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Studies in Gender and Sexuality

3(3):321–341, 2002

Learning to Speak the Language


A Relational Interpretation of an Adolescent
Girl’s Suicidality

Carol Gilligan, Ph.D.


Lisa Machoian, Ed.D.

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Through a clinical case study, this paper explores the peak in
girls’ suicide attempts at ages 13 and 14 and offers a relational
interpretation of girls’ suicidal behaviors as symbolic and indirect
speech, ref lecting a language that is deeply encultured. In early
adolescence, girls learn that if they threaten to harm or endanger
themselves or actually do so, people take notice. Girls then
discover the communicative value of threatening or enacting
harm, danger, or violence against themselves. Thus they “learn


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 Children’s 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 Rice–Smith, Psy.D., and
Bessel A. van der Kolk, M.D. for their support of this work.

321 © 2002 The Analytic Press


322 Carol Gilligan and Lisa Machoian
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to speak the language of violence.” The clinical case illustrates


how girls who speak this language can be called manipulative
and not taken seriously, but also how, when their communication
is heard and interpreted relationally, it can explain why girls’
suicidality peaks in early adolescence and why it is associated with
hope.
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W hen their speaking voices are not heard or when they


have no words to say what they feel and think, children and
adolescents will often speak in the indirect discourse of
symptoms, enacting or saying indirectly what they want and
know. Running away, stealing, cutting, starving, bingeing, and
suicidal behavior can all be seen as forms of communication.
We are interested in the language of symptoms and, specifically,
in the meaning of girls’ suicidality. From a gender perspective,
violence is coded as masculine and typically connotes acts
directed toward other people. As we observe girls learning to
speak a language of violence at adolescence, we discern that
they are discovering that this language is taken seriously in our
society.
By speaking of violence as a language, we mean simply that it
is a system of communication that like the language of dreams,
calls for interpretation (see J. Gilligan, 1996). When we speak
of girls’ suicidality we are referring to a continuum leading from
threats to kill, harm, endanger, or place the self in harm’s way,
to potentially lethal acts of violence directed toward the self,
typically referred to in girls and women as self-harm. Referring
to suicidal threats and acts as part of a language of violence, we
recognize that, if these same threats or acts were directed toward
another person, they would be considered violent threats or
acts. Our title, “Learning to Speak the Language,” refers
specifically to the discovery, often made by girls in adolescence,
that violence is a language that people understand and take
seriously. When girls threaten to harm or kill themselves or
place themselves in dangerous situations, for example, by
running away, people do take notice. Thus girls learn that people
respond to threats of danger and self-directed violence. When
Learning to Speak the Language 323
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these same girls do not actually kill or harm themselves, however,


they tend to be characterized as manipulative or attention
seeking and not taken seriously (Machoian, 1998, 2001). On
the basis of clinical evidence, we suggest that this dismissal
overlooks what may have been the meaning of the suicidal act
in the first place.
Here we follow an early adolescent girl seen by Lisa Machoian
in therapy, as the girl discovers a way to be heard and taken
ser iously in the face of what seems to her the world’s
overwhelming deafness. Reading her suicidal act as a symptom—
that is, as a symbolic or indirect form of speech—we listen as
she obser ves that she was only taken seriously when she
threatened to kill herself. When we consider what she was saying
or dramatizing through her suicidal behavior, we find evidence
suggesting that her suicidality was a complicated expression of
hope, specifically a hope for relationship. Seen in this light,
girls’ nonlethal suicidal acts appear not as thwarted or failed
attempts at killing themselves but, rather, as ways of enacting
the hope that someone does care about them and will listen and
take them seriously. In this way girls who are desperately in
need of help may learn that, by speaking the language of
violence, they can get the help they need.
Research on girls’ development shows early adolescence to
be a time when girls’ resilience is at risk and that what is at risk
is the possibility of a confiding relationship (see Gilligan, 2002).
The peak in girls’ suicidality at ages 13 and 14 (see Background
Research) thus may ref lect the peaking intensity of their fight
for relationship at this time. After an overview of epidemiological
research on suicidality, we move to theory and research on girls’
development as a way of framing the case study. The key
developmental findings of the case point to the way a girl’s hope
for relationship may peak in early adolescence as she sizes up her
situation and sees a possibility for bringing about change. In
contrast, depression, a more common symptom among women,
signifies hopelessness and powerlessness (McGrath et al., 1990;
Jack, 1991). When responding to an adolescent’s suicidality, it
thus becomes important that we recognize girls’ hopefulness
and encourage their experience of themselves as powerful.
324 Carol Gilligan and Lisa Machoian
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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’ suicida l behav ior 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 kill
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 else—and
perhaps they are succeeding.

