Thoughts

Cards for Same-Sex Marriage

It’d be nice if we didn’t feel the need to make these cards. And maybe that’s why they’re a bit late coming to you. We were in denial that they were necessary. But they are.

I’m ashamed and saddened to admit this. I used to hurl the word “gay” around as an insult. I did it for a really long time. Well past my years in the school yard. Statistics was gay. Home and Away was gay. My outfit was gay. When I burnt the chicken dinner, it was gay. The term had become synonymous with being crap, lame and shithouse. And I regrettably used this term a lot.

And this must have been incredibly awful for anyone around me who was actually gay or suspecting they were.

It had become such a part of my lexicon that it took me a really long time and a very concerted effort to break the habit. But I had to. Here I was, using the word ‘gay’ to insult things or people, implying that I thought there was something wrong with being anything other than heterosexual. I didn’t. But it definitely wasn’t sounding that way. To point out the bleeding obvious, the use of this term in this way has the capacity to completely undermine the confidence of LGBTI people, chipping away at their psyche and reinforcing the nonsense that they are “different” in an inferior, unnatural way. It can make them feel like outsiders.

For a long time, my repurposing of the word as an insult persisted in keeping the LGBTI community separate and different. How hurtful is that?

On a larger scale, I'm feeling much the same way again.

I am ashamed and saddened that our Government has had us engage in a non-binding statistical survey on same-sex marriage. An ‘issue’ that is about equality, discrimination, human rights and inclusion for a vulnerable minority and marginalised group.

I can’t quite believe that we are in this place. That as a country we are conducting a survey, on whether we think one group of people should be able to marry each other, like the rest of us can. Are we so intolerant of this group of people that the only way to decide that they can have equal rights under the law is to do a survey on whether it’s the right thing to do?

But I'm even more been devastated by what it’s become. The homophobia. The harmful stereotyping. The hatred. The ‘freedom of speech’ and the right to a ‘respectful debate’ where all sides ‘have a voice’, has been downright sickening. How must this group of people feel?

Probably, fucking horrendous. Maybe inferior? Separate? Different? And not included?

Again.

When we feel that we are included and recognised we are rewarded with a range of health benefits. These include stronger mental health, social cohesion, increased sense of security, improved resilience, increased access to health care and public health benefits. When we are part of a group that experiences social exclusion and/or abuse (e.g., homophobia) we are more likely to experience addiction, self-harm, psychological distress, mental illness, suicide attempts and feeling unsafe.

I’ve quoted these statistics before, but they’re important. So here they are again.

Our Australian LGBTI+ community is already experiencing health effects that are DIRECTLY related to discrimination and exclusion. These include:

  • People who identify as LGBTI have the HIGHEST rates of suicidality of any population in Australia1.
  • 7% of lesbian, gay and bisexual Australians report current suicidal ideation (thoughts)2.
  • Same-sex attracted Australians have up to 14 times higher rates of suicide attempts than their heterosexual peers3.
  • The average age of a first suicide attempt is 16 years – often before ‘coming out’4.
  • Many LGBTI people who attempt suicide have not disclosed their sexual orientation, gender identity or intersex status to others, or to only very few people5.
  • At least 24.4% of gay, lesbian and bisexual Australians met the criteria for a major depressive episode in 2005, compared with 6.8% of the general population6.
  • Lesbian, gay and bisexual Australians are twice as likely to have a high-very high level of psychological distress as their heterosexual peers (18.2% v 9.2%), making them particularly vulnerable to mental health problems7.
  • More than twice as many homesexual/bisexual Australians experience anxiety disorder as heterosexual people (31% vs 14%)8.

And just to reiterate - research shows us that discrimination and exclusion are the key CAUSAL factors of LGBTI+ mental ill-health and suicidality9. That is, the elevated risk of mental ill-health and suicidality among LGBTI people is not due to their sexuality, sex or gender identity in and of themselves. It’s due to discrimination and exclusion as a key determinant to health10. Exposure to and fear of discrimination and isolation can directly impact on people’s mental health, causing stress, psychological distress and suicidality.

AND this is research undertaken BEFORE a vote was undertaken asking us to justify their existence.

Last year, a survey of 1657 Irish LGBTI people was undertaken to investigate the social and psychological impacts of the Irish same-sex marriage referendum by researchers at the University of Queensland and Victoria University. Despite, the same sex marriage debate being ‘won’, the results of the survey were not great.

Nearly three quarters of those surveyed said that the ‘No’ campaign had a highly detrimental impact on themselves, on young LGBTI people and the children of LGBTI people. The survey found 75.5% of participants often or always felt angry when exposed to campaign messages, and two-thirds felt anxious or distress. Younger LGBTI people scored lower on psychological wellbeing compared with older people, including feeling anxious and afraid. Distress was particularly experienced in relation to hearing negative views expressed by family members, friends and colleagues, and seeing posters and television advertisements negatively portraying LGBTI people and their families as deficient or not positive and safe for children.

And unfortunately, UQ’s researcher Sharon Dane concluded that the respondents’ answers to the qualitative questions suggested that the impact of the no campaign was “more than a fleeting experience or something that could be simply undone through a win for marriage equality.”

That’s the thing. We can’t un-see or un-hear the things that are happening right now. They are going to stick with all of us. And they hurt. They are powerful.

I’m so sorry you have to go through this rainbow friends. We love you. We hope you are protecting yourselves and each other.

We’re here for you. Always.

