Modern Perspectives on Suicide

Kate Hoolu

Dave has recently had a piece on this site on suicide and madness in earlier times, and Francis has taken a point from the embryonic version of this article in his (forthcoming) essay on psychopaths in magic, so here is the background, at least so far as the social scientists see it:

The sociologist Durkheim saw suicide as a definite result of the decline of society and a move towards individualism. He decided to investigate the many cases of individual suicides as a collective phenomenon via statistical records in an attempt to define the nature of suicide. He defined four types of the act:

  • Altruistic suicide: sacrificing oneself for the benefit of others or society in general; i.e. Captain Oates on the voyage to the Pole with Scott etc http://www.bbc.co.uk/history/discovery/exploration/south_05.shtml
  • Anomic (also "normless") suicide: occurs when life no longer has any meaning to the person, common in cases of intense loneliness, isolation or loss of personal contacts.
  • Egoistic suicide: following a sense of personal failure compared to society/personal standards.
  • Fatalistic suicide: such as that which occurs in prisons etc, when no life is preferable to life under such extreme control.

Anomic and Egoistic suicide are seen as the more characteristic of suicide in modern society. Fatalistic and Altruistic suicide are more relevant to historical perspectives. These four types can be put upon an axis of suicide as follows:

Suicide

 

The point "X" being the balance at which "normal society" (whatever that is) operates.

Durkheim concluded from his researches that, among other things Catholics were less suicidal than Protestants, and the more family ties a person had, the less likely they were to take their own life.

The phenomenological objections to Durkheim are many and varied. Firstly it is a stance of phenomenology that human BEHAVIOUR cannot be objectively measured by any means. Thus statistics about anything are simply the product of the person(s) responsible for placing events in a category; this process is subject to unavoidable bias of many kinds (See my forthcoming separate article on anarcho-magick in the street, on this site). As a reverse critique of phenomenologists the same comment of subjective biased opinion can be applied to their theories too, which is cute! In Durkheim's attempt to put sociology up on the same pedestal as other, more respected sciences he seems to have actually ‘shot himself in the foot’, because he totally trusted his primary data; i.e. the death certificates. The problem of using "official figures" in any sphere is that all such data relies upon the decisions (and often the religious/moral/political or other bias) of an official person; usually some kind of civil servant, who will most likely be underpaid, feel undervalued and be borderline depressive as a result. In the case of suicides and other deaths it is the verdict of a legal officer, the coroner. There is no way to categorically prove that all coroners everywhere since the first deaths were investigated have shown the same reasoning, the same degree of objectivity and therefore reach comparable conclusions. It would be extremely foolish to assume that they ever have. As Dave’s article shows, methods have changed considerably in just a few hundred years.

The legal matters in any death are to determine the cause; and to thus decide if any further legal action is required; such as an investigation into a murder. Hence, once a verdict of anything other than murder/manslaughter or death from an industrial disease is arrived at the legal process stops and the matter becomes one purely of statistics. The legal establishment has no great interest in suicide as, assisted suicide cases apart, it breaks no laws. Only "assisted suicide" is illegal; being a form of manslaughter, such as in cases of euthanasia; which is another story.

The verdict of the coroner (often based purely on the pathologist's report) gives the actual medical-physical cause of death rather than trying to pin down the underlying reason or motive. For example someone who has deliberately cut the veins in their wrists actually dies from the consequent "severe blood loss"; a deliberate drug overdose causes death by "poisoning" and someone who deliberately jumps from a high building generally dies from "multiple head and body injuries consistent with a fall from a great height"... or words to that effect. In this way a large number of suicides can be misrepresented in official figures, which, while not actually lying, are too simplistic; saying what the actual biological cause of cessation of life was, but not necessarily taking any further circumstantial evidence into account. On many other cases the great umbrella terms of "death by misadventure" or "open verdict" are evoked; which cover (or rather mask) a multitude of causes of death.

It is of interest in the matter of statistics gathering that no official figures are available for attempted suicides- which seems strange as the subjects are still alive to be interviewed. Perhaps, as the Samaritans estimate, it is up to 200,000 attempts a year in the UK; which is simply a case of too big an administrative task?

The general societal view of suicide is still extremely negative, the bereaved families often act to prevent a verdict if suicide; in some cases even stating that a "suicide note" was NOT in the handwriting of the deceased, making it inadmissible as evidence. The Samaritans have a long running campaign to persuade journalists not to use the phrase "to commit suicide"; as it is no longer a crime in England (since 1961) and "commit" has negative legal connotations, which the family of a suicide could do without, emotionally. There are also life insurance pay-out implications depending on the cause of death.

