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"Stepping into the family: Systemic issues in research regarding adolescent suicide"

By Marilyn G. Haight and Eliot "Jake" Gordon

At present we know little about the functional effects that teenagers' suicidal

behavior may serve in the family, including the effects on parents. Families of adolescent

suicide attempters often have high levels of conflict, and adolescent suicidal behavior may

function to temporarily suppress conflictual or hostile behavior in other family members.

Like dysphoric affect, suicidal behavior is a sign of vulnerability that may elicit a

concerned, caregiving response, even though any positive effect may be very short-lived.

Also, like depressive behavior, the suicidal act may in some cases elicit hostile feelings

in others and may carry a punishing or guilt-inducing message that angers other family

members. To the extent that a suicide attempt is simultaneously a signal of distress and

often hostility, parents may find themselves in an emotional and behavioral bind. The

suicide attempt may evoke two sets of seemingly incompatible emotions from parents, anger as

well as concern, and it may prompt two contrasting behavioral responses, including

(a) efforts to comfort and support the adolescent, and (b)efforts to retaliate against the

adolescent in order to send a strong negative message that suicidal behavior is unacceptable.

Parents may express only caring emotions and suppress the expression of negative emotions,

because they may perceive that it is unacceptable or dangerous to express anger in the

presence of a vulnerable child immediately after a suicide attempt. Alternatively, some

parents may suppress the expression of any emotion (positive or negative), perhaps because

they do not wish to lose emotional control in a potentially overwhelming situation (Wagner,

Apr. 2000).

Adolescent suicide not only represents the tragic loss of life, but profoundly

impacts the victim's loved ones. Families are often left with few answers, clinicians are

often taken by surprise, and suicidologists struggle with finding sense among the senseless.

Joiner (1998) allows that because adolescent suicide is so painful and mysterious, it is

appropriate to focus on risk factors and clinical assessments. Careful assessment of risk

is crucial. It is understood that the most lethal actions are associated with the least

communication. Thus, the urgency for comprehensive, thorough clinical assessments,

including adolescents who are not voicing suicidal intention, is made clear. While there is

a key distinction between ideation, attempt, and completed suicide, consistency exists

within the relationship between negative life events as probable antecedents of various

types of suicidality (Joiner 1998).

During 2001, there were estimated to be more than 180,000 people affected by

adolescent suicide. Westefeld et al. (2000) reported, "Nearly 1 out of every 60 Americans

has experienced the loss of a loved one to suicide." As a society, we tend to make life-

ending decisions based on inadequate information. Clearly, both the prevalence of suicide

and the impact on families demand further attention. With consideration for further research,

three primary areas of concern are identified for future study:

I. Inadequacy of mortality statistics. The prevalence of recorded suicide attempts

and completions within the adolescent population and particularly within the marginalized

subpopulations that have self-identified themselves as gay, lesbian, bi-sexual or trans-

gendered is largely ignored. There are holes in theory, intervention, and perhaps most

importantly, prevention.

2. When we try to apply suicide theory to under-represented or marginalized

populations, there are failures of understanding and interpretation because we don't fully

understand their personal experiences, including the impact of their family relationships.

3. One limitation for counselors is that the literature on this topic is spread

across many social science disciplines.

In conclusion and summary, talking about suicide does not cause suicide. Not talking

about it can leave at-risk individuals with no other known option. Suicide, particularly

with regard to adolescents and children, is a social phenomenon affecting families

everywhere. A "head in the sand" theory shores up the survivors, but does little to help

understand the motivation for an adolescent choosing a permanent solution to a temporary

problem, or to prevent the next loss of life. Not only are we amiss in talking about

suicidal attempts at the time of the sentinel event, we often neglect the opportunity to

debrief the event later in life. Many of the issues (i.e. research, assessment, and

interventions) surrounding suicide could best be addressed with a primary systemic theory.

The underlying constructs of suicide have been presented by a variety of renowned researchers

and suicidologists, but we remain at a crossroads for development of a priori theories which

lead to testable hypotheses and an effective meta-theory providing a clear and consistent

conceptualization of adolescent suicidality.

Marilyn Haight, MEd. NcC; LPCintern is a HDFS doctoral student at Texas Tech University

in Lubbock, Texas and may be contacted at mghaight@cox.net. Eliot "Jake" Gordon, Edr. is a

2002 graduate of the Texas Tech University Counseling program. References may be requested

by writing the Editor of The Family Digest.