You can find all our cards to support loved ones through the marriage equality debate here

Support, information and resources for the LGBTI+ community and their allies during the marriage equality debate can be found through the following services:

  1. Rosenstreich, G. (2013) LGBTI People Mental Health and Suicide. Revised 2nd Edition. National LGBTI Health Alliance. Sydney
  1. Pitts, M. et al. (2009). Private Lives: A report on the wellbeing of GLBTI Australians. Australian Research Centre in Sex, Health and Society. LaTrobe University: Melbourne.
  2. Rosenstreich, G. (2013) LGBTI People Mental Health and Suicide. Revised 2nd Edition. National LGBTI Health Alliance. Sydney
  3. Nicholas, J. and J. Howard (1998) Better Dead Than Gay? Depression, Suicide Ideation and Attempt Among a Sample of Gay and Straight-Identified Males Aged 18-24. Youth Studies Australia, 17(4): 28-33.
  4. Dyson, S et al. (2003) Don’t ask, don’t tell. Report of the same-sex attracted youth suicide data collection project. Australian Research Centre in Sex, Health and Society, LaTrobe University. Melbourne.
  5. Pitts, M. et al. (2009). Private Lives: A report on the wellbeing of GLBTI Australians. Australian Research Centre in Sex, Health and Society. LaTrobe University: Melbourne.
  6. Australian Bureau of Statistics. Unpublished data from the 2007 National Survey of Mental Health and Wellbeing provided to Queensland Association of Healthy Communities in 2010.
  7. Leonard, W. et al. (2012). Private Lives 2: The second national survey of the health and wellbeing of gay, lesbian, bisexual and transgender Australians. Australian Research Centre in Sex, Health and Society. LaTrobe University: Melbourne.
  8. Rosenstreich, G. et al. (2011) Primary Health Care and Equity: the case of LGBTI Australians Australian Journal of Primary Health, 17(4): 302-308

 

 

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    Taking each other seriously

    All of these blogs thus far are nice and all. Us humans are wired for social connection. Social connection is really good for us. Both physically and psychologically. Blah blah blah. But what is good social connection? What does it look like? What does it feel like? How do we know when we’re getting it? How do we get it? How do we give it to others?

    There’s this friend of a friend who I occasionally see at the odd event or gathering or dinner. For ages I’ve been completely perplexed by this dude. My friends seem to really enjoy his company and they describe him as funny and nice and intelligent. But all of this is lost on me. Initially I just assumed he must think I am an idiot. Obvs. Over the course of a number of years, I have never been able to connect with him. And now I am going to put all the blame onto him. Obvs.

    Firstly, he has a tendency to speak really quietly out of the side of his mouth to the person/s directly to the side of him. This makes any conversation difficult when you sit on the other side of the table. And he mumbles. His eye contact is incredibly poor. Secondly, when I offer something to the conversation, he will never engage in the topic. And often he will immediately change or dismiss the topic. And in all this time, and despite my best efforts to engage him in conversation, he has never once asked me a question. This could be because he thinks I am an idiot. Or his capacity for connection with me is a bit deficient.

    Social psychologist, researcher and writer, Hugh Mackay reckons that human behaviours are motivated by ten main desires. When it comes to social connection, there’s one of these that I think is particularly important in determining how we relate to others and how we want others to relate to us – that’s the desire to be taken seriously.

    To some degree, all of us want to be taken seriously. We want to be noticed, accepted, appreciated, valued and understood. Perhaps as we get older, we want to make sure we’ll be remembered.

    When I engage with the fellow mentioned above do I have the opportunity to feel that I have been taken seriously? Hell no! The truth of the matter is, that I’ve been taken more seriously by puppies than this gentlemen. And as a result, I haven’t yet had a good connection with this guy.

    And how do we ensure that we take others seriously? We really only need to do a few simple things.

    1. LISTEN
    It’s the desire to be taken seriously that explains why people who listen are the most wonderful people in our society. Is there a better experience than when someone gives you the gift of their undivided attention? It’s not just that they’re listening, it’s the message that they’re taking you seriously enough to listen. And the opposite is true too, when people are looking over your shoulder hoping to find someone more interesting to speak to. Again, listening is just the symptom here. What’s really being said is that this person is not taking me seriously.
    And I’m talking about active listening here. Listening to understand. Not, listening to reply.
    When we give others our undivided attention, the clear message is – I am taking you seriously as a human being. It’s probably why counselling is generally so effective. The counselling relationship and model, says to the client – This is about you. I am here to listen. I am taking you seriously. And all of us need to know that someone is.
    1. Reduce our need to control.
    This is another of our great big desires, but as Hugh Mackay notes, one of the more “troublesome” ones. Us humans really like to control things. But if we really want to connect with something, this desire can get in the way.
    Most of us stumble through life hoping to be able to control the uncontrollable, such as the weather and the traffic, and, most especially, each other! It takes us a long time to realise – and then accept – that the only life we can control is our own and, when it comes to weather or traffic or the myriad other external events and circumstances that affect our lives, the only thing we can control is our reaction to those external forces.
    When we feel the need to impose our own views and “shoulds” on others, they often start running away from us – either emotionally or physically. We are all individual entities, and if we continue to hope or expect something from each social connection we have we will continue to be disappointed.
    1. Respect each other’s differences.
    If we can all acknowledge that we share the same basic desire; to be taken seriously, to be heard and that we matter, what can we do to ensure that our unique views are heard while avoiding as best we can, conflict and opposition?According to Hugh Mackay, it all comes down to the method with which we interact…
    “So the way we listen to each other, the way we respect each other’s passions (even if we don’t share them), the way we respond to each other’s needs, the way we make – or don’t make – time for each other… all these things send clear signals about the extent to which we are taking each other seriously”.
    All of our views of the world and how we live in it are going to be a bit different. That’s because each of us has had a different life experience, each of us has a different temperament, personality, environment. We’ve all experienced love, support and security in a different way. Our accessibility to education and knowledge is different.
    Knowing this and knowing that the basic desire is the same, we can start from a place of compassion and acceptance. When we accept, we judge less. When we judge less the capacity for response and connection is truly open.

    So, the desire to be taken seriously, a possible starting point for us to form good social connections. It does have a dark side though. When we feel as though we’re not being taken seriously, we can become incredibly frustrated and cranky.  But maybe it’s possible, if we go into our dealings with others, recognising that they too want the same thing as we do, we end up with interactions filled with patience, a little more kindness and a little more compassion? And listening. I’m a big fan of listening.