Suicide was only decriminalised in Ireland in the last decade; and is still largely regarded as a mortal sin by the Catholic Church; thus preventing the soul of the departed from entering heaven. I wanted to quote extensively from a case of suicide in Eire that happened around Christmas 1994 or 1995, but I can't remember where I read about it and have had no luck in finding it since.  Briefly it was a case where a man called Joseph Kaye (subsequently proven to be a false name, and a blatant reference to Kafka's "The Trial" ) took his own life in such a rational, premeditated and organised manner that the wealth of notes and sworn statements that he left behind put the (Catholic) Coroner in a position of having to give a verdict of suicide despite the very strict Catholicism of the area. "Mr Kaye" was undoubtedly in a very sad position but he made sure that his death also caused a great deal of embarrassment to the church (which seemed to have deeply hurt him during his life) and brought into the public arena the whole issue of how hugely understated the Eire suicide figures are.

As recently as 1950, a woman received six months' in jail for attempting suicide a second time; and certain C of E clergy still refuse burial services for suicides. Even the Medical Profession are not without prejudiced attitudes; Blacks Medical Dictionary (standard issue for all UK trainee doctors and nurses) under the entry for suicide simply states, “refer to mental illness". There are many common-sense social myths about suicide that still circulate and serve to confuse the matter further; to give just two examples: "It stands to reason that more people kill themselves in mid-winter, especially around Christmas" and (secondly) people who threaten suicide are ‘just’ crying for help and won't actually do it.

The truth of the matter is that most suicides occur within 12 months of either a threat of, or an actual previous suicide attempt- most suicides give warning of their feelings- a cry for help IS a cry, for HELP. More suicides happen in mid-summer than at any other time of the year. It is a sad matter that common-sense is far more common than it is sensible…

Durkheim's broad classification of suicide is further invalidated by the myriad possible causes and the subjective nature of exactly why people attempt to take their own lives.

The main problem in information gathering in suicide cases is that the only person who REALLY knows why is dead. Therefore any definite conclusions must be coloured by this element of uncertainty; it is impossible to know absolutely why in every case. Durkheim took the stance of first conceiving a theory about the cause of suicide and then attempting to fit the data to it. The phenomenologist approach is quite the opposite; where the data is investigated to see what conclusions can reasonably be drawn; a fast summary of the debate would be numbers (positivist) versus descriptions (phenomenologist); or inductive versus deductive reasoning.

Durkheim's causal theory would be fine if it were to fit all possible causes of suicide, but it appears not to: For possible causes there has been considerable demonstrated correlation between suicide and unemployment, poor town planning (the stereotypical despair of isolation for those living alone on benefits in tower blocks etc) divorce and other relationship problems, bereavement, childbirth, confused sexual identity, imprisonment, demoralising perceived effects of feminism upon young men, bankruptcy, unemployment, immigration/emigration, pressure of work, pressure of study in universities and schools, drug and alcohol addiction, mental illness, genetic factors, family/social factors, depression and many more. It is the complex interactions of these and other factors when applied to the varying individual threshold for the pressures of life, which cause suicide. If unemployment alone caused suicide there would be over 2 million attempts in the UK per year, quite obviously such simplification is patently absurd and misleading. Similarly the same family also by definition has commonality of environment, diet, social conditions and other genetic, organic, sociological and psychological factors; there is a great deal of statistical evidence of large "at risk" family groups with only one (or no) suicide which, under Durkheim, seems to be the least likely outcome in such circumstances.

In the field of group psychology this matter has been slightly better addressed when searching for likely causes of severe depression (which is recognised as a potential suicide trigger) by the application of the Social Re-Adjustment Ratings Tables. These are copyright, so I can’t reproduce them here, but check out any standard A-Level or higher psychology textbook and it should be in there. This gives a points-rating of life-changing value for common life events ranging from death of spouse through change in responsibilities at work to minor violation of law. The data from this procedure is still viewed as subjective; only expressed as showing significant risks or dangers to the person rather than absolute and definite results. From purely comparative official statistics it could be deduced that suicide is not a major social problem, because (a) it isn't rising, and (b) it is a relatively minor cause of death when compared to heart disease or cancer. However due to the masking effect of coroner's verdicts in relation to actual cause of death, point (a) is not true. Point (b) is a value judgment anyway, and pretty callous.