THEORETICAL FRAMEWORK

The relational interpretation we bring to our analysis of an


adolescent girl’s suicidality rests empirically on longitudinal and
cross-sectional studies with girls between the ages of 6 and 17.
Learning to Speak the Language 325
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The research, conducted by the Harvard Project on Women’s


Psychology and Girls’ Development, involved girls from public
and private schools; girls from poor, working-class, middle-class,
and economically privileged families; and girls from diverse
ethnic and cultural backgrounds, including girls from African
American, Asian-American, Caribbean-American, East Indian-
American, and Latino and Portuguese families (Gilligan, Lyons,
and Hanmer, 1989; Gilligan, 1990a, b; Gilligan, Brown, and
Rogers, 1990; Brown, 1991; Gilligan, Rogers, and Tolman, 1991;
Brown and Gilligan, 1992; Rogers, 1993b; Taylor, Gilligan, and
Sullivan, 1995).
Critical to the discoveries of this work was the use of a voice-
centered, relational method called “The Listening Guide.” This
method directs attention to the unspoken as well as the spoken.
It highlights the relational dynamics of the research situation,
and builds into the analysis a recognition of the layered nature
of psychological processes and the interplay of psychology with
biology and culture. Our relational approach clarif ied the
importance of creating a resonant research relationship with
girls and also highlighted the importance of considering girls’
development within a societal and cultural framework (see
Gilligan et al., 1990; Brown and Gilligan, 1992; Gilligan, Rogers,
and Noel, 1992; Gilligan et al., in press).
Centr a l f ind ings include obser vat ions t hat of fer a
psychological explanation of why girls’ resilience is at heightened
risk at adolescence. Most striking is the evidence gathered across
culture and socioeconomic class that preadolescent girls can
show a remarkable ability to speak their thoughts and their
feelings, to read the human world around them, and to
distinguish authentic from false relationship. Documenting
these strengths among girls, the research found strong evidence
that the risk to girls’ resilience in adolescence occurs when girls’
relational strengths begin to jeopardize their relationships. Girls’
awareness, their knowledge, and their outspokenness, especially
as they become young women, often arouse fears and concerns
leading to attempts at silencing on the part of even well-meaning
adults and peers. Consequently, girls quickly discover where,
when, and with whom it is safe for them to speak (Gilligan,
1990a, b, 1996, 1997; Brown, 1991; Gilligan et al., 1991; Rogers,
326 Carol Gilligan and Lisa Machoian
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1991, 1993a, b, 1994; Brown and Gilligan, 1992; Taylor et al.,


1995). From yearly interviews with girls moving from childhood
into and through adolescence, evidence suggesting an onset of
dissociative processes at adolescence appeared in the form of
sudden shifts between knowing and not knowing, feeling and
having no feelings, caring and not caring, meaning and not
meaning what they say. The phrases “I don’t know,” “I don’t
care,” and also the reiterative “I mean,” “you know,” “I know,”
“I feel,” and “I think,” became verbal markers of girls’ moves in
and out of dissociation, signaling their presence and absence
with others and with themselves.
Documenting a healthy resistance among girls at the edge of
adolescence to losses that are psychologically consequential—
the loss of an authentic voice, the giving up of relationship for
the sake of “relationships,” we witnessed a progression whereby
a healthy resistance or fight for voice and relationship turns
into a political resistance as girls claim authority and power,
thus challenging the continuation of patriarchal structures; this
political resistance, especially when it is not joined, can, in turn,
become a psychological resistance, a less healthy, dissociated
knowing (Gilligan, 1990a, p. 502). When a girl’s healthy or
political resistance is curtailed by fears or threats or actual
reprisals, dissociation becomes a brilliant although costly way
to hold on to two or more contradictory realities and to protect
a vital self from being overwhelmed. A girl’s voice is a barometer
of her relationships, and loss of voice, a symptom of trauma,
signals a loss of relationship (Gilligan, 1990a, b, 1991).