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    The need to belong - to something.

    “Man is by nature a social animal … Anyone who either cannot lead the common life or is so self-sufficient as not to need to, and therefore does not partake of society, is either a beast or a god.” Aristotle

    Not heaps has changed since Aristotle was around. Just as us humans have a basic need for food and shelter, we also have a basic need to belong to a group and form relationships.

    The desire to be in a loving relationship, to fit in at school, to not be picked last for sporting teams, to join a mother’s group or men’s shed, to avoid rejection and loss, to see your friends do well and be cared for, to share good news with your family, to cheer on your NRL team, and to check in on Facebook—these things motivate an incredibly impressive array of our thoughts, actions, and feelings.

    Abraham Maslow suggested that the need to belong was a major source of human motivation. In his hierarchy of human needs, the believed that belongingness was one of the major five - along with physiological needs, safety, self-esteem, and self-actualization. After we meet the needs of physiological and safety, we are then motivated towards the need to belong and to be loved. According to Maslow, if the first two needs are not met, then an individual cannot completely love someone else.

    Other theories have also focused on the need to belong as a fundamental psychological motivation. According to Roy Baumeister and Mark Leary, all human beings need a certain minimum quantity of regular, satisfying social interactions. Inability to meet this need can results in loneliness, mental distress, and a strong desire to form new relationships.

    Baumeister and Leary argue that much of what human beings do is done in the service of belongingness. They argue that many of the human needs that have been documented, such as the needs for power, intimacy, approval, achievement and affiliation, are all driven by the need to belong. Human culture is compelled and conditioned by pressure to belong and this need to belong and form attachments is universal among us humans.

    And this need to belong has its roots in evolution. In order for our ancestors to reproduce and survive it was essential that they establish social bonds. From an evolutionary selection perspective we now possess internal mechanisms that direct us into lasting relationships and social bonds.

    One of the great mysteries of evolutionary science is how and why the human brain got to be so large. Brain size generally increases with body size across the animal kingdom. Elephants have huge brains while mice have tiny ones. But humans are the great exception to this rule. Given the size of our bodies, our brains should be much smaller—but they are by far the largest in the animal kingdom relative to our body size. The question is why.

    Scientists have debated this question for a long time, but the research of anthropologist Robin Dunbar is fairly conclusive on this point. Dunbar has found that the strongest predictor of a species’ brain size—specifically, the size of its neocortex, the outermost layer—is the size of its social group. It is entirely possible that we have big brains in order to socialise! Scientists think the first hominids with brains as large as ours appeared about 600,000-700,000 years ago in Africa. Known as Homo heidelbergensis, they are believed to be the ancestors of Homo sapiens and the Neanderthals. Revealingly, they appear to be the first hominids to have had division of labour (they worked together to hunt), central campsites, and they may have been the first to bury their dead.

    One of the most exciting findings to emerge from neuroscience in recent years underlines the brain’s inherently social nature. When neuroscientists monitor what’s going on in someone’s brain, they are typically interested in what happens in it when people are involved in an active task, like doing a math problem or reaching for a ball. But neuroscientists have looked more closely at what the brain does during non-active moments, when we’re chilling out and the brain is at rest. Every time we are not engaged in an active task—like when we take a break between two math problems—the brain falls into a neural configuration called the “default network.” When you have down time, even if it’s just for a second, this brain system comes on automatically.

    What’s remarkable about the default network, according to social psychologist and neuroscientist Matthew Lieberman, is that it looks almost identical to another brain configuration—the one used for social thinking or “making sense of other people and ourselves.” He writes: “The default network directs us to think about other people’s minds—their thoughts, feelings, and goals.” Whenever it has a free moment, the human brain has an automatic reflex to go social. Why would the brain, which forms only 2 percent of our body weight but consumes 20 percent of its energy, use its limited resources on social thinking, rather than conserving its energy by relaxing?”

    Evolution only makes bets if there are payoffs—and when it comes to being social, there are many benefits. Having strong social bonds is as good for you as quitting smoking. Connecting with other people, even in the most basic ways, also makes you happier—especially when you know they need your help. One study of adults found that the brain’s reward centre, which turns on when people feel pleasure, was more active when people gave $10 to charity than when they received $10.

    On the other side though, our motivation for belongingness can get us into pickles. When we experience interpersonal strife we often contemplate walking away rather than sticking it out, however, finding a relationship with similar depth is not an easy task. If we always end every relationship thinking that we can swap-out the old for a more positive one, we would find ourselves in a constant state of seeking and never experiencing and this would conflict with our fundamental need to belong.

    This explains why so many of us are apt to hold on to destructive relationships. The fact that some people display an unwillingness to leave an abusive partner conveys the strength and power of our need to belong. Any threat to social attachments can have the capacity to lead to anxiety, depression, jealousy and loneliness. When we feel anxious at the thought of losing an important relationship, we may feel depressed when the connection ends and then feel lonely because we no longer have the important relationship. One such example of this is the death of a loved one. Some researchers even conceptualise grief not as a reaction to the death, but as breaking the connection with another individual.

    And by all means, research shows us that pain caused from social connections is real pain. Research has repeated shown that the feelings of heartbreak can be similar to that of physical pain. This pain is caused by the hormonal triggering of the sympathetic activation activation system (region where flight-or-flight stress takes place) and the parasympathetic nervous system.  To the brain, social pain feels a lot like physical pain—a broken heart can feel like a broken leg. The more rejected the participants report feeling, the more activity there was in the part of the brain that processes the distress of physical pain.

    These studies are no doubt provocative and counter-intuitive. A broken leg and a broken heart seem like very different forms of pain. But there are evolutionary reasons why our brains process social pain the way they process physical pain. Pain is a sign that something is wrong. Social pain signals that we are all alone—that we are vulnerable—and need to either form new connections or rekindle old ones to protect ourselves against the many threats that are out there.

