January 5, 2012

Where Do I Start?

(from American Foundation for Suicide Prevention www.afsp.org)

Know that you are not alone.

If you have lost someone to suicide, the first thing you should know is that you are not alone. Each year over 33,000 people in the United States die
by suicide — the devastated family and friends they leave behind are known as “survivors.” In fact, research shows that during the course of our lifetime
85% of us will lose someone we care about to suicide. That means that  there are millions of survivors who, like you, are trying to cope with this
heartbreaking loss.Survivors often experience a wide range of grief reactions, including some or all of the following:

  • Shock is a common immediate reaction. You may feel numb or  disoriented, and may have trouble concentrating.
  • Symptoms of depression, including disturbed sleep, loss of appetite, intense sadness, and lack of energy.
  • Anger towards the deceased, another family member, a therapist, or  yourself.
  • Relief, particularly if the suicide followed a long and difficult mental illness.
  • Guilt, including thinking, “If only I had.…”

These feelings usually diminish over time, as you develop your ability to cope and begin to heal. We care and want to help.

Professional, compassionate help is available. Call us at 608-785-7000 or click here for an appointment request. 

National Violent Death Reporting System findings with respect to suicide in 2008:

 For 2008, a total of 15,755 fatal incidents involving 16,138 deaths were captured by NVDRS in the 16 states included in this report. The majority (58.7%) of deaths were suicides, followed by homicides and deaths involving legal intervention (i.e. deaths caused by police and other persons with legal authority to use deadly force, excluding legal executions) (26.4%), deaths of undetermined intent (14.5%), and unintentional firearm deaths (0.4%). Suicides occurred at higher rates among males, American Indians/Alaska Natives (AI/ANs), non-Hispanic whites, and persons aged 45–54 years. Suicides occurred most often in a house or apartment (70.6%) and involved the use of firearms (51.5%). Suicides were precipitated primarily by mental health (45.4%), intimate partner (30.9%), or physical health problems (22.6%), or by a crisis during the preceding 2 weeks (27.9%).

 Suicide Patterns

Similar to the 2005–2007 NVDRS data years, the suicide rate for the 2008 data year was highest among males and American Indian/Alaskan Natives, although at least 85% of the suicide victims each year were of white non-Hispanic race/ethnicity. Also, the 2008 suicide rate was highest among those of aged 45–54 years, in general, but the highest rate remained among males of aged ?85 years. These findings have also been documented in other reports (10,11 ).

In 2008, mental health issues (i.e., having a current depressed mood and/or a current mental health condition) remained the most common health characteristic among decedents, which was also reported in previous years (79). Intimate partner and relationship problems, alcohol/substance abuse problems, serious physical health problems and crises immediately prior to death also remained common characteristics or circumstances among decedents (7,8,12–16). This report also showed that intimate partner problems were more common among male decedents and diagnosed mental health conditions were more common among female decedents. However, both male and female decedents were almost equally as likely to be noted as having a current depressed mood prior to death. This finding supports previous research that showed females are more likely than males to seek mental health care and receive a diagnosis for their mental distress (17,18). Among those who received a diagnosis, the majority of both male and female decedents were diagnosed with depression. However, this report revealed some differences in diagnoses by sex; attention deficit disorder was more commonly found among male suicide decedents and bipolar disorder and anxiety disorder were more commonly found among female decedents.

Another similarity with previous data years was that nearly 30% of suicide decedents in 2008 disclosed their intent to commit suicide to others and approximately 20% had made previous suicide attempts (79). This finding indicates that there still remains the need for proper follow-up treatment and monitoring for those who attempt suicide as well as the need for public education on how to respond and seek help when faced with someone disclosing suicidal intentions (79,19).

In contrast to previous NVDRS data years, slightly greater proportions of suicidedecedents in 2008 were identified as having job problems and having financial problems prior to death. In 2008, both proportions were estimated to be 13.4% whereas, in previous data years, the proportion of suicide decedents identified as having job problems ranged from 11.1%–11.5%, and the proportion identified as having financial problems ranged from 11.0%–11.7%. Financial hardship was not found among decedents of undetermined deaths, which further indicated this circumstance was more associated with suicide. Financial and job problems were more common among male decedents and decedents aged >50 years. Job loss can trigger a cascade of negative events, such as more financial problems and relationship problems (20), which can increase risk for suicide. These findings suggest that strategies that incorporate financial planning and social support are warranted for those who might be at risk for losing employment, particularly during difficult economic times.

