First published in HIPPOCRATES March/April 1989.

Jushua Terrell is eight years old, too small to aim his family shotgun with precision. His parents, moreover, have never let him know where they store the shotgun shells, a precaution that may have saved his life last winter when it thwarted his plans to shoot himself.

The third grader, who lives in Crosby, Texas, gives a surprising reason for wanting to die: He'd been paddled at school.

One day, he recalls, for horseplay and talking in class, the vice principal hit him twice with a board, leaving a large purple bruise on his bottom. "At first I wanted to break every window in the school," he says. But then he turned the anger on himself. "I thought if I killed myself, then at least I wouldn't have to go back to school," he says, staring at the tops of his sneakers. "For three weeks that's all I could think about."

The boy planned his suicide in eerie detail. He had decided either to hang himself from his living room balcony with a jump rope or fire the shotgun into his mouth -- "if I could reach the trigger and do it in the woods, so I wouldn't mess up the house." When he revealed his plans to several classmates, a teacher overheard. An alarmed counselor notified his parents. The Terrels took him to a therapist, who confirmed that their son was extremely depressed and needed treatment.

Joshua's is among the many disturbing cases of children in the United States who have said they wanted to kill themselves after a school paddling. Suicide is rare among children under fifteen, and in fact there have been no formal studies to document whether children can be so traumatized by corporal punishment that they become suicidal. But looking back over the past two years, parents and corporal punishment researchers can identify more than two dozen children across the country who have attempted or threatened suicide after repeated classroom paddlings.

"The child thinks, 'If the school thinks I'm worthless, then I must be worthless,'" says psychologist Irwin Hyman, who directs the National Center for the Study of Corporal Punishment, at Temple University in Philadelphia. "School paddlings may cause feelings of low self-esteem and helplessness, which are part of being depressed. And unfortunately, severe depression and hopelessness can be a precursor to suicidal feelings."

Over the past 12 years, Hyman says, he has studied hundreds of corporal punishment cases nationwide. He has interviewed dozens of children so disturbed by corporal punishment that they suffer from nightmares, depression, and other symptoms like those of some Vietnam veterans. Most of these children are not necessarily suicidal, he says, but suffer depression that, if left untreated, could lead to self-destructive behavior later on.

But some researchers are wary of these conclusions. Eugenia Broumas, a social scientist with the National Institute for Mental Health in Rockville, Maryland, says she has seen no evidence linking corporal punishment in schools to depression and suicidal behavior. She accepts, however, that there may be a connection between suicide and child abuse. "We know that humiliation causes people to lose a sense of themselves," says Broumas. And, she says, it can be among the factors that increase the risk of suicide.

"In my opinion, corporal punishment is child abuse," says Charlotte Ross, head of the Youth Suicide National Center in Burlingame, California. In the last 15 years, studies by psychologists have linked corporal punishment at home and in school with increased aggression, vandalism, and juvenile delinquency, and have suggested links with depression and lowered self-esteem.

"With so much evidence that nothing is worse for a child's self-esteem than this type of violent punishment, one wonders how in the world schools in this nation can even consider tolerating corporal punishment," Ross says. "It's ironic, because our schools are deluged with reams of literature talking about how to maintain children's self-esteem -- and then we undo everything by this violence."

Each year more than 1 million students receive some kind of corporal punishment, according to the U.S. Department of Education -- some skeptics claim the figure is two or three times too low. The practice remains legal in 38 states, where, as a means of discipline, children from five to 18 are paddled, spanked, whipped with belts, and even tied to chairs. In rare instances children have been struck with baseball bats and stung with electric cattle prods, according to newspaper reports.

Many school administrators insist that paddling is a disciplinary last resort, but surveys show that most paddlings are for minor offenses such as talking. Some schools paddle half their pupils each year, and most of those receiving punishment are in the elementary grades.

Bruises from paddlings are sometimes so severe that parents have taken their children to emergency rooms. During one 18-month period, a hospital in Columbus Ohio, treated 28 children battered by teachers. Records from hospitals around the country show that injuries are not confined to bruises and welts, but on rare occasions have included broken bones, gashes, sprains and concussions.

Teachers and administrators who support corporal punishment dismiss such injuries as aberrations. They say paddling is an essential tool for keeping classroom order. "The beauty of corporal punishment is that kids can take their punishment and then forget about it," says a fourth-grade teacher in Texas.

But the practice is increasingly being criticized by organizations of parents and child advocates. Calling school paddlings "legalized child abuse," they point out that corporal punishment is banned in the public schools of every major developed country except Canada, Australia and South Africa.

