Losing a client to suicide (with Marie Vakakis)

[00:00:05] Bronwyn: Hey, mental workers. You're listening to the Mental Work podcast. The podcast about working in mental health for early career mental health workers. I'm your host, Bronwyn Milkins, and today we are talking about a topic that we don't really hear about, which is coping with a client suicide. It can be one of the most devastating experiences a mental health professional can face, but as I said, I've never heard it spoken about, and today we're going to address that by giving it a really good chat. The grief, guilt, and self-doubt can be really overwhelming, and many early career workers, if this happens to them, are left wondering how to navigate this situation.

In this episode, we are going to be opening up about this topic, sharing our personal experiences, and we're going to be exploring how mental health professionals can process their emotions, access, support, and move forward after a client's death.

Here to help us out with this topic is our return guest, Marie Vakakis. So Marie, both you and I have experienced the loss of a client to suicide.

[00:01:01] Marie: Yes, and I think the fact that we got to that conversation too just shows how it takes a long time. Like we've been collaborating with each other now for I what, a couple years. Um, and it took a lot of probably trust and connection and rapport to even brace that topic and then be open to having a conversation about it. So it is something we're coming at from a, a healed but personal, uh, experience I suppose.

[00:01:32] Bronwyn: Yeah, it is a topic that I had wanted to do a podcast episode on for a few years actually, and because I had experienced this roughly four or five years ago now... so as you said, it's a healed thing, but, and, and that's the amount of time that I've felt like I needed to be able to come to it and then to discuss it with someone else like yourself as well.

[00:01:54] Marie: I think it felt... 'cause we had, um, we had a one go at this and the recording, it didn't go well for tech issues. We were fine. Um, but I could, I could feel a little bit of heaviness even coming into the second time thinking... it wasn't triggering because like I said, it, it's a healed experience, but I know it's going to be a tough topic and to give people a kind of candid, authentic conversation... I could feel my body saying, don't go there, but you need to go there, but it can't just be superficial. And I don't know, I was just feeling lots of feelings coming into it.

[00:02:31] Bronwyn: Yeah, that's really interesting. What do you notice in terms of feelings? Is it sadness or is it like a, a heaviness? Like, I don't know. How would you describe that?

[00:02:42] Marie: A little bit of both because when we touched on it, um, the first time we tried to record, it evoked, um, memories of the actual climb. And so there was that sense of the loss came back a little bit. The that sadness for them and their family and what could have been.

[00:03:02] Bronwyn: Yeah, absolutely. It, it does bring up that. That's really interesting you say that because I feel the same way. It's like when we talk about it, I do think of memories of them, which I guess don't come up for me day to day anymore. And then when I cast my thoughts over to them, I do think about what a sad loss it is. I do feel that sadness, sadness is the predominant feeling for me.

[00:03:22] Marie: One of the things that, when we were preparing for this topic, I know I did a bit of a little r research, like just a Google search. And I actually found it really hard to find topics around the what to do for the professional, um, what to do if so... there was a lot out there for like suicide postvention, and I know when I worked in schools, uh, we had a suicide postvention plan and the Department of Education, uh, and Headspace have postvention, like there's, there's a lot out there, there's things for the family who are bereaved.

And there wasn't much talking about the unique experiences of a therapist. So there were some things in hospitals talking about, I'm guessing it might've been psychiatrists or doctors 'cause they were referring to clients as patients, or it might've been an American context, but there was not, not much that I could find, actually couldn't find anything. I didn't do like a huge meta-analysis around the therapeutic relationship.

[00:04:21] Bronwyn: Yeah, no, it's a really good point. And it's something that I've noticed as well because I'm aware, for instance, in Australia we have something called the suicide callback line. And I know that the organization who runs that also runs another phone line that people who are affected or bereaved by suicide can call. So I know there's support for family members, for friends, um, for people who have lost someone to suicide, not a professional. And then I'm aware even of Beyond Blue, they've got post suicide services for again, affected family members, community, but there's nothing as far as I know for the professionals. So I think it is a gap. If you do a casual search, it is a gap.

