Tuesday, September 10, 2013


Dr. Sally Spencer-Thomas                                                                   FOR IMMEDIATE RELEASE
CEO & Co-Founder
Carson J Spencer Foundation

The FIRE Within Youth Social Entrepreneurship Program Recognized on World Suicide Prevention Day

Denver, Colorado. September 10, 2013.  Today, on World Suicide Prevention Day, the Carson J Spencer Foundation is pleased to announce today that its FIRE Within program has been listed in Section III of the SPRC/AFSP Best Practices Registry for Suicide Prevention (BPR). Practices listed in Section III of the BPR address specific objectives of the National Strategy for Suicide Prevention and their content has been reviewed by a panel of suicide prevention experts for accuracy, safety, likelihood of meeting goals and objectives, and adherence to prevention program guidelines.  The FIRE Within program, a program of the Carson J Spencer Foundation in partnership with Junior Achievement and the Second Wind Fund, is currently expanding to 50 high schools in Colorado. The program uses principles of impact entrepreneurship to help develop student leaders in suicide prevention. Over the course of an academic year, the FIRE Within students create businesses that generate revenue while also addressing root causes of student distress. Positive outcomes for the FIRE Within program are evident in the areas of youth development, mental health outreach, and business education. For more information: http://www.sprc.org/bpr/section-III/fire-within-youth-entrepreneurs-preventing-suicide

“We are thrilled to have this credential to support our innovative work in youth suicide prevention,” said Jess Stohlmann, Program Director for the FIRE Within. “We will continue to develop and refine practices that promote mental health, student leadership, and community resiliency.”
“One of the most exciting outcomes for us to see is how many of our youth connect others to mental health resources – about 65% of our students do this during the year they are in our program,” said Sally Spencer-Thomas, CEO & Co-Founder of the Carson J Spencer Foundation. “The ripple effects of this level of reaching out are tremendous.”

A fact sheet describing the FIRE Within program is posted in Section III of the Best Practices Registry, located on Suicide Prevention Resource Center’s website (www.sprc.org). For additional information about the FIRE Within, visit our website (www.CarsonJSpencer.org) or contact Sally Spencer-Thomas at 720-244-6535 or Sally@CarsonJSpencer.org.


About the Carson J Spencer Foundation - Sustaining a Passion for Living
The Carson J Spencer Foundation (www.CarsonJSpencer.org) is a Colorado nonprofit, established in 2005.  We envision a world where leaders and communities are committed to sustaining a passion for living. We sustain a passion for living by:

  • Delivering innovative and effective suicide prevention programs for working-aged people
  • Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention
  • Supporting people bereaved by suicide

Bullying and Suicide: The Complex Connection

Written by Guest Blogger: Nicole Cochran

On October 10, 2012 Amanda Todd, 15, a Canadian teenager, killed herself after posting a YouTube video talking about her experiences with bullying, assault, and depression. Amanda begins telling us her story about how when she was in 7th grade, she would go on a webcam with her friends and a stranger eventually talked her into flashing the camera (Grenoble, 2012). “One year later, a man contacted her on Facebook, threatening to send around the picture of her topless "if [she] don't put on a show." Terrifyingly, the stranger knew everything about her: her address, school, friends, relatives, and the names of her family members. Soon, her naked photo had been forwarded "to everyone"” (Grenoble 2012). Amanda ended up switching schools because of the bullying but the stranger did not let up. Once she was at a new school, the stranger created a Facebook page where he used her uncensored picture as the profile image. The kids at her new school found out and this led to further bullying, harassment, and she was eventually assaulted and was left on the ground. Amanda turned to cutting herself. “Amanda's bullying continued despite moving to a new city. Anti-depressants and counseling did little to combat the severe depression” (Grenoble, 2012).

All too often we read media headlines about kids who die by suicide, allegedly “because they were bullied”. Far too often when we look at the reasons why people would take their lives we find bullying in their life history. But the relations between bulling and these individuals often had many additional underlying risk factors that make the relationship far from straightforward. In looking at the research that explains the characteristics that connect those who are involved in bullying to suicidal ideation, we see that bullies and victims of bullying generally have “higher levels of insecurity, anxiety, depression, loneliness, unhappiness, physical and mental symptoms, and low self-esteem” (Nansel et al., 2001). In today’s society, people are finally looking at the correlation of bullying and the connection it has to suicide. Unfortunately, it took too many publicized stories of this problem to bring the conversation to public awareness. The connection between bullying and suicidal ideation is complex and deepened by the mitigating risk factors that are a part of the lives of the bullies and the victims.

