13 Reasons To Be Concerned about the Netflix Series "13 Reasons Why"

You have probably heard of it or watched it by now, but if not, "13 Reasons Why" is a Netflix original series which came out in March 2017. The 14 episode series, now known to be the first season, is about the fallout after a bullied teenaged girl, Hannah, ends her life by suicide. 

Warnings:

*Slight spoilers ahead, some of which I think the viewer ought to know going in.

*Some people are best not to watch this series at all. Please note the detailed recommendations and cautions at the end of this piece. 

Here are my 13 reasons Why I am Concerned About the Netflix Series "13 Reasons Why"

1. It offers an overly simplistic, one dimensional explanation for the motivation behind suicide. By focusing on bullying to the neglect of other factors which are known to frequently contribute to suicide, it puts undue focus and overemphasis on blame. 
2. It glamorizes suicide by presenting it as a viable solution to the main character's problems; problems that unfortunately are not uncommon among today's teens. 
3. It glamorizes suicide by presenting it as an effective and gratifying way to obtain justice and revenge.
4. The music and imagery involved in the marketing, opening sequence and closing credits all have a hip, upbeat feel contributing to and reinforcing the glamorization noted above. 
5. It offers a skewed, unrealistic representation of Hannah's post-death experience.
6. It completely ignores the issue of mental illness which research suggests plays a role in up to 90% of teen suicides. 
7. It shocks unprepared viewers with graphic sexual assault. 
8. Since the focus of the series is on suicide and the sexual assaults are ancillary to the storyline, they could, albeit unintentionally, contribute to a mindset of rape culture and the objectification of women, especially in young viewers. 
9. Because all 14 episodes are available simultaneously, viewers are inclined to binge watch them. This could cause the viewer to become emotionally flooded and overwhelmed by or desensitized to the impact. 
10. The suicide scene is graphic. For most people, it is quite upsetting to watch and for those more vulnerable to the content, it is likely tremendously disturbing, potentially triggering post-trauma reactions in individuals who have past personal experience. Conversely, those who have self harm inclinations may experience  an adrenaline rush and view the scene as alluring and even instructive.
11. The series has been hugely popular among adolescents for many reasons, not least of which is how accurately it portrays the pressures and angst of high school. This contributes to laying the foundation for suicide contagion, or, copycat suicide, a harsh reality that is well proven. A thoughtful teen could easily deduce since it portrays their daily struggles so well perhaps it also portrays the post-suicide experience accurately. To a struggling teen this thinking makes sense since the adolescent brain's capacity to reason, assess risk and predict consequences is not yet fully developed. 
12. Despite insistence that the program is trying to contribute to a constructive suicide conversation, it is in fact an adolescent revenge fantasy with all the entertainment makings intended to hook viewers. It works too. The characters are compelling and believable. There is tension, suspense, and surprise. There is now a much anticipated second season, slated to come out sometime in 2018 which was not originally intended. The viewer wants more and Netflix is loving it. The importance of the suicide conversation is all but lost somewhere in the frenzy of success.
13. It portrays the adults involved as distracted at best, if not  negligent and hapless, right down to the school counselor, Mr Porter. Although this makes for great entertainment and may sadly be true in some real life cases, a vulnerable and impressionable teen may walk away with the belief that there is no point going to adults for help. The scene where Mr. Porter pushes a box of tissues closer to Hannah was almost as difficult for me to watch as the suicide and rapes. 

To the series credit, it does shed light on the impact of bullying behavior and it's connection to sexual harassment that is confirmed by research. The program does demonstrate how our actions can and do affect others and underscores the remorse around of the reluctance to intervene/lack of intervention and regret when weak attempts at intervention are inadequate. 