[00:05:00] Marie: It is. And I wonder if they don't think it's a gap. Like if they're expecting us to be like, well we're affected community. And I think I would feel, I don't know, maybe like I wasn't impacted enough to need that. 'cause it's not for direct family. Like I think it would bring up for me different questions about the nature of the relationship if I was calling those helplines that are for friends and family.

[00:05:25] Bronwyn: Yeah, me too. I, I think it's different, like I think it's qualitatively different. And I do wonder whether there's an expectation that as a professional you should already have your processes in place. Like there's some 'shoulds' around that and it's like, you should know how to cope with this grief. Maybe you shouldn't be so attached to this client. Maybe it shouldn't affect you. I, I don't know whether like people have those judgements or expectations, but maybe it's something I'm feeling for myself.

[00:05:54] Marie: Well, let's hope we are not in that position again, but maybe, I guess we'll see what the feedback is for this, and if people have good resources that they've come across, I'd love to, to, um, pointed in that direction. Comment on, email, LinkedIn, wherever it is that you, you interact with ,us.

[00:06:13] Bronwyn: Yeah, yeah, yeah. Because like we did find an article from the American Psychological Association, which was coping with the client suicide. But that was the main article that you and I could both find, which was helpful. There did have some good tips in it, but nothing more comprehensive, I guess.

So maybe we can start off then by talking about our initial thoughts and emotions we experienced when we did lose a client to suicide. Like did we feel prepared? What was the initial thoughts?

[00:06:43] Marie: I didn't feel prepared. I, I think no matter how many times I've done suicide training/// I've done assist training. I've done one specific for school storm training. I've done advanced suicide training. I've, I'm even a mental health first aid instructor for conversations about suicide. So I've done risk assessments and conversations and none of that flagged anything for this particular young person and so there was no expectation. I got a phone call one day in between clients from one of the parents thinking they were going to reschedule or, you know, shuffle something around appointment wise, to notify me that that weekend he ended his life and it was, I felt like I'd been hit by a bus.

[00:07:30] Bronwyn: It's interesting hearing you say that because I'm a mental health first aider as well, and it's like we've both done these training. We literally lead training for other people around suicide. So cognitively, even professionally, we've got the toolkit around assessing suicide. We know the, there are preventative strategies we know the signs to look out for, and yet it, it does blindside us. I felt the same.

I distinctly have this thought where I thought the person who suicided was getting better the last day that I saw them, I thought that they were improving, and that was one of the sticking points for me after they suicided and I beat myself up about it and I was like, how could I have been so stupid? And I, and I don't think that now, but that, that thought stayed with me for quite some time.

[00:08:15] Marie: Yeah. What was it like for you, because you are part of a team?

[00:08:20] Bronwyn: So I was working alongside other people, multidisciplinary team, and yeah, we, we lost a client to suicide. We were told about it. We saw the obituary in the newspaper. It was, it was really devastating. We talked about it. We debriefed as a team on the day, but it was quite scary because then the coroner immediately wanted the patient's records. And that was really scary. And it just felt like everything was toppling down. It was like my own emotions. I felt, I felt scared. I felt sad. I felt devastated. It, it felt like I'd been hit by a bus. I thought, how could this happen? I, I was so stupid. I blamed myself. I felt very guilty. It was, it was just a law all at once is the best way to describe it.

[00:09:10] Marie: It's been some time since and it still evokes something for you as you talk about it.

[00:09:15] Bronwyn: Yeah, I think it is because there is so many layers to it. I do have an overarching belief of failure in the mental health system. I'm like, why did... I feel like why did this person get let down? Um, I guess I don't... there's part of me which is like, this person had longstanding mental health difficulties, and some people were saying like, this is more or less inevitable. Not using those words exactly, but that was the, that was the feel.

