Podcast Summary: Something Positive for Positive People – Episode 385: "In the Thick of It"

Host: Courtney W. Brame
Guest: Ali
Date: September 18, 2025

Episode Overview

In this deeply empathetic episode, Courtney Brame returns to the foundational purpose of the Something Positive for Positive People podcast: creating a space where those navigating herpes stigma and mental health struggles, including suicidality, can be witnessed without judgment. The conversation with Ali, a yoga therapy client and veteran, centers around the lived experience of suicidal ideation, the (often inadequate) supports available, and the crucial difference between being checked-in on as a process and being truly cared for as a human.

Key Discussion Points & Insights

1. Opening Reflections: Why This Conversation?

• Courtney shares the podcast’s suicide prevention roots and acknowledges the intensity of the topic, especially during Suicide Prevention Awareness Month.
• The intention: to offer an authentic account of what it feels like to be "in the thick of it" with suicidal ideation, not as clinicians but as real people sharing presence and witnessing.

2. Ali’s State of Mind: Living in Emotional Flux

• Ali describes an experience akin to being on an emotional "pinball machine"—fine until suddenly not fine, with emotional states that are "sporadic" and "inconsistent."

  “I am fine. I’ve had a good day...but I am like in a place of resistance right now. And so sometimes it’s hard for me to get to the things where I have a good day.” (03:28, Ali)

3. What Support Really Feels Like

• There's a profound difference between check-ins from loved ones (felt as authentic care) vs. protocol-driven inquiries from medical/mental health professionals that feel empty and dehumanizing:

  “Those...check-ins feel different coming from a person that I have a relationship with...What feels frankly annoying is getting calls from medical professionals...It’s a box to be checked.” (05:14, Ali)

• Courtney highlights the importance of presence and simply ‘witnessing’ someone’s experience, rather than seeking to “fix” them.

4. Authentic Listening and the Need for Context

• Ali references Thich Nhat Hanh’s writings on mindfulness and the power of deep listening, especially in moments of conflict or suffering:

  “Do you think I understand you enough? ...They don't know about me, but my friends do. So the solutions you’re about to offer me have no context.” (09:53, Ali)

5. Naming the Suicidal Experience Directly

• Courtney asks Ali directly about current suicidal feelings. Ali confirms there was a moment earlier in the day:

  “There was a point earlier in the day where the answer was yes. I think, like, I’m always kind of feeling connected to that at this moment, but I don’t feel the urgency of it today.” (11:46, Ali)

6. Fuel for Advocacy: Courtney’s Perspective

• Courtney discusses how his anger about unnecessary suffering (herpes stigma leading to suicidality) motivates his long-term advocacy:

  “It would be nice for people with herpes to not want to kill themselves anymore, right? And it goes beyond just herpes.” (12:05, Courtney)

7. Understanding Pain: The Addiction and Grief Analogy

• Both speakers relate to cycles of chasing relief or highs, whether through substance use or life experiences, and the torture of believing you’ll never regain the best moments you’ve lost.

8. Systemic Issues vs. Self-Blame

• Ali shares a powerful written piece examining both systemic dehumanization (especially for veterans) and self-betrayal (alcoholism):

  “I am tired of other people telling me what I need as if I do not live inside of my own body...Audre Lorde said, ‘The master's tools will never dismantle the master's house.’” (20:00–21:00, Ali)

• Reflection: Healing requires more than individual therapy; structural supports are critical.

9. On Choice, Agency, and the Limitations of Options

• Courtney and Ali dive into the philosophy of choice—whether choices made under constraint are true choices, especially regarding military service and addiction recovery.
• Ali observes that sustainable change took root only when sobriety was chosen from a place of self-love, not self-punishment.

10. Living with Suicidality & the Importance of Human Contact

• Ali expresses that one reason for not acting on suicidal thoughts is a concern for others—specifically, to avoid traumatizing loved ones or first responders.

  “I haven’t figured out a way to do it that wouldn’t be traumatic for somebody to find.” (29:23, Ali)

• The simple, human act of another person just holding Ali during the worst moments is identified as "the most helpful thing."

  “Literally just hold me, wrap her arms around me as I cry, and just like sit with me in that. …she’s not gonna sit there and be like, you know, just love yourself…She’s not trying to do that.” (31:34, Ali)

11. Past Experiences & Cycles of Suicidality

• Ali recounts two major suicidal periods—one during military service, another linked to the menstrual cycle and hormonal changes after stopping birth control.
• In both, peer support was key; institutional responses (hotlines, therapy) felt insufficient.

