Corporal Punishment: The Problem with Personal Experience

Corporal punishment, also referred to as spanking, has remained a divisive and controversial issue for decades. Despite a plethora of credible research detailing the harmful outcomes, not to mention ineffectiveness, of corporal punishment as a form of discipline, it is estimated that 80% of children are subject to this treatment by their parents (Gershoff & Grogan-Kaylor, 2016; UNICEF, 2014). So what gives?

 

Legal Considerations

The Convention on the Rights of Child, a human rights treaty organized by the UN, requires that governments protect children from “all forms of violence”, explicitly including any type of physical punishment in this mandate (UN General Assembly, 1989). So far, 52 countries have legally abolished corporal punishment and 54 more have committed to doing so (Durrant, Fallon, Lefebvre, & Allan, 2017).

Other developed countries, like Canada and the US, have not. The American Academy of Pediatrics (AAP) legitimized spanking in the US and defined it as “striking a child with an open hand on the buttocks or extremities with the intention of modifying behavior without causing physical injury” (AAP, 1998). Canada has retained parent’s use of “corrective and reasonable force against children” as a legal defense. Section 43 of the Criminal Code specifies “non-abusive force” as that which is administered:

  1. by a parent;
  2. to children between the ages of 2 and 12 years;
  3. to a child who is capable of learning from it;
  4. in a manner that is transitory and trifling, or “non-minor”;
  5. without objects or blows/slaps to the head;
  6. with corrective intent;
  7. in a way that is not degrading, inhuman, or harmful.

These seemingly arbitrary guidelines are in place to protect both “persons in authority” (i.e., parents) as well as children by creating a legally acceptable form of non-abusive physical punishment. In other words, the Supreme Court surmised that any physical punishment falling within these limits is considered harmless and without risk to the child (Durrant et al., 2017).

Durrant and colleague’s 2017 study challenged the court’s guidelines and indicated that if these limits are indeed non-abusive and reflect the current state of child welfare in Canada, most confirmed cases of physical abuse should exceed the designated parameters (Durrant et al., 2017). However, this was not the case. They found that 28.4% of substantiated physical abuse cases in Ontario did not surpass any of the seven limits, suggesting a serious discord between the child welfare system and the criminal justice system regarding their definition of maltreatment (Durrant et al., 2017). Parents are therefore provided with conflicting messages about how to discipline their children and may end up feeling protected by one system and condemned by another.

 

Social Norms

This topic garnered national attention in 2014 when Adrian Peterson, running back for the Minnesota Vikings, was charged with child abuse for repeatedly striking his 4-year-old son with a switch. The public response demonstrated the divergent views that people have regarding corporal punishment, with many coming to Peterson’s defense and identifying with his good intentions, while others demanded that he be held accountable for his actions. In the end, Peterson plead no contest to a reckless assault charge and was suspended for the remainder of the 2014 season.

The general acceptance of physical punishment as a disciplinary technique is thought to originate from writings in the Bible, where children were commonly regarded as property of their parents (Belsky, 1980). Many Christians believe that spanking helps children become absolved of their guilt, making physical punishment an “act of love” (Jones, 2014). The approval and support for corporal punishment is often perpetuated by way of intergenerational transmission. Many advocates who were themselves spanked as children use this anecdotal experience as “evidence” of its success (Jones, 2014). You often hear people argue that they were spanked and turned out “just fine”, which some experts suppose may be a way of using selective memory to justify their current parenting practices (Gershoff & Grogan-Kaylor, 2016). This support is communicated through social media and memes, like the one pictured below, as well as popular quotes like “Spare the rod, spoil the child”.

 

Ineffective Discipline Technique

It is clear that, generally speaking, spanking and corporal punishment are employed by parents to discipline their children for bad behaviour. This is especially true for short-term compliance. Although some research points to minimal evidence of physical punishment being effective in the immediate future through conditioning effects and fear, it only works when the parent is actually present (America Psychological Association, APA, 2002). It does not deter children’s future misbehaviour, and therefore is not effective in the long term (APA, 2002). Children do not have the developmental capacity to understand the connection between physical punishment and unwanted behaviour. Furthermore, there are several other ways to discipline children that are less punitive and based in evidence, like withholding privileges or time-outs.