But for me, that's hard to accept that, that it's inevitable. And I feel like we let them down. Uh, like as a sy- system, like 'we'. So yeah, it's still, it still makes me feel upset and I'm like, how can we, how can we not? It's, it's hard, it's hard to accept as a mental health professional that some people die.

[00:10:07] Marie: Well that was, yeah, I was going to, to wiggle into that conversation, what would it be like if we had any other, or any other maybe medical professional where like with cancer or heart disease or certain surgeries, there is an inherent risk of complication or death. And mental illness, severe mental illness, or severe distress can come with that as well.

How do we sit with that? Like how do we learn to recognize that there are things that we might improve in procedures and processes, and maybe in some cases people might have been neglectful. That's not for us to, to, talk about, uh, if there's any sort of malpractice issues and there is an inherent risk.

[00:10:56] Bronwyn: Where I came to for this, was that I had to accept that I can't control everything, because when I looked at the research. What happens with suicide prediction is that like we can never be 100%. With the best tools that we have they are not 100% predictive, and that's a sad reality. It would be great if we could predict everybody who's going to suicide, and we could do that with accuracy and not miss everyone.

But the fact is that we can't. We can only try our best. And so I had to let go of that control that. Even though I could do my best sometimes, because the limitations of the system, of the tools we have of the nature of suicide, sometimes people are going to die and then it's sitting with those emotions and processing that.

That's how I had to come to that, but. I wonder if I can flip the question back on you and ask you the same thing. In particular, I'm interested with your young person who you lost a suicide. There were a young person, whereas with my patient who I lost to suicide, they were an older adult, and I wondered whether the, the youngness of the person made a difference for you in managing.

[00:12:10] Marie: It's hard 'cause it's like with any day, I mean, there's no silver lining, right? Like if they were 85 years old, it would still be a sad thing.

[00:12:19] Bronwyn: Totally. And like to make that clear, I still think it's a tragedy. Yes.

[00:12:24] Marie: Um, there was a, there was a, a shock because, I think there's an extra sadness when it's a young person and you know, that they haven't yet learnt what else is available in life. You know, if they're, let's say, let's say they were, I don't know, 15... and things had been hard for two or three years... that feels like a quarter of their life that feels really big. And so there is that extra, I felt that extra sadness of they might not have been able to realize what's coming up and not even in a comparison, because I don't want people listening to think like, well, other people, if they're 30 or 40... it's just it. It was sad.

And being a family therapist, I had done a lot of work with the system and so I knew other members of the family and we were working quite close. And so there was that extra sadness for seeing and witnessing their grief and having some connection with them. And then when they came back around to seek some additional bereavement and grief support, how to delicately pass them onto someone suitable.

And, and that took a lot of, it was, it was a lot of work. Every, every part of it felt individualized, customized, and put so much thought into it. So maybe it's sort of segwaying into kind of what I did after, but I had lots and lots of supervision and I spoke with a couple of friends about it and I had to be very, or I chose to be very careful who I shared this with because I didn't wanna traumatize... like vicariously, traumatize or trauma dump on someone who didn't know, doesn't know how to respond to something like that. And so I only chose friends who actually were other therapists. And I talk about it in supervision with some of my supervisees around how do you share with loved ones that you are struggling or that you've had a tough day, stressing the content might have been tough, and not burdening them with things that they might just think, oh my gosh, I don't know how you could deal with that. And then it just stresses them to hear it. And so that was, that was a, that was really hard to find that balance.

[00:14:42] Bronwyn: Likewise, it was, I also found that quite hard. I don't think I talked to any friends, um, partner. I didn't, I should have talked more about it is, is my main takeaway. I didn't talk about it enough. I talked about it with my main two team members, but I feel like it got to a point where it was like, okay, we're not gonna talk about this anymore. Whereas I feel like one takeaway that I've gotten from this process is to keep talking about it. I don't think, and I say this to clients, it's like grief doesn't have an end date. It's.... yeah, it can go on and and on and new waves can come up and I think that's really important for us to remember as mental health professionals as well, is that we can still be riding those waves and you might see a new client and they remind you of the lost client in in some way, and that can bring up a new wave of emotions. It's quite tough.

