Podcast #107 This Conversation is for All of Us: Suicide – Cait Maddan, Death Doula/Educator with a Focus in Suicide Care and Conversations

Starting with material from her digital workbook called “How to Live with Suicidal Ideations,” Cait and I discuss how to move from fear and a focus on “100% prevention” to a more reflective, supportive perspective. Let’s move away from stigma and move towards understanding. Let’s move from silence to conversation! What does “suicidal ideating” mean? What’s the difference between passive and active ideating? What can we do or say if we know or sense that someone is considering suicide? What can someone do to support themselves? How is conversation itself suicide prevention?


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Diane Hullet: Hi, I’m Diane Hullet, and you’re listening to the Best Life, Best Death podcast. Today my guest is Kate Madden, and we’ve got a really, really vitally important topic to talk about. I think that suicide is one of those things that touches everyone, whether you personally have a story or you know someone who has died by suicide or has someone in their family or friend group who has, we’re all touched by this topic.

And I came across Kate on Instagram where she’s got a big presence and has a lot to say and a lot to share. So welcome Kate. 

Cait Maddan: Thank you, Diane. 

Diane Hullet: Start by just telling us how you got into this work, what your background is. 

Cait Maddan: Sure. Thank you for having me and I absolutely loved how you said this conversation is for everyone.

So we’ll get into that more of course, but how this work specifically found me and I came to speak so openly on the topic was by way of [00:01:00] tragedy. In 2014, my best friend died by suicide. We’re coming up on his nine year death anniversary in October. And that experience changed the trajectory of my life.

I had had a cousin actually die by suicide when I was a young girl. And the way my family handled it was very secretively, very silently. And her death, though I knew the method, was quickly shuffled under the rug, and it was almost that our family never spoke of it again. So I, I want to say that just because I often reflect on my best friend’s death by suicide so immensely as to what set me on this path.

But I’d like to just honor my cousin’s death as well, knowing that holding space for that conversation then and now is so deeply important. 

Diane Hullet: Yeah, I think you and I kind of connected over just this idea of [00:02:00] conversation. How do we have conversation? How does this come forward? And Kate’s created this incredible workbook called how to live with suicidal ideations.

And I’m so old school that I went on her website thinking I was like ordering a book and then was so excited when it just popped into my download and I simply downloaded it. And, you know, two minutes later I had this 60 page booklet in my hands. So. You know, she really has come to this from both personal experience.

Well, she, I’m talking about you in the third person. You’ve really come to this from personal experience and then also created a path for people to themselves reflect on what’s happening and also for people near. people who are suicidally ideating to reflect on what’s happening. Let’s just back up. I mean, what is suicidal ideation or ideating?

Cait Maddan: Yeah, that’s a great question because it’s terminology that we use so regularly. And that’s actually one question I get most often. What does that even mean? [00:03:00] And really ideation, suicidal ideation, are thoughts around suicide, ideating suicide, which is a very vast spectrum. You may hear of other terminology alongside ideation, such as passively ideating and actively ideating.

And even with those two measures, if you will, of ideation, there’s still a whole spectrum that people fall within when it comes to thinking about and looking at, and even I’m going to say exploring, what suicide is, means, and holds for information. And so we look at then Ideations are thoughts, they’re things that are circulating and ruminating in our mind and our heart and our spirit.

And when we break that down a bit more and look at how they’ve broken it down as active ideation and passive ideation, we see that passively ideating [00:04:00] is a lot more subtle and harder to detect when someone might be conversing or adding that to the conversation. May I give an example? Please, yeah. So just a light, I would say trigger warning as we’re saying some of these statements, of course, but these are things that people will say, and it’s important to discuss so that we can hear it maybe in conversation and be alerted, if you will.

I’ve heard things. I’ve heard folks say in a, in a passive ideating way, statements such as, I wish I just wouldn’t wake up tomorrow. And said really kind of casually like that, not, Oh, I don’t want to wake up tomorrow. I hate my life. Sometimes it’s not even like that. Sometimes it’s just. I, I don’t care if I wake up tomorrow and kind of thrown off the cuff in a convo.