 

Long-term Negative Outcomes

There is a clear correlation between spanking and a number of detrimental cognitive, social, academic, and mental/physical health outcomes (Committee on Psychosocial Aspects of Child and Family Health, 1998; Gershoff & Grogan-Kaylor, 2016; MacKenzie Nicklas, Waldfogel, & Brooks-Gunn, 2013; Taylor, Manganello, Lee, & Rice, 2010). Dr. Elizabeth Gershoff, a leading researcher on physical punishment, found that spanking was associated with more aggression, anti-social behaviour, externalizing and internalizing problems, mental health issues, and negative relationships with parents, as well as decreased cognitive ability and lower self-esteem (Gershoff & Grogan-Kaylor, 2016). It was also shown that these negative outcomes are observed even when a restricted or “soft” definition of spanking is used (Gershoff & Grogan-Kaylor, 2016). In fact, there were few differences found between spanking and physical abuse, with them both indicating an association with the same harmful outcomes at almost the same strength (Gershoff & Grogan-Kaylor, 2016). That being said, several studies have shown that the severity and frequency of corporal punishment makes a difference, with spanking that occurs more harshly or more often linked to worse child outcomes (APA, 2002; Cuddy & Reeves, 2014).

Child aggression is a commonly reported outcome of physical punishment, and for good reason. Think about it: children cannot possibly distinguish the difference between hitting for discipline or hitting for abuse. At the end of the day, a hit is a hit, and since most parents are teaching their kids not to hurt others, it reinforces a “do as I say, not as I do” orientation. It’s not difficult to see how this could be very confusing for children. Social learning theory explains that spanked children come to associate aggression and violence with power over others, and this often manifests itself in bullying behaviour (Taylor et al., 2010). Children also begin to see violence as a coping strategy by observing their parents’ response to stressful situations.

Like most social work research, it is impossible to determine whether corporal punishment causes these adverse outcomes (APA, 2002). In order to do so, families would have to be randomly assigned to either use physical punishment on their children or not use it, which would be unethical and hazardous (Taylor et al., 2010). Furthermore, the inability to control all possible factors linked to corporal punishment or child outcomes may lead to confounding results (Cuddy & Reeves, 2014). Therefore, researchers are only able to make claims about the association or correlation between spanking and the aforementioned issues. This also means that not all children who are spanked will become aggressive or face mental health issues. It is a complex interaction of situational variables that determine a child’s future.

 

A “Stepping Stone” to Abuse

Although many argue that any physical punishment is, by definition, physical abuse, there is evidence that discipline via spanking increases the likelihood of maltreatment in the future. Experts argue that spanking is on a continuum of violence that can escalate into physical abuse (Straus, 2001; Gershoff & Grogan-Kaylor, 2016). At least 75% of physical abuse cases began as disciplinary responses intended to correct the child’s behaviour (Durrant et al., 2006; Gershoff & Grogan-Kaylor, 2016). Some speculate that spanking’s lack of effectiveness over time may be part of the reason that parents use increasingly harsh and intense physical punishment to achieve the same result (Jones, 2014). In addition, corporal punishment is often reactive, rather than planned in advance, which makes it less likely that the parent will be calm when dispensing it (Jones, 2014).

The vast majority of parents who use physical punishment do not do so with an intention to harm their child. What is noted in the literature, however, is a belief among physically abusive parents that they have a “right” to engage in physical discipline and that their behaviour is “justified” (Dietrich, Berkowitz, Kadushin, & McGloin, 1990; Durrant et al., 2017). These parents are also more likely to rely on physical punishment to control their children’s behaviour and do not modify their discipline strategy in response to different forms of child misbehaviour (Belsky, 1993; Trickett & Kuczynski, 1986).

A recent Ontario study found that families who regularly employ spanking were almost 6 times more likely to have their physical abuse cases substantiated than those in which spanking was not typical (Durrant et al., 2017). A US study determined that every single time a child is spanked, their odds of receiving severe violence (like punching or burning) increase by 3% (Zolotor, Theodore, Chang, Berkoff, & Runyan, 2008). If an object is used, those odds increase by 9% (Zolotor et al., 2008).

 

Conclusion

Efforts to define boundaries of non-abusive physical discipline are fraught with issues, as indicated above. When over one-quarter of substantiated physical abuse cases fall within the current definition, it becomes apparent that the abolition of physical punishment entirely is necessary for preventing abuse and protecting children (Durrant et al., 2017). As Gershoff stated, “until researchers, clinicians, and parents can definitively demonstrate the presence of positive effects of corporal punishment, including effectiveness in halting future misbehavior, not just the absence of negative effects, we as psychologists cannot responsibly recommend its use” (APA, 2002).

