Suicide is one of the ten major causes of death in most countries and is one of the biggest concerns for a mental health professional. There are many complex factors involved when it comes to understanding and diagnosing suicidal tendencies in an individual.

As multiple variables trigger self-harming tendencies, there is not one effective way that can be employed to prevent suicide. The family can play a significant role in its prevention, as it is an avoidable cause of death. Still, to be able to prevent suicide among its members, the family should rid itself of some myths associated with suicidal behavior to start with. Some of these myths are that those who want to end their life will not admit it, or those who say they will do it will not.

Some other myths that need to be addressed, for example, that suicide is an impulsive act caused by a powerful trigger in the mind that can lead to someone ending their life. This may be true in rare cases where, in the throes of extreme anger or hopelessness, someone decides to end their life, but even in that case, there is an undiagnosed or unaddressed mental health state that leads to that spontaneous decision. There are many more like this, so families should psycho-educate themselves about suicide.

So, how can suicide be prevented? The most important thing to notice and address is that if a loved one has signs of anxiety or depression, he is taken to a mental health professional. Medicine can do part of the job of regulating neurotransmitters in the brain, but therapy is a must to help the individual work through the cause of depression.

In case mental health is inaccessible, the family needs to be mindful of the risk factors that may increase the chances of suicide like severe depression, debilitating anxiety, history of mental health issues in the family, death of another member by suicide, failure in life, addiction, and life stress such as financial loss or unhappy relationship and so on.

There are multiple cases of suicides every day where the family expresses deep shock and is at a loss as to why would their son or daughter or a parent commit suicide. The more important question is how a family can assess and prevent if a loved one is planning to attempt suicide.

Coming to prevention, there are four principles that family can determine in the individual, which include desire, intent, capability, and buffers introduced by Thomas Joiner, an American psychologist whose theory proposes that “feeling like a burden and experiencing social alienation can create a desire to die, which may progress to intent when individuals begin planning or taking preparatory actions.” However, Joiner argues that acting on this desire requires overcoming the innate fear of death—a process he calls “acquiring the capability” to die. This capability develops through repeated exposure to painful or provocative experiences, such as previous suicide attempts, non-suicidal self-injury, trauma, or physical pain. Joiner’s groundbreaking work explains how suicidal ideation develops and why many with such thoughts do not attempt suicide—they have not acquired the capability.

So, one way to prevent suicide is to pay attention to the suicidal desire expressed by the individual, “I want to kill myself.” Desire refers to the individual expressing suicidal thoughts and feelings of hopelessness, worthlessness, intolerable loneliness, or feeling like a burden to others. It is very important not to make light of such statements or mock them as they reflect a strong desire. Ask questions from a place of empathy if someone expresses this desire and offers support.

The screen is a medium that opens the world to young children and teenagers via online games, social media, entertainment, and so on. A teenager goes through a lot of internal conflict as he leaves childhood and slowly transitions into adulthood. It’s a period of heightened low self-esteem, and many teenagers find digital life an easy escape from interacting with others and seeking comfort in social isolation. It is also true that many will prefer a more social existence and finding comfort in friends, but in today’s age and time, digital addiction is the new norm, and most teenagers prefer socializing or investing their energy into the digital world.

The digital lives of teens are often described as a “silent crisis” because it is an isolating experience and an interaction between the individual and the screen. So why is it a silent crisis?

Firstly, we all know that digital existence has many negative consequences that affect mental health, relationships, and the psychological development of a person. This impact is harder to detect as the teenager is apparently safe in the comfort of his home, and parents find that to be reassuring. There is also a belief that the digital world can cause no harm and provides a false sense of safety. The adverse effects of excessive screen time are imagined to be physical only and difficult to notice or address, and the symptoms of isolation, anxiety, and depression are understood as ‘typical moody teenager’ and not given much attention. As gadgets are in teenagers’ control, parents in their practical, busy lives can’t control their usage beyond a certain point.

This crisis is considered silent because there are no overt symptoms, and what the teenager is going through is very subtle. He is already locked in his room in isolation, so it’s hard to identify a significant difference in his behaviour. Also, parents don’t know enough about the digital world and are ignorant of what the child is going through.

It is important to understand that while some teens may experience overt symptoms like anxiety or depression, many others may be experiencing low self-esteem, body image issues, and difficulty in regulating emotions without outwardly displaying these challenges, and the lack of connection with family prevents them from seeking help.

