Abstract

Suicide rates have risen in the last two decades and the endemic remains a pressing social concern. There are nearly 45,000 suicides and 1.2 million suicide attempts per year in the United States. Current mitigation efforts are generally focused on mental health and subsequent psychiatric analysis. They have largely been ineffective in reversing the rise in suicide rates. However, suicide remains a significant problem that can be approached with a new lens. Social factors such as the prevalence of guns, media reporting, and classification systems are still poorly understood, especially when compared to conventional mental health strategies. This paper analyzes how the individualistic concept of suicide produces misunderstandings, how these misunderstandings hinder progress, and how solutions that acknowledge the public and social factors controlling suicide can help mitigate the growing suicide crises.

Introduction

When twenty-eight-year-old Kevin Baldwin released himself off the side of the Golden Gate Bridge, he felt the shocking reality that “everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.” Baldwin represents one of the millions of Americans who attempt suicide each year. In 2020, according to the CDC, there were 45,979 suicides and nearly 1.2 million suicide attempts in the United States, while suicide rates had slowly risen to 13.5 suicides per 100,000, making it a leading cause of death and a prominent social issue within the nation. Nevertheless, Baldwin’s attempt and his subsequent survival also reflect key misunderstandings about suicide that reveal the potential for new mitigation approaches.

There are several fundamental misunderstandings of the suicide endemic which shape the public understandng of the problem. These include the following: the belief that suicides are long thought-out, premeditated actions, that people who attempt will inevitably reattempt, that mental illness is always tied to suicide, that we can best predict (and understand) suicide from a psychopathological perspective, and lastly, that suicide is an issue predominantly tied to the individual. As such, mitigation efforts, which are often focused on the examination of individuals and individual mental health issues, remain limited given these misconceptions. They continue to fixate on individual assessment, when in reality, the suicide endemic is more nuanced and complex than this conventional approach proposes. Furthermore, the over-fixation on an individualistic lens distracts the public from a relatively feasible, attainable, and immediate set of strategies for mitigating suicide, ones that are often overlooked in the vast response to a national mental health issue.

Given this, a reconsideration of suicide mitigation efforts is necessary. Rather than fixate on individual-level approaches, we can better tackle the problem with a broader understanding of the larger social factors that are at play. this paper explores the misconceptions surrounding suicide and their realities using a thorough analysis of the research on suicide. It details how misconceptions inhibit mitigation strategies, and how more immediate and sensible strategies can be instituted through a better understanding of crucial social determinants of suicide.

Contemporary Misconceptions Regarding Suicide

Introduction

A mere google search, using keywords, can quickly reveal public misconceptions regarding suicide; A browser finds images focused on individuals, often contemplating on their own, and displaying mental distress. There is rarely acknowledgment of public or social factors that may be involved, and the concept of individual mental illness is the dominant framing.

Suicides are Long Thought Out and Inevitable Events

Whether it is Vanity Fair describing Robin Williams’ suicide as the result of a “long and difficult decline” or the Rolling Stone describing Kurt Cobain’s from the perspective of a “downward spiral”, conventional knowledge surrounding suicide and its most famous cases displays a perspective of deliberation, decline, and inevitability. While mental health struggles often precede suicides, a hindsight bias is employed in the aftermath of a suicide attempt. Mental health issues are prescribed as superordinate, or lone, causes of prolonged and unavoidable paths to suicide. Therefore, working with the mental health model, individuals are thought to engage in a prolonged or continued contemplation stage before moving towards suicidal behaviors. This idea creates the conception of inevitable and elongated decline, often presenting as the cause surrounding celebrity and community suicides. On the contrary, there is nothing inevitable about a suicide attempt. Many attempts unfold in short periods and out of temporary crises that provoke immediate and impulsive suicidal actions. (Deisenhammer et al., 2009) analyzed eighty-two patients admitted after a suicide attempt and found that nearly 74% of patients had found the jump from a decision to an attempt to be short (10 minutes or less) and 47% traversed the entire suicidal process (including consideration, decision, and action) within ten minutes of first consideration. Furthermore, researchers concluded, “The process from the emergence of suicidal thoughts to the accomplishment of a suicide attempt, and thus the time for intervention, generally is short”. Another study (Williams et al., 1980 ), analyzing visits to Australian hospitals, noted that a considerable majority of suicidal behavior was impulsive and that nearly 40% of analyzed subjects had acted within five minutes of suicidal premeditation.

These studies provide insight into the impulsive and erratic nature of suicides that is not recognized within mitigative and informational discussions surrounding suicides and suicide attempts. Instead of a calculated decision, a suicide attempt can be characterized by a temporary heightening of turmoil and vulnerability. Interestingly, suicide notes, another concept behind the idea of thought-out suicides, are indeed more rare than conceded by popular understanding. Of nearly 3,000 suicides analyzed in a six-year study by the American organization of suicidology, a small proportion, slightly above 18%, left a suicide note (Cerel et al., 2014). Serving as an indicator of a thought-out process, the lack of suicide notes highlights a propensity for rapid decision-making concerning suicide. As such, suicide attempts are often impulsive, arrive at times of heightened susceptibility and vulnerability, and are all but inevitable. This evidence opposes the common conception of deliberate suicidal processes. It is one of the central realities facing one of the more significant misconceptions surrounding suicide and hindering its mitigation strategies.

More Attempts Will Follow Suicide Failures

In a Harvard opinion survey published in 2006, nearly 74% of respondents believed that if individuals who attempted suicide via jumping off the Golden Gate Bridge had been deterred, they would have been able to complete suicide at another time and through other means regardless. This survey points to another misunderstanding surrounding suicide, the belief that individuals who attempt suicide will often reattempt if their first attempt is non-fatal. In this fashion, this understanding suggests that suicide mitigation can be a futile and overwhelming process. By extention, it follows that treatment should occur within the context of repeated attempts by individuals who continue to present suicidal behaviors and who may inevitably reach a fatal attempt by sheer force of will, regardless of mitigation strategies. However, within the knowledge that suicides are oftentimes impulsive decisions, the realities presented can compound into a more nuanced and hopeful understanding. Nearly nine of every ten individuals who attempt suicide but survive will not die of suicide at a later date. A study ( Owens et al., 2018) affirmed this understanding when it found that in nine years following a suicide attempt, only 7% of patients within a series of studies and databases had fatally relapsed, and nearly 70% never reattempted.

Coming back to the topic of Golden Gate attempters, an analysis (Seiden, 1978) found that of five hundred and fifteen individuals who attempted suicide at the Golden Gate Bridge but had been deterred or survived, only about 10% (35/515) had gone on to die by suicide at a later date. This study supposes a near 90% post-attempt survival rate, one which the public, and respondents in the survey mentioned above, do not acknowledge. As such, it can be supposed that with proper rehabilitation and support, individuals who attempt suicide, survive, and progress past the lapse of vulnerability will be less likely to reattempt than common knowledge suggests and unlikely to reattempt at large. Therefore the mere idea of suicidal inevitability within individuals who have attempted is inaccurate and detrimental to mitigation strategies, and the assumption that reattempts are common distracts from the necessity of preventing suicide means and attempts on hand, as well as from other mitigation strategies.

Mental Health is the Only Factor in Suicide

While there are ties between mental health and suicide, and mental health approaches remain necessary, they are not the only routes toward mitigation. An undivided fixation on specific mental health issues in suicide prevention can be misguided and ineffective. Nevertheless, in common understanding and mitigation efforts, suicide and mental health are often conjoined in an unbreakable manner, and as such, mitigation efforts lack diversity under the mental health context. For example, an overwhelming majority of suicide charities are centered on a mental health approach, and some of the most popular online communities can demonstrate this phenomenon. The With Hope Foundation is focused on “suicide prevention through improving mental health awareness.” At the same time, the Alliance of Hope Community Forum is a forum monitored by “Mental Health Professionals”, and the Morgan Meier foundation describes suicide as “the reaction of extremely intense feelings of loneliness, worthlessness, hopelessness, or depression” to name a few.

Of course, these approaches or claims are not wrong, but these approaches are limited. There is a stark over-fixation on mental health within these communities and little acknowledgment of more nuanced realities surrounding suicide and its prevention. In fact, for many mental health issues, there is a lower prevalence of suicide than accepted, with disorders like substance abuse, schizophrenia, and depression featuring a suicide risk assessment of around 5-8%. This finding, in contrast to an approach fixated on mental health alone, encourages a stress-diathesis model, which analyzes both individual disposition and environmental influence, suggesting that suicide is more multi-factorial than common perceptions around mental health suggest (Brådvik, 2018). Furthermore, in a study of suicidal ideation in psychiatric patients, researchers (Burgess & Hawton 1998) concluded that “the suicidal wishes of psychiatric patients are not always the result of an easily treatable and reversible mental illness or necessarily of any mental illness at all,” making clear that within these psychiatric patients, other factors influenced suicide to create a more nuanced basis for suicide prediction. Further studies (Brent et al., 1993), (Brent et al., 1993), discover a strong link between suicide and the presence of firearms, and highlight instances of suicide victims without psychiatric conditions, but who are most influenced in their decision to attempt suicide by the presence of firearms rather than mental illness. Therefore, while mental health remains a significant and robust connection with suicide, there remains space for analyzing other factors. This conception becomes especially apparent when constructing predictive and preventive measures, in which the connection between suicide and mental health has not been transferred, and the usage of mental health strategies lacks efficacy. This understanding leads us to the next major misconception.