Other statements might sound like I wish I could go back and pause my life at this particular point and the person might share when they really felt like they had life under [00:05:00] control or when they understood themselves a bit more deeper. Other things such as. I just want to pause life. I want to take a rest, a long rest, and come back to life.

And when we hear these statements, it doesn’t mean we have to immediately freak out and say, Oh, there, that’s someone ideating. What that actually offers when we hear the more passive statements is an opportunity to get curious. And say, I heard you just mention that you’d like to pause life. What does that mean to you?

And really putting the question to the person who has said it, not, not making my own judgments, my own perceptions and assumptions, but really putting the ball in their court and saying, Could you explain that to me? Because when we create that space, people often will explain. 

Diane Hullet: Yeah. There’s really something about deeply listening, not you’re really saying if you hear a statement like that, not to just gloss over it and ignore it, [00:06:00] but kind of tune in to like, what’s being said with that.

And can I get curious and might the person share more if I do so, and you really describe in the workbook different levels, there’s ideating passively, ideating actively, and then ideating with a plan. 

Cait Maddan: Yes. There, there is. And that’s really when we get into that active ideation. That’s when we see people that are talking about their despair out loud.

And, and the reality is, though, Not everyone who comes to die by suicide will have ideated actively. And I think that just bears mentioning right now because there’s going to be folks listening that are like, I’ve had someone die by suicide, or I myself have felt suicidal, and I haven’t said these statements to anybody.

And, and so that also is a space that exists. But there are people that will. out loud, actively ideate, and that’s really when, you know, we hear statements like, I don’t want [00:07:00] to live. I can’t do this anymore. And though they’re maybe not saying I’m going to kill myself, we really are going to take that seriously and say, you know, where is the plan?

What is the intent now with this conversation you’re having? Some people Really will ideate actively and might not even have a plan in place or a method or a date, you know, that is, that’s extreme active ideation. So we can see even in this discussion, the vastness of it. 

Diane Hullet: Yes, I think I really love the way you capture both in what you’re saying now and also in your workbook, just the range of what is out there.

And you say right in the beginning, you say in 2020, it’s estimated that 12. 2 million people ideated suicide. And from that 3. 2 million created a plan. And it’s estimated that 1. 2 million people attempted a death by suicide in that same year 2020. These are stats from the [00:08:00] CDC. So, this is You know, this is a huge topic in terms of the ideation part and the thinking about it part.

And I think you’ve got a unique perspective because you’re really trying to reach people and talk to people about that space, which is a little different than the somebody died by suicide grief space. And obviously you, you talk about both, but right now we’re really focused on this space of someone’s thinking about it.

And there is no plan in place necessarily, but what do we do to support them and how can they support themselves. I think that’s one of the things I love the most about your workbook is it’s really about saying, this is your life, and you have choice over this. And think through your reasoning and think through your reasons for staying.

Cait Maddan: Yes. Yes. The word that comes to mind, Diane, when you say that so beautifully is economy and really allowing each of us [00:09:00] as human beings in this human experience. our autonomy. And so I love that. And you’re that’s right. That statistic is actually what really hit home for me. The fact that we knew there was a suicide crisis, if you will, prior to 2020.

But we all saw with 2020, the The fuel was put on the fire, if you will, and like you said, the fact that 12. 2 million people in the U. S. Were ideating. I always comment to like I think of the people that didn’t take part in that poll and report because there are an uncountable numbers. So 

Diane Hullet: You also talk about, I think this is important to throw in here too, we, you have the statistic on young people.

Suicide is the second leading cause of death for folks ages 10 to 34 years old. The second leading cause of death. That’s incredible. And yet you also point out all ages are affected by [00:10:00] suicide. And I think that’s really important to realize. And with conversations about medical aid and dying and when that’s available and when it’s not.

There are numerous situations with older people where suicide is a real piece of the picture as well. 