The much anticipated second season is rumored to be about redemption and healing. That in itself is music to the ears of we therapists. Addressing the harsh reality of tragedy then exploring the healing process is a wonderful idea. Opening the conversation about suicide is an important and admirable goal but quite ambitious in that it matters very much how it is done. "13 Reasons Why" indeed opens up the suicide conversation and deals with the tough subjects of suicide trauma and it's impact, but it does so, in my opinion, at much too great a risk. With this series: proceed with caution.

**If you are in emotional distress or thinking about suicide, you are not alone. Help is available. Contact the Suicide Prevention Lifeline at 1-800-273-8255 its free and confidential

https://suicidepreventionlifeline.org

or go to your local emergency room 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

*I am a licensed therapist who has been practicing since 1994. I have worked in a variety of settings with all types of clients, including those with a history of self-harm, suicide attempts and sexual assault. I watched the series for two reasons: I am the parent of an adolescent daughter and I am a therapist. I would've watched it even if only one of those reasons existed. I plan to watch the second season for the same reasons. 

Based on my experience, the following are my recommendations around deciding what level, if any, of engagement one chooses to take regarding the series. These are general recommendations intended to help people gauge their risk and help determine the degree of caution they choose to take. For your specific circumstances, if in doubt, delay watching this program and consult with a therapist, clergy or a trusted friend. 

Recommendations: 

Be wary and/or do not watch this series if:

1. You or someone you love has current or past mental health issues or diagnoses. 
2. You or someone you love has  a history of suicidal thoughts and/or suicide attempts. 
3. You or someone you love have current or past tendencies toward self-harm behaviors, especially cutting. 
4. You or a loved one have lost a someone significant to suicide
5. You or someone you love are a survivor of sexual assault 

If you fall somewhere in here and are still considering watching the series, I suggest starting by reading a synopsis that includes summaries of the 14 episodes. It will prepare you for what occurs in the story and may be enough to satisfy your curiosity. The best synopsis I found online is from Wikipedia. I read it in its entirety and in my opinion not only is it accurate, it also gives just the right amount of information: 

https://en.m.wikipedia.org/wiki/Thirteen_Reasons_Why

I am somewhat tempted to say that no adolescent should watch this program, but since that is not realistic, here are my tips for parents and loved ones of adolescents: 

1. If your teen expresses interest in watching the series, resist the urge to overreact, tell them no then shut down any conversation. Despite the concerns for the series, this is an opportunity for dialogue with our youth. Use it! If you shut them down, they will find a way to watch it anyway with no opportunity to receive helpful input from you! 
2. Talk to them! Ask them why they want to watch it and what they are expecting. Watch it along side of them and use it as a springboard in discussing important issues that are not addressed in the film such as mental illness, depression and anxiety, healthy problem solving skills, ideas and options, ways to get help, the effectiveness of treatment and the like. Don't let this be a stand alone message! If possible, watch it before them so that you know that to expect. 
3. If you are a parent who would typically choose not to watch the series due to your own personal history with suicide and/or sexual assault but you are trying to support your teen, I once again suggest starting with the synopsis noted above. Depending on your circumstances, you may want to get another trusted adult involved and/or speak with someone such as a therapist, good friend or clergy about your own reactions.

Culture of Cheer: Good Skilled Fronting

I have been wanting to write this post for quite a long time.  It is a subject about which I feel very strongly; so strongly that I have basically built a career on it. Perhaps that is why it has taken so long for me to commit it to actual words.  It is important enough to write about, but so much so that I want to be sure to do it justice.  I guess it just hadn't yet been the right time. Then, Robin Williams died. It is now time. 

We live in an unpleasant emotion-aversive culture and this has long concerned and grieved me.  I thought about a fancier way of saying it, like, "Fallacious Fear of Foul Feelings Phobia"  In any case, I'd hate words to distract from what I see as a significant problem.  As a professional therapist, a good deal of my job involves listening to, allowing and validating people's anger, hurt, grief and fear.  Many of the people who come for counseling are often looking not so much for a trained therapist with knowledge and experience with complex disorders and expert techniques, but rather someone who will sit with them in their hurts, fears and outrage and tolerate those feelings without eagerly or compulsively looking to dismiss, minimize, or placate them away.  Mindlessly repeating familiar cliches, reciting bible verses or dispensing other brief, trite comments, intended to make the person "feel better", however true and ultimately helpful they may be, usually do anything but.  

