HealthyGamerGG - Education on Suicide

Episode Date: July 6, 2021

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Because some of them will just, I mean, you guys will hopefully realize this too, that you just don't have to live like this. It's like, you know, like you can fix this. Like you can feel better on a day to day basis. Like the sun can be a little bit brighter. You can be a little bit happier. You can just enjoy things more. So about one year ago, we had a pretty significant suicide in the gaming community. And I think we've had over the last year, we've had a lot of suicides in our community. I think some of them are not quite as advertised as others. And so I thought what we would do today is try to just do like a quick, sort of like educational segment to help us understand suicide. So today what I'd like to talk to you guys about is just sort of like a quick, almost like lecture about, you know, who commits suicide, why people commit suicide, how, like what's the process or what we, what do we understand about the how of suicide and what you can do either for yourself or for someone else.

So we're just going to answer these four basic questions. And the reason that I think that this kind of lecture is important is if you look at medicine, it's advancing. And we're winning as a profession. So if you look at, for example, like HIV. So HIV used to be a terminal illness. And now people with HIV have a regular life expectancy. We've all but eliminated some kinds of cancer, at least in terms of people who get the appropriate treatment. So, for example, there are certain kinds of like B-cell lymphomas, if I'm remembering correctly, that we now have targeted antibodies that we have really good outcomes for.

We also have, for example, like HPV vaccines, which have done a huge job at sort of reducing or almost eliminating cervical cancer, at least in countries that have access to the vaccine. So we're like, we're doing good. Like, I don't know if you guys get this, but like modern medicine is pretty dope. Like, do you guys understand that if my heart is busted, I can like literally get a heart from someone else? else and we can transplant into my body and then I can continue to live a relatively normal life. If my kidneys are busted, I can literally like transplant someone else's kidney into my kidney, I mean, into my body, and then like I can live off of that kidney. So like medical science has advanced in an amazing rate and it is like really awesome.

So we're seeing generally speaking improved outcomes in most disciplines or just about every discipline of medicine. The one place where we don't seem to be doing a good job, and in fact, arguably things are getting worse, is in the mental health realm. So we are sort of losing the war against mental illness. And so if we look at suicide, for example, like suicides have not appreciably gone down. In fact, if I remember correctly, they've sort of gone up over time. It's also kind of staggering because, you know, if you look at statistics on suicide, like 80% of suicides are men. I'm remembering correctly, I think that's kind of a ballpark figure. Depending on what source you kind of go to, it'll, you know, the numbers may look a little

bit different depending on whether you're looking at the world or a particular country, developed countries versus developing countries have slightly different statistics around that. And so we're losing this war. And so like, I don't really know that just given the nature of the human mind, I don't know that we're going to have like a pharmaceutical revelation. Like we're not going to have some kind of pharmaceutical discovery. I mean, if we do that would be great. That you're going to take a pill and it will cure you of your suicidality. Like we certainly have medications that improve outcomes for people with depression who, you know, may be somewhat protective against suicidality. So we'll talk a little bit about

that. But as we'll see today, the reasons that people kill themselves may not all be solved by medication. So the reason that I'd like to talk to you guys about suicide today is because I think that like the first step in fighting this war is actually like education, right? So like kind of like Sun Tzu says, you know, you have to know your enemy in order to win. And so my hope today is to educate our community and whoever's listening, whoever watches this down the road to help you understand a little bit about like, okay, who kills themselves? Why do they kill themselves? How do they kill themselves and what can we do about it? Whether you are dealing with suicidal thoughts or you're not dealing with suicide or a friend

is dealing with suicidal thoughts. Furthermore, we're going to tackle a couple of different myths around suicidality. And some of these, I think, are quite dangerous. So it's really more of like a public health educational approach. And I will urge you for the first but not the last time that if you were dealing with suicidal thoughts, you should really go see a licensed professional and get help. And we'll deal with some of the reasons why people don't and why it's a bad. idea to listen to the part of your mind that says, basically, I haven't killed myself yet,

so I can manage it, which we'll look at some interesting data around that. So the first question is who kills themselves? So what we can sort of discover, like I sort of mentioned, if you actually look at suicidal attempts, what you discover is that more women arguably attempt suicide than men. But it turns out that when we kind of, when we're sort of looking at attempts, what we sort of discover is that not all suicide looking behavior is actually like intended to be suicidal. So sometimes, for example, like I've had patients that will take a bunch of pills and then will proceed to call me or they will call a friend and they'll say, hey, I just took a bunch of pills.

So it's sort of a suicide attempt, but there's sort of like this kind of idea that like sometimes it's people are looking, you know, to say goodbye, but sometimes they're actually like, it's a little bit more provocative and it's sort of almost like a cry for help. You're sort of demonstrating to people that you really need help and you're willing to go to drastic measures, but at the same time, you're not like, you're not using your full faculty of thinking to actually commit suicide. And so what we sort of discover is that when you really tunnel down into the research, there are a lot of parasuicidal behaviors. So things like cutting or self-induced. serious behavior or like threats for suicide attempts, that it seems like statistically,

we're not entirely sure about, you know, what's happening where, but women seem to make more suicide attempts and men seem to actually kill themselves more often. And so about four out of five suicides are men. So sometimes as we look at the research, what we sort of like look at. So one hypothesis is that the manner of suicide sort of determines is responsible for that statistic. So for example, women are more likely to try to commit suicide by taking pills and men are more likely to commit suicide by using a firearm. And if we just sort of think about that from a medical standpoint, if someone tries to commit suicide via pills, the window to save that person is far larger than someone who, you know, uses a gun because like, you know, it's just g-g depending. So some people have argued that because of the variance in attempts, that's what sort of alters the statistic.

In my experience, I think it's a little bit more complicated than that. And I think that as we get to the reasons of why people commit suicide, I suspect that, at least in my clinical experience, and I also suspect that epidemiologically, that men, there are more men who are more serious about taking their life than women on average. It doesn't mean that women aren't serious about taking their life. I'm just saying that there seems to be something different there, which I think is sort of borne out in the statistics. Could it have to do with just the manner and psychologically both genders are exactly the same?

It's completely possible. In fact, there's good evidence for that theory. My experience is a clinician, and we'll get to the kind of the how, or sorry, the why, and we'll sort of see that suicidality also is not necessarily due to psychopathology, which I know sounds weird. But not all suicidality is due to mental illness. So let's talk a little bit more about who commits suicide. So, you know, men tend to be more of four out of five are men. I think we're seeing a rise in suicidality, like in younger populations as well, just as other kind of interesting examples. One is that there's a black box warning on antidepressant medications called selective serotonin re-uptake inhibitors that for the few weeks after you start taking an SSRI, adolescents especially are. are more likely to commit suicide.

So there's something really interesting there that if you kind of think about, you know, the mind of someone who may be suicidal, you may have thoughts, but if you're severely depressed, your low energy level and your like lack of motivation combined with the suicidal thoughts

is almost like a protective mechanism that you may want to kill yourself, but you have such low energy or your motivation is so low that you never actually like get up off your ass and make an attempt. So there's a really, interesting phenomenon that's been observed when you actually treat someone with depression, or treat

adolescents with depression, with medication, is that there's actually a temporary spike in suicidal behavior, which suggests that, and the best kind of theory that I've heard is that this, the spike actually happens because you're sort of dealing with that motivation first, so people actually get a little bit more energy, but the suicidal thoughts take longer to treat. And so if you really have to be careful if you're a prescriber and you're prescribing antidepressants to someone in adolescents to really watch them carefully for like two weeks. And then it seems like the effect kind of goes away in terms of like then it really starts treating the suicidal thoughts and depression as well. But it's a really interesting thing for you guys to be aware of that if

you're starting antidepressant medication, so here's kind of like the first kind of like PSA, is be a little bit careful because there may be something weird going on and the suicidal thoughts. I don't know if they become stronger or you may actually feel like a little bit more motivated to act on them, which is kind of weird. Right? So it seems like younger people tend to be committing suicide more often. So it seems to be getting slightly worse. And it seems to be men more than women.