In order to understand the connection, we need to first understand bullying and suicidal ideation. Bullying, by definition, is “a specific type of aggression in which (1) the behavior is intended to harm or disturb, (2) the behavior occurs repeatedly over time, and (3) there is an imbalance of power, with a more powerful person or group attacking a less powerful one” (Nansel et al., 2001). Suicidal ideation, or thoughts of suicide, is just that, thoughts about suicide, but not the actual commitment or plan to die by suicide.

In looking at the risk factors that connect bullying and suicidal ideation, outside of a mental health disorder or biological factors, self harm and a prior suicide attempt are the most potent risk factors that underlie the connection. In the research reported by the Suicide Prevention Resource Center [SPRC] “during the 2007-2008 school year, 32% of the nations students ages 12-18 reported being bullied, 21% said they were bullied once or twice a month, 10% reported being bullied once or twice a week, 7% indicated they were bullied daily, 9% reported being physically injured as a result of bullying, and 4% of students reported being cyberbullied” (2011). According to the same publication, in a normal 12-month time frame, “nearly 14% of American high school students seriously considered suicide; nearly 11% make plans about how they would end their lives; and 6.3% actually attempt suicide” (SPRC, 2011).  Possibly the most daunting statistic is that suicide is the third leading cause of death amongst youth ages 12-18 (SPRC, 2011).

The statistics, although shocking, don’t tell the whole story. A lot of the youth that are bullied don’t feel as if they are able to report being bullied because of fear of further stigmatization and the fear that nothing will be done about the problem. To add to that, “many teachers do not consider social exclusion a form of bullying, or [they] consider this form of bullying as less harmful” (van der Wal et al., 2003). The commonality that we see between bullying and suicidal ideation is that many of the perpetrators and the victims suffer from a mental health disorder like depression. Many of them have also have low self-esteem and engage in self harm. These risk factors, along with bullying, elevate the risk for suicide in adolescents.

People turn to suicide when they feel like they have nowhere else to turn. When their psychological pain becomes too much the thoughts of suicide develop as an escape valve.
To effectively harness the problem of bullying and suicide, we need “a concentrated and coordinated effort – a partnership if you will – among our families, schools, youth organizations, and communities” (Morino, 1997 as cited in Donegan, 2012). In order to do this, the Suicide Prevention Resource Center (2011) lays out action steps to best address both bullying and suicide in hopes of creating that unified front. SPRC (2011) states we need to start prevention early (by addressing bullying before suicidal signs are there, there may be some “significant benefits as children enter the developmental stage when suicide risk begins to rise”), we need to keep up with technology (“young people may use social media and new technologies to express suicidal thoughts that they are unwilling to share with their parents and other adults. Both bullying and suicide prevention programs need to learn how to navigate this new world”), and we need to use a comprehensive approach (we need to focus on the young people and the environment in which they live).

One of the very first prevention programs implemented is the Olweus Bullying Prevention Program. This program “develops methods of dealing with bullying on a variety of levels including school-level components, individual-level components, classroom-level components, and community-level components…this creates a cohesive plan in which each level reinforces the next” (Donegan, 2012). By using a multi-tiered approach, models like this are more likely to have a proactive and sustained prevention outcome.

Children are often too scared to talk about these two things because they fear it will either get worse, nothing will be done about it to help them out, or they will be stigmatized. Kids need to know the severity of each of these and they need to know what they can do to help. Our youth need to feel it is safe to report bullying, that it is ok to talk about how they are feeling mentally, and if they are having thoughts about suicide it’s imperative to get help.

Bullying and suicide are both very complicated and serious issues. Once these two issues are connected, they begin to become deeper and more complicatedly intertwined. In order to address this, parents, teachers, students, and professionals alike need to talk about these problems so together we can prevent further suicides from taking place; and hopefully, begin to erase the stigma that is associated with both bullying and suicide.

Let’s look back at Amanda Todd once more. In her YouTube video description she writes:
I'm struggling to stay in this world, because everything just touches me so deeply….I did things to myself to make pain go away…” (Grenoble, 2012).
Amanda lost her battle, but we can remember the complexity of her death in our work for solutions. Those who are struggling need to know that there are resources available for them if they are victims of bullying and if the suffer from any mental health disorders; such as The Bully Project, Stop Bullying Now, The Trevor Project, Love Is Louder, Minding Your Mind, Boo2Bullying, and Stand For The Silent. 1-800-273-8255 is the National Suicide Prevention Lifeline; please call if you ever have thoughts of suicide. Together we can help prevent another heartbreak like Amanda Todd.

