Trigger Warning: Suicide
This post was written by JKP author Marney Schorr. September is National Suicide Awareness Month and Sep 10, 2023 to Sep 16, 2023 is National Suicide Awareness Week. Research shows that taking about suicide in a caring way can help ease suicidal ideation.
In 2018, I was invited to write DBT and Art for Youth Suicide Prevention: When Art Saves Lives with Jessica Kingsley Publishers. This is a book about art therapy and youth suicide prevention that includes the survivor stories of young people and their artwork along with the theories that have made the Arts in Recovery for Youth (AIRY) program so successful. When I began writing the book, I knew almost right away that I wanted to share my story and how it inspired me to create this life saving program.
AIRY is the first of its kind: art therapy groups for teens and young adults combining art and dialectical behavior therapy, peer support, community engagement through the arts and best practices for youth suicide prevention. I began writing the book with my story because it has taken me decades of fighting stigma and shame, to become empowered to openly share that I am a suicide attempt survivor. I wanted to show my audience that it is not only okay, but necessary to share our survivor stories to help others.
Many of the teens and young adults I work with wanted to share their stories, too. It was like a rite of passage on the road of recovery. They wanted to give voice to both their pain (what Schneidman calls “psychache”) and to their strength in overcoming such adversity. Art therapy helped them to rediscover reasons for living. They amazed me then and continue to amaze me now with their endurance and development of coping skills to walk through the waves of suicidality that visit many of us. They inspired me especially during the pandemic.
It is my belief that the pandemic hit our younger generation harder. The extreme isolation and lack of human connection and the existential dread of whether this would end, whether they would ever be able to return to their lives, all contributed to a rise in suicides throughout the world. Looking into a computer screen even with people they knew, lacked the kind of connection that helps people heal. It was a very traumatic situation that felt like it would last forever (see chapter 17).
Working with these young people has become so much more than a job. It is a calling, a mission, that I reinvest in over and over. The rewards of seeing them recover from such depths of despair is incredible. I owe so much to Marsha Linehan’s unique set of skills in dialectical behavior therapy that are teachable and easy to apply to everyday life. I also credit our program’s success to the suicidologists like Thomas Joiner and David Jobes, who have made new information possible to help solve the suicide problem.
Dialectical behavior therapy (DBT) works with teens and young adults who become suicidal. Anyone can learn the skills especially if they are taught in the variety of learning styles that art therapy offers. Being able to learn and reinforce the skills through therapeutic art directives helps them recover.
When I discovered DBT, I think the most liberating aspect was that I could actually learn to manage my own emotions. This was a novel concept when DBT emerged in the early 1990s. So many of us have felt controlled by our emotions and powerless over them. They can be a mysterious driving force triggering an impulse to want to die to make the pain stop.
This skill is known simply as emotion regulation, but involves a unique style of thinking – the dialectic. Over a hundred years ago, Carl Jung believed that it was in the union of opposites that we could discover the solutions to our inner conflicts. This is the essence of dialectical thinking – learning that two very different things can be true at the same time (see chapter 13). It shows us that we do not have to be dominated by either our emotions or our logic. Through mindfulness, we can accept both and be guided by our higher knowledge – our intuition – to solve problems and to regulate, or manage, our emotional states.
In recent years, there has been an abundance of literature on trauma. Much of what we have learned has to do with the brain and its relationship to the nervous system. Because of DBT, there is a skill set in place to calm the nervous system, through self-soothing with the five senses and practicing ways to tolerate distress. At its core, is mindfulness – learning to just notice what’s happening inside of us and in our direct environment, without judgment. Mindfulness sounds like a basic and easy skill, but it can be quite difficult to establish a regular practice at first. Observing the breath is often the first step. Quieting the mind by having a neutral focal point allows the participant to develop the clearer thinking needed to cope or solve problems.
Because I had personal experience over decades with DBT, it was such a pleasure to design art therapy directives to help teens and young adults apply the skills in their day to day lives. I also learned which art activities they liked best, including using painting to release their feelings, and using metaphor through the creation of characters, to tell their stories. It is a wonderful job to continue creating art directives and helping them experiment with new art materials that incorporate the five senses. Some young people learn visually through studio arts like drawing and painting, while others learn more kinesthetically with tactile materials like sand and clay (see chapter 21).
We carry our completed art beyond the scope of the art therapy groups and into the community through events that raise awareness of suicide prevention in the arts. We engage with community members through the stories our art tells at art shows or performing arts events. When our young people sell their art, a sense of confidence and esteem is gained that just enhances their desire to make more art.
This community engagement brings us back to human connection, which is the best medicine for suicidality. I have learned this not just from personal experience, but from my research in suicidology, particularly the theorists that posit there are social factors involved in suicide risk. For example, Thomas Joiner has written extensively about the interpersonal theory of suicide where the social factors of thwarted belongingness and perceived burdensomeness are at the heart of suicidal thinking (see chapter 11). Mark Williams describes societal risk factors as direct components of becoming suicidal – such as social alienation and from an evolutionary perspective, not being part of the pack. Even in the earliest literature, Durkheim did not view suicide as related to psychiatry, but rather to one’s place, one’s role in society.
These theories explain what is often at the front and center for young people. If you can remember, adolescence is a very challenging time socially, trying to find friends you belong with, trying to adapt to social pressures and often, school bullying. Social groups are frequently changing. When youth try on new behaviors, they can be scrutinized by peers. Youth internalize all of these social messages and they become reasons for not wanting to live anymore. Making art with others can be a very freeing and empowering way to adapt to these social challenges, as teens and young adults are able to find their voice, and through self expression, claim their emerging identities.
What they have experienced, and what I have known for so long, is that art saves lives. In my book, I have outlined the ingredients of how to help our youth through the adversity of living in our current world and to become strong, capable members of society. We have learned that through peer support and sharing lived experience about what’s it like to be suicidal, a ripple effect is created that helps so many others. And of course, through helping them, I continue to heal myself.
If you would like to learn more, please see my book, DBT and Art for Youth Suicide Prevention: When Art Saves Lives with Jessica Kingsley Publishers.