 Description of System: NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS data collection began in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two in 2010 (Ohio and Michigan) for a total of 19 states. This report includes data from 16 states that collected statewide data in 2008; data from California are not included in this report because NVDRS was implemented only in a limited number of California cities and counties rather than statewide. Ohio and Michigan are excluded because they did not begin data collection until 2010.

To view the entire report, visit:  http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6010a1.htm?s_cid=ss6010a1_e&source=govdelivery

Self Injury and Teenagers

December 26, 2011

Awareness of non-suicidal self injury is on the increase, however; it remains one of the most difficult behaviors to encounter for parents, caregivers, and professionals alike.  None suicidal self injury consists of a broad class of behaviors defined by direct, deliberate, socially unacceptable destruction of one’s own body tissue without the intent to die. Often, these behaviors include but are not limited to, cutting, burning, picking at or intruding on wound healing, hitting oneself, inserting objects under the skin, and often excessive tattooing/piercing (more than 5). It is estimated that approximately 7% of preadolescents (Hilt, Cha, & Nolen-Hoeksema, 2008) , 12 to 40% of adolescents (Ross & Health, 2003), and 17% to 35% of college students Gratz, Conrad, & Roemer, 2002) have engaged in this form of self injury at one time or another.

Self injury may occur in the context of other mental health issues such as depression, anxiety, substance abuse, eating disorders, and/or behavioral disorders. It may also occur in the absence of psychiatric and mental health disorders.  Motivation for engaging in such behaviors  often includes to stop bad feelings, to relieve feeling numb or empty, to feel something in  the absence of other feelings,  punishing oneself, and interestingly enough – to relax.  A simple summary is to describe motivations for engaging in these behaviors as tension reduction.

Self injury may be only “experimental” or may become habitual.  The  1st step towards treatment is a thorough assessment of the self injurious behaviors. A comprehensive assessment can aid in early detection of such behaviors and aid treatment providers in better understanding the motives behind the behavior. Should you or someone you love be engaging in these type of behaviors,  please contact us at 608–785–7000 or click here  to begin the process of getting the help and relief without harm.


August 17, 2010


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Help: My Teenager Says “I Hate You” – It really makes me mad!

April 29, 2009

I received this email recently from a parent of a 14 year old teenage girl.

Dear Ted:

“I really need some help. My daughter can be so sweet at times but at most other times, I think she is possessed! She gets so moody sometimes and says the most hateful things to me. I know that teenagers are moody – I remember it well, but I never treated my mom or dad with such disrespect.  I have tried everything and am to the point I don’t want to take her anywhere or give to her anymore since she can be so unappreciative.

I really want my little girl back. She gets good grades and has good friends. I don’t think she is using drugs since she signed a contract with the school. I just want some respect. Can you give me some advice”

Frustrated Mom

Teenagers can be very moody. Research shows that their frontal lobe does not develop until early 20’s which controls impulses such as these. This means they need parents guidance and for us parents/adults to always be bigger, stronger wiser, and kind (Circle of Security).

When adolescents resort to these type of tactics, it is often as a result of the parent preventing them from achieving some goal that the teenager has had. In other words, the parent has said”No” in some way, shape or form.

Teenagers then use various strategies in order to get the parents to capitulate to their desires: negotiation, whining and complaining, badgering, martyrdom, defiance, personal and verbal attacks, threats, and acts of violence/property damage.

Parents often reason with their teens and attempt to help them understand the logic behind their decision – because they are using their frontal lobe while the teenagers are using their amygdala (emotion center). This is a recipe for disaster.

While this is most likely cause by an underdeveloped brain,  it can unnerve the most stable of parents.  There is nothing more painful that to hear your child say, “I hate you.” When parents are told, “don’t take it personally” by professionals they often reply with ” how can I not take it personal – it is!” What I often advise parents in these situations is the old adage of “less is more.”  Less emotion, less talking. Also, I share with them that “anything you feed will grow, anything that you starve will wither and die.” Don’t feed the teens tactics.

Through my work with some parents, we have patched together a type of bullet proof vest that has seemed to decrease the impact of the bullet, but still may leave a mark.  Each one of the statements below is based on some of the patchwork and the “less is more” and “starve” the tactic.  If the teenager uses multiple tactics, that may be a good sign that one is not working for them. If they use the same one over and over, the tactic is likley being fed somehow. Following the use of any of these patches, leave the situation or the arguing will get worse.  Go to a cooling off spot for yourself.

