Suicide--much has been written about this subject, and mental health experts study it unceasingly. Yet despite the data amassed and the theories and speculations drawn, ultimate answers, particularly regarding the motives of a particular person, elude even the best professionals. Outside pressures, business reversals, taunting and rejection: all of these can appear to drive even the most well-adjusted person to seek self-annihilation, as George Bailey tried to do after his bank failed in "It's a Wonderful Life." Yet suicide also claims the lives of those you would least expect:
And he was rich, richer than a king / And admirably schooled in every grace
In fine--we knew that he was everything / To make us wish that we were just like him.
And so we worked, and waited for the light / And went without the meat, and cursed the bread
Richard Cory, one calm summer night / Went home and put a bullet in his head.
The poem about Richard Cory was written by Edward A. Robinson in 1897 and in the century since the "why" of a particular person's suicide can remain just as much a mystery. Take for example the Hemingway family. Is there an elusive, destructive gene inextricably woven within their talents, set with an unknown triggering point? Still, despite these grave examples, an opposite viewpoint of suicide--one that contains a certain positive advocacy--has emerged. "During the course of one's professional experiences, dealing with a wide gamut of psychic pain and inability to function," psychologist Kay Tooley of the University of Michigan writes, "the question has to do not so much with why some people crumble under the pressure of human suffering, but rather why it is that so many people do not."
Psychiatrist Aaron Beck's analysis and of depression and hopelessness have given mental health therapists powerful tools for assessing, preventing, and treating suicide. Four decades ago Beck created the empirically-based Beck Depression Inventory and over the course of the ensuing decade discovered that high scores on this test did not necessarily correlate with successful suicide. After further scientific research he discovered that the level of hopelessness is a better (although imperfect) predictor of suicide potential than depression alone. His "Hopelessness Inventory" is used internationally as a triage tool in emergency rooms and many clinical situations. Beck is considered one of the 5 most influential psychologists of all time and he continues to head the center for suicide research and prevention at the University of Pennsylvania.
Suicide prevention has become a specialty, no doubt an effective one, but contrarian thinkers point out with some good evidence that too many suicide prevention programs can actually inspire copy-cat suicides. Yes, suicide prevention has become a cottage industry in some places. (An example of a first-rate and effective suicide prevention program is Paul Quinnett's QPR Institute). Yet despite all the preventative effort, there remains that uncontrollable and immeasurable variable of human choice. But can merciless internal pain annul even free will? Even the Catechism of the Catholic Church acknowledges this possibility; the church is now sympathetic to those who despair, and kinder to the families in allowing funerals without an inquisition.
There are those too who argue that all human misery resides in biological protoplasm, yet this issue will not be resolved in the near future. So instead let us revisit Kay Tooley, who seeks to identify practices in our daily lives that can help prevent despondency and despair, which she calls "ingredients useful in the treatment of disorders resulting from unhappiness, rootlessness, and the fear of things to come":
What exactly might be the contents of an inner treasury that generates hopefulness? Odds and ends one suspects, perhaps resembling the hodegepodge that every child stores in a carton under the bed: souvenirs and bottle caps and and trophies and photographs and baseball card and sea shells and coin collections--things that have symbolic value in their own right (coins), things that have the capacity for stimulating pleasant memories, and things that reinforce a treasured mythology of the self, things that revivify a former version of a self overlooked in the present self; things that recall a time of happiness obliterated by the weight of current unhappiness; things to be touched fondly, turned over musingly, returned to the box, which is in turn shoved back into storage.
In the past, there was a lovable and interesting person that I do not personally remember but I believe that I was. In the future, which is another great void of unknown possibilities, it seems possible that I could become a person lovable and interesting and totally different from every other human being, even though there seems to be nothing in my current perception of my life or myself that would support that possibility.
Not only the depressed but the developmentally dispossessed--the whole of humankind--show evidence of the need for a portable past, a tangible treasure. The delights of coin collecting hinge not on current value but on the promise of a greater value in the future, a value unsuspected by the unenlightened majority. The 1918 copper penny, the Indian-head nickel, the anniversary minting hold a symbolic promise made by the past directly to the future. Baseball cards hold the records of past exploits and faces not currently visible but undeniably existing. Tokens in romantic literature are unarguable proof that the shepherd's daughter, possessor of the ruby ring, is indeed the long lost daughter of the king, unlikely though it may seem.
