Tuesday, June 12, 2018

Talking Suicide

Given the poignancy and the sadness surrounding the suicides of Kate Spade and Anthony Bourdain, we have all had something to say about suicide. I have written a number of posts about it. Others have done the same. For an interesting and valuable comment, see Sarah Hoyt's comments. Hoyt offers some sensible and constructive recommendations, as in:

Now go and do something that makes you want to live.

It sounds a little Rick Warren, but clearly having a purpose in your life will do you a world of good. If you don’t like Rick Warren consider it a version of Aristotelian teleology.

Clearly, going out to do something is a far better course than mulling it over, ruminating about it or imagining that it is going to be solved by taking a pill.

Naturally, celebrity suicide is inescapable. We want to say something about the ambient culture, and especially about the way the culture addresses the issue. And we certainly want to evaluate, as Benedict Carey at the New York Times and your humble blogger have done, what it tells us about the American mental health profession.

And yet, there comes a time when enough is enough, when we have heard enough cries of alarm. There comes a time when we should stop talking about it. This applies to me as much as it does to you.

It certainly applies to a strange Washington Post column written by Petula Dvorak.

Dvorak suggests that we do not talk about suicide enough. End the silence, she intones. Do more research. Remove the stigma surrounding suicide. At a time when the press is filled with reflections on suicide, most of which are frankly not very interesting, we have a Washington Post writer who trots out the conventional psycho wisdom… to the effect that if only we talk about it more, if only we remove the stigma, we will magically solve the problem.

At a time when, as Sarah Hoyt says, everyone is talking about suicide, it takes a newspaper columnist to claim that we do not talk about suicide enough.

We still live in a culture that believes that enhanced awareness will solve all problems. In truth, if you remove the stigma about suicide, the likelihood is… you will have more suicides. We have largely removed the stigma about suicide. We are pondering whether or not we should allow assisted suicide as medical treatment. Some Western European countries do so already. In Holland they allow assisted suicide as a treatment for depression. In Switzerland they have special clinics for those who wish to end it all.

If you normalize suicide and remove the stigma people will start thinking of it as a viable option. Some might even think of it as a Romantic option. Or as a way to rebel against the patriarchy or against capitalism. Remember Sylvia Plath.

Suicide has many causes. It has more than its share of facilitators. Among them the simple fact that in today’s America depression is treated as a biochemical problem, not as a function of pervasive anomie. Among them is the simpler fact that most therapists do not have the time or the inclination to converse with their patients. Some merely write prescriptions. Some think that they merely need to understand the root causes. Others refuse to engage with their patients on Freudian grounds. Others do not know how.

Anyway, we are constantly being told to feel compassion for those who commit suicide. We do not ask whether compassion helps or even when empathy helps. Our goal should not be to have the right feelings. Our goal should be to prevent. 

When a parent leaves children without a parent, perhaps we should also feel a tinge of anger at the utter irresponsibility of it all.


Ares Olympus said...

While we consider suicide, its also good to recognize that destructive choices can also be seen as "suicidal impulses" even if not fully conscious intention is involved. So like the opioid epidemic, or any illegal drugs. In my mind buying illegal drugs is a "death wish" since you can't know what is in the drugs, and cheap fentanyl-laced drugs make overdose extremely easy, even if not intentional, a known risk you can't assess.

I recall in my 20s biking home from work at 2am and seeing a drunk man walking down the middle of the street and I was concerned for him and guided him onto the side walk, but he almost immediately turned back into the street and I tried to ask where he was headed, and I couldn't get a clear answer, so he might have been homeless as well. Now-a-days I would have probably called the police to help him, but back then I just remember wondering why he'd do that, and then I imagined myself in his place, perhaps without family or friends, where no one cared if he lived or died, and really my motive was "good deed" to get him off the road, and he'd be out of my mind after that. And I recognized I couldn't say I'd want to live like that, and I might also act destructively and just try to numb over the pain until my life ends. (And its useful to look at the state-by-state suicide rates by gender to see its older isolated men in the greatest danger.)

I vote for life because as long as you're alive, there's a chance for different choices, but knowing many people are just "dead men walking" and its all suicide fast or slow, it suggests the risk of fast suicide might be preferable, because at least there would be intention, and that awareness of where you're headed might be the only thing that can lead to change.

I do think purpose is what makes life worthwhile, and that people who have passed through the darkest psychological pain may be most able to help others pass through as well, while those of us in more fortunate circumstances really can't understand however much empathy or compassion we have. And if you're not willing to let a homeless man stay at your house, and sit up with him all night when he's on the edge of life, what you're doing isn't empathy, its just feel-goodism, as long as it is convenient.

Assistant Village Idiot said...

Again the Assistant Village Idiot with the CS Lewis tie-in. He noted the number of people in his era who spoke as if our sexual problems would go away if we didn't hush up about it so much. Then they would go on to give some example from Victorian times, usually inaccurate, as proof of how England did not talk about sex in the 1930's-50's. Lewis maintained that people had been talking about nothing but for decades, with no perceptible improvement.

I will suggest a rule-of-thumb from this. Whenever we are told that we are not talking enough about something, it is more likely A) We are talking about it too much, but B) the worst-informed among us are dominating the floor. Suicide is a likely nomination, and I would add race, poverty, and religion as further nominations. There were medieval rabbis who took as the beginning of every answer "Perhaps the opposite is also true."

Dan Patterson said...

"..the worst informed among us are dominating the floor.". Right-O. A common characteristic, I guess, akin to "The Squeaky Wheel Gets the Grease". Or is it " Gets Replaced"?
As one who has stared into that dark hole, literally and figuratively, I have a thought or two on the subject of suicide: The options are to remove the source of trouble, or to remove yourself from the scene one way or another. When the sources are too numerous or there are obstacles to removing them, one's choices are simpler - and the abuser is often not a person but a circumstance. Entanglements, reality versus fantasy, disparity between goal and result, and so on can be cumulative and many of us do not know how to clear that register.
A fully formed adult male can design his own life based on his abilities, and emphasize strengths while minimizing weaknesses, but a juvenile does not see the road ahead, only those recent and magnified failures. Making things worse is the rudderless ship the juvenile is piloting when he is not taught to be the Captain of his own fate and to treat failure as a lesson instead of a punishment. Now everything is his fault, every attempt at success is met with disappointment, relationships are doomed and he has no skills for that combat. Growing older without maturing does not improve the success-to-failure ratio and at some point he just wants to stop failing.
The point from Ares Olympus is also important; having a purpose takes focus off stumbles and on to another project. Staying busy doing something outside of your own head, making something, being productive, getting out of your bubble. Telling other people to kiss your ass if they don't like it and moving on with your effort might be a good first step.
Apologies for the rambling. The subject is broad and deep; thanks to everyone for bringing it up.

ASM826 said...

You should do a post on the fallout of suicide. Having lost an adult son to suicide, I can tell you what it cost me to come back to life, to find what I now think of as my second life. I am aware, from a couple of support groups that I tried and quit, it destroys many people.