In a fundamental way, it makes sense that we desire to make others feel better.  However, it's as if we believe all pain is harmful.  Yes, if you keep your hand on a hot stove, it will continue to burn and terrible damage will occur.  The pain, thankfully, prevents us from doing this.  In some rudimentary sense, it seems we believe all pain is like hand-on-hot-stove pain.  Think about it.  A significant focus in our medical community is around relieving pain. Somewhere along the way, pain relief and pain management has shifted to a strong investment in pain elimination.  For many benign physical discomforts or in the case of chronic misery, this is reasonable.  However, has our obsession with alleviating pain gone too far?  After all, pain is often an alert telling us that something is wrong which needs to be dealt with.  Imagine if we put our hand on a hot stove and we didn't feel pain?  The pain helps us intervene to ensure we not incur further damage. 

During the hospital procedure after my second miscarriage, some things went wrong.  I was required to stay in the hospital for a couple of days to be monitored.  I was given a blood transfusion and immediately afterward, I experienced a sudden, painful sharp headache.  Hardly intolerable, I decided to tell the nurse in case it meant that I was having some adverse reaction they should know about.  Within moments of my reporting this, the nurse silently administered something into my intravenous line and before I got a chance to ask what she was doing, I felt myself immediately begin to go to that calm, "don't care" benzodiazepine place.  She gave me Ativan.  I didn't want it.  She didn't ask me if I wanted pain relief and she didn't even tell me what she was doing.  She just did it.  I got a strong "this will shut you up and stop your complaining" vibe from her action and subsequent attitude.  This intervention was not about my pain relief, it was of hers.  The message:  When it comes to pain, avoid it, eliminate it, fix it and if all else fails, silence it.

Its really quite the same thing when considering our responses to people's emotional pain,  The tendency is to approach it in a "if it can't be fixed, pretend it's not there" fashion.  For people going through difficulties, this lack of acknowledgement can be yet another knife in the heart.  I'd like to think that people who approach friends and loved ones this way, and they are many, don't realize the additional heartache this causes. Unfortunately, they are also likely unaware that their investment is probably more about their own discomfort than anything else. The movie "The General's Daughter", starring John Travolta, demonstrates the far-reaching and tragic lengths someone will go through to have their emotional wounds acknowledged, as well as the sad and shallow investment some people have in maintaining ignorance of reality.  In our own lives, usually in less dramatic ways, this message is usually heard loud and clear, "keep the pain to yourself"  So, people usually do. 

What we learn as psychology students is that in most cases of emotional pain, avoiding, eliminating or ignoring it is unhealthy and will inevitably, eventually, lead to dysfunction of one sort or another.   Pretending it is not there actually increases its destructive power. If any part of us knows this, our discomfort and disdain for the pain along with a culture all too willing to support denial, minimization and a plethora of ways to effectively "cope" with (avoid) the pain, makes it all too easy to inhabit the oblivious land of make believe.  Many a drug addict or alcoholic will tell you that they have found an effective way, albeit high priced, to avoid emotional pain.  They each have a tale to tell you how they got there.  I've worked with many men and women in recovery for the first time in their adult lives who struggle with believing something is wrong if they feel "bad".  Many of them are so used to immediately finding relief that they have a good deal of difficulty tolerating normal distress.  In some cases, even relatively common and inconsequential annoyances create an almost panic feeling followed by the search for a quick solution.  This helps to explain the high relapse rate.  Interesting to note is that when many of these former substance abusers reflect on spending years avoiding pain, they realize they also missed out on joy.

