The Choice to “End it All.”

Suicide Definition Graphic

Written by Steven Barto, B.S., Psy.

IT WAS FOUR IN the afternoon. I was driving along the river in my home town. It was the fourth decade of my struggle with active addiction. Overwhelmed with thoughts of utter failure, rabid hypocrisy and complete hopelessness, I started ruminating about the idea of suicide. Why not? It made sense. I was in bondage to drugs and had grown tired of living a life so out of touch with my Christian upbringing. Seems I could not stop lying, cheating, stealing. Doing whatever it took to keep getting high. Duplicity was the word that most described my existence. I’d grown weary of living on the down-low. I was defeated, exhausted and tired of failing.

I turned into an area boat launch and stopped about fifty yards from the edge of the water. I closed my eyes and took my foot off the brake. I’d barely touched the accelerator when I heard an audible voice. It filled the cabin of my car: Don’t. I jammed the brake pedal to the floor and gripped the steering wheel in a panic. I must be losing my mind! There was no one else in the car. The radio was off. Yet, somehow, I heard a voice that seemed to fill the interior of my car. I could feel the voice, insistent but not loud. No sense of anger or disappointment. It was simply an audible, gentle, compassionate insistence.

Don’t end your life!

It’s been said that suicide is a permanent solution to a temporary problem. Perhaps if some in-between state existed—some alternative to death—many suicidal people would take it. One question every surviving family member has asked without exception, that they ache to have answered more than any other, is simple: Why? Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note is left behind, it still never makes sense. Yes, they felt enough despair to want to take their own life, but Why did they feel that way? Alex Lickerman, MD said, “People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy, but a valid one nevertheless” (1).

A friend of mine took his own life in 1996. We met a few years earlier as co-workers at a Philadelphia law firm. We were both on staff as litigation  paralegals. He had recently started a new career trading stocks. Apparently, he was under investigation by the SEC for insider trading. His wife kicked him out and filed for divorce. He moved in with his parents and had become quite depressed and withdrawn. He stayed home from work on a Tuesday. After his parents left the house, he took his father’s .357 handgun and drove to his wife’s place. When she answered his knock, he shot himself on the stoop in front of her. I always knew him to be outgoing, hilarious, and always up for a good time. His death made no sense to me.

Unfortunately, suicide without warning is common. Patrick J. Skerrett quoted Dr. Michael Miller, a psychiatrist at Harvard Medical School, in a recent article on suicide: “Many people who commit suicide do so without letting on they are thinking about it or planning it” (2). Currently, suicide is the tenth overall cause of death in the United States. In 2018 there were 48,334 suicide deaths in America. Had I not heard God’s voice that afternoon in 2018, the total would have been 48,335. There were an estimated 1.4 million suicide attempts in the U.S. in 2018. The rate of suicide is highest in middle-age white men in particular. It was the second leading cause of death among individuals between the ages of 10 and 34. On average, there are 132 suicides per day. In 2018, firearms accounted for 50.57% of all suicide deaths in America (3).

America’s suicide rate has increased for 13 years in a row.—The Economist

According to the National Vital Statistics Report, suicide was the second leading cause of death for age groups 10 to 24, or 19.2% of deaths, and 25 to 44, or 10.9%. This report presents final 2017 data on leading causes of death in the United States by age, sex, race, and Hispanic origin. These data accompany the release of final national mortality statistics for 2017 (4). In 2017, the 10 leading causes of death were, in rank order: heart disease; malignant neoplasms; accidents (unintentional injuries); chronic lower respiratory diseases; cerebrovascular diseases; Alzheimer disease; diabetes mellitus; influenza and pneumonia; nephritis, nephrotic syndrome and nephrosis; and intentional self-harm (suicide).

Suicidal Ideation and Social Media

Various social media platforms offer an unprecedented volume, velocity, and variety of social data to researchers. Among these, the most consistently studied is Twitter, a microblogging platform in which participants broadcast 140-character posts directly to one another or to the Twitter community simultaneously. Twitter’s sociological and psychological relevance for researchers and treatment providers is elevated due to ease of accessibility to data, the fact that most data collection activities can be undertaken at no cost to the researcher, and the ease of data management. For example, because Twitter limits individual posts to 140 characters, the information is more easily stored and reviewed than longer Facebook posts.

Facebook Suicide Prevention webpage can be found at www.facebook.com/help/594991777257121/ [use the search term “suicide” or “suicide prevention”].

As with a variety of social media platforms, Twitter has been a boon to suicide researchers, who can observe the behavior of individuals in a non-invasive manner, collecting “live” (time-sensitive) information that might not otherwise be shared because of the stigma of mental illness and suicide. One researcher was able to analyze 125 users who publicly announced they had attempted suicide. Analysis of these individuals’ posting history revealed distinct signals in previous posts that could have been used to predict their upcoming attempts and initiate an intervention (5). This is a relatively large sample that otherwise might have been overlooked.

Strong correlations have been discovered between suicidal expressions on Twitter and state-specified age-adjusted suicide rates. It is believed that posting suicide-related content on social media specifically identifies at-risk individuals. In fact, unique posting patterns have been posthumously discovered for Twitter members who died by suicide when compared to those who died of other causes (6). Such results demonstrate the value of verbal content people post on social media sites—providing unique insight into suicidal behavior.

Twitter’s Best Practices in Dealing With Self-Harm and Suicide at https://support.twitter.com [use the search term “suicide,” “self-harm,” or “suicide prevention”].

Psychologists and sociologists have begun to analyze social media data—correlating the content of social media posts regarding the topic of suicide with eventual suicides or attempts. Analysis has proven most useful in this regard. It must be determined whether suicidal behavior can be correlated to online comments among peers beyond one degree of social separation. Also, it must be determined whether that correlation persists after excluding innocuous commentary regarding mood and attitude. In other words, if mood is held to a constant in the analysis, will the observed association in suicide-related behavior still be higher than chance? Recent research has determined that comments on social media relative to suicidal expressions can be studied and correlated  up to three degrees of separation between peers, but no further. 

N.A. Christakis and J.H. Fowler (7) noted that correlation held between suicidal remarks and suicidal actions even when accounting for the distribution of mood among participants in the social media network. They used the bootstrapping method (employing computer-intensive analysis of  variability within their data samples) to study real-time posting activity on Twitter. Their samples were comprised of two non-consecutive 28-day periods. Mechanical Turk (MTurk; Amazon, 2016) raters have compiled suicide-relatedness ratings for each of the 10,222 most common words in contemporary English for use in evaluating social media posts for occurrence of “suicidal conversation.” These words are correlated with a preexisting list of “sad” words (as they relate to the sad/happy continuum) used to infer the general mood of social media users. Collection and analysis was conducted via double-blind method for accuracy and to allow for detecting statistical variation and spurious correlation.

Some variants of “sad/happy” word expressions that may or may not be associated with suicidal ideation include “I’m so sad! I’m gonna kill myself!” “I’m the worst! LOL!” “My final day on earth…” “Just got in a fight…” “It’s a sad day.” “I love my life!” Analysis included placing “sad,” “happy,” and “suicidal” words into columns on a graph and quantifying the number of uses of such words or phrases. Also, degrees of separation (direct friend versus once, twice, thrice removed) were determined at one through six degrees: friend, friend of friend, friend of friend of friend, and so on. The Sad Column, Happy Column and statistically relevant variables were each plotted along the graph comparing “mood” and “suicide-relatedness” comments. Amazingly, this study may be the first of its kind, and involved collection and analysis of over 64 million post from over 17 million unique social media users in two nonconsecutive 28-day periods. Analysis of this real-time data helped predict (by an algorithm) the information collected, which typically has infinite possibilities of correlative meaning.

You might ask, But why is this important? What does it mean? How can it be utilized? Suppose a counselor is concerned with the suicide risk of students in a high school where a fellow student recently took her own life. To get the best data in the shortest amount of time, the counselor would do the following:

  1. Ask a teacher for a list of the decedent’s closest friends and screen them;
  2. Ask any friends on that list to name their closest friends and screen those friends;
  3. Ask any friends from the new group to name closest friend and screen them, and so on; and
  4. Once there are no more positives in a friend group, screen students at random until a positive is found and begin the procedure again until the resources run out (i.e., there are no more students in the population).