    What makes me sad though, is that despite our evolutionary, biological and psychological needs for connection and belonging, we seem to be sacrificing our relationships more and more. Across the board, people are increasingly sacrificing their personal relationships for the pursuit of wealth. The American Freshman survey has been tracking the values of college students since the mid-1960s. The survey is a good barometer of social and cultural change and it shows how far we've come in prioritizing material values over social ones. In 1965, college freshman said that “starting a family” and “helping others” were more important life goals than being “very well off financially.” By the eighties, it was the reverse: “helping others” and “starting a family” were less important to college freshman than making a lot of money. In 2012, freshmen prioritizing being “very well-off financially” peaked at 81 percent, the highest that number has been in the survey’s history.

    But here’s something ironic. When economists put a price tag on our relationships, we get a concrete sense of just how valuable our social connections are—and how devastating it is when they are broken. If you volunteer at least once a week, the increase to your happiness is like moving from a yearly income of $20,000 to $75,000. If you have a friend that you see on most days, it’s like earning $100,000 more each year. Simply seeing your neighbours on a regular basis gets you $60,000 a year more. On the other hand, when you break a critical social tie—here, in the case of getting divorced—it’s like suffering a $90,000 per year decrease in your income.

    So, not only is our need to belong and connect with others a human need, it will make us feel richer. Let's get connected peeps!

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    Mental Health Month 2017 - Let's Connect

    Happy Mental Health Month our friends!

    Yesterday, marked the beginning of the month in which we focus on the psychological wellbeing of ALL of us Australians. And the theme for 2017 is ‘Share the Journey’, highlighting the importance of connecting with others for our physical and psychological health, and survival.

    When we feel connected, valued and loved by others it gives us a sense of security, support, purpose and happiness. Close connections and good relationships with others allow us to enjoy the good times in our lives and also help us deal with the hard experiences we face. This is important for all of us. Unfortunately in today’s society, we have many demands on our attention and time, and more people experience loneliness in Australia than ever before. For those experiencing or living with mental illness, loneliness can be far worse as individuals can face social exclusion, stigma and discrimination. As social beings, this can affect all aspects of our wellbeing.

    And it’s more than just our feelings of connection and sense of safety and support. Hanging out with those around us is vital for our physical survival. Research has shown that:

    • Social connection is a greater determinant to health than obesity, smoking and high blood pressire.
    • Strong social connection leads to a 50% increased chance of longevity.
    • Social connection strengthens out immune system, helps us recover from disease faster, and may even lengthen our life!
    • People who feel more connected to others have lower rates of anxiety and depression than the general population.

    Despite the clear importance for health and survival, sociological research suggests that social connectedness is waning at an alarming rate. A revealing sociological study showed that the modal number of close confidantes (i.e., people with whom one feels comfortable sharing a personal problem) people claimed to have in 1985 was only three. In 2004 it dropped to one, with 25% of of those surveyed saying that they have no one to confide in. This suggests that one in four people that we meet may have no one they call a close friend! This decline in social connectedness may explain reported increases in loneliness, isolation, and alienation and may be why studies are finding that loneliness represents one of the leading reasons people seek psychological therapy.

    Here at Hope Street Cards, we’re totes on board with this year’s theme for Mental Health Month. To encourage us all to connect with others to continue our journey towards better mental health, we’ll be sharing ideas and insights around this theme all month on the blog. We’ve also got a couple of extra surprises coming your way to celebrate the wonder of social connectedness of us social creatures. Stay tuned …

     

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    Showing up after suicide

    This week the latest Australian Bureau of Statistics (ABS) figures were released about reported causes of death in 2016. And for the first time in some years, we saw a decrease in the number of deaths by suicide. It’s possible that the suicide prevention efforts are making some headway.

    There is still a long way to go. Suicide still remains the leading cause of death for Australians aged 15-44 years and we are still looking at a figure of nearly 8 Australians per day, dying by suicide.

    This tragedy means that suicide, in some way, is going to continue affecting our lives.

    And if it directly affects the life of someone close to us, let’s make sure we know how to show up.

    Supporting someone who is bereaved by suicide is possibly one of the most challenging things we can go as humans. But, if we can, being present and being supporting, can be invaluable to someone going through the grief process after suicide.

    There are so many reactions a loved one may experience following a suicide. Grief, in general, is a pretty complex and chaotic and terrifying emotional experience. While a wide range of reactions can be anticipated, our response to grief will be as unique an expression as our personality is. The experience of grief can be impacted by other things like pre-existing mental and physical health conditions, our gender, and most importantly, the relationship with the person who has died. Experiences may include, but are not limited to:

    • Anger – towards the person who has died, towards themselves, or towards others
    • Despair – feeling unable to live without the person who has died
    • Guilt – that they couldn’t save/help the person who died
    • Questioning – ‘why’ and ‘what if?’
    • Sadness
    • Shame – feeling that they have done something wrong or because of the stigma attached to suicide
    • Defensiveness – due to the uncertainty of how people will react, fearing judgment
    • Disbelief
    • Numbness
    • Rejection – from the person who died and/or the community
    • Searching – wanting to go to the places the deceased person went or believing they have seen the person
    • Depression and anxiety
    • Fear
    • Physical reactions
    • Relief – if the person has been in pain for an extended period of time
    • Sense of acceptance – they may feel they can accept the person’s wish to due
    • Shock
    • Suicidal thoughts

    Considering that someone bereaved by suicide could feel any or all of these things, we might feel unable to provide adequate support. Or we might struggle to understand the depth of the distress. We might find it difficult to know what to say and feel awkward, uncomfortable and concerned about saying the wrong thing. Let’s stop worrying about ourselves and just show up for them.

    What has been learned from people bereaved by suicide is they really need compassion, empathy, acknowledgment of what has happened and validation of how they are feeling.

