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13 Reasons Why: Glorifying Suicide, Increasing the Risk


’13 Reasons Why’ has sparked a buzz in popular culture since its full release on March 31st. I must admit, this Netflix Original’s constant praise on social media sparked an intrigue. I wanted to know more. So I did. I began by reading the description and was immediately taken aback. As a mental health professional, I thought, “this is downright disturbing and dangerous.” The content and the buzz. And while it is important to raise awareness of the agony that can lead to suicide, and the physical pain of self-harm, it is equally as important to do so in a responsible way. Romanticizing suicide in ’13 Reasons Why’ is irresponsible, and here are 3 reasons why:

There is no single cause for suicide. The series follows the fictional story of the suicide of a teenager, Hannah Baker, through cassette tapes through which Hannah blames specific people for her suicide. This is the first danger. Assigning blame to others is a projection of misplaced feelings of guilt. It is also inaccurate. The American Foundation of Suicide Prevention (AFSP) indicates that “Suicide most often occurs when stressors exceed current coping abilities of someone suffering from a mental health condition.” Therefore, instead of teaching our culture to assign blame for high-risk behavior, our responsibility is to teach healthy coping skills as a preventative factor of suicide.

Exposure Increases Risk. The season finale includes a scene that graphically depicts the violent suicide of Hannah Baker. It is important to note that the target audience for ’13 Reasons Why’, unsurprisingly, is the teenage and young adult population. This is also the population for which suicide is listed as the second leading cause of death (ages 15-24). More importantly, “exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide, increases risk of suicide. (AFSP)” Therefore, graphically depicting suicide to the population of highest incidence is dangerous, specifically for the at-risk youth, vulnerable to suicide.

Who can I talk to? The season finale also includes a scene where Hannah Baker decides to talk to her school counselor. As a mental health professional, this scene is troubling. The school counselor acknowledges one of the signs of suicide yet does not take action for follow-up (i.e. risk assessment). The counselor also makes assumptions about the student’s social behavior which does not foster a safe space for disclosure. To model a counselor as one that does not take appropriate action, and does not foster a safe space, leaves the audience with the message that no one can be trusted. This is a serious danger because it eliminates yet another preventative measure (i.e. talking to a trusted adult). Eliminating preventative factors for at-risk individuals can increase the risk of suicide.

While I do commend the producers of ’13 Reasons Why’ for taking the challenge of presenting an engaging and relatable series on a serious and under-discussed concern in the United States, there was a grave missed opportunity for preventive messaging. Therefore, it is important to note that help is available and individuals who actively manage their mental health conditions lead fulfilling lives.

If you or someone you know is suffering from suicidal thoughts, go to the nearest emergency room and/or please call, The National Suicide Hotline at 1-800-273-8255.

 

Below are additional resources to learn more:

American Foundation for Suicide Prevention

https://afsp.org/

 

Risk Factors and Warning Signs

https://afsp.org/about-suicide/risk-factors-and-warning-signs/

 

A Teachable Moment: Webinar from AFSP, ASCA, and NASP

Teachable Moment Using “13 Reasons Why” to Initiate a Helpful Conversation About Suicide Prevention and Mental Health

https://afsp.org/campaigns/look-ways-mental-health-awareness-month-2017/

Demystifying Your Child’s Misbehavior


Understanding the misbehavior of children can be quite challenging at times, as their misconduct can present as a mystery to not only their parents, but the reasoning behind their misconduct is often unknown to the children themselves. Evidence of this can be seen when children say, “I don’t know” in response to their parents who ask them, “Why did you do that?” I want to help you answer this very question by explaining the hidden messages that often lie beneath your child’s misconduct, and lend you a few suggestions as to what to do when certain misbehavior occurs.

All people, including children, are driven by a desire to belong and feel significant within their relationships, especially within their family relationships (Dreikurs & Soltz, 1990; Nelson, 2006). As a result, children often misbehave because they want to feel important or belong, but they’re unaware that they’re doing this. Misbehavior occurs when children develop mistaken beliefs or incorrect ideas about how they can feel important or belong, and it’s often at the expense of other people’s feelings (Dreikurs & Soltz, 1990; Nelson, 2006). Most misbehavior falls into one of four categories known as the Mistaken Goals of Misbehavior, and they include the following: 1) Undue Attention; 2) Misguided Power; 3) Revenge, and 4) Assumed Inadequacy (Nelson, 2006).