So when we look at something like the gamer community, we don't really have a good idea about, you know, who, like what the suicide rate is specifically in our community. At least I haven't seen any convincing research in that. We don't really know. but hopefully over time we'll learn more about that and we'll figure out how to intervene a little bit better. So now what I'd like to do is actually screen share for a minute. And we have an awesome. One of our coaches is actually a suicide researcher.

And so he's done awesome work as a coach and kind of does research on the side. So he put together an awesome presentation to educate our coaches. And what I'd love to do is, you know, he goes by James. So James has done an awesome job of putting together this presentation. And so what I'd love to do is share like one or two slides from the presentation with y'all. So let's kind of start with this. So suicide is the 10th leading cause of death in the United States with about 50,000 people dying by suicide. I think this number has actually gone up a little bit since the presentation was made.

This is the key thing. So our pop, you know, when we talk about like who the audiences of people who watch stream and who healthy gamer reaches, We tend to reach people who are like, you know, hopefully like 13 to 40 for the most part, but a lot of parents watch our stream now too. So when we think about, you know, what is the most likely thing that will kill you? I think it is probably accidents is number one for the leading cause of death. And number two is suicide. And so if we kind of look at like this is an important graphic, so trends in the leading cause

of death over time in the USA, so this is USA specific, what we kind of see is like, like I was saying earlier, like we're, we're winning the war against like stroke, heart disease, cancer. But suicide, I don't know if this is, actually this is an interesting, I'd have to double check this particular statistic, whether this is a 33% increase because the causes of death of other things are getting better. So the percentage increase is higher. But generally speaking, I think suicide has been increasing over time, which I feel pretty confident to say. The next thing that we're going to kind of talk about. So that's sort of like who commits suicide. So, you know, we need to be really careful about that in this community.

The next thing that I want to talk about is why people commit suicide. So this is going to sound kind of weird. But there are many reasons why people commit suicide that may not necessarily have to do with psychopathology, okay? So there's a great paper by a guy named Malzberger. So Malzberger is like a great suicide researcher. And so if you actually sit down and you talk to people who are, have tried to commit suicide or thinking about suicide, and I've sort of definitely noticed this as a clinician. What I was really shocked to discover is that the reasons are not necessarily

mental illness. So we sort of think about mental illness is the number one cause of suicide, and I think that that's probably reasonable. And yet, I know it sounds kind of weird, but like psychopathology isn't necessarily the only cause of suicide. And what I mean by that is that if you actually talk to people, what you'll find is there are all kinds of reasons. And some of them have to do with like, you know, self-worth, which is that like an organic brain disease? I'm not really sure. Sometimes suicide has to do with like not having a way out, for lack of a better term. And so suicide sort of serves as an escape. And so I think we have to be really careful about sort of assuming any suicidal behavior is that has a root cause of mental illness.

because if we misdiagnose that, if we assume that everything is mental illness, what I think we end up doing is like we're going to leave out and we're going to lose sight of a lot of important reasons why people kill themselves. So as a clinician, what I'd like to do is kind of start with this idea. Okay. So the first thing to understand is that suicidality is not an illness. It's actually a symptom. Okay.

And so what do I mean by that? So if we think about like fever, for example, like fever is not an illness. It's actually a symptom that can have all kinds of different root causes. So if I have a fever, maybe I have a lymphoma. Maybe I have a cold. Maybe I have COVID. Maybe I have lupus. There are many different diseases that lead to fever.

And so in that way, if I have suicidal thoughts, there are actually many different reasons why I may feel suicide. title. So for example, one reason is psychopathology. So what we mean by this is we know that there are some kinds of mental illnesses, right? So we know that there are things like depression, or actually, this is incorrect. Major depressive disorder is better, right? So there's like major depressive disorder, bipolar disorder. We also know that you have like things like addictions. Sometimes you'll have things like schizophrenia, right? And these are like arguably biological organic malfunctions in your brain that lead to a malfunction in your brain that sort of allows you to create suicidal thoughts and potentially act on suicidal thoughts. But if you kind of, another really interesting thing,

and I don't know that this mechanism is the same. So, so like this is what Maltzberger calls calls loss of the ideal self-state or broken life dream. So some people will have like, let's say, like, aspirations, right? So they say, like, I want to be this or I want to be this. And something will happen in their life where they feel like their life has become broken and irreparable. And if you really talk to them, so a lot of people will assume that this thing, from a mechanism standpoint, is the same as major depressive disorder. But as a clinician, what I oftentimes find is people who have major depressive disorder

will become depressed even when nothing is wrong. So especially when I've worked with people who are like suicidal, sometimes I don't actually, like, do they qualify as depressed? Absolutely. But sometimes they don't really respond to medications. And what it really is is like their perception of life has become so shattered that they don't believe it is worth living. Now, this further gets complicated that sometimes this can actually trigger a major depressive episode. But it's not that the major depressive episode is like shattering.

I mean, it can actually go both ways. But I know it sounds kind of weird, but in my experience, sometimes as someone like, so, for example, you know, I was working with a particular person who was accused of sexual harassment and was essentially like fired from their law firm. or put on suspension. And it was sort of a situation where it was kind of like guilty until proven innocent. They were sort of ostracized. It turned out that they didn't actually do anything inappropriate. But their life was sort of shattered. Like they had lost their job.

Like they had lost the respect of their colleagues. And so like this person's life had fallen apart. I don't know that this was actually the result of an organic brain disease. I don't know that it was the cause was like a neurochemical imbalance. But it really feels to me more like a broken life dream. There are other kinds of weird psychoanalytic sort of stuff. But other causes of suicidality are going to be sudden defense breakdown. So what do we mean by this?

So sometimes we have something called chronic suicidality. And what that means is like I have, you know, I think about killing myself. And even though I think about killing myself, there are a lot of things like a lot of people. so suicidal thoughts are remarkably common. I think something between like 10 and 30% of the population has suicidal thoughts or has had suicidal thoughts at some point. And so if we kind of think about it, suicidality is actually like a balance between pro-suicidal factors and anti-suicidal factors.

And we'll get to that in a second in terms of how we deal with suicidality. But sometimes what can happen is that like, you know, you've got this balance between like reasons that you don't want to live and reasons that you do want to live. And sometimes that defense mechanism, one of the things that you kind of use to hold the suicidality at bay kind of falls apart. So like a good example of this that I'll sort of use is like alcohol usage. So, you know, in your normal mind, you can kind of keep the suicidality at bay. But in some situations, if you like alter, you know, your state of consciousness through alcohol or some other disinhibiting substance, the suicidality can. kind of break through and then you can sort of result, you know, it can end an attempt.

So I know it sounds kind of weird. It's not necessarily like, you know, you can say that addiction is like an organic disease, but alcohol in a temporary sense, this isn't an addiction. This is just like, I can be not addicted to alcohol, use some mind-altering substance, and then it causes something in my psychology that keeps the suicide at bay from like fall, it kind of breaks down my defense mechanism and I end up acting. So, and I know it sounds kind of weird, but like just you don't have to have major depressive disorder to have suicidal thoughts. So the next thing to kind of think about in terms of why people commit suicide is anger turned against the self. So if we think about why people commit suicide, some people find their life

to be like intolerable, right? Like this life is not worth living anymore. And sometimes if you go back to Freud's earliest theories on depression, I believe it was Freud, although I may be misquoting here, who basically said that he sort of discovered that depression is anger turned against the self. So like instead of being angry at the outside world, like if you look at the mind of a depressed person, they're actually like angry towards themselves. So if I get fired from my job instead of blaming my boss for being incompetent or feeling threatened by my competence, which may actually be the reason that I got fired, what I'll end up doing is blaming myself.

Oh, I'm so bad. I'm so dumb. I can't do anything properly. Like, I deserve to be fired. And so sometimes in the case of suicidality, what we actually see is anger turned against the self with like revengeful intent. So what this means is like sometimes we have these ideas about ourselves that are like, I am such a bad person that like you almost want to like punish yourself for being so bad. And it's kind of really toxic, but if I really, it's kind of sad. But when I work with some people, what I really find is that when people have like this self-loathing and self-hatred, they don't believe they deserve to get better. They actually believe that they like deserve punishment.