Although the above process will provide an  initial “hint” of an assortativity-informed treatment approach, additional research would be necessary before beginning any efficacious intervention. Researchers warn that no offline behavior was included in their study, and therefore was not available for comparison.

Co-occurring Issues and Suicide

Suicide is a major public health problem and a leading cause of death in the United States. Everyone who chooses to attempt suicide has an underlying reason for wanting to do so. Suicide does not discriminate—people of all genders, ages, religious faiths, and ethnic groups can be at risk. Most people at risk will not follow through. Still, assessing the risk for suicidal behavior is complicated. Researchers tell us that people who attempt suicide may do so in reaction to a particular event, thought, or emotion. These individuals make decisions differently than those who do not attempt suicide. Such factors for increased risk are depression, anxiety, personality disorders, psychosis, severe bullying, rape or trauma, and substance abuse. 

Suicidal acts may be connected to recent events or current conditions in a person’s life. Although such factors may not be the primary motivation for the suicide, they can precipitate it as underlying or co-morbid triggers. A major underlying cause of suicide has been combat stress and other related PTSD issues. People in this at-risk category do not necessarily have to experience the horrors of a war zone. Other types of immediate stress include natural disasters, terrorism at home, or catastrophic loss from such events as a structure fire or a serious motor vehicle accident.

People suffering from chronic pain, severe disability, or a major illness may attempt suicide, believing their suffering is too great or that their death is inevitable. Victims of an abusive or repressive environment from which they have little or no hope of escape sometimes commit suicide. Situations that fit this category may include torture, confinement, sexual assault, or persistent physical abuse. Also, occupational stress has been indicated in some suicides due to extreme tension, anxiety, disillusion or “burnout,” and job-related financial pressures.

Cyberbullying, Substance Use Disorder

In addition to the above precipitating factors, many suicide attempts are preceded by a severe change in mood that do not correlate to an underlying psychiatric diagnosis. Mood changes most likely to lead to suicide often include extreme sadness, unresolved anxiety, frustration, anger, or shame. Unfortunately, the number of teens and young adults who take their own lives has increased due to bullying at school or on social media sites. Nearly 1 in 5 students (21%) report being bullied during the school year, impacting over 5 million youth annually. See National Center for Education Statistics [NCES], 2018. 

There has been a spike in cyberbullying over the last couple of years. This is willful and repeated bullying behavior that takes place using electronic technology, including texting, comments during gaming, Internet sites, social media, emails, blogs, cell phones, and so on. Unlike traditional bullying it can happen anywhere at all hours of the day. Approximately 34% of students report experiencing cyberbullying during their lifetime. See Hinduja & Patchin, 2015. Students who experienced bullying are nearly 2 times more likely to attempt suicide. See Hinduja & Patchin, 2018.

Worldwide, more than 1 million people die by suicide every year. Self-harm deaths have been on the rise in nearly every state in America. In the U.S., suicide deaths (47,173) were almost equivalent to the number of deaths from opioid overdoses (47,600) in 2017. It is essential that suicide prevention practices be implemented and expanded wherever possible (8). Opioid Use Disorder (OUD) has a distinctly strong relationship with suicide as compared with other substance use disorders (9). Pain causes alterations in brain circuitry in the brain’s reward center (involving the ventral tegmental area, nucleus accumbens, and the amygdala), resulting in vulnerability to suicide and a higher risk of opioid addiction. This is supported by epidemiological data that have shown chronic-pain diagnoses are linked to suicide. These associations are only partially explained by co-occurring mental health conditions, which tend to further complicate morbidity.

Tolerance to THC can build quickly in cannabis users. Teens who seek help for cannabis-use problems often report withdrawal symptoms such as anxiety, insomnia, appetite disturbance and depression (Budney & Hughes, 2006). These symptoms are of sufficient severity to impair everyday functioning (Allsop et al., 2012) and they are markedly attenuated by doses of an oral cannabis extract (Sativex) that contains THC (Allsop et al., 2014). Bagge and Borges (2015) conducted a case-crossover study of 363 persons who had recently attempted suicide and were treated in a trauma hospital for a suicide attempt within the previous 24 hours in Mississippi. The researchers compared rates of cannabis use in the 24-hour period leading up to the individual’s suicide (case period) to individuals who used cannabis during the same time period but did not commit suicide (control period). They found that 10.2% of those who attempted suicide had used cannabis within 24 hours of their suicide.

Cannabis was involved in an estimated 6.5% of drug-related suicide attempts, and in 46% of attempts the person had also used alcohol. In the 23% of drug-related suicide attempts with toxicology reports, 16.8% tested positive for cannabis, although this cannabis use could have occurred days or even up to one week earlier. In general, 9.5% of all toxicology reports for deaths by suicide (Borges, Bagge & Orozco, 2016) show the presence of cannabis. There is preliminary evidence of higher detection of cannabis among suicide decedents that do not involve overdose (CDC, 2006) and higher detection among male suicide decedents using non-overdose methods than among females (Darke, Duflou & Torok, 2009; Shields et al., 2006).

So Now What?

The Centers for Disease Control and Prevention (CDC) released data on the ten leading causes of death in the United States recently. Tragically, suicide—too often a consequence of untreated mental illness and substance use disorders, and as such a preventable condition—remains on that list as the 10th leading cause of death for adults and the second-leading cause of death in our youth. Suicide rates increased from 29,199 deaths in 1996 to 47,173 deaths in 2017. Click here for more information.

What are the contributing factors to a state of mind that ends in a person taking his or her life? What can be done to intervene? How can we turn the numbers around? The increased number of suicides year after year say something about the conditions under which people live and die, and about our society at large. Our teens and young adults are deciding in record numbers that killing themselves is the best solution to what is usually a temporary situation. Citizens at the lower end of the socioeconomic scale are significantly more vulnerable due to negative views about life and an increased amount of psychological and social difficulties. Many of these conditions are not diagnosed in time or go untreated. Many are turning to substance abuse to cope, which often increases the risk of self-harm behavior. This speaks to an environment that can promote depression, anxiety, and elevation in substance use disorder. Some sociologists have referred to these suicides as “deaths of despair.”

There are a number of interventions we can apply to these dire circumstances:

  • Safety Planning. Personalized safety planning has been shown to help reduce suicidal thoughts and actions. Patients work with a caregiver to develop a plan that describes ways to limit access to lethal means such as firearms, pills, or poisons. The plan lists coping strategies and people and resources that can help in a crisis.
  • Follow-up phone calls. Research has shown that when at-risk individuals receive proper screening, implementation of a Safety Plan, and a series of supportive phone  calls, their risk of suicide goes down.
  • Cognitive Behavioral Therapy (CBT) can help people learn new ways of dealing with stressful experiences through training. CBT helps individuals recognize their thought pattersn and consider alternative actions when thoughts of suicide arise.
  • Dialectical Behavior Therapy (DBT) has been shown to reduce suicidal behavior in adolescents. DBT has also been effective in reducing the rate of suicide in adults with Borderline Personality Disorder or related personality disorders. These mental illnesses are typically characterized by an ongoing pattern of varying moods, self-image, harmful or risky behavior, and impulsive actions. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations.

If you are struggling with thoughts of suicide, please reach out to someone before the fog of desperation clouds your mind. If you have a friend or loved one who has expressed an intent to take their own life, do not dismiss it as a cry for attention—instead, it is a cry for help. If you are interested in becoming a volunteer or mental health professional and want to be a part of the solution for this national epidemic, please talk to a teacher, professor, mental health professional, pastor, or mentor to find out how to get started.