The overwhelming multitude of articles written since Robin Williams passed have paid tribute to the kind and talented man, expressed shock and grief at his loss and have put much needed focus on the issues of clinical depression, suicide and mental illness stigma.  Indeed, these are good and worthy subjects.  I would like to expand the concern beyond mental illness stigma to the stigma around displaying emotional pain, essentially, a societal intolerance to virtually any expression of unpleasant emotion.  

There is much speculation and talk about what was going on with Robin Williams which would lead him to take his own life. We can't seem to help it even though we all realize that we will never really know his thoughts and feelings leading up to and at the time of his final act. Perhaps he got substandard treatment, wasn't taking his psychiatric medications or was on the wrong ones.  Perhaps a dangerous mix of abusable substances and medication led to his hopeless state of mind.  Could there have been an adverse reaction to Parkinson's medications?  Or, maybe his life circumstances combined with his long-term mental health challenges created the perfect storm leading to suicide.  

A couple of days ago, I heard a clip on the radio of a now 10-year old interview with Robin Williams and an unknown to me interviewer after Robin had been out of rehab for a couple of months.  I tried to find it online but have been unsuccessful so far.  In the interview, it sounded very much like Robin was trying to be serious, to convey a message of gravity and encouragement to listeners who may be struggling with mental illness and/or substance abuse.  It became instantly apparent to me that the interviewer was not interested in this and was persistent in pursuing comedic input from the somber star.  Robin stated that he had contemplated suicide in the past when he felt his most despondent and hopeless. The interviewer kept trying to make it a joke and Robin eventually conceded, after several attempts to shift the interview into a more stigma crushing, demystifying and supportive outreach opportunity.  The finishing blow to the topic came when the interviewer responded to Williams' statement about thoughts of suicide with a chuckling, now eery "you wouldn't have the guts to go through with it"  He was in it for the laughs, and Robin Williams ultimately delivered.  His comedic genius shown bright, successfully hiding the grim reality he was clearly trying to reveal.  

We are often struck by the frequency of dark experiences and moods of our most beloved comedic entertainers (Jim Carey, John Belushi, Chris Farley, Larry David and others have all reported struggling with clinical depression ) but Williams proved himself a brilliant dramatic actor as well.  Was he attempting to show a part of himself in these more serious movie roles that he otherwise couldn't.  Comedians, in this sense, almost seem the opposite of the kid who misbehaves to get attention. People don't want to hear about the pain and despondency, so they get the attention they need by giving people what they want.  Like a drink or a drug, it only works for a little while. It is a skimpy bandaid used to attempt to cover a gaping hole. 

It would be fantastic to obliterate the stigma of mental health diagnoses, but any progress made will likely be minimal or superficial, in my opinion, until we can learn to willingly deal with emotional pain in smaller ways.  How can we empathize and even begin to understand the complexities and struggles of a stranger, famous or not, who battles clinical depression if we can't face the friend at church who lost her husband a few months ago or we feel compelled to avoid the neighborhood couple who just suffered a miscarriage?  As long as we treat situations such as these like life threatening motion sensor bombs, how can we think a friend considering suicide would reach out to us?  

There has come in recent years to be strong evidence in the study of emotions which reveals that some people are born with more sensitive nervous systems as well as areas of the brain less active resulting in greater challenges in emotion regulation.  Additionally, Dr. John Gray, known for the bestselling, "Men are from Mars and Women are from Venus" notes how the emotional part of women's brains can be up to eight times more active when upsetting stimuli are present than men's.  Perhaps those "too sensitive" people are simply, sensitive.

