Surgical Empathy – The “Save a Life” Conversation

Every time one of His children kills themselves,
God thunders down at us:
“That is not why I gave you the gift of life!”
And then God cries…

Disclaimer: What follows is not a substitute or replacement for consulting your medical doctor and/or seeking the help from a licensed mental health professional. If what follows is too triggering and disturbing, I advise you not to read further or if you believe it does apply to you or someone close to you, use it as a resource with a licensed mental health professional who can assist you.

Surgical Empathy is the process of empathically going into the hopelessness abscess in the Dark Night of the Soul of a person in despair, and using radical attunement to incise and drain it and then proceeding to empatholysis where a person’s attachment to death as the only relief for unbearable pain is broken and instead that person attaches to compassionate empathy which forms a bridge to hope and that person heals from their inside out with their despair organically disappearing.

What follows in the video below and the follow on text is meant as a catalyst for a tough, but potentially life saving and even healing conversation.

Depressed teens have used it to share with their parents to tell them, “This is what I’ve been trying to tell you.”

Worried parents of a sullen, angry and withdrawn teen have used it with that child and asked them, “Is this what you’ve been trying to tell me?” And if that teen relates to it, parents have asked him/her to go over it line by line to explain more while the parents have promised to “just listen.”

From: Talking to Crazy: How to Deal with the Irrational and Impossible People in Your Life

“Given all the things I’m doing that have disappointed you, I’m hoping you won’t just see this as another excuse or a way of manipulating you, both of which I’m very capable of doing and during other times have even been a master at.

In fact I’ve been so good at doing both of those, I’m afraid to tell you what I’m about to and have you think I’m just being dramatic and only trying to get attention or get out of taking responsibility for my actions and paying the consequences for them.

Today, I have a little bigger fish to fry.

I’m losing it. I’m losing my mind, my sense of who I am, of where I belong, and I’m spending more and more time wondering if life is worth living.

I know I don’t have any reason to feel like ending it, I know that so many people have it worse than me, I even know that I have all the reasons to live. I just don’t feel any of them.

I have felt alone for some time now. It hasn’t been a few days or even a few weeks. It’s been at least months.

Also the intensity of rage that I feel not only chills you — which I know is why you back off when it gets really ugly between us — it chills me.

I hate hating you more than I hate you. When I hate you at the level I’m capable of hating you I feel like destroying things. That has escalated and finally shifted to thinking of just destroying me.

But in reality, I don’t want to destroy anything, I just want to destroy the pain I feel and make it go away. But it won’t go away and I can’t make it.

The reasons I drink, do drugs and cut on myself — all of which scare the shit out of you — are because they all relieve me. When I’m stone cold sober and drug free and the pain and the craziness intensifies, all I can think about is numbing myself. I don’t do alcohol and drugs to get high, I do them to get by.

And when I cut on myself, which terrorizes you, I feel like I’m cutting out the pain or at the very least that I’m feeling something. And that gives me relief from the pain of feeling nothing.

Assuming you won’t rub my face in this — which might actually wake me up or push me over the edge, but I don’t think you want to play Russian roulette with me — you’ll probably ask me what you can do to help.

And I wish I had an answer to tell you.

Actually the answer I’d like to tell you, I am telling you by telling you this message and hoping you’ll “just listen.”

I think the hole in my being and the missingness at my core needs warmth from you mom — occasional kindness from pathetic, rational, lecturing, clueless dad is not the same — which I either think you can’t get to because all of us — including dad — fight you or because you no longer have any warmth, either because you didn’t get it from grandma or because it got worn out by all of us.

Dad, you’re not off the hook in this. I think you run interference between mom and me and try to keep the peace and then I think you find your home away from home when you get away to go to work or travel for work or play sports with your buddies.

Maybe a start would be if I saw each of you making the effort to understand me especially when you have no chance of really achieving it.

There is a good chance that neither of you will be able to understand me because I am as different from you as you are from each other, but it might help if I saw you continuing to try and continuing to ask or say things to me like:

‘Tell me what’s happening and how you feel in another way, because I see that I’m not getting it and I want to get it. And then tell me at its worst, what that’s like.’

And if I push you away, you might do well to stand firm and say, ‘We can’t go away because as your parents we can’t allow you to feel so alone in hell and we’ve got to do whatever we can to get you out. Sorry to tick you off, it’s in the parents rule book which you’ll figure out when you become one.’ One of my friend’s parents actually sleeps outside her room on the floor which my friend both resents and feels safer with.