The Mistaken Goal of Undue Attention suggests that some children unconsciously believe that they’re not significant or that they don’t belong unless they keep adults busy with them (Nelson, 2006). An example of this is when your child annoys or irritates you by making constant noise after you have told him or her to stop numerous times. Truthfully, the hidden message beneath your son or daughter’s behavior is that “I want you to notice me” or “Involve me usefully.” One of the ways that you can respond to this is by touching them gently and looking at them while nodding your head “no” without saying a word. This practice is known as acting without speaking. Another response is giving your child a task to do so that their need for attention can be satisfied by being acknowledged for completing a task that is of help to you. Additionally, you can plan individual time with your child so that they have something to look forward to, and they can thus receive uninterrupted attention from you (Nelson, 2006).

Next is the Mistaken Goal of Misguided Power, which means that some children hold the mistaken belief that they are not significant or that they don’t belong unless they prove to others that they are the boss and that no one can control them (Nelson, 2006). An example of this is when you may tell your child to put his or her shoes on, and he or she responds with “No” or they take a long time to carry out the task. In situations such as this, you are likely to feel angry or defeated. Often, the coded message behind such behavior is that “I want a choice.” You can direct this need for power in a positive direction by giving your child limited options (i.e. “I need you to put your shoes on. You can wear the red shoes or the blue shoes, which ones do you want to wear?”) (Nelson, 2006).

The third Mistaken Goal is that of Revenge (Nelson, 2006). This goal is likely at play when a child damages a parent’s property or calls a parent a hurtful name. The coded message is that “I’m hurting, and I want you to feel my hurt” or “I need you to validate my feelings.” In order to address a scenario like this, a useful intervention is to acknowledge the hurt feelings (i.e. “Okay, given that you called me that name, I can tell you’re angry with me. Tell me what’s going on.”). It’s important that you don’t retaliate or hurt your child more at that moment by punishing them, and that reflective listening is used (i.e. “Okay, I hear you, and I see why that upset you.”) (Nelson, 2006).

The last Mistaken Goal is Assumed Inadequacy (Nelson, 2006). This goal is often present when a child stops putting forth effort into his or school work or says, “I just can’t do it.” The truth is that they’re often afraid of failing, so they simply forgo trying. The coded message behind their behavior is that “I need you not to give up on me.” These children are the most discouraged, and they need regular encouragement. In order to help your child if he or she presents this way, it is important that tasks are broken down into small achievable steps and that you acknowledge them for their effort and hard work. Additionally, it’s important that all criticism stops, and that you focus on your child’s strengths and not their weaknesses. For example, if a child has brought home all ‘F’s in the past, and he or she turns one of those ‘F’s into a ‘C’, it’s important that this is recognized by saying something like, “Oh my goodness, you brought that F up to a C! I’m so proud of you! This is a testament to how hard you’ve worked. Keep working hard and I know the other grades will improve too.”

In conclusion, I hope that I’ve been able to make your child’s misbehavior a lot less mysterious. It’s important to remember that when you catch your child exhibiting any of the characteristics that were described, the coded messages behind the behavior are often nobler than the surface behavior may lead you to believe. If you keep this in mind, it’ll help you to keep your anger in check and also to help you to get back to enjoying your children again.


Dreikurs, R. & Soltz, V. (1990). Children: The challenge. Plume: New York, NY.

Nelson, J. (2006). Positive discipline. Ballantine Books: New York, NY.

Cyber-bullying: What it is, what to do, and how to prevent it


Any form of bullying can hurt a person’s self-esteem due to feeling not deserving of love and belonging (Brown, 2010). In the Bible, Joseph, a favored son, was bullied by his brothers out of jealousy because of the dreams God had given him. Goliath was a bully who taunted others and used power and stature to intimidate. Although these are examples of traditional bullying that occurred in the Bible, a different type of bullying has emerged in modern society called cyber-bullying.