And so sometimes suicidality is not about like, oh, woe is me. I no longer have a life to live. Sometimes it's not like a sudden breakdown of a defense mechanism of like a dynamic equilibrium. and sometimes what it is is like I deserve to kill myself because a POS like me doesn't deserve to be alive. And so what we can kind of see is as I've talked to people, you know, I'll have someone like in the MDD camp who, for example, is like has a happy marriage and has a stable job and has like kids who love them. And despite all of these positive factors, they'll still be suicidal. And so when I kind of see that, like, that's when I really think about, like, this seems to me like a malfunction. This is not supposed to be the way that this person, this person isn't supposed to feel that way.

Right. So if we think about a brain malfunction, it's like your brain is not thinking the way that it's supposed to be. But as you actually spend time with people who are suicidal, what you actually find is that some people, like, it sort of makes sense that they're suicidal because their life really has fallen apart. They really don't believe that there's anything worth living for. And we may call that depression. They may get diagnosed with depression, but I don't know that this is like an organic brain disease. It's sort of a chicken or egg situation or like the brain in our psychology is complicated. And sometimes it's not that like life isn't worth living.

So this is sort of like life isn't worth living. Okay? And then over here what we have is I don't deserve to live. You guys see how like these thoughts are different? And over here is like, and over here what we have is I'm suicidal despite life being great. Right. And so these are very different buckets in terms of what goes on in the mind of the person. And then like, you know, as we kind of go to other options, so like here's another kind of like psychological manifestation.

but I'd kind of say that another one is intolerance of humiliation, shame, or envy. And so like this is kind of, I know it sounds kind of weird, but like this is sort of like a different bucket.

If you think about the emotion that's at play for these different buckets, like sometimes it's like hopelessness. So if we look at the first column, okay, so if we look at this column, okay, this is transmitting. So if you look at this, look at this column, this is hopelessness. This is going to be anger and this is going to be shame.

Okay? So these are going to be like a little bit different. So the point here is that when we're thinking about, you know, why people want to kill themselves, you know, and what is the nature of their suicidality? What we sort of arrive at is that there are actually like a number of different reasons, which are not all the same. So this isn't just like one thing. It's not just mental illness. It's that is causing suicidality. And I think that it's the assumption that, like, you know, SSRIs will cure suicidality, that despite the fact that our SSRI prescriptions have gone through the roof over the last couple of decades, suicidality is still increasing, which sort of naturally implies

that, you know, we're missing something here. Like, as a profession and as a society, we're missing something really important about suicidality. So if people are kind of curious, this is the paper that I'm pulling from, which is a sort of an examination of a particular narcissistic person and different causes. And it's by Elsa Ronningstam, Igor Weinberg and John Maltzberger. I think all these, maybe all three of these people are at Harvard. That's number two. Okay? So we started off by talking about, you know, who is vulnerable to suicide. The second thing is like why people kill themselves. And what we sort of discover in terms of why people kill themselves is that there's actually like a lot of different reasons.

So sometimes it's hopelessness. Sometimes it's anger. Sometimes it's shame and humiliation and some degree of envy. And I think each of these causes, as we sort of think about the differential diagnosis of suicidality, what we sort of result in is that different causes are going to have different solutions. So once again, if you're feeling like killing yourself or you have suicidal thoughts, this is like reason number two to go see a mental health professional, right? Like, understand that these things when you work with someone can be addressed. So for the person who's hopeless, you know, we can sort of help them build a life dream again. So a big part of what we try to do here at Healthy Gamer is like help people construct a life that is worth living.

Our original goal was like helping people with video game addiction. And what we sort of found is the antidote to video game addiction is having a life that is worth living. in the real world. And so as you build that life, which can absolutely be done, right? It takes time and it takes effort and you may feel hopeless, but like with a little bit of help

and with a little bit of intention, you will be amazed at what you're capable of. The biggest thing about people who are hopeless is that they don't exert effort, right? And so you can even beat yourself up over that. So there can be some amount of hopelessness, they can be some amount of anger and self-hatred. I don't deserve to live.

I don't deserve to be happy. And so that sort of has a different solution as well in terms of like learning how to gain compassion. So sometimes we'll teach like particular meditation techniques that can help people like learn how to love yourself and learn how to forgive yourself. There's a lot of stuff about this in one of the Dr. K guides around, you know, anah chakra meditations and things like that. So like there are different antidotes to that. There's also things like shame and envy, which who, who, those tend to be. be some of the hardest things to deal with. Like, they require a lot of self-reflection because it's sort of like, you know, there's some

amount of, you know, hopelessness is something that we want to fix. Anger is something that we want to replace with compassion. Like, we sort of want to do that. But when I deal with people who are like really envious and suicidal because someone else's life is like better than theirs, that's really, really hard to deal with. It requires a lot of self-reflective. because it's like people hold on to their envy so much more. So now what we're going to do is sort of talk a little bit about how people go about killing themselves

and understanding sort of like a clinical approach to like suicide risk assessment and a couple of common myths that I want you guys to be careful about. So the first thing to understand is that psychiatrists are notoriously bad at predicting whether someone is going to kill themselves or not. In fact, overwhelming amounts of research have shown, I know this is kind of shocking, that psychiatrists cannot see the future. And so we don't really know whether someone is going to kill themselves or not. And so the question sort of becomes, well, like, why is that? And this is where, like, research gets to be really, really interesting.

We have this kind of idea that when someone wants to kill themselves, what they do is put their affairs in order. Okay? There are signs? Absolutely. We're going to get to those. So, like, they put their affairs in order because this is what the media sort of says, right? Like, you, like, you settle all your things. You, like, you know, you make sure no one's in the house.

You write all your, like, suicide notes and things like that. But it turns out that, so there's sort of this idea that, like, people kill themselves, like their suicidality kind of starts out here and then gradually over time, it increases, increases, increases, increases. And when it gets to up here, this is when you kill yourself. So a lot of people feel reassured, right? They kind of say, like, okay, yeah, I'm suicidal. but like I'm over here. And since I'm over here, it's okay.

I don't need to get help yet because I'm not up here. And I'll know I need help when I start to feel worse and things like that. So there's sort of this myth that like suicidality builds up over time and people like make a calculated decision to kill themselves. Whereas if you look at the data, what you actually find is if we look at the decision to make the most recent suicide attempt, the most common. is that like, you know, I don't know exactly what the Y axis is here. It may be a number of people. So if you look at like, let's say this is like 30 people who tried to kill themselves. What you find is that 12 out of the 30 people decided to make the attempt within one minute of the attempt.

You know, the vast majority of people decided within half an hour or within two hours to make the attempt. So what we actually discover is that most of the like attempts of suicide are actually drastically impulsive decisions. And what we actually see is out of this sample, no one was planning suicide for more than three days. Right? So like what this means is that if you guys have been struggling with suicide for a long period of time and you think to your yourself like, oh, like since I'm not planning it, I don't need to be worried. I know it sounds kind of weird, but you should absolutely be worried because what the data actually tells us, if you take people who tried to commit suicide, who survived and you ask them, this is how the study was done, when did you make the decision to kill yourself? The vast majority was like

within 60 seconds. And so this is kind of another thing to kind of look at. So if you look at suicidal ideation over time, okay? and this is people like checking their suicidality like four to eight hours apart. What you basically see is that like the suicidal score like is all over the place. Right. So like this person will be very suicidal this moment and will be like not very suicidal four hours later. So basically like the key takeaway here is that the first important myth to address is that like if you're telling yourself that because you're not planning. to kill yourself, you are safe, that's something you need to be really careful about.

So what you want to really do is go see a clinician either way. Like if you've been dealing with suicidal thoughts for a long time, I know it sounds kind of scary, but like you just never know. Like when we come to that sudden defense breakdown, you never know when the stars will align and like something will crack through and you will actually make an attempt. So what I strongly encourage everyone to do is just because you've been feeling. feeling that way for a long time and nothing, nothing has happened yet is not a sufficient reason to not get help. So even if you feel like it hasn't, if you have it under control, if you feel like, you know, it hasn't happened yet. So there's a famous saying from the stock market, you know,

like people in finance will say that the stock market past performance is not an indicator of future gains, right? And I think that's absolutely true of suicidality as well. When we're thinking about forming like a risk assessment, you know, that's not really like that reassuring because we just know as clinicians that it's sort of like on a given day, like something may happen in your mind. We don't really know. And you can kind of result in an attempt. So what do we look at as clinicians? So we tend to look at means of access. And this is why means of access is like the number one protective thing. So if we think about, if we now understand that suicidality is impulsive, Most people decide to kill themselves within 60 seconds of making the attempt.

