Louisville Medicine Volume 69, Issue 4 | Page 12

AUTHOR Allison Yoder , MD
TAKING A STAND AGAINST BULLYING

COUNTERACTING BULLYING AND PREVENTING SUICIDE THROUGH TRAUMA-INFORMED CARE AND RESILIENCE

AUTHOR Allison Yoder , MD

When I was asked to write an article about bullying and suicide prevention , I thought it would be a great opportunity to talk about important issues that I encounter every day as a child & adolescent psychiatrist . Yet I realized it was going to be harder than I thought with these broad , complex issues .

I kept coming back to the same theme : trauma . A lot of people think of bullying as an issue only affecting schoolchildren ; I do not . I believe it is a pervasive issue that affects people of all ages and all parts of society , including individuals , families , communities and institutions . It often involves violence ( whether verbal , physical or psychological ) toward another person or group . Kids who bully others are quite often victims of trauma themselves , related to abuse , neglect , witnessing domestic violence or experiencing community violence . They could have been targeted by bullies themselves , or suffer from a parent with a serious mental illness or addiction .
It ’ s easy to think of the bully as the villain , but it ’ s not that simple . A staff member once said something to me that summed it up : “ Hurt people hurt people .” This concept helps give me compassion for not only patients who are the victims , but also for the bullies , patients who have been persecutors because they have previously been targeted . A helpful way to conceptualize these roles is by looking at the “ Drama Triangle ” originally described by Stephen Karpman , MD , in the 1960s .
The Drama Triangle is a model of social interactions , typically related to conflict and dysfunctional interactions . On each end of the triangle is a role . These three roles include the Victim , Persecutor and Rescuer . Anyone can play any role , and we often do so unconsciously . I suspect all of us have played the Rescuer role in our profession of medicine . However , that doesn ’ t exclude us from playing the other two roles . People can switch roles in
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