[00:15:38] Marie: Did you feel, I mean, going through it as a team, was it... were there some benefits to having other people that had a shared experience or did that feel like you, neither person or neither wanted to compete for who's sad or who was affected? Or would they be judged 'cause they didn't get on with it? Like what was that like in a team dynamic?

[00:16:01] Bronwyn: No, I had such a supportive team and I'm still friends with the team members who I had back then now, um, I think, which speaks to how well we got along and just how well we understood each other. There wasn't any competition. I found that like the main benefit of being a team is that I think it took off the burden of some of the emotional aspects.

So when I hear your story and it's like, because it was a family context, then you needed to go back with the family, um, and discuss and potentially see them for grief counseling or refer them on, but still you needed to have those conversations. Whereas for me, you know, part of our tasks was we were in a group setting. So one of our tasks was we needed to let the other patients know that we had lost a patient to suicide. So one of us did that. Um, another team member went to the funeral and I opted not to go to the funeral. And so I felt like those emotional tasks could be divvied up between us, which I think is a key benefit. But for you, I feel like as a solo practitioner, that was all with you. And I wonder whether that was quite heavy for you.

[00:17:06] Marie: It would have been had I not had good supervision. And so it's sort of, and I talk about it a lot on the podcast around self-care and supervision. And it's not just, it's not, I'm not saying it to be, um, cliche, it really matters.

[00:17:24] Bronwyn: Yeah, it does.

[00:17:25] Marie: If you're going into private practice, you have to put on your grownup pants and put systems and processes in place to build that network. There needs to be something in place. You cannot, or firstly for your registration, you need supervision. And also it's really good to have supervision that is historical... like someone can be with you. Maybe it's fortnightly, monthly, every two months. It doesn't ma- I think having those things in place is crucial for exactly these kind of situations, but also your, you do have a team, it just looks different. Your team consists of a bookkeeper, an accountant, maybe a virtual assistant or administrative assistant, peer supervision group, an external supervisor, you, you, you still have a team. It looks different and you have to invest in that time or money or energy, all of it perhaps.

And so had I not had a really, really good supervisor, I had two, I had one for EMDR and one for family therapy. Both who've been guests on this podcast actually on my, on the Inside Social podcast. And... I'd been working with them for years and so I was able to, I called a friend first who's like, put the phone down, cancel your clients, and call... she knew my supervisor by name, call her for a session, and I sent her, I think I had an email, a text, I can't remember how I got in touch, and she rearranged her diary to fit me in that day.

And so we were able to really proactively put some practical things in place and get the follow-up, emotional support, and then it went on with any other sort of legal support and what to do with a subpoena and all those things that came up afterwards. So we needed, I needed to build those. I- I was fortunate that I, I had those in place.

[00:19:18] Bronwyn: Yeah, it is, it is so essential, and I completely agree. Like I, I don't think it's tokenistic or, um, insincere what you're saying. It's, I, I totally believe in the, the essentialness of supervision, and it sounds like it came through for you in that moment, and that was exactly what you needed.

[00:19:36] Marie: Absolutely, and I, I'm so grateful for how everybody handled it. And it's funny, the things that stick with you, like I think of different random gestures throughout, um, my life of... I really don't like silver lining, but it, it's in moments of, of tragedy or pain, you can really notice how much people step up.