We can best predict and mitigate suicide through psychiatric or mental health analysis alone

Since mental health is the primary fixation within the study of suicide, predictive and preventative measures are generally focused within the same context. This fixation can be seen through the statements of the organizations above and many organizations in general, in which mental health and the amelioration of mental health crises galvanize their efforts. These are sound efforts toward a broader attack on the suicide endemic. However, within the scope of predictive measures, which are necessary for ameliorating the suicide endemic, psychiatric and individual analysis, contrary to how they are commonly seen, are ineffective in predicting suicidal behaviors. In a meta-analysis of nearly three-hundred and sixty-five studies (Franklin et al., 2017), researchers found that predictive measures based on common risk factors (mental health issues, mental disorders, etc.) were only slightly better than chance for all outcomes and that no broad category could accurately predict far above chance levels. Furthermore, studies rarely examined the combined effect of multiple risk factors, and the researchers found that risk factors analyzing internal psychopathology accounted for a dominant 25% of all risk factor analyses. This led the researchers to suggest a multi-factor approach via algorithmic methods. As such, current single-factor prediction methods, structured mainly on mental health practices, are not effective alone, and there remains a necessity for multi-factor analysis to supersede a fixation on psychiatric analysis. Continuing, another study (Noch et al., 2022) analyzed clinician assessments, predicting one-month and six-month risk factors of a little over eighteen-hundred patients admitted to an emergency department, and found that clinician prediction was little better than chance at anticipating which of the patients would go on to attempt suicide within the time frame. It therefore becomes problematic to endorse mitigating efforts on the single factor analysis of individuals’ mental and psychiatric status, which has been fixated on in both research and shared understanding, and has distracted from other efforts through its sheer domination of the study of suicide. Instead, a multi-factored and open approach, acknowledging public and social causes of suicide, can be used in conjunction with preexisting strategies to access more immediate and attainable solutions.

Suicide is a problem tied to the individual

The effects of the various misconceptions above compound into a general focus on the individual, and the absolvement of the public, within a suicide endemic that can also be approached through a community lens but is often not. Risk factors, predictive measures, and treatment generally rely on individual examination and individualistic context. This focus manifests in focus on individual assessment and sometimes individual blame. Often, treatment and prediction efforts will include examinations of psychiatric conditions, recent life events, substance use habits, relationship happenings, job loss, family history, and more. On the other hand, aggregate suicide statistics, patterns, and trends indicate that suicide can be considered a public and social problem and can be mitigated as such. For example, per 2020 NCHS data briefs, stark disparities remained within suicide rates regarding demographic factors such as location and gender. Rural male suicide rates rose to 30.7 per 100,000 by 2018, while urban rates were at 21.5 per 100,000. Female rural and urban suicide rates reached 8.0 and 5.9 suicides per 100,000, respectively. As such, there remain significant social and demographic disparities within the suicide endemic along both geographical and gendered lines. Further, as a 2019 NCHS data brief highlighted, disparities exist along racial and ethnic lines. Suicide rates for American Indian and Alaskan Native populations (33.8 per 100,000 for men and 11.0 per woman), as well as for Whites (28.2 per 100,000 for men and 7.9 per woman), proved to be significantly higher than figures for other racial and ethnic populations such as Hispanic populations (11.2 per 100,000 for men, 2.6 for women) and African American populations (11.4 per 100,000 men, 2.8 for women). Another study ( Ellison et al., 1997) found a religious homogeneity index to be inversely related to suicide rates, while further studies (Baller & Richardson, 2002) found evidence suggesting that the geographical clustering of suicides in France and the United States was caused by the influence of both social integration and imitation factors. These studies support the understanding that suicide prevalence depends on compounding circumstances much more significant than just the individual, such as culture, social networks, access to means, environmental influence, geographical situation, gender socialization, and more. As such, there is strong evidence suggesting that suicide is influenced on a social and public level and can therefore be treated on a social and public basis. Furthermore, an over-fixation on an individualistic lens in the analysis and mitigation of suicide can be misguided, and distract from more attainable public solutions, such as the ones we will discuss below.

The Shortcomings of Current Mitigation Strategies

Introduction

The suicide endemic is growing, and current understandings and strategies, often solely fixated on individual analysis and ignorant of social and public factors, have not been practical enough. From 2000 to 2020, suicide rates in the United States rose nearly 30%, per the CDC. Not only have current mitigation efforts failed to minimize the existing suicide endemic, but they have also failed to prevent its growth; there remain difficulties that encumber mitigation efforts. Current strategies constructed on the common misconceptions outlined above are faced with mitigation difficulties that face these misconceptions. Furthermore, limitations of healthcare infrastructure within the privatized systems of the United States limit the efficacy of strategies solely based on the prediction and treatment of suicide through a psychiatric approach or the assessment of a mental health crisis. As such, on an aggregate level, the current, overly individualistic approach to suicide research, treatment, and prediction struggles to slow and reverse the suicide endemic due to difficulties we will discuss below.

Stigma

Despite the more than one thousand suicides at the Golden Gate Bridge since its opening, its only recently approved suicide barrier is yet to be completed. As mentioned in the expository New Yorker article ‘Jumpers,’ when a then engineer, Roger Grimes, protested along the Golden Gate Bridge in 1976 for the construction of a suicide barrier, his sign was met with flying soda cans and people telling him to jump himself, even in what can still be described as among the most progressive cities in our nation. Thus, the collection of misconceptions and the individualistic approach towards the suicide endemic produce a stigma that significantly impairs national mitigation efforts. As the British Journal of Psychiatry lamented, “the stigma around suicide remains just high enough to discourage people from discussing their suicidal thoughts” (Jadros & Jolley 2018). Ultimately, this runs in conjunction with the individualistic approach; when the roots of suicide are said to come from the individual, whether spoken or unspoken, the individual becomes partially culpable by societal standards.

Furthermore, alongside the discussion of suicide, moral weakness remains an understanding held by common thought, while individual pathology might be the equivalent in the more educated realms of research. Ultimately, stigma is harmful to the cultivation of public interest in mitigating suicide and treating suicide patients. In an analysis of public opinions, researchers have found the stigma toward Non-Suicidal Self Injury (NSSI) within sample populations to be significant to the extent that it may impact help-seeking behavior (Lloyd et al., 2018).

Furthermore, social acceptance of suicide is negatively correlated with suicide rates, in which nations and regions where suicidal behaviors are stigmatized have been found to maintain higher suicide rates (Schomerus et al., 2014). As such, the stigma around suicide is harmful to the broader treatment of the suicide endemic and is also largely present in our society. If mitigation efforts are to be reformed, public responsibility and involvement in the suicide endemic must be analyzed and accepted to relieve the blockading influence of stigma on the individual, and allow for the crafting of more immediate solutions.

Practical Inabilities

Alongside stigma, there remain practical limitations plaguing the current models and approaches to suicide. As outlined, beliefs that suicidal individuals often have a mental illness, engage in the process of deliberation, and progress through a state of inevitable deterioration do not run in conjunction with reality. As such, mitigating efforts that solely dedicate themselves to these conceptions, such as those focused on clinical prediction and analysis of the individual, have failed to prevent the growth of the suicide endemic. Practical limitations include the lack of preventative measures in the context of the rapid suicidal decision, the inability of physician-based prevention, and the ineffectiveness of general medical and clinical approaches toward the unique case of suicide. To start, the impulsive disposition of suicide, as discussed above, means that preventative measures would be most successful if focused on aiding the individual during crises rather than the more complex undertaking of ameliorating suicide in its early stages. Since, per the CDC, firearm deaths make up nearly half of all suicides, this could include reducing access to means in our social environment, like firearms, in order to block an individuals ability to attempt suicide while in a temporary crises. Currently, many preventative measures involve medical prediction that employs earlier mitigative strategies. However, as noted before, psychiatric practitioners are largely ineffective when asked to stretch their disciplinary limits and predict suicidal behaviors that are often the product of temporary crises. General practitioners prove to be similarly ineffective; Of 286 cases of suicide examined in a study (Pearson et al., 2009), 91% of individuals contacted their general practitioner within a year of committing suicide, but in only 27% of cases were concerns reported prior to the suicide, leading researchers to conclude that “Consultation prior to suicide is common but suicide prevention in primary care is challenging.” As such, while there remains a focus on psychiatric prevention of suicide, the medical professionals most often contacted by suicidal patients have not produced ameliorating results within the strategies of suicide prevention in the earlier stages. Continuing further, the use of psychiatric strategies (Mehlum et al., 2006) and psychological treatments (Brown, Jager-Hyman 2014), including therapy and pharmaceutical treatments, are either ineffective at mitigating suicide or in need of further improvement, leading further researchers (Large, 2018) to conclude that “Refraining from the temptation to predict suicide in clinical psychiatric practice might even assist suicide prevention.” In this sense, the commonly accepted notions of suicide and its prevention, including the processing of patients through routinized healthcare avenues, and mediums of individual prediction, consultation, and treatment, prove to be limited by a series of practical limitations that drawback to the realities behind the misunderstood suicide endemic. As researchers (Cole-King, Lepping) have enunciated, we need to ask ourselves ‘What can be done to prevent this person harming themselves today, this week, this month?” and move past the desire for an outright and clinical “cure” toward suicide when there are approachable and multidisciplinary methods available.

The Inadequacies of the Public Health Care System in Mitigating Suicide

Another, albeit less mentioned, question behind the mitigation of suicide through an individualistic and psychiatric lens would be our nation’s ability to provide widespread access to the clinical methods necessitated by such a model. Nearly one in every five (53 million) Americans suffer from varying mental illnesses. Nevertheless, studies analyzing the National Comorbidity Survey indicate that only 15.3% of respondents received minimally adequate treatment for severe mental illness (Wang et al., 2002). Meanwhile, in a report on suicide mitigation strategies, the CDC laments that “relatively few people in the US with mental health disorders receive treatment for those conditions.” Furthermore, a large proportion, two-thirds, of physicians reported that they could not get outpatient mental health care for patients, which is nearly two times that of other services, due to inadequate insurance coverage (Cunningham et al., 2009). As such, there remain healthcare and insurance barriers to providing mental health care at a rate that current strategies necessitate. Even further, in an aggregate analysis, our current healthcare system, even if made available to all, may not have the capabilities to combat a national mental health crisis; over 155 million Americans, often in low-income communities, live in Health Professional Shortage Areas (HPSAs), or areas with inadequate mental health infrastructure and capabilities. It seems unfortunately and unjustly predictable that treatments would tend not to reach those of lower socio-economic status, especially in our privatized healthcare system, but even more jarring is the fact that treatments are not reaching the severely mentally ill patients who would be at the highest risk for suicide. These are two glaring wrongdoings within the broader incapabilities of our healthcare system and its necessity for suicide prevention. Therefore, if current strategies necessitate large-scale mitigation of the suicide endemic through a parallel, clinical movement against the mental health crises, they remain hindered by our inability, through coverage and healthcare delivery difficulties, to provide access to clinical treatment and prevention of suicide for all. This understanding further necessitates the need for more diverse and attainable prevention methods outside of the current model.

