Episode 142: Suicide (with Matthew Nock)

[00:00:00] [SPEAKER_01]: Very Bad Wizards is a podcast with a philosopher, my dad, and psychologist, David Pizarro, having

[00:00:06] [SPEAKER_01]: an informal discussion about issues in science and ethics.

[00:00:09] [SPEAKER_01]: Please note that the discussion contains bad words that I'm not allowed to say, and

[00:00:14] [SPEAKER_01]: knowing my dad, some very inappropriate jokes.

[00:00:18] [SPEAKER_00]: And fuck us all anyway for the limber dick cock suckers we are.

[00:01:09] [SPEAKER_06]: Welcome to Very Bad Wizards, I'm Tamler Sommers from the University of Houston.

[00:01:17] [SPEAKER_06]: Dave, I saw Hamilton a few weeks ago, so now I fully understand hip hop in America.

[00:01:23] [SPEAKER_06]: When are you finally going to let me start composing beats for the break?

[00:01:28] [SPEAKER_06]: I just took a Xanax.

[00:01:33] [SPEAKER_05]: You can compose beats all you want, but I don't know if people wouldn't know this, but every

[00:01:38] [SPEAKER_05]: time we record we have to line up our audio tracks and the way that we do it is we do a

[00:01:44] [SPEAKER_05]: little count and we clap.

[00:01:46] [SPEAKER_05]: And so that way it's easy to see where our recordings start and line them up.

[00:01:52] [SPEAKER_05]: And let's just say that for about a year the claps, we never knew what we were going

[00:01:58] [SPEAKER_05]: to get with Tamler.

[00:01:59] [SPEAKER_05]: Well, that's because I'm Jewish.

[00:02:03] [SPEAKER_05]: But I think you've improved sufficiently so I'd be happy to put one of your beats.

[00:02:09] [SPEAKER_05]: Have you seen Hamilton?

[00:02:11] [SPEAKER_05]: No.

[00:02:11] [SPEAKER_05]: In some ways that's kind of irresponsible.

[00:02:13] [SPEAKER_05]: You know nothing about rap.

[00:02:15] [SPEAKER_05]: There's an interesting discussion to be had.

[00:02:18] [SPEAKER_05]: I was talking to somebody about what it is about Hamilton that makes me not consider

[00:02:24] [SPEAKER_05]: it rap, which is not to say that it's not good art.

[00:02:28] [SPEAKER_05]: I think it's great art.

[00:02:30] [SPEAKER_05]: I think, you know, Lin Manuel Miranda is...

[00:02:33] [SPEAKER_05]: Manuel.

[00:02:35] [SPEAKER_05]: Manuel.

[00:02:37] [SPEAKER_05]: That's right.

[00:02:38] [SPEAKER_05]: Thanks for correcting my Spanish.

[00:02:43] [SPEAKER_05]: Is brilliant, but there is something about calling it hip hop that rose me the wrong

[00:02:50] [SPEAKER_05]: way and of course I'm not the fucking arbiter of what hip hop is or what's not.

[00:02:53] [SPEAKER_05]: But I think that it is very similar to, and some of our listeners wanted us to talk

[00:02:57] [SPEAKER_05]: about this.

[00:02:58] [SPEAKER_05]: It's very similar to the reason why rappers get dissed for having ghost

[00:03:04] [SPEAKER_05]: writers, which is that when you say when you're a rapper and you're rapping as

[00:03:09] [SPEAKER_05]: a hip hop artist saying other people's words seems to really violate some core

[00:03:17] [SPEAKER_05]: feature of what hip hop is.

[00:03:20] [SPEAKER_05]: And so reciting the words that somebody has composed seems like it takes it away

[00:03:27] [SPEAKER_05]: from what hip hop is.

[00:03:29] [SPEAKER_06]: But what about when he does it?

[00:03:32] [SPEAKER_06]: I mean, he was the star of the first Broadway show.

[00:03:35] [SPEAKER_05]: Yeah, no, no.

[00:03:35] [SPEAKER_05]: When he when he does it, like I have zero problem.

[00:03:40] [SPEAKER_06]: So it just transforms from hip hop to not hip hop like the moment.

[00:03:45] [SPEAKER_05]: Yeah, but weirdly, it's not.

[00:03:47] [SPEAKER_05]: It's rap in both cases.

[00:03:49] [SPEAKER_05]: But it is akin to just rapping somebody else's somebody else's stuff.

[00:03:54] [SPEAKER_05]: And I think it's just because rap so has so maybe it's like poetry in this

[00:04:00] [SPEAKER_05]: sense that it's so much supposed to be an expression of your of your identity

[00:04:05] [SPEAKER_05]: and your thoughts that that reciting other people's words seems seems

[00:04:11] [SPEAKER_05]: like a violation, hence the accusations that Drake has received for having

[00:04:15] [SPEAKER_05]: other people write his song.

[00:04:17] [SPEAKER_06]: Doesn't that happen a lot that people write other people?

[00:04:21] [SPEAKER_05]: But it's it is sort of like in the academic book writing world.

[00:04:28] [SPEAKER_05]: It's a secret.

[00:04:29] [SPEAKER_05]: So they are ghost writers, so they don't get credited.

[00:04:33] [SPEAKER_05]: And when you find out that somebody else, somebody else wrote,

[00:04:36] [SPEAKER_05]: you know, what you thought was a book from whatever, Tamler Summers.

[00:04:40] [SPEAKER_05]: But I know you wrote your book.

[00:04:43] [SPEAKER_05]: You would be like, wait.

[00:04:46] [SPEAKER_05]: What the fuck?

[00:04:47] [SPEAKER_05]: Right.

[00:04:48] [SPEAKER_06]: Well, yeah.

[00:04:49] [SPEAKER_06]: And it always seems to come out when they start beefing

[00:04:52] [SPEAKER_06]: then the accusations of that fly.

[00:04:55] [SPEAKER_06]: But is it true that like the 50 cent wrote hated or love it for the game?

[00:05:03] [SPEAKER_05]: You know, I don't know for sure.

[00:05:06] [SPEAKER_05]: He definitely would write hooks.

[00:05:08] [SPEAKER_05]: He may be wrote but but the game is so talented that that I

[00:05:14] [SPEAKER_05]: I can't imagine that he wrote the whole song for him.

[00:05:17] [SPEAKER_05]: No, and part of his identity is that he never does that.

[00:05:20] [SPEAKER_05]: Right. Yeah.

[00:05:21] [SPEAKER_05]: Yeah.

[00:05:22] [SPEAKER_05]: The thing is, you know, there are some people who get away with it for other reasons.

[00:05:26] [SPEAKER_05]: So Dr.

[00:05:26] [SPEAKER_05]: Dre never writes his own raps.

[00:05:30] [SPEAKER_05]: Right.

[00:05:31] [SPEAKER_05]: And but it's because he's the producer of all the music that that he gets away with it.

[00:05:37] [SPEAKER_05]: And early on in hip hop, people used to, you know, there was it was no secret

[00:05:41] [SPEAKER_05]: that like Big Daddy Kane wrote wrote songs for Biz Markey.

[00:05:47] [SPEAKER_05]: And I don't know what the difference is.

[00:05:49] [SPEAKER_05]: I think as rap evolved, it became much more an expression of

[00:05:54] [SPEAKER_05]: your personal feelings from going from sort of like just party,

[00:05:57] [SPEAKER_05]: like a hip hop, a hippie that stuff

[00:06:01] [SPEAKER_05]: to being much more an expression of your of your persona.

[00:06:05] [SPEAKER_05]: So you can lot like somebody can say

[00:06:08] [SPEAKER_05]: Nas lied about his life experiences.

[00:06:12] [SPEAKER_05]: And that's not nearly as damning as saying

[00:06:15] [SPEAKER_05]: somebody else wrote the words that Nas recited.

[00:06:18] [SPEAKER_05]: Yeah, which is I think weird because everybody

[00:06:22] [SPEAKER_06]: lies to some extent.

[00:06:24] [SPEAKER_05]: Well, yes. Yeah.

[00:06:26] [SPEAKER_05]: About yeah, it would be weird if they didn't.

[00:06:28] [SPEAKER_05]: But sometimes they're so honest that they caught get caught in a crime.

[00:06:32] [SPEAKER_05]: He actually happened.

[00:06:35] [SPEAKER_05]: Or they like detail the specifics about the crime that they committed

[00:06:40] [SPEAKER_05]: and the police use it as evidence.

[00:06:44] [SPEAKER_05]: That's real. That's straight up.

[00:06:46] [SPEAKER_05]: Yeah. And I think this is why

[00:06:49] [SPEAKER_05]: why rappers get get in trouble for violent lyrics.

[00:06:53] [SPEAKER_05]: And sometimes rappers have said, like, why doesn't people?

[00:06:56] [SPEAKER_05]: Why don't people get mad at Arnold Schwarzenegger

[00:06:57] [SPEAKER_05]: for killing like a bunch of people in his movies?

[00:07:00] [SPEAKER_05]: You know, I'm an entertainer.

[00:07:01] [SPEAKER_05]: You can't have it both ways.

[00:07:03] [SPEAKER_05]: You're either being authentic and talking about killing motherfuckers

[00:07:07] [SPEAKER_05]: or you're lying.

[00:07:11] [SPEAKER_06]: I don't know. I've seen a lot.

[00:07:13] [SPEAKER_06]: A lot of rappers sort of say, look, this is art.

[00:07:16] [SPEAKER_06]: We are rapping about like real people

[00:07:20] [SPEAKER_06]: and real not necessarily my experience.

[00:07:23] [SPEAKER_06]: But yeah, sometimes and especially when you're going after somebody else,

[00:07:27] [SPEAKER_06]: it is about how you've lived the life and they haven't.

[00:07:31] [SPEAKER_05]: Right. Right.

[00:07:33] [SPEAKER_05]: And and it is the most damning to say

[00:07:36] [SPEAKER_05]: that somebody has written your raps for you.

[00:07:38] [SPEAKER_06]: Kind of like four beers, two psychologists or whatever

[00:07:46] [SPEAKER_06]: about drinking, like

[00:07:48] [SPEAKER_06]: they're fronting about drinking, but like they're not real G's.

[00:07:52] [SPEAKER_05]: I think they're being completely honest.

[00:07:55] [SPEAKER_06]: They're drinking to like unless they're not drinking those beers.

[00:07:58] [SPEAKER_06]: Well, apparently I didn't listen to it,

[00:08:00] [SPEAKER_06]: but apparently you didn't finish his second beer.

[00:08:03] [SPEAKER_06]: Oh, well, then yeah, then then it might as well be,

[00:08:06] [SPEAKER_05]: you know, then I want him to pre-register his fucking beers

[00:08:11] [SPEAKER_05]: and I want him to report the entirety of his beer drinking.

[00:08:17] [SPEAKER_05]: Even if there was a failed beer drinking, it should be it should be reported.

[00:08:23] [SPEAKER_05]: Yeah, he's massaging the data.

[00:08:27] [SPEAKER_05]: I want them to report the size, you know,

[00:08:30] [SPEAKER_05]: where's this like a yard?

[00:08:32] [SPEAKER_05]: So was it a pint?

[00:08:33] [SPEAKER_06]: Right, exactly.

[00:08:35] [SPEAKER_06]: And what the alcohol level is, like, is he drinking to course?

[00:08:39] [SPEAKER_05]: I mean, I'm sure they say he's drinking it on an empty stomach.

[00:08:42] [SPEAKER_06]: Right. You know, like speaking of

[00:08:46] [SPEAKER_06]: the ongoing fraudulence of social psychology

[00:08:50] [SPEAKER_06]: and psychologists. Damn.

[00:08:54] [SPEAKER_06]: Actually, I should say that on the main segment of today's episode,

[00:08:57] [SPEAKER_06]: we are going to have Matthew Nock,

[00:09:00] [SPEAKER_06]: a researcher on the topic of suicide and self-harm.

[00:09:05] [SPEAKER_06]: And we will talk about that.

[00:09:10] [SPEAKER_06]: But first, well, I want to talk about two things.

[00:09:12] [SPEAKER_06]: So there was this big kind of an expose

[00:09:14] [SPEAKER_06]: about the Stanford Prison Experiment

[00:09:16] [SPEAKER_06]: that came out in this blog post that was on medium.

[00:09:21] [SPEAKER_06]: And then that was based on listening to recordings

[00:09:27] [SPEAKER_06]: from the experiment that I guess have been available for a while.

[00:09:31] [SPEAKER_06]: But for some reason, this was the first time they were brought to light

[00:09:35] [SPEAKER_06]: in such a highly publicized way.

[00:09:39] [SPEAKER_06]: And I know also J.Van Bavle on Twitter said that he listened

[00:09:43] [SPEAKER_06]: separately to the blog post.

[00:09:44] [SPEAKER_06]: He listened to all the tapes and was somewhat shocked to find out

[00:09:49] [SPEAKER_06]: what they contained.

[00:09:51] [SPEAKER_06]: And it really casts a shadow on the Stanford Prison Experiment

[00:09:55] [SPEAKER_06]: as being not at all how it's been portrayed, both by Zimbardo

[00:10:00] [SPEAKER_06]: and by others who have taught it and presented it.

[00:10:06] [SPEAKER_06]: I know I'm one of those people.

[00:10:08] [SPEAKER_06]: I've I teach this in my intro class,

[00:10:11] [SPEAKER_06]: my interview with Zimbardo every single year.

[00:10:14] [SPEAKER_06]: The students connect with it.

[00:10:15] [SPEAKER_06]: And there is two parts of it that I happen to kind of emphasize

[00:10:22] [SPEAKER_06]: the want because Zimbardo emphasized them to me in the interview.

[00:10:26] [SPEAKER_06]: One that the prisoners just kind of forgot that they were free

[00:10:31] [SPEAKER_06]: to leave anytime they wanted, that they were so

[00:10:37] [SPEAKER_06]: enveloped in the role of being prisoner that they forgot that

[00:10:40] [SPEAKER_06]: he had no legal right to keep them and they could walk out

[00:10:43] [SPEAKER_06]: anytime they want.

[00:10:46] [SPEAKER_06]: So that was according to the recordings and according

[00:10:49] [SPEAKER_06]: to the documents never made clear to the prisoners.

[00:10:53] [SPEAKER_06]: At first there was some idea of like having a safe word,

[00:10:57] [SPEAKER_06]: which is funny, like but which they never used.

[00:11:01] [SPEAKER_06]: And so they weren't allowed to be liberated

[00:11:04] [SPEAKER_06]: because they forgot the safe word.

[00:11:06] [SPEAKER_06]: And then and then further inquiries seem to reveal

[00:11:10] [SPEAKER_06]: that there wasn't even that like nothing in the original

[00:11:13] [SPEAKER_05]: documentation revealed it.

[00:11:15] [SPEAKER_05]: And moreover, people were asking to be released.

[00:11:17] [SPEAKER_05]: Yeah. Yeah.

[00:11:19] [SPEAKER_05]: We're not allowed to.

[00:11:20] [SPEAKER_05]: Right. There's another the other part of this doesn't come

[00:11:23] [SPEAKER_05]: from the tapes.

[00:11:24] [SPEAKER_05]: It comes from the sort of reveal that

[00:11:31] [SPEAKER_05]: that the mental breakdown of one of the particular prisoners

[00:11:34] [SPEAKER_05]: that is, you know, in whatever the original video is

[00:11:39] [SPEAKER_05]: that Zimbardo put together of it, which I also show to my class.

[00:11:43] [SPEAKER_05]: We'll talk about the teaching of it in a second.

[00:11:45] [SPEAKER_05]: But that he was just like acting the whole time,

[00:11:51] [SPEAKER_05]: that it wasn't a real breakdown.

[00:11:52] [SPEAKER_05]: And he's insisted on this for quite some time.

[00:11:55] [SPEAKER_05]: And apparently early on enough that he was he was asking Zimbardo

[00:12:01] [SPEAKER_05]: to stop to stop asking him to be part of the like the media

[00:12:05] [SPEAKER_05]: and like all of the media that he was just he says,

[00:12:09] [SPEAKER_05]: like not only was acting, I was like poorly acting, like listen to it.

[00:12:12] [SPEAKER_05]: Like I'm not.

[00:12:13] [SPEAKER_05]: I just was doing what I thought he would want for this experiment.

