Tuesday, April 25, 2017

13 Reasons Why

I know I've been away for awhile, and have so much to say, but all those snapshots about less essential things will have to wait. 

Because this is really important. 

There is a new show on Netflix, 13 Reasons Why, capturing the attention of teenagers and adults everywhere. When I saw it on the Netflix menu last week I passed without thinking. It seemed so much like work, you know?

But it is at the top of my list now. A therapist has to be informed.

This is a series of 13 shows focused on 13 people, people who in one way or another contributed to a teen's decision to end her life. Hannah Baker has already done the deed, leaves behind 13 audio cassettes implicating others. The screen adaptation is based on teen fiction writer Jay Ashers'  2007 novel of the same name.

Any therapist will tell you that we all, in one way or another, have at some point in our lives, affected the mental health of another person, for better or worse. Indeed, there is a therapy adage, well-understood:
For every suicide, there is someone else who wanted that person dead
Yes, that sounds macabre, but it is true. Well, sometimes it is true. Certain personalities are so grating, so annoying, so abusive (whether intentionally or not) so hard on us, so needy and intrusive, that loved ones (loved ones!) wish they were dead. And the one who is the problem picks up on that.

The suicides of patients diagnosed with BPD, Borderline Personality Disorder are often blamed (in notes) on family and friends who could not meet insatiable needs, or who outright rejected them, ended the relationship. The one who took his life likely put impossible demands upon others, expected them to drop everything to help. But it catches up on people, dropping everything else. It takes a toll. It becomes a matter of survival to limit the relationship.

We can't love everyone, and love can hurt. Mostly it is the lack of love that hurts the most, the withdrawal of love.

Borderline Personality Disorder is probably not what 13 Reasons Why is about (remember, I haven't seen it). In Alexa Curtis's article in Rolling Stone (a must read) we learn that Hannah has been raped by a popular boy, and witnessed sexual assault, suffered from bullying and the rejection of friends. She likely didn't have BPD, rather suffered loneliness, hopelessness, low self-worth, and depression.

Alexa Curtis, nineteen years old herself, a survivor of teenage bullying, upon hearing about 13 Reasons had to watch it. She is the founder of Media Impact and Navigation for Teens (M.I.N.T.), an online guide to media, self help. Alexa thought to herself, Had I watched this as a young teen I would have done it! I'd be dead today!  In her Rolling Stone opinion article she suggests that the show does more harm than good, the risk of glamorizing suicide is too great. Her opinion-- Hannah's story lives on forever in the audio tapes, and suicide should be an ending-- that's the point.

Which is not true, unfortunately. It is never an ending, because those who have loved and lost someone carry that person's legacy forever. They never forget the salient details of that person's life, now snuffed out, and will talk about it in therapy, given the opportunity, speak with tears and self-recrimination, of their own guilt, their failure to provide enough help, support, love. The survivors own it, right or wrong, their contribution, and attribute death to their failure.

There is that percentage, one in five of all borderline patients in a clinical population, for whom suicide will be the answer. The act is often to punish the "failures"of other people. The suicide literally says,
It Is Your Fault. 
For others suicide is the choice because they can no longer cope with their depression and need it to stop. Suicidal patients are at the greatest risk when they feel a little better, have the energy to do it. It takes a lot of energy to kill yourself. Depression, abated somewhat, is still close enough to touch. Why not now, is the thinking. It will come back.

And sometimes, with mental illness, even with much, much therapy, the memories of the many reasons not to do it, reasons discussed in therapy, are entirely erased. It is as if, in the throes of an episode, either manic or depressed, the only right thing to do is end it. It is the logical choice of an impaired, illogical mind, a painful choice, sometimes, and always illogical.

And there are other reasons, more than 13 of them, most likely. Complicated reasons.

So we have to have these discussions, talk about them. Make them long discussions.

Teenagers will be watching this new show that depicts fictional Hannah Baker's suicide in one of those episodes, and it looks frighteningly real. And our kids, our friends, the ones who watch, who are vulnerable and depressed, who have been bullied, perhaps, will consider the option. Peers, siblings, children. There will be copycats. Some are videotaping themselves right now.

It is a graphic show, we're warned, one that begs discussion, conversation.

And there is a media debate about it:
Is this the best way to raise suicide prevention, to get the conversation started?
Yes, because everybody's talking about it.
No, because there will be copycats. Kids will die as a result, will feel empowered. Hannah did it, so can I. 
We have a teenage suicide epidemic going on.

I thought about it and made a note in my calendar to make a few calls, catch up with the adolescents I've seen in the past year who haven't come back, who for one reason or another, dropped out of therapy or terminated therapy. That's one thing I can do.

What can you do?  Well, ask any teenager you know,
Have you seen 13 Reasons Why?
And get a conversation going. You might save a life.
Because for every reason why, you're likely to be able to counter with a good reason Why Not.

therapydoc

Other discussions on this blog about suicide:

Ten Reasons Not to Kill Yourself

How to Save a Life

How to Save a Life, Part 2

How to Save a Life, Part 3








4 comments:

Lisa from Lisa's Yarns said...

Thanks for sharing this post. I meant to read this book awhile back as I heard good things about it. I didn't realize that it was being made into a Netflix series so I need to read it soon and watch it. My family was impacted by suicide as my cousin committed suicide in his early 20s which shocked our family to its core. I'll never forget the funeral homily. The priest asked anyone who would have supported my cousin, been his confidant, or lent him a shoulder to lean on. The entire congregation (which was a huge Catholic church that was packed) rose to their feet. The priest said to look around and remember that when you feel alone, you are not. I thought that was a powerful message for me to take in because I was in my mid-20s at that time and I struggled with depression.

I hadn't thought of the implications, both good and bad, of this series. I'll have to share your post with a friend who is a child psychologist.

therapydoc said...

Thank you for sharing that story. A good one to tell over. Depression happens, and we have to help one another, and let people in when it feels like the last thing we want to do.

Mound Builder said...

I have seen 13 Reasons Why. I saw it before I knew there was any controversy about it. So for whatever it may be worth, it hadn't occurred to me to think of this series as somehow promoting suicide or that it showed how someone can get even with others who they feel have wronged them. As I watched I thought of it was as answering the question that usually lingers after a suicide--why did it happen? I also thought that as the story unfolded it seemed sad to think that young woman would have killed herself. It was hard for me to understand why she seemed to be the object of contempt/ridicule/humiliation by others. She seemed like there were many positive things going for her. I thought it was too bad that the young man who apparently really cared about her was not able to let her know that more clearly.

I've known 3 people who committed suicide, though none of them well. Of those three, one of them hit me particularly hard in part because neither I nor most of the people who knew that person had any idea the person suffered from bipolar disorder and medications had become less and less effective the older the person got. The person had relatively little mania but the depression was worse and worse. I felt sad to know that the person was hurting that much. And my understanding was that the person very likely had spiraled quickly into a psychotic depression, so I'm not entirely sure that the suicide was even an intentional act in the way that sometimes people assume. That is, the person had the capacity to end the person's life, but may have been so affected by depression that I'm not sure it was a thought out ending the way the 13 Reasons Why showed about the end of Hannah Baker's life.

Ronak Shah said...
This comment has been removed by a blog administrator.