Immediate and Practical Prevention Methods

Introduction

We live in a society with several complex social problems, but suicide does not have to be one. There are many attainable and immediate ways to prevent and mitigate suicide and circumvent the debilitating circumstances around the suicide endemic. In this paper, we have discussed the presence of a harmful over-fixation on individualistic, psychiatric approaches to suicide mitigation; however, through a public and social lens, we can create a multidisciplinary approach and achieve more immediate gains in suicide mitigation. Continuing on the theme of public responsibility, we will discuss the following immediate and practical solutions toward suicide mitigation that move past the individualistic view and incorporate the realities behind the suicide endemic.

Reducing Means Toward Suicide

To most immediately combat the suicide endemic, restricting means remains the most viable pathway. This strategy aligns with the argument we have laid out; if suicides come at impulsive moments of vulnerability, and are unlikely to be followed by further attempts, then restricting an individual’s ability to attempt or complete suicide on hand becomes incredibly important to mitigative efforts. Most importantly, limiting access to firearms, which prove to be tools of no return, would prove the most effective policy for reducing suicide rates. Of all suicides in 2020, nearly 53 % involved a firearm (CDC). Furthermore, of all suicide methods, firearms remain the most lethal, at around an 83% fatality rate as opposed to lower rates for suffocation/hanging (61.4%) and significantly lower rates for Poisoning (1.5%) and cutting/piercing (1.2%), which represent the other most common means toward suicide (Spicer & Miller, 2000). Continuing, several studies show that the presence of firearms can have an inflating effect on suicide rates; in case-control studies, guns were twice as likely to be found in the homes of those who had made fatal attempts (Brent et al., 1991), and further research finds that the relationship between suicide and the presence of any firearm within a household are significant (Brent et al., 1993). On an aggregate level, regions of the United States with high gun ownership were found to possess suicide rates nearly 14% higher than regions with low gun ownership (Miller et al., 2002), while studies controlling for regional culture variation found that short-term exposure or visiting regions with high gun ownership, by outside residents, was found to have a positive effect on suicide rates (Shrira & Christenfield, 2010). As such, we know that guns have a significant, and potentially causal, effect on suicide on an individual and aggregate level— as the Harvard School of Public Health states, “Every study that has examined the issue to date has found that within the US, access to firearms is associated with increased suicide risk.” In regards to the progression from restricted methods to available methods, it has been further demonstrated that many individuals will not progress past or substitute their favored method, which often exists, if they find it restricted (Hawton, 2007). Furthermore, it is known that restriction of means has proven successful at reducing suicide rates in the past; suicide rates fell with the restriction of access to carbon-monoxide methods via charcoal in Hong Kong (Yip et al., 2010), regulation of lethal pesticides often used in Sri Lanka (Gunnell et al., 2007), and the decades’ long progression from monoxide usage in domestic gas in the United Kingdom (Kreitman, 1976). The restriction of means, mainly firearms, remains a necessary strategy in suicide prevention through both quantitative and qualitative understandings of suicide. If our nation is willing to reduce means, such as by taking steps to reduce firearm access or building suicide barriers in places like the Golden Gate Bridge, it can incorporate an understanding of the public power and responsibility within the suicide endemic. Its subsequent recognition of suicide means can be an effective preventative strategy, which accepts the overwhelming numerical and contextual evidence toward a more holistic approach regarding suicide prevention.

Optimizing Media Output and Suicide Contagion

Media reporting on suicide has been demonstrated to strongly correlate with suicide rates. As such, the optimization of media output concerning suicide contagion is necessary. Generally, suicide contagion can be understood within social learning theory, in which individuals are influenced by imitation effects and social tides larger than themselves, and can produce suicide clusters as a result. In this sense, regulating media output can be a powerful mitigative tool. In a 1979 study, to be followed by further studies (Kuezz et al., 1986), (Michel et al., 1995), Dr. David D. Phillips found a positive correlation between front-page or marked reporting styles of suicide and an increase in suicide rates, an effect he dubbed the “The Werther Effect” (Phillips, 1974). The Werther Effect remains the basis for suicide contagion theories and can be accessed for mitigative strategies. Meanwhile, in an international comparative study, nations where suicide is reported in a more discouraging light (The United States, Finland, and Germany), have been found to have lower suicide rates than nations that portray suicide in a more open light (Hungary and Japan) (Fekete et al., 2001). Furthermore, researchers (Niederkrotenthaler et al., 2010) have found that repetitive reporting of suicides and suicide myths also correlates with increased rates, while reporting of suicidal thoughts that are not followed by a suicide attempt correlates with decreased rates. Therefore, there remains an influence of media reporting on suicide contagion, but there is further evidence supporting the fact that reporting guidelines can prove beneficial. During a spike in suicide attempts on Viennese subways in the 1980s, the implementation of media reporting guidelines and restrictions proved successful at reducing subway suicides by nearly 75% over several years (Sonneck et al., 1994). In the opposite fashion, when California Highway Patrol and local newspapers used to keep a running suicide count for the Golden Gate Bridge, landmark numbers like 500 and 1000 were met with cases of suicide frenzy. As a result, many organizations, including charities and the CDC, have offered guidelines for newspapers and media corporations to use to aid media regulations. Nevertheless, in a study analyzing the acceptance of basic guidelines set forth by the Samaritans, an organization from the UK that deals with mental health and suicide, it was deduced that 199 of the 229 articles examined failed to comply with one of the said guidelines, such as mentioning support sources or avoiding excessive or influencing details (Utterson et al., 2017). Thus there remains room for improvement within the reporting of suicide. Media reporting has been demonstrated to positively and negatively influence suicide rates, depending on how it is displayed. The narrative surrounding individuals within our societies can influence their suicidal vulnerability. Therefore, we must accept the public responsibility of establishing proper reporting and journalistic guidelines, via the acceptance of suggestions put forth by knowledgable organizations, to combat another of the many social influences on suicide effectively.

Creating More Standardized Data Collection and Classification Methods

Another difficulty that plagues suicide mitigation efforts is the struggle that our society experiences in tracking and classifying suicide cases. If suicide efforts are to be adequately addressed and organized, data sets behind suicide research, and further action, must be accurate and standardized. Lack of resources, lack of information, communal stigmas, ambiguous classification systems, and the perplexing nature of suicide are all barriers that can hamper the classification of individual suicides and create inaccuracies in aggregate measures of suicide. (Silverman, 2016) captures the difficulties of suicide classification systems in the face of widespread moral and procedural ambiguity in the field of suicidology. Meanwhile, on an aggregate level, African American and Hispanic suicide rates have been found to experience excessive rates of suicide misclassification due to cultural differences in classification, explaining the misleading gap in White and African American suicide rates ( Wang et al., 2010). In the past, studies have indicated a social construction of suicide rates and a range of misclassification. (Pescolindo & Mendelsohn, 1986) Highlighted the influence on suicide rates by the social organizations or groups tasked with counting them and the presence of widespread and consistent miscalculation at the hands of responsible agencies. Furthermore, (Douglas, 1967) demonstrated the principle that suicide rates are often constructed by external social factors, while statistics experience widespread error as a result. For example, From 1985 to 1989, suicide rates in New York City fell substantially due to policy changes in the New York City Chief Medical Examiner’s Office, which was engaging in preservative practices in the face of backlash and criticism at the time (Witt, 2006). These shifts affected efforts to measure or quantify suicide behavior or approach mitigating strategies, and demonstrate the malleability of suicide statistics in the face of broader social movements. As such, even the most advanced nations struggle to compose suicide statistics. To better understand or approach the suicide endemic, we must accept standard approaches to classification and provide practitioners with the resources to properly examine cases of suicide. It is imperative to construct an objective classification and nomenclature system, which currently does not exist, that can avoid the variation present in suicide classification systems.

Reform of Cultural Influences Behind Suicide Ignorance:

Everything from the language we use to the narratives we create can impact our ability to mitigate suicide rates in the United States. In an expressly individualistic culture, our understanding of and interactions with suicide can become harmful. As we have seen earlier, there are many specific misconceptions surrounding suicide, but our society also engages in broader malpractice as a whole. The obsessive individualism that the United States has grown around makes it almost inevitable for our strategies against suicide to be so focused on the individual and mental health strategies. As such, the difficulty of releasing this rugged individuality disposes us to focus our efforts on the individual’s well-being, not the communities and demographics that encircle them. Much in the American tradition, each individual is seen as a carrier of their outcome, and each instance of suicide is seen as its outlying case. Whether spoken or unspoken, individuals are cast off, blamed even, for what is seen as a pathology of their mind or weakness of their disposition. Because social solutions do not fall within the cultural paradigm of individuality, they are often displaced by a hyper-fixation on the individual, which does run in conjunction with our societal values. Nevertheless, as we have argued, suicide is as much an affliction of the individual as it is a social failure, and suicide is a unique tragedy that the United States cannot force its cultural values upon. If we can find the humility to deviate from our cultural values when approaching its suicide endemic, we can more effectively combat a social issue of our time. We could do this by providing social support, easy access to crisis management, restricting suicide means, creating more accepting discussions on suicide, and more. However, while there are many solutions available, to approach them or move on to the solutions we have highlighted in this paper, we must start by reforming our nation’s thoughts on the individual and suicide. We must absolve the individual of its scrutiny in the suicide endemic and move past our cultural beliefs to craft a more knowledgeable and viable strategy against suicide.

Conclusion

The suicide endemic and our efforts to mitigate it remain oriented around individuals and individual-level approaches. Moving forward, we must first adjust and update our understanding of the suicide endemic; contrary to the individualistic fixation on mental health, the individual is not culpable in the broader social patterns that influence their propensity for suicide, and current approaches reveal how suicides are regulalrly misunderstood. Our current mitigation strategies, bogged down by practical limitations and stigma, must be reformed to accept the broader social responsibility and act accordingly by accessing strategies that challenge the current methods. We can do this by accepting the realities and strategies we have displayed behind our theme of societal solutions. If we broaden our view of suicide and its mitigation, we can approach a public health issue that has too often been considered intractable, and make progress towards reform and change. In this sense, we can persevere in the face of what might feel like an overwhelming number of social problems today.