[00:12:17] [SPEAKER_05]: I don't know if I agree that he was poorly acting.

[00:12:20] [SPEAKER_05]: I mean, I bought it.

[00:12:21] [SPEAKER_06]: Yeah, I bought it too.

[00:12:23] [SPEAKER_06]: But but then oh and then the other one

[00:12:26] [SPEAKER_06]: that is something I emphasize in the class.

[00:12:28] [SPEAKER_06]: Well, I mean, it's something everybody emphasizes

[00:12:31] [SPEAKER_06]: how the guards naturally started to become brutal

[00:12:36] [SPEAKER_06]: towards the prisoners almost right away.

[00:12:39] [SPEAKER_06]: And I guess the tapes just shows Zimbardo pressuring them

[00:12:44] [SPEAKER_06]: to behave in that way.

[00:12:46] [SPEAKER_06]: And according to what I've read, I haven't listened to the tapes.

[00:12:50] [SPEAKER_06]: But according to what I've read, you know, act like real prison guards.

[00:12:54] [SPEAKER_06]: You need to be abusive prison guards.

[00:12:57] [SPEAKER_06]: And that is so damning if that's true

[00:13:01] [SPEAKER_06]: because that's really everyone's big takeaway from it.

[00:13:06] [SPEAKER_06]: That's the connection between that and the Stanford Prison Experiment

[00:13:10] [SPEAKER_06]: in Abu Ghraib, which was sort of the basis of the book,

[00:13:14] [SPEAKER_06]: the Lucifer Effect that Zimbardo wrote and that I interviewed him about.

[00:13:20] [SPEAKER_06]: Like all of that, like if that was just something that Zimbardo set up,

[00:13:25] [SPEAKER_06]: then I don't even know what value the experiment has anymore.

[00:13:30] [SPEAKER_05]: Yeah. Well, so yeah.

[00:13:32] [SPEAKER_05]: So a few things like I listened to the little portion of the audio that was posted

[00:13:36] [SPEAKER_05]: where the whoever the lead research assistant or graduate student,

[00:13:42] [SPEAKER_05]: I don't know, was explicitly saying, yeah, we have to play the role.

[00:13:47] [SPEAKER_05]: You guys all have to play the role of the tough guard.

[00:13:49] [SPEAKER_05]: Like we really want to make this like and so, you know, sort of ironically,

[00:13:53] [SPEAKER_05]: what it does illustrate is the power of authority.

[00:13:56] [SPEAKER_05]: Right. I mean, it's like, oh, it's Milgram kind of.

[00:14:01] [SPEAKER_05]: Exactly. It's like a Milgram.

[00:14:02] [SPEAKER_05]: And so in some sense, it might have value like that.

[00:14:06] [SPEAKER_05]: The lying I cannot abide, right?

[00:14:08] [SPEAKER_05]: Like the just blatant apparently blatant

[00:14:11] [SPEAKER_05]: lying about what was done is something that that is to me,

[00:14:17] [SPEAKER_05]: just will cast a shadow on Zimbardo's entire career.

[00:14:22] [SPEAKER_06]: Now, the and I personally like sat face to face with him

[00:14:27] [SPEAKER_06]: and it's it's and I don't know how much of this is conscious or unconscious.

[00:14:31] [SPEAKER_06]: But it would one way to look at it is

[00:14:35] [SPEAKER_06]: you can also get this from the book, The Loose for a fact.

[00:14:39] [SPEAKER_06]: It's a kind of insidious sort of lying

[00:14:41] [SPEAKER_06]: because he's very critical of himself in that book, in the interview.

[00:14:48] [SPEAKER_06]: He's he's he's kind of condemning himself

[00:14:51] [SPEAKER_06]: for having put this situation in place and so caught up in the role himself.

[00:15:00] [SPEAKER_06]: And so because he's being so self critical

[00:15:05] [SPEAKER_06]: and he seems to feel so guilty about it,

[00:15:08] [SPEAKER_06]: you take for granted that what happened actually happened.

[00:15:11] [SPEAKER_05]: Yeah, it's like, why would you lie about that?

[00:15:13] [SPEAKER_05]: But in its part of what became the lore

[00:15:15] [SPEAKER_05]: and it's almost like he's apologizing for his amazing powers

[00:15:19] [SPEAKER_05]: of like within three days turning people into like, you know, complete sadists,

[00:15:23] [SPEAKER_05]: including himself, including himself.

[00:15:27] [SPEAKER_05]: Yeah, no, I just like I don't I believe that over time

[00:15:31] [SPEAKER_05]: he probably came to believe it, but but it does not exculpatory at all.

[00:15:36] [SPEAKER_05]: Like that he that he was I mean the original study and, you know,

[00:15:40] [SPEAKER_05]: I'll put a link to when I was on Partial Examine Life,

[00:15:43] [SPEAKER_05]: we talked about this experiment.

[00:15:45] [SPEAKER_05]: We read Milgram paper and this in part of paper.

[00:15:49] [SPEAKER_05]: It was never really published, at least at first,

[00:15:52] [SPEAKER_05]: not published in an academic in an academic journal.

[00:15:56] [SPEAKER_05]: And here's like something that that I think should be a distinction.

[00:16:02] [SPEAKER_05]: It it was always the case that it was

[00:16:07] [SPEAKER_05]: viewed as a horribly designed study and not a true experiment at all.

[00:16:12] [SPEAKER_05]: And in fact, I remember in I think it was let's see right around 1999.

[00:16:18] [SPEAKER_05]: I could be wrong, but it was the very first conference of this.

[00:16:22] [SPEAKER_05]: I think it was one of the early conferences of the Social and

[00:16:25] [SPEAKER_05]: Personality Psychology Society and Zimbardo got a Lifetime Achievement

[00:16:31] [SPEAKER_05]: Award and it was given to him by John Darley, a Princeton psychologist

[00:16:34] [SPEAKER_05]: who was famous for the bystander effect stuff.

[00:16:37] [SPEAKER_05]: And John Darley was introducing him to receive this

[00:16:40] [SPEAKER_05]: Lifetime Achievement Award.

[00:16:42] [SPEAKER_05]: And I think it was the very last thing he said, he goes, you know,

[00:16:46] [SPEAKER_05]: the one thing I would say, Phil is that next time you do this,

[00:16:49] [SPEAKER_05]: you should include a control group.

[00:16:51] [SPEAKER_05]: Yeah. And and so like the crappy methodology has been evident,

[00:16:56] [SPEAKER_05]: you know, so much so that people, you know, get away with calling it a demonstration.

[00:17:00] [SPEAKER_05]: I know that two of the Black Goat podcasts,

[00:17:04] [SPEAKER_05]: Samin Vazir and Sanjay Sravastava have come out really,

[00:17:07] [SPEAKER_05]: really strong on Twitter saying that like, fuck it, it's not even a demonstration.

[00:17:11] [SPEAKER_05]: Like fuck this, take it out of the textbooks.

[00:17:13] [SPEAKER_05]: But when when I taught it at least and I'm not going to teach it anymore,

[00:17:18] [SPEAKER_05]: I at least went out of my way to say this was not.

[00:17:22] [SPEAKER_05]: This is not a good experiment.

[00:17:24] [SPEAKER_05]: It's it's not right methodologically there's a lot to be desired.

[00:17:27] [SPEAKER_05]: Obviously, ethically, there's a lot to be desired.

[00:17:30] [SPEAKER_05]: But when John Darley said that right before Phil Zimbardo came up,

[00:17:35] [SPEAKER_05]: Phil Zimbardo clearly like was not happy with that accusation.

[00:17:41] [SPEAKER_05]: And the first thing he said, and I'll never forget it,

[00:17:43] [SPEAKER_05]: because I was just it was like my first year of studying social psychology.

[00:17:47] [SPEAKER_05]: And these guys are like gods to us, you know, like, and he goes,

[00:17:51] [SPEAKER_05]: John, you said there's there was no control group.

[00:17:54] [SPEAKER_05]: But I I'm here to tell you the control group was there.

[00:17:58] [SPEAKER_05]: The control group was you and you and you and me.

[00:18:02] [SPEAKER_05]: The control group was society itself.

[00:18:07] [SPEAKER_05]: And like maybe maybe it's a powerful demonstration

[00:18:10] [SPEAKER_05]: until we found out that he was just pressuring people to be assholes.

[00:18:14] [SPEAKER_06]: But again, like, you know, even that is something

[00:18:17] [SPEAKER_06]: that he was sort of upfront about in the book.

[00:18:19] [SPEAKER_06]: He has this sort of funny story of a colleague coming in during

[00:18:23] [SPEAKER_06]: like on the fourth day and asking him what the independent variable was

[00:18:27] [SPEAKER_06]: and him sort of saying, look at this if feet liberal academic

[00:18:33] [SPEAKER_06]: like I have a prison riot on my hands and he's asking me about

[00:18:36] [SPEAKER_06]: like an independent variable. Right.

[00:18:39] [SPEAKER_06]: Like fuck that guy, fuck that SJW.

[00:18:42] [SPEAKER_06]: We're doing God's work here. Leave me alone.

[00:18:45] [SPEAKER_06]: I mean, I so there's a lot of interesting questions.

[00:18:49] [SPEAKER_06]: Has Zimbardo responded to not that I know of, you know,

[00:18:54] [SPEAKER_05]: but but but if he doesn't, I mean, he's denied.

[00:18:59] [SPEAKER_05]: So he's come out and denied blatantly that that the guy said

[00:19:02] [SPEAKER_05]: that he didn't have a breakdown for real.

[00:19:04] [SPEAKER_05]: But there's no reason to believe him on that.

[00:19:07] [SPEAKER_06]: Well, no, apparently not.

[00:19:09] [SPEAKER_06]: Like there's no reason.

[00:19:10] [SPEAKER_06]: I mean, one possibility is that he really believes.

[00:19:14] [SPEAKER_06]: Yeah. That he believes the story

[00:19:18] [SPEAKER_06]: that he's been spinning about it.

[00:19:20] [SPEAKER_06]: One thing to say in favor of that is that for a long time,

[00:19:25] [SPEAKER_06]: he just didn't talk about it very much.

[00:19:27] [SPEAKER_06]: He didn't try to capitalize it.

[00:19:28] [SPEAKER_06]: He didn't try to make money off of it.

[00:19:30] [SPEAKER_06]: He didn't write a book about it.

[00:19:32] [SPEAKER_06]: He didn't he just and that all changed after Abu Ghraib.

[00:19:38] [SPEAKER_06]: But but there's this big like 20 year

[00:19:41] [SPEAKER_06]: window where he really just didn't.

[00:19:45] [SPEAKER_06]: He kind of left it alone, right?

[00:19:47] [SPEAKER_05]: Well, you know, not in the field.

[00:19:49] [SPEAKER_05]: So like I think the Abu Ghraib thing was an

[00:19:53] [SPEAKER_05]: opera, an opportunity that catapulted it.

[00:19:57] [SPEAKER_05]: But the dude used to sell

[00:19:58] [SPEAKER_05]: Stanford Prison Experiment T-shirts at conferences.

[00:20:01] [SPEAKER_05]: Like he was yeah, he was hustling.

[00:20:04] [SPEAKER_05]: Like OK.

[00:20:06] [SPEAKER_05]: So it's like us, you know, it's like if 15 years from now

[00:20:09] [SPEAKER_05]: we become a national phenomenon, you know, people say, well,

[00:20:13] [SPEAKER_05]: they weren't doing that much work all this time.

[00:20:16] [SPEAKER_05]: No, no, we're trying.

[00:20:17] [SPEAKER_05]: We were trying.

[00:20:18] [SPEAKER_05]: We just didn't get that break.

[00:20:20] [SPEAKER_06]: It was all scripted.

[00:20:22] [SPEAKER_06]: All their so-called improv.

[00:20:24] [SPEAKER_06]: But we were we're up front about that in our Patreon.

[00:20:27] [SPEAKER_06]: That's right. That's right.

[00:20:29] [SPEAKER_06]: Everything is fully honed and precise down to the second here.

[00:20:34] [SPEAKER_06]: So don't try to do your expose a medium

[00:20:40] [SPEAKER_06]: piece on us because we've already done that.

[00:20:44] [SPEAKER_05]: Well, you know, I was going to say, I think that Zimbardo

[00:20:46] [SPEAKER_05]: just got caught up in the role of psychology professor.

[00:20:50] [SPEAKER_06]: Right. Fragulent psychology.

[00:20:53] [SPEAKER_06]: Or is that really redundant?

[00:20:55] [SPEAKER_05]: Oh, but you know, when the PEL guys

[00:21:00] [SPEAKER_05]: and I read these in Bardo and the Milgram papers back to back,

[00:21:04] [SPEAKER_05]: it was actually really kind of cool to hear them

[00:21:08] [SPEAKER_05]: when we were sort of concluding, wrapping up one of the things

[00:21:11] [SPEAKER_05]: that they said, which is totally true, is,

[00:21:16] [SPEAKER_05]: you know, one thing so obvious is that the Zimbardo experiment

[00:21:21] [SPEAKER_05]: quote unquote experiment was so much sloppier than the Milgram one.

[00:21:27] [SPEAKER_05]: And Milgram was just meticulous.

[00:21:29] [SPEAKER_05]: He ran like, you know, for whatever, 40 variations

[00:21:32] [SPEAKER_05]: where he would tweak one little thing.

[00:21:34] [SPEAKER_05]: He had just very, very, very clear

[00:21:36] [SPEAKER_05]: hypotheses about about these things.

[00:21:38] [SPEAKER_05]: You know, he would manipulate the color of the lab coat.

[00:21:43] [SPEAKER_05]: The distance between the shocker and the person.

[00:21:46] [SPEAKER_05]: And I know that the Milgram experiment has has come under fire for some things.

[00:21:50] [SPEAKER_05]: But I think that it's it's one of those things that will hold up.

[00:21:54] [SPEAKER_05]: It's just the question of like what what exactly are the situations

[00:21:58] [SPEAKER_05]: and those those situations, the situational variables might change over time.

[00:22:04] [SPEAKER_05]: You know, he had one of the manipulations was

[00:22:07] [SPEAKER_05]: the professor was either at University Bridgeport or Yale University.

[00:22:11] [SPEAKER_05]: You know, who knows whether that's something that would work now.

[00:22:15] [SPEAKER_05]: But he was meticulous in collecting data.

[00:22:18] [SPEAKER_05]: And I think that we have enough in his original data

[00:22:20] [SPEAKER_05]: to at least make some general conclusions about what was there and what wasn't.

[00:22:25] [SPEAKER_05]: And it's been replicated.

[00:22:26] [SPEAKER_05]: Stanford Prison Experiment is not.

[00:22:28] [SPEAKER_06]: So like you said, we'll talk about the teaching.

[00:22:31] [SPEAKER_06]: Yeah. About that now.

[00:22:32] [SPEAKER_06]: So I mean, I can't tell you how central it has been to my intro to ethics class.

[00:22:40] [SPEAKER_06]: You know, for the last six years or something.

[00:22:44] [SPEAKER_05]: I think into a lot.

[00:22:45] [SPEAKER_05]: I mean, to a lot of that, like sort of just the emergence of the

[00:22:48] [SPEAKER_05]: situation is to view in ethics.

[00:22:50] [SPEAKER_05]: Yeah. Right. It is so central to it.

[00:22:52] [SPEAKER_06]: And so right. So it's big in philosophy.

[00:22:55] [SPEAKER_06]: I've I've often paired that with virtue ethics.

[00:22:58] [SPEAKER_06]: Now, you know, if I hadn't interviewed Zimbardo,

[00:23:01] [SPEAKER_06]: it would have been one and it still is like this when I teach it.

[00:23:05] [SPEAKER_06]: It's it's one of, you know, along with the Ash conformity experiments,

[00:23:10] [SPEAKER_06]: the Milgram experiments, the diamond, the phone booth.

[00:23:14] [SPEAKER_06]: I don't even want to know the problems with that.

[00:23:16] [SPEAKER_06]: But it's such a it's such a good experiment to teach.

[00:23:21] [SPEAKER_05]: It's hard to teach it now because no one knows what a phone booth is

[00:23:24] [SPEAKER_05]: and why you can make jokes about that.

[00:23:28] [SPEAKER_06]: And students really connect with it.

[00:23:31] [SPEAKER_06]: And and connect with it in like some of in good ways, you know.