Having a gun at home is part of the reason why suicide is like so much more likely if there's easy access to an attempt. If you have a gun at home, if you can like make a decision in 60 seconds later, you can actually make the attempt. If you have the means to do that, that's incredibly dangerous. So when I think about like suicidal like probabilities, what I really try to protect against, Because remember, like, what we've got is, like, your mind working against you and your mind working for you. So as a clinician, what I really try to do is buy time for my patients to, like, get their head above water and reach out for help. And so if someone has to, you know, order something from the internet, in that 24-hour period, their suicidality will fluctuate and they'll reach out to me. And they'll say, like, hey, I had, like, a really scary, like, near miss.

and then we'll kind of talk about it, we'll help them through it, and then they end up, generally speaking, doing well. Okay? You know, when it comes to a risk assessment, we think about things like, and this is for you guys to understand too. If you're thinking about a particular,

there's a big difference between it would be okay. So let's talk about like the scale of risk, okay? So if I went to bed and I never woke up, I would be fine with that. That's something that we call passive suicidality. It's not that you actually want to die. It's just sort of like, you know, if you unplug things, like, you would be okay with it.

Then they're sort of like, I wish I went to bed and never woke up. So at that point, it's sort of like a desire, but it's not really like an intent, right? You're not trying to not wake up. It's just like, we move from a passive suicidality to like sort of a wish. And then the next phase is like, I actually don't want to wake up. Like, I'm going to try to not wake up. Right? So then we sort of cross over into intent, which is like scarier.

and then like the scariest thing is like plans and then means. So then like if you kind of think, okay, I am going to not wake up in this particular way. Right. So like once you start to think about a plan, that increases your risk of a bad outcome. And then once that plan becomes available, that's when things get really scary. And it's usually towards those like later stages that we sort of really think about things like hospitalization. You know, just another important reminder here that like, like, you, should not be using this risk assessment to determine whether you should go see a clinician or not.

If you were anywhere on this axis in any way, you should get a professional evaluation. Because we know how to ask questions that will sort of help us figure out where you are. Because I know hopefully you guys, if you guys have been watching the stream for a while, a big part of this problem is that people don't know what's in their mind. right? The whole point of this stream, if you think about like how do people benefit from coming on stream, watching stream, it's that we help you understand the things that you are not aware of in your mind. And this is why I cannot urge you more strongly that if you are anywhere on the spectrum or even not on the spectrum, it's completely reasonable. And I urge each and every, it doesn't, and now that I think about it,

like, just go get evaluated. Like, even if you don't think you need to, right? Because you may be missing something. The other reason to go get evaluated or reach out for treatment, I know this sounds like absolutely crazy. Like it sounds absolutely crazy. It's that you don't have to live in this mindset. So for people who are chronically suicidal and think about never waking up again, you don't have to live that way. Right? So like there are trained professionals whose job it is to help you through that stuff. And this is the really crazy thing, right? It's like, our mind does this really stupid thing where it's like if I can't figure it out no one can figure it out it's like I've been dealing with this for a long time I've read so many books I've watched so many

YouTube videos I haven't figured it out so like I don't think anyone can help me I'm unhelpable like they can help other people but I have tried really hard to figure this out and I haven't been able to so I don't really think there's any point in seeing a professional be careful because if you have that thought, if you think there is no point, that is actually, you should do the exact opposite. If you think there is no point to see a professional, you should actually go see a professional. If you're on that axis, you should absolutely go see a professional. Right. And we'll get to this in a second in terms of like what you can do. Or I guess we can do. So now like moving on to like point number four is like what do you do in this situation, right? So the answer is going to be like sort of

broken record here is like you go get help. So like in the same way that if like if you've got a flat tire, like maybe you know how to change it to yourself, but if you let's say your engine is busted, right? Like you go see a mechanic. Like there are as as human beings, we have a society, we have a community and we have a diversification of our labor pool. Like if you want to eat a burrito, you go to a place where people know how to make burritos or you make it yourself, right? If you want to, you know, get, if you've got COVID, like you go see a medical doctor because they're going to help you with COVID. You go to the appropriate person for the appropriate thing. And if you're dealing with feelings of hopelessness or

suicidal thoughts, the appropriate place to go because there's a profession of people whose job it is and who's been spending years of their life to train and get good at helping you. So you should go see them. Right. And be careful about all of the reasons that your mind may populate. And if your mind populates these reasons, then you should really like notice that and recognize that this could be a part of like the negative process. So if your mind is telling you there's no point. If there's your mind is telling you that you don't deserve help and that you deserve to feel this way because you're such a POS and you like, you know, like other people deserve help, but you don't deserve help. Like that's like just recognize that and then don't give into that.

So I know this sounds kind of weird, but I encourage all of you all to really think about what is it that dictates your life. Do you want to live a life that's based on like what you're emotions tell you and eat, I know it sounds kind of weird, but based on what your thoughts tell you, because the mind is just a thinking machine. It just generates thoughts. It generates all kinds of random crap. Like your mind will say like, I want a burrito. Or it'll say like, I want to play Dota or like, I don't want to do this. And do you want to listen to your mind? So be careful, right? Because sometimes you want to listen to your mind and sometimes you don't. But you don't want your mind and your emotions to be in control of you. You want to be in control of them. So the last thing that

I'm going to kind of talk about is like, you know, this sentiment that you can handle it is not a sufficient reason to, this is not the last thing, this is the second last thing. The sentiment that you can handle it is not a sufficient reason to not see a mental health professional because it's just dangerous. Like statistically, it's very dangerous. So the last thing that I'm going to talk a little bit about is like how to help someone else who is dealing with suicidality. So this is really tricky because a lot of times people in our community are like good people and you try to help other people out, which is awesome, right? Like we love that.

It's part of the reason that we're here. Like our Discord has a lot of people that try to help each other out. Our subreddit has like people posting about their problems and like other people post on the subreddit to try to support them. It's like fantastic. Like it's really great. It's beautiful. We have coaches who will also like, you know, are also kind of trained in our methodologies or sort of specifically there to help you out. And that seems to be going really well.

I had the privilege of dropping into a coaching group this morning. And it was fun to really see, like, you know, how people are progressing. So the last thing is, like, you may have a friend who is struggling with suicidal thoughts. So the first thing to understand is that, like, a lot of people feel like I don't know how to help them or they won't let me help them, which is sort of fair because it's, I know it sounds kind of weird, but, like, it's your job to be their friend, not their doctor. So a lot of times I notice that people get really kind of like frustrated or they feel like really like stressed out because they're trying to fix this person's suicidality. They're trying to like because it's like so scary and you want to fix it. But you're just not trained or capable. And so I know it sounds kind of weird, but like you shouldn't stress about that. Right. So like fixing someone's suicidality is not your job as a friend. You're not trained in it. So you, I mean, I guess you can kind of give it a shot, but like I wouldn't really recommend that. Really, your job is a friend is to be their friend and support them through it. So this is where it's like encouraging them to actually get help. Because this is huge where a lot of times people won't want to get help for any number of reasons because they feel ashamed.

So like, you know, you can kind of support them through that. Sometimes it's like practical. Like, you know, their mental is not functioning properly so that like they just don't have the wherewithal to like sit down and like call around and try to find an appointment. So you may be able to help with that. Like, it's kind of crazy, but you could ask them, hey, would you like my help in making an appointment? Like, because 60 minutes from now, like, you could have two appointments. We can make, you know, one phone call every six minutes,

and we can make 10 phone calls. And out of those 10 phone calls, there's a decent chance that 20% of the people, like, will have availability. So it's going to be an uphill battle because in the mind of the depressed person, in the mind of the hopeless person, they may must drop the courage to make one, phone call, but when like, you know, they don't get an appointment, they kind of give up. So as a friend, you can help them get into treatment. You can encourage them to get into

treatment. You can support them to get into treatment. The second thing is don't underestimate the power of being a friend. So while you may not be able to actually treat their suicidality and nor should you try, don't underestimate the value of you caring about them, right? Because in their mind, remember that there's an equation between pro-suicidal. factors and anti-suicidal factors. But like one of the things that you're doing there just by being their friend, and even like, I know it sounds kind of weird, but like I'll even say this as a psychiatrist. Like it's one of the most powerful things that I've like learned how to say.