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About the author

Victor Josifovski

Victor is a senior at Los Gatos High School. He is a huge history buff, and enjoys reading, everything from Orwell, to Hemingway, to Dostoevsky. Victor also enjoys playing basketball, both through clubs and his school team. He coaches youth sports in his free time.

The post Suicide Mitigation: Moving from an Individualistic Lens to a Collective Analysis in Preventing Suicides appeared first on Exploratio Journal.

Abstract

This experiment explores how disclosing a mental disorder affects people’s perceptions of the target on a range of thirteen traits such as intelligence and agreeableness. It is hypothesized that disclosing a mental disorder can induce lower ratings on the targets’ abilities to perform well in the workplace, intelligence, and how calmly they could handle a given situation. When evaluating a total of twenty-eight responses across two Google Forms, no statistically conclusive evidence was found between those who disclosed a mental disorder and those who did not. Research participants read four vignettes narrated by the target (the actual vignettes can be found in Appendix A and B). Research participants were either assigned a condition where the target disclosed a mental order or a condition where the target did not disclose a mental disorder in the four vignettes. After reading each of the vignettes, research participants rated each of the targets on thirteen traits. Four major limitations could have affected the accuracy of the experiment and results: a small sample size; no preliminary testing on the content of the vignettes; using a convenient sample; no testing to see how the phrasing of the questions could have affected the research participants’ answers.

The Influence of Disclosing Mental Disorders on Impression Formation

Have you ever wondered if disclosing a mental disorder would be viewed negatively by a friend or employee? Consider this example: James is debating whether to disclose his anxiety disorder to his boss. On the one hand, he feels this information could help his boss understand his work style better, but on the other hand, he feels his boss may think he will have difficulty keeping up with the pace of the workplace. The following experiment was conducted to determine whether disclosing a mental disorder (such as ADD, Anxiety, Bipolar) in any environment negatively affects how people view the individual disclosing a mental disorder. Mental disorders, or mental illnesses, are occasional or chronic conditions that have an impact on one’s feelings, moods, behavior, and thinking (Mental Disorders, n.d.).

Television dramas, celebrities, and the younger generation are raising awareness around mental health and are helping lessen the stigma surrounding mental health (Spector, 2020). However, even though there is more awareness now about mental disorders, (such as attention deficit disorder (ADD), bipolar disorder, anxiety disorder, and post-traumatic stress disorder (PTSD)) individuals may still be unclear whether it would serve their best interest to self-disclose their mental disorders.

Self-disclosure is the process of revealing information to someone else intentionally or unintentionally. The information disclosed can vary in depth. For example, one example of self-disclosure may be revealing the name of one’s favorite color while another example may be sharing one’s biggest regret in life. An example of verbal self-disclosure could be sharing a phobia while an example of non-verbal self-disclosure could be a visible tattoo. Some benefits of self-disclosure include creating stronger bonds with the individual(s) one is self-disclosing, getting one to trust an individual more, greater life satisfaction, and better cooperation (Self-Disclosure, n.d.). The hypothesis for this study is that disclosing a mental disorder would lead to lower ratings in performance in the workplace, intelligence, and handling a situation calmly.

The decision to self-disclose a mental illness may vary based on the industry. In professions that rely more heavily on networking where traits such as Empathy, Authenticity, Kindness, extroversion, and Agreeableness were rated more highly in a high self-disclosure format, self-disclosing a mental disorder may be beneficial.

Past experiments conducted on the topic of impression formation and mental disorders online influenced many aspects of the experiment discussed in the rest of the paper. In one experiment, research participants viewed targets’ interviews and rated the targets on openness, conscientiousness, agreeableness, extroversion, neuroticism, physical attractiveness, and likeability (Fiedler et al., 2004). The target, or narrator, of the vignette, decides whether or not to disclose that they have a mental disorder. Some of the targets had personality disorders which are a type of mental disorders (Personality Disorders, n.d.). It was found that research participants rated those who displayed traits of paranoid, schizotypal, dependent, and avoidant PDs as less extroverted and less likable (Fiedler et al.). On the other hand, research participants rated targets who displayed histrionic PD (symptoms include a strong need for attention) as more extroverted and more likable (Fiedler et al (Fiedler et al.). Rating the targets on multiple personality traits inspired many of the questions in the experiment discussed in this paper.

Another experiment explored the impact on impression formation of disclosing a speech disorder or a mental disorder in the context of employment. In this experiment, research participants were presented with pictures and audio recordings of targets who were applying for a job at a university. Research participants were assigned a scenario with disclosure of either a speech or mental disorder. The scenarios contained no disclosure, visually implicit disclosure, or verbally explicit disclosure. Research participants were told to rate the targets’ characteristics after witnessing the scenarios. It was found that research participants viewed a speech disorder more favorably than a mental disorder in the context of employability (Fisher, 2007). Some factors people consider when deciding whether to disclose a mental disorder to their superior in the workplace are their gender, work setting, diagnosis, and emotional support in the workplace (Susman, 2021).

Inspired by past research that explored disclosing a mental disorder in the workplace, the following experiment further explored how disclosing a mental disorder affected people’s perceptions of the target without giving them the context of employment. After reading a vignette, research participants were asked to rate the targets on traits related to performance in the workplace. However, the purpose of rating the targets was not disclosed. As previously mentioned, before conducting this experiment, it was hypothesized that disclosing a mental disorder would lead to lower ratings in performance in the workplace, intelligence, and handling a situation calmly. The responses showed no significant results. By evaluating a total of twenty-eight responses across two Google Forms, no conclusive evidence was found between those who disclosed a mental disorder and those who did not.

In the context of how one would regard the individual disclosing a mental disorder after they disclose it: a negative perception would be quantified by lower ratings in categories such as performance in the workplace, agreeableness, openness, and various other traits. It can be beneficial to know whether or not people develop a more negative perception of an individual’s skills or traits when they disclose a mental disorder for a multitude of reasons. For example, the conclusions of the research could help an individual determine whether it would be beneficial to disclose their mental disorder to an employer, colleague, or friend.

Emotional self-disclosure, disclosing emotions and emotional experiences, can encourage empathy and trust while helping the individual disclosing a mental disorder cope with stress and burnout (Empathy at Work, 2022). Research found benefits of both: positive and negative self-disclosure. Surprisingly, negative self-disclosure is preferred and can have a positive influence (Zhang et al, n.d.). An example of negative self-disclosure could be “I am really bad at math” or “I struggle to manage my time well.” When disclosing negative information, the receiver may perceive the individual disclosing a mental disorder as honest and attribute other positive descriptions to the individual disclosing a mental disorder (Zhang et al, n.d.). An example of positive self-disclosure could be “I am really good at math.” When one discloses positive information, they may be perceived as dishonest since the information disclosed may seem to boast (Zhang et al, n.d.).

Self-disclosure can also be used as a tactic to make an individual seem more authentic. For example, someone in a position of power may self-disclose to employees- in both difficult and non-difficult situations- to show their ‘human side,’ which can compel employees to rally behind them (Zhang et al, n.d.). Similarly, in certain circumstances, it might be beneficial to disclose a detail that may seem ‘negative’ to create stronger bonds. To restate, it was hypothesized that disclosing a mental disorder would lead to lower ratings in performance in the workplace, intelligence, and handling a situation calmly. However, the responses do not confirm this hypothesis. Thus, it is important to understand some of the flaws in the experiment to gather more conclusive data.

Research Participants

Method

The forms used for the experiment were circulated via social media where followers viewed an Instagram story that explained the social experiment on impression formation. On the same slide, research participants were informed that their participation included filling out a form that would take 10-15 minutes to complete. The link given to research participants randomly assigned which of the two links they would complete. Social media seemed to be the best way to distribute the form given the time frame; on Instagram, the form would be shared instantly and the research participants would all have the same incentive: helping who they followed on social media.

Administration and Random Assignment

The link to access the Google Form was circulated online via Instagram. Research participants were randomly assigned one of two forms.

The Targets

Between the four targets in the vignettes, there was one young male (8), one young female (17), one older male (68), and one older female (42). The ages and genders of the targets were deliberately selected to gather insight into a diverse set of targets.

Experimental Stimuli and How They Were Comprised

The form had nine parts. The order of the questions in the individual parts was randomized. One section asked questions about the research participants’ demographics. After the demographics portion, a vignette was described and then the research participants were asked to provide their opinions of the target as an open-ended question. Then, the research participants were asked to score the targets on a scale of one to seven on thirteen personality traits/qualities. The thirteen traits were empathy, authenticity, kindness, extroversion, intelligence, easily frustrated, openness, ability to perform well in the workplace, conscientiousness, neuroticism (worrying frequently and easily slipping into anxiety and depression), agreeableness, selflessness, trustworthiness, and how calmly/well the target would be able to handle a stressful situation (Pappas & Biggs, 2021). The same format was repeated for the other three vignettes. Open-ended responses were featured to collect reasoning and thought into why research participants selected certain ratings.

Format of the Forms

Each form included four paragraph-long vignettes which disclosed the targets’ names, the targets’ ages, and a problem or accomplishment they encounter[ed] in the span of three days. The vignettes were written in the first person, with the target as the narrator. Across the four vignettes, the order of the information disclosed was the same. The only difference between the two forms was that in one form the target disclosed a mental disorder after they disclosed their age, and in the other form, the target did not disclose a mental disorder. The four mental disorders disclosed were bipolar disorder, anxiety disorder, ADD, and PTSD.

Results

Surprisingly, the two overall means between the high and low self-disclosure forms were not significantly different. By conducting statistical tests, it delineated that there was no statistical difference between the two overall means of the two forms. As shown in the table below, the only marginally statistically significant T-value was found in the vignette disclosing anxiety disorder: 1.811. If people did have different ratings it was not caused by the disclosure of a mental disorder. Thus, no conclusive evidence was found that disclosing a mental disorder affects people’s ratings of the thirteen traits listed above. Interestingly, when the target disclosed that he had PTSD, research participants rated him higher on the scale of calmly handling a stressful situation. In the three other vignettes, it was the opposite for this trait. The greatest difference between the means of vignettes was in the anxiety disorder vignette where the target disclosed he had anxiety. However, these differences were not statistically significant, but showed a slight trend in the data.