[00:23:36] [SPEAKER_06]: So what do you I mean?

[00:23:38] [SPEAKER_06]: Obviously we can't teach it.

[00:23:40] [SPEAKER_06]: But what are you what's your plan?

[00:23:42] [SPEAKER_05]: So one of the things to make so I teach a big intro

[00:23:45] [SPEAKER_05]: psych course in Cornell and you actually we could talk about

[00:23:52] [SPEAKER_05]: we didn't say this yet, but I'll pretend like we did

[00:23:55] [SPEAKER_05]: because you might have to insert it.

[00:23:56] [SPEAKER_05]: But Matt Nock, who is going to be our our guest in part two,

[00:24:00] [SPEAKER_05]: is actually a co-author of the textbook I use for intro psych.

[00:24:05] [SPEAKER_05]: And one of the big problems for me is that as things

[00:24:09] [SPEAKER_05]: have failed to replicate, textbook textbooks haven't caught up on it.

[00:24:14] [SPEAKER_05]: So even if I don't want to teach it,

[00:24:16] [SPEAKER_05]: chances are that the textbook I select for the class will have a lot of that in it.

[00:24:20] [SPEAKER_05]: So it's so either I talk about it and tell them to ignore it, you know.

[00:24:26] [SPEAKER_05]: But then I have to sort of explain why

[00:24:30] [SPEAKER_05]: or I just I just don't talk about it, right?

[00:24:34] [SPEAKER_05]: And and don't say anything about it.

[00:24:37] [SPEAKER_05]: But it's like not just a sample for an experiment.

[00:24:40] [SPEAKER_05]: Obviously, there's a lot of findings that that don't hold up.

[00:24:43] [SPEAKER_05]: And and I think that a lot of.

[00:24:46] [SPEAKER_05]: Psych teachers, especially intro psych teachers are really wanting

[00:24:50] [SPEAKER_05]: somebody to keep track of what we can say with some certainty is a true finding

[00:24:55] [SPEAKER_05]: and what we can't.

[00:24:56] [SPEAKER_05]: And I don't know that the textbooks can keep up like the pace of textbook

[00:25:00] [SPEAKER_05]: publishing isn't enough so that it isn't fast enough so that we can keep up.

[00:25:04] [SPEAKER_05]: So what I try to do, what I what I think I'm going to do with this

[00:25:10] [SPEAKER_05]: is just try to use it as an example of where science can go wrong

[00:25:15] [SPEAKER_05]: and use it as sort of a teaching moment.

[00:25:18] [SPEAKER_05]: I try at first when I was teaching, I was like,

[00:25:21] [SPEAKER_05]: I'm unsure how much to talk about the replication stuff in an intro course

[00:25:26] [SPEAKER_05]: because it's sort of like it's almost self defeating to be like,

[00:25:30] [SPEAKER_05]: oh, by the way, a lot of this is just bullshit.

[00:25:33] [SPEAKER_05]: But I think that I can't do that anymore.

[00:25:36] [SPEAKER_05]: Like I have to teach what rigorous science is.

[00:25:38] [SPEAKER_05]: And I think we have to like as a field just be completely transparent about about it.

[00:25:45] [SPEAKER_05]: Yeah. So so definitely if I talk about it,

[00:25:48] [SPEAKER_05]: it'll be in a very critical tone.

[00:25:50] [SPEAKER_05]: I mean, the like the methodology stuff,

[00:25:51] [SPEAKER_05]: at least you can teach them about methodology for me.

[00:25:54] [SPEAKER_06]: That's like not that's not part of an intro to ethics, really.

[00:25:58] [SPEAKER_06]: Intro to like scientific ethics, but that's not my course.

[00:26:03] [SPEAKER_06]: It is, you know, it's one of.

[00:26:06] [SPEAKER_06]: The crown jewels or was one of the crown jewels of my book.

[00:26:12] [SPEAKER_06]: The interview with him now, it's more of like an interesting artifact

[00:26:17] [SPEAKER_06]: that you're going to pull it.

[00:26:18] [SPEAKER_05]: Are you going to ask for the chapter to be removed?

[00:26:21] [SPEAKER_06]: No, no, I'm not like Soviet like a race from is never happened.

[00:26:29] [SPEAKER_05]: Never.

[00:26:30] [SPEAKER_05]: It is that racist?

[00:26:32] [SPEAKER_06]: Let me ask you this.

[00:26:34] [SPEAKER_06]: This is something this is not actually related to this.

[00:26:37] [SPEAKER_06]: This is about the failed replication of a couple of famous studies.

[00:26:42] [SPEAKER_06]: I think it was the slow walking study saying words that right.

[00:26:50] [SPEAKER_05]: Unscramling words that had to do with elderly, elderly people.

[00:26:53] [SPEAKER_06]: Right. And then there was another famous one that didn't replicate.

[00:26:56] [SPEAKER_06]: And then the marshmallow test may be replicated,

[00:27:00] [SPEAKER_06]: but it wasn't as clear cut.

[00:27:03] [SPEAKER_06]: So Sanjay Sravastava.

[00:27:07] [SPEAKER_06]: Sravastava.

[00:27:07] [SPEAKER_06]: He was one of us.

[00:27:09] [SPEAKER_06]: He posted about this and he's kind of a watch.

[00:27:12] [SPEAKER_06]: He could be that watchdog.

[00:27:14] [SPEAKER_06]: Yeah, replication.

[00:27:16] [SPEAKER_06]: So he he tweeted something that kind of bugged me.

[00:27:19] [SPEAKER_06]: And I couldn't.

[00:27:20] [SPEAKER_06]: I almost replied on Twitter, but I couldn't figure out exactly why it bugged me.

[00:27:25] [SPEAKER_06]: But he said something like for those of you who are using these as evidence

[00:27:31] [SPEAKER_06]: that psychology is invalid.

[00:27:34] [SPEAKER_06]: It was psychology.

[00:27:36] [SPEAKER_06]: The whole reason we know about these is from psychology.

[00:27:39] [SPEAKER_06]: There were psychology experiments.

[00:27:41] [SPEAKER_06]: Good luck chasing your own tail.

[00:27:43] [SPEAKER_06]: He said that was the tweet.

[00:27:45] [SPEAKER_06]: That it's not verbatim, but that was.

[00:27:46] [SPEAKER_06]: Yeah.

[00:27:47] [SPEAKER_06]: And there was something that bugged me about it because it it seems like

[00:27:51] [SPEAKER_06]: that just makes psychological or meth or that makes methodology in psychology

[00:27:59] [SPEAKER_06]: unfalsifiable if if there you can't ever.

[00:28:06] [SPEAKER_06]: Question.

[00:28:07] [SPEAKER_06]: Well, is there something wrong with the methodology given that you're going to

[00:28:12] [SPEAKER_06]: always be using the methodology to try to challenge the methodology?

[00:28:18] [SPEAKER_06]: Then it seems like there's something about it that's unfalsifiable.

[00:28:22] [SPEAKER_05]: Well, right.

[00:28:24] [SPEAKER_05]: So.

[00:28:25] [SPEAKER_05]: So I think I think what he's trying to say and we should have him on at some point.

[00:28:31] [SPEAKER_05]: You know, yeah, he actually gave me a bunch of resources for the personality.

[00:28:35] [SPEAKER_05]: Which we will do.

[00:28:36] [SPEAKER_05]: We will do.

[00:28:38] [SPEAKER_05]: I think like we can distinguish between the scientific method writ large and then

[00:28:45] [SPEAKER_05]: methodological improvements that we've made within psychology.

[00:28:48] [SPEAKER_05]: So as we have realized the errors that we were making, we've improved sort of it locally.

[00:28:55] [SPEAKER_05]: We know that we were committing errors.

[00:28:58] [SPEAKER_05]: Like small sample sizes, like not publishing failed attempts, all of the p hacking stuff.

[00:29:09] [SPEAKER_05]: We've improved that through the help of just, you know, statisticians and people

[00:29:15] [SPEAKER_05]: who who who know the errors that we're making.

[00:29:17] [SPEAKER_05]: But the scientific method of gathering empirical data just writ large is what

[00:29:25] [SPEAKER_05]: has allowed us to know that these effects were not true.

[00:29:30] [SPEAKER_05]: So right.

[00:29:31] [SPEAKER_05]: So yeah, the only way to learn about science is to do science, you know,

[00:29:35] [SPEAKER_05]: and you just hope that we're improving.

[00:29:37] [SPEAKER_06]: So I guess the the thing that bugs me is I think you could make a case

[00:29:44] [SPEAKER_06]: that psychology, social psychology, in the way that it's being practiced,

[00:29:50] [SPEAKER_06]: you could make a similar case against that, that people make against economics,

[00:29:56] [SPEAKER_06]: that they're looking for laws and looking for generalizations at the wrong level.

[00:30:04] [SPEAKER_06]: Like that those things don't exist.

[00:30:08] [SPEAKER_06]: Right.

[00:30:09] [SPEAKER_06]: And that the problem with social psychology and these all, you know,

[00:30:14] [SPEAKER_06]: things failing to replicate and the p hacking that people have been

[00:30:19] [SPEAKER_06]: doing, the massaging all of that, the outright fraud is just are just

[00:30:24] [SPEAKER_06]: symptoms of this larger problem.

[00:30:26] [SPEAKER_06]: And which is that the level of explanation that it is hoping to provide

[00:30:32] [SPEAKER_06]: just it can't provide.

[00:30:34] [SPEAKER_06]: And so that's the thing I guess that I wouldn't want that critique.

[00:30:39] [SPEAKER_06]: I wouldn't want to be ruled out by definition.

[00:30:42] [SPEAKER_05]: Yeah.

[00:30:43] [SPEAKER_05]: I see what you're saying.

[00:30:46] [SPEAKER_05]: And I tend to agree with you that one, a real problem may be that they're

[00:30:55] [SPEAKER_05]: using the methods that we are using and the approach that we're using

[00:30:58] [SPEAKER_05]: that we are not going to uncover laws of human behavior by looking at

[00:31:06] [SPEAKER_05]: these slices of behavior in a lab or even in a real world setting that

[00:31:11] [SPEAKER_05]: we're not uncovering anything stable and reliable.

[00:31:15] [SPEAKER_05]: I think the point that he's making though really is just one of

[00:31:21] [SPEAKER_05]: and maybe two year point, if we doing it way better than we used to do it,

[00:31:27] [SPEAKER_05]: like avoiding all chances of airing in the direction of finding something

[00:31:33] [SPEAKER_05]: that isn't true.

[00:31:34] [SPEAKER_05]: If we continue to do this and we find that nothing that we thought was

[00:31:38] [SPEAKER_05]: true is actually true, then that would be at least something that should

[00:31:43] [SPEAKER_05]: give us pause to evaluate whether or not we're approaching it the right way.

[00:31:47] [SPEAKER_05]: Right.

[00:31:48] [SPEAKER_05]: I think the truth is, you know, and I'm kind of pessimistic about it.

[00:31:51] [SPEAKER_05]: If you want to understand human social behavior, the number of things

[00:31:57] [SPEAKER_05]: that influence whether or not say you're going to act dishonestly on

[00:32:02] [SPEAKER_05]: any given day or moment, there are so many things influencing that

[00:32:08] [SPEAKER_05]: that the kind of study that we do where we manipulate one thing

[00:32:12] [SPEAKER_05]: and see if it has a significant effect.

[00:32:15] [SPEAKER_05]: I just I'm not I'm not optimistic that that is going to yield anything

[00:32:20] [SPEAKER_05]: that interesting.

[00:32:21] [SPEAKER_05]: What we're going to need is increasingly complex ways of looking

[00:32:25] [SPEAKER_05]: at how all of the things interact together in producing behavior.

[00:32:31] [SPEAKER_05]: And I think that human behavior ought to be predictable, given that

[00:32:36] [SPEAKER_05]: I don't I don't believe that there's anything fancy or supernatural

[00:32:39] [SPEAKER_05]: about the way our minds and brains work.

[00:32:41] [SPEAKER_05]: But I think that it is such a complex problem and that social

[00:32:46] [SPEAKER_05]: psychology has drastically underestimated how complex it is

[00:32:49] [SPEAKER_05]: to think that it would be so easy to build a theory of human

[00:32:53] [SPEAKER_05]: behavior based on little two by two manipulations.

[00:32:58] [SPEAKER_05]: I don't know, makes me want to kill myself, which maybe

[00:33:01] [SPEAKER_05]: Matt not can help me with.

[00:33:03] [SPEAKER_05]: In her segment.

[00:33:05] [SPEAKER_06]: OK, so let's let's get to

[00:33:09] [SPEAKER_06]: does this this the more somber topic of today's episode.

[00:33:15] [SPEAKER_05]: This one's going to be hilarious, guys.

[00:33:18] [SPEAKER_06]: Suicide and the the causes of suicide, what we know about it,

[00:33:24] [SPEAKER_06]: what we don't know about it.

[00:33:25] [SPEAKER_06]: We will be right back.

[00:34:36] [SPEAKER_06]: Welcome back to Very Bad Wizards.

[00:34:39] [SPEAKER_06]: At this time in the podcast, we like to thank all the people who

[00:34:43] [SPEAKER_06]: get in touch with us, who contact us, who tweet us, email us,

[00:34:49] [SPEAKER_06]: criticize us, explain why they like the podcast, how they've

[00:34:55] [SPEAKER_06]: binge listened to like a hundred of them in five weeks.

[00:35:01] [SPEAKER_06]: Some insane maniacs seem to do that.

[00:35:04] [SPEAKER_05]: And how we play footsies with the new right, the alt right.

[00:35:09] [SPEAKER_06]: The alt right.

[00:35:11] [SPEAKER_06]: I can I can pretty much say with confidence that I have never

[00:35:17] [SPEAKER_06]: played footsie with a member of the alt right.

[00:35:22] [SPEAKER_05]: But it was a metaphor.

[00:35:23] [SPEAKER_05]: That's the thing.

[00:35:25] [SPEAKER_06]: Yeah, I don't understand metaphors.

[00:35:27] [SPEAKER_06]: I'm a very literal person.

[00:35:30] [SPEAKER_06]: Anyway, so no footsie for me.

[00:35:32] [SPEAKER_06]: I don't think I really play footsie with progressives either,

[00:35:36] [SPEAKER_06]: though. I'm like I limit my footsie to just moderates.

[00:35:42] [SPEAKER_05]: I don't even know what it is to play footsies with.

[00:35:45] [SPEAKER_05]: If it means that we're not we try not to be too mean to

[00:35:48] [SPEAKER_05]: anybody, then I play footsies with everybody.

[00:35:50] [SPEAKER_06]: Well, I mean, I think it's more like a footsie whore.

[00:35:53] [SPEAKER_05]: I'm a footsie whore.

[00:35:54] [SPEAKER_05]: I like have weird diseases on my foot now.

[00:35:57] [SPEAKER_06]: I think it's you're like with friends.

[00:36:00] [SPEAKER_06]: It's like everyone's your friend.

[00:36:02] [SPEAKER_06]: If everyone's your friend, no one's your friend.

[00:36:04] [SPEAKER_06]: If you play footsie with no one,

[00:36:07] [SPEAKER_06]: you play footsie with everyone or everyone or the other way around.

[00:36:12] [SPEAKER_06]: I don't know. I'm the fucking master.

[00:36:14] [SPEAKER_06]: Did you see Incredibles 2 speaking of if everyone is special?

[00:36:19] [SPEAKER_06]: No one is. No.

[00:36:21] [SPEAKER_06]: It's good.

[00:36:22] [SPEAKER_05]: No spoilers. Yeah.

[00:36:23] [SPEAKER_05]: Belislaw last night.

[00:36:24] [SPEAKER_06]: Yeah.

[00:36:25] [SPEAKER_06]: It's not great, but it's definitely

[00:36:28] [SPEAKER_06]: the best thing that they've done in a while.

[00:36:32] [SPEAKER_06]: So, yes, we'd like to thank you all if you'd like to interact with us

[00:36:35] [SPEAKER_06]: in all the ways you do.

[00:36:37] [SPEAKER_06]: You can email us verybadwizardsatgmail.com.

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[00:36:45] [SPEAKER_06]: You can join the conversation on Reddit,

[00:36:49] [SPEAKER_06]: which has been lively lately.

[00:36:52] [SPEAKER_06]: A lot of stuff going up.