NATIONAL SUICIDE PREVENTION HOTLINE
1(800) 273-8255

Footnotes

(1) Alex Lickerman, M.D. (April 29, 2010). “The Six Reasons People Attempt Suicide.” Psychology Today. https://www.psychologytoday.com/us/blog/happiness-in-world/201004/the-six-reasons-people-attempt-suicide

(2) Patrick J. Skerrett (Sept. 24, 2012). “Suicide Often Not Preceded by Warnings.” Harvard Health Publishing.

(3) “Suicide Statistics.” American Foundation for Suicide Prevention. https://afsp.org/about-suicide/suicide-statistics/

(4) Melonie Heron, Ph.D., (June 24, 2018). “Deaths: Leading Causes for 2017.” National Vital Statistics Reports, Vol. 68, No. 6. https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_06-508.pdf

(5) Wood, A., Shiffman, J., Leary, R., and Coppersmith, G. (2016). “Language Signals Preceding Suicide Attempts.” CHI 2016 Computing and Mental Health, San Jose, CA.

(6) Bryan, C.J., Butner, J.E., Sinclair, S., et al. (2018). “Predictors of  Emerging Suicide Death Among Military Personnel on Social Media Networks.” Suicide and Life-Threatening Behavior, 48, 413-430. http://dx.doi.org/10.1111/sltb.12370

(7) Christakis, N.A., and Fowler, J.H. (2013). “Social Contagion Theory: Examining Dynamic Social Networks and Human Behavior.” Statistics in Medicine, 32, 556-577. http://dx.doi.org/10.1002/sim.5408

(8) https://doi.org/10.1016/j.jcjq.2019.10.001

(9) Bohnert KM, Ilgen MA, Louzon S, McCarthy JF, Katz IR. Substance use disorders and the risk of suicide mortality among men and women in the U.S. Veterans Health Administration. Addiction 2017; 112:11931201.

 

 

The Billy Graham of Generation Z?

Jordan Whitmer Screen Shot CBN

Jordan Whitmer’s zeal for evangelism and vision for a movement have some comparing his ministry to that of Billy Graham. And he’s only 19.

Hannah Stephens was 17 and in trouble with her parents. She had gotten caught stealing their tablet computer in order to chat with strangers online and subsequently grounded. “The only places I was allowed to go were home, school, and church,” Hannah said. To this brooding teenager in the small Ozark town of Mountain Home, Ark., life seemed painfully limited. Yet she was about to discover a whole new world.

In January 2016, Hannah’s partner in chemistry class at Mountain Home High School Career Academies invited her to join the planning team for an upcoming event for teenagers called HowToLife. The planning process would require her to attend several meetings leading up to a night of worship, testimonies, and prayer. Hannah knew little about the event—only that it had something to do with Christianity. “This counted as a church activity that could get me out of the house and away from my parents,” she said. That was all the incentive she needed. She was in.

“The second I entered that meeting at the First Baptist Church of Mountain Home youth room, my life was completely changed,” Hannah says, recalling that the students she met seemed to be genuinely in love with God and weren’t merely serving Him out of habit. “I went home that night in tears, telling my mom I wanted what they had, the hope they had.” That may sound unusual considering Hannah is the daughter of an itinerant church planter, raised in the church and reared in a Christian home. She could recite Bible stories and prayed to accept Christ as the Messiah as a little girl. “I did it because I knew that’s what I was supposed to do,” Hannah remembers. But that was as deep as her relationship with God had gone. She had grown up in a Christian culture but wasn’t yet a follower of Christ.

Christ Carrying His Cross

We might “inherit” our faith from our parents, but we cannot inherit their salvation. In fact, we are told to work out our individual salvation with fear and trembling (Phil. 2:12). The faith of my parents is my faith. My mother and father brought the family to church every Sunday morning, Sunday evening, Wednesday night Bible study, and Thursday night prayer and worship. Although I tried numerous times in my adolescence and young adulthood to rebel against it, as we all have, it is clear to me that my faith is truly grounded in the example shown by my parents. I don’t necessarily agree with everything my parents have believed over the years relative to Christian doctrine, but my faith is what it is in part because of their influence.

howtolife pic.jpg

For a month leading up to the HowToLife event, however, Hannah felt the Lord working on her heart. She was beginning to really see who was at the heart of the hope she noticed in her peers. Because her family never settled down in one place, she hadn’t ever connected deeply with Christian young people. Now she felt a dynamic closeness with her new friends. She could see the joy of intimately knowing Christ coloring virtually everything about them. Though deep down inside she still felt spiritually unprepared, she served as a counselor on the night of the event. “I saw so many hearts changed that night, including my own,” Hannah says. “I had friends who started crying and confessing their sins to God, opening up for the first time since I’d known them. It reaffirmed that my generation is utterly heartbroken and needs Jesus.”

A BROKEN GENERATION

Demographers, social scientists and journalists commonly refer to Hannah’s generation, starting approximately with people born in the mid- to late-1990s, as Generation Z. Though there seems to be no clear agreement on hard and fast boundary lines, it’s safe to say that anyone who’s a teenager today is part of Generation Z. This generation has grown up in the digital age, giving it some advantages over prior generations. News outlets have broadly described members of Generation Z as more inherently comfortable with technology and better skilled at multi-tasking than their predecessors.

generation-z-statistics.jpg

But there’s a dark side too. The numbers show Generation Z socializes (at least in person) far less than Generation X or the Baby Boomers. Today’s teens spend large chunks of time checking social media. A sense of isolation often sets in for Gen Zers, psychologist Jean Twenge wrote in a recent article for The Atlantic, because of factors like cyberbullying and the nagging sense of missing out on the fun everyone else seems to be having. As a result, Gen Zers’ rates of suicide and depression are so high, Twenge fears today’s teens are “on the brink of the worst mental-health crisis in decades.”

That fact hasn’t been lost on Jordan Whitmer. ‘[Generation Z is] more ready than any generation to date to experience Jesus, to have that hope,” says Whitmer. “So who better than teenagers who do have that hope—who do have Jesus—to be able to step up, to share the Gospel and to reach Generation Z for Jesus?” Whitmer is the founder and CEO of the HowToLife Movement, the organization responsible for the event that changed Hannah Stephens’ life. It began as an idea in Whitmer’s dining room in December 2014. Back then, Whitmer was in his junior year at Harrison High School in Harrison, Ark., just across the border from Branson, Mo. He felt a burden for his classmates, so many of whom were spiritually lost. How could he reach them with the Gospel?

Christian Teens

The vision that began to take shape in Whitmer’s mind was a student-led youth rally for his whole community. He invited three friends over to brainstorm. There, around the dining room table, they hashed out the details. It would be a night of drama, testimonies, prayer, and worship music, all led by students. Though security guards and a few adult chaperones would be in attendance, Whitmer and his fellow organizers decided no one older than 18 would be allowed to take the stage.

The four friends also came up with the unusual name “HowToLife.” Whitmer notes, “We were thinking along the lines of how to live your life or talking about how to do life, and the ultimate answer to that is Jesus… so that’s kind of how the name emerged.” Students and adult leaders at schools and churches across Harrison got involved in spreading the word. When the rally became reality, in March 2015 at a local junior college, 750 students attended—and 75 of them reported placing their trust in Christ for eternal life. Whitmer was blown away by what God did that night, and he sensed it couldn’t just end there.

A MOVEMENT IS BORN

Word of what happened in Harrison rippled across the Ozarks. Students in other communities wanted to know how they could invite similar work from God where they lived. Whitmer’s instincts were right: HowToLife had become more than just a one-night event in his hometown. It was an emerging movement. During Whitmer’s senior year, he helped organize HowToLife rallies in Missouri and other parts of Arkansas. HowToLife became an official 501(c)3 nonprofit organization in August 2016. Then, during the 2016-17 school year, communities in Illinois, Tennessee, and Texas hosted events. All told, Whitmer says, there have been 19 HowToLife events in seven states so far. That number is on pace to expand to 15 states by summer vacation, and 20 by the end of 2018. About 600 teens have become Christians at HowToLife rallies so far and gotten connected to local churches.

