Saturday, May 3, 2014

Preventing Suicide

When a man is suicidal does he need sympathy and care? Or, does he need to know that suicide is a selfish act, one that his community considers to be grossly immoral?

If an individual is the sole proprietor of his body, does he have the right to put it to death? If society condemns the bad habits—like smoking—that will hurt his body, should it also denounce as immoral any act that would kill his body?

If we condemn smoking because of the health care cost it imposes on the rest of society, ought we to condemn suicide because of the mental health care cost it imposes on friends and family?

Writing about a new book by Jennifer Michael Hecht, Stay: A History of Suicide and the Philosophies Against It, Emily Esfahani Smith raises these questions. In particular, she wants to question whether the modern view of suicide, its being an illness—is the problem or the solution:

Rather, our contemporary culture treats suicide as a medical problem—a “public health concern,” as Joshua Rottman, a psychological researcher, recently told The Atlantic. According to his new research, religious and non-religious people have a moral bias against suicide, and the bias stems from “disgust reactions” they have when confronted with stories of suicide. Committing suicide, people think, taints the soul. To Rottman, this is a problem. These reactions are irrational and, therefore, harmful: “The million-dollar question,” Rottman says, is “how to de-stigmatize suicide as impure.” He went on to say, “That’s not to say that we should start thinking that suicide is perfectly OK, but I don’t think we should treat it as taboo (and therefore avoid bringing it up in polite conversation). Instead, we should engage with it as a public health concern and find ways to effectively increase prevention.” But Rottman is wrong to demoralize the notion of suicide. If we are serious about helping people overcome the dark nights of their souls, we must insist with Chesterton that suicide is a moral, not just a clinical, problem.

Medicine sees us suffering from a “moral bias” against suicide. But, if we destigmatize suicide, making it an occasion for medical care and attention, does our attitude prevent or promote the problem we are trying to fix?

Naturally, we prefer to show our sympathy and care for those whose torments become so unbearable that suicide seems like the only solution.

While Hecht’s arguments are persuasive, I cannot imagine telling someone who is suicidal that what he is contemplating is grossly immoral.

At the same time, the way society reacts to suicide certainly has an effect on the behavior of those who are thinking about it. If society condemns people who commit suicide, then perhaps those who might be inclined to do so will think twice or thrice.

Also, Hecht and Smith are right to ask whether our efforts to shower suicidal people with sympathy are not contributing, however inadvertently, to the problem.

Note well, there is a difference between saying that suicide is not a solution and denouncing it as a contemptible action.

Suicide attempts garner considerable attention. They attract an army of caring medical professionals. We all seem to want to understand how it happened. Does this prevent and deter suicide, or does it tell people that by attempting to commit suicide they will be taken very, very seriously?

Religion, especially the Roman Catholic Church has declared suicide a sin. Not merely a sin that would imperil the victim’s soul, but one that would shame his family.

Smith described the old way to deter suicide:

Those who violated the moral law, by taking their own lives, faced a grisly posthumous fate. Their bodies would be tortured, dragged through the streets, their estates seized by the church, their families left impoverished.

Anyone who believed that suicide would benefit their families—through what Durkheim called an altruistic motive—would have been disabused by these practices.

On the other side, when the Enlightenment rolled through Europe, serious thinkers seemed to go to an excess in taking the other side of the argument.

Baron d’Holbach wrote this, seemingly in favor of altruistic suicide:

Besides, what assistance or what advantage can society promise to itself from a miserable wretch reduced to despair, from a misanthrope overwhelmed with grief, from a wretch tormented with remorse, who has no longer any motive to render himself useful to others, who has abandoned himself, and who finds no more interest in preserving his life?

While some argue that human life is sacred, others, like Hecht, say that suicide does not just hurt oneself; it hurts other people.

Smith and Hecht see humans as social beings. They want to prevent suicide by telling people that they belong to a family and a community.

Clearly, this would serve as an antidote to what Durkheim called suicide provoked by anomie. Hecht explained:

The arguments against suicide that I intend to revivify in public consciousness assert that suicide is wrong, that it harms the community, that it damages humanity, that it unfairly preempts your future self.

To be clear, in order to help people to overcome the anomie that might drive them to kill themselves, we need to show them how to become an active participant in social activities, on a consistent and regular basis. It will never suffice merely to point out the problem.

Surely, these are good arguments, but one feels compelled to add that some people commit suicide because they want to hurt others, because they want to punish those who have been tormenting them. It is a variation on what Durkheim called egotistical suicide.

If we condemn egotistical suicide as immoral for the negative effects it produces in friends and family, we need also to note that some individuals very consciously want their suicides to be a punishment against those who have hurt them.

If an individual has a real grievance there are better ways to express it and even, if need be, to redress it. Those who treat suicidal individuals should know how to help their patients to find better ways to right wrongs.

Telling someone that suicide is a condemnation of community will not work if the individual has a serious grievance against the community.

4 comments:

  1. It certainly messes up the lives of the suicider's immediate family.

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  2. Yes, the argument that judging suicide as immoral will reduce it is foolish to me, or at least it would at best encourage people to only attempt suicide if they can be sure to succeed.

    I also wonder about the psychological aspects of suicidal thoughts, and psychological growth, and ideas that we can only be born into the new by surrendering our old identities. And that process is a social one, even like bootcamp, where they intentionally dismantle our personality, to reintegrate into a collective purpose.

    So whatever else we are during suicidal periods, it is vulnerable, and if suicidal thoughts are to be shunned, then they will remain hidden until a person can finish them. But if there is a process where suicidal feelings can be expressed, then perhaps trusted family or friends or spiritual leaders can help the person identify what self needs dying and what self might be emerging, and how to aid that process?

    Anyway, a high responsibility place, to know someone's most vulnerable thoughts, and not know how to help them. So perhaps only those who passed through their own suicidal thoughts and understood them can trust themselves enough to try to help another?

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  3. The last psychology course I took is back in 1996. At that time, little was discussed in class, since little was known about suicide, especially about successful suicide attempts.

    What little was known came from people who were unsuccessful at the attempt. Apparently, most suicide attempts are not planned. They are impulsive acts. Often committed by someone suffering from depression. Surprisingly, the person attempts suicide while recovering from a state of depression rather than while going into a state of depression.

    So, how do you prevent someone from committing an impulsive act?

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  4. Suicide rates for Men are much higher, and related to more rural western states, perhaps related to higher access to guns.
    https://en.wikipedia.org/wiki/File:Suicide_by_region,_white_men.png

    If suicide is impulsive as Charles proposes, then encouraging depressed people you care about to give up their guns (or offer to hold them) seems a sensible way to show you care?

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