 

References

American Psychological Association. (2002). Is corporal punishment an effective means of discipline? Retrieved from http://www.apa.org/news/press/releases/2002/06/spanking.aspx.

Belsky, J. (1980). Child maltreatment: An ecological integration. American Psychologist, 35(4), 320-335.

Belsky, J. (1993). Etiology of child maltreatment: A development-ecological analysis. Psychological Bulletin, 114(3), 413-434.

Committee on Psychosocial Aspects of Child and Family Health. (1998). Guidance for effective discipline. Pediatrics, 101(4), 723-728.

Cuddy, E., & Reeves, R. V. (2014). Hitting kids: American parenting and physical punishment. Brookings. Retrieved from https://www.brookings.edu/research/hitting-kids-american-parenting-and-physical-punishment/.

Dietrich, D., Berkowitz, L., Kadushin, A., & McGloin, J. (1990). Some factors influencing abusers’ justification of their child abuse. Child Abuse & Neglect, 14, 337-345.

Durrant, J. E., Fallon, B., Lefebvre, R. & Allan, K. (2017). Defining reasonable force: Does it advance child protection? Child Abuse & Neglect, 71, 32-43.

Durrant, J., Trocmé, N., Fallon, B., Milne, C., Black, T., & Knoke, D. (2006). Punitive violence against children in Canada. CECW Information Sheet #41E. Toronto, Canada: University of Toronto, Faculty of Social Work. Retrieved from www.cecw-cepb.ca/DocsEng/PunitiveViolence41E.pdf.

Gershoff, E. T., & Grogan-Kaylor, A. (2016). Spanking and child outcomes: Old controversies and new meta-analyses. Journal of Family Psychology, 30, 453-469.

Jones, C. (2014). Corporal punishment in the home: Parenting tool or parenting fail…. Science-Based Medicine. Retrieved from https://sciencebasedmedicine.org/corporal-punishment-in-the-home-parenting-tool-or-parenting-fail/.

MacKenzie, M. J., Nicklas, E., Waldfogel, J., & Brooks-Gunn, J. (2013). Spanking and child development across the first decade of life. Pediatrics, 132(5), 1118-1125.

Straus, M. A. (2001). Beating the devil out of them: Corporal punishment in American families (2nd ed.). Piscataway, NJ: Transaction Publishers.

Taylor, C. A., Manganello, J. A., Lee, S. J., & Rice, J. C. (2010). Mothers’ spanking of 3-year-old children and subsequent risk of children’s aggressive behavior. Pediatrics, 125(5), 1057-1065.

Trickett, P. K., & Kuczynski, L. (1986). Children’s misbehaviors and parental discipline strategies in abusive and nonabusive families. Developmental Psychology, 22, 115-123.

UNICEF. (2014). Hidden in plain sight: A statistical analysis of violence against children. New York, NY: UNICEF.

UN General Assembly. (1989). Convention on the Rights of the Child. United Nations, Treaty Series, vol. 1577.

Zolotor, A. J., Theodore, A. D., Chang, J. J., Berkoff, M. C., & Runyan, D. K. (2008) Speak softly – and forget the stick. Corporal punishment and child physical abuse. American Journal of Preventive Medicine, 35, 364-369.

Children’s Mental Health: A Complex Problem

The World Health Organization (2011) defines mental health as:

‘A state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.’

While there is no doubt that most parents wish this for their children, many experience significant obstacles to finding adequate help for their children’s mental health issues. That is, if they can recognize that there is a problem in the first place. In Ontario, it is estimated that 20% of children struggle with a mental health problem but 80% of these kids do not receive the necessary treatment (MHASEF Research Team, 2015). Put differently, this equates to about 6 students in every classroom. It is likely that the prevalence rate is even higher than these conservative estimates, however, since children’s mental health disorders often go undetected or fail to meet the stringent diagnostic criteria, despite the presence of symptoms that impair and interfere with daily functioning (Girio-Herrera, Owens, & Langberg, 2013).