[00:36:54] [SPEAKER_06]: Actually hard.

[00:36:56] [SPEAKER_06]: At first we could keep up.

[00:36:57] [SPEAKER_06]: I could keep up with it for the most part, but now I can't.

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[00:37:21] [SPEAKER_06]: Sorry, follow us on Instagram.

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[00:37:29] [SPEAKER_06]: you can do that in one of three ways.

[00:37:32] [SPEAKER_06]: You can PayPal us a one time donation.

[00:37:36] [SPEAKER_06]: This will be all of these are found on the support page.

[00:37:39] [SPEAKER_06]: You can PayPal us a one time donation.

[00:37:42] [SPEAKER_06]: You can click on the Amazon link before you shop at Amazon.

[00:37:46] [SPEAKER_06]: And we will get a small portion of that.

[00:37:49] [SPEAKER_06]: And you can become one of our beloved Patreon supporters.

[00:37:53] [SPEAKER_06]: Go to patreon.com slash verybadwizards.

[00:37:56] [SPEAKER_06]: There is a whole series of rewards

[00:37:58] [SPEAKER_06]: that you can choose from based on the tier of support that you do.

[00:38:04] [SPEAKER_06]: We are so grateful to our Patreon listeners

[00:38:08] [SPEAKER_06]: and they keep the lights on for us.

[00:38:13] [SPEAKER_06]: They keep the microphones live.

[00:38:16] [SPEAKER_06]: They keep hot.

[00:38:17] [SPEAKER_06]: They keep the microphones hot.

[00:38:19] [SPEAKER_06]: Yeah, thanks to everybody.

[00:38:21] [SPEAKER_06]: We appreciate it and we keep on appreciating it.

[00:38:26] [SPEAKER_06]: That's like it still seems incredible

[00:38:30] [SPEAKER_06]: that people have stuck with us this long.

[00:38:33] [SPEAKER_05]: Exactly.

[00:38:34] [SPEAKER_06]: Unreal. Thank you.

[00:38:36] [SPEAKER_06]: And those who haven't stuck with us,

[00:38:38] [SPEAKER_06]: you know, we probably don't know about.

[00:38:41] [SPEAKER_06]: They're not listening.

[00:38:42] [SPEAKER_05]: They're not listening.

[00:38:44] [SPEAKER_05]: Fuck off, y'all.

[00:38:45] [SPEAKER_06]: Like what the hell was I thinking?

[00:38:48] [SPEAKER_06]: It's like they woke up from a bad dream or something.

[00:38:52] [SPEAKER_06]: Also, I just want to give a plug for another podcast,

[00:38:57] [SPEAKER_06]: Hi-Fi Nation that I like a lot.

[00:39:01] [SPEAKER_06]: And it's a philosophy podcast very different from ours.

[00:39:05] [SPEAKER_06]: It is well produced.

[00:39:07] [SPEAKER_06]: Well, I think ours is kind of well produced in its own style of well produced.

[00:39:12] [SPEAKER_06]: Yeah, but this is it's highly produced in the style of this American life.

[00:39:19] [SPEAKER_06]: He picks a topic and he goes out

[00:39:22] [SPEAKER_06]: and interviews people most relevant to that topic.

[00:39:26] [SPEAKER_06]: He did a recent one on addiction.

[00:39:29] [SPEAKER_06]: He's wrapping up season two.

[00:39:32] [SPEAKER_06]: He does seasons.

[00:39:33] [SPEAKER_06]: That's we should have thought of that.

[00:39:35] [SPEAKER_06]: We should have been six years.

[00:39:38] [SPEAKER_05]: We're almost in six years here, you know, I think we pretty much are.

[00:39:42] [SPEAKER_06]: Yeah. And yeah, his latest one on addiction is really good.

[00:39:47] [SPEAKER_06]: So check out Hi-Fi Nation, Hi-PHI Nation.

[00:39:52] [SPEAKER_06]: I think if you like this podcast, you may enjoy that one,

[00:39:55] [SPEAKER_06]: even though they're very different in style.

[00:39:59] [SPEAKER_05]: And apologies to two psychologists.

[00:40:01] [SPEAKER_05]: Just four beers. We couldn't plug you this time.

[00:40:04] [SPEAKER_06]: Yeah, we do kind of shit on them a little bit in the first segment.

[00:40:10] [SPEAKER_05]: They're going to be our, you know,

[00:40:11] [SPEAKER_05]: how Jimmy Kimmel does apologies to Matt Damon all the time.

[00:40:15] [SPEAKER_05]: Yeah, yeah.

[00:40:17] [SPEAKER_06]: We're going to do I'm fucking you.

[00:40:19] [SPEAKER_06]: You L.A. bar.

[00:40:23] [SPEAKER_05]: All right, we're now here with the illustrious Matthew Nock,

[00:40:28] [SPEAKER_05]: professor at Harvard University,

[00:40:31] [SPEAKER_05]: MacArthur Fellow and also just all around cool, cool motherfucker.

[00:40:38] [SPEAKER_05]: I knew Matt from grad school.

[00:40:41] [SPEAKER_05]: We were we were role dogs, as they say.

[00:40:44] [SPEAKER_05]: And we've been friends.

[00:40:46] [SPEAKER_05]: We've been friends since then.

[00:40:49] [SPEAKER_05]: But since that time,

[00:40:51] [SPEAKER_05]: Matt has gone on to an illustrious career studying suicide and self-injury,

[00:40:55] [SPEAKER_05]: whereas I record a podcast.

[00:40:59] [SPEAKER_05]: So thanks for coming on, Matt.

[00:41:01] [SPEAKER_05]: And you're real are.

[00:41:03] [SPEAKER_05]: It's it's it's really nice to have you.

[00:41:05] [SPEAKER_05]: Thank you guys for having me.

[00:41:06] [SPEAKER_06]: Yeah, how did that happen?

[00:41:08] [SPEAKER_06]: If you guys start in the same place and have such

[00:41:10] [SPEAKER_06]: fastly different career arcs,

[00:41:13] [SPEAKER_06]: one so successful and the other just slumming it.

[00:41:17] [SPEAKER_05]: Yeah, I got tenure at a minor Ivy and you got tenure at a real Ivy.

[00:41:20] [SPEAKER_03]: Is Cornell is Cornell Ivy?

[00:41:22] [SPEAKER_03]: They consider that.

[00:41:23] [SPEAKER_05]: That's what they say.

[00:41:24] [SPEAKER_05]: That's what they say.

[00:41:25] [SPEAKER_05]: I mean, I never heard that when I was at Yale.

[00:41:27] [SPEAKER_05]: That's right. Not.

[00:41:30] [SPEAKER_05]: It was a state school.

[00:41:31] [SPEAKER_05]: It is half of it is.

[00:41:34] [SPEAKER_05]: You obviously, like I just said, I know you from grad school

[00:41:37] [SPEAKER_05]: and you studied under an adviser

[00:41:42] [SPEAKER_05]: very well known in clinical psychology, your your apesies in clinical

[00:41:45] [SPEAKER_05]: psychology, if I didn't say that.

[00:41:47] [SPEAKER_05]: Yes.

[00:41:49] [SPEAKER_05]: Somebody who studied child conduct disorders.

[00:41:52] [SPEAKER_05]: Right. Alan.

[00:41:52] [SPEAKER_05]: How did how did you how and what Alan hasn't yet?

[00:41:55] [SPEAKER_05]: How and when did you switch to studying suicide and self injury?

[00:41:58] [SPEAKER_03]: Yeah, so I was I got interested in the topic of suicide

[00:42:04] [SPEAKER_03]: during my junior year of college at Boston U.

[00:42:06] [SPEAKER_03]: I was doing a semester abroad in London

[00:42:09] [SPEAKER_03]: and the program you did a few classes

[00:42:13] [SPEAKER_03]: and then they put you in an internship.

[00:42:14] [SPEAKER_03]: So I had one friend who was into marketing

[00:42:16] [SPEAKER_03]: and he was working at the Guinness Brewery.

[00:42:18] [SPEAKER_03]: Another guy was into music and he was working at like EMI records.

[00:42:21] [SPEAKER_03]: So in clinical psych, they placed us in psychiatric settings

[00:42:24] [SPEAKER_03]: and I was the only male in the program.

[00:42:26] [SPEAKER_03]: Psychology is very female dominated field.

[00:42:28] [SPEAKER_05]: So they had especially clinical, right?

[00:42:30] [SPEAKER_05]: Especially clinical.

[00:42:30] [SPEAKER_03]: So that's one placement that was in a violent ward of a hospital

[00:42:34] [SPEAKER_03]: where they had a lot of violent self injurious suicidal patients.

[00:42:37] [SPEAKER_03]: And so they said, well, put you in there

[00:42:38] [SPEAKER_03]: because we don't want any of the female students getting assaulted.

[00:42:42] [SPEAKER_03]: And so I was working this unit for a semester

[00:42:45] [SPEAKER_03]: and was exposed to lots of really violent

[00:42:48] [SPEAKER_03]: self injurious suicidal patients that was really

[00:42:51] [SPEAKER_03]: shocked, blown away by the behavior

[00:42:54] [SPEAKER_03]: behaviors and at the time wanted to be a practicing clinician.

[00:42:57] [SPEAKER_03]: I want I want to nothing to do with research

[00:42:58] [SPEAKER_03]: and sounded like a cold, sort of boring field.

[00:43:01] [SPEAKER_03]: But I thought as a clinician,

[00:43:03] [SPEAKER_03]: this is probably the most difficult problem I'll have to face.

[00:43:06] [SPEAKER_03]: So let me figure out how to treat suicide and self injury

[00:43:08] [SPEAKER_03]: and then I can go and graduate

[00:43:09] [SPEAKER_03]: and hang up a shingle somewhere and see patients.

[00:43:12] [SPEAKER_03]: And you know, everything else would be easier

[00:43:13] [SPEAKER_03]: once I understand this behavior

[00:43:15] [SPEAKER_03]: and just obviously didn't understand it.

[00:43:19] [SPEAKER_03]: As a field, we still struggle to understand it

[00:43:21] [SPEAKER_03]: and through that process, start reading about suicide

[00:43:24] [SPEAKER_03]: and got involved in suicide research all before grad school.

[00:43:27] [SPEAKER_03]: And I was looking when I went to grad school

[00:43:29] [SPEAKER_03]: for advisors that study suicide and self injury

[00:43:32] [SPEAKER_03]: and there weren't a lot at the time.

[00:43:33] [SPEAKER_03]: There's still not a lot relatively speaking.

[00:43:36] [SPEAKER_03]: And so I ended up applying to work with people

[00:43:38] [SPEAKER_03]: who study related behaviors like violence,

[00:43:40] [SPEAKER_03]: child conduct problems, alcohol substance use

[00:43:42] [SPEAKER_03]: and was fortunate to land at Yale to work with

[00:43:46] [SPEAKER_03]: with Allen and study child conduct problems

[00:43:50] [SPEAKER_03]: but also did some suicide work with Allen.

[00:43:52] [SPEAKER_03]: And then Mitch Princeton arrived while Dave and I were there

[00:43:55] [SPEAKER_03]: and I started to work with him,

[00:43:56] [SPEAKER_03]: doing work more squarely on suicide self injury.

[00:44:00] [SPEAKER_05]: So that helps as context because I realize

[00:44:03] [SPEAKER_05]: I didn't know that at Boston you were already interested in it.

[00:44:07] [SPEAKER_05]: For I wanted Tamler to say a little bit about why we wanted to talk about

[00:44:09] [SPEAKER_05]: we've been wanting to talk about, I think, suicide for a while.

[00:44:13] [SPEAKER_05]: But it sort of just like we just decided kind of like,

[00:44:16] [SPEAKER_05]: no, we got to talk about it now

[00:44:17] [SPEAKER_05]: and I'll have Tamler talk a little bit about it.

[00:44:19] [SPEAKER_06]: I mean, it's not hugely surprising why we wanted to talk about suicide now

[00:44:25] [SPEAKER_06]: given that there were these two highly publicized suicide.

[00:44:29] [SPEAKER_06]: Kate Spade and then Anthony Bourdain.

[00:44:32] [SPEAKER_06]: I did not know who Kate Spade was before that happened.

[00:44:36] [SPEAKER_06]: But I was a huge Anthony Bourdain fan,

[00:44:39] [SPEAKER_06]: you know, loved his book, Kitchen Confidential.

[00:44:41] [SPEAKER_06]: I wasn't a religious watcher of those shows that he did.

[00:44:44] [SPEAKER_06]: But, you know, the one he did about Houston

[00:44:47] [SPEAKER_06]: has completely transformed the way the country thinks of the city that I live in.

[00:44:52] [SPEAKER_06]: And I've always just liked him and it raised these questions

[00:44:59] [SPEAKER_06]: to me that I've been thinking about a lot.

[00:45:01] [SPEAKER_06]: I think the first time they really became palpable

[00:45:04] [SPEAKER_06]: was when David Foster Wallace committed suicide.

[00:45:08] [SPEAKER_06]: This is a guy that seemed like Bourdain

[00:45:12] [SPEAKER_06]: not just at the top of his field,

[00:45:15] [SPEAKER_06]: not just well respected, but doing work that was clearly worthwhile.

[00:45:24] [SPEAKER_06]: Doing work and having a life, you know,

[00:45:28] [SPEAKER_06]: David Foster Wallace was teaching at one of the Claremont colleges,

[00:45:31] [SPEAKER_06]: which he seemed to enjoy.

[00:45:34] [SPEAKER_06]: And Bourdain is traveling a lot,

[00:45:37] [SPEAKER_06]: but he seemed like he was in a relationship with someone that he loved.

[00:45:42] [SPEAKER_06]: And just like had a lust for life.

[00:45:44] [SPEAKER_06]: You know, that's why people loved him is it was infectious,

[00:45:48] [SPEAKER_06]: his lust for life and his lust to connect with people

[00:45:53] [SPEAKER_06]: and connect with their traditions and to eat with them.

[00:45:58] [SPEAKER_06]: And it just made me realize how much I don't understand about suicide

[00:46:04] [SPEAKER_06]: and the kind of depression that might lead to it.

[00:46:10] [SPEAKER_06]: I think I've been really fortunate to not have the kind of mental health issues

[00:46:15] [SPEAKER_06]: that people that said that have come into much sharper focus

[00:46:20] [SPEAKER_06]: in these last five or 10 years and to not also be really, really close

[00:46:25] [SPEAKER_06]: to anybody, you know, a close member of my family who suffers from them.

[00:46:31] [SPEAKER_06]: So we thought we'd have somebody on just to tell us what we know

[00:46:36] [SPEAKER_06]: and what we don't know about suicide.

[00:46:39] [SPEAKER_06]: But that's why I sort of proposed that we do this topic today.

[00:46:43] [SPEAKER_06]: If it's something that we floated, we're a little concerned about it

[00:46:46] [SPEAKER_06]: because it's very somber and we're not a somber podcast.

[00:46:50] [SPEAKER_06]: But that's that's sort of why we decided to do this,

[00:46:54] [SPEAKER_06]: why we decided to do it now and why Dave thought that given how much

[00:47:01] [SPEAKER_06]: we don't know, it would be good to have you on.

[00:47:03] [SPEAKER_03]: Yeah. Yeah.

[00:47:04] [SPEAKER_03]: I'm glad you guys are doing it.

[00:47:06] [SPEAKER_03]: It is a somber topic and it's something that people often don't like to talk about,

[00:47:12] [SPEAKER_03]: which I think is part of the problem with suicide.

[00:47:15] [SPEAKER_03]: I don't mean to get on a soapbox, but it's, you know, it's

[00:47:18] [SPEAKER_03]: just to get a few facts out there.

[00:47:21] [SPEAKER_03]: It's the 10th suicide, the 10th leading cause of death in the US,

[00:47:24] [SPEAKER_03]: the second leading cause of death among young people,

[00:47:27] [SPEAKER_03]: adolescents and young adults, four times as many men and women die by

[00:47:32] [SPEAKER_03]: suicide, and that's true around the world.

[00:47:34] [SPEAKER_03]: So it's a big problem and it's been a big

[00:47:36] [SPEAKER_03]: problem for a really long time.