A FAMILIAR MODEL

For the moment, Whitmer is HowToLife’s only paid employee, working out of his parents’ home in Harrison. The ministry has 5,000 followers on Instagram, and over the past six months, Whitmer says, hundreds of students have messaged him on social media platforms asking how they can hold HowToLife events in their communities. He responds by assuring them there’s a tried-and-true template to follow. “It’s in essence like a mini-Billy Graham Crusade event that is done by local high school students to reach their friends and their community for Jesus,” says Whitmer.

Billy Graham Pic

Indeed, HowToLife’s event planning model bears many similarities to that to the Billy Graham Evangelistic Association. A regional team of students must provide each event’s core leadership. Weeks of detailed preparation (including meetings for prayer worshiping, and reciting testimonies) follow. All the while, publicity is spread as students wear #HowToLife t-shirts to school (the social media-friendly hashtag is ever-present in HowToLife’s marketing efforts) and church youth pastors are invited to get involved. The prayerful preparation pays off the night of each event. To date, more than 6,000 teenagers have attended HowToLife rallies.

Whitmer readily admits the Graham crusades of the latter half of the 1900s have served as his model. That makes sense given that his grandfather, radio broadcaster and teacher Ron Hutchcraft, has a long history with Billy Graham, who passed away on February 21, 2018 at the age of 99: Hutchcraft chaired a crusade in New Jersey in the 1990s and has spoken extensively for the organization over the last 30 years. “I would so love to see a generation of teenagers around the U.S. and around the world that emerge,” Whitmer says. “People that step up, that have a passion for evangelism, a passion for the Great Commission.”

Great Commission Banner

Does all of this potentially make Whitmer his generation’s Billy Graham? Yes and no, he says. Unlike Graham, he doesn’t feel evangelistic preaching is his gift (though he did speak at several HowToLife rallies before he “aged out”). In his desire to build an organization that has global impact, however, Whitmer definitely senses a kinship with the 20th century’s most famous preacher. “My dream is that ultimately there may be some aspects of true global awakening to Jesus that could come through something like this,” he says.

THE NEXT PHASE

From his earliest days, Whitmer has had a sense of where he’s going, and seen no reason to wait in getting there. He led Bible clubs in elementary, middle, and high school. After graduating from Harrison High School in 2016 (he was valedictorian), Whitmer sprinted on and completed his bachelor’s degree in Biblical Studies online through Liberty University just a year and a half later. Now Whitmer is taking on his most exciting, and perhaps daunting, task: Moving HowToLife to the next level. “I would love to see that we have significantly more paid staff and a headquarters in the next two years, by 2019 or 2020,” Whitmer explains. Getting there, he estimates, will take $500,000. That’s why, in addition to helping regional student leaders organize rallies, he spends much of his time crisscrossing the country on a fundraising blitz.

christianworldview

A survey from the Barna Group released last October revealed that only 4 percent of Generation Z holds a biblical worldview. About 35 percent claim to be atheist, agnostic or unaffiliated with a religion, a figure 5 percent higher than for Generation X, and 9 percent more than that of Baby Boomers. Such findings led Barna Group to consider Gen Zers as the first “post-Christian” generation. Post-Christianity is characterized by loss of the primacy of the Christian worldview in political affairs, especially in the Northern Hemisphere where Christianity flourished, in favor of alternative worldviews such as secularism or animism.  It includes personal worldviews, ideologies, religious movements, or societies that are no longer rooted in the language and assumptions of Christianity. A post-Christian world is one in which Christianity is no longer the dominant civil religion, but has gradually assumed values, cultures, and worldviews that are not necessarily Christian.

Whitmer notes, “People are excited to come out to events that are completely led by their friends because teenagers listen to teenagers more than anyone else,” adding that the teen-to-teen dynamic is “the biggest strength of this movement.” HowToLife board member Ralf Stores, 63, agrees. “That idea of youth leading youth to Christ has a very powerful component to it,” he says. “I have found over the years there’s almost a universal culture among youth—clothes and talk and music and those sorts of things. It transcends languages and it transcends the different countries and cultures around the world.” That’s why, going forward, Whitmer says HowToLife will keep the teenagers-reaching-teenagers, no-one-over-18-on-stage component. He believes that inspired idea conceived at his dining room table is timeless.

But he also wants to continue impacting Generation Z as its members enter their 20s and 30s. He’s open to HowToLife becoming a multi-generational, international ministry. “I believe that God can and will continue to do incredible things through this movement on a teenager level, on an adult level and [through] more and more elements as things continue to grow,” he says.

CLOSING REMARKS

Whitmer expects to continue leading the HowToLife Movement for the long haul. Under his leadership, he says not to expect the Movement to get sidetracked by political debates or to delve deeply into secondary (though still important) moral issues. His plan is to borrow another page from Billy Graham’s playbook and keep the primary focus on the Gospel. “My firm belief is that the lack of understanding of the Gospel is the root [of Generation Z’s problems]. Everything else stems from that,” he says. “Focusing on Jesus and the Gospel at the center of everything is what I continue to commit to doing.”

FOR MORE INFORMATION To learn more information about the HowToLife Movement visit: http://howtolifemovement.com

 

Today’s Media: Content & Constraint

MEDIA IN THE 21st CENTURY

Media today more than ever, in its various forms, has become the determiner of the thoughts and intents of our hearts and minds. This is a scary concept! The definition of the word media is the means of communicating information or ideas through publishing, radio, television, computers, smart phones, videos/DVDs, movies, the Internet, and computer games. Media influence has a profound effect on our thinking and lives. It can be a very useful, positive tool in many ways, but if misused it can bring devastating and destructive consequences to us and to the lives of those we love. Because of wrong choices in this area many young people have been drawn down the path of spiritual bankruptcy and sinful disobedience to God.

More importantly, the advent of the personal computer has transformed how we communicate, promote ideas, perform research, plan vacations, and conduct our personal finances. Of critical concern is the extent to which we—especially our youth—text, post and chat rather than sit down face-to-face and have a conversation. Among family and friends, among colleagues and lovers, we turn to our smart phones instead of each other. It is not unusual, for example, for couples to break up via text message or by changing their relationship status on Facebook to single. This new mediated life has gotten us into trouble. Face-to-face conversation is the most human—and humanizing—thing we do. When fully present to one another, we learn to listen. Frankly, this is the only way we learn the capacity of empathy. Experts worry that social media and texting have become so integral to teenage life that they are causing increased anxiety and low self-esteem. Snapchat, Facebook, Twitter and Instagram are leading to feelings of depression, anxiety, poor body image and loneliness.

Lately we seem to be finding ways around conversation. We hide from each other even as we’re constantly connected to each other. From behind our mini screens, we are tempted to present ourselves as we want to be seen. On line and at our leisure, it is easy to compose, edit and improvise as we revise. We put our best foot forward, even if we’re lying or exaggerating. The word phubbing has been coined to describe the habit of snubbing someone in a face-to-face conversation in favor of texting. Unfortunately, this has become such a normal part of life that we might not even notice we’re doing it.

JUST HOW WIRED ARE WE?

According to the Pew Research Center, U.S. Census figures from 2015 indicate that 84% of U.S. households own a computer, and 73% of U.S. households have a computer with a broadband connection to the Internet. (Census: Computer Ownership, Internet Connection Varies Widely Across U.S., Sept. 19, 2014). The Internet, and specifically social media, has had a major impact on the Christian church. While some pastors and elder church leaders see this as troubling, worrying that Christ can only be properly shared face-to-face, and that online churches will eventually replace the local church, others see it as aiding the church in spreading the Good News worldwide. Regardless, it is important to see computer technology from a biblical worldview. 

GOOD OR EVIL?

My great-grandmother had a very jaded and suspect view of computers, and felt they were the makings of the Beast. To her, computers would be integral to establishing a one-world government, and would help the government establish complete domination.  I used to see computer technology as one of those tools that were “of the world,” with the potential to do more harm than good. By the time I reached college in 1982, I no longer held that negative opinion. My biblical worldview regarding computer technology has been given a positive boost as a result of personal experience and research.     