The things I have heard in response to some of my expressions of emotion from people who are clearly uncomfortable with this are striking.  Some acted as if even a reasonable amount of angry or sad expression for a specific upset or circumstance amounted to impending catastrophe.  After my first miscarriage, I was entirely unprepared for how more than one person, about a half dozen at least, acted like nothing happened.  No condolences.  Avoiding any conversation. Even avoiding eye contact.  It was extremely painful.  It actually felt quite selfish.  Once, a coworker was speaking about attending the wake and funeral of a six year old boy who was tragically killed when struck by a car while riding his bike.  Speaking of the services, he said "You would've never been able to handle it"  The implication that there is a preferred or superior "way" to handle such an occurrence.  I replied with a question, "How exactly ought one handle the death of a six year old child?"  This feeds the mistaken but commonly held notion that not feeling or expressing vulnerable emotions is a strength, somehow an admirable demonstration of character.  That's nonsense!   A close family member noticed my daughter's early development was off, but we learned of these concerns from a virtual stranger, a newly hired childcare worker.   When the family member learned of this, they shared that they thought about sharing those same concerns, but decided not to because, "I know you cry easy so I didn't want to get you upset"  The logic here is ridiculous, but these types of things happen often by otherwise seemingly intelligent caring people.   I was speaking with a ministry leader at my church about an upsetting situation I experienced in my role as therapist with another (non-client) individual.  My reactions to mistreatment and disrespect included anger and tears. Instead of validation and supportive input, I was given a lecture which essentially communicated: when people come to a therapist, they expect someone who is not emotional.  Really? Says who?  I take offense to this presumption, which would probably earn me the label of "too sensitive"  I have concerns that in some ways the Christian church has taken the fruit of the spirit "self-control" (Galatians 5:22-23) and the multiple verses peppered throughout scripture urging us to "be slow to anger" (Proverbs 16:32; James 1:19) too far, often carelessly promoting stoic suppression of valid God-given emotions.  There needs to be more balance. This is, however, a subject for another post. 

When someone as famous and as loved as Robin Williams takes his own life, the world stops and all attention is focused on the stark reality.  We fully experience the strength and destructive power of a stampede of a thousand herds of elephants.  Well, there is an elephant in the room folks and sooner or later, it is gonna get hungry.  The elephant is not just in rehab programs and inpatient units.  The elephant is not deterred by church walls or unspoken family rules.  The elephant is no respecter of persons be it race, class, gender or any other factor. Some elephants are small, but they grow. They are all around us: anger at injustices, sadness despite being blessed, guilt with or without cause, disappointments, setbacks, fears. They are hidden behind smiles, behind jokes, behind masks of all sorts. Ignoring the elephants is at the peril of all of us. 

It turns out that Robin Williams was an even greater actor than any of us ever knew. 

 

A View From This Therapist's Broken Chair

     Have you ever wondered if your therapist has a therapist?  Or, if they don't now, had they in the past?  If you were to ask them, do you think they would tell you?

     It takes a good deal of time for a therapist to develop their own style of conducting therapy which is a genuine reflection of both who they are personally, with appropriate boundaries, merged with professional approach, preferences and expression.  Erring on the side of caution, most novice therapists maintain fairly rigid boundaries.  Experience brings out more of the therapist's natural tendencies and in time, a functional balance is realized.

     I have come to be known as a therapist with a more of a casual, easygoing interpersonal style.   Unpretentious by nature, an acquaintance once described me as a "daisy among roses"   Later on, they went on to say "You're a daisy among roses and a daisy among weeds"  Please do not mistake casual style with indifference to the content or motivation for therapy.  Despite being more informal in form of delivery, I am passionate about the content, methods and dynamics of psychotherapy.  For instance, I am a stickler about therapists receiving regular supervision.  Although not required once licensed, I am a staunch believer that every therapist, whether licensed and practicing 1 year or 30 years, absolutely needs solid clinical supervision.  Also, I think each and every therapist ought to have gone through counseling of  their own with some minimum time commitment.  I wouldn't want to meet with a therapist who hasn't. I have received my own therapy at several points in my life.  One particular period of about 18 months was solely for the purpose of undergoing therapy in preparation to become a professional counselor.  I may not know what it is like to be in recovery from drug addiction or have grown up experiencing sexual abuse, but I know something of what it is like to sit in the "other chair"  I know the risk, the fear, the need for trust, the desire for and aversion to mental challenge, the anger and the pain.