And this was actually on the cusp of in and out of lockdowns here in Melbourne. And so we did go into lockdown. I think we might've actually been in lockdown, and this young person, because of the severity of their mental health, was the only person I was seeing face-to-face and outside. And so the funeral was online. All my supervision was online, so everything was online. I even got the phone call, like working from home. I remember where it was. I've had to rearrange that whole bedroom. Well, not just for that, but just to feng shui. I don't know. It needed, it needed sage burning. It needed to, I needed to have that space feel bright and colorful and different to how it felt.

And I had a friend send me a pack of cheese and salami, um, and this, so this beautiful box arrived on my doorstep with, um, little bacci chocolates and assortment of cheeses and dips and, uh, that was just amazing 'cause it was something, it showed she cared and it actually took pressure off actually. I didn't have to to cook. Like I had something I could eat for a couple of days when I was in that, you know, 'woo', like the feelings of it that I could graze on that still felt nourishing and cared for. So I really appreciated a gesture like that.

[00:21:15] Bronwyn: So did the loss of this client, did it change how you practiced?

[00:21:21] Marie: It, it did for, I, I didn't see anybody with that presentation for quite some time. Whether it was that, that's just how my brain was, like anything that resembled things that were part of that person's profile and, and features of their illness, I was like, oh, no.

And then I felt very hypervigilant. So every single person had a risk assessments. Frequently I was a bit jumpy when the phone would ring, um, if it was a parent calling me out of session. So that, that, that took a little while to reduce. And I think it was made worse by the, the conditions here during the lockdown of everything just felt heightened in general, and then having that experience...

And my, a lot of my coping strategies are exercise based and yoga, the gym and swimming. Like I couldn't do a lot of those things. So I think I didn't have an outlet the same way that I would maybe now. And I think it was winter as well, so it was dark and gloomy and it was... yeah, it did change my, my practice for a little bit.

And then when it felt like the rawness moved away, I felt more confident. Like one of my supervisors, um, we've been talking recently in about another situation, but it, it resonated. He was saying, I'm, I'm not, no longer as invested on the outcome, I'm invested on- like I judge it on the process. He is like, that's the bit I can control. And I really like that because I'm like, I can control my skills, how up to date I am with training my, my forms. I can do all of that and that's the bit that's within my scope. And I can be less... not less invested on the outcome. 'cause obviously it's not the outcome we want, but the outcome doesn't, I can't change that all that much if I've done all these things well... I'm not articulating it the best, but it made sense when he said it.

[00:23:21] Bronwyn: Yeah.

[00:23:22] Marie: How about you? Did it change your practice?

[00:23:25] Bronwyn: yeah, I, um, I completely overcompensated and I tried to be super therapist and my... so I was working in a team environment and I became very hypervigilant and made sure everything was, air quote, perfect. And then shortly after that, I moved into private practice and I have the, and like I don't wanna, uh, you know, toot my own horn too much. But I have a really, really good suicide like assessment tool for myself that I comprehensively developed and added from all these evidence-based frameworks. And I was like, this piece of paper is going to be the, the true and one paper that will make sure that this will never happen again.

And then I think through supervision, I, I learned that I have to let go of control and I can do my best, but this piece of paper is still not going to prevent this from happening. It's good, but the way that I improved from there was I got better at talking about suicide with clients. Like really talking about it. Talking about what, what they mean when they're thinking about suicide. What's it like when they're experiencing these thoughts and feelings? How do they respond to it?

Whereas I think before the suicide, um, I was, I think I was. Using it more as a checklist. I was like, oh, okay. So suicidal thoughts, frequency. Have you got any access to means? Have you got a plan to, to use those means? Where would you do it if you did? And it was like a, it was like a list. Whereas I feel like after the suicide, after I'd processed it a bit and moved to a conversation and so I got better at that. But yeah, it did take a while for the hypervigilance and the fear, I guess, to go down.

[00:24:55] Marie: Hmm, that makes sense. And the bit we, we maybe don't, well we don't talk about any of this is it's okay not to be okay. And all of these reactions are appropriate and normal.

[00:25:10] Bronwyn: Yeah.