Late-night social media use and phone addiction also disrupt sleep patterns, cause fatigue, irritability, concentration issues, and an overstimulated nervous system, all of which can be subtle yet harmful. Parents need to look out for mood and behavioural changes in children and teens, such as more than normal irritability, angry outbursts, or seeming “on edge” when away from devices. Some kids may seem lazy, sleeping more than normal. Young person depression is very common, and parents need to educate themselves about the markers.

Very often, I am asked: Why do therapists charge so much? Many other unsolicited comments follow this inquiry: “But you are only paid to listen to someone.” “A friend can do that.” “It’s too much money spent for simply talking.” “It looks like an easy job.” “I can give therapy to others as well,” and so on.

Simply put, and a very difficult concept to explain: we charge for the space we give to our clients in our psyche. The client might as well pay me rent for a space in my psyche at the beginning of each year rather than paying for each session. Unlike doctors who see us for a short time and do not engage beyond physiology, we emotionally invest in people every week in a process that will last from weeks to months to years. During an hour-long session, we are not simply listening but using our cognitive, emotional, and intuitive awareness to hold space and understand the unique and complex human being sitting before us. We sit with them as they open their wounds, becoming the reparative parents, friends, and spouses in their psyche as we guide them towards a free and functioning life. Is the therapist’s hour alone? No, it isn’t. Beyond all the training, years of experience, supervision, emotional energy, and thinking, the professional fees, we also spend time outside the hour, carrying our clients with us. When a client expresses suicidal tendencies, we think and worry about them beyond that hour and at the expense of our time.

I think this question arises from the limited understanding of what a therapist does. A therapist is NOT paid to just listen. There is additional work between sessions and time and cost outside the session. That one-hour session is just one part of the therapist’s job description. Every therapist continues to invest time and energy in their personal therapy, supervision, and continuing professional development to understand the complex human psyche and support the mental health of clients. Time is spent making notes, record-keeping, and taking complex cases to supervision. Education doesn’t end for a therapist once they get a license; every professional therapist continues to train themselves in different modalities, keep up with new developments, or specialize because the psyche is so complex and one lens is not enough to understand it. A therapist has to be exceptionally mindful of their self-care to be able to work in this field, which also means that at most, a therapist can work for six to seven hours a day. The fees, which are regulated at market price, mean the monthly income will not grow beyond a point, unlike in other fields. There are no annual bonuses or promotions, etc. So, if the charges are high, it is also because a therapist cannot work beyond a few hours a day to provide a high standard of mental health support.

One cannot begin to explain the emotional labor in this job, where on a regular day, a therapist moves from one emotionally powerful experience to another and by the end of the day, may have very little bandwidth left for their personal life.

Another important factor to reflect on is how we are unwilling to pay for our mental well-being but willing to spend twice the cost on coping skills. A drug addict is willing to waste thousands on drugs to cope with trauma but not on therapy that can help with the addiction. There is a higher cost being emotionally and monetarily paid with unhealthy coping mechanisms, but there is resistance to paying for professional help that has been tried and tested.

I think the real question is not why therapists charge so much, but why are you unwilling to invest in the mind that defines every important aspect of your life? How well do you understand and value yourself?

I recently met someone who shared her frustration over the ambiguity of her relationship with her partner, who labels it as a ‘situation-ship’ even after many years of being together. This term amused me and piqued my curiosity about relationships and why people like putting them in a box and needing a label. The title of marriage is at the top of this hierarchy of relationships and is considered an achievement that places an individual in a higher place in society.

Relationships in our culture are most frowned upon, whereas the tolerance for friendships, especially with the opposite gender, is increasing and less judged and criticised. So where does a situation-ship fit in all of this? I understand it as a space that transitions between a friendship that is perceived as a black-and-white, platonic dynamic and a relationship that is an intimate affair that promises the possibility of marriage. I think a situation-ship falls in the middle of a friendship and relationship, a bridge where the people involved stand and decide if they want more and delve into an intimate space or should they stay where they are and friend zone each other.

I am not surprised at the frustration that my friend is experiencing. Ambiguity in relationships is an exhausting place to be in. All human relations, regardless of their category, are attachment-based, and when attachments deepen, and both parties are not on the same page, that is a recipe for disaster. It means there is great potential for individuals’ old wounds to get triggered, and those emotional wounds are primarily rooted in primary relations. For example, a girl whose father left the family as a child will be terrified in an adult situation-ship where she does not know If the other person is committed.

Our primary need is for belonging and emotional connection, and it makes us feel safe and grounded as human beings. If that space is under threat, it is triggering for the parties involved; ad their other attachment-based traumas will get badly activated.