Cait Maddan: Yes. In fact, these are conversations I’m having sort of behind the scenes that I can’t wait to share on social media more because you’re right, Diane, that statistic of 10 to 34 years old being the second leading cause of death for us, it’s, it’s wild.

And yet. Then we look at, okay, what about the other age folks? And suicide doesn’t have an age specificity, I suppose. So you’re right, it will touch anyone of any age, and there needs to be a real conversation had with our aging and elder population. And I, I share in the workbook about a gentleman that I walked alongside who came to die by suicide at over 80, 80 years of age.[00:11:00] 

Because he was unable to access medical aid and dying and what ended up happening was he chose death and he chose death by suicide in his home and his wife, his caregiver had to find him and that adds so much complexity and trauma to the entire life experience. So yes, I really want to be having more conversations about our aging population because Of course, the topic of suicide in general is steeped in stigma, and it is for different age groups as well.

And our, our aging older population certainly gets a heavy stigma with, oh, they’re not, they wouldn’t think of suicide. They’re not going to come to die by suicide. And I really think that we’re eliminating their needs and proper care. 

Diane Hullet: Yeah, we’re not looking at their needs always and it’s, you, you say at the end of the book, you, you have this great list where you talk about.

Oh, gosh, can I find it quickly? [00:12:00] I’m flipping through these pages. I really should have put this more in an organized way. You say suicide prevention is, and there’s a long list, and I think it’s really powerful because the first one is food security, safe sleep, affordable housing, accessible mental health care, suicide prevention groups, mentorship.

Safe schools. I mean, these are these are the base for mental health and creating community that is suicide prevention. So I love this. And you include family acceptance of gender and sexual orientation, etc. Advocacy for youth community engagement. This is this to me was this profound list of suicide prevention and underlying all of that is conversations and support.

Cait Maddan: Yes. Yes, because we are in a society that is obsessed with a couple of things. We’re obsessed with prevention, zero prevention, preventing every [00:13:00] suicide. And though in Nirvana, if you will, that would be the case where people didn’t come to suicide because of anguish and suffering and living in a capitalist society.

But the reality is, we do live in a capitalist society that is Systemically steeped in issues and problems for people like that list shows things right down to safe sleep, equitable housing, basic human needs being met. And this is the reality of why so many folks in our country here in the U. S. are coming to die by suicide.

And that’s a whole other conversation our society isn’t quite having yet. And that’s, that’s at the core of it. 

Diane Hullet: That’s it. We’ve said early on, we were talking about supporting people in ideating, and we talked about picking up on clues, subtle clues that they might offer in conversation. What else can people do [00:14:00] if you sense that somebody is in an edgy kind of place, a loved one, a friend, an acquaintance, what other suggestions do you put forward?

Cait Maddan: That’s a great question. My first recommendation is to not freak out. And I’m sure that might seem kind of obvious on the surface when you might have heard that little, what I call double hearing, that little, Oh, there’s something there. Or maybe that’s the intuition where you’re like, ask another question because this doesn’t feel right.

Just getting curious to that and really not. freaking out based on that initial intuition or maybe statement that you’ve heard, having some slowness come in. And what I mean by slowness is just taking a second with your own thoughts, your own body, and kind of getting into yourself and your mind. And I say that so you’re not projecting on the person who has just shared and not [00:15:00] thinking, I’ve got to call the hospital.

Or do I, what do I do? Where do I go? Who do I call? Really, we want Just some softness and some pause to come in. And really allowing, like you mentioned earlier, that listening skill, which is a skill that should be practiced. I think each of us has room to grow as better listeners. And what we want to do is listen to understand.

That’s a big thing I say a lot of times. Listen to understand the person not to respond with, Here, let me give you a hotline. Here, let me call your doctor. Do you want me to call your mom? Just pause on those things for a minute. Save your advice, save the fixing for a minute, and just allow the space to be open and really, to say it again, be curious.

What do you mean by that person? I, I’m here, I want to help you, I want to care for you, and I understand that maybe in the past you haven’t been able to share, but this is a safe space to [00:16:00] say the words out loud, and it has been proven to be open. through data and statistics that when we give people places to talk out loud about how they’re feeling about suicide, it saves lives.

