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wilderness therapy north carolina

Wilderness as an Antidote for Self-Harm and Suicidality

In my time working with adolescents and young adults, the prevalence of self-harm and suicidal ideation has exponentially increased. When I entered this field in 1999 as a field instructor, a child who enrolled in wilderness with a history of self-harm or suicidal ideation was a rare occurrence. Now over twenty years later, 90% of the children enrolled in my group at Blue Ridge Therapeutic Wilderness, at any given time, have a history of self-harm or suicidal ideation ranging from mild to severe. It certainly seems that there may be a cultural script developing among certain segments of the youth population in terms of more tolerant attitudes toward suicide. Pop culture is inundated with more explicit messages around self-harm/suicidality from lyrics by the $uicideboy$ like, “Think I’m joking when I’m talking about blowing my head open. ‘Till the moment you walk in and find my body motionless, wrists slit…” to the popular Netflix series 13 Reasons Why, which arguably normalized suicide as a viable response to a traumatic event.

While mainstream American culture has normalized suicidal ideation and self-harm, and this continues to increase, emotional resilience has decreased. We are a culture that distracts, numbs, and avoids discomfort at any cost. Generally speaking, if we are experiencing discomfort, we can find an activity to engage in that allows us to avoid that experience of discomfort. Hungry? We can go to the refrigerator or pantry to satiate ourselves with food that takes minutes to prepare in the microwave. Most communities have food access 24/7 with drive-thrus, food stores open 24 hours a day, food delivery services, and the list goes on.


Bored? We can distract ourselves with TV, social media, music, exercising, eating, overworking, etc…all at our fingertips 24/7. In emotional pain? We can do all the above, and often our children do more, using social media in unhealthy ways, turning to drugs and/or alcohol, refusing to go to school, withdrawing from the family, and self-harm. If we have discomfort, we can ameliorate it without attending to the core issue that is going on, and we avoid feeling the feelings of our life experience.

The advent of convenience has created a life experience where we can “just Google it” instead of going through a process that actually is necessary for social and emotional development. Consider this; if you want to go to a new restaurant, you can simply use an app that tells you directions, turn by turn. When I was in high school and college, if I wanted to go somewhere I’d never been before, it required having conversations with others, perhaps making a phone call to that establishment, using problem-solving skills to follow directions, and even stopping to speak with strangers if I got lost. Shopping for clothes in those days meant a trip to the mall where the entire experience had opportunities for social and emotional development. Now our children can get online, click a button, and days (sometimes even hours) later, their order arrives. The creation and increase of technology is both a blessing and a curse. Now more than ever, we can connect to someone in a moment on the other side of the world, yet our children feel lonelier than ever.


Parents are often guilty of reducing opportunities for building their children’s emotional resilience. Parents oftentimes participate in obstacle removal: getting kids out of tickets or other consequences for their actions, intervening with teachers and other authority figures to fight the fights for their kids, even facilitating conflict resolution between their child and their peers. All of these factors impact our children’s ability to build emotional resilience. While they are not the sole reason for these behaviors, they directly correlate to an increase in these behaviors, including suicidality and self-harm.

In an article from 2011 featured in the American Psychological Association, Jamie Chamberlin writes, “Suicide is the third leading cause of death among adolescents and young adults.” Newer research on the subject, according to the American Foundation for Suicide Prevention reports that in 2017, adolescents and young adults aged 15-24 had a suicide rate of 14.46. We know that feelings of hopelessness, helplessness, consistent devaluation, and fatalistic despair are attributes leading to suicide. In 2011, I attended a conference on Suicide and Self- Mutilation and learned that for 70 years, the suicide rate has been statistically insignificant for elderly Black women. That data is still true in 2020, and being that this is the case, research was conducted into what protective factors this group has that make them more resilient to suicide. This research concluded there are four protective factors:

  • Resiliency
  • Radical acceptance of life
  • Social cohesion
  • Hope

Wilderness life at Blue Ridge Therapeutic Wilderness provides a unique experience for students to strengthen these protective factors. By being in an experience where living requires resilience to face daily challenges such as; completing camp chores like bear hang and pumping bottles to filter water, learning and practicing communication and coping skills, hiking with a heavy backpack, learning and practicing bow-drilling, and facing inclement weather, students are given opportunities to build resilience and a sense of self-efficacy. Life is simplified, carrying only the things on their back that they need, versus living in a world where anything they want (read: soothing discomfort) is at their fingertips. In the wilderness, students are “forced” to sit with the discomfort both physically and emotionally, rather than using endless distractions. Therefore they are continually doing work that is core to building the wherewithal necessary to cope with life’s ebbs and flows.


Students have daily opportunities to learn radical acceptance of life through delaying gratification; being impacted by the behaviors of others, not receiving “future information” about the events of the day, waiting a week for a response to a letter, the unpredictability of the weather, repairing gear rather than it being replaced, cooking their own food, and waiting for restock (to get more cheese!), among many other things. These are all ways that students learn to be in the here and now, and not have their every want satisfied in the moment.

Social cohesion refers to a sense of connectedness and solidarity with others. Students in the wilderness gain a sense of belonging to a community with their peers; a natural camaraderie is built by living together and accomplishing tasks. Students learn to find a sense of belonging through their individual relationships with each other, as well as through the relationship to the whole group. Each individual contributes to the group functioning, depending on each other to be able to live as comfortably as they can in nature. Students participate in therapeutic groups discussing shared values and facing shared challenges.

On the factor of hope, anecdotally, students in wilderness report a sense of hope increasing over the course of their stay. Being witness to and experiencing healing in themselves and those of their peers shapes a sense of optimism. Students learn to master tasks that renew autonomy and can provide an incredible consciousness of empowerment. If you’ve ever seen Tom Hanks in Cast Away, when he builds a fire by hand using the plow method, his response is no exaggeration from the feeling that students get when accomplishing “busting” a fire by the bow-drill method. And often, students for the first time have an experience of being part of a community that has similar struggles, rather than feeling ‘othered’ in more-traditional environments where they learn differently or relate differently than peers their age. At intake, Blue Ridge Therapeutic Wilderness students complete a YOQ (Youth Outcome Questionnaire) form, which measures overall outcome and functioning. Typically at intake, YOQ scores reflect high distress based on difficulty with basic functioning such as relationships with family and peers, somatic symptoms, poor frustration tolerance, and suicidality, all of which correlate with a sense of hopelessness. Upon discharge, students complete this same YOQ form, and an OBHRC (Outdoor Behavioral Health Research Cooperative) study on wilderness programs found that

“…clinically and statistically significant improvements were made during treatment, and that clients maintained these positive results one year after discharge…two years after leaving…83% reported to be doing better, 58% said they were doing well or very well, and 81% rated outdoor behavioral healthcare treatment as effective.”

In a world that constantly pulls our children to avoid, numb, and distract them from their experience, wilderness therapy provides an opportunity not only to have a lived experience where factors like hope, social cohesion, radical acceptance of life, and resilience are renewed through facing difficulties; it also invites us to feel fully our experiences of success, connection, and joy.