THE CASE OF ABBY

It is autumn, and I (Lisa Machoian) am beginning my clinical


training as a clinical psychology fellow. On a breezy, sunny, and
warm Wednesday morning our clinical team assembles for its
weekly meeting and the director reads a referral: A 13-year-old
g irl, named Abby, 1 from a middle-cla ss fami ly wit h a
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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
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multicultural background, has been referred to the clinic. She


has a histor y of early physical abuse and severe neglect.
Throughout her infancy and early childhood, she lived in shelters
and multiple foster homes; her family relationships have been
disrupted. During the middle of her latency years, she was
adopted into a single-parent home. The referral note cites such
problems as anger, stealing, and self-destructive behavior in the
form of scratching herself. A bright and academically successful
girl, she recently stole her teacher’s grade book. This detail
catches my attention. Having been a teacher, I appreciate the
magnitude of the act. I offer to take the case. The referral note
also mentions that Abby saw a psychotherapist for over a year;
but, although she went to her sessions, she did not speak at all.
The following week, I meet Abby. Slim, with short brown hair,
running shoes, and jeans, engrossed in a book, she sits in the
waiting room. As I introduce myself, she looks up at me with
large, green eyes, wary, shy, uncertain, and tired. Immediately,
I feel worried about her. Perhaps it was the sense of exhaustion.
I ask her whether she wants to come with me by herself or wants
to bring her mother with her into the therapy room, and she
chooses to come with me by herself. When I ask if anyone has
told her why she was coming to meet with me today, Abby says
quietly, “I don’t know.” She continues to respond to my questions
by saying, “I don’t know” until I decide to address the
relationship between us directly. I say, “I’m asking you a lot of
questions,” and then I ask her, “Do you want to ask me some
questions?” Now Abby suddenly comes to life, sits up in her
chair, smiles at me with bright eyes, and eagerly nods her head
in assent. “Yeah,” she says, “Are you married? Do you have your
own apartment? Do you have children? Are you a student? Who
do you live with?”
Rather than exploring with Abby why at that moment she
wants to know these things about me, I hear her questions as a
test of relationship: will I be authentic with her, and also who
am I? Deciding to take her questions at face value to let her
know that I’m not hiding myself from her, I tell her that I am
not married, that I have my own apartment, that I do not have
children, and that I am a student. “Why did you wonder if I am
a student?” I ask. She says, “I saw the sign when we came in that
328 Carol Gilligan and Lisa Machoian
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said this was a teaching hospital.” “How do you feel about my


being a student?” I ask. She replies, smiling, “That’s OK. I like
that.” Returning to the one unanswered question, she repeats,
“Do you have roommates, or do you live on your own?” I tell
her, “I live on my own.”
Abby then tells me about herself: she likes poetry and is good
at soccer; she loves school and enjoys reading and writing; she
names her favorite characters on television shows. She agrees
to come back the next week. In our second session, Abby tells
me about an incident at school when a boy made fun of her
because she did not live with her birth parents. She adds,
“Sometimes at school I remember what happened to me when I
was little, and I feel like crying but I don’t want to cry in front
of the other kids.” When I ask her if she wants to tell me about
what happened when she was little, she tells me that she
remembers being in one particular foster home where she was
hit, deprived of food, and left alone for long periods of time
with other foster children. She recalls being removed abruptly
from that home.
Talking about her current situation at home, she says, “I can’t
take it anymore.” She tells me she is hit, slapped, kicked, called
names, and verbally abused by her mother. When I remind her
that I am mandated by law to report what she has told me to the
state’s department of child protective services, she says that she
tried to run away a year ago but that, when the police found
her, they made her return. She tells me that she told workers
from the state’s child protective service about the abuse: “They
came and talked to me once and never came back. They didn’t
seem to care much.” I say that I do care, that I will do all that I
can to help her, and she looks relieved. Before she leaves, we
construct a safety plan. We write down the addresses of friends’
houses close by where she can go if she is physically threatened,
and I give her other emergency phone numbers.
When I call the state child protective services, I learn that a
similar report of abuse had been f iled in the past year,
substantiated by that agency. Yet, despite the knowledge of
substantiated abuse in Abby’s current home, she is classified as
a “defiant adolescent butting heads with authority.” The agency
closed the case because everyone was in therapy, but, in response
Learning to Speak the Language 329
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to my report, they determine that they will investigate. This