That is suicide prevention. And there’s a huge taboo that says, and in so many hearts, people think, well, if I talk about that, talk about it. It’s going to cause the person to do it. They’re going to romanticize it or want to go out and it’s going to be the thing that pushes them over the edge. And in fact, it’s the opposite.

I’ve got goosebumps as I say it. It is the lifeline for folks because all of a sudden, this thing that’s been so darkened and quiet and Isolating has freedom and space to share. 

Diane Hullet: Yeah, I love that image that suddenly there’s some space in it. And, and I like how you’ve kind of delineated like not freaking out would look like just slowing down yourself and listening and getting [00:17:00] curious rather than jumping to conclusions.

You’ve got a great page page 21 of the workbook is also what to say, and you’ve got this great list of things what to say. I believe you’re suffering. I know how hard you’ve been trying to stay alive. I hear you say your plate is too full. Want to tell me more about that? Your feelings are safe to be expressed here.

Is there anything you’d like to share about suicide? Your pain is valid. I see the weight you’re carrying and I get that it may feel lonely. Would you like to share it with me? So these are the kind of empathic kind of compassionate responses that might allow somebody to come forward a little bit. And then I, I even think sort of, you know, I wonder what the point at which you might say to someone, Hey, I’ve learned about this workbook that might be interesting for you.

Because again, I think the workbook goes back and forth between supporting the person who might be near the [00:18:00] person who’s ideating and then supporting the person who’s ideating. And let’s talk about some of your resources in this for that person. Because like one of the ones I was struck by is you’ve got places for.

Daytime and places for nighttime reflection, and you say really clearly those are two different aspects of the suicide ideators experience because the day often does have distractions and people and maybe obligations and nighttime can get much lonelier and darker. And I think that research says that most suicides occur between midnight and 4am.

So there really is something here about. What are what resources do we offer that person who’s ideating and you’ve you’ve got some wonderful ones here. 

Cait Maddan: Thank you. I love it. Someone shared with me recently that they had someone close to them that they knew was ideating or walking alongside their suicidality in some regard, and they purchased the work And what they did was write little notes.

[00:19:00] They printed it off cause you’re right. It is a digital version, but I always say if you’re a person like me that loves a printed copy, go ahead and get it printed. I also think it’s wonderful if there’s a specific like. planner or trackers because it’s got all of these interactive tools in it. Especially for like, maybe you want to bring one of the planners into show your therapist.

You’ve been keeping track and now you want to go over a certain segment with your therapist or social worker. Like it offers a lot of interact. conversation. But they printed it off and they actually filled out different spaces in the workbook with their own loving intent and thoughts and then gifted it to their person.

They knew that was living with the ideation. And I just, I would love to see that replicated for anyone. But you’re right. It holds spaces for, for both. So I really wanted to design this for. Kind of anyone that stumbles upon it truly to flip through and think, Oh, [00:20:00] well, maybe this isn’t for me, but I know someone that might need this resource page or might benefit from having access to that or on the opposite, maybe someone like us, Diane, that’s in this care space that’s working alongside folks in all vast taboo ways, if you will have a resource to then say, Here’s something for us to just Start with.

It’s not the end all be all guide of suicidality, but I really wanted a place for people to start their curiosity journey around the conversation. Oh, 

Diane Hullet: I love that. I love that. That idea of, of getting that there is, there is a way that’s not just in your head to get started on curiosity. And I know there are also some apps.

I know one young person found an app that was recommended by a therapist. I think it was called my sober or get sober. I don’t remember exactly, but it allowed this young man to kind of [00:21:00] track his, you know, his relationship to each day. And he could build days that were in this case, sober meant no self harming.

So he was able to track. You know, his progress and say, I’ve got seven days with no self harm, and that was a big piece out of suicidal ideation. So I think, you know, whatever, whatever it takes, whether it’s a journal, or the reflective kind of pages you have, or a conversation with a therapist, or friends.