About the Author

Nicole Cochran is currently studying to receive her Masters in Social Work from Colorado State University in Fort Collins, Colorado. She received her Bachelor of Arts in Sociology from Regis University in Denver, Colorado. While Nicole was in her undergraduate degree she became involved with a group called Active Minds. Active Minds is a nationally recognized mental health awareness and suicide prevention organization. In her time with Active Minds, Nicole found a love for suicide prevention and mental health. She is planning on concentrating in mental health and wants to get her LCSW and eventually become a high school counselor helping those who suffer from any mental health diagnosis while continuing to bring awareness to bullying and helping in the prevention of suicide.

Donegan, R. (2012). Bullying and cyberbullying: History, statistics, law, prevention and
analysis. The Elon Journal of Undergraduate Research in Communications, 3(1), 33-42.
Grenoble, R. (2012, Oct 11). Amanda todd: Bullied canadian teen commits suicide after
prolonged battle online and in school . Retrieved from http://www.huffingtonpost.com/2012/10/11/amanda-todd-suicide-bullying_n_1959909.html
Nansel, T. R., Overpeck, M., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P.
(2001). Bullying behaviors among us youth: Prevalence and association with psychosocial adjustment. JAMA, 285(16), 2094-2100.
Suicide Prevention Resource Center (SPRC). (2011, March). Suicide and bullying.
Retrieved from http://www.sprc.org/sites/sprc.org/files/library/Suicide_Bullying_Issue_Brief.pdf
Van der Wal, M. F., de Wit, C. A. M., & Hirasing, R. A. (2003). Psychosocial health
among young victims and offenders of direct and indirect bullying. Pediatrics, 111(6), 1312-1317. Retrieved from http://pediatrics.aappublications.org/content/111/6/1312.html

Tuesday, September 3, 2013

The Paradox of Traumatic Grief

Take the light, and darken everything around me
Call the clouds and listen closely, I'm lost without you
Call your name every day when I feel so helpless
I'm fallin' down but I'll rise above this, rise above this
~“Rise Above This,” Seether
The lead singer for the rock band Seether wrote those lyrics in the aftermath of his brother’s suicide. The video for the song depicts what many people feel upon hearing the news that their loved one has died.  A mother, a father, a sister – all going about their normal daily lives -- are suddenly blown completely off their feet by an unseen force. 
The course of a complicated bereavement, like the process that often follows suicide, usually does not follow the straightforward path outlined by Elizabeth Kubler-Ross so many decades ago, but rather twists and turns and circles back on itself through mazes of denial, sadness, anger, shame, blame, and multiple physical reactions.  Several authors have described an “oscillating process” in complicated bereavement – a moving back and forth between loss-orientation and restoration orientation[1], between growth and depreciation[2]. In this oscillating process survivors of suicide loss can move closer to some people and further away from others. They may simultaneously experience increased symptoms of distress and feelings of adaptation as these states appear to be independent dimensions.
As survivors of suicide loss learn to adjust to the empty chair and redefine life without the physical presence of their loved ones, they can feel like they have lost a part of themselves.  Not everyone is debilitated by this loss, however, and the bereaved often fall into one of three clusters:
  1. Quick recovery.  Those who recover quickly without assistance and can return to functioning as before.  Some of these people are not distressed because they had only superficial contact with the deceased, while others are often internalizing and suppressing pain, anger or guilt.  In the latter case, maladaptive strategies of coping may emerge such as substance abuse or other compulsive behaviors.
  2. Modest support needed.  Most people who were functioning well before the suicide need only a modest level of support for anywhere from a month to a couple of years.  This level of support might include outpatient therapy or support groups.
  3. Psychiatric disability. Some people may develop a mental disorder, such as post-traumatic stress disorder or depression, in reaction to the trauma and loss and may require extended or intensive treatment.
For the first couple of years after my brother Carson’s death, I moved in and out of these three states. Sometimes I would feel like I was functioning well, other days I would get through with a call to a friend or a visit to a support group, and some days I would be so consumed with the sadness of what had happened that I would benefit from periods of counseling.
In the aftermath of an unexpected death, especially suicide, traumatic grief is a common reaction.  When this occurs both trauma and grief reactions are experienced together, and elements of this combined level of psychological distress are often debilitating and complex. 
A number of circumstances about a suicide death may influence traumatic grief reactions[3]:
  • Suddenness or lack of anticipation.  The unexpected death offers no opportunity for goodbyes, unfinished business, resolution of conflict, or answers to questions.  Very often the bereaved are left with endless “whys” and “what ifs.”  When loved ones die from a prolonged illness, by contrast, we have time to prepare ourselves for their absence.
  • Violence, mutilation, and destruction.  Deaths that involve suffering or extreme pain may cause horrifying traumatic imagery and intrusive thoughts – whether or not the bereaved actually witnessed the death or the body. If the death occurred in a familiar or personal space of the bereaved, that space will most likely continue to trigger traumatic reactions.
  • Preventability or randomness of death. The randomness of such a loss can trigger a greater sense of vulnerability and anxiety. This is often the case when there were no apparent warning signs before the person died.
  • Multiple deaths (bereavement overload) or multiple losses. In addition to the primary loss of the person, secondary losses may include loss of an income, loss of a home, or loss of all things familiar.  The resulting disorganization can strain the family and social system.
  • Contact with first responders or the media. Sometimes the reactions of first responders – who need to rule out homicide in every suicide case – can increase confusion and distress among those bereaved. If the events surrounding the death were newsworthy, the bereaved may also be dealing with the intrusion of the media.
Trauma reactions and grief work are often at odds with each other. On one hand, the trauma experience leads to continual intrusion of the death event.  That is, survivors of suicide loss can’t stop thinking about the death scene (even when they are dreaming), and disturbing images may flash before the mind’s eye when they least expect it. The horror can be overwhelming and the natural impulse is to stay away from anything that reminds them of the trauma.  Sometimes survivors develop post-traumatic stress disorder (PTSD) in the aftermath of a violent or unexpected death. 
When I first started reading about trauma as a graduate student in the 1990s, I was moved by Ronnie Janoff-Bulman’s book Shattered Assumptions.[4] Her basic premise is that traumatic events shatter three world views that all people tend to hold:
·         Benevolence of the world – people are generally good
·         Meaningfulness of the world – good things happen to good people
·         Self-worth – I am good and can keep myself and those who love me safe and healthy.