Children can develop all of the same mental health disorders that adults can, although they may be expressed in very different ways. Potential conditions include Generalized Anxiety Disorder (GAD), Separation Anxiety Disorder, Social Anxiety, Obsessive Compulsive Disorder (OCD), Attention-deficit/hyperactivity disorder (ADHD), Autism Spectrum Disorder (ASD), Eating Disorders, Depression, and Bipolar Disorder. Belden (2005) notes that although mental illness, like anxiety and depression, are becoming more common, it’s difficult to determine whether increased numbers of children are actually experiencing these disorders or if an increase in awareness and screening techniques are bringing them to our attention (or a combination of both). Regardless, it is reported that 70% of lifetime mental health issues begin during childhood or adolescence (Children’s Mental Health Ontario, 2017), indicating an opportune period for prevention and early intervention.

Extensive research demonstrates that early diagnosis and intervention enhance the individual’s ability to cope with a mental illness and provide improved outcomes for recovery (Belden, 2005; Crawford, 2016; Honeyman, 2007; Reidenberg, 2011) The effects of untreated mental health disorders, however, are often chronic and cumulative. For example, untreated childhood anxiety is associated with mood disorders, substance use, and delinquency in adolescence (Bittner, Egger, Erkanli, Costello, Foley, & Angold, 2007; Cole, Peeke, Martin, Truglio, & Seroczynski, 1998; Kendall, Safford, Flannery-Schroeder, & Webb, 2004; Mian, 2014). Evidence suggests that providing mental health treatment with young children is effective due to the high level of neuroplasticity in the brain structure of children, thus allowing adaptive changes to occur in neural pathways (Mian, 2004). In other words, the child’s developmental stage better facilitates positive learning through neural flexibility. Early intervention is also beneficial from an economic standpoint. It is estimated that for every dollar spent on prevention and intervention, 7 dollars are saved in future health and social costs (SickKids Centre for Community Mental Health, 2017). Furthermore, the Ottawa Citizen (2016) reports that schizophrenia, bipolar disorder, and depression cost Canada more money than every type of cancer combined.

So why is it that so many kids do not get the help they need? First, it’s difficult for parents to recognize mental health problems in their children. Children, due to their level of development, do not yet have the awareness and vocabulary to express their emotions or concerns (Mayo Clinic, 2015). In addition, many parents cannot differentiate between a symptom of mental illness and problem behaviour that is typical in childhood or adolescence. Every child is moody, anxious, or sad at least some of the time.

Even once a problem has been identified, several parents face additional barriers that fall into two main categories: structural and attitudinal (Ohan, Seward, Stallman, Bayliss, & Sanders, 2015). Structural barriers are the logistical considerations associated with mental health treatment, including transportation, time, child care, financial cost, and accessibility of services (Ohan et al., 2015; Ingoldsby, 2010). Attitudinal obstacles are beliefs related to stigma, fear of judgment, and skepticism of mental health providers or services (Ohan et al., 2015). Some parents may also minimize the problem or believe that it can be managed without professional help.

Unfortunately, even when the obstacles mentioned above are overcome, many Ontario parents encounter difficulties gaining access to treatment. Children’s Mental Health Ontario (2016) reports that 6,500+ children and youth waited over a year for treatment in 2016 and 76% of families stated that it was very or extremely difficult to know where to find help (Parents for Children’s Mental Health, 2013). Although the Ministry launched a plan, Moving on Mental Health, in 2012 to improve access to mental health services in Ontario, the Auditor General’s 2016 Report has indicated an overwhelming lack of progress to date. It is hoped that with increased awareness and funding that this gap can be narrowed.

Tips for Parents

Know the Warning Signs 

While the presence of any of the following signs is not necessarily indicative of a mental health disorder, they can help you to determine whether there might be an underlying condition to investigate further.

Changes in mood: intense feelings (e.g. sadness, withdrawal, fear) that last at least two weeks

Extreme mood swings: with little/no provocation that cause problems in relationships with others (Elements Behavioral Health, 2010)

Changes in behaviour: uncharacteristic and sudden changes in behaviour or personality (Mayo Clinic, 2015)

Dangerous or violent behaviour: frequent fighting and a propensity to use violence or weapons; expressing habitual anger towards others (Mayo Clinic, 2015)

Difficulty concentrating/focusing on a task; distracted easily

Unexplained weight loss or gain

Loss of appetite, frequent vomiting, or overeating

Evidence of self-harm or unexplained injuries (e.g. wounds or burns)

Talking/writing about suicide or death and feelings of hopelessness; statements that suggest a lack of future

Loss of pleasure or interest in activities enjoyed in the past (Elements Behavioral Health, 2010)