[00:47:38] [SPEAKER_03]: It's gotten more attention in the past few weeks, especially for the reasons you've

[00:47:42] [SPEAKER_03]: described. There was also a recent CDC reports

[00:47:45] [SPEAKER_03]: suggesting or reporting that the suicide rate in the US has been climbing each year

[00:47:50] [SPEAKER_03]: for the past 15 to 20 years.

[00:47:52] [SPEAKER_03]: And so some describe this as a current epidemic.

[00:47:55] [SPEAKER_03]: I think that's wrong.

[00:47:58] [SPEAKER_03]: I mean, the numbers are right, but it's not a new problem.

[00:48:01] [SPEAKER_03]: If you look back to the 15, 20 years before that,

[00:48:04] [SPEAKER_03]: the suicide rate was dropping and the suicide rate now is literally

[00:48:09] [SPEAKER_03]: virtually identical to what it was 100 years ago.

[00:48:13] [SPEAKER_03]: So if you look at other leading causes of death,

[00:48:16] [SPEAKER_03]: cancer, accidents, flu, pneumonia and on and on,

[00:48:21] [SPEAKER_03]: the mortality rate has dropped precipitously over the past 100 years.

[00:48:24] [SPEAKER_03]: Science has advanced, policy has advanced,

[00:48:27] [SPEAKER_03]: HIV, AIDS, all these things, they've dropped enormously.

[00:48:31] [SPEAKER_03]: The suicide rate, the line is flat.

[00:48:34] [SPEAKER_03]: And so to me, the big story isn't why this recent uptick.

[00:48:37] [SPEAKER_03]: It's why hasn't the rate changed over 100 years where it has for so many other

[00:48:41] [SPEAKER_03]: conditions for suicide, it stayed the same.

[00:48:44] [SPEAKER_03]: And I think it has a lot to do with exactly this,

[00:48:46] [SPEAKER_03]: the stigma that people don't talk about it.

[00:48:49] [SPEAKER_03]: It's a somber topic.

[00:48:50] [SPEAKER_03]: There's concern about contagion.

[00:48:52] [SPEAKER_03]: If we talk about it, maybe it will give people the idea to do it and it

[00:48:55] [SPEAKER_03]: will make things worse.

[00:48:56] [SPEAKER_03]: And so people have largely stayed away from it.

[00:48:58] [SPEAKER_03]: Researchers have stayed away from it.

[00:49:01] [SPEAKER_03]: Congress has stayed away from it.

[00:49:02] [SPEAKER_03]: And so funding wise, if you look at how much funding there is for suicide research,

[00:49:06] [SPEAKER_03]: again, it's one of the leading causes of death, but it's dwarfed by other

[00:49:11] [SPEAKER_03]: other causes of death in terms of funding.

[00:49:13] [SPEAKER_03]: You know, there's more funding for dietary supplements, for migraines,

[00:49:16] [SPEAKER_03]: for these not that we don't need dietary supplements.

[00:49:18] [SPEAKER_03]: Actually, that's our people.

[00:49:19] [SPEAKER_03]: Right.

[00:49:19] [SPEAKER_03]: Dietary supplements, but things like migraine,

[00:49:22] [SPEAKER_05]: I mean, the baldness just alone.

[00:49:25] [SPEAKER_05]: She probably lots of problems that, you know,

[00:49:29] [SPEAKER_03]: we should study baldness, but, you know,

[00:49:32] [SPEAKER_03]: given the scope of the problem, the magnitude of the problem for suicide,

[00:49:35] [SPEAKER_03]: it's a travesty that we don't have more attention to this.

[00:49:38] [SPEAKER_05]: So let me ask you like a bit like I find that there is so much sort of

[00:49:44] [SPEAKER_05]: maybe because of the stigma, what you learn about suicide is often just

[00:49:50] [SPEAKER_05]: lore, right?

[00:49:52] [SPEAKER_05]: Like we get a lot of basic facts wrong about it.

[00:49:55] [SPEAKER_05]: But is one reason that we don't talk about it as that much

[00:50:01] [SPEAKER_05]: because

[00:50:04] [SPEAKER_05]: people just think

[00:50:06] [SPEAKER_05]: that if you take your own life,

[00:50:10] [SPEAKER_05]: a lot of people respond to anger,

[00:50:12] [SPEAKER_05]: I respond with anger at when a close one commit suicide.

[00:50:16] [SPEAKER_05]: And I remember that Matt and I had a close

[00:50:18] [SPEAKER_05]: friend at grad school who took his own life.

[00:50:20] [SPEAKER_05]: But, you know, for reasons we can distinguish these reasons he had a terminal

[00:50:24] [SPEAKER_05]: terminal illness and I was so surprised that my initial reaction was being mad at him.

[00:50:31] [SPEAKER_05]: And that like it was a heavy dose of like, well, you chose to do this.

[00:50:35] [SPEAKER_05]: So like

[00:50:37] [SPEAKER_05]: this isn't like AIDS where like it's a side effect of doing what everybody does.

[00:50:42] [SPEAKER_05]: This is like people who are who are clearly making some sort of choice.

[00:50:47] [SPEAKER_05]: And and maybe we just don't think that it's as important as things that are uncontrolled.

[00:50:52] [SPEAKER_05]: Like we view it as more controllable.

[00:50:54] [SPEAKER_05]: Like if you decide to end your life, it's very much not a disease.

[00:50:58] [SPEAKER_03]: Absolutely.

[00:50:59] [SPEAKER_03]: And there's some research on this that, you know, clinical staff doesn't

[00:51:04] [SPEAKER_03]: I'd say doesn't like likes less people who are self-injurious and suicidal

[00:51:08] [SPEAKER_03]: because there's a perception that they are voluntarily taking up quote unquote

[00:51:12] [SPEAKER_03]: resources that could be used for people who didn't quote unquote create their own

[00:51:16] [SPEAKER_03]: problem. And so there's this for if it's a love when anger,

[00:51:20] [SPEAKER_03]: confusion and for clinical staff that you have suicidal self-injurious patients

[00:51:23] [SPEAKER_03]: can get treated differently.

[00:51:25] [SPEAKER_03]: And again, there's there's a small body of research documenting this.

[00:51:29] [SPEAKER_06]: So one reaction that actually you haven't seen so much in the Bourdain thing.

[00:51:35] [SPEAKER_06]: But, you know, it's certainly something that crossed my mind.

[00:51:40] [SPEAKER_06]: He has an 11 year old daughter.

[00:51:43] [SPEAKER_06]: So one question is, well, why how can you as bad as things might get for you?

[00:51:50] [SPEAKER_06]: How can you just commit suicide when you have this this girl that depends on you?

[00:51:56] [SPEAKER_06]: It's really important for kids to have fathers and you know that you're one

[00:52:02] [SPEAKER_06]: of the smartest people and savviest people out there.

[00:52:05] [SPEAKER_06]: So what's wrong with a kind of anger?

[00:52:10] [SPEAKER_06]: Not from us, but from people who knew them.

[00:52:14] [SPEAKER_06]: What is there a mistake in looking at it that way?

[00:52:19] [SPEAKER_03]: Yeah, there's a few things in there.

[00:52:21] [SPEAKER_03]: One is slight tangent.

[00:52:24] [SPEAKER_03]: You both said use the term committed suicide.

[00:52:27] [SPEAKER_03]: If I may, people in this area don't like the term committed because it

[00:52:31] [SPEAKER_03]: works in fact when suicide was a crime and so the preferred term is died by suicide.

[00:52:38] [SPEAKER_03]: Having young children is associated with a lower risk, lower odds of suicide

[00:52:43] [SPEAKER_03]: attempt and suicide death.

[00:52:46] [SPEAKER_03]: Kate Spade and Anthony Bourdain both had both had young kids, you know, young teens.

[00:52:51] [SPEAKER_03]: So there is some sort of protective

[00:52:54] [SPEAKER_03]: effects, so to speak, of having kids of people who are suicidal.

[00:52:57] [SPEAKER_03]: Actually, we did one study where

[00:52:59] [SPEAKER_03]: people with young kids have a higher rate of thinking about suicide,

[00:53:03] [SPEAKER_03]: understandably given the increased stress and so on, but lower rate of suicide

[00:53:07] [SPEAKER_03]: attempts and suicide death.

[00:53:10] [SPEAKER_03]: I think it's understandable to be angry and confused about why would the person

[00:53:16] [SPEAKER_03]: quote unquote do this to their to their kids?

[00:53:18] [SPEAKER_03]: One thing to keep in mind is 90 to 95 percent of people who die by suicide

[00:53:23] [SPEAKER_03]: have a diagnosed with mental disorder.

[00:53:26] [SPEAKER_03]: And our psychological research in this area suggests that people,

[00:53:30] [SPEAKER_03]: you know, think differently when they're suicidal.

[00:53:33] [SPEAKER_03]: They become much more cognitively constricted,

[00:53:37] [SPEAKER_03]: much more focused on the present, less so on the past, less so on the future.

[00:53:41] [SPEAKER_03]: And they experience a lot of psychological pain.

[00:53:43] [SPEAKER_03]: And so we think of suicide.

[00:53:45] [SPEAKER_03]: A lot of the research focuses on suicide as being related to mental disorders,

[00:53:49] [SPEAKER_03]: but that doesn't tell the whole story.

[00:53:50] [SPEAKER_03]: It's if you talk to people who tried to kill themselves and survive,

[00:53:53] [SPEAKER_03]: what they say is I was in this intense psychological pain,

[00:53:57] [SPEAKER_03]: this intense predicament, and I couldn't see a way out of it.

[00:54:00] [SPEAKER_03]: The only way I saw out of it was to escape by suicide.

[00:54:04] [SPEAKER_03]: And often there's a perception that for them to live is worse for their family.

[00:54:08] [SPEAKER_03]: Aronies, as that is, they think, you know, I am a burden to my family.

[00:54:12] [SPEAKER_03]: I do more harm than by being alive.

[00:54:14] [SPEAKER_03]: That's how awful I am, how awful my situation is.

[00:54:16] [SPEAKER_03]: If I die, they'll be better off.

[00:54:19] [SPEAKER_05]: You mentioned the link between psychopathology and suicide.

[00:54:23] [SPEAKER_05]: I think everybody assumes, and it might be right, you tell me that

[00:54:27] [SPEAKER_05]: that it's depression that is the pre-curt, the psychological precursor to suicide.

[00:54:33] [SPEAKER_05]: But I don't know if that's always the case.

[00:54:35] [SPEAKER_05]: And and maybe just well, maybe actually because you study self-injury as well.

[00:54:39] [SPEAKER_05]: And I think that's something that people don't understand.

[00:54:42] [SPEAKER_05]: So cutting non lethal, cutting behavior or like non attempts

[00:54:46] [SPEAKER_05]: or self injurious behavior, ideation, attempt and completion.

[00:54:52] [SPEAKER_03]: Right. So

[00:54:53] [SPEAKER_03]: all of these things refer to intentional self injury or intentional self harm.

[00:54:58] [SPEAKER_03]: So doing things to purposely hurt yourself.

[00:55:01] [SPEAKER_03]: You can make a big split between

[00:55:04] [SPEAKER_03]: self harm that's suicidal in nature, whether some intention of dying

[00:55:08] [SPEAKER_03]: and non suicidal in nature.

[00:55:10] [SPEAKER_03]: So non suicidal self injury refers to direct

[00:55:13] [SPEAKER_03]: deliberate destruction of body tissue in the absence of any intent to die.

[00:55:17] [SPEAKER_03]: So often taking the form of cutting or burning of the skin.

[00:55:21] [SPEAKER_03]: About 15 or so percent of young people,

[00:55:23] [SPEAKER_03]: adolescents and adults report engaging in non suicidal self injury.

[00:55:27] [SPEAKER_03]: They cut, they burn, they insert objects under the skin.

[00:55:30] [SPEAKER_03]: They don't want to die.

[00:55:31] [SPEAKER_03]: And they say that very clearly.

[00:55:32] [SPEAKER_03]: They do it to get some kind of relief.

[00:55:34] [SPEAKER_05]: And this isn't a big predictor of suicide.

[00:55:36] [SPEAKER_03]: It actually is. We've learned in the past few years only.

[00:55:39] [SPEAKER_03]: I mean, there's always always for a number of years has been a big split.

[00:55:43] [SPEAKER_03]: And people have said there's suicidal self injury.

[00:55:45] [SPEAKER_03]: There's non suicidal self injury,

[00:55:48] [SPEAKER_03]: NIH and other folks that said, well, we're not so concerned about non suicidal

[00:55:51] [SPEAKER_03]: self injury because it's not suicidal.

[00:55:53] [SPEAKER_03]: But we've recently over the past few years seen that non suicidal self

[00:55:56] [SPEAKER_03]: injury is actually a pretty strong predictor of making a suicide attempt

[00:55:59] [SPEAKER_03]: down the road. So it's something that people are taking a lot more seriously

[00:56:03] [SPEAKER_03]: in the realm of suicidal self injury.

[00:56:05] [SPEAKER_03]: People often make distinctions between suicidal ideation,

[00:56:09] [SPEAKER_03]: which is a made up psychology term for thoughts.

[00:56:11] [SPEAKER_03]: So basically, suicidal thinking, thinking about wanting to kill yourself,

[00:56:15] [SPEAKER_03]: making a suicide plan, so formulating some kind of plan of how you're going

[00:56:18] [SPEAKER_03]: to kill yourself, which we see as a little bit more concerning and then

[00:56:22] [SPEAKER_03]: actually making a suicide attempt, which refers to engaging in potentially

[00:56:27] [SPEAKER_03]: lethal behavior with some intention of dying,

[00:56:29] [SPEAKER_03]: taking pills, trying to hang yourself, shooting yourself and so on.

[00:56:33] [SPEAKER_03]: In terms of mental disorders, things like depression

[00:56:37] [SPEAKER_03]: predict all of these outcomes.

[00:56:39] [SPEAKER_03]: And for a long time, the research said that mental disorders like depression

[00:56:43] [SPEAKER_03]: and depression is present in about 60 or so, about two thirds of cases

[00:56:46] [SPEAKER_03]: of suicide attempts, so not all, but the majority.

[00:56:50] [SPEAKER_03]: Mental disorders in general, things like depression, anxiety,

[00:56:53] [SPEAKER_03]: substance use, alcohol use, impulse control disorders like conduct problems

[00:56:57] [SPEAKER_03]: and so on, all predicts suicide attempts.

[00:57:00] [SPEAKER_03]: Over the past few years, we've done research looking at data

[00:57:02] [SPEAKER_03]: on over 100,000 people from two dozen countries.

[00:57:07] [SPEAKER_03]: So really big sample size, really big representative.

[00:57:10] [SPEAKER_03]: What we see is that mental disorders like depression are actually really

[00:57:13] [SPEAKER_03]: strong predictors of thinking about suicide.

[00:57:16] [SPEAKER_03]: If you look at the few thousand people in our sample who are thinking

[00:57:19] [SPEAKER_03]: about suicide, depression doesn't predict who goes on to make a suicide attempt.

[00:57:23] [SPEAKER_03]: What does predict is disorders characterized by anxiety, agitation,

[00:57:28] [SPEAKER_03]: poor behavioral control, things like PTSD, panic disorder,

[00:57:32] [SPEAKER_03]: antisocial behavior, conduct problems.

[00:57:35] [SPEAKER_03]: So putting this together, what we think happens is

[00:57:37] [SPEAKER_03]: depression and related conditions might get a person thinking about suicide,

[00:57:41] [SPEAKER_03]: but this sort of problem with behavioral regulation or behavioral control

[00:57:46] [SPEAKER_03]: predict acting on those thoughts.

[00:57:48] [SPEAKER_05]: Right. You know, one of the things that I remember learning from you

[00:57:52] [SPEAKER_05]: in a conversation back in the day is how much suicide is actually impulsive.

[00:57:58] [SPEAKER_05]: And I remember here at Cornell, you know,

[00:58:01] [SPEAKER_05]: that I don't think the suicide rate over the years is different than any other

[00:58:04] [SPEAKER_05]: institution of its size.

[00:58:05] [SPEAKER_05]: It's just that that it is it makes more headlines.

[00:58:09] [SPEAKER_05]: These are very, very sort of public suicides when people jump off of the

[00:58:13] [SPEAKER_05]: gorges here.