The notion of being able to connect to millions of people worldwide with a personal computer or smart phone is irresistible to someone with a story to tell. I found an online article on the Society page at www.christianitytoday.com that fits completely with my biblical worldview of computer technology and social media. According to Tim Kenny, vice president of Media Services and Internet Evangelism for BGEA, “We happen to think we’re called to tell the greatest story in human history, so it’s a no-brainer that we need to be active in social media.”

Christian-Social-Media

Richard Helsby of CBN’s Digital Media department, said, “As [Christians], we now have unprecedented opportunity to reach people we could never reach before.” CBN Social Media manager Juana Lopez said the response toward evangelism has been so great that in just one month they received over 7,000 salvation responses through social media. (Christian Ministries Using Social Media to Connect to Millions All Over the World, April 11, 2016).

CONTENT OF MEDIA

Two important areas in the use of media today must be carefully considered to help guard our minds and hearts. The first area is content. Many of the programs on television are an increasing source of crudeness which lead us to accept warped social standards and immorality. Bold, blatant sexual content, profane language and graphic violence are entering our homes on a regular basis through television. The videos and DVDs that have made their way into our living rooms have served to desensitize us even further to what the world’s view is and what is acceptable to watch.

Christian parents, teens and children watch movies that the world has rated PG, PG-13 and R. According to one Barna survey, 30% of born-again Christians watched an R-rated movie in the past week. At the college level, many students don’t even realize there are sexual scenes or profane language in some of the DVD movies they watch. Ephesians 5:3-4 says, “But among you there must not be even a hint of sexual immorality, or of any kind of impurity, or of greed, because these are improper for God’s holy people. Nor should there be any obscenity, foolish talk or coarse joking…” (NIV).

The computer with its Internet and gaming capabilities has not only had a negative effect on many people, but has destroyed their lives and families. The readily available “private” pornography on the Internet, the graphic sexual violence on many video games, and cyber gambling have the devastating consequences of control and addiction. As much as 60% of all websites typically visited are sexual in nature and the term “sex” in the word search is used more than the next eight most popular terms combined. More than 50% of men with Internet access admit to spending significant amounts of time viewing explicit material.

There are an alarming 15-plus million Internet users that visit gambling sites, wagering a combined amount of money in the billions. Also, smart phone capabilities have compounded the problem with easy downloading of pornography and gambling sites. Christians, young and old, have been drawn in and hooked. Content choice in these types of media, unfortunately, is very destructive to our spiritual well-being and ultimately to those around us.

CONSTRAINT OF MEDIA

The second area that needs to be very carefully considered is constraint in media usage. Not only is pornography/gambling controlling and addictive, gaming has become a worldwide obsession. Young adults enjoy many of the fast-paced computer games, which are very entertaining. But it’s hard to stop at a game or two. Because of the time spent playing these games late into the night, high school and college students are failing their courses and dropping out. My research shows that sitting for long periods of time—as occurs often in all-night gaming sessions or regional gaming marathons—may increase a person’s risk of developing deep vein thrombosis (DVT) regardless of age. Chris Staniforth, 20 years old, died after spending twelve hours at a time playing video games. He suffered a blockage—pulmonary embolism—to his lungs when he developed DVT. The coroner confirmed DVT as the cause of death despite Chris having no medical history of ill health or underlying medical conditions.

Chris Stanisforth

BUT IT’S NOT ALL BAD NEWS

A mind-blowing number of people are able to become members of a global community today as a result of the Internet and social media that would otherwise be severely limited in their exposure to other cultures, geographic images, writings, publications, news and religion. I believe God, in His infinite wisdom and omniscience, knew future population growth on our planet would reach the billions. He knew the Body of Christ would need extraordinary help in reaching the four corners of the globe. Inasmuch as God created man in His image, and given the fact that He created all raw materials available, I also think the computer is an indirect creation of God.

CONCLUDING REMARKS

The rise of social media has provided for the church both challenges and opportunities. Social media opens doors and opportunities to engage with people who rarely, if ever, step foot in a congregation. Numerous pastors have started blogging. Pastor Mike Miller, of my home church Sunbury Bible Church, writes a weekly blog. Our church also has a Facebook page and an official website. These media outlets allow for spreading information about our church, including worship times, community and Sunday school groups, special events, and the opportunity to watch sermons and worship services online. In addition, we are able to provide links to websites relative to special Sunday school groups, such as our current class in Dave Ramsey’s Financial Peace University.

Through social media, Christians can share their faith with people they might not otherwise have the opportunity to witness to. The Internet allows for posting of testimonies, spiritual or inspiring quotes, photographs and other images relating to missions, teaching Bible study, inviting people to events, reaching out to individuals mired in sin or in bondage to addiction, create prayer groups or bulletin boards, share contemporary Christian songs, hymns, and gospel music, and seek to create unity in the Body of Christ.

He said to them, “Go into all the world and preach the Gospel to all creation.” (Mark 16:15, NIV).

Teenagers, Monkeys, and Mirrors – Developing Self-Image in a Cyber-Addicted Society

Inside her classroom at Coral Springs Charter High School, Susana H. was in distress. The Florida teacher, seven months pregnant, was suddenly experiencing labor contractions. She sat down in a desk chair and struggled to endure the pain – her mouth open, her eyes wide, one hand on her brow. That’s when one of her students, junior Malik W., pulled out his mobile phone. It was time for a selfie. In dreads, cap, and big sunglasses, he flashed a big happy-go-lucky grin for his camera while angling the lens to show his grimacing, pain-stricken teacher in the background. “Selfie with my teacher while she is having contractions,” he tweeted.

Selfies. They bring new meaning to the word self-conscious. These quick, seemingly innocent self-portraits – typically taken with a smartphone or webcam and shared via social media – serve many functions. They can be a preened vision of a public self, a bragging moment of accomplishment, a display of humor, or a declared irony to the world, almost a performance. The ubiquitous mobile phone with its mirror-image camera technology, makes self-portraits easy to take, delete, filter, or fix, and even easier to share.

Some kids would call what Malik in our example did, taking his own picture with a featured but unsuspecting person in the background, a kind of photobomb selfie. It’s a prank or joke. Photobomb moments are something like a tourist’s snapshot souvenirs. I was there. But this time, the background wasn’t Mount Rushmore or Niagara Falls. It was Malik’s teacher’s suffering. Whatever you call it, in the time it took for the teacher to reach the hospital to be examined by doctors, Malik’s pic was making the rounds on social media, first to other high school students at Coral Springs, and then quickly beyond. By evening, it was viral and had been retweeted by thousands. When asked later by local TV news reporters what possessed him, Malik said he was just hoping to record the unexpected event for himself and “for her.”

It went viral mainly because people found it funny. BuzzFeed raved: “Behold! The greatest selfie of all time.” Was it funny? Sure, if you don’t take a moment to consider this act in a deeper way – and what it means to use a human being in distress as a visual joke in the background of a curated self-portrait shared on a public social network. There are more troubling trends to notice here – invasion of privacy, breach of good manners, absence of empathy, not to mention a demonstrated lack of respect for pregnancy, motherhood, and classroom setting, and a teacher’s authority. Let’s be honest: Nobody looks to teenagers as role models of civility and decorum. They can be jokesters, disrupters, provocateurs. Pushing the limits is what they do best. Why? In psychological terms, they are said to be forming self-concept, or identity, and enjoy experimenting with boundaries and taking risks.

They also crave feedback, which helps them figure out, eventually, who they are – and what the world expects of them. So when teenagers take selfies and share them, what are they hoping to discover? Probably themselves. Prior to the Internet, this crucial time of identity formation was spent in the real world – a more intimate greenhouse where feedback, both positive and negative, was received from a real-world audience of friends, family, and figures of authority. The social norms and what was expected of these developing human beings was fairly consistent. Twenty or thirty years ago, would a teenager have been allowed to take a photograph of a distressed teacher in a classroom and, without permission, been allowed to publish it in a magazine?

