Every show with a suicide now has a disclaimer with a suicide hotline at the beginning. Is there any evidence that these warnings make a positive difference?
I remember my college had a suicide awareness day where among other things they told people to tell their suicidal friends to call the hotline if they felt suicidal.
Now imagine you are that person and you reach out to a friend for help only to have them tell you to call someone else in a canned speech you were told to tell others.
Two sides to every story. Your friend isn’t your therapist and while instantly reacting with “go call hotline” means you don’t have a friend at all, you cannot expect your friend to be able to bear the weight of your feelings, of your darkest moments with you. Stuff like this ruins people and I know that from experience from both sides. Dealing with suicidal thoughts of other people is extremely stressful and basically a landmine field. You aren’t trained to navigate it properly. You are not objective. And ultimately, other than being a sympathetic ear, you are unable to help them in the way they need help.
Feeling suicidal usually isn’t something that talking to a friend can resolve.
Getting a suicidal person to access the right kind of help is the right move.
That doesn’t mean you refuse to talk to a suicidal person, it means that part of supporting them as a friend is helping them get help.
Also as someone who spent a lot of time when I was younger as an untrained suicide counselor, it’s rough on you. Suicidal people should reach out to friends, but understand that if your friends aren’t able to help or keep boundaries there it’s not you, it’s not you being a burden, they may love you very much, but they need to engage in self preservation and the experts have better coping mechanisms, are in therapy, and have professional distance. Being an untrained suicide counselor was both a form of self harm and working through my trauma. I did real good for others and I don’t really regret it, but if you’re feeling the urge to do it, either get trained or get therapy, ideally both. I did later get trained in a form of counseling relevant to my traumas and I’m still comfortable doing that, but suicide counseling is rough at the best of times like being an emotional emt. And like emts they want to get to you in time to help, so if you need them use them, but the untrained are more like first aid, they can keep you around until an emt can get you to a doctor.
Serious question: How do you tell someone suicidal that opens up to you, that you can’t handle the topic without making them feel worse?
“I care deeply for you and that’s why I’ll acknowledge I can’t give the help you need. You need an expert not just a friend, and I can’t hurt myself helping you”
Tone matters, like the difference between telling someone they should consider seeing a therapist, and telling someone they need a therapist.
In text it is still hard, but convincing someone to talk to a professional (not saying they are all doctors or something) because you don’t feel equipped to handle the situation on your own shouldn’t be devastating if you go through a small course like that. Never taken one but just off the cuff I’d say offering to call with them and staying for the conversation until you/they agree they feel comfortable carrying on with the help line or what not on their own before walking away would probably be a decent step in the right direction. The line could advise you of the next steps you might not be thinking of in that moment, getting them around other friends/family/bringing them to a medical professional, I’m sure it varies.
I wish I could opt out of those messages. On streaming platforms that should be doable! (I really hate spoilers.)
I predicted in about 10 years disclaimers at the beginning will include, ‘This show depicts murder. Neither the show’s creators producers or actors condone the taking of another human life.’
They need “This show depicts stupidity” but they will never have it.
I don’t think it’s about making a positive difference, it’s about liability.
I don’t doubt that someone might be thinking that, but I do doubt that any lawyer thinks it’s necessary. As far as I know nobody has ever brought suit against a TV show for a suicide case.
But I’m not an attorney.
Lawsuits of “my child died because they copied your TV show” have been going on for decades.
I’m pretty sure that 13 Reasons Why show had a whole thing involving just this
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
That said education on access to resources like 988 or other warm lines can lower suicide rates, maybe. Research is more mixed here because it’s difficult to prove causation
good points! this is a decent depiction of exposure therapy.
TW have an odd history. they originally were very useful, because one thing you forgot to mention about exposure therapy is all the work that needs to be done leading up to it. you have to have physical grounding skills in place before exposing someone to adverse stimuli.
so imagine you have severe PTSD from SA and a college class is gonna show a film that depicts it in an ugly scene. it could fuck up your whole semester to have traumatic stress symptoms come back unexpectedly. I’m talking panic attacks, flashbacks, mood disruption, difficulty controlling violent impulses, difficulty concentrating, difficulty connecting with others… PTSD can be wild.
so the prof might give a TW on the syllabus, so people just dont come in that day if they don’t wanna see it.
nowdays TW is just “here’s a thing you dont like!” not “here’s something that could potentially ruin your life again”
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
I’d be interested in seeing these studies.
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
These two paragraphs seem to contradict each other. Controlled access in a safe setting like a media depiction sounds great. That’s exactly what trigger warnings are for. How can you possibly do controlled exposure without knowing if the content is there or not?
Trigger warnings enable active avoidance.