decision is critical since no residential settings would accept a
girl her age without a referral from the state. Although Abby’s
mother does not acknowledge her own abusive conduct—she
blames Abby’s history instead—she does seem to have Abby’s
best interests at heart. Throughout Abby’s treatment, her mother
and I develop and maintain a very positive relationship.
One evening during the week between Abby’s disclosure and
the investigation, I receive an emergency phone call. Abby has
run away from home, and the police are involved. The next
morning, when I call her school, I find, to my relief, that she is
there and that she followed the safety plan. She had been
physically threatened at home and went to the home of one of
the friends on the list.
With permission from her mother and her friend’s mother,
Abby stays at the friend’s house until the state’s investigation
concludes. When the state’s investigator determines that Abby’s
situation does not warrant removal from her home, she tells
Abby she must return home. Abby responds, “If I go home, I’ll
run away,” which she proceeds to do, although she is eventually
found. But because she ran away, Abby is not returned home
and instead is placed in a 14-day temporary shelter for teens
quite a distance from where I work. During this time, Abby and
I remain in phone contact because she cannot come to sessions.
I believe our continued phone contact may be the key to
understanding the rapid escalation of Abby’s behav ioral
demands to be heard and taken seriously. When she breaks a
rule at the shelter that she says she did not know about, she is
punished by losing the privilege to walk home from school with
her best friend. Sobbing and deeply disappointed, Abby calls.
She pleads, “Please get me out of here.” I say I know how hard
it is not to be listened to and explain that I cannot change the
shelter’s rules; I tell her that I will do all that I can to find a
good placement for her, that I take her feelings seriously. “If I
can’t get out of here, I’m going to run away,” she threatens.
When I tell her that I am worried about her safety, especially
right now as it is nighttime, she hangs up on me. I call her back,
and she refuses to speak to me. I ask the staff to leave Abby
notes with my messages when she refuses to take my calls.
330 Carol Gilligan and Lisa Machoian
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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. T he
adolescent shelter where she is currently residing recommends
a group home, an idea that her mother supports as well. Yet,
remarkably—although the crisis team, the shelter, my agency,
and Abby’s mother all request placement—the state’s 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
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warrant hospitalization, although she stays in the emergency


room for the night.
The next day I drive to see Abby to reiterate my team’s
recommendation for placement. Abby looks scared and
exhausted but resumes speaking when she sees me and begins
drawing with the markers I brought along. We eat lunch together
while she waits to find out where she is going. She is sent that
evening to a specialized foster home for the weekend, but
child protective services still maintains the plan to send her
home. Over the weekend Abby’s mother tells me it looks as
though Abby might run away at any given moment and that she
suspects that Abby turned on all the stove burners, which she
eventually discovered. Although she said she liked Abby, her
mot her feared that t his youngster wa s psycholog ica l ly
deteriorating quite rapidly. She felt it was not safe for Abby to
be in home care at this time.
The following day Abby is sent to the adolescent unit of a
psychiatric hospital, where she stays for over three months. The
psychiatric hospital treatment team refuses to discharge her
home and even provides her with free care when her insurance
expires. They do not discharge her until an appropriate
adolescent residential group home program is found for her,
one that allows her to continue to work with me. Finally the
state agrees to send her there.

Discussion
It seems clear that Abby had to escalate her self-destructive
behavior if she was to be effective in getting her needs met in
this treatment system. In our terms, she learned the language
that would be taken seriously and listened to—the language of
violence—a language that everyone understands and also a
language that is widely spoken in the society and culture in which
she lives. Neither my speaking on her behalf, multiple clinical
recommendations from various agencies, nor Abby’s speaking
plain language had any effect in changing the plan to return
her home. When she realized I was unable to protect her, she
became silent in our relationship, although perhaps the very
fact of the relationship gave Abby the courage to speak for
332 Carol Gilligan and Lisa Machoian
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herself, to use the “language of violence” and to believe that