Use of alcohol or drugs

Uncharacteristic impulsive or risky behaviour

Physiological complaints (e.g. headaches, stomach pain, heart racing, difficulty breathing)

Persistent irritability

Lack of self-care and personal hygiene

Dramatic increase or decrease in sleep (Elements Behavioral Health, 2010)

Fatigue or low energy

Extreme and unwarranted feelings of guilt

Stress or worry that interferes with functioning on a regular basis

Feels uncomfortable around others

Engages in ritualistic or repetitive behaviour

Frequent nightmares or distressing memories (Elements Behavioral Health, 2010)

Acts hypervigilant, fearful or “on guard” frequently (Elements Behavioral Health, 2010)

Communicate with Teachers or Childcare Providers

If you suspect that your child is struggling with a mental illness, talk to their teacher. It is likely that your child’s teacher spends more waking hours with your child than you do, and they see them in a structured environment amongst other children. Therefore, they will have a perspective that is different from yours and may be able to shed some light on your child’s daily behaviour and functioning. A teacher’s position offers them the opportunity to observe and compare behaviour across several same-age peers in a social and academic setting (Girio-Herrera et al., 2013). These open lines of communication and sharing of mutual concerns can lead to increased surveillance and detection of a mental health issue.

Prioritize Mental Health

Emphasize the importance of mental health at the same level as physical health in your household. Recognize it as an essential pillar of holistic wellness. Your kids will likely pick up on this ideology and adopt it for themselves. 

Talk to your Doctor

In an ideal world, all health professionals would be mandated to screen for mental health issues as standard protocol during annual physical health assessments. Unfortunately, the onus of identification is on the parents and other adults in children’s lives. If you begin to suspect that your child is displaying symptoms of a mental health issue, keep track (in writing, if necessary) of the concerning behaviours and when they typically occur, the frequency (how often), and when you began to notice them. Bring this information to your next doctor or pediatrician appointment. For diagnosis and specialized treatment, your doctor may then refer you to a psychiatrist, psychologist, social worker, or behavioural therapist. 

Talk to your Child

Although they may not be ready to talk as soon as you broach the subject, letting your children know that you are open and available for conversations about mental health will help to ensure that stigma and shame will not silence them. Kids need to hear from their parents that they are loved and supported unconditionally, and that a mental health concern will be taken seriously. Research has recognized parental support as a major factor in fostering resilience among children (Brown, Khan, & Parsonage, 2012; Membride, 2016). If your child discloses mental health issues, believe them and take appropriate action. 

Don’t Use the “Wait & See” Approach

It may be tempting to put off treatment for your child until you are absolutely certain that there is a mental health condition to treat, but adopting the “wait and see” strategy can have lasting negative repercussions (Girio-Herrera et al., 2013). Mental health symptoms can interfere with normal development and learning, producing a cumulative effect. Furthermore, crisis intervention and delayed treatment are more costly and challenging than prevention and early intervention.

Be an Advocate

As mentioned above, the mental health system in Ontario is underfunded and hard to navigate. Finding effective treatment can be difficult, but don’t give up! You may need to push and fight to get your child the help they need.

Get Help for Yourself

Coping with your child’s mental health conditions can be stressful and scary. It may be helpful to speak with a mental health professional to address your needs and validate your fears in these unfamiliar circumstances. Therapy or counselling can assist you in coming to terms with a diagnosis and in turn, better support your child. Therapy can also provide important coping strategies, like stress management and mindfulness techniques, that will improve the way you interact with your child and respond to their challenging behaviours (Elements Behavioral Health, 2010).

 

Additional Resources

For expert advice on strategies and information regarding specific behaviours, symptoms, or disorders, visit The ABCs of Mental Health – Resources for Parents, A free web-based resource regarding children and adolescents aged 3 to 18. The Resource is searchable by “worrisome behaviour” or by chapter.

www.hincksdellcrest.org/abc

 

Child Mind Institute Symptom Checker – You indicate the behaviors that are making you concerned about your child by answering a series of questions. The Symptom Checker analyzes your answers to give you a list of psychiatric or learning disorders that are associated with those symptoms.

Since individual symptoms can reflect more than one disorder, this tool will give you a range of possibilities and guide you toward next steps. This tool cannot diagnose your child, but it can help you inform yourself about possible diagnoses and will offer information and articles to help you learn about them in order to facilitate a conversation with a professional.

https://childmind.org/symptomchecker/

References

Belden, A. C. (2005). When children have a mental illness. Portland, OR: United Parenting Publications.