The Internet is now a primary adventure zone where teenagers interact, play, socialize, learn, experiment, take risks – and eventually figure out who they are. This blog post will try to grapple with this shift, and look at the impact of this new environment on youthful identity formation. Could growing up in cyberspace change a teenager’s sense of self? Why not?

WHY SO HEARTLESS, SELFIE?

The same year as Malik’s cyber-celebrity moment, another controversial selfie was seen by millions. A lovely young woman with long blond hair, aviator sunglasses, white knit scarf, and matching hat was caught in the act of posing for her own selfie while, behind her, a suicidal man was hanging on the rails of the Brooklyn Bridge. What, aside from basic psychopathic tendencies, would cause a person to be so cold and unfeeling about another human being’s emotional crisis? Let’s stop and contemplate this. Just as Malik made a joke of his teacher’s  moment of physical crisis, the young blond (she would remain anonymous), whether she planned to share her selfie with a wide audience or not, was apparently making fun of a stranger who was so emotionally troubled and confused that he wanted to end his life. Yes, her selfie seems more heartless than Malik’s selfie, but aren’t the sense of disengagement and lack of empathy eerily similar? The day after the Brooklyn Bridge incident, an observer’s photograph of the anonymous young woman took over the entire front page of the New York Post with the apt headline “SELFIE-ISH!”

This slap of disapproval only encouraged a new trend. In 2014, when traffic was stopped on a Los Angeles freeway due to a man threatening to jump from an overpass, a group of drivers left their cars to pose – big smiles – for group shots and selfies with the suicidal man in the distance behind them. The same year, a policeman in Istanbul was called to the scene of the Bosporus Bridge, where a desperate individual was clinging to the rails. The suicidal man jumped three hours later, but before he went, the officer took a selfie. The bridge and the jumper were in the background. More recently, in March 2016 – in perhaps the ultimate example of this trend – a hostage on an EgyptAir flight posed for a bizarre smiling selfie next to a hijacker in his suicide vest.

Let’s try to consider the mind-set of these people – not the distressed suicidal individuals, but the selfie-takers. Were they conscious of what they were doing? Or were they so lost, so separated from ethics and empathy, that they weren’t able to clearly consider their actions? Are they emotionally impaired, or has cyberspace impacted their judgment? A condition that results in lack of empathy toward another person’s distress is narcissism. This is a personality trait that exists to varying degrees in almost all human beings and can be facilitated by cyberspace. A little narcissism can be a good thing. Actors are famously perceived as the ultimate narcissists, and the psychologically healthier ones even crack jokes about it. They aren’t necessarily heartless people. But a narcissist’s desire to be noticed and become a focus of attention can override a concern for other people – and result in callousness about their suffering.

As with so many personality traits, psychologists have defined a spectrum of narcissism – generally assessed by the Narcissistic Personality Inventory (NPI). Individuals with high scores demonstrate an inflated sense of their own importance, grandiosity, extreme selfishness, enormous self-regard, and a deep need for admiration. Behind the mask of ultraconfidence, their self-esteem is very fragile and vulnerable to criticism. Why get into all of this? Because teenagers (as well as children) can display narcissistic-type traits due to the simple fact that their sense of self, or “self-concept,” is still being formed. They can seem to be uncaring about others because they are distracted by the work of creating an identity. Teenagers will try on new selves and new clothes and new hairstyles to the point of total disengagement with anything else going on in their family life or home. For a teenager, this sort of experimentation, along with risk-taking, is one way that identity is formed. Going too far is part of the process – almost a requirement.

Who am I today? Who do I want to be tomorrow morning? They look for answers in the feedback they receive from their peers. And today, to a greater and greater degree, this feedback happens online, not just from their friends but in free online astrological profiles, personality questionnaires, and a plethora of phone apps that will analyze their handwriting, music tastes, food preferences, and even bathing styles. Teenagers are consumed by their own reflections, in other words, hoping to figure out who they are. What happens when the bathroom mirror, where teens used to state at themselves, is replaced with a virtual mirror – a selfie that they just took with their phones?

MONKEYS AND MIRRORS

In a famous study done forty years ago, great apes – chimpanzees, orangutans, and gorillas – born in the wild were placed before a full-length mirror on a wall. At first, the wild chimps reacted as if another chimp had appeared in the room; they vocalized and made other threatening gestures at the mirror. After two or three days, they began to understand the image in the mirror as a reflection of themselves in some way. Interestingly, they began exploring their own bodies before the mirror – studying parts of themselves they hadn’t seen before, or couldn’t see without use of a mirror.

In psychology, one way to describe what happens in front of a mirror is called mirror-image stimulation, referring specifically to “a situation in which an organism is confronted with its own reflection in a mirror.” An animal that shows signs of recognizing the image in the mirror as it own is said to have “passed the mirror test,” which is strong evidence of having developed self-concept. This is not innate, but learned. Self-concept is used in human social psychology to describe how people think about, evaluate, or perceive themselves. The actual definition is “the individual’s belief about himself or herself, including the person’s attributes and who and what the self is.” A monkey that has self-concept demonstrates an awareness of a self that is separate and distinct from others, as well as constant.

What are teenagers learning about themselves by looking at their own selfies? Could this impact the development of self-concept? The study also raises this question: Could young people who have grown up with too much technology and not enough face-to-face interaction with peers remain more isolated, retreating to the comfort of their own digital reflection rather than turning to their friends or family for comfort and physical interaction? Could this cyber effect encourage children or young teenagers to lose interest in others – or never develop it in the first place? Since there hasn’t been time for proper developmental studies in this area, we just don’t know.

Humanistic psychologist Carl Rogers’s work is valuable in terms of illustrating how a young person develops identity. He described self-concept as having three components: (1) the view you have of yourself – or “self-image,” (2) how much value you place on your worth – or “self-esteem,” and (3) what you wish you were like – or “the ideal self.” Given the advent of social media, perhaps we need to add a fourth aspect of “self” Rogers didn’t consider. In today’s technology, identity appears to be increasingly developed through the gateway of a different self, a less tangible one, a digital creation.

Let’s call this “the cyber self” – or who you are in a digital context. This is the idealized self, the person you wish to be, and therefore an important aspect of self-concept. It is a potential new you that now manifests in a new environment, cyberspace. To an increasing extent, it is the virtual self that today’s teenager is busy assembling, creating, and experimenting with. Each year, as technology becomes a more dominant factor in the lives of teens, the cyber self is what interacts with others, needs a bigger time investment, and has the promise of becoming an overnight viral celebrity. The selfie is the frontline self, a highly manipulated artifact that has been created and curated for public consumption.

THE PSYCHOLOGY OF FEEDBACK

To understand feedback more deeply, we need to go way back to the work of sociologist Charles Horton Cooley in 1900, decades before the advent of the Internet or when monkeys were stuck in front of mirrors. Cooley came up with what he called the looking-glass theory. Cooley used the concept of a person studying his or her own reflection as a way to describe how individuals come to see or know themselves. In the case of Cooley’s looking glass, the information that we use to learn about ourselves isn’t provided in a mirror’s reflection. It is provided by others – their comments about us, the way they treat us, and things they say. In the looking-glass self, a person views himself or herself through others’ eyes and in turn gains identity. In other words, the human self-concept was dependent upon social feedback. Philosopher William James, the so-called father of psychology, expanded this idea by pointing out that individuals become different people, and express their identity in different ways, depending on whom they are with.

Now let’s fast-forward to the next century and do the math – and consider the psychology of this effect in cyberspace. If you have a repertoire of many selves – potentially as many as people who know you – social media could exponentially expand the number of selves you create. Is your “self” environmental-specific? Are you the same person on Twitter, Facebook, Instagram, WhatsApp, SnapChat, and LinkedIn? Does this new explosion of selves cause a splintering of identity or, particularly for teenagers, who are going through critical stages of identity formation, cause developmental problems? And what about critical feedback? Presenting yourself to the whole world is a risky business. It’s hart to imagine an individual alive who hasn’t experienced some form of rejection, subtle or strong, embarrassing or humiliating. But you can also be accepted for the self you present – and feel rewarded by pleasant feelings of pride and affection.