she would be listened to and heard.
From Abby we have come to understand more clearly the
relational dynamics of girls’ suicidality and its relationship to
girls’ resilience and resistance. Abby’s suicidal, dangerous
behavior was the only voice that was heeded and hence the only
way she could get herself placed in a good prog ram for
adolescents. I continued to meet with Abby in therapy, and,
later, we talked about her running away, her wish to kill herself,
and her potentially self-harming acts and explored their meaning
to her. When I asked her what she liked about running away,
she said, “It got people to listen to me.” She explained, “When
they wouldn’t listen to me about how bad things were at home,
I told them I would run away and they took me to the shelter.
When the protective people wouldn’t listen to me and I was
going to have to go home, I ran away and then I went to the
hospital, and now I’m in the program.”
When I asked her about her thoughts of killing herself, she
said, “I didn’t want to go that far, but I knew it would get them
to notice.” Clearly Abby’s suicidality was effective, but sadly and
paradoxically it also disqualified her: she was labeled “calculating,”
“manipulative,” “controlling,” and “trying to get attention.” This
catch-22 signifies the escalation of the relational crisis in girls’
adolescence: if girls threaten to kill themselves, they will be
taken seriously; if they do not actually kill themselves, they will
be dismissed as manipulative and will not be taken seriously.
Reporting on research with adolescents, Laufer (1995) writes
that, in the past, suicide attempts were described by many
distinguished psychoanalysts as a cry for help. However, he
writes that this “very apt term has fallen into disrepute because
it has been used in a pejorative way about those who have
attempted suicide, implying that they behaved in a manipulative
way to draw attention to themselves” (p. 104). Either way—killing
themselves or not killing themselves—girls will lose relationship
in the attempt to gain relationship. As one of the crisis evaluators
says about Abby’s success in getting herself into a residential
program rather than being returned home, “It was calculated.”
Abby, once labeled a “defiant adolescent,” is now at age 13 in
danger of being classified as a “borderline personality.”
Learning to Speak the Language 333


LEARNING THE COMMUNICATIVE


VALUE OF VIOLENCE

When a girl discovers that her voice is not being heard or not
taken seriously, or when her experience is unspeakable, that is,
that no one will listen, or, as girls say, “No one will believe me,”
we believe that creative resistance and a commitment to voice
remain possible if she can sustain a sense of hope about a
relationship. Relationship depends on voice—on the presence
of self—just as voice, or the sense of self, depends on relationship.
Abby’s suicidality can thus be understood as an active resistance
to disconnection; as an active f ight for voice, it becomes,
paradoxically, a sign of hope.
When Abby felt that I had left her in a dangerous situation,
she literally hung up on me and then proceeded to dramatize
her predicament by subjecting herself to the danger and
potential violence to which others had been willing to subject
her. Endangering herself, she communicated her knowledge that
she was in danger and was asking in effect if anyone cared. I
understood her suicidal behavior as ref lecting both her intense
need for recognition and her belief and hope for relationship.
I saw our relationship as supporting her resilience and
encouraging a healthy resistance.
It is important to recognize that young adolescent girls like
Abby are looking for a way to express themselves that will be
recognized. In middle and later adolescence, girls will often
protect a bruised and fragile sense of self-worth by “not caring”
or appearing not to care. “Not caring,” in our terms, means
giving up hope for connection. Here is an example:
Isabel, following years of chronic childhood sexual and
physical abuse, cut her wrists at the age of 14. She was
hospitalized and given the Thematic Apperception Test (TAT).
The stories she told all had people interacting in them, even
her stories in response to the two cards where no people are
pictured. Following her hospitalization, Isabel was sent to a foster
home. She ran away because for the first month she was not
allowed to see or speak with any people from her past with
whom she had relationships. Consequently, she stole a car,
crashed it, and then ran away to New York, where she survived
334 Carol Gilligan and Lisa Machoian


by joining a prostitution ring. When Isabel was 16, she was


raped; and when she threatened to go after and kill the rapist,
she was hospitalized. Again given the TAT, Isabel, at age 16,
told very different stories. This time there were no people in
Isabel’s stories. If the presence of people in her stories suggested
a hope for relationships at age 14, by age 16 Isabel may have
given up this hope. At age 19, Isabel has two children and is
married to a man who batters her.
Researchers have discovered that girls’ suicidal acts most often
occur in close proximity to a person with whom they may have
a desire to be in relationship (Hawton et al.,1982; Rotheram-
Borus and Trautman, 1988; Trautman et al., 1991). The suicidal
act becomes, in our view, an expression of that desire and also
a test of that relationship. Moreover, that girls’ suicidal acts are
often not letha l ref lect s g irls’ cor rect reading of their
relationships: that, on some level, the other is paying attention
and cares whether they live or die. It is crucial to respond to
adolescent girls’ suicidal behaviors as expressions of the desire
for relationship, and not merely as attacks on the self. Moreover,
it is important to recognize girls’ discovery that the language of
violence is taken seriously in our society. When suicidal acts
enable them to get what they need, it is a misconstrual to see these
acts as “manipulative.” Treating such behaviors in disqualifying
ways may be effective in temporarily stopping them, but it may
also lead such girls to give up hope. And then, literally or
psychologically, they are more likely to kill themselves.
Suicidal girls, by rendering their desire for relationship a matter
of life and death, exemplify what Erik Erikson (1938) called the
“meaning of meaning it” (p. 170) and the “voice that means it”
(p. 198). In his work with adolescent patients, Erikson observed
that adolescents often reach for a “benediction which is to lead to
the patient’s conviction that he is an alive person, and, as such,
has a life before him, and a right to it. For less, such patients will
not settle.” He called this the “‘rock bottom’ attitude . . . an attempt
to find that immutable bedrock on which the struggle for a new
existence can safely begin and be assured of a future” (p. 103).
By suggesting that this bedrock is “relationship,” we draw also
on the insights of the economist Albert Hirschman (1970) and his
analysis of exit and voice, leaving and speaking, as alternative
Learning to Speak the Language 335