So, what do you do if you are in a situation-ship? Although challenging, the best way forward is to introspect your history. If you grew up in a safe environment where you experienced stability with your family relations, you have a greater capacity to explore the situation-ship and see where it goes, but if you have experienced non-committal parent or sibling relations, then be compassionate to yourself and remember that you will not have the resilience and strength to deal with a relationship space that has no label which means it’s not defined clearly and no expectations or boundaries established. The hot and cold dynamic will add more emotional pain to unprocessed traumas.

Sometimes we unthinkingly fall into relationships that hurt as we were hurt before as children. Freud called it repetition compulsion, which involves unconsciously repeating painful situations that occurred in the past.

So, if you find yourself in such a situation, see how familiar it is in terms of the emotions it evokes in you. It’s not that your adult partner will be similar in personality traits to your father or mother. Still, you will probably notice how you experience similar and overwhelming emotions in the present relationship as you did in the past.

If it’s similar, be honest with yourself and don’t ignore any red flags if there are any to feel attached to another being, and most liked, you want the adult person to compensate for parental failure and love deficit. And if the present relationship is different, then self-evaluate and see what you are bringing to the dynamic that makes the other person feel unsafe and hesitates to commit.

The best thing is to speak to a therapist or a confidant and look at your relationship from a third-person perspective to understand what’s happening. A situation-ship is an excellent opportunity to resolve the unseen and unexplored past; if you can work through that, your present relationships will become safe and secure.

I recently did a training in trauma therapy that discussed what trauma in early years means, how it affects the functions of the brain, how the nervous system gets involved when a human being experiences real or perceived threat, and most importantly, how trauma in early years catches up on an individual in his adult life in the form of mental and physical illnesses.

Everything is biology. I was familiar with trauma and its effects on the human psyche. Still, this training further highlighted the impact of trauma, and it was overwhelming to imagine how blindly we live our lives and how we have the wrong lens through which we have been managing our minds and body.
Gabor Mate is a Canadian physician and author interested in childhood developmental trauma and its effects on physical and mental health, including physical and psychological health, ADHD, cancer, and autoimmune diseases. He believes all these issues are rooted in trauma, and it “is not what happens to you; it is what happens inside of you as a result of what happens to you.” In Greek, trauma means ‘wound’ and is the invisible force that shapes our lives. It shapes the way we live, the way we love, and the way we make sense of the world. It is the root of our deepest wounds.

We all can, with conscious intention, work through our traumatic responses, which get presented as diseases, physical illnesses, insomnia, mental health issues like anxiety, depression, nightmares, brain fog, memory issues, and the list goes on. Where all of this affects us individually, trauma also gets presented in relationships, and the unsafety we have experienced gets projected in our relationships. For example, a man whose father cheated on his mother will grow up with trust issues and be paranoid about his partner’s loyalty. When people ask why more and more people are coming into therapy, it’s simply about people acknowledging their traumatic histories and having the will to work through them.

It’s necessary to understand here that childhood trauma doesn’t mean a significant life event only, like the death of a loved one, divorce, or sexual abuse, but when I ask an adult client, ‘‘When you felt bad as a child, whom did you talk to? And he says, no one, that’s trauma. Children learn to suppress emotional pain when they don’t have parental support to process it, and the child, in an attempt to disconnect from the pain, disconnects from the inner self. He no longer has ‘himself’ and will continue life sublimating that pain in addictions, introverted behaviors, and drive towards achieving, to name a few. At the same time, the body and mind will protest in the form of something as benign as neck pain or panic attack.

Underneath the trauma is a healthy individual who hasn’t found expression or a healthy way to connect to others. He seems to live everyday life, but the nervous system is vulnerable to being triggered instantly. Childhood trauma creates ‘procedural memory’ that can get activated by any being triggered through life unless processed, and the nervous system’s fight, flight, or freeze response gets activated. Road rage is a typical example of that. Have you seen how angry some drivers get? Do you think it’s terrible driving that induces that kind of rage? If you want to understand what I am referring to here, watch ‘Beef’ on Netflix, the best example of traumatic childhood experiences manifesting in so many moments of life as we try to rationalize our emotions by distracting ourselves with narratives about ourselves and others. ‘I am overreacting because you made me’ whereas the ‘you’ in this scenario is as lost and trying to see how he or she had the power to provoke such an extreme reaction in the other.

