with them. You're building rapport out of respect, rapport first, you're connecting with them. They're having a neurochemical exchange. You're asking them to reorganize by telling the story again with oxytocin on board, as opposed to cortisol on board. And then therein has a neurochemical,

neuroelectrical, maybe even neurostructural change. Absolutely. Right. And then from that point place, potentially a psychological change. So you're working from a neuro, you're working from psychology into neurochemistry and biology back to psychology. Yeah. Okay. And the psychology means the rapport, like using the, um, I, the, the, the bag of tissue that we are to relate to one another. Right. Okay. Yeah. Mark, that's really good. I've got a, I'm mentoring a young man who jumped off the Golden Gate Bridge and survived. His name is Kevin Hines. He speaks 300 days a year. They made a movie about him called suicide, the ripple effect. Uh, he has a mission it's and whenever he speaks, he's amazing. It's hashtag be here tomorrow.

And I'm mentoring him. And we had about a two or three hour interview that he taped a month ago. And this is when we bonded. So as we were talking, I'm kind of listening into him. And he's asking me questions about, can you explain how I felt and what I felt? And so I'm doing that. And then he says, okay. And this gets back to, you know, pick an event. You know, pick an event when you feel one of those words. And so he says, okay, Mark, you get to ask me a question.

I said, take me back to the nanosecond when you went over the rails. Can you feel that? Yeah, the mix of anxiety and commitment. And so he paused. And this will really tell you about neurochemistry despair. He said, all I could think about was getting out of the pain. But when I went over the rails, I immediately woke up. And why did he wake up?

Because he paired with death in two seconds and the pain would be away. And knowing that the pain would be away, he realized he didn't want to die. What have I done? That's right. And I don't know what happened, but it's one of those things where life must slow down. But he had two seconds before he hit the water. So he realized, I better go in feet first. I'll break both legs, but I probably won't die if I make it. If I go in head first, I'll be dead. So he made sure he went in feet first. He broke both legs. He went on about 70 feet because that's what they calculate. He swam to the surface. And this is part of his story. I don't know if it's an urban legend, but he believes it.

He says, I was bobbing up and down, and someone saw me, and I guess they call it a coast guard, and I was bobbing up and down, and I felt something lift me up as I was coming to the surface, and there was a seal holding me up on its back. And the coast guard came over, you know, and they saved me. But in that moment he got crystal clarity because he got a huge oxytocin burst from, I'm going to die. The pain's going to be away. If the pain's going to be away, I don't want to die. So that's really amazing. This is, so you've brought up two extreme events, but one is your psychic break where you felt, saw and experienced what another person was experiencing.

That's like a break in reality. You know, so one that's not lost on me. And the second is this quote unquote miracle, actual connection with another compassionate animal saving somebody you know in his water right because i want to i want to pull in that thread for a minute in a minute but the thought so i'm haunted right now the thought of the space of on the edge of the bridge anxious lonely pain hurting now there's a choice you can get up on the edge of the bridge, anxious, lonely, pain, hurting. Now there's a choice. You can get up on the railing, and there's still a choice.

Get off, or you can jump. And so that calculation, that space between commitment and hesitation is really powerful. The story that I'm about to tell you is haunting. My uncle killed himself. And he put himself on a train track. Now, this was my favorite uncle. This was my uncle who, he was like, he was great. He was fun.

He was wonderful. He had mental illness. Went through a lot of pain. Nobody quite could reach him. And so here I am, a professional in the field. Can't quite reach him. And so we got a call one day. He put himself on a train track.

And so the haunting thought. Where were you when you got the call and what did the person say? I don't know. Isn't that phenomenal? Someone called you, like your family? Yeah, it was a family member. I think it was. And then said, Uncle So-and-so? It was a freaking text. Talk about dysfunction of my family. got a text yeah i don't know i do not

remember where i was though actually it's a i it's hard for me to even go back to that experience like where i was what it was like it was like it was so it wasn't like this big but oh my god my life changed it was like oh you know so it was it was different than a traumatic experience you know so much so that i don't remember those details of it but the thought that he laid himself down and had a choice looked up and so the conductor got back to our family that so the conductor was traumatized because they made eye contact how about? And so all of that being said is that the thought that he might've had a choice, but it was too late. He was in a lot of pain, drugs were on board, really difficult to reach. And he was, he made a decision. I don't feel traumatized by it,

but the idea that he could have maybe, maybe gotten to a place where he didn't want that decision to be made, like your friend. Well, there's a back story to all of this stuff. And you'll see the power of reliving something. It's the back story for everything. We got time for this, or can I run away from it? I'm right here with you. Oh, God. So one of my greatest personal accomplishments and, you know, I'm humbled that apparently I've accomplished a lot. But I think my

greatest personal accomplishment is I dropped out of medical school twice and finished. And I didn't drop out to see the world. I had untreated depression. And the first time I dropped out, I took a leave of absence because I was passing everything, and I worked in blue-collar jobs, and I loved them. I mean, I still romanticize them. I have wet dreams over those jobs because there was no responsibility. It was simple.