Let’s imagine you have just turned thirteen. The five years ahead of you are a natural time for questioning and seeking. You’ll be trying new clothes, mannerisms, friends, interests, and pastimes. You’ll probably begin experimenting with what you think of as adult behavior. This helps you make sense of the self within, as you unconsciously piece together an identity, like a collage. You are working to create a constant, steady, reliable, knowable, and familiar self. What kind of information – or feedback – is the virtual mirror going to give you? In this regard, the cyber environment may be much more overwhelming than the real world. To begin with, the sheer number of “friends” has grown, and therefore the volume of feedback will be far greater. Prior to the Internet, a teenager would have a limited number of social groups to juggle – family and extended family, schoolmates, maybe neighbors. Now the number of social groups is potentially limitless.

The cyber self is always under construction, psychologically and digitally. Even while the real you is sleeping, the cyber you continues to exist. It is “always on” – evolving, updating, making friends, making connections, gaining followers, getting “likes,” and being tagged. I started this blog in December 2014. To date, I have 181 regular followers; however, 9,840 people from 93 countries have visited my blog since its inception. The constant source of feedback we receive today can create a sense of urgency, a continuous feedback loop, a sense of needing to invest more and more time in order to keep the virtual self current, relevant, and popular. This is especially true of a blog.

This may explain the obsessive interest among teens in curating their selfies. When the process of identity formation in real life becomes confusing and difficult to control, as it is for most teenagers at some point, what could be more satisfying than being able to perfectly calibrate and manage the portrait that the online world sees? To some extent, we all engage in image management, but it now begins at an earlier age, and in some cases before identity has been properly formed. This may lead to identity confusion. After all, which matters the most: Your real-world self or the one you’ve created online? Probably the one with the greater visibility.

CYBER MIGRATION

Amazingly, plastic surgery among teenagers is another area that has been impacted by the norms online. The easy curating of selfies may be linked to a rise in plastic surgery. According to a 2014 study by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), more than half of the facial surgeons polled reported an increase in cosmetic surgery for people under thirty. There is also a rise in children and teenagers requesting teeth whitening and veneers reported at dental clinics. “Social platforms like Instagram, SnapChat and the iPhone app Selfie.im force patients to hold a digital microscope up to their own image and often look at it with a more self-critical eye than ever before,” explains Dr. Edward Farrior, president of AAFPRS. “These images are often the first impressions young people put out there to prospective friends, romantic interests, and employers, and our patients want to put their best face forward.” Sadly, surgeons have reported that bullying is also a cause of children and teens asking for plastic surgery, usually as a result of being bullied rather than a way to prevent it.

Okay, so let’s put all these trends and technological developments together – from teenagers using apps to filter and “improve” the appearance of their selfies, to the  rise of plastic surgery among young people, the escalation in provocative self-presentation, and the quest for the perfect body. What do these developments tell us, given that we know human beings look to feedback in order to develop identity? Imagine for a moment the shy thirteen-year-old who feels uncomfortable speaking to others. For this child, posting a selfie will be easier and more rewarding – no actual contact! Now imagine that child progressing through the stages of identity formation and never having to practice being a human being on the stage of real life. This is what causes isolation in adulthood.

SELF-ACTUALIZATION

The cyber self, while it offers glimpses into who you are, is a literally detached self. This cyber self is like a hand puppet that is speaking for you but isn’t really you – and can actually be quite different from the authentic real-world you. In other words, the real you has turned the cyber you into an object: The selfie is proof of this objectification. By posting a selfie, you are required to experience yourself as an object that is presentable or not. You judge your selfie from a detached distance, even if it is posted impulsively. This self-objectification, and the sense of detachment from true self, could explain many of the negative behaviors seen online. It feeds disassociation. Detached from your cyber self, you can feel detached from your actions – and come to believe you aren’t truly accountable. Now let’s think about a teenager in the process of identity formation from the age of ten, eleven, twelve to late teens, a crucial window of time to create a strong foundation and sense of self. This process is critical to development, and can have an enormous impact on the rest of an individual’s life and sense of self-esteem.

Carl Rogers described “self-actualization” as an ongoing process of always striving to be one’s ideal self. A “self-actualized” person is one whose “ideal self” is congruent, or the same as, his or her perceived actual self or self-image. Rogers believed that this sense of being, or having become, the person you want to be is a good marker for happiness, and a sign of a fully functioning individual. If you accept his description of happiness, then it’s troubling to see the results of a survey of children and teens, ages eleven to sixteen, in which half agreed with this statement: “I find it easier to be myself on the Internet than when I am with people face-to-face.”

The transition from childhood to adulthood is a critical developmental phase, what psychologist Erik Erikson described as a “psychosocial stage.” For an awkward adolescent or teen, it may be a lot easier to avoid painful experiences performed on the stage of real life, but these are often important developmental milestones and come with consequences if missed. Identity may not be fully developed – and what one wants to do or “be,” in terms of a future adult role, may not be fully explored. Social coping skills may not be acquired. Learning to navigate the tension or lack of comfort that the real world sometimes brings is necessary for the developmental process, as youth explore  possibilities and begin to form their own identity based on their explorations.

Failure to successfully complete a psychosocial stage can also result in a reduced ability to complete further stages. For Erikson, the next stage is intimacy versus isolation, occurring between ages eighteen and forty, when individuals learn how to share more intimately with others and explore relationships that lead toward long-term commitments with someone other than a family member. Avoiding intimacy for fearing relationships or commitment can lead to isolation, loneliness, and often depression. This is why we need to talk more about the repercussions of teenagers failing to establish a sense of identity in real life as well as cyber life. The result of such a failure can be what Erikson calls “role confusion,” when young people become unsure about themselves or their place in society. Some experts believe contemporary boys are in crisis due to excessive use of technology. The digital self tends to become less and less like the real-life operator.

The cyber self is a masterful creation – funnier, wittier, better looking than the real self. But the problem lies with the vulnerability of this split-self existence. And it’s a serious problem. If you look at all the studies done over the past ten years on cyberbullying, you’ll see that few of the solutions and awareness campaigns have worked effectively. Each year, more teenagers are devastated, even destroyed, by experiencing bullying online. Why? Think of the time and energy that teenagers put into their cyber selves – the self-portraits they’ve painted. When the cyber self is attacked – called “stupid,” “ugly,” “a loner,” “a loser” – then this could cause a catastrophic inter-psychic conflict, an emotional clash of opposing impulses within oneself. Look at it this way: If the best version of you that technology can produce is rejected, how does that make you feel about the only self that’s left, your real one?

THE PRIVACY PARADOX

In real life, would a teenager girl walk around with a photograph of herself naked – and show everybody at school? Would she undress in class and pose suggestively? That’s what happens, potentially, every time a sext is sent. Besides impulsivity and narcissism, what are the other possible explanations for this disinhibited behavioral shift online? Teenagers exhibit a lack of concern about their privacy online. It’s an interesting shift because so often in the real world, many teens are self-conscious and tend to seek privacy. But online, something happens. Even teenagers who are well-versed in the dangers and have read stories of identity theft, sextortion, cyberbullying, cybercrimes, and worse, continue to share as though there is no risk.

I read an article in my hometown newspaper, The Daily Item, published online on May 7, 2017 regarding the Netflix mini-series Thirteen Reasons Why, based on Jay Asher’s book of the same name. I watched the show, which follows the final weeks of a high school girl who commits suicide. The writer of the Daily Item article interviewed local educators regarding Thirteen Reasons Why, specifically focusing on whether the young girl in the show justified her suicide and blame others, and whether the final scene was an unnecessarily graphic depiction of the act. The topic of teen suicide is one that is emotionally volatile, and is currently of much concern to educators.