Like when I'm dealing with patients with trauma, you know, they'll tell me about all this terrible stuff that happened to them. And it's like we're 10 years later and I can't do anything about that. and just sharing how much I wish I could, like, you know, because really the cure for this person is for me to invent a time machine, go back in time and protect that from, protect them from like that ever happening. That's the cure. And I wish I could do that, but I can't. And I'm actually completely powerless in this situation to like take that trauma away from them. And being able to share that with them because like instead of like, you know, you trying to help them, you're actually joining them in the hopelessness. And then what happens once you join them in the hopelessness is like both you all are down there together. And y'all are hopeless together. So at least you can't change time. You can't change the past.

They can't change the past either. But at least both you all are down there and like they're not shouldering that powerlessness on their own. You're helping them carry that powerlessness too. And so then once you kind of get down there with them and you say like, hey, I can't take this away from you. I wish I could. But I'd like to try to help you in some way. What can we do? What can we do?

And that's really the most important question you can ask as a friend. Right? And then like meet them where they're at and try to like help them. Like if it's sort of like, can I make phone calls for you? Can I help you get into treatment? Like what can I do? You know, what is it that you would like to do that you're not able to do? And sometimes it's like other kinds of things, right?

It's like, hey, let's play like let's make phone calls for, 30 minutes and then like we'll play like one game of league and then like after that like we'll take a break and we'll make phone calls for another 30 minutes and then like we're going to keep doing that until you have two appointments and then we'll you know there's a lot that you can do as a friend so remember that your Dharma as their friend is to be their friend it's not to cure them and so be careful about what you're capable of and what you're signing up for So let's actually start with kind of a quick summary.

So today we're talking a little bit about suicidality and how to understand it. So we started off by talking about, you know, who suicide affects, who has suicidal thoughts, kind of how that works. We sort of talked a little bit about how women may be more likely to attempt suicide, although men are more likely to complete suicide successfully, about 80% of suicides are men. We also talked a little bit about why that statistic may be different. So some of it may have to do with the means of suicidality, like women are more likely to try to overdose, which means that the window for medical intervention and the window to save that person's life is a lot greater than using something like a gun, which men are more likely to use guns. Women are more likely to try overdose via pills. So we talked a little bit about statistics. I suspect that there's more to it than that. I think that there's something going on in terms of like why men are so much more likely to kill themselves.

thing that we kind of talked a little bit about is like, you know, why do people kill themselves? And as we sort of get into the mechanisms to recognize that suicidality is a symptom, it's not a diagnosis, and that suicidality is born out of all kinds of psychopathology as well as potentially like psychological complexes that are not necessarily a discrete medical illness, brain malfunction, or neurochemistry imbalance. So we talked a little bit about, diseases like major depressive disorder, bipolar disorder, addiction, sometimes things like trauma, but also that when you actually sit down and talk to people with suicidality, what you discover is that sometimes they want to kill themselves because they don't feel like life is worth living,

that their dreams have been shattered and they don't really feel like they can ever put things together again. Sometimes people kill themselves because they have an immense amount of self-hatred. And it's not that life can't be put back together. It's that they don't deserve to live. a life that is like put together. Sometimes it's born of things like envy and humiliation and shame. And sometimes what can actually happen is we always sort of have this war going on in our mind between reasons to live and reasons to not live. And sometimes we can have acute events that will sort of shatter some of our defense

mechanisms that help keep us alive. And sometimes I'll see this especially in the case of disinhibition through substances. So like, you know, if you think about alcohol, alcohol will make you more likely to do things that you wouldn't do if you were like level-headed. And suicidality includes that. So like the number of suicide attempts that I've seen under the influence of alcohol is like staggering. It's like through the roof. And then we sort of talked a little bit about, you know, how to think about suicidality. So we talked a little bit about risk assessment. And the main takeaway here is that regardless of how suicidal you've been, if you've had those kinds of

thoughts or you're currently having those kinds of thoughts, you should absolutely go get help. It's a no-brainer. And a big reason for that is one of the most common myths behind suicide, which is that people like really plan it out, right? It's like weeks and weeks of careful planning and I'm going to do this and settle my affairs in order. Whereas if you look at the research, at least in one study, no one planned more than three days. And like the vast majority, like 50% or more, 60, 80% of people made the decision within two hours.

And about 30% of the people made the decision within 60 seconds. So the reason you should go get help is because you never know when your mind is going to change. And the last thing that we talked a little bit about is, okay, so what do we do about it, right? If you're struggling with these thoughts, like the short answer is get help. Recognize that there are all kinds of thoughts in your head that will prevent you from getting help. And if you're having those thoughts, that's not a reason to not get help. In fact, it's the very opposite. So sometimes your mind may be telling you things like no one will be able to help because I haven't been able to fix it myself.

your mind may be telling you, I don't deserve help. And if you have any of those thoughts, you should actually get help because you're having those thoughts. And the last thing is, you know, how do you support someone else? The short answer is get them into treatment. And in terms of how you do that, it's supporting them sometimes through like a very practical, hey, do you want me to like Google stuff for you? Can we make phone calls together? And sometimes it's just being their friend because it's your job to be their friend. It's not your job to be their doctor. And a lot of times people get really bent out of shape and stressed out because they try to be their doctor when you just can't you're not trained to do that nor should you i don't i don't play doctor i i don't

accept patients that are friends of mine so like you know people who have working relationships with people who are my friends people who are my family like i won't be their doctor i will send them to someone else so that's our quick talk about suicide i hope it's been helpful um you know the goal of having this talk is because as we looked at earlier, we are sort of losing the war against mental illness. We are losing the war against suicide. And despite many advances in medicine, despite, you know, a lot of new pharmaceutical medications and things like that, some of which I've really seen like clinically do a fantastic job. I really have seen some patients with depression who've tried like five or six medications and a new drug comes on the market. It really does turn things around for

them. So it's great that like we have all these advanced. and at the same time, you know, the suicide has like increased as a cause of death by like 33% over the last like 20 years, I believe. Whereas like, you know, deaths due to cancer and heart disease and stuff like that have gone down by 20 to 40%. And so the first, you know, we're going to start by educating on it, educating y'all, right? So we as a community need to understand more about suicide. We need to understand like what it looks like, what it feels like, what to do with it. and I encourage all y'all to get some help because the, you know, the biggest, the most common thing that I hear from my patients who were reluctant to engage in mental health is like, I wish I had done this sooner. Because some of them will just, I mean, you guys will hopefully realize this too, that you just don't have to live like this.

It's like, you know, like you can fix this. Like you can feel better on a day-to-day basis. Like the sun can be a little bit brighter. You can be a little bit happier. You can just enjoy things more. you can actually live life with like more motivation and like food can taste better and all you have to do is just get a little bit of help so someone's asking a question what if you don't have money so it depends a little bit on where you live but uh you know most places actually have most places meaning like even countries like so the u.s basically has free mental health clinics or community mental health clinics in most places actually have most places meaning like even countries like so the u.s. basically has free mental health clinics in most places. most like cities actually. So I don't think people realize this, but like you can just do like community mental health

center and you call the community mental health center and you say, hey, I have no money. I'm depressed. Can you guys help me? You'll be surprised because there are all kinds of programs out there, right? So we also have programs like rise above the disorder or rad, which is like, you know, a gaming nonprofit that supports like gamers and actually pays for their treatment through like scholarships and grants. So there are nonprofit organizations out there that will help.

there are community mental health centers that are helped, just call them up and ask. So I wouldn't let that be a barrier. Okay, so what's a good way I can open up to a clinic or therapist about this kind of topic without making it seem like I am in immediate danger, but it is still a very serious ongoing issue. So it is their job. So my job as a clinician is to keep people out of the hospital, right? Like the hospital is like a last resort. It's not a first resort.