Bittner, A., Egger, H. L., Erkanli, A., Costello, E. J., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict? Journal of Child Psychology and Psychiatry, 48(12), 1174-1183.

Brown, E. R., Khan. L., & Parsonage, M. (2012). A chance to change: Delivering effective parenting programmes to transform lives. London, UK: Centre for Mental Health.

Children’s Mental Health Ontario. (2016). 2016 report card: Child & youth mental health. Toronto, ON: Children’s Mental Health Ontario. Retrieved from https://cmho.org/about-cmho/improving-mental-health-care-for-children-and-youth/our-work/report-card.

Children’s Mental Health Ontario. (2017). Key facts & data points. Retrieved from https://www.kidsmentalhealth.ca/education-resources/facts-figures.

Cole, D. A., Peeke, L. G., Martin, J. M., Truglio, R., & Seroczynski, A. D. (1998). A longitudinal look at the relation between depression and anxiety in children and adolescents. Journal of Consulting and Clinical Psychology, 66(3), 451-460.

Crawford, B. (2016, October 19). Research into early diagnosis of mental illness in children wins The Royal’s $100,000 prize. Ottawa Citizen. Retrieved from http://ottawacitizen.com/news/local-news/research-into-early-diagnosis-of-mental-illness-in-children-wins-the-royals-100000-prize.

Elements Behavioral Health. (2010). Recognizing signs of mental illness in your child. Retrieved from https://www.elementsbehavioralhealth.com/news-and-research/recognizing-signs-of-mental-illness-in-your-child/.

Girio-Herrera, E., Owens, J. S. & Langberg, J. M. (2013). Perceived barriers to help-seeking among parents of at-risk kindergarteners in rural communities. Journal of Clinical Child & Adolescent Psychology, 42(1), 68-77.

Honeyman, C. (2007). Recognising mental health problems in children and young people. Pediatric Nursing, 19(8), 38-44.

Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19, 629-645.

Kendall, P. C., Safford, S., Flannery-Schroeder, E., & Webb, A. (2004). Child anxiety treatment: Outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up. Journal of Consulting and Clinical Psychology, 72(2), 276–287.

Mayo Clinic. (2015). Mental illness in children: Know the signs. Rochester, MN: Author.

Membride, H. (2016). Mental health: Early intervention and prevention in children and young people. British Journal of Nursing, 25(10), 552-557.

MHASEF Research Team. (2015). The mental health of children and youth in Ontario: A baseline scorecard. Toronto, ON: Institute for Clinical Evaluative Sciences.

Mian, N. D. (2014). Little children with big worries: Addressing the needs of young, anxious children and the problem of parent engagement. Clinical Child and Family Psychology Review, 17, 85-96.

Ohan, J. L., Seward, R. J., Stallman, H. M., Bayliss, D. M., & Sanders, M. R. (2015). Parents’ barriers to using school psychology services for their child’s mental health problems. School Mental Health, 7, 287-297.

Parents for Children’s Mental Health. (2013). Family input survey: A system that truly makes sense. Retrieved from http://www.pleo.on.ca/family-input-survey-a-system-that-truly-makes-sense/.

Reidenberg, D. (2011). Ways to identify mental illness — and help save our children. Retrieved from http://www.ourkids.net/blog/tips-to-identify-mental-health-problems-9584/.

SickKids Centre for Community Mental Health. (2017). Prevention and early intervention services. Retrieved from https://www.hincksdellcrest.org/Home/Services-to-Infants-Youth-and-Children/Prevention-and-Early-Intervention.aspx.

The Importance of Language

William Shakespeare, in his timeless play Romeo and Juliet, famously wrote “What’s in a name? That which we call a rose, by any other name would smell as sweet” (Shakespeare & Durband, 1985). It’s a romantic line meant to signify the forbidden love of star-crossed lovers who are banished from being together due to their family names. Although I appreciate the gesture, I think that our friend Billy had it wrong here. Let me explain…

Language matters, words matter, labels matter.

In this postinternet society, in which there is a fierce stronghold on freedom of speech in the steadfast fight against political correctness, advocating for this cause feels almost controversial. But I believe that it’s important. And for those that struggle with saying the “right” thing, avoiding contentious topics like colloquial landmines, I can understand your difficulties… to an extent. We all make mistakes, and none of us are perfect. However, in my professional (and personal) experience with oppressed and marginalized people that fall all over the human spectrum, questions asked with genuine curiosity, respect and open-mindedness are often well-received. It is the taken-for-granted assumptions that stem from ignorance and derogatory stereotypes that cause harm.