Some kind of self reflection begins to move. I think I think of suicide ideation is a bit of a stuck place, but maybe that’s just my projection. But like, how do you move that stuck place? Make it a little more spacious, make it a little bigger, give it some elbow room. 

Cait Maddan: Yes, you nailed it. That’s how I look at it too, Diane, is energy and suicidal ideation is really stuck, really dense energy.

And I [00:22:00] often call it like being in the trenches because it’s heavy too. So I love that. And that’s exactly what these tools are meant to do is just create a little room for something else to come in. Yeah. Yeah. 

Diane Hullet: Do you want to say anything, Kate, about the sort of You know, we alluded to at the beginning that we’re really talking more here about suicide ideation and supporting someone in that space.

Do we want to talk more about, you know, the grief of a completed suicide? Do you have anything you’d want to add to that? 

Cait Maddan: I’d love to especially being a griever of someone and having lived alongside that process, I think you’re right, it is such a vast conversation. It’s like, do you want to go in that direction?

But the thing I’d like to say about having experienced the death by suicide of someone you know or love and the grief around that is the grief is complex. [00:23:00] And I say that not to put constrictions or barriers, but I think it just bears noting because what I noticed was I had grieved many different things, different deaths prior, but all of a sudden with this type of death was suicide.

I noticed guilt came in and shame and anger and disgust. All of these really interesting emotions that didn’t really, I never had picked up on it in other grieving circumstances. And I really was able to. pinpoint that it was from this experience of suicide, because suicide holds so many unanswered questions.

Oftentimes, when someone comes to die by suicide, it’s a very ambiguous loss. We don’t have all the answers. We’re Oftentimes not gonna ever find out all the answers. And so there and with grief, too, that happens with many other deaths [00:24:00] we see, but there is a different type of complexity. And so I just think that bears some noting especially if you have gone through that experience or find yourself going through it at any point.

However, your experience with grief comes to be, please know it’s okay. There is no right way to grieve, especially alongside something as traumatic oftentimes as suicide. And one death by suicide can touch either directly or indirectly up to 130 plus people. That is a large number and I like how that also says directly or indirectly.

So maybe you’re a schoolteacher and you’ve just had a student die by suicide. And though that’s not your child, you know, your biological child or, or someone that you live with, you, you, you might’ve taught them art. You might’ve seen them in the hall. You’re allowed to grieve and feel that grief however as well too.

Like it’s. It’s [00:25:00] big and it’s hard and and so just however you grieve around this sort of loss is okay. 

Diane Hullet: I think that’s so well said and, and acknowledging that that feeling is grief and finding a way, like I sort of think the only way, wow, see, listen to me, what do I know? But the, it’s feels like a powerful way to support that is to find other people in a grief group who have had the same grief.

I just, this one is one that. I just don’t know that it’s held by family and friends in the way that the grievers closest to a death by suicide might need. And so there might be, you know, I would say some encouragement to get out of isolation, get out of your comfort zone and find an online grief group.

There’s some amazing online support or a local grief group where you can go in person and explore this complexity with people who get it. Who, who just get it because I think the stigma and the guilt in the, as you’ve named it, just the complexity [00:26:00] makes it easier to be isolated and then, you know, be at risk for depression and real difficulty yourself.

Cait Maddan: That’s right. And, and, and we see that come to be where that isolation can then create more, more harm for whoever is sitting in that space. So I agree. And you also Pointed out, which is really important to sometimes our family and our friends who may or may not have also experienced that same death may or may not be able to support us oftentimes, they’re unable to truly as as you sort of said in a different way, but they too have experienced that loss and what I found just as an example, with my best friend’s death Is our friend group all?

i’m going to use the word shattered, but I mean that with love It, we, we dispersed after his death and once in a blue moon, one of us might talk and once in a blue moon now, we’ll see something in [00:27:00] passing, but I just think that’s really interesting because sometimes we think, oh, well, we all experienced this, we’ll come together and you can really count on those people around you and though that would be wonderful.