We need to address our traumas. If therapy isn’t your cup of tea, seek support from people you trust to process unresolved pain. Stories you have not shared. Hurt that’s locked inside for decades. It will be the most challenging thing you do. But the pain that you think is locked inside and not affecting your life because you are not consciously thinking about it is an active part of your body-mind system and gets presented as ‘jittery nerves’ that get over-triggered in unhealthy ways, physically and psychologically, in behaviors and life choices. So, start healing your trauma sooner than later to live an authentic and healthy life.

The world seems to be shocked and fixated ever since the canoodling couple at the Coldplay concert last week was caught on camera and is suspected of having an affair. Chris Martin’s comment, “Either they’re having an affair or they’re very shy”, when the couple ducks away from the limelight, added fuel to the fire. I am more shocked at the moral policing by netizens and anyone and everyone I know, and the oscillating emotions varying from shock to perverse pleasure at them being found out.

Love is a messy business, and an affair more so. It hurts the parties involved and there is a cultural transference towards anyone having an affair, who is seen as the villain of the story; the perpetrator of causing a broken home. My dilemma is that we all know how complex human relationships are; rooted in conflict and pain, and we all have our plates full as we navigate our multiple roles and try to meet the expectations of these roles.

An affair is not as simple as understanding it to be lust, a mid-life crisis, or an itch. Nine out of ten times, it is rooted in unmet emotional needs that can date back to primary wounding being enacted decades later in a connection with someone outside of a marriage. An affair very rarely starts off on a whim. It will start with a basic connection, a liking that gets augmented, leading to a deeper relationship. Most people do not want to hurt their loved ones, and that is mostly what gives birth to the element of secrecy. The one who is having an affair is conflicted between surrendering to his or her needs and protecting the family from pain. It is also important to understand that an ‘affair’ is not happening outside of the marriage and has to be understood within the context of the marriage.

I can imagine eyebrows being raised at what I have expressed so far. Am I endorsing dishonesty in a marriage? Am I giving an implicit permission of sorts here? No, I am not. Is honesty and commitment in a marriage the foundation it stands on? Yes, it is. In an ideal world, people should walk out of unhappy relationships rather than hurting the family, because it is true that an affair always, sooner or later, gets disclosed. My point is that someone having an affair should not be treated as a social outcast and painted as the villain as a knee-jerk reaction. Every marriage is unique, and so is every affair. We don’t know anything about this couple, their marriage, or the life they have had, so why are we hating them so much? I also want to ask those who are moral policing what kind of life they lead, and whether they have no skeletons in their closet. I want to ask married couples if the thought of another person has never crossed their mind.

This culture of shaming and blaming needs to stop. We have to stop jumping on the bandwagon of the haters just because everyone else is on it. What if one of the two people we saw at the concert has depression and is suicidal? What will the haters feel if one of the two, or people associated with them, harms themselves? We know nothing about people’s lives or their struggles, so for the love of God, stop being unkind. Stop hating. Don’t assume and do not judge. Do not play God with people’s lives as a pastime. Your one like, one share, is what makes videos go viral.

The psyche of human beings is unimaginably complex, and before we shame others and add to their public shaming, we should take a look at our own lives, and I am sure there will be many moments where our moral decisions could be questioned.

Live and let live.

Anxiety is as familiar to human beings as water is to fish. The human psyche/mind/body is the natural habitat for anxiety, a term coined by Freud, the father of psychoanalysis. I became familiar with this term when I became a student of psychology, and even until then, it only had a theoretical significance. Entering the field of psychology is when anxiety became the most heard word, and I came to the realization that throughout my life, different thoughts, emotions, and physiological symptoms I used to go through all come under this umbrella term: anxiety.

Nine out of ten clients I work with have the presenting problem: I have anxiety. How do I get rid of it? So, like an archeologist digging for hidden historical treasures, I would start searching for factors in the past and present that were contributing to the client’s anxious crisis. We would resolve one set of issues, so to speak, and something else would come up after some time. The anxiety, I realized, has become an extra body part that cannot be amputated. What now? How do I help my client? After months and months of therapy, anxiety is not dissipating.

As an intervention, I asked one of my clients to rename the ‘anxiety’ with something that he is fond of. He stated ‘football,’ and so I suggested that every time he talks to me about his anxiety, he would say I am feeling ‘football’ rather than ‘anxiety.’ Viola! Something started shifting. Despite external circumstances remaining the same, he started to react differently, and there was a significant shift in his anxious symptoms. We worked through that for the next couple of months, and without medication, he became much more regulated.