Discussion

Due to methodological errors in this preliminary experiment, no conclusive data was found. The results would be more indicative and conclusive with a larger sample size. Given the amount of content on the internet that describes the debate on whether or not to disclose a mental illness, this is an important issue that needs to be studied and there is still a need for conclusive data on this subject.

As an article from Psychology Today also notes, the stigma surrounding mental disorders can cause individuals to hesitate to disclose a mental disorder due to not wanting to be labeled negatively or a fear of rejection (Susman, 2021). One article written in 2013 disclosed that 70% of the global population with a mental disorder does not receive treatment (Thornicroft et al., 2013). Some factors which prevented individuals from receiving treatment for a mental disorder were a lack of knowledge about mental disorders, ignorance surrounding accessing treatment, and stigma attached to mental disorders (Thornicroft et al.). Similarly, data collected by the Substance Abuse and Mental Health Services Administration in 2020 found that 46.2% of adults in the U.S. with a mental disorder receive mental health services (Mental Illness, 2022). That means that over half the adults with a mental disorder in the U.S. did not receive treatment. There is both a lack of education and misinformation surrounding mental disorders which can cause misconceptions and lack of treatment (Shrivastava et al., 2012). Therefore, educating individuals on mental disorders can help eliminate stigma. Understanding people’s attitudes towards mental disorders can be beneficial to understanding specific causes of stigma which is why gathering data on this subject is crucial.

Limitations

This preliminary study had four major limitations. First, the research participants in this experiment were part of a convenient sample. Since all research participants were gathered through a message on social media, the motive- of the research participants who opted to complete the form circulated via Instagram- might have tampered with the accuracy of scores they assigned to targets. In contrast, using the data of randomly selected participants who are not incentivized to complete the form in order to assist someone they know personally might produce more authentic scores. Second, there was no preliminary testing to uncover any preconceptions related to the targets’ names, mental disorders, and targets’ problems described in the vignettes. This might have led to certain research participants answering the questions with a different perception which may have affected the results. Third, due to the time and resource constraints in which this experiment was designed and conducted, only a small number-twenty-eight participants, to be exact- of research participants filled out the survey. Thus, the confidence level in the certainty of data is less than ideal.

Tables

References

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Appendix A

Vignettes Given to Research Participants in the First Form Where the Target Disclosed a Mental Disorder in the Same Sequence as the Form

My name is Anna. I am 17 years old and have bipolar disorder. Yesterday, I was jogging in my local park and when walking to my car, a biker crashed into me. Quickly, an ambulance came and I went to the hospital. I am a competitive pianist and have a competition in a week so I was nervous and needed to make sure I was okay and could recover quickly. I got an x-ray and luckily I just had bad bruising. Since I was in so much pain, I missed my classes today but emailed my teachers to make sure I would not miss any material. I now am going to try and finish my work. Tomorrow, I will meet with my teacher to discuss whether or not I should compete.

Figure 1: Anna’s Vignette (Bipolar Disorder)

My name is Max. I am 8 years old and have an anxiety disorder. I have a soccer game after school in 2 days and have been practicing a lot to prepare. I feel pretty good about my progress but am working on my free kicked as I missed one during the last game. After soccer practice today, I have to go home and get ready for my friend’s birthday party. I bought him a gift two days ago and hope that he likes it. I also have another birthday party after my soccer game in two days, but I feel that I might be too tired to go after the game. Well, I will see how it goes.

Figure 2: Max’s Vignette (Anxiety Disorder)

My name is Jane. I am 42 years old. I am a professeur and have ADD. I just finished grading my students’ tests and am now having a cup of coffee. I did not expect this week to be so hectic but luckily it was a good type of hectic. Two days ago, I received an email from the school board with the news that I earned a promotion. I hesitated to open the letter as letters from the school board do not often come with good news, but was happy to feel that my work was being acknowledged. Then, yesterday, I attended my sister’s wedding. It was nice to be able to spend time with my family after a while.

Figure 3: Jane’s Vignette (Attention Deficit Disorder)

My name is Ted. I am 68 years old. I am a real estate agent and have PTSD. The last 3 days have given me new insights. 2 days ago I was at a work conference in the morning and then flew to an awards ceremony for my colleague in the afternoon. Yesterday, I flew to Hawaii with my family for a much-needed family vacation. On the way to the airport, I saw a car crash which made me feel very nervous. In fact, I almost stopped in the middle of the road. Luckily, I was able to calm myself down and continue driving.

Figure 4: Ted’s Vignette (Post Traumatic Stress Disorder)

Appendix B

Vignettes Given to Research Participants in the First Form Where the Target Did Not Disclose a Mental Disorder in the Same Sequence as the Form

My name is Anna. I am 17 years old. Yesterday, I was jogging in my local park and when walking to my car, a biker crashed into me. Quickly, an ambulance came and I went to the hospital. I am a competitive pianist and have a competition in a week so I was nervous and needed to make sure I was okay and could recover quickly. I got an x-ray and luckily I just had bad bruising. Since I was in so much pain, I missed my classes today but emailed my teachers to make sure I would not miss any material. I now am going to try and finish my work. Tomorrow, I will meet with my teacher to discuss whether or not I should compete.

Figure 1: Anna’s Vignette (Bipolar Disorder)

My name is Max. I am 8 years old. I have a soccer game after school in 2 days and have been practicing a lot to prepare. I feel pretty good about my progress but am working on my free kicked as I missed one during the last game. After soccer practice today, I have to go home and get ready for my friends birthday party. I bought him a gift two days ago and hope that he likes it. I also have another birthday party after my soccer game in two days, but I feel that I might be too tired to go after the game. Well, I will see how it goes.

Figure 2: Max’s Vignette (Anxiety Disorder)

My name is Jane. I am 42 years old. I am a professeur. I just finished grading my students’ tests and am now having a cup of coffee. I did not expect this week to be so hectic but luckily it was a good type of hectic. Two days ago, I received an email from the school board with the news that I earned a promotion. I hesitated to open the letter as letters from the school board do not often come with good news, but was happy to feel that my work was being acknowledged. Then, yesterday, I attended my sister’s wedding. It was nice to be able to spend time with my family after a while.

Figure 3: Jane’s Vignette (Attention Deficit Disorder)

My name is Ted. I am 68 years old. I am a real estate agent. The last 3 days have given me new insights. 2 days ago I was at a work conference in the morning and then flew to an awards ceremony for my colleague in the afternoon. Yesterday, I flew to Hawaii with my family for a much-needed family vacation. On the way to the airport, I saw a car crash which made me feel very nervous. In fact, I almost stopped in the middle of the road. Luckily, I was able to calm myself down and continue driving.

Figure 4: Ted’s Vignette (Post Traumatic Stress Disorder)

About the author

Riya Daga

Riya is a senior at Horace Mann. She is a semi-pro racecar driver who is also passionate about skincare, the business of Formula 1, entrepreneurship, and ultimate frisbee. She lives in Englewood Cliffs, NJ and loves playing Connect Four and cards.

The post The Influence of Disclosing Mental Disorders on Impression Formation appeared first on Exploratio Journal.

“I think I have OCD because I want everything to be neat.”

Obsessive-Compulsive Disorder is one of the most well-known mental illnesses. However, it’s also one of the most misunderstood. Often when someone says, “I think I have OCD,” they’re referring to the fact that they always like to keep things organized. This, however, is not true. OCD symptoms consist of obsessing over the tiniest things. The obsession leads to constant anxiety and crushing stress. It’s not just someone wanting everything to be neat. People with OCD face repeated intrusive thoughts that mix with fear or danger. [1]

The fear that envelopes those with OCD can materialize as a need for symmetrical arrangement, although everyone’s symptoms differ based on their doubts in themselves and other internalized concerns. People who genuinely have OCD do not simply engage in excessively detailed practices because they feel like it. They constantly have these compulsions because of the anxiety that’s weighing on them; for example, the constant need to check on their family members or loved ones to make sure that they’re safe. [2]

According to www.helpguide.org, the cycle of OCD includes 1; an obsessive thought taking over someone’s mind. 2; the anxiety that comes along with not being able to control the thought. 3; compulsive behaviors such as repeatedly tapping or touching an object. 4; the temporary relief. Upon reaching the final step, the cycle starts again. These continued thoughts are what makes OCD such a severe illness and not something to joke about. [2] Patients who have it describe it as a ‘mental discomfort’ that leads to anxiety and fear. [5]

Simply because someone prefers everything to be neat does not mean that they have OCD. This common misconception can lead to others believing that this illness is not as severe and profound as it truly is. Bystanders will think that it is okay to use the term “OCD” lightly. 

When people see the symptoms and effects of OCD, they start to say things such as, “calm down, nothing bad will happen,” or, “the stove is off, don’t recheck it, it’s fine.” [3]However, for someone who truly suffers from OCD, these obsessions cannot just be cured by “calming down.” This is a severe chronic illness that deserves more attention. These obsessions and compulsions are almost outright impossible to control without medical help. [3] The thought itself is caused by a disturbance between the frontal cortex of one’s brain and the ventral striatum. Patients cannot just “calm down” when in the cycle of OCD because it is near impossible to control their anxiety. [4]

My research aims to identify the frequency of misinterpretation of OCD as well as the adverse effects that such misinterpretation may cause on those who have OCD. My study analyzes existing data on the prevalence of OCD, including self-developed surveys of individuals with and without OCD.

