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Mark Goulston M.D., F.A.P.A.
Mark Goulston M.D., F.A.P.A.

Humiliation Kills - The Wound that Will Not Heal for Men

Trey Pennington social media giant dead at age 46.

A significant percentage of men
who feel and act suicidal
and sadly commit suicide
either have been or are about to be humiliated

Trey Pennington, a social media leader known to hundreds of thousands of people and someone who I followed on twitter, who followed me and even interviewed me about the importance of listening committed suicide this past Sunday at age 46. He was a consummate and caring host and interviewer and had the ability to make you not only feel smarter and wiser than you are, he also make you feel worthwhile and deserving or even a blessing to be on this planet.

I only wish someone had listened to him (or that he allowed someone to listen to him to ease his torment) and helped him feel the same way so that he could still be among us.

Since I didn’t know him well, I don’t know how much of the following applies to Trey, but it certainly applies to many men I have seen over the years who felt suicidal.

From Vince Foster, to Mark Madoff to Enron’s Vice Chairman J. Clifford Baxter the infamous Bronco chase of O.J. Simpson, the news and the public’s fascination about suicide stops viewers and listeners in their tracks to find out more. That is because such scenarios have touched something at the core of our humanity (or as you will discover, maybe something even below our humanity).

It may not be readily apparent to women (who commit suicide to get out of unendurable pain) why mere embarrassment should cause you to want to kill yourself. After all it’s not the death of a child or a divorce which on the surface seem more understandable triggers for self destruction.

However to most men, it isn’t so surprising that extreme humiliation can cause suicidal thoughts and action.

Why is that?

What may be happening neurospsychologically is that the three parts of a man’s mind/brain i.e. his lower, reptilian, “fight or flight” brain; his middle, mammalian, emotional brain; his upper, human, rational brain have been rigidly wired together in service of a particular mission or goal (the soldier fighting a war and being willing to die for his fellow solider, for example). But then when their current reality or their mission changes and calls for something entirely else that their rigidly wired mind/brain cannot adapt to (the soldier who in civilian life has to put up with people whining about trivial stuff and who only care about themselves), that situation eventually can push that person’s mind/brain to uncouple from the way it is hard wired. And rather than feeling like merely an internal readjustment to a new reality, for some it can feel like a breakdown.

It’s simply this. When as smart as you thought you were is as foolish as you turn out to be; when as powerful as you thought you were is as powerless as you turn out to be; when as much of a hero as you thought you were is as much of a villain or coward as you turn out to be, a man’s sense of himself begins to plummet and heads towards shattering.

A man without competence is useless and worthless;
A man without courage is not a man.
A man who is useless, worthless and not a man has no reason to live.

The anticipation of shattering and like Humpty Dumpty never coming back together again can be terrifying and terrorizing. Therefore, while that man still has some control of his actions and before he completely loses control over his life, taking his life can be ironically an act of self-preservation (vs. self-fragmentation) even as he ends it.

What to do?

Six steps that may help to talk a man out of suicidality (done in a very calm, reassuring, patient, let-him-talk-as-much-as-he-needs-to way):

  1. “Tell me what happened.” This is essentially picking the scab off a deep psychological and emotional wound. Regardless how out of control and incompetent the man feels, he can still usually report on events that led up to the current crisis.
  2. “Tell me more.” This is opening up the pus under the scab. After the man finishes telling you what happens, he anticipates that you will get into a debate or a discussion or try to have a dialogue with him, none of which he is ready to enter into. Because he is not finished telling his story* is why he will push back or interrupt you if you attempt to say or advise anything. Instead, pick one of the things he told you in relating his story to you and say, “Tell me more about that.” Showing more interest in his pain and furthermore wanting to relieve it by having him talk more about it is counterintuitive, not what he is expecting and counterintuitive.
  3. “What’s really going on?” This is draining the pus in the wound. When you ask this after you have patiently heard them out in 2 above, they will start to go deeper and say, “I really f--ked up” or “I blew it and now I’m screwed” or “I’ve destroyed my life forever.”
  4. “And the way it makes you feel is ___________" leads to emotional exhaling (and putting some distance between him and his suicidal impulse). Invite them to fill in the word or offer examples such as: “worthless,” “hopeless,” “that life is pointless,” “that you can’t go on,” or “what exactly?” After all the pus has been drained and when you ask and have them fill in the blank with an emotional word(s), they will further calm down. That is because according to UCLA researcher, Dr. Mathew Lieberman, when people attach and express the correct emotional word to what they are feeling it lowers the activation of a part of their emotional brain which results in their beginning to calm down (i.e. exhaling).
  5. “At its worst, how bad does that get for you?” Again, by not prematurely cutting them off in their emotional exhale, and having them say something like, “It’s unbearable,” “Like I can’t go on,” or as one of my patients said with a (more relaxed smile), “Duh… I’m suicidal ain’t I? How bad do you think it got to get me here?”
  6. “And that’s why we need to come up with something to make it better, because you can't tolerate another minute of feeling this way. Is that correct?” You have now moved the person away from their suicidality to a conversation and to hopefully cooperating with you to find another option besides killing themselves.

Re-pairing Des-pair

Despair or as I like to call it, des-pair, means feeling unpaired in a world it which it feels like everyone else is paired with a good job, a happy marriage, loving family, caring and hope and you’re not. When the pain of feeling so unpaired becomes intolerable and that is when “pairing with death” as a way out and as a way to relieve intolerable pain becomes plausible.

The six steps above are a way of “re-pairing” with such an individual via empathy. And when it is successful and they can pair with that kind of understanding and caring, they will no longer need to pair with death.

About the Author
Mark Goulston M.D., F.A.P.A.

Mark Goulston, M.D., the author of the book Just Listen, is a Clinical Assistant Professor of Medicine at UCLA's Neuropsychiatric Institute.

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