Saturday, May 1, 2010

"The Truth Today..."


Deconstructing 'Myths About Suicide'

Dr. Thomas Joiner explains that suicide is not easy, cowardly, vengeful or selfish...

Listen to the Story


Talk of the Nation
[30 min 20 sec]

Excerpt: 'Myths About Suicide'
by Thomas Joiner
Hardcover, 304 pages
Harvard University Press
List price: $25.95

Those who have recently lost a loved one to suicide are stunned by many things following their loss, including the profound change in their address books — once trusted friends fall away after ignoring a loved one's suicide or after saying hurtful and appallingly glib things like "It was God's will." Of the many survivor anecdotes that have touched and moved me over the years, a memorable one came from a powerful Southern man who had been "comforted" by hearing that his son's death by suicide was God's will. In reaction, he thundered in his drawl: "It was NOT God's will that my precious son shot himself in the head." Good for him that he said that; I wish I had said more such things (though I said some, no doubt) in reaction to the inanities I heard after my dad's death by suicide. In Shakespeare's Hamlet, Ophelia has died, and a priest would deny her full funeral rites because she died by suicide. Her brother responds, "I tell thee, churlish priest, a minist'ring angel shall my sister be, when thou liest howling." Most people bereaved by suicide can identify with this sentiment.

A May 2007 case in Oklahoma involved the family of a young woman who had died from a gunshot wound to the head. It was not clear if the wound was self-inflicted or not, but the family felt determined to show that it was not, and to have an insurance company pay death benefits. A judge decided that the insurance company's lawyer did not adequately demonstrate the manner of death as suicide, and ordered them to pay the family (which they would have had to do anyway, as long as the death by suicide occurred more than two years after the policy was initiated. That is the standard policy, at any rate). The family's lawyer was quoted as saying, "It wasn't about the money ... This is about clearing a daughter's name of the stigma of having committed suicide."

Really? It's more about clearing a stigma than about finding the woman's actual killer?

Psychiatrists and psychologists — highly trained, doctoral level mental health professionals — sometimes whisper about or panic about or skirt around the issue of suicide, an aversion that has always puzzled me, and one that strikes me as similar to a surgeon being afraid of blood. I know about this too: I'm a clinical psychologist who specializes in the understanding and treatment of suicidal behavior. Why this profound stigma? For any stigma, the usual ingredients are fear and ignorance. If suicide is special in the degree to which it is stigmatized — and I and others believe it may be — then it is simply because the fear and ignorance are so great. Stigma about suicide should be reduced, of course, and it is a point of this book to do so, but I think it should be reduced via a decrease in ignorance, not in fear. I would prefer to leave the fear of death by suicide more or less intact. Fear can be quite healthy, and its absence can be deranged. Some of the most consistently fearless people are the most dangerous and disturbed.

Fear of injury and death, and of self-injury and self-inflicted death in particular, is natural and normal. Fear is self-preservation's substrate. In his biography of Jack London, Alex Kershaw described the author thus: "he was aware that mankind's terror has always been its most basic emotion ... it has far deeper roots than love, tracing back to the days before history, when man was just another wild, frightened savage."

The self-preservation instinct is hard-wired and strong, and, as Voltaire understood centuries ago, relevant when it comes to understanding suicidal behavior. Voltaire wrote of the death by suicide of the Roman orator Cato, "It seems rather absurd to say that Cato slew himself through weakness. None but a strong man can surmount the most powerful instinct of nature." Centuries earlier still, the Jewish historian Flavius Josephus understood this as well; he wrote that suicide "is contrary to the instincts shared by all living things." This view is found as well in Camus' The Myth of Sisyphus, in which he states, "The body's judgment is as good as the mind's, and the body shrinks from annihilation." The simple but compelling idea that occurred to Voltaire, Josephus, and Camus is that one must first grapple with one of nature's strongest forces — self-preservation — before one dies by suicide.

Based in part on this insight, I developed a new theory of suicidal behavior (in the 2005 book Why People Die by Suicide). In my view people die by suicide because they have both the ability and the desire to do so. This may seem glib or superficial, and if things were left here, it would be. What is the ability to die by suicide and in whom and how does it develop? What is the desire for suicide, what are its component parts, and in whom and how do they develop?

Self-preservation is a powerful enough instinct that few can overcome it by force of will. The few who can have developed a fearlessness of pain and death, which they acquire through a process called "habituation." Formally, habituation is defined as "a response decrement due to repeated stimulation." Less formally, it can be defined as "getting used to something." In his Memoirs from the House of the Dead, Dostoevsky wrote, "Man is a creature who can get used to anything, and I believe that is the best way of defining him."

Getting used to pain, injury, and death — becoming fearless about it — is, according to my theory, a prerequisite for serious suicidal behavior. People get used to such things by having repeatedly experienced them, often through previous self-injury, but other painful experiences serve too. A corollary to this view is that the self-preservation drive — the fear of pain, injury, and death — protects people from death by suicide (which is why this fear should remain more or less intact). This corollary is supported time and again by cases of people who report that they genuinely desired to die by suicide, but that their bodies would not allow it (e.g., people have cut at their veins for hours, only to eventually surrender to their bodies' ability to clot the wounds).

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For Stephen Christopher Harris who inspired my last suicide attempts...

"Fear Eats the Soul"

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