[00:25:11] Marie: When would, and we can't speak to all the different circumstances that someone might experience this, when would it be seen as you're not coping and you might need to take time off work or move into a non-client facing role? Like what are some things that maybe, for you, if they were showing up, but you would've made some different decisions about your work arrangements?

[00:25:37] Bronwyn: I think the things that I look for in myself are, and I've had this because of some different circumstances, like I guess some different events. It's like if I'm seeing this client, is it too interfering because they're reminding me of something in the past that I can't be with them in this present moment and help them with what's happening for them. Like I'm too preoccupied with the past? I think that might say to me like, okay, this is coming up too much in, in my work, um, and it's, it's clouding. It's clouding my work with. With the person in front of me... that might indicate for me that I need to get therapy, um, or that I need to take some time off.

And then I think the other sign for me is if I'm thinking about it too much outside of sessions, and for me, I have a big tendency to self criticize. So it would be the critical voice coming up too much. And so it would be like, let's say a client. Um, said that they were feeling down and they thought about like, what would it be like to not exist here anymore? If I didn't respond with a full on suicide comprehensive assessment and I beat myself up about that, then that would be a red flag for me. I'm like, I'm beating myself up way too much. Like, yeah, that's, that's too much. So there's the signs for me. What about for you?

[00:26:52] Marie: I instinctively reduced my caseload. I think I might've even taken the whole week off and then increased the capacity. So I- it would've been like any bad news or any like illness. Like my body was not, I wasn't able to, and even a few nights of broken sleep or like carrying, that meant I needed to reduce my, my load because the kind of work we do is so intimate and is so interpersonal and he is so relational that I couldn't focus if I was tired or had a migraine like I- I can't, I can't give people the, I don't expect to be at a hundred percent all the time, but this was below what I thought was good for them.

And so I sometimes suck at taking time off and even when I'm sick, like the couple times I've had COVID, I've like spent that whole time like making a diary on Canva that I print out and then decide I don't want or rearranging my Asana board or switching from Trello to a, like I'd spend doing stupid things. But my body was my, my body was telling me no, um, and I, I'm pretty sure probably knowing me, would've either binged watch one or two seasons of Grey's Anatomy or started off with Harry Potter. I would've just done something easy and mind numbing. And because I have a dog, I know I have to walk him every day. It was an energetic kelpie.

But it would've been hard in private practice had I had it been a more, a prolonged grief. Let's say did trigger a quite a physical at being unwell. I didn't have a second income stream, so if I wasn't seeing clients, I dunno what I would've been able to do. And so part of the self-care, when I talk about self-care, is also financial, having financial buffers and being able to build up what is an equivalent of sick leave in your business, even if it's just you as a sole trader. And also then having in your personal account some sort of buffer. Because if you're forced to work financially when you're in so much pain or grief or unwell, I don't know that it's not a recipe for something good.

[00:29:10] Bronwyn: No, absolutely not. Yeah. Really important. So I guess overall, what have you learned from the experience of losing a client to suicide?

[00:29:21] Marie: I am just looking at the notes I took of that article. I think the biggest, the first two, the big, the biggest things that popped up straight away was the grief, and then straight away the of litigation. Like there's this fear, like we are so hypervigilant anyway, like I think of how many times I freaked out if I put the wrong Medicare item number for a telehealth verse in person, like, oh my God, I'm gonna get audited and Medicare's gonna like come down on me and I'm gonna be on the front page of the Herald Sun.

There's this like, and so there's this, there was that fear of like an inquest and I'm probably catastrophizing, I'm picking some, you know, probably some American legal movie where someone's like on the stand and getting grilled. So that fear of that system that came up, which meant it was, if I really held onto that, it might've silenced any support, help seeking, 'cause if, if that triggered any shame or, or extreme fear, if I really... if I, if I held onto that narrative, I wouldn't have seen anybody and gotten any help. And so I think I've learned talking about it away the, any shame and took away some of the pain and picking the right people to help was enormously beneficial for me. How about for you?