How OCD is Mischaracterized

Having OCD misinterpreted is extremely disrespectful to actual patients suffering from the disorder. Over 1 percent of Americans suffer from OCD. [6] Yet around 66% of Americans say that a dirty home makes them feel anxious.[7] These two types of anxiety are completely different. While OCD is a serious mental illness affecting 2.2 million Americans, feeling anxious about a dirty home is a common anxiety shared among over half of the population. There are so many people among these patients who hide their symptoms from embarrassment or fear. [8] Joking about OCD is extremely disrespectful and embarrassing to those who suffer from the illness. Saying “I’m so OCD” can blur the line between a devastating disorder and a regular need for neatness. People are stripping the illness of its severity, and this also applies to any illness. This can make it extremely hard for people to seek help. [9]

Making light of this extremely serious mental illness is not only insensitive, but extremely detrimental to a patient. Those with OCD might feel as though their very real symptoms and obsessions aren’t as important, leading them to avoid seeking help. Making a joke of OCD, or saying that one has it is making fun of an extremely tortuous routine that patients have to go through daily. Those who mischaracterize OCD are contributing to the stigma that has made many patients hide their illness for years and years. People are joking about patients who have to go through exhausting rituals as well as intrusive thoughts just to sound “quirky and different.” [8]

There are multiple scenarios where people mischaracterize OCD. The seven main ones include: Keeping a tidy living space, worrying about an upcoming event, wanting to arrive somewhere early, being a “perfectionist,” wanting to wash one’s hands, hanging onto things one doesn’t use anymore, and finally checking and then double-checking things. [10] Each of these examples are common anxieties among people who don’t have OCD. All of these things might annoy or bug someone, but it’s not to the extent of OCD, and it doesn’t have as negative of an impact on people, says a licensed psychologist Dr. Crystal I. Lee. [10]

A lot of things that annoy the usual person doesn’t affect them the same way as an obsession would affect a patient with OCD. OCD is much more extreme and it takes up so much more time in a patient’s life. The reason why OCD is so mischaracterized is because of the lack of education. Most people don’t easily come across information on certain illnesses because it doesn’t affect them, and they don’t search it up. OCD is also extremely misportrayed in the media. There’s a false representation of the mental illness. It’s usually represented mainly around a fear of germs and cleaning compulsions. When the majority of people look at the media and see this, it doesn’t give a clear picture of OCD. They feel like OCD is just what the media portrays it as. [11]

What It Truly Means to Have OCD

Charlotte, an anonymous contributor to the mental health awareness website www.mind.org, says OCD is like a constant fear of not being able to complete something the right way. She lives with obsessions taking over her thoughts daily. He also has rituals to get rid of those obsessions, which are called compulsions. She says that these compulsions are extremely horrific, especially because she has these thoughts on a daily basis. [12] Imagine having unwanted thoughts up to 20 times a day, and not being able to get rid of them. 

Mark Highet, a father and public servant from Queensland, Australia, says that even everyday actions like turning on a light switch can trigger his OCD. This can lead to anxiety, causing him to do rituals in order to forget about the obsessions. “For example, one day I was filling up my daughter’s water bottle,” he says, “and I had the thought that the water might be contaminated. I rationally knew it wasn’t, but I had this worry. So, I turned back to the sink, tipped it out and filled it again. I went to give it to her, but then I worried again, so I tipped it back out. I must have done it 40 times.” Mark goes on to say that it almost feels humiliating when someone from work sees him doing a ritual. He says that it feels like he’s so busy trying to live, that he’s forgetting to live. [13]

OCD isn’t just wanting everything to be neat. It’s about spending minutes to hours of one’s day trying to get rid of a thought that’s taking over one’s mind. For some, it might be “if I don’t do this, my family is going to get hurt.”[9] For others, it might be “If I turn something on, I might not be able to turn it off.” [13] These thoughts cause extreme and heavy anxiety among patients who have OCD. It can cause them to fear for their loved ones, because they think that they’ll end up hurting someone close to them. These thoughts aren’t just shallow little ‘what ifs.’ They are thoughts that can significantly impact a person’s life. It’s extremely complex, far past the point of wanting everything to be perfect. OCD can cause an overload of function systems in one’s brain. [14]

Having a constant obsession on one’s mind can lead to rituals. Rituals are an action that a patient performs when they try to forget about the obsession taking over their mind. For example, performing a repetitive activity, like locking, unlocking, and relocking a door. These rituals are usually performed physically to get rid of the muscle tension coming from obsessive thoughts. Rituals are usually described as mental and physical exercises that people with OCD perform to get rid of feelings such as disgust or anxiety. Rituals can also be performed to prevent a dangerous situation. People with OCD often can’t suppress their thoughts, which is why they cope through performing rituals. [15] Hattie Gladwell from metro.co.uk says that OCD takes up around 14 hours of her week every single week. [16] That’s over 8% of her entire week. These rituals aren’t actions that can be done only one or two times and solved. Patients spend hours and hours trying to get rid of their obsessions. 

Dangers of Mischaracterization

Charlotte at Mind.org also mentions, “anyone who says that having OCD is ‘helpful’ couldn’t be further from the truth. I may spend hours cleaning dishes and making sure my things are organised/symmetrical – but when will any of these compulsions benefit me? NEVER.” [12] Saying that OCD is beneficial to patients is disrespectful in and of itself because one is making a really serious mental illness seem like it’s benefiting a patient, even if in reality, it’s hurting them. 

Mark Highet has experienced jokes about OCD firsthand. He says, “At my work we have a regular meeting, where everyone goes around the table and updates on how they’re going. One day, one of my co-workers said, ‘Oh sorry, that’s so OCD of me,’ when she finished her bit. When I hear that, I think, ‘if only you knew.’ It’s a real, and really hard, condition.” Jokes like this can increase the stigma around OCD itself, which is harmful to people who are seeking help. It’s a real mental health issue, and no laughing matter. Michelle Blanchard says that “OCD is often appropriated as a casual term but trivialising it only adds to the stigma that often prevents people from seeking help.” [13]

Serena Ata from the website inkspire.org says that she wasn’t able to fully diagnose her OCD because of the stigma around the disorder. All of her symptoms were viewed as “normal” because people said that all her compulsions were things that she would grow out of. Serena says that making jokes about OCD is extremely damaging to patients who suffer from the  disorder. For her, she had to spend years scrolling through the internet to try and find an answer and a reason as to why she was spending hours of her week on rituals. “Unfortunately, many sufferers find themselves dependent on unreliable platforms for answers, often leading to a vicious cycle of misinformation, misunderstanding and misdirection.” [17]

It can take up to 17 years on average for people to receive an OCD diagnosis. [18] Only about 200,000 people with OCD seek therapy out of the 4.1 million people who need the treatment. [19] When patients view the media and see OCD being portrayed as a simple little quirk, they won’t seek out help, and they won’t try to get treatment. Patients would feel like their symptoms are normal, and they put it aside. Mischaracterizing OCD can lead to actual patients taking years and years to seek the treatment that they actually need. This can harm the patients themselves, because OCD symptoms can progressively get more intense. OCD symptoms get worse with age, so when patients don’t seek help at a young age, it would be harder for them to deal with it. [20]

Conclusion and Further Guidance

Mischaracterizing OCD can lead to patients not getting correct treatment, and patients feeling like their mental illness isn’t actually serious. It harms the OCD community by joking about a mental illness that’s extremely legitimate. Mischaracterizing OCD can also add to the stigma around the topic. When the media portrays OCD as something light and fun, it can lead to patients feeling like their symptoms aren’t important, even though they are. If any individuals have ever made a joke about OCD or have mischaracterized OCD, they should do their best to educate themselves on the topic. One should start to take this disorder more seriously from now on, and do one’s best to support patients with OCD as best as they can.

If someone knows a family member or friend who has OCD, the Victoria State Government Department of Health recommends that one should first make sure to educate themselves on their family member’s disorder. When people have connections with patients, it can ease the tension around their relationship. When they’re performing a ritual, one shouldn’t participate in the rituals themselves, because it could reinforce OCD behaviour and it could lead to symptoms potentially getting worse. [21] Though one shouldn’t assist them in the rituals themselves, they should remind them that it shouldn’t be something that they’re embarrassed about. They should make sure that they’re getting the right treatment like professional help. 

In the event that a patient starts to lose motivation in seeking help, close relatives and friends should continue supporting them. If they start to have less motivation to go get treatment, studies say that individuals should make sure that they remind patients about the progress that they’ve made through the whole process. Seeking help isn’t a sign of weakness, it’s a sign of strength. [21] It shows that they’re trying to treat their disorder. The general public can also help with maintaining a non-judgemental attitude, which can help as well, because patients know that their obsessions are irrational. Finally, the Victoria Department of Health recommends encouraging patients and rewarding them for the gains they’ve made. Most importantly, accept patients for who they are, and don’t ridicule them for their rituals. Supporting a patient with OCD is the best thing to do when they’re going through a difficult time. 

Works Cited:

[1] Benenden Health. (n.d.). OCD: Myths vs Reality. Benenden Health. Retrieved May 7, 2021, from https://www.benenden.co.uk/be-healthy/mind/ocd-myths/ 

[2] Smith, M., Robinson, L., & Segal, J. (2021, February). Obsessive-Compulsive Disorder (OCD). Help Guide. Retrieved May 7, 2021, from https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm#:~:text=Common%20compulsive%20behaviors%20in%20OCD,senseless%20things %20to%20reduce%20anxiety. 

[3] Ryback, R. (2016, May 9). 4 Myths About OCD. Psychology Today. Retrieved May 7, 2021, from https://www.psychologytoday.com/us/blog/the-truisms-wellness/201605/4-myths-about-ocd 

[4] Pronghorn Psych. (n.d.). How Obsessive Compulsive Disorder Affects the Brain. Stone Ridge. Retrieved May 7, 2021, from https://pronghornpsych.com/how-ocd-affects-the-brain/#:~:text=Researchers%20know%20that%20obsessive%2Dcompulsive,known%20as%20 the%20ventral%20striatum 

[5] Mind. (2019, May). Obsessive-compulsive disorder (OCD). Mind. Retrieved May 7, 2021, from https://www.mind.org.uk/information-support/types-of-mental-health-problems/obsessive-compulsive-disorder-ocd/about-ocd/

[6] ADAA. (2021, October). Facts & Statistics. Anxiety and Depressions Association of America. Retrieved May 18, 2021, from https://adaa.org/understanding-anxiety/facts-statistics#:~:text=Crisis%20(Oct%202020)-,Obsessive%2DCompulsive%20Disorder%20(OCD) ,cases%20occurring%20by%20age%2014.