Incorrect. Trigger warnings inform you that the content is present in the media you’re about to watch. What you do with that information is up to you.
https://journals.sagepub.com/doi/10.1177/2167702620921341 - the bigger takeaway from this one is that trigger warnings reinforce trauma as a central part of the traumatized individuals identity but they did find some incidence of drawback/harm
https://journals.sagepub.com/doi/10.1177/21677026231186625 meta finding no benefit and actually can cause an anticipatory reaction making the person more engaged with the material
There are others, this is just what grabbed from 30 seconds on google scholar. Its been a bit since I’ve done more serious lit review and it’s not like I keep a directory of papers I’ve read
The issue is the culture surrounding trigger warnings. Let’s be real here, people looking for trigger warnings are generally (perhaps overwhelmingly) not looking for material to help with their exposure therapy. They are looking for a “warning” to help them screen material to avoid. The issue is that this creates an unrealistic expectation that is incompatible with the real world. You can avoid suicide, sexual assault, eating disorders, or whatever in your media (maybe) but real life won’t sanitize itself or warn you. You will encounter these topics, whether through the news, careless speech from friends, or even intrusive thoughts of your own. Research continues to show that avoidance of upsetting topics can worsen anxiety and ptsd symptoms
To your final point the idea of it helping to create a choice isn’t even as clear cut as you describe
https://journals.sagepub.com/doi/10.1177/21677026221097618 content warnings actually increase the likelihood someone will view problematic content. This point is further reinforced by similar findings in the meta linked above
So you have a system that ultimately makes creators feel like they’re doing something noble, that is likely at best useless and potentially harmful. Said system increases the likelihood that a person will view the problematic content but also enables the reality that a person will simply avoid the things that provoke their anxiety which again is more strongly established as harmful
https://www.sciencedirect.com/science/article/abs/pii/S0005796712001064 - ptsd worsens with avoidance
https://www.sciencedirect.com/science/article/abs/pii/S0962184904000290 - anxiety disorders do the same
One tricky thing here is that existing literature is really examining the potential effects of trigger warnings in and of themselves, devoid of context or non-immediate decision making. Does seeing a literal trigger warning make someone feel less anxious? Almost certainly not, why on earth would it?
In studies that find no or slight negative effect, the outcomes are immediate measures. How do you feel right now? If it assesses decision making, it’s whether you do or do not immediately consume the content.
But for trauma survivors the potential to be triggered is always in flux, always dependent on everything else going on in your life, often set off by things that seem unrelated or irrational. Trigger warnings give someone a choice in that exact moment for what to do based on what they believe they can* manage. Yes, it may promote avoidance, but avoidance can increase feelings of agency that allow for reduced avoidance behavior in the future.
As an example from the great college campus syllabus trigger warning kerfuffle: I assign chapters from Durkheim’s Suicide in some seminars, as well as complementary readings with less obvious titles. My students get a warning about this ahead of time, but they don’t get to just skip that part of the class. Some things students have done: scheduled extra therapy sessions during those weeks, read in small groups in the library instead of isolated in dorm rooms, missed a class meeting and made up for it with office hours and a short additional assignment (so they didn’t out themselves to their peers with a panic attack in class). It’s about agency and self-assessment.
A screen with a suicide hotline number isn’t going to magically make someone ok with seeing suicide represented, but it offers an action the person can take to regain agency.
*Or just want to manage. Sometimes you’re just living your life and not super in the mood for exposure therapy, and if you can get your brain somewhere else for a while that’s a very good thing.
What do you propose as the solution, then? Without any up-front disclosure of the triggering content being present, how can anybody make the choice whether or not to expose themself to it?
Thank you.
A big part of why I have severe anxiety to this day is because I was exposed to traumatic things far too young/quickly. I was pushed into situations where I was not ready or emotionally/mentally equipped to handle. Constantly.
Exposure is only good if a person is ready for it. Desensitization is only helpful when you are equipped to handle such a thing.
I had an ex who would say that we were doing one thing, then take me to do something completely different, then boast that he was “helping me”, which only heightened my fears in the end. As a foil to that, I had an ex after that who was encouraging and supportive and kind, and gently led me into the same situations, where I knew what I was getting into. Guess how which one had me overcoming my fears?
Exposure works best if you are prepared for the exposure and have the support you need in those kind of situations.
I am always thankful for trigger warnings.
I can’t imagine they’d be helpful to me, if anything it makes me feel lesser or condescended to. It’s not the right way to talk about suicide with people who are suicidal.
Suicide comes in many different flavors. The most common in my limited experience is desperation. If you are so utterly desperate for literally anyone to listen to you, I don’t see how it would hurt. Especially since there’s such a positive stigma surrounding the hotline. I personally know a couple of people that the hotline helped.
I like the hotline
I would never call one.
Look at all these people downvoting you for living your life.