[00:58:14] [SPEAKER_05]: And so so Cornell has this sort of reputation as a school where a lot

[00:58:19] [SPEAKER_05]: of suicides occur when we had a year where there was a rash of

[00:58:24] [SPEAKER_05]: suicides,

[00:58:27] [SPEAKER_05]: they put big fences around the bridges

[00:58:31] [SPEAKER_05]: to prevent people from jumping off of them into the gorge.

[00:58:35] [SPEAKER_05]: And now it's been replaced by nets.

[00:58:38] [SPEAKER_05]: But I remember thinking, well, if somebody wants to die,

[00:58:43] [SPEAKER_05]: you know, you can find your way around a fence.

[00:58:46] [SPEAKER_05]: Like it doesn't seem to be

[00:58:49] [SPEAKER_05]: something that would really impede a strong desire to die until I realized

[00:58:54] [SPEAKER_05]: what you say, that if you can kill that behavioral impulse in the moment,

[00:58:59] [SPEAKER_05]: perhaps you can actually prevent a suicide.

[00:59:02] [SPEAKER_05]: And I don't know what the data is on this,

[00:59:04] [SPEAKER_05]: like how much is planned and how much is impulsive?

[00:59:07] [SPEAKER_05]: Because I imagine it's hard to gather data about.

[00:59:09] [SPEAKER_03]: And there's a lot of the data around this in the field right now,

[00:59:12] [SPEAKER_03]: how impulsive are suicides?

[00:59:14] [SPEAKER_03]: And there's data on, you know, in both directions.

[00:59:18] [SPEAKER_03]: There is a really interesting paper done by a researcher named Alex Milner.

[00:59:23] [SPEAKER_03]: I'm biased. He's one of our postdocs.

[00:59:25] [SPEAKER_03]: He interviewed a bunch of people who were who had made suicide attempts

[00:59:28] [SPEAKER_03]: and asked them very carefully about the timeline.

[00:59:30] [SPEAKER_03]: You know, some people say suicide is very impulsive

[00:59:33] [SPEAKER_03]: and people think about it only a few minutes before they make an attempt.

[00:59:37] [SPEAKER_03]: And if you give measures of impulsiveness to suicidal people,

[00:59:42] [SPEAKER_03]: stop signal tasks, go no, go tasks, the latest counting tasks,

[00:59:46] [SPEAKER_03]: you see no effect.

[00:59:48] [SPEAKER_03]: There's no difference between suicidal and non-suicidal people.

[00:59:50] [SPEAKER_03]: So they're not more impulsive on our measures.

[00:59:53] [SPEAKER_03]: When he interviewed people, he sees that

[00:59:55] [SPEAKER_03]: the average person that they interviewed,

[00:59:57] [SPEAKER_03]: they had thought about suicide for the first time about five years before they

[01:00:01] [SPEAKER_03]: made their attempt.

[01:00:04] [SPEAKER_03]: Suicidal thoughts can ebb and flow.

[01:00:06] [SPEAKER_03]: They come and go over the years.

[01:00:07] [SPEAKER_03]: For the current attempt, they started thinking about suicide

[01:00:09] [SPEAKER_03]: about two weeks beforehand.

[01:00:12] [SPEAKER_03]: About six hours before they started really mulling it over

[01:00:16] [SPEAKER_03]: and only about five minutes before were they sure, OK, I'm going to do it

[01:00:19] [SPEAKER_03]: today. So it's a little bit more subtle, a little more complex.

[01:00:24] [SPEAKER_03]: The thought, it very rarely happens that someone's never thought of suicide

[01:00:30] [SPEAKER_03]: and they're walking across a bridge and says, I think I'm going to kill myself.

[01:00:32] [SPEAKER_03]: What happens is the thought was there for a year or so before

[01:00:36] [SPEAKER_03]: in the past few weeks, maybe someone's thinking about it.

[01:00:39] [SPEAKER_03]: In those contexts, the decision can happen right before.

[01:00:43] [SPEAKER_03]: And the idea is right.

[01:00:44] [SPEAKER_03]: If you if you can prevent a person in those five minutes,

[01:00:47] [SPEAKER_03]: 10 minutes before, given that these things tend to ebb and flow,

[01:00:51] [SPEAKER_03]: maybe if you can get them through that period, they'll be OK.

[01:00:55] [SPEAKER_06]: What? So one group of people that I talk to who have a lot of connection

[01:01:01] [SPEAKER_06]: with people who take their own lives are military.

[01:01:04] [SPEAKER_06]: I have a lot of students who are military.

[01:01:07] [SPEAKER_06]: And when I talk to them, they seem to all have friends,

[01:01:12] [SPEAKER_06]: often multiple friends, people they know who have died by suicide.

[01:01:18] [SPEAKER_06]: Well, first of all, I don't know.

[01:01:22] [SPEAKER_06]: I've read that the statistics are higher for people who come out of the military.

[01:01:29] [SPEAKER_06]: And so are those statistics true?

[01:01:32] [SPEAKER_06]: Or is it more common among soldiers?

[01:01:36] [SPEAKER_06]: And if so, why?

[01:01:38] [SPEAKER_03]: It's a great question.

[01:01:39] [SPEAKER_03]: The suicide rate among army soldiers has historically been

[01:01:44] [SPEAKER_03]: well below that of the general population.

[01:01:48] [SPEAKER_03]: The idea being that the army screens people for mental disorders and excludes

[01:01:52] [SPEAKER_03]: people who have mental disorders, there are supports in place

[01:01:55] [SPEAKER_03]: in terms of counseling, social supports.

[01:01:58] [SPEAKER_03]: You are constantly surrounded by other people.

[01:02:00] [SPEAKER_03]: You're active, you're exercising, you're eating well and so on.

[01:02:04] [SPEAKER_03]: Over the past 10, 15 years,

[01:02:06] [SPEAKER_03]: the suicide rate among soldiers has crept up and the first time has surpassed

[01:02:11] [SPEAKER_03]: that of the general population, look at age, gender match population.

[01:02:15] [SPEAKER_03]: And so the Department of Defense funded a huge study

[01:02:20] [SPEAKER_03]: called the Army Study to Assess Risk and Resilience Among Service Members or Army

[01:02:24] [SPEAKER_03]: Stars, and it's a big initial study was a five year,

[01:02:29] [SPEAKER_03]: sixty five million dollar effort to really try and understand this.

[01:02:32] [SPEAKER_03]: And the simple explanation has turned out not to be true.

[01:02:36] [SPEAKER_03]: And there's a website.

[01:02:37] [SPEAKER_03]: If you Google Army Stars, you can find the website and find out.

[01:02:39] [SPEAKER_03]: We'll put a link. We'll put a link to things like, well,

[01:02:43] [SPEAKER_03]: it's deployment, soldiers are deploying and deployment stressful.

[01:02:46] [SPEAKER_03]: So if you look at who is deployed, that will tell you who's suicidal.

[01:02:50] [SPEAKER_03]: And if you look at the data, you see soldiers who have been

[01:02:53] [SPEAKER_03]: were currently deployed, the suicide rates have gone up.

[01:02:56] [SPEAKER_03]: But it also has gone up for soldiers who have been previous employed

[01:02:59] [SPEAKER_03]: and also has gone up for soldiers who have never been deployed.

[01:03:01] [SPEAKER_03]: So it's not just deployment.

[01:03:03] [SPEAKER_03]: Some said, well, it's waivers.

[01:03:05] [SPEAKER_03]: The Army is having trouble recruiting people.

[01:03:07] [SPEAKER_03]: And so they loosened the criteria for joining the Army.

[01:03:10] [SPEAKER_03]: So if you look among only people who got a waiver to join the Army,

[01:03:13] [SPEAKER_03]: they had a mental disorder, they had a criminal record.

[01:03:16] [SPEAKER_03]: That's where the uptick is.

[01:03:18] [SPEAKER_03]: That's not the case.

[01:03:19] [SPEAKER_03]: And on and on.

[01:03:19] [SPEAKER_03]: So there's a lot of potential explanations that have panned out to not be the case.

[01:03:26] [SPEAKER_03]: The effort still ongoing to understand, well, why is it that soldiers?

[01:03:29] [SPEAKER_03]: We should not just that soldiers are at risk,

[01:03:31] [SPEAKER_03]: that we're seeing an increased risk among soldiers and we don't yet

[01:03:34] [SPEAKER_03]: understand it, but that effort has produced some really,

[01:03:38] [SPEAKER_03]: some really nice findings.

[01:03:39] [SPEAKER_03]: For instance, Ron Kessler and colleagues at Harvard Medical School,

[01:03:43] [SPEAKER_03]: as part of Army stars, have been using machine learning models,

[01:03:47] [SPEAKER_03]: machine learning algorithms to go across army, medical and administrative

[01:03:51] [SPEAKER_03]: records to identify soldiers at risk for suicide.

[01:03:55] [SPEAKER_03]: And I've gotten pretty accurate at using quote unquote big data

[01:03:58] [SPEAKER_03]: to identify the soldiers at highest risk for suicide.

[01:04:02] [SPEAKER_03]: And so our predictive

[01:04:06] [SPEAKER_03]: capabilities are increasing over the past several years.

[01:04:10] [SPEAKER_05]: Are the predictions that are generated by machine learning?

[01:04:14] [SPEAKER_05]: Are these matching up with the proposed mechanisms,

[01:04:18] [SPEAKER_05]: the theoretical approaches that have sort of been

[01:04:24] [SPEAKER_05]: proposed for understanding suicide?

[01:04:26] [SPEAKER_03]: The big data predictive analytics, I think,

[01:04:30] [SPEAKER_03]: are most accurately thought of as as crassly empirical prediction

[01:04:35] [SPEAKER_03]: and approaches that might point us towards variables that we weren't

[01:04:38] [SPEAKER_03]: considering previously that could be part of our theoretical models.

[01:04:42] [SPEAKER_03]: I think in general, we've been way overly simplistic

[01:04:45] [SPEAKER_03]: in our theoretical model of suicidal behavior.

[01:04:48] [SPEAKER_03]: And I'm not picking out on any one

[01:04:51] [SPEAKER_03]: theory, but they generally tend to say there's two factors

[01:04:55] [SPEAKER_03]: that if they're present lead to suicide,

[01:04:57] [SPEAKER_03]: it was three factors that if they're present lead to suicide,

[01:04:59] [SPEAKER_03]: it's not that simple.

[01:05:01] [SPEAKER_03]: This is a really

[01:05:03] [SPEAKER_03]: behavior that's a result of complex interaction between a lot of different factors.

[01:05:07] [SPEAKER_03]: Distress, sadness clearly played a big role.

[01:05:11] [SPEAKER_03]: Problems with sleep,

[01:05:12] [SPEAKER_03]: problems with agitation, conditions from which a person might want to escape,

[01:05:16] [SPEAKER_03]: all play a role.

[01:05:17] [SPEAKER_03]: A lot of the things that pop out in some of these papers,

[01:05:19] [SPEAKER_03]: genetic papers, papers looking at voice, movement.

[01:05:25] [SPEAKER_03]: These are probably all capturing

[01:05:26] [SPEAKER_03]: different pieces of being distressed or having trouble sleeping and so on.

[01:05:29] [SPEAKER_03]: So they're a little bit a little bit redundant.

[01:05:32] [SPEAKER_03]: So we're still struggling as a field, I think, to come up with

[01:05:34] [SPEAKER_03]: a theoretical model that explains

[01:05:38] [SPEAKER_03]: the pathway from not being suicidal to thinking about suicide

[01:05:42] [SPEAKER_03]: to making a suicide attempt to dying by suicide.

[01:05:45] [SPEAKER_06]: What about isolation?

[01:05:48] [SPEAKER_06]: So that's the hypothesis that I've seen floated around

[01:05:53] [SPEAKER_06]: that to explain the increasing rates of suicide among former military

[01:05:58] [SPEAKER_06]: is going from a regimented and highly social communal environment

[01:06:04] [SPEAKER_06]: to one that's more isolated.

[01:06:06] [SPEAKER_06]: And then, you know, the dark, you know,

[01:06:08] [SPEAKER_06]: ever since Durkheim people have been saying that in modernized,

[01:06:13] [SPEAKER_06]: more isolated environment, suicide rates are much higher than in

[01:06:19] [SPEAKER_06]: places that are more communal.

[01:06:22] [SPEAKER_06]: Is that does that hold up in the research?

[01:06:24] [SPEAKER_03]: Yeah, in various ways it does.

[01:06:28] [SPEAKER_03]: On a broad scale, you know, what's the suicide rate with

[01:06:31] [SPEAKER_03]: sorry, the state with the lowest suicide rate?

[01:06:34] [SPEAKER_03]: What do you think?

[01:06:36] [SPEAKER_05]: No, Googling.

[01:06:38] [SPEAKER_05]: Massachusetts.

[01:06:39] [SPEAKER_03]: No, Massachusetts is low.

[01:06:42] [SPEAKER_05]: I would say a southern state with a heavy black population.

[01:06:46] [SPEAKER_03]: No, the suicide.

[01:06:47] [SPEAKER_03]: So 90 percent of suicides in the US are, quote unquote, white people.

[01:06:52] [SPEAKER_03]: Right.

[01:06:52] [SPEAKER_05]: I was saying like what?

[01:06:54] [SPEAKER_05]: Because, you know, it's a weird finding that.

[01:06:56] [SPEAKER_03]: There's a big, yeah, there's a big, a big racial effect.

[01:06:59] [SPEAKER_03]: New Jersey, New York have the lowest suicide rate.

[01:07:01] [SPEAKER_04]: Oh, wow.

[01:07:02] [SPEAKER_03]: The highest rates are out in western states, not California.

[01:07:06] [SPEAKER_03]: So, you know, Nevada, Wyoming and so on.

[01:07:09] [SPEAKER_03]: And what we think it has to do with at least in part population density

[01:07:12] [SPEAKER_03]: that, you know, New Jersey is New York very densely populated.

[01:07:15] [SPEAKER_03]: As you go out west, people are more spread out and so perhaps more socially isolated.

[01:07:20] [SPEAKER_03]: We also have data not yet published.

[01:07:22] [SPEAKER_03]: So don't share this, but I don't think I don't think anyone listens to this podcast.

[01:07:26] [SPEAKER_03]: So it's fine.

[01:07:28] [SPEAKER_03]: Yeah, nobody did data from new smartphone study where we look at people's calls

[01:07:33] [SPEAKER_03]: and texts going in and out and we see that the less people are getting and

[01:07:39] [SPEAKER_03]: sending texts, the more likely they are to be thinking about suicide and have

[01:07:42] [SPEAKER_03]: more severe suicide.

[01:07:43] [SPEAKER_03]: So there seems to be something across multiple, you know, levels of analysis

[01:07:47] [SPEAKER_03]: to this idea of connectedness being protective against suicidal thinking.

[01:07:52] [SPEAKER_05]: Do you is there's a huge always this like very weird

[01:07:59] [SPEAKER_05]: discomfort in talking about people who attempt suicides and some people really

[01:08:05] [SPEAKER_05]: want to say or wasn't serious, you know, the whole cry for help thing.

[01:08:09] [SPEAKER_05]: But from what I read in the literature that you reviewed,

[01:08:14] [SPEAKER_05]: it seems as if suicide attempts

[01:08:19] [SPEAKER_05]: are pretty strong predictors of future suicide attempts.

[01:08:24] [SPEAKER_05]: You know, there's obviously you never want to not take somebody's suicide

[01:08:27] [SPEAKER_05]: attempt seriously, I guess.

[01:08:29] [SPEAKER_05]: Right? Yeah.

[01:08:31] [SPEAKER_03]: Yeah. So I would say, you know,

[01:08:33] [SPEAKER_03]: anytime a person says they're suicidal, you should take it seriously.

[01:08:36] [SPEAKER_03]: Anytime a person makes a suicide attempt, you should take it seriously.

[01:08:39] [SPEAKER_03]: But

[01:08:40] [SPEAKER_03]: we don't have a good understanding of when someone says they're suicidal.

[01:08:46] [SPEAKER_03]: Which of those people are going to die by suicide and which ones aren't?

[01:08:50] [SPEAKER_03]: When someone makes a suicide attempt,

[01:08:52] [SPEAKER_03]: which of those is going to be lethal or which one isn't?

[01:08:56] [SPEAKER_03]: Two thirds of people who die by suicide told someone ahead of time

[01:08:59] [SPEAKER_03]: they were thinking about suicide.