And so I would say, just share that with them. Just say like, hey, I'm not in any immediate danger, but this is a very serious issue. And I'm afraid that you're going to think I'm in immediate danger. Just tell them. I'll be like, okay, cool. Thank you for sharing that. That's like one of the most reassuring things that I can hear as a psychiatrist. Oh, great.

This patient is taking this seriously. Good. That means I can rely on that. them. I can trust them. They respect the enemy that they're facing. Someone's asking, why do you not want to be a doctor for people that you know? So being a doctor is about being objective, right? So what I want to do is not let my emotions get in the way of like my clinical training. And when personal relationships arise, emotions and other kinds of boundary issues arise that like make it hard for me to actually function as a competent doctor. So there have been numerous stuff.

studies done that show that physicians who treat family members are more likely to miss diagnoses than like a rando from the street. Ah, so what if your friend doesn't want you to get them help? How do you convince them otherwise? That's a great question. You don't convince them otherwise. So this is sort of where like what I would encourage you to do is like instead of trying to convince them to get help, ask them why they don't want help. So any of the, time, so anytime you have a disagreement with someone, I think we try too hard in this society to like convince instead of understand. And I want you guys to just pay attention to any argument. Like I really wish I could. So I, anyway, wish I could share something with you, but I can't.

So like, I want you guys to just pay attention to any argument. And like, think about the arguments in your life where you try to convince someone and they try to convince you. What happens? Like, it doesn't work. Whereas it's kind of interesting because if you try to understand them, they will automatically, empathically, like some circuit in their brain will flip where they will try to understand you. You know? And so it's kind of interesting because I wouldn't try to convince them,

but I would still like state your perspective. And you can say like, hey, I see you suffering. It hurts me to see you suffering. I care about you. I think this would help. But if you don't want to, like, you know, I can't make you. Can you help me understand why you don't want help? Because there may be something there that needs to be addressed, right?

So someone else is asking, what if I'm afraid of my parents not knowing, or my parents knowing? So, like, there may be something like that where they're like, you know, they have some fear. Like, they're afraid that they're going to be hospitalized or they're afraid they're going to, you know, get kicked off of like whatever team they're on. Or they're afraid that, you know, their parents. will find out. And so then you can kind of like help them work through that, right? Like you can be like, okay, so like what, you know, what are you afraid of your parents knowing? What are you afraid of in terms

of reaction? Or you think that they're not going to be supportive? You think they're going to call you weak. You think they're going to punish you for it. And then like, you know, then the conversation sort of becomes like we can maybe talk about, you know, parents who are against mental health treatment at some point. The conversation then becomes like, you know, what's more important to you? I know it sounds kind of weird, but like, you know, when I work with kids whose parents aren't supportive of mental health treatment, it's actually like really amazing to see what happens because the kid actually like, we work to the point where like they can be strong about it. And it's sort of like my parents may react poorly and I can't control that, but that's on them. And I'm not going to let the opinions of my parents dictate the life that I lead. And that's hard.

It requires a lot of like internal fortitude and support from the outside to get to that point where you can let your parents know and sometimes we'll even coach people into how to have a conversation with your parents. So when you tell your parents, hey, by the way, like, I want to see a therapist. They'll be like, you don't need that. And then like once again, don't try to convince them, right? So you're, you ask the question. You ask them like, what do you think I'm feeling? what do you think I need?

And they'll be like, you know, and just listen. And be like, okay, I see. So you think I'm feeling unmotivated because I got a B. How would, how would, like, how would that, like, how would you, so you think that I don't need therapy because you think this is just a temporary part of adolescence? if I were to tell you that what I'm feeling is very different from what you're describing, if I'm feeling something that's very different from what you think I'm feeling, would that change your mind about whether seeing a therapist is appropriate or not?

It's kind of like a weird question, right? Because they're like, it's kind of a weird question. It's like a hard question to answer because if they say, and then you may even get to therapy doesn't do anything. And then you can ask them, like, what's your, like, help me understand why you think therapy doesn't do anything. What do you base that on? Where does that come from? And just have a conversation with your parents.

And then like even I've had like, you know, people working with super religious parents. It will be like, you know, you just need to go to church more. Like, you know, mental weakness can be solved through God. So you can say like, okay, so what's your understanding about like why people, like, you know, why the profession of psychiatry exists. And then the answer can be something like, well, it's because people have gotten away from God. And then you can be like, okay. So do you think that like seeing a therapist necessarily means that I've moved away from God?

Or can I do both? Like what do you think about me trying it? And like just being open-minded and seeing what the deal is. And oddly enough, when you approach, I've approached very religious parents in that way and found them to be, you know, like quite receptive. It's bizarre. You know? And even as a psychiatrist.

Like sometimes, like, they'll come into my office, right? And they'll be, like, prepared to do battle. And so you just listen to them. You can be like, yeah, like, I completely agree. Would it surprise you guys that I spent seven years training to become a monk before I became a psychiatrist? I actually agree with you that a lot of the reason that's, that mental health is getting worse in this country is because we've lost some element of spirituality. And I think that, like, God puts, like, gives us us. like a lot of options, right?

Like, and so we should use everything at our disposal. It's crazy. Like, they'll be like, and I'm like, do you guys think I'm evil? You just ask them. And they're like, no, you seem like a nice guy. And I'm like, okay. So like, how do you guys feel about your son coming and seeing me once a week for an hour? And we're just like going to talk about stuff.

They're like, okay. And I'm like, you guys can come once a month too. and let's just check in. Like when you guys drop him off, if you guys have any concerns, you can let me know. And they're like, okay. Like, it's really strange,

but I think just, you know, if you have someone who's resistant to being convinced, don't try to convince them, try to understand them. Right? And try to find some common ground. Like, because it's there.

Like, just because they don't want to see a therapist for some reason does not mean that they may want to avoid therapy for a reason, but they may want therapy for another reason. So it's about sitting with them in that space. This is why it's kind of interesting that, you know, one of the outcomes we're now measuring from our coaching program is like how good our coaches are at getting people into therapy. Because a lot of people, a lot of times for whatever reason, you all feel more comfortable working with a coach than a therapist. Therapist will work with you for a while. Like Asriel's a good example if you guys caught that interview.

like was in coaching for a little while, like went to therapy for a while and then came back to coaching. And he seems to be doing way better. The two are complementary. Yeah. So what if you're dealing with someone who's psychotic? So the other thing that I, for the sake of complete, I really should have included is if you think that someone is at like imminent risk to themselves, it's absolutely appropriate to call whatever emergency services is. 9-1-1-2. Like if you think someone is like actually going to hurt themselves, you all should absolutely just call 911 or whatever the emergency services. And, and like, you know, because like if someone is someone asked a question, like, what if

someone is psychotic? Like, if someone is high on drugs or psychotic and like, like, or something like that, like, you should just call an ambulance and get that person to an emergency room because that's what the doctors in the emergency room are there for, which is, you know, most of my bread and butter when I work overnight shifts in the ED. And it's really fantastic. Like, I'm so glad that, you know, someone picked up the phone and, like, made a phone call. Because they're going to come, I mean, there's a decent chance they're going to wind up in the emergency room either way.

And it's just going to be like, you know, if their friend called, then we've got a good shot at saving this person's life. And if no one calls, then we have less of a shot at saving this person's life. And I can also say that, you know, I would say 90% of people that get hospitalized are grateful that they were hospitalized when they leave. in my experience. I wish it was 99, but honestly it's 90. 10% of people really dislike it. Yeah, so someone's saying, I feel like I'm where a wreckful was that would the day he died.

