Professional Documents
Culture Documents
Carol Gilligan, Ph.D. recently moved to New York City, where she is
University Professor at New York University. Her latest book is The Birth of
Pleasure.
Lisa Machoian, Ed.D. is a Lecturer on Education in Human Development
and Psychology, Harvard University Graduate School of Education.
Earlier versions of this paper were presented at the conference of
Psychological Trauma: Maturational Processes and Therapeutic Interventions,
Boston University Medical School and Massachusetts Mental Health Center,
March 1998; and at the Biennial Peter Blos Lecture, Jewish Board of Family
and Childrens Services, New York City, December 1998. A version of the
case study is in the doctoral dissertation of Lisa Machoian (1998).
The authors thank, in alphabetical order, Blair Barone, Psy.D., Holly
Gelfond, Ed.D., Francis Pescosolido, Ph.D., Elizabeth RiceSmith, Psy.D., and
Bessel A. van der Kolk, M.D. for their support of this work.
Studies in Gender and Sexuality
3(3):321341, 2002
BACKGROUND RESEARCH
Epidemiological studies have repeatedly indicated that suicidal
acts peak among girls at the ages of 13 and 14 (Deykin, Alpert,
and McNamara, 1985; Velez and Cohen, 1988; Angold and
Rutter, 1992; Kovacs, Goldston, and Gatsonis, 1993). Researchers
also report a strong correlation between suicidal behavior and
a history of trauma (Herman, 1981, 1992; Kosky, 1983; van der
Kolk, 1987, 1996; van der Kolk, Perry, and Herman, 1991;
Romans et al., 1995; Kaplan et al., 1997; Lipschitz et al., 1999).
However, while girls and boys alike may experience sexual and
physical abuse during the childhood years (Russell, 1983, 1984a,
b; Finkelhor, 1993), boys tend to behave suicidally in childhood
whereas girls suicidal behavior tends to begin in early
adolescence (Pfeffer et al., 1980, 1982; Rutter and Garmezy,
1983; Pfeffer, 1986; Rutter, 1986; Borst, Noam, and Bartok, 1991;
Angold and Rutter, 1992; Lewinsohn, Rhode, and Seeley, 1996;
King, 1997). During adolescence, girls engage in suicidal acts
more frequently than boys do, but boys more often kil l
themselves.
This epidemiological finding takes on added significance in
the light of the surprising discovery that although feelings of
helplessness correlate with suicidality in adults, hopelessness is
not significantly associated with suicidality among adolescent
girls (Carlson and Cantwell, 1982; Dyer and Krietman, 1984;
Asarnow, Carlson, and Guthrie, 1987; Rotheram-Borus and
Trautman, 1988; Borst and Noam, 1993; Metha et al., 1998).
We speak of girls suicidal acts rather than suicide attempts,
both to counter the implication that girls attempt but, compared
with boys, more often fail to kill themselves and also to recognize
the presence of hope in their actions. It may be that girls, by
acting suicidally, are hoping to achieve something elseand
perhaps they are succeeding.
THEORETICAL FRAMEWORK
The relational interpretation we bring to our analysis of an
adolescent girls suicidality rests empirically on longitudinal and
cross-sectional studies with girls between the ages of 6 and 17.
Learning to Speak the Language 325
1
The authors thank Abby (a pseudonym) for permission to tell her story.
It is her hope that by our doing so she may help other adolescents and those
who work with them. We have changed some identifying information in order
to protect the privacy of those involved.
Learning to Speak the Language 327
I learn from the shelter staff that Abby did not in fact run
away that night, but the next day after school she ran away;
that is, she walked home with her friend and spent the afternoon
with her. She returned to the shelter at sunset, indicating
perhaps that she took my concern about her safety seriously. I
continue to call her and leave messages for her when she refuses
to speak to me.
During her second week at the shelter, Abby is told once again
by the state agency that she will have to return home at the end
of the week. She writes a poem: I want to be out of this horrible
pain/this horrible life/my spirit yearns to break free/soar free
out of this pain. I receive an emergency call from the shelter
staff; they are concerned about suicidal thoughts and feelings,
and, in a hospital emergency room, a crisis evaluation team is
summoned to assess her danger to herself. When they conclude
that she is not a danger to herself, she is sent back to the shelter.
The crisis evaluation team does not think she should be returned
home and recommends an out- of- home placement. The
adolescent shelter where she is currently residing recommends
a group home, an idea that her mother supports as well. Yet,
remarkablyalthough the crisis team, the shelter, my agency,
and Abbys mother all request placementthe states child
protective agency maintains the plan that she must return home
at the end of the week because they do not think her situation
is serious enough to warrant removal from her home.
At this point, Abby becomes frankly suicidal. She writes a
note wondering if anyone knows how many times a day she feels
like killing herself. She also runs away daily and does not return
until well after dark. Abby and another girl ran down railroad
tracks one night, in the rain and got lost. The other girl was
frightened when Abby knocked on the doors of strangers houses
to ask for directions. At the shelter, the staff tells me she waved
a butter knife during dinner and later was seen hiding in a
nearby graveyard. The staff of the shelter calls an ambulance to
take Abby to the nearest hospital emergency room and decides
her behavior is too potentially dangerous for her to return to
their program. But the crisis evaluation team at the emergency
room determines that her behavior is not dangerous enough to
Learning to Speak the Language 331