The Mindfulness Response: Personal Safety, Suicide, Homicide

            The Mindfulness Response helps us find ways to identify warning signs of trouble and stop them before they overwhelm us.  The ability to work with a team and communicate with supportive people and healthcare providers enables us to be honest about symptoms, side effects of medications, and problems that we have without wanting to take them. Realizing that serious mental illness is a disease, just like diabetes or cancer, we need to take care of ourselves each day and manage our symptoms. This includes taking medications and being open about our feelings and emotions, negative thoughts, psychosis, and PTSD symptoms.

            The Distressing Reaction Response is the nervousness, ruminating thoughts, and constant worry about many things. This ongoing worry and rumination create negative thoughts.  Participants told the group how they could not stop the worry. The strong feelings cause distress and frustration.  More negative thoughts and self-critical thoughts come, as a result. People feel distressed and tend to isolate themselves from others. They become fearful and anxious about social situations. This is also called the Experiential Avoidance Response and is associated with “Safety Behaviors.”

Awareness of Untreated Mental Illness

            Participants were afraid to admit that they needed help. The group discussed how the US culture places stigma upon mental illness and people to hide their serious problems.  Some participants told the group they had a “breakdown,” or a “setback.”  National Alliance of Mental Illness (2023) reported that less than half of the people needing treatment (43%) got it.

Most of those were adults, (65%) and not teens or children.  Half of the kids and teens (50.6%) receive treatment for mental health disorders, although all of them would benefit from help.

Cultural Awareness

            NAMI noted that the majority of people who seek counseling are LGBTQ, followed by Whites and Mixed Races, then Black and Hispanic people, and followed by Asians in the USA.  \ The most people who get treatment are 6-17 years old, followed by adults.  Most of those seeking treatment have a serious mental illness.  Many people don’t seek treatment for years and postpone it for 11 years (NAMI.org 2023).

            Of those seeking mental health services, White and multiracial adults were more likely to get treatment than Black, Hispanic, Latino, or Asian adults.

            Latino or Hispanic adults were more likely than White, Black, or Asian to have attempted suicide.  Adults who had both a serious mental illness and a substance use disorder were highest among multiracial adults. Asian adults were least likely to have both diagnosed (SAMSHA, January 2023).

            One participant talked about looking White but being Native American and talked to others about recurring mental health symptoms, and problems managing them.  The participant explained how Native Americans perceived grief and loss differently from other races and how it was more comforting. The group acknowledged how Whites would avoid distress, or grief and loss issues.

Cultural Awareness LGBTQ+ and Suicide

            Suicide-related behaviors were higher among LGBTQ+ adults than heterosexual adults. The rates of suicide were three to six times higher for this group when compared to all age, race, and ethnicity groups.  LGBTQ+ men had higher rates of suicidal thinking than women. Black women had a lower risk of suicidal thoughts and plans when compared to White women (National Institute of Health November 2021).

Understanding Reasons for Referral

            Participants talked to the group about why they were referred. They came with many different issues. The group was open to listening.

Major Depressive Disorder:

“I don’t want to talk to anyone. No one cares. I don’t deserve to be here. I have no motivation. I just want to die.”

Bipolar Disorder:

“I was manic and got psychotic. I don’t remember everything that happened, but I couldn’t focus well and started seeing things and then got really scared.”

PTSD:

“I’m ok if I stay home. I know I’m safe.  When I’m going to the grocery store, I always look over my shoulder to make sure I’m not being followed.”

Social Phobia:

“I haven’t gone to a party with my partner for months. I feel like people are watching me and will judge me. I feel anxious and people might insult me at a party.”

Agoraphobia:

“I am fine when I’m at home.  I don’t go out in the community much. I haven’t gone out to the grocery store for 3 months; my family goes for me.”

Obsessive Compulsive Disorder:

“I have to make sure that everything is locked, and I go back to check many times, because I don’t want anyone to break into my home and steal stuff.  I must clean and make sure that everything is cleaned, so I don’t get contaminated.  I have to organize so I don’t lose things.”

Substance Use Disorder:

“I get cravings and I dream about using substances. I can’t get the thoughts out of my mind, unless I have some more alcohol, cannabis, etc.

This is also related to trauma where people will try to drown their memories in a substance to avoid the feeling and can get addicted to it.”

Eating Disorders:

“I have this image in my mind of what I should look like, and I want to achieve that goal.

I want to look like a model and be thin…”

“I have this problem with bingeing on food and can’t control it, and don’t want to gain

Weight, so I throw up to get rid of the calories.”

This is also related to trauma and panic disorder, where people can vomit due to excessive anxiety. Anxiety symptoms can cause people to get upset stomachs, headaches, backaches, nausea, and vomiting.           

Borderline Personality Disorder:

“I don’t want to feel the stress of the trauma memory, so I harm myself to feel something else.” 

Psychosis:

Sometimes participants cannot recall a psychotic episode. Participants said that they remembered some, but not all of it. 

Hallucinations can be related to any of the senses in the body. There are some side effects from medications that can cause this. Some diseases can cause hallucinations and psychosis symptoms. Sleep and wake schedules or hypnopompic and hypnogogic hallucinations are experienced upon waking or falling asleep.

Visual:

This is a huge problem when participants talk about scary scenes of violence and blood, demons, and seeing people they know who died.

Auditory:

Hearing noises, sounds of doorbells, knocks on the door, screaming, singing, talking, voices criticizing or telling the participants to harm themselves are very distressing.

Olfactory:

Smells and odors that others can’t smell or shouldn’t be there. Sometimes participants talked about smelling death, decaying things, or blood. These disturbing hallucinations cause uncomfortable feelings even when they know it’s not real.

Tactile:

Touch sensations are feeling something crawling on your skin. Sometimes participants talked about feeling things move inside themselves.

Taste:

Some participants talked about tastes in their mouths that were odd or unusual.

Vestibular:

The room and the walls are moving. Things are steady. This affects balance.

Proprioception

Participants talked about not feeling connected to their bodies and not being grounded.

Interoception

This is the feeling inside your body, such as nausea, hunger, need to urinate. Some participants may complain about aches and pains and believe they have cancer or are dying.

Paranoia

There are different types of paranoia. Participants who experienced paranoia were treated with therapy and with medications from a psychiatrist. Understanding genetics and family history can help educate people about their symptoms. This helps to understand troubles in childhood when a parent exhibits paranoia or other psychosis symptoms.

The self-compassion concept of non-judgment helped build trust in the group therapy setting. The group openly discussed paranoia and how each person managed it. One participant talked about doing reality checks with a supportive person. Another talked openly to a psychiatrist and they both determined that no one would harm the participant, since there had been many days of strong fear, nothing had occurred, and no one had harmed the participant.

Persecutory paranoia is the most common and participants believe that someone will harass them, watch them, steal from them, or harm them in some way.

Grandiose paranoia is a belief that someone is born superior to others. Participants can become argumentative or violent when challenged on beliefs.

Litigious paranoia is the tendency to involve lawyers and the law in daily disputes. People will insist that their rights have been breached and they must seek retribution or justice.

Jealousy paranoia is the spouse who won’t believe their partner and accuses them of being unfaithful. The person creates a confirmation bias that every detail of evidence points to cheating and having an affair. Any new evidence confirms old paranoid beliefs.

Delusions: 

A false belief a false belief, judgment about reality. Some participants in group therapy held on to these beliefs despite evidence stating it was wrong. Delusions are associated with serious mental illness.

Grandiose: People believe they are rich, influential, and talented beyond other people’s capabilities.

Paranoid: Other people will harm or persecute them.

Somatic: Something is wrong with their body, or a body part is missing.