Amy McManus, LMFT
Why You Need to Be Familiar with 13 Reasons Why, Even if You Don’t See Teenagers in Your Practice
by Amy McManus, LMFT
13 Reasons Why, the Netflix series based on the 2007 book by Jay Asher, was released on March 31. The show presents a picture of teen suicide that is highly romanticized, even attractive, and mental health experts, parents, and school personnel all over the world have been responding to the issues presented. The National Association of School Psychologists (NASP) has issued an excellent handout discussing the show that provides guidelines for educators, parents, and students, as well as a list of resources (1).
As mental health professionals we all need to be prepared to discuss the distorted characterizations of suicide, school counselors, and mental health that are presented therein, as well as the unfortunately much more realistic depictions of cyber-bullying and sexual assault. Nowhere in the show is there any discussion of mental illness, even though we know that this affects approximately 90% of people who commit suicide (2). The school counselor, Mr. Porter, is clearly inept–he misses Hannah’s implied requests for help, dismisses her emotional experience, and tells her to “move on.”
However, there is another, more immediate reason to be familiar with this show. We need to provide parents or other clients who interact with teenagers the support they need to be able to discuss the controversial topics presented in the show with the teens in their lives. They need to be able to ask them questions about this show in a non-judgmental manner (always tricky with teens!). Parents are terrified of having their kids watch this show, and will need guidance in how to approach this. We can give them counseling on how to approach their teenager. We can practice with them so they are confident when broaching these troublesome topics, and we can give them resources to help them with this discussion. One resource we can give parents is the excellent “Talking Points” developed by The JED Foundation and SAVE (Suicide Awareness Voices of Education) so that they will have the guidelines in their hands when they watch the show together with their child (3). Teenagers are quick to imagine others are judging them (especially parents!) so this discussion is especially tricky. Sometimes all a parent can do is repeat the phrase, “That sounds really difficult/confusing/frustrating/sad/disappointing. I’m so sorry you are going through/went through that. Can you share some more about it with me?” When a parent freezes up from what they are hearing in response to this show, it is helpful for them to have practiced this and be able to repeat it as calmly as possible, and then to reassure the teenager that they will get more help for them from the appropriate adult- counselor, therapist, doctor, or even, in some instances, the police. The parent needs to know that they do not have to solve the problem. They do have to listen intently, and they do need to reassure the teenager that they will be in charge of seeking help until adequate help is found.
We can also use the way the show depicts its teenage characters as being emotionally fickle and sometimes unpredictable in their behavior, to illustrate to parents and other adults how difficult it can be to understand what a teenager is experiencing, and the importance of asking directly if they have thoughts of suicide or of harming themselves in any way. Parents are often afraid of bringing up the subject of suicide. They need to be given permission, indeed strongly encouraged, to talk about it. They need to know that their teens have already discussed it, googled it, and maybe even contemplated it themselves. Parents need to be ready with answers and places to go for help. They can give their teens the hotline numbers for the National Suicide Lifeline that is available 24/7 (4), and of course they can contact us for more resources that are specific to the problem presented, whether it be cyber-bullying, sexual assault, suicide, or other mental health issues.
For therapists who do see teenagers in their practice, it can be very useful to have a questionnaire available with several questions about specific thoughts of suicidal ideation and history, because it’s often much easier for teenagers to answer a written question. These should be followed by two or three questions to the effect of “I have a hard time being truthful about my darkest thoughts,” or “I am not able to trust anyone with my deepest feelings.” Though it seems counterintuitive, these later questions can sometimes open the door to a much more meaningful conversation (5).
Suicide contagion and copycat suicides
Advocates of this show need to understand that while it may be an excellent starting point for a discussion on bullying, its presentation of teen suicide is extremely harmful to many teenagers, especially those who have been affected by suicide and who are depressed, anxious and/or potentially suicidal (6),(7).
Hannah’s suicide is glorified and romanticized, and by leaving behind tapes exposing all the people who wronged her, she achieves three important goals. 1. She is no longer invisible. In fact, by all appearances she is just about all the kids at the school ever talk or think about. 2. She gets revenge. It’s clear that almost everyone is feeling miserable, guilty, and scared of being exposed. Bryce himself is in jeopardy of being arrested if the other students reveal what they know. And finally, 3. She makes the world a better place. All of the people on the tapes have a chance to reflect on their actions and do the “right” thing. Jessica stops drinking. Alex speaks his mind. Sheri becomes friends with the man who was injured in the accident for which she may have been partly responsible. Finally, Clay tells Mr. Porter, “It has to get better. The way we treat each other, and look out for each other. It has to get better somehow.” Those of us who remember the riots in Los Angeles in 1992 recall how Rodney King’s “Can’t we all just get along” became the ubiquitous motto for a better Los Angeles, a better morality.
Parents and educators all over the world are justifiably concerned. At-risk teens who want to watch this show will very likely do so, whether or not they have been forbidden by parents, school, or government. We, as therapists, can offer psycho-education, skills, and reassurance to anxious parents, educators and teens. If we can reach any teenager out there who feels this show resonates for them, then we may have saved a life. If we can talk to teens about the terrible cyber-bullying that happens to Hannah, we can create some empathy and understanding. And if we can help parents talk to their teenagers about a subject so fraught with anxiety and shame, then we will have made a difference that can last a lifetime.
Notes for 13 Reasons Why
- (National Association of School Psychologists. (2017). 13 Reasons Why Netflix series: Considerations for educators [handout]. Bethesda, MD: Author.) http://www.nasponline.org/assets/documents/Resources%20and%20Publications/
- The National Suicide Prevention Lifeline: Call 1-800.273.TALK (8255), or text “start” to 741-741. For The Trevor Project, specializing in supporting the LGBTQ community, call 866.488.7386, or text “Trevor” to 1-202.304.1200.
- I first heard of this concept from David Burns, M.D., at Stanford University. This and many other useful forms are part of his Therapist’s Toolkit, available on his website https://feelinggood.com/
Amy McManus, LMFT, specializes in communication between parents and teens. Amy previously worked for four years as a school counselor in various high schools in Los Angeles. She has raised four teenagers of her own, and is married to a high school teacher and administrator. Amy’s weekly blog (http://www.thrivetherapyla.com/blog/) offers parenting tips and other mental health information for parents and teens. You can contact Amy at email@example.com.