[01:09:01] [SPEAKER_03]: So you should take it seriously.

[01:09:03] [SPEAKER_03]: Eighty percent of people who die by suicide explicitly denied suicidal

[01:09:07] [SPEAKER_03]: attempts in their last communication before dying, which is contrary.

[01:09:11] [SPEAKER_03]: So most people are telling others they're going to kill themselves.

[01:09:13] [SPEAKER_03]: But most people are also saying I'm not going to kill myself.

[01:09:16] [SPEAKER_03]: So it's hard to know which cases or in which instance should we be really

[01:09:20] [SPEAKER_03]: concerned and in which instance might be still concerned but less so.

[01:09:24] [SPEAKER_03]: And the same with suicide attempts.

[01:09:26] [SPEAKER_03]: So we don't know a lot of the biggest effects that are out there like for

[01:09:30] [SPEAKER_03]: gender, for age, for race.

[01:09:34] [SPEAKER_03]: They've been there for years and years and we just don't have a good understanding

[01:09:36] [SPEAKER_03]: of why they're there.

[01:09:38] [SPEAKER_06]: So you don't there's no good hypothesis for why the rates are much lower among black people.

[01:09:45] [SPEAKER_03]: There are hypotheses.

[01:09:47] [SPEAKER_05]: It is among African American.

[01:09:49] [SPEAKER_05]: It's among African American, right?

[01:09:51] [SPEAKER_05]: It's not even among like I don't know what the rates are in Africa.

[01:09:53] [SPEAKER_05]: But is it?

[01:09:54] [SPEAKER_03]: It's among African Americans in the US have a much lower suicide rate.

[01:09:58] [SPEAKER_03]: And the hypothesis that people tend to offer are well, this greater

[01:10:03] [SPEAKER_03]: social connectedness.

[01:10:05] [SPEAKER_03]: People are more tied into their community and so perceive more social support.

[01:10:12] [SPEAKER_03]: The suicide rate is highest among white men and it really skyrockets an older white man.

[01:10:18] [SPEAKER_03]: And the idea you mentioned, Tamela earlier, isolation,

[01:10:20] [SPEAKER_03]: the hypothesis older white men tend to not be as connected and they retire

[01:10:24] [SPEAKER_03]: from their jobs and they lost their social network.

[01:10:27] [SPEAKER_03]: Now they're on their own, they're no longer providing.

[01:10:30] [SPEAKER_03]: And so perceive that they have no meaning in life and that they're burdened to others.

[01:10:34] [SPEAKER_03]: And so they are more likely to die by suicide.

[01:10:36] [SPEAKER_06]: Do you work in terms of suicidal suicide prevention with individual people?

[01:10:43] [SPEAKER_06]: I know if are you still in clinical psychology?

[01:10:46] [SPEAKER_06]: Are you working with patients?

[01:10:49] [SPEAKER_03]: I am a licensed clinical psychologist.

[01:10:51] [SPEAKER_03]: So I have the ability to see patients.

[01:10:53] [SPEAKER_03]: I haven't seen a patient for purely clinical purposes in over 10 years.

[01:10:58] [SPEAKER_03]: But a lot of the work that we do is in hospitals and with patients.

[01:11:02] [SPEAKER_03]: So we have studies running in local emergency rooms and psychiatric inpatient units

[01:11:07] [SPEAKER_03]: where we are trying to deserve

[01:11:11] [SPEAKER_03]: one way that we work is develop tests that try and help us predict

[01:11:16] [SPEAKER_03]: suicidal behavior, develop them in the lab and then bring them into clinical

[01:11:19] [SPEAKER_03]: settings and see can these help us better detect suicidal thinking and understand

[01:11:23] [SPEAKER_03]: suicidal thoughts and behaviors and predict these outcomes.

[01:11:26] [SPEAKER_03]: And we do test out interventions as well.

[01:11:29] [SPEAKER_03]: So I don't work clinically on a personal level, but we're trying to develop

[01:11:33] [SPEAKER_03]: tools that can help prevent suicide in a scalable way.

[01:11:38] [SPEAKER_05]: One of the things that just strikes me the most and maybe it's just in what

[01:11:42] [SPEAKER_05]: I've read that you've wrote is exactly how little,

[01:11:47] [SPEAKER_05]: how like non-powerful or predictive models are for suicide.

[01:11:53] [SPEAKER_05]: And it's kind of depressing.

[01:11:56] [SPEAKER_05]: But how much do interventions like suicide prevention hotlines work?

[01:12:01] [SPEAKER_05]: I mean, there's a big selection effect.

[01:12:03] [SPEAKER_05]: So if you're going to call one of those places,

[01:12:08] [SPEAKER_05]: you just behaviorally are distinguished from somebody who doesn't call them

[01:12:15] [SPEAKER_05]: and dies by suicide.

[01:12:18] [SPEAKER_03]: We don't know.

[01:12:20] [SPEAKER_03]: There's actually just a great article written on this coincidentally by Cole

[01:12:23] [SPEAKER_03]: Kazdan just wrote a piece this past week titled something like our suicide

[01:12:28] [SPEAKER_03]: hotlines effective.

[01:12:30] [SPEAKER_03]: And the answer is we don't know because no one's really done the randomized

[01:12:33] [SPEAKER_03]: test. No one really has.

[01:12:34] [SPEAKER_03]: No one has done the randomized trial to to test out whether calling the hotline

[01:12:39] [SPEAKER_03]: decreases the person's risk of suicidal behavior because of complications of how

[01:12:43] [SPEAKER_03]: do you follow up somebody who's calling it anonymous hotline?

[01:12:46] [SPEAKER_03]: Nor have we really a good understanding of are there things that one can do

[01:12:51] [SPEAKER_03]: on a hotline to decrease the person's risk of suicidal behavior or suicide death?

[01:12:55] [SPEAKER_03]: So we, you know, a lot of what's out there,

[01:12:57] [SPEAKER_05]: you don't want to like randomize the things that you say.

[01:13:00] [SPEAKER_05]: Right.

[01:13:01] [SPEAKER_03]: Right. But one could, you know, do an observational study where we

[01:13:05] [SPEAKER_03]: as a first step examine whether certain kinds of interventions are more effective

[01:13:08] [SPEAKER_03]: than others. Yeah.

[01:13:10] [SPEAKER_03]: But yeah, we don't have a good.

[01:13:12] [SPEAKER_03]: There's a lot of people doing the name of suicide prevention.

[01:13:14] [SPEAKER_03]: A lot of it is very well intentioned.

[01:13:16] [SPEAKER_03]: We haven't done a good enough job at experimentally testing what

[01:13:21] [SPEAKER_03]: what that we're doing is working and what isn't.

[01:13:23] [SPEAKER_03]: And let's get rid of the stuff that doesn't work or is actually harmful

[01:13:27] [SPEAKER_03]: and scale up to stuff that does work and try to make it more powerful.

[01:13:29] [SPEAKER_03]: So we got, we've got a really far way to go.

[01:13:32] [SPEAKER_06]: So if we have listeners say that knows

[01:13:36] [SPEAKER_06]: somebody that has suicidal thoughts, is there anything you can tell them?

[01:13:43] [SPEAKER_06]: Any advice you can give them that you have any confidence might reduce

[01:13:48] [SPEAKER_06]: the person's chance of going through with it?

[01:13:53] [SPEAKER_03]: I think that the best advice we have right now is if you think someone

[01:13:57] [SPEAKER_03]: is thinking about suicide, you should ask them about it directly.

[01:14:01] [SPEAKER_03]: We know from experimental from experiments, asking someone,

[01:14:04] [SPEAKER_03]: are you thinking about suicide does not make that person more distressed,

[01:14:09] [SPEAKER_03]: nor does it make them more likely to think about suicide or to make a suicide attempt?

[01:14:13] [SPEAKER_03]: So we know clearly experimentally it is safe to ask someone.

[01:14:18] [SPEAKER_03]: So you should ask someone if you think they're at risk.

[01:14:21] [SPEAKER_03]: Let them know you're there to talk with them.

[01:14:23] [SPEAKER_03]: Tamela, you mentioned the importance of social connectedness and

[01:14:28] [SPEAKER_03]: think you're right and that's never a harmful thing.

[01:14:32] [SPEAKER_03]: And encourage that person to get help, whether it's I'm not saying one shouldn't

[01:14:36] [SPEAKER_03]: call a hotline, I'm just saying we don't yet know how effective it is

[01:14:40] [SPEAKER_03]: and or bring the person to a local emergency room.

[01:14:43] [SPEAKER_03]: People are often very fearful of going to the emergency room because they

[01:14:45] [SPEAKER_03]: don't know what's going to happen.

[01:14:46] [SPEAKER_03]: They don't want to be hospitalized against their will.

[01:14:48] [SPEAKER_03]: Usually a person isn't hospitalized.

[01:14:50] [SPEAKER_03]: Usually they'll go and look into evaluation

[01:14:52] [SPEAKER_03]: and then we'll get connected with care.

[01:14:54] [SPEAKER_03]: We're in an appointment for a follow up meeting with a psychiatrist or a

[01:14:57] [SPEAKER_03]: psychologist or another mental professional and can start getting treatment

[01:15:01] [SPEAKER_03]: for whatever underlying problem might be leading them to feel like

[01:15:04] [SPEAKER_03]: they don't want to be alive anymore.

[01:15:05] [SPEAKER_03]: They want to escape from some problem.

[01:15:07] [SPEAKER_03]: So I think we're in the process of trying to identify

[01:15:11] [SPEAKER_03]: and improve the interventions we have, but we do have treatments that have

[01:15:14] [SPEAKER_03]: been shown to decrease at risk, a person's risk of suicidal behavior.

[01:15:18] [SPEAKER_03]: And so people should try and if you think someone's at risk,

[01:15:20] [SPEAKER_03]: try and get them into one of those interventions.

[01:15:23] [SPEAKER_05]: Right. So what I was reading in your in your review paper was that there's

[01:15:27] [SPEAKER_05]: some evidence that CBT and attachment therapy for families,

[01:15:31] [SPEAKER_05]: at least in youth can reduce it.

[01:15:33] [SPEAKER_05]: Right. Yeah.

[01:15:34] [SPEAKER_03]: And there's a treatment called dialectical behavior therapy or DBT,

[01:15:38] [SPEAKER_03]: which along with cognitive therapy has been shown to decrease the risk

[01:15:42] [SPEAKER_03]: of suicide attempts among adults and with some new evidence for adolescents as well.

[01:15:46] [SPEAKER_05]: You know, in the time we have left, I don't know,

[01:15:49] [SPEAKER_05]: Tamler, how many questions you have?

[01:15:50] [SPEAKER_05]: But like I can't help but like ask about the contagion effects that everybody

[01:15:54] [SPEAKER_05]: discusses and how powerful those actually are.

[01:15:58] [SPEAKER_05]: I mean, in some ways it's kind of insane

[01:16:03] [SPEAKER_05]: that they would be strong given the horrible track record of social priming

[01:16:10] that we have.

[01:16:12] [SPEAKER_05]: But but you know, I saw people just getting really mad like at the New York

[01:16:16] [SPEAKER_05]: Times and the way they talked about the Kate, the Kate Spade suicide,

[01:16:20] [SPEAKER_05]: because apparently there are guidelines for how to talk about something.

[01:16:23] [SPEAKER_05]: You never talk about the method.

[01:16:24] [SPEAKER_05]: I know that in the Bay Area, the Golden Gate Bridge,

[01:16:28] [SPEAKER_05]: they don't publicize

[01:16:31] [SPEAKER_05]: death by suicide on the Golden Gate Bridge because of fear of attempts.

[01:16:37] [SPEAKER_05]: And and I mean, on the one hand, you could say

[01:16:41] [SPEAKER_05]: if five people more

[01:16:44] [SPEAKER_05]: attempt suicide because of the headline, it might be significant.

[01:16:48] [SPEAKER_05]: But like what is the size of this?

[01:16:50] [SPEAKER_05]: Is it really?

[01:16:52] [SPEAKER_05]: You know, how concerned should we be about not publicizing it?

[01:16:56] [SPEAKER_05]: Because it really puts a pair.

[01:16:57] [SPEAKER_05]: It's a paradox because you want to talk about it.

[01:16:59] [SPEAKER_05]: Yeah, you know, you want to make it less stigmatizing.

[01:17:03] [SPEAKER_05]: But here you are having people, police don't say that that it was death

[01:17:07] [SPEAKER_05]: by hanging like, don't say it.

[01:17:09] [SPEAKER_03]: Yeah, you're exactly right.

[01:17:11] [SPEAKER_03]: It is a paradox.

[01:17:13] [SPEAKER_03]: There does there is evidence that there is some

[01:17:16] [SPEAKER_03]: not surprisingly influence of influence on our behavior of the behavior of others.

[01:17:23] [SPEAKER_03]: Some of the one of the best recent studies I saw on this was an army study

[01:17:27] [SPEAKER_03]: was a study done by by Bob Versano as a uniform services University of Health

[01:17:32] [SPEAKER_03]: Sciences showing that in units and army units where there is an

[01:17:37] [SPEAKER_03]: increasing that the more suicide attempts in your unit,

[01:17:41] [SPEAKER_03]: the greater the odds that you're going to make a suicide attempt.

[01:17:44] [SPEAKER_03]: So these things tend to pile up, especially in smaller units,

[01:17:48] [SPEAKER_03]: which suggests that they're sort of closer to you.

[01:17:51] [SPEAKER_03]: So there does seem to be some what one can call

[01:17:54] [SPEAKER_03]: a contagion effect or a social influence effect at the same time is important

[01:17:59] [SPEAKER_03]: to acknowledge it doesn't spread in the same way that many, you know,

[01:18:03] [SPEAKER_03]: airborne diseases do where you hear about it, you're going to catch it.

[01:18:07] [SPEAKER_03]: And so on one hand, we have to be conscious of the fact that there is some impact

[01:18:11] [SPEAKER_03]: of suicidal behavior on those around.

[01:18:15] [SPEAKER_03]: But we can't let that prevent us from talking about it at all because then we

[01:18:18] [SPEAKER_03]: miss the opportunity to talk to people about it, who might be at risk and to

[01:18:23] [SPEAKER_03]: connect them with care.

[01:18:24] [SPEAKER_03]: And so we've got to get it.

[01:18:26] [SPEAKER_03]: I think we've got to do a better

[01:18:27] [SPEAKER_03]: guy, get a better understanding as researchers on exactly how we should

[01:18:30] [SPEAKER_03]: thread that needle and how society, how should we deal with this week?

[01:18:35] [SPEAKER_03]: We can't let the fact that there is this quote unquote contagion effect

[01:18:39] [SPEAKER_03]: keep us from talking about suicide and keep us from funding research on it and keep

[01:18:43] [SPEAKER_03]: us from getting the research that we have out into the hands of clinicians and

[01:18:46] [SPEAKER_03]: others who can use it.

[01:18:48] [SPEAKER_03]: So I think we've got to do a better job of figuring out that balance.

[01:18:52] [SPEAKER_03]: The media guidelines try and do that.

[01:18:53] [SPEAKER_03]: They say talk about suicide, but do it in ways that we think won't lead

[01:18:56] [SPEAKER_03]: to contagion, don't romanticize it, don't glamorize it, don't, you know,

[01:19:01] [SPEAKER_03]: present the sort of how to guide of how the person did it because those

[01:19:04] [SPEAKER_03]: kind of things could could make things worse.

[01:19:07] [SPEAKER_03]: Could increase the number of people who try and copycat.

[01:19:10] [SPEAKER_06]: Is there any evidence that reading about suicide in the New York Times about

[01:19:15] [SPEAKER_06]: increases, the chance that you're not just the New York Times, but in the media?

[01:19:21] [SPEAKER_06]: Yeah, because I mean, it's very different when your friends are doing it versus.

[01:19:26] [SPEAKER_03]: No, I mean, the precise over the years suggesting that there's a small

[01:19:29] [SPEAKER_03]: effect for how popular was the person who did it?

[01:19:33] [SPEAKER_03]: How much was that person perceived to be like me versus not?

[01:19:38] [SPEAKER_03]: And there's some suggestions, some data

[01:19:41] [SPEAKER_03]: suggesting that the way it's reported on can have an impact.