What is cyber-bullying and why does it matter?

Cyber-bullying is when someone uses an electronic device to “threaten, harass, tease, or embarrass another person” (Greenfield, 2015, p. 144). With the development of the Internet and social media, we are now connected to others 24/7. Depending on the age group, 20-40% of young people have been cyber-bullied (Tokunaga as cited in Greenfield, p. 144). This is concerning because, unlike traditional bullying, the victim is unable to experience relief by not being around the bully. The online identity that is viewed as a “tethered self” (Turkle, 2012, p. 155) can be verbally abused by large amounts of people constantly. In 2012, a survey of US, Canada, the United Kingdom, and Australia, showed 44% of suicides from the previous 15 months were due to cyber-bullying (LeBlanc, 2012 as found in Greenfield, p. 144).

What makes cyber-bullying so prevalent?

Anonymity seems to offer people permission to experiment with a new identity on the Internet (Suler as cited in Greenfield, p. 113). Moreover, for Digital Natives, time spent online is significant, creating more opportunities for impulsive, even harmful, choices in online interactions (Whitson, 2014). Research shows that starting at age 11, kids create a different online identity that is more rude, sexy, adventurous, or risky (Kidscape as cited in Greenfield, p. 121). Additionally, the Internet can lack typical social consequences that deter traditional bullying such as the victim’s facial expression and body language, social disapproval, and the fear of getting caught, which seem to make even those who have never bullied more likely to bully online (Greenfield; Whitson). This may contribute to ideas that cyber-bullying is not wrong since research shows cyberbullies have less remorse than traditional bullies (Greenfield, p. 146). It also speaks to the “diffusion and dilution of responsibility” of online activity (Robson & Witenberg as cited in Greenfield, p. 146). For example, who will catch the bully, how will they prove the online activity was done by that person, and what are the consequences? Thankfully, schools and the legal system are improving in navigating and litigating this difficult arena.

What makes it so dangerous?

As mentioned before, the permanency and continuity of cyber-hate appears to offer no solstice for the victim. Bullies attack something about a person that can confuse the victim, troubling the view that one is valued and effective in the world. This feeling of being wrong or not good enough can bring about anxiety and depressive symptoms. The victim may feel more insecure or ashamed, begin to isolate from others, and even believe the perspective that bullies have amplified and declared as truth about the victim (see Brown, 2010). The viral nature of cyber-bullying can lead victims to make poor conclusions about their worth and identity (Whitson, 2014, p. 68). When feeling down, a youth can believe they are not worthy of love and belonging, even doubting the love received from family and friends because of the perceived overwhelming online evidence of what others believe to be true about the victim. The hopeless feeling of being unable to stop it, change it, or challenge it can lead a person to thoughts or acts of suicide. If you have been cyber-bullied, seek additional support to work through difficult emotions, find belief in yourself as a person who is worthy of love and belonging, and develop a resilient identity that is valued and that you define.

What do we do about it?

If cyber-bullied…

  1. Tell an adult
  2. Disengage from it, don’t add to it
  3. Block harassers and log off
  4. Use privacy settings
  5. Take screen shots
  6. Do something to stop it with help of adults
  7. Empathize with victims

How do we prevent it?

  1. Keep person-to-person connections strong
  2. Educate kids about Netiquette
  3. Monitor kids online
  4. Write an online agreement for family
  5. Take breaks from tech and view it as a privilege
  6. Adults hold kids accountable for online behavior

The previous two step-by-step guides can be found in the chapter on cyber-bullying in the book 8 Keys to End Bullying referenced below. For more information on overcoming bullying and understanding the impact of digital technology on our world, view the references used for this article.


Brown, B. (2010). The gifts of imperfection: Let go of who you think you’re supposed to be and embrace who you are. Center City, MN: Hazelden.

Greenfield, S. (2015). Mind change: How digital technologies are leaving their mark on our brains. New York: Random House.

Turkle, S. (2012). Alone together: Why we expect more from technology and less from each other. New York: Basic Books.

Whitson, S. (2014). Key 4: Deal directly with cyberbullying. A chapter from 8 keys to end bullying: Strategies for parents and schools (pp. 66 -95). New York: Norton & Co.