In this country, the South is corporal punishment's stronghold. Within that region are nine of the ten states with the highest rates of paddling. Texas, according to government records, reports the most paddlings -- an estimated 260,000 a year. And it was Texas where the news of paddled schoolchildren who turned suicidal first came to light, not from news accounts but through the efforts of a group of concerned parents and teachers.

Former teacher Jimmy Dunne, who directs People Opposed to Paddling Students in Houston, argues that few people realize how severe many school paddlings really are. "I mean we have teachers in East Texas who shave down baseball bats and swing with both hands," Dunne says. In the past few years, he has logged several reports from distraught parents who said their children wanted to kill themselves because they were beaten at school.

Among these parents is Joe De La Cerda of Galveston, Texas. He says his son Joey, 11, became despondent after being paddled regularly in the first through third grades. "My son has got a very poor outlook on life," says De La Cerda. "He's talked about suicide a lot of times, about running in front of a school bus or onto the freeway to get away from everything."

Seven-year-old Brian Arwood of Madison, Tennessee, felt a similar desperation. Although Brian's parents had asked the school not to spank or paddle their son, explaining that he was hyperactive and recovering from abuse by a babysitter, they later learned that his first-grade teacher had paddled him more than 15 times for talking, drawing pictures at the wrong time, and other infractions. During this time Brian drew picture after picture of monsters, people hanging from trees, and other images suggesting a preoccupation with death.

One morning, furious over a paddling he'd just received, Brian climbed to the top of a ten- foot-high circular slide, tied one end of a jump rope around his neck, secured the other to the steel handholds. He remembers feeling "nothing inside" as he pushed off. The rope jerked him backward off the slide and left him swinging three feet off the ground.

"I was real scared then and trying to scream for help," says Brian, who recalls clawing at the rope around his neck.. "The rope was smooshing all the air out of me. I could see all the kids underneath me, staring, circling and circling like lions in a cage. Jamie and another boy were trying to push me back up, and it seemed like it took forever for a teacher to get over to me."

Brian's mother Connie and her husband believe that their son didn't actually want to die. "It was a cry for help," she says, "so we would finally listen to him when he talked about school."

Children like Brian -- who suffer from hyperactivity or other learning disabilities -- may be particularly vulnerable to trauma at school. In a three-year study of suicides among children under 15, researchers at the Los Angeles Suicide Prevention Center found that half the teenagers who took their own lives had been diagnosed previously as having learning disabilities.

Sometimes these children conceal the source of their hurt. For months, ten-year-old David Turpin of Dayton, Texas, who was diagnosed with both dyslexia and a type of learning disability called "attention deficit disorder" failed to tell his parents of the near-daily paddlings he received for not completing his schoolwork. "We had no idea he was getting paddled regularly at school," says Debra Turpin, who had informed his teachers that her son had learning disorders and asked them not to hit him -- ever. "We were telling him, 'It's okay now, son. The teachers understand and we understand." But he had quit doing schoolwork, was eating compulsively and crying all the time, getting more and more frustrated. Finally he broke down and said, 'I'm so stupid I just ought to kill myself.' That's when we went into action." David spent three months in a psychiatric hospital, at a cost of $80,000, before the doctors felt it was safe to release him.

Even educators who don't agree that corporal punishment is a form of child abuse may see cause for concern in recent research. The latest federal report on youth suicide contains a study by psychiatrist Felton Earls and sociologist Lee Robins at the University of Washington Medical School in St. louis. Analyzing interviews with 2,700 teenagers attending free clinics in ten states, they found that four percent had attempted suicide in the past year. These suicidal children were much more likely than others to have been threatened or assaulted.

Another study, led by Eva Deykin of the Harvard School of Public Health, compared teenagers hospitalized for attempted suicide with teenagers hospitalized for other reasons. The finding: Suicidal teenagers were up to four times more likely to have been seen by the state agency that investigates child abuse.

Although these studies did not look at corporal punishment, they suggest that physical pain inflicted by adults may be among the traumas that make some children try to kill themselves.

Even in the face of such research, however, some adults bent on discipline continue to act as if children are somehow immune to extreme pain and anguish. Says psychologist Israel Orbach in his 1988 book, Children Who Don't Want to Live, "Many still find it hard to believe that children as young as five or six can sincerely wish to die -- and that some actually do commit suicide.... It is commonly but mistakenly believed that children do not comprehend the meaning of death. In most cases, it is exactly because children do understand the meaning of death that they wish to die."

NOTE: Since this article appeared in 1989, the number of states in the U. S. that permit corporal punishment in schools has fallen to 23. The frequency of school corporal punishment is now about half the above figures. South Africa no longer permits corporal punishment in either public or private schools. Cyprus and Italy have joined Finland, Norway, Sweden, Denmark and Austria by prohibiting spanking of children by any caretaker, including parents.