responses to an unbearable situation. Observing the interplay of


exit, voice, and loyalty, Hirschman notes that the possibility of
leaving increases the likelihood of speaking and that the option of
speaking is more likely to be exercised in the presence of loyalty.
Contrasting the “neatness of exit” with “the messiness and
heartbreak of voice,” Hirschman’s analysis also brings us back
to the issues of gender that are embedded in our discussion of
suicidality. Suicidal acts have typically been interpreted as acts
of self-destruction or violence directed toward the self. Our
relational interpretation of an adolescent girl’s suicidality
stresses the relational communication of the violent intention
or act, but it also suggests that the act itself may express a
complicated hope for relationship. In this way, we make sense
of two seemingly anomalous findings: that, compared with those
of boys, girls’ suicidal acts are, in fact, less likely to be self-
destructive and that girls who act suicidally generally do so in
close proximity to a relationship. Hence, girls may alert us to
the relational aspects of suicidal behavior that are more difficult
to see or to read in boys and, as Abby did with Lisa, encourage
us to think through our responses to suicidal behavior in terms
of relationship and what it is that constitutes loyalty.
A subtheme of our analysis has to do with the readiness with
which girls learn to speak the language of violence when they
discover that it is the coin of the realm. As we observe this
phenomenon, we also note that girls may stress the difficulties
and disappointments of their relationships and forget or
dissociate themselves from the experiences of love that continue
to fuel their hope for relationship. At the beginning of her novel,
The Bluest Eye, Toni Morrison (1970) illustrates and then undoes
this form of dissociation. The narrator begins by recalling her
impoverished childhood: the house was old and cold, her mother
overburdened and distracted, a child’s illness became the last
straw. But then she stops herself, asking, “But was it really like
that? As painful as I remember?” What she had forgotten was
love, not an idealized or romanticized image of love or of
mothers, but her memory of

love, thick and dark as Alaga syrup . . . I could smell it—


taste it—sweet, musty, with an edge of wintergreen in its
336 Carol Gilligan and Lisa Machoian


base—everywhere in that house . . . it coated my chest, along


with the salve, and when the f lannel came undone in my
sleep, the clear, sharp curves of air outlined its presence
on my throat. And in the night, when my coughing was dry
and tough, feet padded into the room, hands repinned the
f lannel, readjusted the quilt, and rested a moment on my
forehead. So when I think of autumn, I think of somebody
with hands who does not want me to die [p. 14].

CODA

Later in our work, I asked Abby how it was that she talked with
me in therapy after she had been silent for over a year in her
previous therapy. “It’s because you talked about yourself. When
you asked me if I wanted to ask you questions, I was like yeah!
And, I asked you all those questions!” she tells me as she smiles
and laughs. When we talked about her stealing the teacher’s
grade book, Abby mused, “It’s like, I’m sort of like a rebel, I
guess.” She sat back in the chair for a moment, looked pensive,
and was quiet. Then, she said, “I think that I kind of like that
I’m a rebel.” I too liked Abby’s rebellion against being sent back
alone into danger, her willingness to risk relationships, her
insistence on being heard.

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Carol Gilligan, Ph.D.


NYU School of Law
Vanderbilt Hall
40 Washington Square South, Rm. 511
New York, NY 10012

Lisa Machoian, Ed.D.


Harvard Graduate School of Education
Larsen Hall
Appian Way
Cambridge, MA 02138
Lisa_Machoian@gse.harvard.edu

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