I don't know where to go. Seriously, dude, I'd pick up a dude or woman or, you know, whatever you identifies. I'd pick up the phone and I'd call 911. If you guys are where he was, you'd pick up the phone and call. Seriously, that's like, that's the only answer if you're where he was. Dr. Kay, why are we so different to,

our own mind? Shouldn't our mind be nice to us? No. Our mind should not be nice to us. This is a good question. Someone's asking, shouldn't our mind be nice to us? No. So, chat, let's do a little bit of Socratic teaching. Okay? You guys are going to get like Professor Kenosia today instead of Dr. Kay. What is our mind designed for? Absolutely. Good job. Chat has learned a lot. It is for survival. It is not, it is evolved to survive, not to make you feel happy. So if we think about some of these things like ego, negative emotion, even stuff like shame. Like, think about this for a second. There's a, there's a, there's a video on Dr. Kay's guides about why we have negative emotions.

It's like one of my favorite videos. Because like, like, just think about this chat. Why the hell do we have the experience of shame and sadness and fear? Like they're just negative. They make us feel like crap. So this is conserved across the human race. Every single human out there is capable of feeling, anger, sadness, fear, and shame. Why?

Right? Like, just like, understand this. This is important. So, the reason we have negative emotions is because they're helpful from an evolutionary state. Otherwise, we wouldn't have them. Right? It's not even like 50-50. It's not like, you know, brown hair or blonde.

hair. It's like there's a variance in the population because blonde hair is not necessarily better than brown hair. But there is no variance in the population about the experience of negative emotions. So negative emotions absolutely serve a function. And at the end of the day, you can say survival. But if you kind of think about, you know, like on a day-to-day basis, like, you know, what is the purpose of fear? Like fear is to protect you. What is the purpose of anger? Anger is to like help you stake out your territory and, like, not be, you know, taken advantage of by other people.

Like, those are necessary emotions. And so, like, anxiety. Like, what is the purpose of anxiety? Like, anxiety forewarns us of danger. If we didn't have anxiety, we wouldn't, like, anxiety is just our predictive capacity and our ability to plan for, like, negative scenarios in the future, right? It's like, anxiety is the reason that we're able to, like, store food for the winter. Like, those link, like those circuits are linked. Should we prioritize survival or happiness? Survival first, happiness second. So remember Maslow's hierarchy of needs? So this is what we sort of discover. And this is part of the reason. So if we want to talk about why is mental illness getting worse, it's because I think we've, as society met a lot of our basic needs. So self-actualization and

finding purpose and meaning is like more of an issue now. Like I still remember talking to my grandmother about when she was growing up, like India had rationing. It was like under British colonial rule. And basically like, it doesn't matter how much money you had. Like there wasn't enough flour or sugar to be bought. There was no such thing as a grocery store. There was like a dispensary where you go once a week and you get a certain amount of thing. And if you run out of flour, you're out of flour until next week.

You're not going to get anymore. You know where to buy it. She doesn't exist. And self-actualization is like, not that important in that situation. Survival is important. And what we sort of discovered, as the human race gets better,

we start to become, like, more mentally unsatisfied. Which is not a bad thing. It's just part of the process. So even if you look at Budha, like, there's a reason why, if you look at all of the people, not all, but the majority of people who started religions in the East, they're all kings. So, like, it's kind of interesting,

because if you look at the Indian subcontinent, right? So like India gave us Buddha, it gave us Ram, it gave us Christian, it gave us all these like diities from this like karmic set of religions. And in India there used to be a caste system, or there still is a casteism sort of. And the top cast were the Brahmins, who were the closest to God, the teachers of meditation and the most spiritual.

And all of the enlightened figures from India are not Brahmins. They're Chhatrias, the noble caste, the warrior caste. They were kings. So then it begs the question, why don't Brahmins get enlightened? And why do the Chhatrais? Why do the students get enlightened, but the teachers don't?

There's a really simple answer for it. It's because the Brahmins lived in poverty. And the chattrias lived in luxury. So there's always a seed of like desire in the mind of a Brahman who takes a vow of poverty, right? They're not allowed to earn. What they do is they live off of the donations of other people. And so the Shatryas are the ones that get enlightened because like if you kind of think about it,

if your mind is unhappy, what is your mind tell you? It tells you, if you had this, you would be happy. If I had a girlfriend, I'd be happy. If I had more money, I'd be happy. If I had a, you know, the right video card, I'd be happy. If I had a PS5, I'd be happy. If all these things happened, I would be happy. And so what happened with the nobles is like they got all those things.

And they like climbed the hedonistic treadmill for a while and they sort of like reach the top. and they're like, wait, I'm still not happy? Now what? Woodrow was loved, respected, revered, powerful, and wealthy. And then he woke up one day and he was like, I'm unhappy. And so all that's left is spirituality. Right? So this is when people are saying all kinds of stuff.

Like if I had a GTX or RTX 3090 or whatever. And then other people like, if anime was real, I'd be happy. No, you wouldn't. You'd be happy for a time. And then you'd become just as unhappy as the people in the animas. Are you saying that spirituality is required for us humans to be happy? That's been my experience. So, like, I think so.

I mean, y'all are welcome to disagree. I have read The Power of Now. Do I recommend it? Sort of. So I think that, like, you know, reading a book is never a bad thing. But I don't think that I think it's good. Like, you should read books on spirituality and meditation. Like, Power of Now is Eckhart Toll, right?

So I think he's got a lot to offer. I personally find a lot of those books to be like a touch simplistic and a touch repetitive. I tend to be a little bit more systematic and like want more detail and understanding. And I think a lot of that has been lost with like the explosion of mindfulness. So like mindfulness is like this is also in Dr. Kay's guides. We'll sort of contextualize where mindfulness belongs in the tradition of meditation. Mindfulness sort of offers 5% of what I think like the meditative traditions are. offer. Someone's asking, I've heard of spiritual reasons to live in poverty too, though. So I don't know if

this is like, okay, so we're going to do a little bit of lore, all right? So this story maybe is top of mind because I just shared it this morning in said group. But so when I tried to become a monk at the age of 21, my teachers were like, they didn't tell me this at that time. But they're, you know, they said, go back, finish your studies, get a doctoral degree and we'll take you if you if you still want to do it when you're 30. And I didn't understand this, but, like, you guys understand that, like, becoming a monk is about renunciation, right? So you, like, give up your life.

At the age of 21, I had less than a 2.0 GPA, was on academic probation. Had a net worth of $0 and had never been in a relationship, had never, like, accomplished anything. I had nothing to give up. My life was, like, completely empty. There's nothing to renounce. it was escapism. Right?

It's like this life is like, I'm not giving anything up. I'm running away from a pile of crap that is my life. And so they were smart because they realized like you're not going to make it unless you give something up. Like becoming a monk is about giving up stuff.

It's about renunciating, right? Like it's like renouncing stuff. So in order to renounce something, you have to have something. So like, we'll take you. Like once you succeed in the material world, So my teacher told me, he's like, be as successful as you can in the material world. And when you reach the height of success in the material world, then give it up and then we'll take you.

So like win the trophy and then quit the tournament before you get your prize. You know, that's the road of renunciation. So when we kind of say that like people, like, so someone was asking about isn't there poverty through spirituality? Like, yes, there is. but I think it's grossly misunderstood and tends to be like really, really abused. So I want you all to understand this. When someone like a monk, like a real monk,

like someone who understands this stuff, the reason that they don't wear a fancy watch is not because avoiding a fancy watch makes you spiritually strong. It's the other way around. It's the spiritual strength that allows them to recognize that like whether you wear a watch or you don't wear a watch,

it doesn't mean anything, right? It's detachment from the thing. So we see this a lot, like, especially, like, in the Indian and Hindu community. Like, a lot of people will fast because they think, I mean, fasting can be healthy and can be a spiritual practice. But I think a lot of times they'll, like, look at the way that monks eat and they're like, wow, like, you see how that monk doesn't indulge in anything. If I don't indulge in things, I will become spiritual too. Monkey see, monkey do, I will get spirituality too. But they've got it backwards.

It's the renunciation and detachment of the monk that allows them to eat whatever without a problem. And so, like, I can eat, like, rice and dal every day because it's all the same to me. It's the detachment that allows me to live a simple life. It's not forcibly living a simple life that will create the spirituality. So you'll see a lot of people who will be these, like, false spiritual. spirituality, egotistic people. And I've seen them all the time. They're like these people who like,

I'm not going to live a material life. Like I'm going to be above that crap. I'm going to deprive myself of all of the materialism because I'm going to be a spiritual person. So much ego. It's all ego. Completely misses the point. I'm going to be better than that.