[00:30:43] Bronwyn: It's. a really good point because my fears of litigation or any action, negative action or consequences in that domain were quickly, um, alleviated because of the ex- experienced team member that I had alongside me. So they'd been practicing for 30 years. They had had a few clients suicides and they just assured me like, this is a normal process. So we've got our risk assessment here, we've got our documentation there. This is what the coroner is requesting for us. This is just what they will need to know to be able to conduct their investigation because all suicides go through this to determine if they were a genuine suicide as opposed to foul play.

And so, receiving that reassurance from somebody who was very experienced immediately alleviated all of that for me, and it would've been very different, I would've felt very scared if I didn't have that reassurance. So yeah, having the right people to speak to who can take you through the process, reassure you it's normal, that you've done what you've needed to do, um, is really helpful.

[00:31:41] Marie: Yeah. And what would you, I mean, is there anything you wish you knew that you would do different now?

[00:31:48] Bronwyn: The immediate thought that comes into my head is that, and I don't know if it's controversial to say, actually, but that the immediate thought was that not all suicides can be prevented. And yeah, I'd say, I dunno if it's controversial or not, because I think there are some people who would love to see zero suicides, as would i, I would love if we could to see zero suicides.

But I think as a mental health professional, if I took that approach that no one would die by suicide, it opens me up to a lot of self blame, guilt. Of course, I, I'll always try my hardest, but there is a. I think a freedom in letting go of control, and it's like, I'm just gonna be here with you in the moment and apply my professional skills to help you as best I can. But sometimes suicide happens. I wish I had known that because I spent a lot of time beating myself up and saying I should have done better. What about you?

[00:32:40] Marie: Yeah, as you were saying about the, you know, the zero, I think there is, I don't know if it's. it might be a suicide campaign and a safe time, but this idea of towards zero and we wanna still keep putting all these things in place and... it will happen. There was a lot of things I felt I did really well. I- I dunno if more time off would've been helpful because I had nowhere to go. We, I was literally stuck within a curfew in my house with only a couple hours of walking. So, I don't know what else I would've been able to do. So that might be something that, I dunno next time whether I'd need to go stay in a hotel or change environments. I don't know what would help.

I wish I had more conversations with friends and I don't know how I can prepare like my partner or close friends to say if I have a day at work. That is an absolute cluster fuck. Um, and it's distressing, how do I share it with you without distressing you about the content? Because I've got a pretty high threshold for what I, what, what I hear, what I absorb that... I mean, we've seen people on their worst days, often in some of their worst experiences. So there's a lot of vicarious trauma and the risk there is really high. And there are some times where I might want to give someone a bit of context to why I might not be okay, but not, not traumatize them.

And so I think, I think that will be follow up conversations that I'll keep having is, and maybe even just, you know, following up from either when this episode comes out or when I usually listen to it back again, it might spark some ideas of, I did this, I did this episode with Bronwyn and we talked about, uh, what to do and I dunno what to do if it happens again, can we have a chat?

So I'm very big on ting things and I might just use that as a conversation of, this is what I think I'll need if anything like this happens. Because when it does happen, that's not the time where I can teach someone else what I need them to do for me.

[00:34:43] Bronwyn: Yeah, exactly. Um, it's a really excellent point and I think sometimes, yeah, I do forget that, that like you. Because we sit in a lot of difficult topics every day. I forget that other people don't have that same, um, I guess, uh, capacity for, for hearing some things, and so it is a really good point. I think one thing that I did find helpful for me was my partner was just able, I was able to say to my partner. I'm just going through like such a difficult time. More than usual, more than usual. It's really hard for me and they're able to just be there with me and sit with me in my emotions, not make it better, not try to cheer me up necessarily. Just be there with me while I binge watch X TV show, you know?

[00:35:27] Marie: And now we have each other, so.