You know, at 5 o'clock, I was done. I have a couple beers. I mean, I was a real American. And then I came back after working in a blue-collar job, and I was highlighting my book, every book in yellow, because I could read it, but I couldn't recall it. I come back, and in three months, it's all back again. So I ask for another non-consecutive leave of absence.

Now, what you may not know is that medical schools lose matching funds when someone takes a leave of absence. So the tuition doesn't cover the expense. And so if there's an empty seat, they're losing thousands of dollars. I didn't know that. And so I'm going to ask for a second leave of absence. And I meet with the dean of the school. The dean of the school is the big honcho and he cares about money. I don't remember meeting with him. And then Dean William McNary, Boston Irish Catholic, we called him Mac, calls me. And he says, Mac, Mac, this is Mac, Mac,

you better come in here. Got a letter from the dean, the other guy. Better come in here. So I go in there, and I was sort of in a low point. A low point. And he says, Mark, better read this letter. So I read the letter. It's from the main dean, and it says,

have met with Mr. Goulston, discussed an alternate career, perhaps the cello. There's a guy who's really in tune with pain and suffering, right? Perhaps the cello. I'm advising the promotions committee that he be asked to withdraw, which means I wasn't flunking, so they couldn't kick me out,

but they could put pressure on me to withdraw. So I read the letter. I'm confused. I mean, I'm kind of a broken guy. And I come from a background, you know, good, hardworking parents, dad, product of the depression, but also taught you that if you can't do anything, you're not that mindset. If you're listening, you may know someone like that. So I said, what does that mean? He says, Mark, you've been kicked out. And I thought I was being shot. And I know what a gunshot wound feels like because I had a perforated colon about 12 years ago. And so when he said that, I sort of went, and something was wet on my cheek

and I thought I was bleeding. So I'm not spiritual, but this gets like resurrection type time. And I thought I was bleeding and I kept looking at hands. And it wasn't blood, it was tears. And he said to me, so imagine this. You don't feel worth anything. You're feeling unpaired with everything. Hadn't reached suicidal because I didn't know that I was kicked out, going to be kicked out. So imagine hearing this.

And Kevin Hines, imagine if you heard this before you went to the Golden Gate Bridge. He said, Mark, you didn't screw up. In fact, you're passing everything. It's kind of a miracle. But you are screwed up. But if you get unscrewed up, I think the school would be one day glad they gave you a second chance, Mark. So whatever those blood was, it starts to turn to tears.

I mean, I am just sobbing. I can't look. I can hardly look at you because I'm reliving it. So imagine you're broken. You feel useless. And he says, and Mark, even if you don't get unscrewed up, even if you don't become a doctor, even if you don't do another thing the rest of your life,

I'd be proud to know you because you have goodness in you that we don't grade in medical school, and you have no idea how much the world needs that goodness, and you're not going to know it until you're 35, but you're going to make it until you're 35. And then I just looked away at him, and I'm just sobbing, and he says, you look at me. You look at me.

And he pointed at me. He said, you deserve to be on this planet. Do you understand me? You deserve to be on this planet, and you're going to let me help you. If he had said, oh, if I can help you, call me. I never would have called him. I would have gone back to my apartment. You know, maybe I'd be alive. Maybe I wouldn't be. But what happened is he saw a future for me. He saw value as me as a human being. You don't have to do anything, Mark. You got something in you that the world needs and we don't grade it. You're just going to stay around long enough. And by the way, I'm

going to stand up for you because I don't think you can do it on your own. It flipped everything. It flipped everything. And it was interesting. I just spoke to someone a few hours ago that I hadn't spoken to in about five years. His name is Reverend Jim Kowalski. He's the dean pastor of St. John the Divine in Manhattan. It's the largest Gothic cathedral in Manhattan. I just spoke to him. And I remember I was telling him the story about Dean McNary. And when I was telling him the story about five years ago, and I'm almost feeling it now, is my

whole body starts to flush. I can feel warmth. Maybe you're helping me with this or I'm recalling it. And I said, Jim, Dean McNary was an angel. He was a real angel. I'm not even the right religion. And he was sent to save me. And without missing a beat, he said, yes, he was, Mark. Now, there's good and bad news when an angel steps in your life. The good news is it changes the way you walk in the world.

The bad news, and it's not bad news, is you are forever compelled to pay it forward. And that's why this mission to scale empathy, to get other people to break through to people who are depressed, to get through people they're not getting through. I'm living the reason I was born. Doesn't get much better than that, Mike. Yeah. Finding Mastery is brought to you by Cozy Earth. Over the years, I've learned that recovery doesn't just happen when we sleep. It starts with how we transition and wind down. And that's why I've built intentional routines into the way that I close my day. And Cozy Earth has become a new part of that. Their bedding, it's incredibly soft, like next level soft. And what surprised me the most is how much it actually helps regulate temperature. I tend to run warm at night and these sheets have helped me sleep cooler and