That's ego. You're not doing anything. You're just confusing yourself. right? Like it's it's like bro you're like completely missing the point. The desire to not want material things should come naturally as a consequence of your spiritual practice. That's been my experience. Like sometimes people will be confused by how I dress

and it's not I'm not like dressing to advertise my spirituality. I just genuinely don't care. Like why do I care about you know sometimes I'll dress nice because I recognize that I'm a human and I have to play by the rules of the humans. So So, you know, back, I don't know if you guys remember this, but back when I, like, worked in an office, I would stream in a suit. And it's like, why do you, like, you know, I don't need to stream in a suit anymore. I don't. So I don't. Thought crosses my mind. It's like, maybe every now and then I should wear a suit. I was thinking about streaming in a suit, actually, recently. More just because I was like, I should use this article of clothing that I spent some money on. But understand that spirituality is like, it's a little bit backwards, right? So, and there is value to fasting for the sake of gaining spirituality. There's definitely value to that, but it's not quite what I see the way most people do it, which is like, this is what spiritual people do. So I'm going to do that thing to become more spiritual. Whereas those behaviors are the consequence of an internal change. That's what they don't understand. And so then they walk the walk. And then they think that like that's sufficient. But spirituality isn't about outward behaviors. It's about internal stuff. It's like, you know, you can be in the world. or not in the world,

and you can be a monk either way. Is the waking up app an okay way to get into meditation? Sure, I think it's an okay way to get into meditation. But here's the problem with the apps. The apps don't have in-depth instruction. So if you look at most meditation apps,

what they actually will do is give you a variety of techniques to keep the curiosity of the mind engaged. Right? They say like, okay, like today we're going to do this kind of visualization. today we're going to do that visualization. Because like the monkey mind that we have like needs novelty to continue to do something. Whereas like if you want to do real meditation, like I've been doing the same damn meditation practice for 17 years. And that's when it really starts to work. I encourage you to just think about anything else that you like build a skill in.

Right. It's like today I'm going to write and today I'm going to paint or tomorrow I'm going to paint and the next day I'm going to play music. Like there's value to that. Sure. Like you're sort of artistically doing a bunch of stuff. But, I mean, I think that there's a lot of power to doing the same meditation practice, which is the right meditation practice for you over a long period of time. And generally speaking, when you look at, you know, people who are very accomplished meditators, they didn't get that way through an app. They like, like, I've never heard of anyone becoming enlightened through an app.

It generally tends to be like a dedicated, focused spiritual practice, like taught by a real teacher. But I think apps are a great introduction. I think they're a great way to like anchor some degree of practice. But I just don't think they're that in depth. So it's a good introduction. What does this have to do with suicide? Not very much. Or a lot.

I feel like we've gone to feel. I'm just kind of answering random questions. That's a good point. Any questions about suicide? Do you like MBSR? Personally, no, but it's a good evidence-based, mindfulness-based stress reduction. It's an evidence-based mindfulness program that's quite secular and has good clinical results.

But personally, I'm not a big fan. I like meditation more so than mindfulness. And then everyone's going to ask, what's the difference between mindfulness and meditation? Also, there's a whole section on this in Dr. Kay's guide. But mindfulness is Sakshibha, which is one state of consciousness that is one step on the road to, like, true meditation or dian. So mindfulness is cultivating a witnessing attitude. So it's like cultivating the witness. It's not a state of Vian or Samadhi.

So Dian is a temporary state of enlightened. I'm sorry. Dian is like a no mind state. And then samadhi is a temporary state of enlightenment. What does it mean if many people around me have attempted suicide? Is it because of me? Does something about me attract to these people? How would you tell?

So I don't think people are trying to commit suicide. because of you. What I would say is that if you look at a cluster of like behavior in your like if a bunch of people around you're committing or trying to attempt suicide, it probably has something to do honestly

with stuff like socioeconomic status and sort of like the way you live. Like it or like this, not the way you live like the life that you were born into. So you know, they're like I saw an interesting post recently about someone having like like a very high divorce.

Like, they were like, everyone I know is divorced. Like, what's up with that? I think that has more to do with, like, the individual community you happen to be a part of, as opposed to, like, any effect that you have. Right? Because, like, most people that I know are not divorced. So, like, I'm arguably happily married. And we, like, do other things with, like, other married couples with young kids.

And so we don't know that many divorce. I mean, we know several people who are divorced. but like, you know, our social circle happens to be like young parents or like middle-aged parents with like young kids. And so that's my social grouping. So depending on your social grouping and who you're kind of like what community you're a part of, the rate of suicidality may be higher or lower. So it's not I wouldn't really think it's your fault or anything like that. Does something about me attract these people?

So. Okay. So we're going to talk. I'm going to go off on a quick tangent, okay? So sometimes when people are dating, they find themselves continuously in relationships with, like, people that are hard to be in relationships with. And so then, like, it kind of begs the question,

like, why do I keep on dating people? Or why do I end up in, like, maybe it's not even a real relationship? It's sort of like, you know, why do I wind up involved with people who are, like, difficult to have relationships with and things tend to fall apart? Like, what's up with that? So this could have something to do with your environment, but especially with the growth of online dating,

what I've really found is a common factor in terms of people who find themselves continuously in, like, relationships that are very hard. And it comes down to this. This is the most common factor I've seen. Sometimes when people are looking at different profiles on dating apps, there's an interesting thought that goes through their head. They'll look at someone and they'll say, oh, crap, this person has it put more, has it, has it, more put together than I do. Like, this person is going to think that, like, I'm not worth dating.

And then they don't reach out to them. And eventually what they'll do is they'll find someone and they'll be like, oh, this person is kind of cute. And it seems like they're kind of like as much of a hot mess as I am. So I won't feel inferior reaching out to them. They won't, like, I'm playing at their level. And I'm a little bit busted. So it makes me feel comfortable.

to like try to reach out to someone who seems like a little bit busted as well. And it turns out that their perceptions are correct. And like that person has their struggles, right? And then like you have your struggles. And then like you enter into a relationship where like, you know, your depression could wax and wane. Their anxiety could wax and wane. And then eventually you like, you get into this situation where your depression is bad. Their anxiety is bad.

And then you like have problems. And these people sort of start to wonder like, you know, why can't I find like a healthy person to date? and what it really comes down to is what is the thought that you tell yourself when you see someone who has their crap together online? Because if you say to yourself like, oh, that person wouldn't want to date me. And then there's like an interesting selection process, right? And that selection process may have to do with like your low self-esteem and you may be selecting for other people with low self-esteem. And when you get two people who have low self-esteem in a relationship, sometimes it works out really well. and they sort of manage to equilibrate. Sometimes they actually both grow as people

and they can help build each other's confidence. But what I'd say happens like 70% of the time and this could be a selection bias because there's a selection bias for people who come to me, right? But what I'd say is 70% of the time it ends up like being really hard because you've got two people with low self-esteem and then like if something bad happens,

like they both think, oh my God, this is my fault, this person doesn't like me anymore, let me pull back, let me withdraw, and then they're like get in. all these like, you know, relationship dynamics. And so be careful. So if you find yourself in a pattern of like difficult relationships, ask yourself when a seemingly, like when a particular person comes along, what are the reasons that I choose

not to try to date them? Do I think, oh, that person is too good for me, that person wouldn't want to date me? You know, like, just be careful about your own thought process because I do think there can be a selection bias there. Sometimes it's circumstance. Sometimes it's selection bias. Another good example of this is like, I think, I don't know how fair this is, but like a lot of streamer relationships, right? So like when two streamers get together, it's not that they can't have a successful relationship. And I understand. Kinjitsu. Absolutely, Chad. All right, who are you rating? So thank you guys very much for coming. Happy Friday. I hope you all enjoyed it.

I know stream was a little bit different today. I know sometimes we have. have the feels and the emotions and stuff like that. And other times we've got a little bit of, you know, education. I know it's challenging because so many people want so many different things in terms of like people want questions, answer. We do Reddit reviews. Sometimes like today I just sort of like was viving and enjoyed. Hey, what's up?

Hi.