     I imagine my experiences as a counselee, my inborn temperament and my early life events and personality development led to my inclination to favor a more relaxed "we all put our pants on one leg at a time" therapy style vs a more rigid, formal approach.

     So, would I answer the above question if asked by a client?  It should come as no surprise at this point that, yes, I would answer.  I know many therapists who wouldn't.  Incidentally, in my experience, most clients don't ask.  A seasoned therapist usually learns how to effectively shift the boundaries depending on the client.

     All of these contributions to the therapist I have become helped to cushion the blow (pun intended, you'll understand soon) on the day I leaned back in my office chair during a session, bypassing the expected familiar "catch" after the usual partial recline, and falling all the way back with my feet flying over my head, stopped only by the wall behind me (err, the one which had been behind me 10 seconds earlier).  After quickly jumping up and realizing that I was OK, my first thought was how glad I was I had not worn a dress or skirt that day.  My second thought was how glad I was that the client I was with was a female.  My third thought was how glad I was that it was this particular client.  Seriously. More about that later.  My fourth thought was......well, I didn't have a fourth thought.  By that point, both the client and I were in tears and hysterics laughing.  Assured that I was OK, we both broke out into spontaneous side-splitting gasping-for-air belly laughing which lasted about 20-25 minutes.  Several times, we managed to begin to settle down  only to start again when one of us could no longer contain it.  When the session was over, the client turned to me before leaving and told me it was one of the best sessions she has had.  The next time we saw each other, she indicated that her mood was better for the rest of that day and well beyond.  When I asked her why she thought that was, several reasons were speculated: less focus on her concerns and woes, the pure healing effect of laughter, seeing her therapist handle an undignified situation with, well, dignity, seeing her therapist be able to laugh at herself and not flee from potential humiliation.  Perhaps it was all of those, I suggested.

     To me, this unplanned incident with my client and it's immediate and lasting impact is richly symbolic of the significant depth, multiple layers and paradoxical nature of both the therapy process and the continuously evolving relationship between client and therapist.  The idea that simple humor may meet the need when technique cannot. That a therapist's humanity may amount to a great deal more than years of training and expertise. That modeling healthy behavior when opportunity presents itself can be a more powerful tool than teaching or prescribing behavior.  Additionally, it serves to remind both the counselee and the counselor of a crucial truth.  The truth that sometimes, or more often than not I suspect, psychotherapy is provided by a therapist with a view from a broken chair.  A view broken by personal weakness or sickness or grief or heartbreak.  Broken by conflict or pride or exhaustion or confusion.  If not broken, then at least limp, unsteady, worn or otherwise damaged.  Limp from life's storms, unsteady from lack of balance, worn from exhaustion and damaged by the demands and disappointments of past and current life circumstances.  I contend that whether it is realized or not, your therapist is providing you with ongoing care from the view from their broken chair.  Regarding the perspective of the seeking, hurting and vulnerable client, there is no better view from which to guide and grow.

      Most people blog these days looking for "followers" Some even do so to earn money. For me, this is just a place to keep my collection of writings. I'm not sure I have it in me, at least at this point, to be consistent and disciplined enough to have a successful blog with followers. I write when the mood strikes. So, if you are reading this....cool. Comment if you like and I will respond. If you are reading, I hope you are blessed and somehow benefit from the thoughts and stories I share. Peace to you!

     **Disclaimer: This blog is the opinion of an individual and is not to be construed as professional advice or a professional relationship between the reader and the writer. If you are seeking mental health advice contact a therapist in your area. If you are experiencing an emergency, head to your nearest emergency room or call 911.  **Names and details will be changed as needed to protect real client's privacy**