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Section 19
A Brief History of Suicide

Question 19 found at the bottom of this page
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The historical story of the locus of suicide (in the Western world) can be told rather briefly. During classical Greek times, suicide was viewed in more than one way. It was tolerated and even lauded when done by patricians-generals and philosophers-but condemned if committed by plebians or slaves, whose labors were necessary for the smooth functioning of a patrician-slave society. In classical Rome, in the centuries just before the Christian era, life was held rather cheaply, and suicide was viewed rather neutrally or even positively. The Stoic philosopher Seneca (4 B.C.- 69 A.D.) said, "Living is not good, but living well. The wise man, therefore, lives as well as he should, not as long as he can... . He will always think of life in terms of quality not quantity. . . . Dying early or late is of no relevance, dying well or ill is ... life is not to he bought at any cost."

In the early Christian era the excessive martyrdom and penchant toward suicide of early believers frightened church elders sufficiently for them to introduce a serious deterrent. That constraint was to relate suicide to crime and to the sin associated with that crime. A major change occurred in the 4th century with a categorical rejection of suicide by St. Augustine (3 54-430). Suicide was considered a crime because it precluded the possibility of repentance and because it violated the biblical Sixth Commandment relating to killing. Suicide was a greater sin than any sin one might wish to avoid. This view was elaborated by St. Thomas Aquinas (1225-1274), who emphasized that suicide was a mortal sin in that it usurped God's power over man's life and death. Neither the Old nor the New Testament directly forbids suicide, but by the year 700 the Catholic Church proclaimed that a person who attempted suicide was to be excommunicated. The notion of suicide as sin took firm hold and for hundreds of years thereafter played an important part in the Western view of self-destruction.

There is much to learn about the long stretch of several hundred years from 1000 A.D. to the 18th century, and much of it is explicated in the French historian and scholar Georges Minois's scholarly book entitled History of Suicide (1996). That book provides us with a segue to the French philosopher Jean Jacques Rousseau (1712-1778) who, by emphasizing the natural state of man, transferred sin from man to society, making people generally good and asserting that society makes them bad. The disputation as to the locus of blame-whether in people or in society-is a major tension that resonates throughout the history of suicidal thought. David Hume (1711-1776) was one of the first major Western philosophers to discuss suicide in the absence of the concept of sin. His famous essay "On Suicide," published in 1777, the year after his death, was promptly suppressed. That well-reasoned essay is a statement of the Enlightenment's position on suicide. The burden of the essay is to refute the view that suicide is a crime; it does so by arguing that suicide is not a transgression of our duties to God or to our fellow citizens or to ourselves. Hume states that prudence and courage should engage us to rid ourselves at once of existence when it becomes a burden. . . . If it be no crime in me to divert the Nile or Danube from its course, were I able to effect such purposes, where then is the crime in turning a few ounces of blood from their natural channel?

Whereas Hume tried to decriminalize suicide, Rousseau turned the blame from man to society.

In the 20th century, the two giants of suicidal theorizing-Emile Durkheim (1858-1917) in France and Sigmund Freud (1856-1939) in Austria-played rather different roles: Durkheim focused on society's inimical effects on the individual, while Freud, eschewing both the notions of sin and of crime, gave suicide back to man but put the locus of action in our unconscious mind.

Durkheim's best-known work Le Suicide in 1897 (although unavailable in English until 1951) established a model for sociological investigation of suicide. There have been many subsequent studies of this genre. The monographs and books on suicide by Ruth Cavan (Chicago, 1926), Calvin Schmidt (Seattle, 1928), Peter Sainsbury (London, 1955), and Henry and Short (business cycles, 1954) all fall within the tradition of taking a plot of ground-a city or a country-and figuratively or literally reproducing its map several times to show its socially shady (and topographically shaded) areas, and their differential relationships to suicide rates. According to Durkheim, suicide is the result of society's strength or weakness of control over the individual. He posited three basic types of suicide, each a result of our relationship to society. In one instance, the "altruistic" suicide is literally required by that individual's society. Here, the customs or rules of the group demand suicide under certain circumstances. Harakin and suttee are examples of altruistic suicide. In such instances, the person acted as though he had little choice. Self-inflicted death was honorable; continuing to live was ignominious. Society dictated a person's actions, and as individuals we are not strong enough to defy custom.

Most suicides in the United States are "egoistic"-Durkheim's second category. Contrary to the circumstances of an altruistic suicide, egoistic suicide occurs when the individual has too few ties with his or her community. Demands-in this case, to live-do not reach him or her. Proportionately, more unconnected individuals, especially men who are on their own-lonely old men-kill themselves than do people who are connected to church or family.