[7] Heinz, A. (2019, October 7). Survey: Americans More Annoyed With Clutter Than Dirt. Apartmentguide. Retrieved May 18, 2021, from https://www.apartmentguide.com/blog/americans-annoyed-with-clutter/

[8] George, N. (2014, September 3). When It’s Not Just OCD. Everyday Health. Retrieved May 10, 2021, from https://www.everydayhealth.com/news/when-its-not-just-ocd/?pos=2&xid=nl_EverydayHealthMentalHealthandMoodDisorders_20171015 

[9] Gallagher, W. (2017, October 23). You’re Actually Not “So OCD,” And Here’s Why You Shouldn’t Joke About It. Rolling Hills Hospital. Retrieved May 10, 2021, from https://rollinghillshospital.org/youre-actually-not-ocd-heres-shouldnt-joke/#:~:text=Unfortunately%2C%20for%20about%202.2%20million,OCD%20is%20no%20laughing %20matter.&text=You%20may%20not%20realize%20it,who%20deals%20with%20the%20disorder 

[10] Steber, C. (2018, January 30). 7 Symptoms That Are Wrongly Mistaken As OCD. Bustle. Retrieved May 19, 2021, from bustle.com/p/7-symptoms-that-are-wrongly-mistaken-as-ocd-8026866 

[11] D’Arcy-Sharpe, A.-M. (2020, January 6). Why Is OCD So Misunderstood And Misdiagnosed? IMPULSE. Retrieved May 19, 2021, from https://impulsetherapy.com/why-is-ocd-so-misunderstood-misdiagnosed/ 

[12] Charlotte. (2016, June 23). Living with OCD. Mind. Retrieved May 7, 2021, from https://www.mind.org.uk/information-support/your-stories/living-with-ocd/ 

[13] Queensland Health. (2018, October 10). What is it like to live with obsessive compulsive disorder? Queensland Government. Retrieved May 11, 2021, from https://www.health.qld.gov.au/news-events/news/living-with-obsessive-compulsive-disorder-OCD-symptoms-treatment-Queensland 

[14] International OCD Foundation. (2016, October). OCD – Misunderstood and Misdiagnosed | Orlando OCD Therapist Raises Awareness #OCDWEEK. Ground Work Counseling. Retrieved May 11, 2021, from https://www.groundworkcounseling.com/ocd/ocd-misunderstood-and-misdiagnosed-orlando-ocd-therapist-raises-awareness-ocdweek/#:~:text=A%20misdiagnosis%20of%20OCD%20has,management%2C%20 hospitalization%20and%20inaccurate%20reporting.

[15] Pulse. (n.d.). OCD Rituals: Symptoms and Treatment Options. Pulse. Retrieved May 11, 2021, from https://pulsetms.com/ocd/rituals/ 

[16] Gladwell, H. (2018, January 26). How much time OCD rituals take out of my day-to-day life. METRO. Retrieved May 19, 2021, from https://metro.co.uk/2018/01/26/how-much-time-ocd-rituals-take-out-of-my-day-to-day-life-7259595/ 

[17] Ata, S. (2020, November 2). “So OCD”: The Consequences of Delegitimizing a Disorder. INKSPIRE. Retrieved May 19, 2021, from https://inkspire.org/post/so-ocd-the-consequences-of-delegitimizing-a-disorder/-MHg9RS6V1RColwvc–S

[18] NOCD Staff. (2020, December 15). How Long Does OCD Treatment Take? NOCD. Retrieved May 19, 2021, from https://www.treatmyocd.com/blog/how-long-does-ocd-treatment-take

[19] Gershkovich, M., Middleton, R., Hezel, D. M., Grimaldi, S., Renna, M., Basaraba, C., Patel, S., & Simpson, H. B. (2020). Integrating Exposure and Response Prevention With a Mobile App to Treat Obsessive-Compulsive Disorder: Feasibility, Acceptability, and Preliminary Effects. ScienceDirect. Retrieved May 19, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S0005789420300666

[20] Penn Psychiatry. (n.d.). OCD: SOME FACTS. Perelman School of Medicine. Retrieved May 19, 2021, from https://www.med.upenn.edu/ctsa/forms_ocdfacts.html#:~:text=Symptoms%20fluctuate%20in%20 severity%20from,symptoms%20were%20disrupting%20their%20lives.  

[21] Obsessive compulsive disorder – family and friends. (n.d.). BetterHealth. Retrieved May 27, 2021, from https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/obsessive-compulsive-disorder-family-and-friends 

[22]Dogra, T. (2020, July 22). Obsessive-Compulsive Disorder (OCD): Symptoms, Treatment And Diagnosis. Onlymyhealth. Retrieved June 1, 2021, from https://www.onlymyhealth.com/obsessive-compulsive-disorder-ocd-symptoms-treatment-diagnosis-1595417322 

About the author

Sophia Zhang

Sophia is a student at the Shanghai American School – Puxi Campus.

The post Obsessing Over Obsessive Compulsive Disorder: The Damage Done by Mischaracterizing OCD appeared first on Exploratio Journal.

Abstract

The purpose of this paper is to inform young adults, possible employers of those with autism, and those interested in learning more about the stigmatization of autism within society. Autism is one of the most common neurological differences – yet is all too often misunderstood. Though a relatively new term, introduced in the 1900s, autism has existed within human societies for far longer – but was only medicalized and treated as a disorder much more recently. Many of those with it have demonstrated incredible intellectual and artistic talent, making autism a catalyst for bringing diversity into society. The isolation and ostracization that many of those on the spectrum experience is not only completely unjustified and morally wrong, but it is also detrimental to all of humanity when these unique individuals’ talents are being suppressed and their voices’ muted. Does it have to be this way? Companies like Ernst and Young are adopting new programs designed to help bring the neurodiverse into the workforce, putting these individuals’ incredible talents to meaningful work. Modern movements centered around equality have also aided in forming an environment conducive to change, an environment where the needs of those with autism can be brought to light. If we all work together to support those with autism, including them in the workplace, friend groups, and social events, we can break the stigma around those that do not fit in to what is perceived as “normal”.

Introduction

“Most people see what is, and never see what can be.” ~ Albert Einstein

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder used to describe an ever-increasing number of the world’s population. A recent CDC study indicates the prevalence of autism is now as high as 1 in 40 children, a remarkable increase from 1 in 125 children just ten years earlier. (CDC, Data & Statistics on Autism Spectrum Disorder, 2020) In 2013, The American Psychiatric Association updated the diagnosis for autism in the release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The disorder involves deficits in both social communication and social interaction combined with repetitive or restrictive patterns of behavior and thoughts. The use of autism to define people is relatively new; the term was coined in the 1940s and added to the DSM in 1994 (Zeldovich, 2018). As a spectrum, ASD incorporates an ever-growing number of traits. This array of traits has meant that vastly different people can fall under this single term; this wide range has prompted skepticism, even criticism, from a culture that seems to forget its most fundamental teaching about accepting and celebrating diversity.

In the struggle to be “normal” and “fit in,” people with autism all too often lose that spark that makes them unique. However, as a society, do we want to criticize people for their differences or celebrate them for their unique attributes and perspectives? This paper will explore how autism is more than a neurodevelopmental disorder and instead an enormous opportunity to add diversity and enhancement to our American society.

As Americans, we believe the hallmark of being human is uniqueness – everyone possesses distinct traits. We champion the rhetoric that everyone is an individual, and in theory, we celebrate the person who “marches to the beat of their own drum.” We are encouraged to champion and celebrate diversity, but sadly, we become uncomfortable with people who are perhaps a little too different. In one study on individuality and difference in American culture, researchers found that Americans’ “cultural-based values of independence do not promote the development of mental tools needed to take into account another person’s point of view” (Keysar, 2007). We tend to overlook this when interacting with an individual with autism. In short, as a society that champions diversity, we struggle to accept people capable of bringing that diversity to it.

Individuality

ASD is a broad diagnosis encompassing those that are low functioning and in need of substantial support, to those who are high functioning, needing very little support. Since childhood, I have developed a unique perspective on ASD, having been surrounded by friends and family on both sides of the spectrum. While I understand the fundamental need for early diagnosis and intervention as a substantial benefit for people with autism, I found that the label of ASD can create bullying and prejudice as so many do not understand the varying degrees of this “disorder.” Those that look “normal” and do not broadcast their diagnosis (or outwardly identify as having an ASD diagnosis) are expected to act normal. Those people who appear to pass as “normal” based on looks and disposition are often the ones subjected to more ridicule and bullying.

When a person who looks “typical” acts differently from what others would expect, they are called strange and ostracized. The uncomfortableness that much of society feels towards these unique individuals can snuff out the light that people with autism bring. I have heard stories from all of my autistic friends about being called “retarded,” “mental,” and “weird” at some point in their lives. These insults can result in internal trauma, causing them to further distance themselves from the outside world, and research finds these experiences cause deleterious outcomes (Hoover, 2018). While many with autism struggle to understand specific social cues, they are prohibited from further learning and practicing those social skills with their “neurotypical” peers and colleagues because of society’s ignorance of the condition. A study found that ASD children are bullied three to four times more than non-disabled peers, negatively impacting their mental health (Hoover, 2018).

Contributions and gifts

The neurodiversity movement aims to remove the stigma of “abnormal,” believing that eliminating the stigma surrounding an ASD diagnosis would build resilience in children with ASD (Schmid, 2019). Nurturing self-esteem in children and teens and encouraging them to embrace their uniqueness can prepare them to handle the challenges they will face in college and adulthood when seeking employment.

Furthermore, despite people with autism facing social-environmental challenges, ASD can also come with notable advantages. Many people with autism have exceptional long-term memories, intelligence, perception in their senses, and sometimes a better understanding of animal behavior (Crespi, 2016). In the past, many distinct cultures recognized the diversity within their society and adapted to it – even going so far as embracing these differences. While there is no concrete evidence, as again, the term ASD is relatively novel, many experts agree that certain well-respected timekeepers, mathematicians, and scientists of the ancient world, may have also been on the autism spectrum.