more consistently, which has made a meaningful difference in how I show up the next day for myself, my family, and our team here at Finding Mastery. It's become part of my nightly routine. Throw on their lounge pants or pajamas, crawl into bed under their sheets, and my nervous system starts to settle. They also offer a 100-night sleep trial and a 10-year warranty on all of their bedding, which tells me, tells you that they believe in the long-term value of what they're creating. If you're ready to upgrade your rest and turn your bed into a better recovery zone, use the code FINDINGMASTERY for 40% off at CozyEarth.com. That's a great discount for our community. Again, the code is Finding Mastery for 40% off at CozyEarth.com. Finding Mastery is brought to you by Caldera Lab. I believe that the way we do small things in life

is how we do all things. And for me, that includes how I take care of my body. I've been using Caldera Lab for years now. And what keeps me coming back, it's really simple. Their products are simple and they reflect the kind of intentional living that I want to build into every part of my day. And they make my morning routine really easy. They've got some great new products I think you'll be interested in. A shampoo, conditioner, and a hair serum. With Caldera Lab, it's not about adding more. It's about choosing better. And when your day demands clarity and energy and presence, the way you prepare for it matters. If you're looking for

high quality personal care products that elevate your routine without complicating it, I'd love for you to check them out. Head to calderalab.com slash finding mastery and use the code finding mastery at checkout for 20 off your first order that's caldera lab c-a-l-d-e-r-l-a-b dot com slash finding mastery well done no life well done thank you for sharing thank you for reliving and and sharing from an authentic place that is not easy to do. And so, I feel a lot being in this conversation. So thank you. Give me some facts and basic, some basic pillar facts about suicide. And what are some of those numbers that are current that you're aware of? Well, I just read yesterday, they said one third of all American college students have mental issues. I saw that as well. I also heard that I think the executive director of the American Foundation for Suicide Prevention said five to 10 percent of college students had suicidal thoughts in the last two to three weeks.

That's outrageous. They may not have acted on them. Yeah, it's outrageous. And a lot of the warning signs, I'll give you the clinical warning signs, is you see a change in behavior. They're moody. They're irritable. They talk about dark things. Sometimes they suggest, you know, I don't even know what the point of things are. They're withdrawn. They're irritable. One of the paradoxical things is they give away things at the end because often when they see that relief is near, they give away things and they feel better. And so a lot of people say, geez, they seem better.

Well, that's because they were locked and loaded when they were going to do it. And my whole approach is to complement all the great work that's being done. But as I said, I think if you have a way to listen into and empathize compassionately with them when they're in hell. If they cry, don't put a lid on it. Because if you're listening to them with the desire to alleviate their pain and they start to cry, they're crying with relief. Great insights. Oh, Mark. Okay. What's an action step that people can take if they're

connected to someone who is struggling, potentially suicidal? And then what's an action step that people can take to follow you? And I've retired as a doctor. I'll help people in mass or I'll help people to help the suicidal individual in their family. Where do they go? There is a suicide hotline. I don't have it memorized, but it's just like a national suicide hotline. And it's open 24-7. They're all around the country.

Something that you can help me in this mission is I have a pretty big Twitter following and I leave a tweet up there that says, have you ever known of someone or known someone who died by suicide? And it has 970 comments, about half of them people just listing all the people that killed themselves that they've known. Probably about 20% mentioned that they've tried it. About 10% say they're probably going to do it sometime. And it's not a clinical thing. It's a community. And so I encourage people to connect with each other.

And here's an interesting thing. Someone did email me a direct message and say they were feeling worthless, anything they could do about it. And so I gave them this direction. I said, go back into the community, find someone who's having a hard time, who hasn't posted for a while. Reach out to them and just say, are you okay? And hopefully all the people in the community, you know, hopefully they haven't killed themselves. We don't know. But if you do that, you're going to get some people who message you back and say, you have no idea what your message did for me. And when you do that, my friend, you're going to feel worthwhile.

So it's a way of feeding back into the community, that kind of thing. I do have, you know, I do presentations, which give people a taste of kind of my approach. And I do workshops. And I am hoping to do ongoing training because I'd like to, I don't want to replace everything that's out there. I just want to give it more of a compassionate, empathic kind of feeling. So it's like my veteran friends say, you help me feel like the person and the patient, as opposed to just a patient who's carved up into billable procedures.

And when we get pissed off, they say, let's throw in anger management just to be safe. And you can also, so Twitter? Twitter. And then also I have a new website called, it's markgoulston.com. It's new, but it's really, I'm pretty proud of it. And it talks about me as kind of a, I guess a listener. Brilliant. G-O-U-L-S-T-O-N. Right.

Mark Goulston. You've got a book here, Get Out of Your Own Way, sold over 200,000 copies. Bravo. You've got a book, Talking Too Crazy, Just Listen, you referenced, and Dummy's Guide to PTSD. And then you've got some translations that have happened as well. So Mark, well done on your career, on the insights and the impact that you're having. So thank you for spending the time to be with us today too. All right. Thank you so much for diving into another episode of Finding Mastery with us. Our team loves creating this podcast and sharing these conversations with you. We really appreciate you being part of this community. And if you're

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