Hopefully it’s because you’d never need one
And I have called one. Nothing wrong with needing help
Did they alert authorities? Hope you’re doing better.
Same, I dont get them
Suicides can be really easy to prevent.
Like, the hotline itself is incredibly effective, and reminding people it exists would naturally help.
People aren’t getting the number from the intro, but it reminds them it exists.
Even though crisis hotlines are common, they have not been well studied for efficacy.
Somewhat related, but I think suicide hotlines can be a big problem if they are understaffed. I feel like in my country they are just there to check a box. I’ve had two suicidal crises, both times I called the hotline, waited 20+ minutes and gave up. It made me feel even worse and more lost.
That really sucks. I hope you’re doing better now.
:( I’ve been in a similar situation, but I’ve never called; I have friends that I can talk to openly about this stuff, and not freak them out or have them be judgemental. I don’t know you, but I hope you are doing better, and can persevere. Life can be awful, brutal. Being alone in a time of need is… I can’t even think of a word with enough emphasis.
If you want, you can send me a message. Might not be helpful, but maybe it will. Just say hi, if you want. You aren’t alone. :)
It also helps normalize actually think about it or discussing the subject.
No idea, but I thought this would be a good time to share that teen suicide attempt rates spiked almost 30% in the month following Netflix’s 13 Reasons Why. It’s a pretty bad show, so of course it got 4 seasons.
TBH, I think that’s why shows have this now. Fear of legal liability.
No. It it makes normies feel good for trying
Good question, but I expect as far as whether it should be there or not, it doesn’t really matter. There is no harm in it being there, after all. And in the end, if it helps one single person not kill themself, I’d say that’s a win.
There is no harm in it being there, after all.
See, that’s where having the data would be great Because while this is intuitive, it’s not confirmed. I think most shows showing suicide also paint the event in a pretty bad light. What if having the disclaimer there makes someone not want to watch the show, and they continue to glorify suicide, whereas maybe if they watched the show and saw someone in pain after their loved one committed suicide, maybe it’d trigger something in them, to know how much this act would hurt others.
I’m not saying this is the case. I would just like to know the numbers, because unless they show a decrease in suicide attempts since the warning/phone number was introduced, then we’re really just speculating if it’s helping, hurting, or just neutral.
I can say I’ve never glorified suicide. When I’ve been suicidal, suicide is literally the only logical solution my brain can arrive at. It’s completely irrational in hindsight, but it makes so much sense at the time.
I don’t think I have ever not-watched something due to content warnings alone. But it has alerted me that there may be issues, so it doesn’t surprise me when it comes up.
The national suicide prevention hotline is almost always too busy and callers often need to wait on hold. They’ve calibrated everything from the hold music, the script, and the recorded voice to keep callers on the line.
This factoid splits people pretty evenly between those who find it horrifying and those who find it hilarious.
I should say that according to the hotline, the changes made to the hold system has resulted in 100,000 fewer hang-ups per year.
Are you telling me they intentionally avoid playing Van Halen - Jump for anyone put on hold?
No, you see the trick is to play Jump by Van Halen exactly once at the right time followed immediately by Killing in the name of by Rage Against the Machine.
This combo is super effective… As long as the stay listen until the end.
The word hang up threw me off a little given the context
This is interesting. Source?
It’s really about not being sued by someone’s family for claiming that they got the idea from the show.
Oh please, there are hundreds if not thousands of stories about suicide out there and they don’t have warnings
Stop being so overly cynic, trust me, it’s not as edgy as you think it is
It’s notable that you needlessly made this personal…almost as if you existed at trump levels of projection.
Having more experience than you in a topic does not mean projection
You know nothing about me yet chose to make it personal twice. This is too strange.
Nothing here is about you bud… Self centered much?
I’ll just stop feeding the attention hungry hippo
Sorry but you don’t get to walk in, behave badly, and blame the other person. That’s just toxic. Have a block.
Oh no! Anyways…
To my knowledge, there hasn’t been a major peer reviewed study to show whether these warnings make any difference.
Now, my own anecdotal non-peer reviewed personal opinion would be that they probably make no difference at all. Businesses likely began adding them only to waive potential liability and not to actually do anything helpful. They can be frustrating because they spoil upcoming events in media that may have been unexpected or unknown, but because of the warning are now definitely known and thus feels “ruined” when it happens. They can also reinforce ideation of suicide because a person may feel like the ones that added the warning did it as a token thing, treating the person like they are a badge of honor or some kind of selling point. Whether that is true or not doesn’t really matter, a person that is suicidal is almost never “in their right mind,” and if they feel that way, they feel that way. Nobody can tell them how to feel, not even themselves sometimes.
Need to test by providing a tag at the start of these episodes that provides instructions how to kill yourself