More importantly I think it might help if I saw you not getting so frustrated and throwing your hands up, because I keep pushing back and won’t agree to what you think should make me feel better. Going along with it to get you off my back hasn’t worked and actually makes me feel worse.

I think I can live with the pain, I just can’t live with suffering. I think the suffering happens when I feel alone in my pain for a long period of time and it doesn’t let up.

I think if I could feel less alone from the inside out, I could listen to what you and the world are telling me from the outside it.

Feeling alone is feeling that I am unpaired with what everyone seems to have.

Being unpaired with a future worth living causes me to feel hopeless; being unpaired with any help that I or others can provide causes me to feel helpless; being unpaired with a reason to go on causes me to feel that everything is both pointless and meaningless; and being unpaired with doing or accomplishing all the things I’m supposedly capable of causes me to feel worthless.

And feeling unpaired with all of those things cause me to feel des-pair.

I feel like I am trapped in a deep dark cold mine shaft, have run out of food and water and am running out of oxygen and time.

I keep hearing people digging to find me. I hear them thinking they have found me and are all excited. But what I know that they don’t know is that they’re digging in the wrong direction because one of them got a glimpse of a doll in a different mine shaft that I left there many years ago and everyone thinks it’s me.”

From: “Just Listen” Discover the Secret to Getting Through to Absolutely Anyone

Epilogue: Dodging a Bullet, Saving a Son

“Dr. Goulston, please call me when you have a chance,” Frank, a CEO I had been working with, called me with a sense of urgency in his voice. I immediately went into my worry state and returned the call.

“What is it Frank?” I asked doing my best to lay a veneer of calmness over my concern.

“I think you helped me dodge a bullet,” he said with a level of emotion in his voice that was unusual being the highly analytic person he was.

Dodging a bullet sounded better to me than taking one, so I felt immediately relieved. “What do you mean exactly?” I asked.

He explained, “You and I were speaking about my frustration with my moody son who I think is lazy and blowing it in his junior year in high school. After you listened to me, you told me that I was blowing it in not recognizing his pain and you sent me a message (above blog) to give to my son that you told me was the cumulative collection of many of things you have heard teenagers say to their parents. Well I gave it to him, he read it and I asked him what applied to him. He looked at me… no actually he looked right through me and narrowed his eyes in a hostile manner and said, ‘All of it.’ I then said to him, ‘Why didn’t you tell me it was so bad?’ And he replied firmly, but less hostile, ‘Because you didn’t f*%king want to know!’ And he was right. I told him realizing my big error, ‘I’m sorry about that and I’m even more sorry for beating up on you verbally or just walking away in disgust.’”

At this point Frank began to cry with deep emotion in his voice and continued, “Then my son, seemed to let go of much of his anger and looked straight at me and said, ‘I’m sorry for some of the things in that email you sent me that I have already done that you must swear to me you will never tell mom.’”

Frank paused and I asked, “What happened next?”

“That’s where the dodging a bullet comes in,” Frank explained, “I told my son that with his permission I just wanted to bring my laptop with me and sit on his bed and work while he tried to do his homework. I told him it that it wasn’t to spy on him or monitor him, it was just to hang out with him because I couldn’t and wouldn’t allow him to be alone in hell. And he said to me in his still teenage rebellious voice, ‘Suit yourself.’ And that’s what we have been doing and although he won’t admit it, I think we’re turning a corner and he feels a little lighter… as does my wife. I just called to thank you.”

“My pleasure, any thoughts on how you can keep from taking your eye off the ball?” I asked.

“When I clearly saw my son alone in hell, it was a sight that I will never forget, so I don’t think there is much chance I’ll blow it a second time,” Frank said with determination.

“Glad to hear,” I said.

If you listen for hurt, fear and pain or for people’s hopes and dreams, it is nearly always there. And when the other person feels you listening and feeling them, they will let down their guards and open their hearts and minds to you.


If you’ve been touched by suicide and feel alone with it, here is a community you never wanted to belong to, but you do and might find comfort along with the utter heart-wrenching sadness you will feel by reading the comments:

And… If you’re an entrepreneur who loves to solve problems, watch the following to see what, Jay Reid, who is on a mission to stop teen suicide by 2030 discovered he did wrong after his son Ryan died by suicide two years ago.

Tell My Story – Documentary Trailer

Stay Alive – documentary – co-created and moderated by Dr. Mark Goulston

Stay Alive – Music Video

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