Psychologist Simon Baron-Cohen from Cambridge University and many other leading psychiatrists have claimed that Albert Einstein showed signs of ASD (Buchen, 2011). Einstein’s work on relativity revolutionized the world’s understanding of the universe, and his discovery of the photoelectric effect won him a Nobel Prize for Physics in 1921. In an era when ASD labeling did not exist, it led to significant discoveries from individuals now thought to have had ASD. Simon Baron-Cohen also thinks autism is more prevalent in families of scientists and engineers (Buchen, 2011). Her research even found a genetic link between mathematical talent and autism; they found a three to sevenfold increase for ASD among first-degree relatives of mathematicians (Baron-Cohen, 2007).

The idea that Autism Spectrum Disorder is a disorder assumes that it must be “cured,” not allowing the individual to be seen as an example of the diversity present in the human condition. When observing actor Sir Anthony Hopkins, who was diagnosed with ASD later in life, we see an example of autism not as a disorder that needs to be “cured” but as a condition that adds to human diversity in society. He has won many accolades, including an Academy Award, two Emmys, and knighted by Queen Elizabeth II for service in the arts. (Gannon, 2017) When asked if ASD helped him with acting, he stated, “I definitely look at people differently. I like to deconstruct, to pull a character apart, to work out what makes them tick and my view will not be the same as everyone else (Gannon, 2017).” That difference in view makes us all, particularly those on the spectrum, unique and an essential contribution to society.

Furthermore, as artificial intelligence and computer science extend their reach to all parts of society, a demand for those skilled in the medium increases. Many people with autism have shown exceptional expertise in pattern recognition, information analysis, and other foundational skills of technology (Auticon, 2019). From the Institute of Cognitive Neuroscience at UCL, Professor Lavie found autistic individuals could focus and process information more quickly without distraction (Remington AM, 2012). She states, “Our study confirms our hypothesis that people with autism have higher perceptual capacity compared to the typical population (Castillo, 2012).”

This innate aptitude over an average neurotypical person makes many on the spectrum ideal candidates for jobs that work in the burgeoning field of IT. In fact, around 51% of workers with ASD carry higher skills than what their current job entails, yet less than 1 in 6 adults with autism have a full-time job (Twaronite, 2019). Why is this? Frequently, when a person on the spectrum is interviewed for an occupation- even if they have been educated for years and excel at the particular work required for the job- they are rejected simply based on social quirks (2019). The extraordinary skills and unique perspective of individuals with autism have been dismissed by a culture that cares more about social norms and fitting in than diversity and workplace improvement. A company making this change is Ernst and Young (EY) through a neurodiversity program initiated by executive Hiren Shukla. He recalls telling his boss, “you have this population of neurodiverse individuals that are known to be extremely detail-oriented, extremely logical, and process-focused. We are moving into emerging technology and we need to think differently to disrupt ourselves — where are we going to find this skill set?” He advocated that some individuals with autism are quick at learning new technologies and would boost the firm’s bottom line (Lebowitz, 2019). In a pilot project at EY, “neurodiverse EY employees saved roughly 800 hours for the firm (which translated to $100,000 in cost savings) when they redesigned an automation process (Lebowitz, 2019).” They have developed a neurodiversity program to hire even more neurodiverse individuals throughout the company nationwide. They have received recognition by increasing innovation and productivity with this program, while helping other companies follow this path, and give hope to those with autism (Twaronite, 2019).

Culture

Culture plays a significant role in the stigmatization of differences, both within ASD and outside the spectrum. Culture influences our behaviors, and therefore local norms can significantly impact the response to typical autistic mannerisms. In South Africa, for example, it is considered disrespectful to look directly at an adults’ eyes whilst in conversation (DeWeerdt, 2012). Meanwhile, lack of eye contact is a trademark of autism and is commonly considered an indication of having autism- a diagnostic trait that is often dismissed in South African culture (Erickson & Shaffer, 2017). Western clinicians might overlook such local/cultural norms and misdiagnose, causing severe problems for both the patient and the understanding of autism by society. A famous example of another stigmatized mental difference is epilepsy; although, among specific Hmong populations, epilepsy is revered. It is said that epileptic individuals within Hmong society often become shamans – a highly respected group within that culture, a view not shared in our western diagnostic methods (Fadiman, 1998).

In addition, the media has also had a significant impact on how the general population views autism. Frequently, the media (movies, television series, and books) is a major source of information that neurotypical people have to learn about the disorder. Autism is commonly dramatized in shows like Sherlock Holmes in Sherlock on the BBC, Shaun Murphy in The Good Doctor on ABC, and Sheldon in The Big Bang Theory. These shows only depict a small portion of autistic individuals, and they either portray the savant nature of the disorder or use it as comic relief, thus seriously undermining the vast majority of individuals with autism who do not fall into these select categories. Even as the media tries its best to show the bright sides of autism and aims to have as realistic of an outlook as possible, like Sam Gardner on Atypical, it can still create the same negative consequences. When real people let neurotypicals know of their diagnosis, they are assumed to be like those depicted on television. When they “do not hit the mark,” it can result in them being bullied and misunderstood. As a society that is revisiting and revising our racist, sexist and discriminatory history, we are broadening our perspectives of others and becoming more inclusive – but when it comes to the neurodiverse, we still have more work to do.

Social communication and interaction

Through my interactions with autistic friends, my cousin, and kids I interact with in my organization, Connect A Kid, my personal experiences have allowed me a unique perspective into the clinical diagnosis for autism: deficits in social communication and social interaction of autistic traits (CDC, Diagnostic Criteria, 2020). I have developed a keen awareness of the breakdown those with autism face in developing and maintaining reciprocal relationships and the deficit in nonverbal communicative behavior, such as body language. Connect A Kid was formed to provide the neurodiverse with nurturing social interaction with neurotypicals who understand these deficits. It helps both neurodiverse and neurotypicals understand one another and helps form meaningful relationships.

To investigate autism in children more fully, I interviewed Tim Kowalski, MA, CCC, a social pragmatic who works with neurodiverse individuals. I learned that the majority of individuals with autism often lack understanding of the hidden rules of life, the ones neurotypicals instinctively pick up on. According to Dr. Kowalski, neurotypicals go to school and generally know what to expect from a strict teacher and a relaxed instructor on the first day of class, while the neurodiverse often do not see this. He stated that the time and place of appropriate behavior is something they often miss. They may not understand that math class behavior is different from the lunchroom. The basic understanding of body language is challenging; facial expressions and, more importantly, the nuance of tone is something they work hard on (2021). I learned from him that autistic individuals have a hard time distinguishing between “sit down” [harsh tone] vs. “sit down” [soft tone] – a big difference to neurotypicals. Thus, in turn, this gets them into a great deal of trouble in social situations. My understanding is that they do not always comprehend how the difference plays a prominent role in such empathetic interactions. When repeatedly interacting with people who fail to understand this, the individual with autism can be left with “emotional overlays”; they struggle to grasp why the world is so harsh and punishing them (Kowalski, 2021).

Behavior aspects

From personal experience, the clinical diagnosis for autism under behavioral aspects is commonly encountered among those I interact with. It incorporates repetitive motor movements, insistence on routines or ritualized patterns or behavior, and a hyper or hyporeactivity to sensory input (CDC, Diagnostic Criteria, 2020). The ASD-diagnosed individual can go on and on about a topic once it is on their mind. They find comfort in the repetition. (This is referred to as stimming, a repetitive stimulating behavior; common examples are stacking objects, rocking, repeating words, pacing, or even banging one’s head (Smith, 2018)) It mostly comes from stressful situations and can be triggered by fear. Understanding what to do under these circumstances is crucial. The primary importance is to avoid shaming and using nonjudgmental language. The idea of redirecting the behavior is what makes it difficult for neurotypicals to understand. Many autistic individuals crave routine to avoid the fear of the unknown, thus avoiding shaming (Smith, 2018).

My friend, when he was feeling overwhelmed or anxious, would repeatedly rock back and forth. If he did this at school, they would call him names, making the behavior even more pronounced. It was thought of as a bad habit at home, and it caused him a great deal of emotional scarring since he was unable to stop. Once he was diagnosed, his family and friends, including myself, would use the rocking to signal that he felt anxious and found ways to distract him or make him comfortable. More often than not, autistic children are left emotionally damaged from the interactions with neurotypicals even if that neurotypical person is sympathetic to the plight of the autistic child (Hoover, 2018).

Conclusion

My generation strives to be better and move positively towards diversity, equity, and inclusion. I believe we must change the way we look at all members of society, not just through the lens of race, ethnicity, and gender, for example, but also how we interact with all groups, including the neurodiverse. The year 2020 has brought renewed demands for justice throughout the world. These collective actions have been primarily focused on racial justice through movements like Black Lives Matter. The ideal that drives them is the establishment of a more just, equitable, and inclusive society for people from all backgrounds and orientations. Given the unjust murders of Black and Brown people by police, the violence experienced by African- Americans has understandably been at the center of these demands. Nevertheless, the movements are rooted in a belief in providing safe and equitable schools, communities, and opportunities. These same ideals are also necessary for the Autism community. Too often, kids with autism are mistreated and misplaced in school systems that do not understand their needs. As I have learned from interviewing Dr. Kowalski, young people with ASD can see themselves as broken, damaged, or simply not good enough due to their interactions with neurotypicals. In their struggle to “fit in” and be “normal,” they so often lose what makes them unique. Their individuality is silenced, and their unique voices are snuffed out. Ultimately, we all lose out by creating a less robust society, less informed, less varied. We attempt to create a cookie-cutter homogenous society where differences are unwelcome, leaving many emotionally scarred if they cannot meet the standard. As a society, we fall far short of meeting our fullest potential when our neurodiverse youth’s talents, creativity, and strengths are not developed, nurtured, and given the opportunity to contribute to the broader community. Clearly, it is not just the individuals that suffer because, as a whole, we all lose when potential contributions are foreclosed on. Does it have to be this way? I believe the answer is clearly, no.

References

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About the author

Jay Khemchandani

Jay is a rising junior at the Windermere Preparatory School in Florida.

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