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In the Fall of 2018, I was invited to a conference of church leaders on the island of Molokai (Hawaii) to specifically address the issue of suicide prevention, given the alarming rise of suicide deaths and attempts for the relatively small population. Church leaders there, especially pastors, are often one of the first to be contacted in urgent or emergent situations. In preparation for the conference, I scanned the empirical work on suicidology as it relates to prevention. Admittedly, I approached it with a bit of hubris since at that point I had been in clinical practice for a quarter century. I had dealt with survivors of loved ones who died by suicide, clients many of whom had attempted suicide, and attended (I felt) one too many suicide prevention seminars (for CE credits). Soon after my conference and reflecting on the possibility of doing more talks, I was struck with a gnawing sense of uneasiness.

Serendipitous, the cause of my discomfort was revealed. While listening to a podcast, the topic of suicide was discussed. The interviewer, a well-known practicing psychiatrist, had as his guest, Dr. Igor Galynker, who discussed the subject of imminent suicide risk factors. The interviewer was startled with what Galynker was saying about his findings in suicide prevention. Basically he pointed out the logic flaw in what most suicidologists and practitioners were using - presenting risk factors as indicators of suicide attempt imminence. Example, eating a diet of high fat, high refined carbohydrates, rarely exercising, being hypertensive and smoking are risk factors for getting a heart attack but not predictive of being imminently at risk of getting one. On the other hand, if one is simultaneously experiencing tightness of the chest, radiating pain down one’s left side, dizziness, jaw pain and nausea, these are considered signs of an imminent heart attack.

I could not get hold of the book fast enough - The Suicidal Crisis: Clinical Guide to the Assessment of Imminent Suicide Risk by Igor Galynker. I interviewed my clients who had a history of serious suicide attempts, as to their thought processes especially leading up to their attempts. Their stories fit Galynker’s paradigm of the Suicide Crisis Syndrome (SCS). After doing several (in-person) presentations based on the SCS, several attendees shared their experiences of the moments before their serious attempts, again confirming Galynker’s model.

On the wings of a prayer and thinking what-do-I-have-to-lose, I contacted Dr. Galynker, who surprisingly agreed to zoom chat with me on March 2, 2021. OK, in full disclosure, I had prior sent him a box of macadamia nuts thanking him for helping me to quell my unease about suicide assessments. More importantly, thanking him for I believe, saving several of my clients’ lives due to my being able to recognize imminent signs of suicide; signs of which I would have not been aware had I not read his book. He not only gave me a 1/2 hour of his valuable time (without charge) but also gave me some insights when I had discussed with him my idea of putting an app, based on his paradigm of imminent suicide, literally into the hands of all potential first responders.

The work to improve this mobile app will be on-going, hopefully with the help others also. Lives can’t wait til it’s perfected.

THE INSPIRATION