    To do this, we really only need to do three things:

    1. Show up
    2. Ask
    3. Listen

    It really is this simple. Firstly, let’s ignore all of those thoughts and feelings which might stop us from being present with the person – ‘I don’t want to make it worse for them’, ‘They don’t need me’, ‘There is nothing I can do anyway’. All BS. Ignore these thoughts and do what you know will be tough and challenging but the most important – show up.

    And then we ask them to talk. If they want. We might ask how they are feeling today. Or if they’d like to chat. Or if they’d just like to hang out. Whatever. An open question would be good here. Don’t avoid the subject of suicide.

    And then we shut up. And we listen. Listen to understand the experience. With patience and compassion and no judgment. By allowing a loved one to express their grief, we are helping. We can’t take away the pain, but we’re enabling part of the process. This is probably the most important bit of the process. For those of us who are more prone to talking than listening, reverse this impulse – try and listen 80% of the time and talk only 20% of the time. Because we are listening, rather than talking it will also mean that we might be less-inclined to do some of the less helpful things (e.g., provide advice, try and compare this to the time our dog nearly died, fill moments with clichés and simplistic explanations for one of the most complex issues).

    And once we’ve done that, we’ll do it again. And again. And again …

    If we do these three things – repeatedly – we have the opportunity to provide the person who is bereaved the following:

    • To be really listened to, heard and understood
    • To receive non-judgmental support
    • An opportunity to tell their story over and over again
    • A safe and supportive environment
    • The capacity to express their grief in their own way

    People bereaved by suicide can feel really alone and isolated. The silence that surrounds the issue of suicide can complicate the experience. Because of the social stigma surrounding suicide, it is common for people feel the pain of the loss, yet may not believe they are allowed to express it. By being present, asking the questions, listening and learning, we can provide the comfort of companionship on the most tragic path of sorrow.

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    Bullying and Suicide: Are they really related?

    This topic is really hard to write about. Or even think about. I don’t really know why I have chosen to do either.

    Bullying and suicide, as all of us know, can be tremendously painful experiences for young people. And both issues – independently - are causes for public concern. But with the extensive media coverage of the deaths by suicide of young people who were victims of bullying, we could almost assume a causal relationship.

    The link between the two might be a little more complex than that.

    When we talk about bullying we’re referring to the intentional and repeated intimidating behaviour by an individual or group against another person or group, in the context of ongoing social relationships. It can take many forms and can occur in a ‘real’ or virtual environment. Bullying that occurs face-to-face can be verbal, physical, relational/social, and indirect (involving a third party). Cyber-bullying involves intimidating behaviour or degradation via technological resources such as mobile phone text messages, email, chat rooms/discussion groups and online social networking sites. Methods of bullying tend to overlap, so often if young people are cyber-bullied that also tend to be bullied face-to-face.

    Bullying can be seen as a significant public health problem because it is prevalent and harmful. Australian data reveal that 1 in 8 young people have experienced verbal bullying over the past school term and half of year 8 students reported being victimised in a large-scale Victorian survey. Around 10% of Australian students have reported being cyber-bullied. In 2010, bullying was ranked the third highest issue of concern for 11 to 14 year olds. Specific subgroups are more likely to be victimized. For example, in one survey bullying victimization was found to be more prevalent upon lesbian and gay youth—60% reported victimization during the past 30 days prior to the survey compared with 28.8% of heterosexual youth.

    For young people involved in bullying in any capacity—youth who bully others, who are bullied, or who both bully and are bullied - this involvement is correlated with poor mental and physical health and engagement in other risk behaviours. Youth who are bullied are more likely to be depressed or anxious, have lower academic achievement, report feeling like they do not belong at school, have poorer social and emotional adjustment, greater difficulty making friends, poorer relationships with classmates, and experience greater loneliness. Bully-victims (those who bully and are bully) are more likely than those who bully, those who are bullied, or their uninvolved peers, to report being physically hurt by a family member, to witness family violence, and exhibit suicide-related behaviours. Those who bully others are more likely to drink alcohol and use cigarettes, to have poorer academic achievement and poorer perceived school climate, but to also report greater ease of making friends.

    Involvement in bullying can also have long-lasting, detrimental effects months or even years after the bullying occurs. Young people who are bullied are more likely than uninvolved youth to develop depression and anxiety and report abdominal pain and feeling tense over the course of a school year. One study examining the impact of bullying victimization of those who were between 9, 11, and 13 years of age when they were victimized found, that over a 7-year period, youth who were bullied were more likely to develop generalized anxiety and panic disorder as adults while bully-victims were more likely to subsequently suffer from depression, panic disorder, and suicidality. Another longitudinal study found that those who were perpetrators of bullying at age 14 were more likely to receive a diagnosis of antisocial personality disorder, to have low job status at age 18 years, and to use drugs at ages 27–32 years.

    Many studies have examined the relationship between bullying and suicidality, which includes suicidal thoughts and behaviours. One recent meta-analysis – a study that rounds up all the studies to date on the topic – examined 47 studies on bullying and suicide among students in K-12 settings. The studies were from a number of countries including the US, China, Australia, the UK and Finland. The meta-analysis found:

    • Overall, youth involved in bullying in any capacity were more likely to think about and attempt suicide than youth who were not involved in bullying.
    • The studies showed that bullies and bully-victims (youth who bully others and are also bullied themselves) all reported more suicidal thoughts and behaviours that those who were not involved in bullying.
    • Bullying and suicidality were most strongly related for bully-victims. This suggests that bully-victims are a group at a particularly high risk for experiencing mental health issues.

    So, it appears there is a link between bullying and suicidal thoughts and behaviours. But it’s not just a relationship between the person who is being bullied and feeling suicidal. It’s to do with everyone involved. And there’s also some other things that might need to be considered.

    For example, one study of fifth through eighth graders found that youth with no involvement in bullying reported significantly fewer thoughts of suicide and suicidal behaviours than youth who were involved in bullying in any way. However, once depression and delinquency (engaging in illegal behaviours) were considered, there were only small differences between youth who were not involved in bullying and kids who were targets of bullying and between these uninvolved kids and bully-victims. Another study has highlighted the role of low self-esteem and depression as factors contributing to suicidal ideation for sexual minority and heterosexual youth who had been bullied.