All three of these assumptions are usually deeply challenged, if not shattered, after a suicide death. The traumatic responses of re-experiencing intrusive thoughts through flashbacks and ruminations are the mind’s way of rebuilding new world views about the self and the world. When Randy and I were in Hawaii just months after Carson’s death, we were hiking along the Napali Coast – one of the most beautiful places on Earth – and I could not stop ruminating about the horror of my brother’s suicide. I remember saying to Randy, “In the last hour, I have imagined Carson’s final moments at least 40 times and have only thought of our children once. What is wrong with me?”
On the other hand, the grief experience works in phases as survivors of suicide loss come to accept the reality of the loss, and the tendency is to move toward things that remind them of the deceased. The intense sadness can feel like it will never go away; and I like to reframe this grief reaction as honoring our loved one. Kahlil Gibran once said, “When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for that which has been your delight.” 
The alternating cycle of horror and loving memories, of avoiding and embracing things related to the loved one, makes traumatic grief complicated.  Not everyone is incapacitated, however, and many find unexpected twists in the journey can lead them to “rise above it” and integrate their experience into a deeper understanding of themselves, their purpose, and their world.
For more information on getting support in the aftermath of a suicide death, please visit: http://www.suicidology.org/suicide-survivors/suicide-loss-survivors
About the Author
Sally Spencer-Thomas, Psy.D., is CEO and co-founder of the Carson J Spencer Foundation, a Colorado-based nonprofit established after the suicide of her brother. The foundation is known for “sustaining a passion for life” by developing innovative and effective approaches to suicide prevention among working aged people, coaching youth social entrepreneurs to be the next generation of suicide prevention advocates, and supporting people bereaved by suicide. www.CarsonJSpencer.org

[1] Stroebe, Margaret & Schut, Henk (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197-224.
[2] Baker, Jennifer, Kelly, Caroline, Calhoun, Lawrence, Cann, Arnie & Tedeschi, Richard (2008). An examination of posttraumatic growth and posttraumatic depreciation: Two exploratory studies. Journal of Loss and Trauma, 13, 450-465.
[3] Ambrose, J. T (n.d.) Traumatic grief: What we need to know as trauma responders. Retrieved October 30, 2005 from http://wwwctsn-rcst.ca/Traumaticgrief.html

[4] Jannoff-Bulman, R. (1992). Shattered Assumptions: Towards a New Psychology of Trauma. New York: Free Press.