13 Reasons Why - Side 7: Do depictions of suicide provoke imitation?

Side 1: The Setting
Side 2: An overly contrived premise can present a challenge
Side 3: Hannah Baker, from joy to despair
Side 4: Clay, an outsider who isn't an outcast
Side 5: Clay's tape leads to one of this year's most heartbreaking episodes
Side 6: Mr. Porter - Terrible Counselor or Worst Counselor?

I came to 13 Reasons Why a few weeks late and managed not to be spoiled by any of the twists within the story because there was a larger topic sucking up all the oxygen: was it responsible of the series to actually depict Hannah's suicide.

First, I want to lay out two stipulations before I dive in here:

1) There's no way any single post I write can be comprehensive enough to resolve this to anyone's satisfaction.

2) I don't think anyone involved with the show made the creative choices they did lightly. I believe they considered all angles and depicted the issue the way they felt made the most appropriate impact. It's absolutely fair to question that judgement, but I don't think any choice was made on a whim.

Soon after the show was released, the National Association of School Psychologists issued a statement saying, "We do not recommend that vulnerable youth, especially those who have any degree of suicidal ideation, watch this series. Its powerful storytelling may lead impressionable viewers to romanticize the choices made by the characters and/or develop revenge fantasies. They may easily identify with the experiences portrayed and recognize both the intentional and unintentional effects on the central character. Unfortunately, adult characters in the show, including the second school counselor who inadequately addresses Hannah’s pleas for help, do not inspire a sense of trust or ability to help. Hannah’s parents are also unaware of the events that lead to her suicide death."

That seems fair, and their entire statement is worth checking out. I disagree with the interpretation that the show is a revenge fantasy, BUT since that's a popular misconception about the series it makes sense to be aware of how to council people who will take it that way.

Dan Reidenberg, the executive director for Suicide Awareness Voices of Education, a suicide prevention non-profit, said, "There is a great concern that I have ... that young people are going to overidentify with Hannah in the series and we actually may see more suicides as a result of this television series."

That's a heavy thing to lay on a show. I don't put a great deal of stock in the threat of imitative behavior. A simplistic way to express my point might be this quote from SCREAM, "Don't go blaming the movies! Movies don't create psychos. Movies make psychos more creative!"

You're all about to jump on the extension of that analogy and say that it doesn't discount the influence on someone already suicidal. Make no mistake - that should be a concern.

There is a psychological phenomenon known as suicide contagion. It's defined by the Department of Health and Human Services as the belief that "the exposure to suicide or suicidal behaviors within one's family, one's peer group, or through media reports of suicide and can result in an increase in suicide and suicidal behaviors. Direct and indirect exposure to suicidal behavior has been shown to precede an increase in suicidal behavior in persons at risk for suicide, especially in adolescents and young adults."

You might have noticed a few passing references to suicide contagion within the show itself. Frankly, with the way season one ends, you could make a VERY strong case that the series is depicting this very threat within the subtext through Alex's storyline. I'm not going to be shocked if season 2 deals with this more explicitly. There is a study that documents that students who have experienced a classmate's suicide are more likely to have suicidal thoughts. The same study also found the same level of risk was present whether or not the person was friends with the victim.

But does exposure to a depiction of suicide have the same risk as when it's the death of a living person? I don't know. I'm not going to blame anyone for an abundance of caution, but I also don't think the creators should be stoned in the square for showing one.

One of the series writers, Nic Sheff, penned an essay for Vanity Fair discussing why they didn't have Hannah kill herself off-screen. We see the act in brutal, careful detail as she fills a tub, gets in and then takes a razorblade to each arm, clearly causing a lot of pain. It's a rough scene to watch and to my eye, didn't romanticize the act at all. It makes the act look about as appealing as sticking your arm into a woodchipper.

It's easier for me to wrap my brain around the idea of that scene prompting an anti-suicide reaction rather than fearing imitative behavior. Psychologically, it makes sense to me that the more graphic the ugliness, the less appealing.