 

 

Back-to-School Season


This time of Back-to-school season can cause a variety of different emotions. After a long summer of relaxation, fun in the sun, and little responsibility, children can have a hard time adapting to the level of structure that learning requires. However, going back to school does not have to be a dreaded experience for parents or children. Below are some tips for back to school preparation that can help.

  1. Highlight the benefits of school: Discussing the possibility of new achievements, and past academic successes can be a source of encouragement and excitement for the upcoming school year. This can also stop the complaining and negativity about starting school as summer begins to come to an end.
  2. Reestablish routines: The summer tends to be a lax season and this could mean bed times tend to get pushed back and schedules are not as busy. Reestablishing a bedtime routine that ensures restorative sleep will support physical health, emotional and psychological well-being. We all know the feeling and are far too familiar with the consequences of a restless night, which includes: headaches, stomach discomfort, confusion, and grumpiness. However, research links poor or inadequate sleep with children to reduced neurobehavioral functioning and cognitive problems that ultimately impact a child’s ability to perform in school. Due to the importance of sleep, it is imperative that good sleep patterns are exercised at home. The National Sleep Foundation recommends school aged children should sleep nine to eleven hours per night. Establish a bed time that allows for enough sleep, be consistent every night, turn off screens at least 30 minutes before bed, and create a routine before bed that prepares the child for bed time. Getting used to a routine takes time, so start at least a week before the big day.
  3. Prepare for the unknown: Starting something new can trigger uneasiness and even fear. If your child is attending a new school, schedule a tour prior to the beginning of the school year. Being exposed to the new environment will ease fears, provide a chance to ask questions, and help to feel more prepared to tackle their first day. If your child is attending the same school, chances are your child will have a new teacher and this too can be difficult for children. If the school offers meet and greets, take advantage of this opportunity to familiarize yourselves with the teacher’s style and expectations. If your child’s school does not offer meet and greets, do your research by reaching out to other parents who may have worked with this teacher in the past or by sending an email to introduce yourself and ask questions.
  4. Organize school supplies: Involve your child in the organization process. This can build excitement about a new school year and also help them to practice this valuable life skill.
  5. Ask questions and be available: Check in with your child about how he or she is feeling about going back to school. Validate his or her emotions by showing your concern. Share a time in your life where starting something new was difficult for you and express to your child how you managed and coped. Your disclosure can both serve as encouragement and better align you with your child at the same time.

Tips for Back-to-School


The back-to-school season can be stressful for everyone involved. As parents, we want our children to have the best school year yet. Parents, here are three tips to keep in mind while supporting your children to prepare for the upcoming school year.

1.       Remember that this is a time of mixed emotions.

Dread. Excitement. Worry. All these (and more) are experienced as the return to school draws near and each is a very real part of the back-to-school process. See if you can think back to your school days and what this season was like for you. Although this isn’t exactly what your child is experiencing (because everyone’s experience is unique), it can help parents remember that there is more to this time of year than our excitement that the kids are out of the house after all summer home. Check in with your child about his/her thoughts and feelings about going back to school and watch for clues that can give insight into his/her perspective about this time of year.

2.       Create and follow a routine.

Transitions are difficult, and the transition into a new school year is no different. Transitions often trigger emotional distress; routines can help to decrease and manage the stress that may arise. Some important things to think about when working to develop a routine include sleep, healthy food, homework time, fun time, and relaxing time. Beginning the routine before the first day of school can help your child more slowly transition back into the school year rather than abruptly going from a fun summer to sitting in a classroom.

3.       Prepare in advance.

Taking time to visit the school before the first day can decrease some of the stress of the first weeks of school. Help your student find his/her classroom(s) and work together to make sure he/she can confidently open that pesky locker. If your child is attending a new school building, figure out where the office, bathrooms, gym, and cafeteria are located. After purchasing all of the necessary school supplies, take time to organize the supplies and put your child’s backpack together so it is ready for the first day. Help your child decide what clothes he/she will wear and what he/she wants to eat for lunch. These aspects of preparation can happen well before the last days of summer and can help to decrease the stress of the quickly approaching first day of school. If your child has received special services at school in the past, reach out to school staff to ensure that all necessary supports are in place for the first day of school.