You’re right. A grief group, something out in the public with other people that might be different from your friends and family is also wonderful. 

Diane Hullet: Yeah, really powerful. I want to end with, with another page that I love from your book. This is page 44 and you talk about types of rest. And I thought this was so beautiful because there’s something about this as a tool that I thought was really valid for all of us.

So you say, here are some examples of different types of rest. Notice which is easiest for you and which is more difficult. So there’s physical rest. Sleeping, napping, laying down, there’s mental rest, meditation, disconnect from devices, little breaks, there’s social rest, saying no to big gatherings, creating one on one time with people, there’s [00:28:00] spiritual rest, there’s sensory rest, there’s emotional rest.

And there’s creative rest. I won’t read the details on all those, but I thought it was so wonderful to kind of you, you say in the workbook to the person that you’re working with in the workbook, you’re like, are you getting enough rest? And then instead of assuming that that for most people would mean sleep or napping, you really lay out these other kinds of rest.

And I do feel that our, in our very fast paced society. Particularly that age group that’s so at risk for suicide. They don’t have these tools of rest. I think for a lot of teenagers, rest is staring at their phone, which is really not restful in the same way as making art or going on a bicycle or taking a simple walk or cooking.

And so naming that and saying, Hey, we all need rest and we all need different kinds of rest. I just sort of love that as something to end on for listeners to take [00:29:00] away. I love that. 

Cait Maddan: That’s a perfect nugget for the end. And I agree. I, through my own discovery, had always thought rest equals sleep and sleep isn’t always accessible.

And, and though sleep is restorative once again, it’s not always accessible. So what other types of rest exist? And through this journey, it really gives us expansion around the topic. And we see that mental rest comes in and playing, you know, Frequency music really paying attention to our energy levels.

I think of my Children in the storybook, you know, is your bucket filled? How are we supposed to hold space for these vast conversations and walk alongside someone who might be living with their suicidality? Or even if you are living alongside your suicidality, I’m supposed to have any sort of energy reserve if we’re not resting and however that looks.

So I agree. I love the opportunity to look at these different facets [00:30:00] of what rest means. I follow the nap ministry on Instagram and they’re always talking about rest is revolutionary and like you mentioned in our society that. Is so fast paced and obsessed with constantly working and doing. It is revolutionary to look at rest and how each of us can access that space.

Diane Hullet: That’s so great. That’s so fabulous. Well, that, that makes me want to, I’m going to read the details on this because if I were listening, I’d be like, Oh, why didn’t Diane read those last three? I’m going to read those last few. So spiritual rest is volunteer, connect with your ancestors, pull an oracle card, Sensory rest, go for soft sounds, cozy fabrics, a darkened room, good food, emotional rest, allowing yourself to feel however you feel and creative rest, dance, play, make art, go outside, swing, bicycle.

So think for yourself, you know, listeners about like what, what is restful for you and how [00:31:00] might you create more rest spaces and curiosity spaces in your life so that you’re bringing that to others who might. Need it. Well, Kate, I appreciate this conversation so much. And why don’t you go ahead and name websites and Instagram and tick tock where we can find you.

Cait Maddan: Perfect. Thank you so much for this conversation today, Diane, and all the listeners here. You can find me and I’m going to give you a mouthful. So go ahead and get your pen and paper at www dot death by suicide aware care. One word dot com and on social media platforms. I have the same handle on Instagram, Tick Tock, Facebook, you name it and that is at Kate C A I T period death education.

Diane Hullet: Fabulous. Thanks so much Kate and I look forward to I feel like we could have another conversation as your elder care kind of piece plays out. I would love to hear [00:32:00] more about that. So Thanks for today and thanks for all the work that you do. As always, you can find out more about me at Best Life. Best death.com.

And again, I’m Diane Hallett, the host of Best Life, best Deaths podcast. Thanks so much for your time. 

Picture of Diane Hullet

Diane Hullet

End of Life Doula, Podcaster, and founder of Best Life Best Death.