The rate of suicide for women, aged 15-24, over the nineties stayed steady; for men in the same group it rose by over 71 per cent and in 1996 it accounted for 12 deaths in every 100,000. Suicide is the second most common cause of death among young people under 25. A British Medical Journal sponsored study team at Oxford's Warneford hospital said that at least 100,000 patients, of whom two thirds are aged between 15 and 34, are likely to be referred each year to hospital in England and Wales because they have tried to kill themselves. In one small-scale study in the 1990s in Bristol, a panel of psychiatrists re-classified 61 Coroner's verdicts of open verdict or accidental death as suicides. In a TV documentary a senior coroner admitted that: "Some of the Open Verdicts that I have returned. I would say were (probably) suicides but I cannot say so in court because the evidence is insufficient."

Durkheim's own definitions seem logically and philosophically flawed, he failed to reasonably describe the units by which "social integration” could be assessed (vital for the axis of suicide diagram) and saw suicide itself as: "every case of death which results directly or indirectly from a positive or negative act, accomplished by the victim himself which he knows must produce this result".

A cause of death resulting directly or indirectly as a consequence of smoking seems to be lung cancer; and with the years of health publicity that smoking has had, no-one can claim ignorance of the dangers. So is smoking a suicidal act? Under the vagaries of Durkheim's definition it could well be classified as such. Without being too logically brutal it should also be pointed out that (in the absence of immortality pills) we are all performing positive and/or negative acts which must produce the cessation of our lives; simply because we all die in the end. Under Durkheim’s view any act, which is not involved with successful research into the absolute prevention of death, is suicidal; virtually all of us are therefore suicidal.

A better definition of suicide might include the clause of ‘deliberate’ self-termination of life at an earlier date than might reasonably have been expected given the state of physical health (and other circumstances) of the individual. Again, even this is clumsy and has gaping holes in the logic and semantics. Durkheim's use of the word "victim" seems to imply an element of the suicide being not entirely under the control of the subject. Victim is generally used for those killed in accidents or murders. Suicide being an intentional willed act the term would perhaps better be phrased as "participant" or "director".

From my own experiences of a prolonged suicidal state I can fit my motives and circumstances (at that time) simultaneously onto all four different arms of Durkheim's axis of suicide. This begs the question of how I would have been categorised under his scheme had I (lived and) died in France 100 years ago, in Durkheim’s time? Whichever the category it would have been wrong, and I do not believe myself to be unique in this. I see suicide as being an entirely unique and personal act, which is unlikely to be of much use in general sociological study; but probably of relevance in institutionalised suicides; such as prisoners and very long stay hospital patients where there is a greater commonality of environment and circumstances.

I hold very much with the view of suicide statistics being a social construct and not an objective fact. There is no religion which condones suicide. With the possible exception of the form of Buddhism under which the Samurai code of hari-kiri is enacted; but that is more a religious aspect to warriorship than a straightforward religion. It’s debatable whether Buddhism is a religion anyway; depends on how you define religion (which is another matter entirely and way beyond the scope of this piece) and as much of world society until very recently was under the very strong influence of some form of religion it is extremely unlikely that any suicide statistics have EVER been accurate or truthful. This all but invalidates any conclusions that can be drawn from the figures alone.

It is from better reporting of figures, and study of emotions and thoughts in many individual cases that we can best progress. As an outreach worker for the Samaritans, said: "It's not facts that kill people, it's feelings. It's not the bad events, but the way the person feels about them. A final straw can be gossamer light.” I understand that Dave has a piece in progress about stress and life events, in a psychological framework, so watch this space….

This all seems very hard on Durkheim, who has been a convenient whipping boy for sociologists. I'm sure he has his good points, but I don't know enough about his other works. If nothing else he provides starting points for discussion. The whole argument is a reflection of Bertrand Russell's struggle with himself in "Problems of Philosophy"; which ends with a compromise between the Empirical (Positivist) and Rational (Phenomenological) views; i.e. it needs a balance of both schools of thought to make any progress, a more perceptive means of statistics gathering plus confidence in those making the definitions of cause of death; or rather confidence in their religious, moral, political and philosophical impartiality. Yeah, that big a shift…

An entirely phenomenological approach would no doubt be extremely interesting but it is unlikely that any macro-sociological theories could be derived from such small-scale studies. Phenomenology seen in its most negative light is an insular process of only believing what is directly experienced; and not information from second-hand sources- which, for example, precludes a belief in the existence of America if one has never been there. A sceptical but open-minded approach, perched in the middle between empiricism and pure rationality would seem to be the way forward; the much-desired objective science devoid of value judgments. If only! Short conclusion? The figures are screwed, but the authorities still rely on them.

KH

Suicide is a very emotive subject, and you would be surprised how many people’s lives have been touched by it; so this article may jar some painful memories for some, and it is likely that at least one reader will be suicidal. Help is available:

The Samaritans in the UK

There are other, very obvious and well-advertised support organisations in other countries- look for them