    So after all of this analysis we can’t really do not know if bullying directly causes suicide-related behaviour. We know that most youth who are involved in bullying do NOT engage in suicide-related behaviour. It is correct to say that involvement in bullying, along with other risk factors, increases the chance that a young person will engage in suicide-related behaviours.

    When we focus attention on the relationship between bullying and suicide it can have some positive impacts. It can raise the awareness of the serious harm that bullying can do to all the youth involved in bullying in anyway and it can highlight the significant risk for some of our most vulnerable youth.  

    The risk though, is that if the discussion of the issue is of bullying being a single, direct cause of suicide it can be unhelpful and potentially more harmful. There’s the risk that that the increased attention could perpetuate the false notion that suicide is a natural response to being bullied which has the dangerous potential to normalise the response and thus create copycat behaviour among youth and it may encourage further sensationalized reporting. Furthermore, the focus of the response on blame and punishment can become misdirected from getting the required support and treatment to those who are bullied as well as those who bully others.

    While a young person’s death by suicide is a tragedy and both bullying and suicide-related behaviour are serious public health problems, our response to such situations must reflect a balanced understanding of the issues informed by the best available research.

    So, if bullying doesn’t directly cause suicide, what do we know about how bullying and suicide are related?

    Circumstances that can affect a person’s vulnerability to either or both of these behaviors exist at a variety of levels of influence—individual, family, community, and society. These include:

    • emotional distress
    • exposure to violence
    • family conflict
    • relationship problems
    • lack of connectedness to school/sense of supportive school environment
    • alcohol and drug use
    • physical disabilities/learning differences
    • lack of access to resources/support.

    If, however, young people experience the opposite of some of the circumstances listed above (e.g. family support rather than family conflict; strong school connectedness rather than lack of connectedness), their risk for suicide-related behaviuor and/or bullying others—even if they experience bullying behaviour—might be reduced. These types of circumstances/situations or behaviours are what we sometimes call “protective factors.”

    In reality, most people will have a combination of risk and protective factors for both bullying behaviour and suicide-related behaviour.

    And this is one of the reasons why we need to remember that the relationship between the two behaviours and their health outcomes is not simple. The ultimate goal of any prevention efforts is to reduce risk factors and increase protective factors as much as possible.

    BUT, I suppose if I did have to sum it up as simply as possible it’d be this - The bottom-line of the most current research findings is that being involved in bullying in any way—as a person who bullies, a person who is bullied, or a person who both bullies and is bullied (bully-victim)—is ONE of several important risk factors that appears to increase the risk of suicide among youth.

    I knew that would be hard.

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    Self-Harm and Suicide: Are they related?

    Please note - Some may find the content in this article distressting or triggering. For support or information please make contact with the support phone numbers listed below. 

    On the surface, deliberate self-harm and suicidal behaviours can seem pretty similar. But mostly they’re not. And unless we’re clear on both the differences between the two, and the relationship they can possibly share, things can get even more confusing.

    Self-harm is also commonly known as self-injurious behaviour (SIB), self-mutilation, non-suicidal self-injury (NSSI), para-suicide, deliberate self-harm (DSH), self-abuse, and self-inflicted violence. As one would expect, having multiple terms of self-harm begins the multitude of misunderstanding and confusion in the academic research and clinical settings – let alone in the community.

    Self-harm (and all the other terms) refer to a range of behaviours, but not a stand-alone mental illness or disorder. People who engage in self-harm behaviour deliberately hurt their bodies. Most commonly this is done by cutting, burning, hitting, picking at skin, pulling hair, or biting.

    The majority of those who self-harm do not have suicidal thoughts when they are self-injuring. And here lies the difference between self-harming and suicidal behaviours. It is one of intent. Whilst this may seem counter-intuitive, the person who is self-harming, does not intend for this harmful behaviour to be fatal. Instead, there are a number of reasons why a person may self-harm (Klonsky, 2007):

    • To alleviate intense emotional pain or distress, or overwhelming negative feelings, thoughts or memories
    • As a form of self-punishment (some people damage their bodies to punish themselves for what is going on in their lives. They may lack the appropriate coping skills and suffer from low self-esteem so feel they are deserving of what they are doing to themselves).
    • To feel euphoria (When we experience pain, endorphins are released into the blood stream, resulting in a ‘natural high’ or a feeling of euphoria. Sometimes self-harming behaviours can become addictive and habit-forming.)
    • To experience dissociation or numbness from overwhelming negative experiences.

    So although self-harm is not the same as suicide, self-harm does have the potential to escalate into suicidal behaviours. The intent to die can change over time. One study found that almost half of people who self-harm reported at least one suicide attempt.

    Self-harm has also been found to lead to suicide when:

    • Self-harm is no longer an effective coping method. It ceases to assist in helping the person deal with the feelings cause by stress or trauma.
    • In a crisis situation, people who engage in self-harm and have become desensitized and habituated to pain through repeat harming episodes may view a suicide attempt as less threatening.

    For some of us, when we engage in things for a while and these behaviours have a positive effect on our mood (i.e., release our anger, alleviate boredom, ease stress, reduce pain) such behaviours can eventually take on a repetitive and almost compulsive and habitual quality when used in response to regulating our mood. Something similar to how we might conceptualise substance-use disorders. And this can come with an increasing tolerance – having to engage in the behaviour more often and with more intensity to get the same effect – and withdrawal – difficulty ceasing the behaviour.

    So whilst not initially intended to be fatal, the potential for harm with deliberate self-harm is great and should be taken seriously. Many people may try and hide their self-harming behaviour and only around 50% of people who engage in self-harm seek help – other through informal sources such as friends and family, rather than professionals.

