Saturday, 24 March 2012

A Study of Attitudes to Suicide

Suicide is seen as an indicator of crisis in a society, a serious phenomenon most worthy of our attention.

Therefore, broader questions should be asked, such as:
•Is suicide at the summit of all manners of death, requiring the considerable energy and expenditure now
involved in prevention strategies?
•Why do we respond to suicide in the way we do?
•Do we see it as a rejection of ‘us’, an affront to a civilisation we prefer to see as capable of offering hope, faith, spirituality, learned optimism, knowledge, technology?
•Is suicide always a medicalised problem, a ‘mental disorder’ which specialists can treat or remedy?
•Is it an act of free will which society does not want the individual to exercise?
•Does life ‘belong’ to society at large rather than to the individual?

It is noteworthy that in the four major professions or areas dealing with suicide, there is suicide prejudice. James Hillman has written an important book, Suicide and the Soul. His aim is to examine suicide, not as an exit from life but as an entrance to death. He is searching for a root metaphor befitting an analyst. His concept of soul embraces any of the following: mind, spirit, heart, life, warmth, humanness, personality, individuality, essence, purpose, morality, sin, virtue, wisdom, death, and perhaps God. In his search or struggle for understanding of the soul, he has rejected the ideas about suicide prevention inherent in sociology, law, theology, and medicine. I now summarise his admonitions about the attitudes of these disciplines to suicide.

•For sociology, suicide is always negative. It presents a loosening of the social structure, a weakening of group bonds, and disintegration. ‘As an open enemy of society, suicide must be opposed and prevented ... suicide prevention for sociology means group reinforcement, which of course reinforces the root metaphor of sociology itself.’
•Roman law, church law, and English law declared suicide criminal. Again, Hillman argues, prevention is the main end in view. In law, death is ‘an act of God’ and a ‘force majeure’. Durkheim noted that ‘the causes of death are outside rather than within us.’ Thus law recognises death as something from outside. To take one ’sown life, to originate death from within, is neither ‘force majeure’ nor an ‘act of God’, ‘but a one-sided abrogation of contract’, thus a breach of the law. Western law has judged suicide from the viewpoint that man belongs first to God, then to King, then last to himself. There are many instances of justifiable homicide; however, until very recently, the law prohibited being ‘mine own executioner’. Insanity thus became the only loophole.
•The Abrahamic religions have their root metaphor in Creation: ‘Almighty God created life. It is His’. We are, therefore, not our own makers, and so we ‘cannot take our lives because they are not ours’.
•As to medicine, the root metaphor above and beyond all others, is to ‘promote physical well being, that is, life’. He contends that in the present era it has come to mean not just promotion of life but the prolonging of life. Suicide, or the threat of self-death, cries for ‘the immediate action of locks and drugs and constant surveillance—treatment usually reserved for criminals.’ Good life equals more life. The physician, he says, ‘is obliged to postpone death with every weapon he can command’. Suicide is death—the arch-enemy. Accordingly, there can be no objectivity about suicide in the medical approach.

Thomas Szasz, a radical and often disparaged psychiatrist, has long supported Hillman in asking that we re-examine our attitudes to suicide. Al Alvarez, David Lester, and more recently, Mark Williams, have put forward cogent arguments which confront the restricted views of suicide as madness or badness, as being near-criminal, as a condition warranting coercive treatment or special strategies such as prevention agencies. Szasz condemns R. E. Schulman, an American lawyer and psychologist, who argues that even if a person does not value his life, society does and is entitled to preserve it. Schulman insists that suicide ‘surely falls within the province of the law’: he calls suicide ‘self-murder’. Szasz disapproves of Phillip Solomon for treating the would-be suicide as an unruly child. Solomon wrote that physicians ‘must protect the patient from his own [suicidal] wishes’. Szasz is even harsher on Shneidman, who says that ‘suicide prevention is like fire prevention’, which Szasz contends reduces the would-be suicide ‘to the level of a tree!’ Szasz quotes a telling passage from Stefan Zweig, the renowned Austrian writer and biographer, who committed suicide in 1942.In Zweig’s novella, Amok, his protagonist says:

Ah, yes, ‘It’s one’s duty to help.’ That’s your favourite maxim, isn’t it? ... Thank you for your good intentions, but I’d rather be left to myself ... Sir, I won’t trouble you to call, if you don’t mind. Among the ‘rights of man’ there is a right which no one can take away, the right to croak when and where and how one pleases, without a ‘helping hand’.

In citing these authors, I am being neither anti-medicine nor anti-prevention. Rather, I suggest a reconsideration of our approach towards suicide, customarily seen as something so horrific that, even though it occurs far less frequently than other deaths, we have to marshal enormous resources to cope with it, and to prevent it. We label suicide as ‘depression’ in too many cases; suicidal behaviour is not always the domain of ‘mental health’. We need serious reflection on why we react to suicide the way we do, why we perceive youth suicide as more calamitous than, for example, young deaths on motor bikes or in fast cars, or from drug-taking. We need to ask why we continue to be so affronted, or confronted, by those who would rather not be in life.

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