Although these strategies can be helpful for many students, each child and family is unique and you are the expert about your child/family. Thinking through what has helped your child during previous transitions and back-to-school seasons can help you generate more ideas of how to best support your child in the midst of this season.

Resources:
Back to School Psychology 101: Tips for Parents. Retrieved from http://www.massgeneral.org/news/newsarticle.aspx?id=3716
Dealing with the back-to-school blues? Retrieved from http://www.apa.org/helpcenter/school-rush.aspx

Do Children Actually Need Therapy? An Insightful Look into the World of Child and Adolescent Therapy


shutterstock_66823009As a clinical therapist, who specializes in working with children and adolescents, I have been asked why children would ever need therapy. My answer is this: Why does anyone ever need therapy?

People seek therapeutic services for a variety of reasons. Some seek therapy to aid them through a life transition, a death of a loved one, a divorce, a mental disorder or a trauma (to list a few). Life is full of twists and turns; it is full of unexpected challenges. Individuals face an array of challenges throughout their lifetime. However, should a trauma, transition or learning disorder occur during childhood and adolescence, the individual may face a different set of obstacles.

Science shows that the human brain is not fully developed until the age of 25 (Aamodt, 2011). Therefore, any traumatic event that happens during the adolescent life stage occurs while the brain is still developing, meaning the individual simply does not have the cognitive function to react or process the way adults do. One such example is suppressed memories. The brain, while in the developmental stage, will often shut down in response to a trauma in order to survive (Ferrara, 2002). If a child is raped, and they do not understand the concept of abuse or sex, they simply have no way to process the event, but they must go on. This is when the child or adolescent’s brain goes into survival mode, and shields the child from the memory until it can be processed at a later time (Ferrara, 2002). Not all children who experience a traumatic event will suffer from suppressed memories. However they will likely respond in drastically different ways than adults.

One situation I often see in my practice, is a child suffering from grief and depression due to divorce. Children of divorce often harbor anger, the emotion that hides true feelings: hurt, confusion and grief (Luepnitz, 2002). Due to the stage of brain development, a child may respond to the divorce by acting out: negative or destructive behaviors, temper tantrums, bullying, sulking, withdrawal, etc (Ferrara, 2002). Should one ask the child why they are acting in such a manner, and they respond ‘I don’t know’, one should not assume they are lying. They truly may not connect the event (divorce) to their feelings (hurt, confusion) to their actions (disruptive behaviors). This is where therapy may be help the child and the family.

To help a child process and grow beyond a negative event, one must step into their world, and a child’s world is based around play. Children cannot sit still and have a 50-minute conversation about their feelings like adults do; thus child therapists use many tools, such as games, art, role playing, workbooks and music to appeal to the client’s development stage. They are stepping into the child’s world, that they might help them to process in a safe place and learn healthy, age appropriate coping mechanisms. Children need therapy much like adults need therapy. Yet children need therapeutic interventions that are tailored to their life, needs and developmental stage of life.

To learn more about services for children, adolescents or teens please click here. To schedule an appointment for your child or family click here.

 

 

References:

Aamodt, S (2011, October 10). Brain maturity extends well beyond teen years: NPR. NPR: National public radio: news and analysis, world, us, music and arts: NPR. Retrieved April 30, 2016, from http:// www.npr.org/tempates/story/story/php?story Id=141164708

Ferrar, F.F. (2002). Childhood sexual abuse: Developmental effects across the lifespan. California:Wadsworth Publishing.

Luepnitz, D. A. (2002). The family interpreted: psychoanalysis, feminism, and family therapy. New York, N.Y.: Basic Books.

Childhood Anxiety


Just like adults, children often struggle with anxiety too. They often worry about their grades, fitting in with their peers, or separating from parents. Although most children will worry, some kids experience excessive distress that causes severe impairment in their academic and social functioning. A study showed that 8% of teens between 13-18 years old reported having an anxiety disorder, with many of the symptoms appearing at the age of 6 (NIMH).