    While all the people are different, there are some warning signs that someone may be self-harming. Aside from the obvious signs such as exposed cuts or bruising, some less obvious signs might include:

    • Appearing withdrawn, or more quiet or reserved than usual
    • Social withdrawal - Stop participating in their regular activities
    • Rapid mood changes
    • Get angry or upset easily
    • Have experienced a significant event in their lives (e.g., a relationship break up)
    • Suffer poor school/work performance when they usually do very well
    • Wearing clothes that are inappropriate for the weather (e.g., wearing long sleeves on a hot day)
    • Strange excuses provided for injuries
    • Hiding objects such as razor blades or lighters in unusual places

    If you think that someone you know or love is engage in self-harm, the very best thing you can do is talk to them about it. I’ve worked with a number of people who have overcome self-harming behaviour. There are heaps of excellent services and supports to help. Here are some ideas for how you might be able to get the conversation started:

    • Ask them how they are feeling
    • Try not to be judgmental
    • Be supportive without reinforcing their behaviour
    • Educate yourself about self-harm
    • Acknowledge their pain
    • Try not to avoid the subject
    • Do not focus on the behaviour itself
    • Encourage the person to seek professional help (a good place to start is with the person’s GP).

    As always, talking and learning about self-harm and suicide is so important but it can bring up some really tough emotions. Please take care of yourself and reach out to a trusted family member, friend or one of the suggested crisis lines below if you need to talk about how you’re feeling.

    Lifeline 13 11 14 www.lifeline.org.au/gethelp
    Suicide Call Back Service 1300 659 467 www.suicidecallbackservice.org.au
    Kids Helpline 1800 55 1800 www.kidshelp.com.au
    MensLine 1300 78 99 78 www.mensline.org.au

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    The C-word

    Please stop using the ‘c-word’

    No, not that c-word. The word ‘commit’. In relation to suicide.

    Consider the phrase “commit suicide”. Does this seem unusual? Acceptable? Familiar?

    We could argue that there is nothing all that alarming about the words themselves. They are a pretty standard and common description of a tragic act. In any case, it’s such a common and widely accepted descriptor that we could almost expect to see a hyphen (one of these ‘-‘ things) between the words, if it were grammatically correct to do so. We could be wondering if it’s even worth considering question the phrase, and instead just dismissing the question. Shouldn’t we be more concerned with the act of suicide itself, not the triviality of a particular verb or adjective?

    Over time, the phrase has become so entrenched in our collective vocabulary that is has an apparent naturalness, implying harmlessness. This harmlessness is pretty deceptive though. Like so much of the language we use, there are underlying negative connotations to this phrase. This one is particularly repugnant.

    The word ‘commit’ has a number of significant implications when associated with the word ‘suicide’:

    1. The word ‘commit’ is commonly used in connection with religious offences. Indeed suicide is considered wrong in many religions. Over time suicide has been regarded as a cardinal sin in some religions and is still often considered a moral sin.
    2. In the past, suicide was a criminal act in many countries. For example, there was a legal prohibition against suicide in England and Wales until the Suicide Act 1961 was introduced. As well as decriminalising suicide, this Act made it an offence to assist in a suicide, which had the unique effect of criminalising an accessory when the principal has not committed a crime. The law relating to suicide in Australia varies between States and Territories, but it is no longer a crime in any jurisdiction. In the State of Victoria for example, the Crimes Act 1958, Section 6A, states “The rule of law whereby it is a crime for a person to commit or to attempt to commit suicide is hereby abrogated” (Crimes Act, 1958).
    3. The word 'commit' has been applied to the incarceration of people against their will in a mental institution. In many countries care for those with mental illness can be sought involuntarily (usually when the person is so unwell that they are unable to admit themselves to care). This is often the only occurrence, outside of committing a crime and being held, where an individual can be detained without his or her consent.

    As a result, to “commit” suicide has criminal overtones which refer to a past time when it was illegal to kill oneself. Committing suicide was akin to committing murder or rape; linguistically, therefore, they are still linked. The original notoriety of the word may have dulled over time but the underlying residue remains.

    Suicide is a cause of death. Of interesting note, I’ve never noticed or heard of someone “committing” another form of legal death. Do we ever say that someone ‘committed cancer’ or ‘committed heart failure’, even when they may have lived lifestyles that contributed to such diseases (for example, smoking or having a high fat diet)? Even suggesting this sounds ludicrous, and yet every day we see such examples in relation to suicide.

    Making some small changes to how we speak about suicide, is not my own original thought. The impetus to alter the language of suicide began ostensibly in the bereavement community. In addition to the insensitive language used to describe suicide, silence and denial - the absence of suicide language and conversation - was targeted as a major contributor to the stigma around the subject.

    “When a tragedy is not spoken of openly there can be no true sympathy, sharing or healing,” “Suicide leaves the bereaved with especially acute feelings of self-denigration and self-recrimination” (Sommer - Rottenburg, p.240).

    Those who are left behind feel the full burden of suicide’s stigma, and others often steer clear of suicide survivors to avoid the “contamination” of suicide association. The bereaved can feel abandoned and ashamed, and adding to this injury is the mention of suicide in euphemistic, obituary-type language that goes to great lengths to whitewash any moral stain there might be to a particular death. Because this silence can be debilitating, the need for language that addresses the act of suicide in a direct but respectful way was identified and has, in recent years, gathered momentum.

    I know I bang a lot about language and words. I am aware that policing language is not the most popular sport and rarely an easy activity. But I do it because language is powerful. Making small adjustments to our language alone, will only deal with stigma on a superficial level, however if we consider our context, intention and audience when we’re conversing with others the level of responsibility shifts. Sometimes, political correctness can be good, especially when it helps, in whatever ways possible, vulnerable people and those who love them.

    Suicide is a massive public health issue throughout the community and those affected (either personally, or due to the death of a loved one) are vulnerable and often stigmatised. To overcome this health issue we need to talk more about the issue. However, such talk is often steeped in concepts and language from the past that perpetuate stigma, constrain thinking and reduce help-seeking behaviour. With this knowledge, am I still going to use language that stigmatises and increases feelings of shame in people who might be experiencing excruciating psychological distress? No. Can I still be frank and polite? I reckon.  And am I going to ask others to do the same? I think I just did.