Olivia Masser, director of the Milton Public Library, believes Asher’s story Thirteen Reasons Why unwisely portrays Hanna Baker as a martyr. Masser admits that the story raises awareness of the serious issues of sexual assault, cyberbullying and teen suicide. As Phillips, Brown and Stonestreet (2008) indicate, “…there exists a ‘quiet desperation’ that drives humanity to think about the question, ‘Does life have meaning?’” This question is faced by every teenager growing up in America. Certainly, when Hanna is sexually assaulted and bullied, and photographs are posted online that make her look “easy,” she is already struggling to find her way at a young age. She asks the ultimate question, “Why am I here?” What meaning was left in her otherwise meaningless life now that she’d been raped, bullied (including online), and labeled a “slut?”

According to Danah Boyd, the TED Talk celebrity and visiting professor at New York University, most teenagers scrutinize what they post online very carefully. In her book It’s Complicated: The Social Lives of Networked Teens, Boyd argues that teens adjust what they present online depending on the audience they want to impress Everything is calibrated for a specific purpose – to look cool, or tough, or hot. When it suits them, teenagers can be enormously savvy about how to protect the things they want kept private, mostly from their parents. For example, they might not care if Facebook knows their religion, but they do care if their parents find out about their sex life.

CONCLUDING REMARKS

We just might owe teenagers an apology. We are failing to protect and defend them in cyberspace. Period. We are failing to understand and therefore protect their developing selves. Tech companies have made billions of dollars while looking the other way. Opportunistically, they have jumped in to offer solutions to emerging obstacles, creating social platforms such as SnapChat, Wickr, Confide, and the German-based Sicher, where risqué images can be sent and viewed. While they supposedly can disappear almost as soon as they are posted, in fact there are many ways they can be saved. Do teenagers need to explore and have adventures? Yes. And we should let them. But the risks in the cyber environment are real.

And what about the more nuanced and much-harder-to-study risk of harm to a developing identity? Juggling two selves, the real one and the cyber one, is a lot to expect of young individuals who are still figuring things out, about themselves and the world. We are likely a decade away from seeing the cyber effect on psychological and emotional well-being and the formation of a sturdy and sustainable self. We can see signs and clues coming already in the new norms of sexting, the obsession with the cyber self, premature sexualization, the plastic surgery among younger people, the escalation of body and eating disorders, and the rise of narcissistic behavior (if not true narcissistic personality disorder). These trends should be cause for alarm. Narcissism and excessive self-involvement are both known attributes of those who suffer chronic unhappiness.

A teenager may think he or she is creating a better “self,” a better object with each selfie. Every selfie taken, and improved upon, causes an erosion or dismissal of the true self. With each selfie taken, and invested in, the true self is diminished. In a way, it’s similar to the phobia in Amish tradition that each portrait photograph robs the soul. Adolescents are naturally prone to “storm and stress,” during which kids will often experience mood swings, fight with parents, and engage in risky or dangerous behavior. We can’t blame the Internet for that. But we can wake up and see that it’s even more important to protect them there.

And, parents of teenagers, if you find a sext, sit down and talk about it. Resist the urge to shut down or confiscate all your son’s or daughter’s devices. The point at which you banish your teenager to his or her bedroom – hating themselves, hating you, and hating their lives – and take away their phone and computer, you are depriving them of their entire support system. That can be too hard. They need to vent. They need to reach out to friends. Let them. And finally, if anything goes wrong in their cyber life, tell them not to try to handle it on their own. That’s what parents of teenagers are for.

References

Aiken, M., PhD. (2016). The cyber effect: A pioneering cyberpsychologist explains how human behavior changes online. New York, NY: Random House

Asher, J. (2007). Thirteen reasons why. New York, NY: Razorbill

Phillips, W., Brown, W., and Stonestreet, J. (2008) Making sense of your world: A biblical worldview, second edition. Salem, WI: Sheffield Publishing.

 

Mobilizing Citizen Science to Address the Overdose Epidemic

From the blog of Dr. Lora Volkow, National Institute of Drug Abuse, posted November 16, 2017.

In the terrorist attack in New York City on October 31, citizens on the scene shared information and pictures in real time via their smartphones, using social media apps like SnapChat. index.png  The social media site recently introduced a location-sharing feature called Snap Maps, which was also used during the Las Vegas shooting, the Mexico City earthquake, and the hurricanes that devastated the Caribbean and some US cities. Could existing social media or new, built-for-purpose apps, be used to attack the opioid problem? It is an area where additional research and partnerships with technology startups could potentially make a big impact.

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Social media and crowd-sourcing apps could be particularly useful for gathering and sharing information in real time about overdoses and using that information to prevent overdose deaths, thereby translating “citizen science” into “citizen prevention.” In October, 2016, NIDA partnered with the FDA and SAMHSA in a competition to develop an app that would use a crowd-sourcing approach to facilitate access to naloxone during opioid overdoses. The winning entry (out of 45 submissions) was an app called “OD Help” that will be developed by a Venice, California startup called Team Pwrdby. OD Help will link potential opioid overdose victims with a network of naloxone carriers; it will give instruction in administering the medication; and it can optionally be interfaced with a breathing monitor to detect signs of an opioid overdose and automatically alert the network.

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Crowd-sourcing apps could potentially be used to facilitate access to evidence based care in specific regions of the country by sharing information about treatment capacity, waiting lists, and available beds in treatment centers. They could also help opioid-addicted patients in treatment, by enabling them to share their withdrawal experiences, ease fears, and offer suggestions. Families could also share ideas for encouraging loved ones to seek treatment. Crowd-sourcing capabilities like this might also augment mobile health (or mHealth) tools being developed as treatment and recovery aids. One mobile app, the Addiction Comprehensive Health Enhancement Support System (ACHESS) tool, developed with NIH support, utilizes GPS to warn users recovering from alcohol addiction when they are near locations that may be personal triggers for alcohol use; but it can also link users to other ACHESS users via text messaging or to pre-approved family members, friends, or peers for help, thereby bringing the power of crowd-sourcing to recovery support.

Crowd-sourcing is already beginning to change the face of public health. Since 2011 a participatory disease surveillance system called Flue Near You has collected reports of flu-like symptoms encountered by volunteer users via its Website, Facebook, or a mobile app. Similar tools are being used to crowd-source information on food-borne illnesses, toxic waste hazards, and other health threats. They could readily be applied to monitor drug overdoses. [Crowd-sourcing is featured in the new Jeremy Piven crime drama Wisdom of the Crowd. Piven’s software company created a program called “SOPHE,” which is basically Twittr for crime solving, where people can post any evidence or information they have related to a crime.]

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The NIDA-funded National Drug Early Warning System (NDEWS) already crowd-sources emerging drug trends from its nationwide network of researchers, such as regional spikes in overdose deaths or emergency department admissions caused by particularly dangerous batches of heroin or counterfeit pills. If augmented with smartphone technology, this information could be more readily used to warn the public and share with public health authorities so that resources could be quickly mobilized to prevent further deaths in an area where a pocket is detected.  Such information could be a boon to implementation research by allowing researchers to determine if a prevention or treatment intervention or a new model for delivery of care was successful in achieving its goals.

The Office of National Drug Control Policy (ONDCP) funded the Baltimore/Washington High Intensity Drug Trafficking Area (HIDTA) to develop an app for first responders and emergency personnel called the Overdose Detection Mapping Application Program (ODMAP). Data gathered through this system can be used to identify localized spikes in overdoses over a 24-hour period, enabling a public health and safety response to be swiftly mobilized. Additionally, the app enables users to enter how many administrations of naloxone were used (if any) and whether the overdose proved fatal, which in turn can help identify areas where more potent opioids or mixed drugs might be responsible for the naloxone failure.

There are obvious issues of privacy protection and bystander legal protection, among others, that will need to be addressed in developing crowd-sourcing apps. But we should not allow the inevitable challenges in this relatively unexplored domain dissuade us from studying the possibilities. If we are going to end the opioid overdose epidemic we need “out of the box” thinking, and must avail ourselves of the new crowd-sourcing possibilities smartphones and social media apps are making possible.