12. What Help Actually Looks Like in Crisis

• People "in the thick of it" do not need open-ended offers ("let me know if you need anything"); they need concrete, specific gestures of support (e.g., a meal brought over, a forced walk, company during paralysis).

13. Systemic Gaps in Care: The VA and Bureaucratic Failure

• After seeking help at the VA, Ali describes being processed through protocols, but not actually helped with concrete needs (financial, housing, meaningful conversation).

  “I did an intake...I spent the night...nobody spoke with me really...It was like three pages of documents that were just like, all of you know, ‘This is the PTSD clinic’ ...I did my stay in August and it’s September.” (53:25, Ali)

• Systemic failures often perpetuate feelings of helplessness and alienation.

14. Redefining Suicide Prevention: Beyond Therapy

• Ali and Courtney discuss how suicide prevention must encompass community care, direct material support, financial literacy, shelter, and addressing systemic barriers, not just therapy or medication.

  “Having three therapies at one time is pretty enough, I think. And so when people say, what do you need? They're not in a place to, like, offer what I actually need.” (48:03, Ali)

15. The ‘Care Menu’ Concept

• Ali describes a resource she saw about a “care menu”—where both parties explicitly state what help/support is wanted or can be given, instead of vague offers or assumptions.
• This model relies on specific, actionable tasks and reduces the cognitive load during crisis.

Notable Quotes and Memorable Moments

• On protocols vs. real care:

  "This mechanized thing that you've created, this structure you've created...is for structures, it's not for people." (07:37, Ali)

• Describing the inner struggle in crisis:

  "My brain, inside of itself is like, kill yourself, stay alive. Kill yourself, stay alive, kill yourself, stay alive. ...It's the same brain." (39:02, Ali)

• On autonomy and survival:

  "Having support and basic functions is really helpful in those moments. …all of these other things that are seemingly simple are like, I can't fathom somebody being like, where do you want to go eat today? I don't want to be alive." (41:18, Ali)

• On systemic constraints:

  "If you don't have choice and you make a choice, is that really a choice?" (24:23, Courtney)

• On friends as literal life-support:

  "I feel like I am...attached to this life support machine and other people have the power and I'm only alive because other people want me to be here. And I have nothing for myself..." (45:47, Ali)

• On suicide prevention as community-care:

  “Suicide prevention is...community building. It is food, it is shelter. …I need information like that. Well, I'm not going to get those by trying my fifth different kind of therapy.” (50:44, Ali)

Timestamps for Important Segments

• 03:28 – Ali on living with emotional ups and downs
• 05:14–07:37 – Feeling the difference between real and procedural support
• 09:53–10:50 – Mindfulness, understanding, and the need for context
• 11:46–12:05 – Ali answers candidly about current suicidality
• 15:25–17:29 – Courtney and Ali discuss high/low emotional anchors and grief
• 20:00–21:30 – Ali’s written meditation on systemic vs. self-inflicted pain
• 29:23–32:49 – Ali describes concrete moments and what keeps her alive
• 33:05–38:42 – Reflecting on the role of environment and community in survival
• 39:02–41:18 – Navigating the storm of inner conflict and paralysis in crisis
• 48:03–50:44 – Therapy’s limits and redefining what real help looks like
• 53:25–55:53 – A look inside the VA’s failing crisis protocols
• 61:44–63:20 – Introducing the “care menu” support model

Final Takeaways

• True support isn’t about checklists—it’s about presence, contextual understanding, and concrete help.
• Suicide prevention must go beyond traditional talk therapy and crisis lines, encompassing material, financial, and community support.
• People in crisis need action and care, not more decisions or generic advice.
• Systemic failures compound and perpetuate the crisis, particularly in vulnerable populations (like veterans).
• Specific, actionable, and consent-driven offers (“care menus”) are far more effective than open-ended platitudes.

For Listeners Supporting Loved Ones

• Don’t ask “let me know if you need anything”—offer something concrete.

  “Hey, I’m bringing you soup,” “I’m taking you for a walk now,” “I can give you $20 for groceries”—these are tangible, actionable, and far easier to accept for someone overwhelmed.

• Expect and accept “no” as an answer without taking it personally.
• Be present without seeking to fix or change; sometimes just sitting with someone is the greatest act of love.

If you or someone you know is struggling, please seek support—community matters.

Resources referenced:

• Thich Nhat Hanh, Mindfulness Book Series
• Audre Lorde, "The Master’s Tools Will Never Dismantle the Master’s House"

For more, visit spfpp.org for support groups, 1-1 calls, and resources.