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    Suicide Myth Busting - #7 Most suicides happen unexpectedly.

    This is a hard one. Let’s start with what we've learnt over the last week and what we now know.

    At a glance:

    • The factors associated with suicide are varied and complex.
    • Predicting who will take their life is extremely difficult, even for experienced professionals.
    • There are several common characteristics of suicide, including a sense of unbearable psychological pain, a sense of isolation from others, lack of belonging, feeling trapped and hopeless and a burden on others and the perception that death is the only solution when the individual is temporarily not able to think clearly due to being blinded by overwhelming pain and suffering.
    • Excruciating negative emotions – including shame, guilt, anger, fear and sadness – frequently serve as the foundation for self-destructive behaviour. These emotions may arise from any number of sources.

    So the question 'Why did they take their life?' is complex and unfortunately we may never be able to be completely resolved. The most honest answer is that we don't fully understand it.

    A number of years ago, we lost one of our clients to suicide. It was a tragic loss. It was devastating. And shocking. And it was overwhelmingly unexpected. Even to the individual’s treating team.

    There are indeed some suicides that occur without warning. They may be impulsive behaviours. Or the level of distress may have been very well hidden by the individual. To the point that may appear completely unexpected to those around them. We'll never know why they happened. But this is not the norm.

    The majority of suicides have indeed been preceded by warning signs, whether verbal or behavioural. Most people experiencing suicidality — including those who are more ambivalent about suicide — consciously or unconsciously drop those around them some hints.

    Some of the warning signs that a loved one might be considering suicide include:

    Physical Changes

    • Major changes in sleep patterns – too little or too much
    • Losing energy
    • No interest in personal hygiene or appearance
    • Losing interest in sex
    • Sudden and extreme changes in eating habits
    • More minor illnesses

    Behaviours

    • Alcohol or drug misuse
    • Fighting or illegal activities
    • Withdrawing from family and friends
    • Stopping activities they used to enjoy
    • Past suicidal behaviour
    • Self-harming
    • Putting affairs in order – giving possessions away, making funeral arrangements.
    • Writing a suicide note or goodbye letters
    • Risk-taking or recklessness
    • Unexplained crying
    • Possessing lethal means – medication, weapons.
    • Emotional outbursts

    Conversational Sins:

    • A sense of hopelessness or no hope for the future – “what’s the point? Things are never going to get better?
    • Isolation or feeling alone – “No one understands me”.
    • Aggressiveness and irritability – “Leave me alone”.
    • Negative view of self – “I am worthless”.
    • Guilt – “It’s all my fault, I’m to blame”.
    • Frequently talking about death – “If I died would you miss me?”.
    • Feeling like a burden to others – “You would be better off without me”.
    • Making suicide threats – “Sometimes I feel like I just want to die”.

    It’s so important that we all know and respond to these warning signs. The very best thing we can do if we notice any of the above is to raise the issue with the person we love. They won’t take their own life just because we’ve had a conversation with them about it. We know the opposite is true. Instead, we’ll have the opportunity to reassure them that we care, we’re here to help and that they’re not alone.

    Every suicide, like every person, is different. We can’t prevent every person in excruciating psychological distress from taking their own life. But if we can reach out to those who are sending us the signals, maybe with the right help and support, they can go on to live a more enjoyable life.

     

    If you’re concerned about a loved one’s risk of suicide or this post has raised concerns for you, please contact one of the below organisations who can provide 24/7 support, information and referral:

    Lifeline 13 11 14 www.lifeline.org.au/gethelp
    Suicide Call Back Service 1300 659 467 www.suicidecallbackservice.org.au
    Kids Helpline 1800 55 1800 www.kidshelp.com.au
    MensLine 1300 78 99 78 www.mensline.org.au

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    Suicide Myth Busting - #6 Once someone is suicidal, they will remain suicidal.

    We’re nearing the end of our suicide myth busting. To recap, we’ve covered some pretty important stuff. We’re now fully aware that most individuals who are experiencing suicidality desperately want to live; they just don’t know how to live with their pain and distress. Talking about suicide will never cause someone to suicide. Suicide is a complex behaviour, not a response to one problem. It can occurs across all age, economic, social, racial and ethnic boundaries and whilst it is more common in people experiencing a mental health disorder, this is not always the case. And, the people who do die by suicide usually tell those around them about it first.

    Excellent sleuthing. We are getting through some of the complexity of the facts.

    Today’s myth-busting comes with much hope. There is absolutely no truth behind the statement – once someone is suicidal, they will remain suicidal. Thank the baby cheeses!

    People who want to kill themselves will not always feel suicidal or constantly be at a high risk for suicide. They feel that way until the crisis period passes.

    We can think about suicidal thoughts, feelings and behaviours occurring on a spectrum from low to high risk. Heightened suicide risk is often short-term and situation-specific. Someone may experience a period where they are of high risk of suicide. After receiving help to overcome this pain, the pain and distress may reduce and they could go on to live rewarding and meaningful lives, never again seriously contemplating suicide. For others, a current suicidal crisis may be overcome and the risk of suicide significantly lowered or eradicated for a period of time. This period of time can range from minutes, hours or days, to possibly months, or even several years.

    Whilst different for everyone, suicidal thoughts or behaviours are not a life sentence.

    Like all thoughts, suicidal thoughts are not permanent.

    Similarly, the feelings of distress and pain associated with suicide, whilst overwhelming, debilitating and isolating, are still just feelings. Which are also not permanent.

    Our bodies and brains are resilient vessels for survival, with incredible capacity for change. This is where the hope lies. I’ve worked with many remarkable individuals who have at points, desperately wanted not to be alive; only to transform into people expressing sincere gratitude for still being here. That’s magical.

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