How do you know your child is struggling with anxiety? Here are some signs that may indicate that symptoms of anxiety:

1. Experiences excessive fear that is developmentally inappropriate
2. Has difficulty with transitions or coping with unexpected changes in their routine
3. Avoids or refuses to participate in particular activities
4. Experiences physical symptoms such as headaches or stomachaches
5. Cries, is irritable, or displays anger outbursts due to anxiety.

Sometimes it can be very frustrating to parent a child who feels anxious. However, there are helpful strategies that can ease the worry a child experiences. Here are some tips for parents and caregivers to consider if the child struggling with anxiety.

1. Label their feelings. Talk to your child about what anxiety is and the symptoms they may be experiencing. Parents should emphasize that anxiety is a normal feeling and that everyone experiences worry. Giving the anxiety a label or name will empower the child to challenge their fears.

2. Model how to cope with stressful situations. Parents are in the best position to show how to cope with anxiety. Try to demonstrate problem-solving strategies or positive self-talk when there opportunities arise.

3. Praise for small accomplishments. Children who worry often avoid things or situations that they are anxious of. Provide positive reinforcement when attempt to face their fears or take steps to challenge their worries.

4. Warning for transitions. If possible, give your child some warning of when transitions will be coming up. For example, preparing your child ready to start or end school can begin a few weeks prior to the transition. Give them opportunity to ask questions and express their worries.

5. Don’t punish your child for behaviors related to anxiety. Sometimes children may be irritable or oppositional. Often anxious children are not be trying to be purposefully disobedient but these behaviors are a result of avoiding things they fear and worry.

6. Seek professional help. If the anxiety becomes severe and interferes with your child’s functioning, it may be time to consider getting help. Cognitive-behavioral therapy has been shown to be an effective treatment to address anxiety.


Information from the National Institute of Mental Health (http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-adolescents/index.shtml) and “Practice Parameter for the Assessment and Treatment of Children and Adolescents with Anxiety Disorders.” 2007. Journal of the American Academy of Child and Adolescent Psychiatry 46(2): 267-283.

Dreams for Our Children


Many parents have hopes and dreams of what their child will do or become in life. Do the goals that you have for your child line up with the goals that they have for themselves? If you are not sure how to answer this question, this may be a great conversation to have with your child.

Many children have big dreams of what they want to be when they become adults. Let’s nurture that hope and help them develop a plan and then set them on a path to achieve that goal.

You may be wondering, “How do I go about doing this for my child?“

That’s a great question.

Many parents want great things for their child, hoping that their children can have opportunities and experiences they feel they have missed in their own childhood. This may lead many parents to feel anxious and overwhelmed at the thought of helping their child plan for their future: Many people have experienced the shattering of their own dreams after being a hopeful child and excited about the future. After these painful experiences it can be very scary to face an unknown future and the possibility one’s own child may also experience the same kind of hurt.

What can I do to help my child achieve their goal(s)?

  1. Have a conversation about what their goal(s) are. If they are not sure what their goals are, encourage them on what you’ve noticed that they are good at and just start the conversation. Children want to share their life with their parents (even when they say they don’t). Children long for their parent’s approval. Your child wants your support more than any other person.
  2. If you do not know who your child’s school counselor is, call the school and ask. Your child’s school counselor has a wealth of experience in helping children plan and begin working toward current and future goals. Create a working relationship with the school counselor to ensure your child has all the support they need from the school and from you to achieve their current and future goals.
  3. Ensure your child has regular attendance at school. If your child is reluctant to participate in school or resistant to attend, there is a reason. There are many reasons why a child may refuse to attend school and whatever they are, they need to be identified so that you can help your child overcome barriers to achieving their goals in life. If you are having a difficult time identifying what that reason is or how to manage the situation, reach out to the school counselor or a therapist. There are many people ready and willing to help you support your child in achieving their highest potential.

 

5 Local Family Activities You Can Do This Summer


One of the most important ways to help children transition from the school year to the summer is provide structure to their vacation. Planning family outings and activities keep your kids learning while out of school, and give them a memorable summer experience. Listed below are 5 free activity ideas in the city that will help keep your children busy, engaged, and away from the T.V. Read more!

Cornerstone Counseling Center of Chicago