That was the intent. Sheff relates a story of his own experience, talking about how just before he was going to swallow a lot of pills in a suicide attempt, he flashed on the memory of a story a member of his self-help group told:

"She’d decided to kill herself, just as I was doing. Her plan was to drift off peacefully into an eternal sleep, taking copious pills and drinking copious amounts of wine. She lay down on the bed. An hour passed. Then her body reacted. Involuntarily, she sat up and began projectile vomiting blood and stomach fluid. In a total blackout, she ran headlong toward the bathroom, but instead smashed face first into the sliding glass door, shattering the glass, breaking her arm, pulverizing her face, and collapsing unconscious in a pool of blood and vomit and whatever else. She woke up next morning in a pain unlike anything she thought was even possible. She crawled, moaning and crying, to a phone and dialed 911. She was bleeding internally, but she would live.

"The whole story came back to me in heightened detail. It was an instant reminder that suicide is never peaceful and painless, but instead an excruciating, violent end to all hopes and dreams and possibilities for the future. The memory came to me like a shock. It staggered me.

[...]

"It overwhelmingly seems to me that the most irresponsible thing we could’ve done would have been not to show the death at all. In AA, they call it playing the tape: encouraging alcoholics to really think through in detail the exact sequence of events that will occur after relapse. It’s the same thing with suicide. To play the tape through is to see the ultimate reality that suicide is not a relief at all—it’s a screaming, agonizing, horror."

Here's the rub: because this suicide scene is fairly unique in its bluntness, I don't know if there's any way to quantify the risk it presents. There might be studies to show that fictional depictions of suicide present a risk of suicidal feelings - but if all that data is based on "sanitized" suicidal scenes like the ones 13 Reasons Why was trying not to emulate, is it applicable to this situation?

We're in somewhat uncharted territory. I don't blame anyone for an abundance of caution.

Oh.

Per The Washington Post, "Robert M. Avossa, superintendent of Palm Beach County schools in Florida, told parents that school personnel had seen a rise in the number of students who have hurt themselves and threatened suicide."

Then again, we're talking about anecdotal evidence, not results that are derived from scientific study, which is why I feel it's fair game to offer this Thought Catalog post as a counterpoint: "How 13 Reasons Why stopped me from hurting myself." The author is a young woman named Pihu Yadav, a young woman who writes of her own struggles with depression.

"I still remember what it felt like when I saw that for the first time, and will probably remember it for the rest of my life. I saw how her parents reacted to it, I saw how they had absolutely nothing left after their daughter was gone, and I know now that I would never want to put anybody in that place. Ever. 

"Hannah Baker stopped me from killing myself. Even if I’m hurting, I would never want for others to hurt because of me. Hannah Baker taught me to fight and to live. And for that, she is a hero."

For this young woman, the scene worked in the way the creative team intended. I hope that the people like her, the people who saw demonstrated that suicide is no easy answer, far outnumber those who might be inclined to imitate her.

So what are the final takeaways here? First, if you're dealing with a loaded subject like this as a writer, do your homework. You're going to have to defend your choices when called out. If you're smart, you'll have found the foundation to stand on.

Secondly, OWN that choice. You made a creative call and if your strategy is going to be to dodge and pass the buck, you're not ready to write this. Sheff brings his own personal experience to the issue and he stands behind what he wrote. Also, I like that he's not a dick about it. he stands his ground, but his piece feels like it's intended as part of a dialogue, rather than a pissy "You know nothing of our work!"

Write responsibly, and when taken to task, be ready to explain what that means to you.

Side 8: Generating tension that stokes viewer intensity
Side 9: Keeping storytelling clarity in non-linear structure
Side 10: Alex's storyline hides parallels in plain sight
Side 11: Fleshed out parents help deepen the other characters
Side 12: Episodic structure makes a comeback
Side 13: Thoughts on Season 2