Here is the list – avoid sarcasm:

“That is too bad.”

“Sorry to hear that.”

“Regardless,  what I said stands.”

“That does not change anything.”

“I see that we are not going to be able to talk through this. Conversation is over.”

“I am going to take a time out for myself before I say something hurtful back.”

Of course, saying nothing is another option.

Hang in there…as my friend Dr Bill Whelan at the Mary Ainsworth Institute says, “Always be Bigger, Stronger, Wiser, and Kind.”

Teens and Unhealthy Self Esteem

November 26, 2008

Major Tasks of Development

One of the major tasks of adolescence is for the teenager to re-evaluate themselves. There are three main areas of evaluation:appearance, performance, and status. Teens conduct on a daily basis a self-evaluation of their functioning in these three areas. This self-evaluation helps create their self concept.

Causes and Effects of Unhealthy Self Esteem

While there are many factors that may contribute to unhealthy self esteem there are several that
clearly impact self-esteem: abuse, perceived parental rejection, and ‘stinking’ thinking.
The effects of unhealthy self-esteem are the teens attitude toward his/her world and the ability to cope
with challenges. They will tend to believe they cannot influence their world and are victims of life circumstances.

Symptoms of Unhealthy Self Esteem

Some symptoms of unhealthy low self esteem are:

  • pessimistic outlook on life
  • lack of confidence
  • extreme sensitivity to criticism
  • view of others as competition
  • defensiveness in behavior and conversation
  • attitude of chip on shoulder
  • constant anger
  • inability to accept compliments
  • pattern of self-defeating behaviors

Some other symptoms of unhealthy high self esteem:

  • overinflated ego
  • unrealistic appraisal of ability to complete a task
  • overly optimistic look of life that denies reality
  • lacks empathy for others
  • defensive
  • puts others on the defense chronically
  • does not use their past as a learning experience
  • life is a one way street
  • takes the path of least resistance as a way of life
  • refuses to be held accountable
  • blames others frequently

A poor self image is not formed overnight and takes time to nurture and develop a positive self image. Help is available

Adolescence: Changes in Development

July 25, 2008

Programs Teens
Parenting Teens: Weathering the Storm
Changes In Thinking
July 2008 Year
Website Images Top

This edition of the Stein Counseling E-Newsletter will focus on adolescent development and what every parent needs to know about their blooming young adults.

mother and teen Three Types of Teenagers

Teenager development can be categorized into three types: Early Developers, Late Developers and Troubled Development.

frustrated teen Early Developers
Research into early developers suggest these type of adolescents do well during the elementary school years and are basically cooperative youth prior to adolescence. Longitudinal research indicates these adolescents turn out to be responsible members of society as adults regardless of the level of rebelliousness present during adolescence. Their resiliency is large part due to healthy pregnancy and prenatal care, love and nurturing during the first three years of life, and during the second and third year the parents were kind but firm and loving regarding discipline. These parents set limits on their child’s inappropriate behavior consistently.

sadgirl2 Late Developers
Late developers are often described as by parents as “independent, strong willed, and stubborn” as infants and toddlers. Longitudinal research suggests that by age 11, these youth continue their independence, however; have partnerships with others to reach common goals. They do well in adolescence and their adult life.

troubled teen Troubled Development

Troubled teens tend to act in ways that are destructive to themselves and others. As children, parents report these youth to be difficult to sooth, aggressive, bossy, irritable and very difficult to parent. As teenagers, the often have a great deal of rage and have tend to make decisions based on instant gratification rather than working towards long term goals. They don’t trust adults and and often have problems with authority. They may be abusing drugs or alcohol, damage property, skipping school, failing grades, sexually acting out, extreme acts of disrespect, violence or threats of violence and may runaway or threaten suicide. They key here is a pattern of this behavior rather than moments or episodes of behavior. The most cooperative teenagers will often have instant gratification moments and strong emotional upsets. Click here to read about our adolescent services or click here about our services that support and help parents with these issues.

Upcoming Events
1-2-3 Magic! Child Management September 23, 2008 and October 21, 2008

Parenting with Love and Limits (based on the book “Parenting Your Out of Control Teenager”) September 22, 2008

Tender Parenting: Getting Past the Guilt; September 10, 2008

Closing Headline
Thanks for taking the time to read this information. We are grateful to be a service to the community and try to “give away” as much education as possible to help make our community stronger and our future brighter.
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