[01:19:45] [SPEAKER_03]: There's no data that I've seen that you

[01:19:48] [SPEAKER_03]: well, again, there's data suggesting that

[01:19:51] [SPEAKER_03]: being exposed to the concept of suicide or suicidal behavior doesn't in itself

[01:19:58] [SPEAKER_03]: increase a person's risk.

[01:20:00] [SPEAKER_03]: So reading about the idea of suicide or listening to this podcast,

[01:20:03] [SPEAKER_03]: you know, isn't going to uptick anybody's suicide risk.

[01:20:07] [SPEAKER_03]: It's when you're exposed to the suicide of someone else,

[01:20:11] [SPEAKER_03]: maybe there could be some impact of that.

[01:20:13] [SPEAKER_03]: Maybe if you've been thinking about suicide and you observe that somebody

[01:20:16] [SPEAKER_03]: who you idolize died by suicide, maybe it could increase your or have you

[01:20:22] [SPEAKER_03]: revisit some of those thoughts and get you thinking about it again.

[01:20:24] [SPEAKER_06]: There is kind of like I remember Kurt Cobain,

[01:20:27] [SPEAKER_06]: it was almost a lead part of his legend that he committed suicide.

[01:20:32] [SPEAKER_06]: That was one that seemed a lot more glamorized.

[01:20:38] [SPEAKER_03]: I went 13 reasons why without recently there is a paper showing an upticking

[01:20:42] [SPEAKER_03]: cool searches about how to kill myself.

[01:20:45] [SPEAKER_03]: So, you know, not so surprising that if you have a show for kids about

[01:20:49] [SPEAKER_03]: suicide and the effect of suicide and many people think that wasn't it wasn't

[01:20:52] [SPEAKER_03]: done in the best possible way, not surprising that we can uptick in

[01:20:56] [SPEAKER_03]: searches about this is it's going to raise people's consciousness about the

[01:20:59] [SPEAKER_03]: problem in a way that's not necessarily positive.

[01:21:02] [SPEAKER_05]: You said at the outset that that suicide is really marked by a flat line like it's

[01:21:07] [SPEAKER_05]: but but is is there any understanding of why there was that 1520 year dip?

[01:21:13] [SPEAKER_03]: No, I mean, people will give you explanations.

[01:21:16] [SPEAKER_03]: You know, yeah, there's a 15 year increase and you'll find people saying,

[01:21:20] [SPEAKER_03]: well, it's opioids. It's a social media.

[01:21:22] [SPEAKER_03]: Yeah, it's very bad.

[01:21:24] [SPEAKER_03]: It's it's hard.

[01:21:26] [SPEAKER_05]: It's hard to classify opioid deaths too, right?

[01:21:29] [SPEAKER_03]: Because yeah, yeah, what's an overdose?

[01:21:31] [SPEAKER_03]: What's accidental versus intentional?

[01:21:34] [SPEAKER_03]: So there's no shortage of offered explanations, but I have not seen any any

[01:21:39] [SPEAKER_03]: good empirical any good explanation of the variant showing this is why it decreased.

[01:21:45] [SPEAKER_03]: And this is why it increased.

[01:21:46] [SPEAKER_05]: I did have one specific question to what is the connection with sleep

[01:21:51] [SPEAKER_05]: deprivation? It seems to be something that that people point to a lie.

[01:21:55] [SPEAKER_05]: And I don't know if it's a cause of of suicidal attempts or if it's just what

[01:22:01] [SPEAKER_05]: comes along with the symptoms of being so distressed.

[01:22:04] [SPEAKER_03]: It's a great question that there's there's for decades we've known that

[01:22:07] [SPEAKER_03]: there's a link between sleep problems and subsequent suicide.

[01:22:13] [SPEAKER_03]: Yeah, we don't yet, to my understanding, have a good understanding of.

[01:22:18] [SPEAKER_03]: You know, what is that distress causing problems in sleep?

[01:22:23] [SPEAKER_03]: And so the sleep is a this third variable that's explained by distress or is sleep

[01:22:27] [SPEAKER_03]: causing the distress or causing some disinhibition or most likely it's both.

[01:22:32] [SPEAKER_03]: It's a sort of transactional process where you're upset, you're anxious,

[01:22:35] [SPEAKER_03]: you're distressed and so you're sleeping less and you're sleeping less.

[01:22:38] [SPEAKER_03]: And that's causing more irritability and agitation and inhibition.

[01:22:41] [SPEAKER_03]: And this might cycle and increase your risk of suicidal behavior.

[01:22:45] [SPEAKER_03]: So we don't know.

[01:22:46] [SPEAKER_03]: We're doing studies now where we have people wearing biosensors 24 hours a day

[01:22:50] [SPEAKER_03]: for weeks at a time tracking suicidal thoughts to see can we

[01:22:56] [SPEAKER_03]: try and tease us apart?

[01:22:58] [SPEAKER_03]: And right now we haven't published this yet to the point where we can use just

[01:23:01] [SPEAKER_03]: with biosense, a wearable biosensor using your data from today.

[01:23:04] [SPEAKER_03]: We can predict with about 80% accuracy whether you're going to think

[01:23:07] [SPEAKER_03]: about suicide tomorrow.

[01:23:09] [SPEAKER_03]: And so it starts to go in and say, well, what is it sleep?

[01:23:11] [SPEAKER_03]: Is it motion? Is it skin conductance?

[01:23:14] [SPEAKER_03]: What kind of predictive power do you get from these different pieces?

[01:23:17] [SPEAKER_03]: And what does the timeline look like?

[01:23:19] [SPEAKER_03]: And can we tease apart when distress started taking up and when sleep

[01:23:22] [SPEAKER_03]: problems started taking up?

[01:23:24] [SPEAKER_05]: Man, I mean, that's going to be like as wearable technology increases

[01:23:28] [SPEAKER_05]: and the Apple Watch gets more complex.

[01:23:30] [SPEAKER_05]: Like that might be a real source of intervention.

[01:23:34] [SPEAKER_05]: How are you using this as an opportunity to pimp Apple products?

[01:23:39] [SPEAKER_05]: Fine. It could be an Android watch.

[01:23:45] [SPEAKER_05]: It maybe will end with this because our time is running out.

[01:23:48] [SPEAKER_05]: But I have to say for a second, how the fuck like what kind of a scholar we have here,

[01:23:53] [SPEAKER_05]: man, we're just rattling off questions.

[01:23:55] [SPEAKER_05]: You're like an expert. We rarely have experts on this.

[01:23:57] [SPEAKER_05]: Oh, come on.

[01:24:00] [SPEAKER_03]: Thank you for lowering the bar and allowing me on.

[01:24:04] [SPEAKER_06]: Well, I mean, I can't like we've never really done something like this

[01:24:07] [SPEAKER_06]: where we just rattle off questions the whole time.

[01:24:09] [SPEAKER_05]: Yeah, we never just rattle off questions the whole time.

[01:24:11] [SPEAKER_05]: I think it's just like you're you're satisfying our thirst for knowledge.

[01:24:15] [SPEAKER_05]: And hopefully are listening to you

[01:24:18] [SPEAKER_05]: at the ethical problems that come along with knowing, for instance,

[01:24:23] [SPEAKER_05]: that you have increased predictive power.

[01:24:26] [SPEAKER_05]: How do you deal with those?

[01:24:29] [SPEAKER_05]: What are the main ethical problems?

[01:24:30] [SPEAKER_05]: Like obviously, the hugest

[01:24:33] [SPEAKER_05]: ethical problem from somebody who comes from an experimental tradition is

[01:24:37] [SPEAKER_05]: you cannot do an intervention that causes an increase in suicidal

[01:24:43] [SPEAKER_05]: ideation or behavior or whatever.

[01:24:46] [SPEAKER_05]: But what are the ethical problems that you face in your research?

[01:24:51] [SPEAKER_03]: Like, yeah, the ethical piece is a really interesting one.

[01:24:54] [SPEAKER_03]: I think it we are in suicide unlike most other areas of science.

[01:24:59] [SPEAKER_03]: Right. If you want to study,

[01:25:01] [SPEAKER_03]: I think we've talked about this before the podcast.

[01:25:04] [SPEAKER_03]: If you want to study disgust, you can discuss people.

[01:25:06] [SPEAKER_03]: You can show the things discussed in it.

[01:25:08] [SPEAKER_03]: If you want to study anxiety, you can expose people to tarantulas and see how

[01:25:12] [SPEAKER_03]: interesting if you want to study ants or stars or whatever it is, you can you can do that

[01:25:16] [SPEAKER_03]: for suicide.

[01:25:17] [SPEAKER_03]: We can't ethically bring people into the lab and make them.

[01:25:20] [SPEAKER_03]: We're trying to do suicidal thinking or suicidal behavior.

[01:25:23] [SPEAKER_03]: And so as a result, we're in this sort of funky place where we're trying

[01:25:26] [SPEAKER_03]: to understand something without ever having observed it.

[01:25:30] [SPEAKER_03]: And I think this also has led to our lack of progress in this area where

[01:25:33] [SPEAKER_03]: people are throwing out ideas about why they think people are suicidal

[01:25:37] [SPEAKER_03]: without ever having observed a suicidal person, you know, while they're suicidal.

[01:25:41] [SPEAKER_03]: With advanced technology, we can now use machine learning on medical records.

[01:25:46] [SPEAKER_03]: We can use Apple watches, smartphones,

[01:25:50] [SPEAKER_03]: biosensors to try and track people as we get better at identifying high risk

[01:25:54] [SPEAKER_03]: periods. What do we do? When do we intervene?

[01:25:59] [SPEAKER_03]: If we have a model that says this person now has a high probability of

[01:26:03] [SPEAKER_03]: making a suicide attempt in the next month, shouldn't intervene?

[01:26:07] [SPEAKER_03]: Of course we should intervene.

[01:26:09] [SPEAKER_03]: But the positive value of a model is only about 4 percent.

[01:26:13] [SPEAKER_03]: So 96 times out of 100 is going to be a false positive.

[01:26:16] [SPEAKER_03]: Maybe we shouldn't intervene.

[01:26:17] [SPEAKER_03]: Maybe there's a harm telling a person that they are at risk of suicide.

[01:26:22] [SPEAKER_05]: You are just the kind of person when really they're not.

[01:26:26] [SPEAKER_03]: So it's it's it's I don't know.

[01:26:29] [SPEAKER_03]: You know, right now our approach is let's try and get better at predicting.

[01:26:33] [SPEAKER_03]: And we don't think we're yet at a point where we

[01:26:37] [SPEAKER_03]: should be acting on what we're doing because we have such inaccuracy in our

[01:26:40] [SPEAKER_03]: models as we get better and better, though, isn't at some point there

[01:26:44] [SPEAKER_03]: becomes a situation where we have an ethical obligation to act.

[01:26:48] [SPEAKER_03]: We actually just hosted or co-hosted with NIMH.

[01:26:51] [SPEAKER_03]: I'm meeting here at Harvard to address exactly this to say what are the

[01:26:55] [SPEAKER_03]: ethics of doing digital monitoring with high risk subjects?

[01:26:59] [SPEAKER_03]: People who are thinking about suicide, using drugs, you mean alcohol.

[01:27:03] [SPEAKER_03]: And we have bioethicists and psychiatrists and lawyers and researchers to say,

[01:27:08] [SPEAKER_03]: if we're tracking someone with a smartphone and they say 10 out of 10,

[01:27:11] [SPEAKER_03]: I'm going to kill myself today and we have a GPS tracker or their phone.

[01:27:15] [SPEAKER_03]: We know where they are.

[01:27:16] [SPEAKER_03]: Shouldn't we intervene?

[01:27:17] [SPEAKER_03]: On one hand, yes, of course we should.

[01:27:19] [SPEAKER_03]: On the other hand, about five percent of our responses,

[01:27:22] [SPEAKER_03]: people say 10 out of 10, I'm going to kill myself, but they don't.

[01:27:26] [SPEAKER_03]: So we don't want to be sending ambulances to people's school or their home and

[01:27:30] [SPEAKER_03]: liars, liars.

[01:27:31] [SPEAKER_03]: Well, not some people walk around with a high level of suicidal thinking,

[01:27:35] [SPEAKER_03]: but they're not going to act on it.

[01:27:36] [SPEAKER_03]: And so,

[01:27:38] [SPEAKER_03]: you know, ethically, our position is

[01:27:41] [SPEAKER_03]: we should do a really good job of consenting people and letting them

[01:27:44] [SPEAKER_03]: know exactly what they're agreeing to, how we're going to use their data,

[01:27:47] [SPEAKER_03]: how we're not going to use your data, what we're going to do in terms of

[01:27:50] [SPEAKER_03]: intervention or not, and just be very clear with them as they go.

[01:27:54] [SPEAKER_03]: And if we think of pertinence above a certain threshold,

[01:27:57] [SPEAKER_03]: we'll tell them ahead of time, we once we feel some obligation to do something,

[01:28:00] [SPEAKER_03]: we will take steps to try and keep you safe, which could mean reaching out to

[01:28:03] [SPEAKER_03]: you, it could mean trying to get you into to see a clinic at the local hospital

[01:28:06] [SPEAKER_03]: and so on.

[01:28:07] [SPEAKER_03]: But it is tricky and it is, to my mind, an iterative process.

[01:28:11] [SPEAKER_03]: We do the best we can with our predictive models.

[01:28:13] [SPEAKER_03]: As we get better, we've got to update and change our plan.

[01:28:16] [SPEAKER_05]: Well, like the harsh reality is that that you could be in a position where

[01:28:20] [SPEAKER_05]: somebody accuses you of negligence because five percent is enough to have

[01:28:25] [SPEAKER_05]: intervened and my child killed themselves.

[01:28:28] [SPEAKER_05]: And you know, I'm sorry, five percent,

[01:28:30] [SPEAKER_03]: about five percent of the responses we get, a person is top of our scale

[01:28:34] [SPEAKER_03]: saying I'm going to kill myself right now, right?

[01:28:37] [SPEAKER_03]: But nobody has.

[01:28:38] [SPEAKER_05]: So yeah.

[01:28:39] [SPEAKER_05]: The sort of banal legal issues of somebody accusing you of having

[01:28:45] [SPEAKER_05]: information that you didn't act on.

[01:28:47] [SPEAKER_05]: Absolutely.

[01:28:47] [SPEAKER_05]: It's so nebulous, right?

[01:28:49] [SPEAKER_05]: Yeah. Super.

[01:28:51] [SPEAKER_05]: It's an area that I would be just kind of freaked out about studying.

[01:28:54] [SPEAKER_05]: We used to do, right?

[01:28:56] [SPEAKER_05]: Like when we were in grad school and we would do these like sad mood inductions

[01:28:59] [SPEAKER_05]: in Salove's lab, you know, we'd have to debrief and give people

[01:29:03] [SPEAKER_05]: information about counseling, you know, because we were afraid that just

[01:29:06] [SPEAKER_05]: watching whatever terms of endearment was going to get them fighting like

[01:29:09] [SPEAKER_03]: depressed, listening to Russia under the Mongolia and Yolk at half speed.

[01:29:13] Yeah, exactly.

[01:29:14] [SPEAKER_06]: All right. On that note, we should probably wrap up.

[01:29:18] [SPEAKER_06]: Yeah.

[01:29:18] [SPEAKER_06]: Unless you have anything else, Dave, but thank you very much for for joining us on.

[01:29:25] [SPEAKER_06]: I would say almost certainly the most somber VBW.

[01:29:28] [SPEAKER_04]: Yeah. Yeah. Sorry.

[01:29:30] [SPEAKER_05]: I wanted I want to first say thank you, but also just tell people that

[01:29:35] [SPEAKER_05]: Matt's an extremely hilarious person.

[01:29:37] [SPEAKER_05]: It's just that this is not a hilarious topic.

[01:29:39] [SPEAKER_03]: It's not a hilarious topic, but I'm glad you guys covered it.

[01:29:41] [SPEAKER_03]: Thank you. Thanks for featuring this topic on the on your podcast, because as I said,

[01:29:45] [SPEAKER_03]: it is a somber one, but one because of that, that often gets ignored.

[01:29:50] [SPEAKER_03]: So it's great that you're bringing attention to it.

[01:29:52] [SPEAKER_03]: Really appreciate it and thanks for coming on.

[01:29:54] [SPEAKER_05]: Thanks, Matt.

[01:29:55] [SPEAKER_05]: Thank you.