[00:35:30] Bronwyn: Yeah, exactly. Yeah. So I

[00:35:33] Marie: Do you want a ch- do you want a cheese hamper? Do you like...?

[00:35:36] Bronwyn: I'd love a cheese hamper. Yeah, when you said that earlier I was like, your friend knows what's up.

[00:35:42] Marie: Yeah, she's Italian. So food is a love language that, uh, we speak in common.

[00:35:47] Bronwyn: Yeah, totally. Um, very appropriate.

[00:35:51] Marie: Which is interesting. I mean, a bit of a sidetrack, whenever I talk to folks about grief and I've done an episode on the This Complex Life podcast with Liam Spicer, one of the things people say is, how can I help? And I find that really frustrating because when you're in a, you don't know what exactly what you need and you don't know what the other person's capable of.

And so I usually give people the... I guess tip to say, give a couple of options of what you're capable of doing and let the person pick. So it can be saying, I can come over and we can binge watch tv. I can bring you a lasagna and just drop it off on your doorstep. Or I can take you for a long drive, like I'm just making it up.

But give that person a couple of options of what you're actually capable of doing, 'cause if I said, look, the lasagna's good, it would mean I appreciate that, but I don't wanna talk to anybody. Just leave it on my doorstep. Like, I think it's nice to know, you know, if you are listening for a friend or, or if this happens, to share practical things that you are capable of doing so they know how to pick options.

[00:36:59] Bronwyn: Great tip. Sometimes just our cognitive capacity is reduced when we've gone through a difficult situation. It's hard to be in tune with that, but sometimes the presentation of options can make it easier.

[00:37:10] Marie: Yeah, and I guess look after, I mean, we have to look after each other. We're a community as well.

[00:37:16] Bronwyn: I think so. So I would love to see more conversations about suicide amongst mental health professionals. Like we both said at the start, we haven't seen it. You know, there was a podcast episode that was just released. I know you and I both listened to this podcast. Have you seen it? It's, um, the Modern Therapist Survival Guide. They literally just released an episode last week on losing a client to suicide.

[00:37:35] Marie: And if people want to hear it, they can get in touch with either of us. And if you like these collabs that we do, yeah, we're happy to do more. tell tell us what you wanna hear.

[00:37:44] Bronwyn: Anything else you wanted to leave listeners with?

[00:37:46] Marie: I mean, we, we could talk about this for a long time. It's a very big, deep topic and it, it might be hard to listen to and we get it. We've been there. And we and our hearts go out to you. It is a huge, it's a significant moment in our career that can be filled with a lot of pain and heaviness and it's, you know, the worst case scenario that a lot of us- I hope will never happen. And I just wanna say to people, you know, we, there is support out there and I'm thinking of you. It's really tough. How about you?

[00:38:19] Bronwyn: It was really sweet. Yeah. I, it, for me, it was like, I grew up pretty fast through this experience professionally. Like what was an abstract concept and what was questions on a page? Have you had suicidal thoughts, became reality, and I wasn't prepared for that and it was really shattering. And yeah, if you're going through that right now or if you have been through that, like, Marie, I am thinking of you. Please treat yourself very gently and with a lot of kindness. Yeah, a lot, a lot of compassion and kindness. And do reach out for support.

[00:38:49] Marie: I guess that's it from us. Well, I know it's not an uplifting ending, so take care everybody, I guess.

[00:38:57] Bronwyn: Yeah. Thanks everyone.

Okay, thanks so much for listening to this episode, and yet if this episode has sparked, I guess some, some feelings for you, I encourage you to reflect on those feelings, reach out for support, speak to someone who's really trusted within your circle. Reach out for supervision.

And if you liked this episode, please follow the Mental Work podcast. Leave a rating or review and share it with a friend or a colleague who might find it helpful. That's a wrap. Thanks for listening to Mental Work. I'm Bronwyn Milkins. Have a good one, and catch you next time.