Finally, Durkheim called "anomic" those suicides that occurred when the accustomed relationship between an individual and society is suddenly shattered or disrupted. The shocking, immediate loss of a job or the death of a close friend or the loss of a fortune is thought sufficient to precipitate anomic suicide or, conversely, poor men surprised by sudden wealth have been shocked into anomic suicide. A situation of estrangement to one's usual ties to the habitual aspects of one's society is called anomie.

The students and followers of Durkheim include Maurice Halbwachs in France and Ronald Mans and Jack D. Douglas in the United States. Douglas, especially, argued that Durkheim's constructs came not so much from the facts of life and death as from official statistics that may have distorted those very facts that they are purported to report.

As Durkheim detailed the sociology of suicide, so Freud (although not writing directly on this topic) fathered psychological explanations. To him, suicide was essentially in the mind. Because individuals ambivalently identify with the objects of their own love, when they are frustrated the aggressive side of the ambivalence turns itself against the internalized person. The main psychoanalytical position on suicide was that it represented unconscious hostility directed toward the introjected ambivalently viewed love objects. For example, one killed oneself to murder the image of one's loved-hated father within one's breast. Psychodynamically, suicide was seen as murder in the 180th degree. Contemporary psychoanalysis has modified this view in a number of ways that extend the confines of this original prescription.

In an important exegesis of suicide, Robert E. Litman (1921- ) traced the development of Freud's thoughts on this subject, taking into account Freud's clinical experiences and his changing theoretical positions from 1881 to 1939. It is evident from Litman's analysis that there are more factors to the psychodynamics of suicide than hostility. These factors include the general features of the human condition in Western civilization, specifically suicide-prone mechanisms involving rage, guilt, anxiety, dependency, and a great number of predisposing conditions. The feelings of helplessness, hopelessness, and abandonment are very important.

Psychodynamic explanations of suicide theory did not change too much from Freud to the American psychiatrist Karl Menninger (1893- 1990). In his important 1938 book, Man Against Himself, Menninger, in captivating ordinary language, delineated the psychodynamics of hostility and asserted that the hostile drive in suicide is made up of three skeins: the wish to kill, the wish to be killed, and the wish to die. Gregory Zilboorg (1890-1959) refined this psychoanalytic hypothesis and stated that every suicidal case contained strong, unconscious hostility combined with an unusual lack of capacity to love others. He extended the locus of concern from solely intrapsychic dynamics to the external world and maintained that the role of a broken home in suicidal proneness demonstrated that both intrapsychic and external etiological elements were present.

In addition to the sociological and psychological approaches to the study of suicide, there is a contemporary thrust that might be called philosophic or existential. The French philosopher Albert Camus (1913-1960) begins his essay "The Myth of Sisyphus" (1942) by saying, "There is but one serious philosophic problem and that is suicide." The principal task of man is to respond to life's apparent meaninglessness; despair and its absurd quality. Ludwig Wittgenstein (1889-1951)-an Austrian born, English citizen-also stated that the main ethical issue for man is suicide. To Camus, Wittgenstein, and other philosophers, their ruminations were never meant as prescriptions for action.

There is yet another contemporary thread; it comes from the laboratory and has aspirations of being applicable in the clinic. It focuses both on the living and the dead brain and on such bodily fluids as blood and cerebrospinal fluid. It relates to the anatomy and physiology of suicide- the biological approach to the understanding of specific human behaviors.

The locus of conceptualization of suicide is set by the church, the government, books, mores, society, writers, and leading-edge intellectuals. It reflects the zeitgeist: the commonly held beliefs that are "in the air." Looking at this panorama of ideas and sentiments over the past millennium, it seems to me that a number of ideas have occupied intellectual space on the topic of suicide. Alliteratively, I call them sin, sacrilege, socius, soma, serum, psyche, and selfhood. Over the past 200 years, the main emphasis (and locus) for suicide has moved from accusations of sin toward efforts at compassion, understanding, and prevention. The Encyclopedia Britannica reflects these changes. My recent study2 of the 14 separate articles on suicide in the various editions of the Encyclopaedia since 1777 (see the Epilogue) showed that society has moved light-years since the 18th-century excoriation of suicide as cowardly, sinful, and shameful to a contemporary emphasis on nurturance and support-like the Samaritans in Great Britain and the suicide prevention and hotline activities in the United States, whose interactions often begin with the question "How can we help you?"
- Shneidman, Edwin S., Comprehending Suicide: Landmarks in 20th~Century Suicidology, American Psychological Association: Washington DC, 2001.

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Personal Reflection Exercise #5
The preceding section contained information about a brief history of suicide. Write three case study examples regarding how you might use the content of this section in your practice.

QUESTION 19
According to Durkheim, what are the three basic types of suicide? Record the letter of the correct answer the Answer Booklet.