Affirmative care reinforces suicidality
If I don’t get that promotion, I’ll kill myself.
If I don’t get invited to the party, I’ll kill myself.
I’f I don’t get an A on my assignment, I’ll kill myself.
If I don’t get accepted to the college of my choice, I’ll kill myself.
If Obama doesn’t get re-elected, I have no reason to live.
These are a few real-life examples of things I’ve heard from clients who haven’t learned to regulate their emotions. Their entire emotional wellness depends on what others do or don’t do. This is a set-up for emotional turmoil. This is a defining trait of personality disorders. This is also common behavior for young people.
People with abandonment and trauma particularly struggle with this because they have learned not to trust themselves.
Therapy such as Dialectical Behavioral Therapy (DBT) teaches people that they should not depend on others for their emotional well-being, rather that they should “Build a life worth living.” They learn interpersonal effectiveness so they can set appropriate boundaries, learn how to self-validate and surround themselves with people who are genuine and trustworthy so the trauma cycle doesn’t continue. Relationships need to be earned and not built on threats. “If you don’t do ____ , I’ll kill myself” creates an abandonment cycle, which many who engage in these behaviors suffer. A person may feel suicidal and ask for help, but empty threats and blackmail tends to keep people around only in the short-term, but will cause distance, broken relationships and disappointment in the long term.
Therapists like myself were trained to break that cycle, but with this new push to instantly affirm, we are reinforcing the instant gratification we were working so hard to fight. Teaching young people to parrot “If you don’t affirm my gender identity, I will kill myself” is no different than the examples above. We are raising a generation to be non-resilient, empty and lonely.
We can look at the data and how affirming a trans-identified person doesn’t help in the long-term. https://pubmed.ncbi.nlm.nih.gov/21364939/ (There is no valid study that proves affirmative care saves lives, all that claim they do have been redacted)
-OR- we can look at what has been the most effective type of therapy for disregulated suicidal individuals: DBT. DBT, or Dialectical Behavioral Therapy has been used across treatment programs and helped millions of people learn important coping skills which are categorized as: mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance.
These skills are a foundation to help someone live a more fulfilling life, to accept life as it is, while simultaneously working on improving it. This is the dialectic; holding two opposing ideas, seeing the shades of grey, taking away black and white thinking, accepting oneself for flaws while working to better themselves, seeing friends and family as not all good or bad, but as flawed human beings and separating a sense of self from other people’s actions. These are the building blocks to reduce suicidal thoughts and to lessen suicidal threats as a means to get others to change behaviors. These are all things to help people suffer less and live more fulfilling lives.
Dialectical Behavioral Therapy teaches how to hold opposing ideas simultaneously.
So let’s stop focusing on affirmation and focus more on helping a person live a life where they can be more comfortable in their own skin, build meaningful relationships, enjoy the moment, regulate intense emotions, get through tough times without self-harm, explore underlying issues and build a life worth living.
The statement “If you do not affirm a person’s new gender identity or the person will kill themselves.” goes against everything the mental health profession has been preaching for over 30 years.
Pamela Garfield-Jaeger is a licensed clinical social worker in California with over 20 years of clinical experience with adults and teens, including in IOP and PHP programs where intensive DBT is utilized. Pamela was fired from Sutter Health’s PHP program in 2021 for not complying with the California State vaccine mandate. Since then, she has dedicated herself to educate parents and help guide them through the complex mental health system, www.thetruthfultherapist.org. She is active on Instagram as @the.truthfultherapist and twitter/x as @truththerapist.
Your common sense combined with years of relevant experience are so refreshing! Thank you Pamela!