I realized that the attachment to the word anxiety was part of the problem and, most importantly, the association with this word, which is negative and understood as a mental health problem that needs a solution. Post that, what he felt in situations was considered normal, the nervous system’s fight/flight response that did not require the label of ‘anxiety.’

Starve your anxiety. Understand that our mind, heart, and body join forces in situations where we experience an external threat or feel unsafe internally, and the response to it is normal. It does not require a label. Starve it by not using that word at all and expressing what you are going through in different words. For example, if there is an important presentation you are worried about, rather than saying I feel anxious, you may say, my mind or my body is preparing for this presentation. Suddenly, the symptoms, be it recurring thoughts, tightening in the chest, or worried feelings, will all feel like allies rather than foes.

What is a healthy mechanism has become a pathological disorder with so many categories that further augment the issue. Starve this monster called anxiety by not recording and repeating what you are going through daily. For example, if you have health anxiety, tell yourself that for one week, you won’t share the symptoms at any time or google the symptoms, but every Friday, let’s say you will talk about it as much as you want to. You will be surprised how the attachment to the health anxious part will dissolve, and you will not have the same energetic tendency to talk about your health anxiety as before.

Anxiety is not a monster. The symptoms of it are similar to excitement. It’s the narratives we have attached to it that make anxiety a negative experience and excitement a positive one. To begin with, change your language and, as mentioned before, express what you are going through without using the word anxiety. Secondly, accept that all the symptoms are an energy that propels you forward. In most cases, I have seen anxiety as the bigger problem to tackle than the problem itself. Trust your inner resource that can make you successfully survive anything in your life. Trust the human resilience and the evidence of which is a dime a dozen in the history of mankind.

Starve the anxiety and start breathing.

Starve the anxiety and start breathing.

Very often, I am asked: Why do therapists charge so much? Many other unsolicited comments follow this inquiry: “But you are only paid to listen to someone.” “A friend can do that.” “It’s too much money spent for simply talking.” “It looks like an easy job.” “I can give therapy to others as well,” and so on.

Simply put, and a very difficult concept to explain: we charge for the space we give to our clients in our psyche. The client might as well pay me rent for a space in my psyche at the beginning of each year rather than paying for each session. Unlike doctors who see us for a short time and do not engage beyond physiology, we emotionally invest in people every week in a process that will last from weeks to months to years. During an hour-long session, we are not simply listening but using our cognitive, emotional, and intuitive awareness to hold space and understand the unique and complex human being sitting before us. We sit with them as they open their wounds, becoming the reparative parents, friends, and spouses in their psyche as we guide them towards a free and functioning life. Is the therapist’s hour alone? No, it isn’t. Beyond all the training, years of experience, supervision, emotional energy, and thinking, the professional fees, we also spend time outside the hour, carrying our clients with us. When a client expresses suicidal tendencies, we think and worry about them beyond that hour and at the expense of our time.

I think this question arises from the limited understanding of what a therapist does. A therapist is NOT paid to just listen. There is additional work between sessions and time and cost outside the session. That one-hour session is just one part of the therapist’s job description. Every therapist continues to invest time and energy in their personal therapy, supervision, and continuing professional development to understand the complex human psyche and support the mental health of clients. Time is spent making notes, record-keeping, and taking complex cases to supervision. Education doesn’t end for a therapist once they get a license; every professional therapist continues to train themselves in different modalities, keep up with new developments, or specialize because the psyche is so complex and one lens is not enough to understand it. A therapist has to be exceptionally mindful of their self-care to be able to work in this field, which also means that at most, a therapist can work for six to seven hours a day. The fees, which are regulated at market price, mean the monthly income will not grow beyond a point, unlike in other fields. There are no annual bonuses or promotions, etc. So, if the charges are high, it is also because a therapist cannot work beyond a few hours a day to provide a high standard of mental health support.

One cannot begin to explain the emotional labor in this job, where on a regular day, a therapist moves from one emotionally powerful experience to another and by the end of the day, may have very little bandwidth left for their personal life.

Another important factor to reflect on is how we are unwilling to pay for our mental well-being but willing to spend twice the cost on coping skills. A drug addict is willing to waste thousands on drugs to cope with trauma but not on therapy that can help with the addiction. There is a higher cost being emotionally and monetarily paid with unhealthy coping mechanisms, but there is resistance to paying for professional help that has been tried and tested.

I think the real question is not why therapists charge so much, but why are you unwilling to invest in the mind that defines every important aspect of your life? How well do you understand and value yourself?