A number of problematic terms have (thankfully) been eradicated from most of our vocabularies and popular media thanks to the work of folks dedicated to this initiative (like the LGBTQ community and the Special Olympics, for example). That being said, I’m often surprised to see a lack of awareness in discussions regarding suicide, even among those in the helping profession. Some ubiquitous and seemingly innocuous phrases from well-meaning people are actually very harmful and stigmatizing to those affected by suicide.

Suicide is the second leading cause of death among Canadians ages 10-24 after motor vehicle accidents (Canadian Mental Health Association, 2017). Unfortunately, many friends and family are unaware of the extent of their loved one’s pain until it is too late. The persistent shame and stigma regarding suicidal thoughts (also known as suicidal ideation) prevent many people from coming forward and asking for help. Using terminology that is non-judgmental and non-stigmatizing when referring to suicide is one way to let those around you know that you are supportive and receptive to these difficult conversations. As a former crisis line responder, I can attest to this statement.

“Committed Suicide”

The word suicide comes from the Latin words “sui” (of oneself) and “caedere” (kill) (Oxford University Press, 2017). The use of the value-laden verb “commit” in association with suicide originated in religious and legal domains, back when it was a crime or moral dishonor to kill oneself (Sommer-Rotenberg, 1998). Although it is no longer “illegal” to die by suicide, this term still carries significant negative connotations that perpetuate stigma and further alienate suicidal individuals. Suicide is a cause of death much like any other, and is one of several tragic consequences that may follow severe and chronic depressive illness (Sommer-Rotenberg, 1998). As Beaton and colleagues (2013) note, “Do we ever say that someone ‘committed cancer’ or ‘committed heart failure’, even when they may have lived lifestyles that contributed to such diseases (for example, smoking or having a high fat diet)? Even suggesting this sounds ludicrous, and yet every day we see such examples in relation to suicide.”

“Successful” or “Failed” Suicide

“Successful” or “completed” suicides are also stigmatizing terms for this community. These adjectives do not accurately reflect the reality of people’s experiences and imply victory for an undesirable outcome (Silverman, 2006). Similarly, using “failed suicide attempt” to describe that which does not end in death is also problematic. This language is often perceived by suicidal folks as yet another thing that they are not able to get “right”. Not only does it suggest an inadequacy of some sort, but it typically represents an unconfirmed assumption based on the clinician’s subjective assessment of behaviour (Silverman, 2006). In other words, deliberate self-harm without suicidal intent is often incorrectly categorized as a “failed” attempt.

Suicide as “Selfish”

A deeply entrenched belief held by some is that suicide is a selfish act, that those who end their own life are simply “passing their pain onto others”. This is, of course, a blatant misrepresentation that minimizes a suicidal person’s experience. The disconnect here seems to be driven by a lack of understanding of the complex, nuanced picture that precedes suicide. Suicide is not one final, isolated act; it’s a process. The decision to end one’s own life is not made haphazardly or easily, and certainly not without the consideration of others. Suicide is seen as the only remaining option to end their long-standing emotional pain and suffering.

People do not die from suicide, they die from sadness.” – Timothy Long

Susan Beaton, a Suicide Prevention Advisor from beyondblue, developed a handy table to assist us with replacing problematic terminology in everyday conversations (Beaton, Forster, & Maple, 2013):

TALKING ABOUT SUICIDE
Stigmatizing terminology Appropriate terminology
Committed suicide Died by suicide
Successful suicide Suicided
Completed suicide Ended his/her life

Took his/her own life

Failed attempt at suicide Non-fatal attempt at suicide
Unsuccessful suicide Attempt to end his/her own life

If you, or someone you know, is thinking about suicide, there is help.

Toronto Distress Centres: 416-408 HELP (4357) or 1-800-SUICIDE (784-2433)

 

References

Beaton, S., Forster, P. & Maple, M. (2013). Suicide and language: Why we shouldn’t use the ‘C’ word. InPsych, 35(1).

Canadian Mental Health Association. (2017). Suicide and youth. Retrieved from http://toronto.cmha.ca/mental_health/youth-and-suicide/#.WWAfKdPyuRs.

Oxford University Press. (2017). Suicide. Retrieved from https://en.oxforddictionaries.com/definition/suicide.

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