While George Bailey and Richard Cory represent the knowable and the mysterious ends, opposites of a continuum explaining the causes of suicide, and Aaron Beck and Paul Quinnett give us first-rate professional tools, it is in Kay Tooley's perception that we travel to a deeper meaning of why despondency occurs, not just in suicidal persons but in our own lives. She offers us a Theology of the Ordinary, emphasizing experiences of nurturing, caring, and loving: fondly recalled through our lives in conversation, songs, art, and even bottle cap collecting. These pursuits bring a buoyancy that can counter the opposite pull of hopelessness, genetics, and severe rejection, and carry a strong re-statement of another command and message given from a mountain in Galilee many years ago.
To readers: Paul Quinnet has made his book, SUICIDE: THE FOREVER DECISION free to everyone. It was a bestseller and classic from Continuum Publishing and may be accessed here: In my review years ago I stated, " "I am in awe of this book. It will be especially valuable to such nonprofessional counselors as teachers, clergy, doctors, nurses, and to experienced therapists. It has already become a classic."
William Van Ornum
We may be headed toward an area where I lack knowledge and competence. I myself have never been in a situation, nor have I heard an account from someone else directly, where I had any inkling that some other powerful force, other than natural ones, may be at work. So instead I must listen and try to make sense of everything I hear and see in the wider world, which is how I define empiricism. William James brought a talented mind to these topics in "The Varieties of Religious Experience." As noted before, I think mental health workers from the Western worldview are going to need to learn more about these things when they work with severely troubled persons in the Caribbean and Africa. Thanks again for your thoughts and have a good weekend. best, bill
Furthermore, as the article states, the religious perspective on the matter has changed, as well. I am wondering what happened to the possibility that the individual is being visited by evil (Satan/demons/ESP coming from enemies) that should be resisted and that he or she is not strong enough to overcome alone.
THE FIFTH COMMANDMENT
You shall not kill.54
You have heard that it was said to the men of old, "You shall not kill: and whoever kills shall be liable to judgment." But I say to you that every one who is angry with his brother shall be liable to judgment
Suicide
2280 Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.
2281 Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God.
2282 If suicide is committed with the intention of setting an example, especially to the young, it also takes on the gravity of scandal. Voluntary co-operation in suicide is contrary to the moral law.
Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide.
2283 We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.
I work on an in patient psychiatric unit. I spend my days discussing little else other than suicidal ideation. So accustomed are we now to "treating" mental illness, that we have lost sight of the construct of suicide as "sin". Lord knows, were I to bring the enemy into the discussion, I might find myself admitted. Make no mistake, where homicide and suicide transpire, the malignant enemy is there...
You bring up a good point regarding being visited by Satan or other malevolent forces, and that modern psychology and psychiatry view these as coming from the person's own mind; professionals might use terms like paranoid ideation, auditory hallucinations, or even mood-congruent delusions. And of course, mental health professionals will "treat" these, and first line treatmen usually is by a psychiatrist with one of the anti-psychotic medications.
The possibility that the person is being visited by Satan-this was a view prevalent in many other ages, and sadly it often led to cruelty toward the person expressing these thoughts, and now we know that many times our modern treatments alleviate these symptoms.
However-academically speaking-a person being visited directly by Satan is not inconsistent with our faith. Has it ever happned or does it happen-i don't know, and this is not the same as denying it can happen. I have read of at least three exorcisms done by the Church in the last two decades, and I believe these were only done after all psychiatric resources were exhausted.
Your thoughts here have huge relevance to other cultures especially in parts of Africa and the Caribbean. Many of the religions, even ones of Christian heritage, believe in the direct influence of Satan, and mental health professionals need to be very careful to understand and respect these other worldviews. Otherwise, their help will be refused and their efforts may even go against the Hippocratic adage, "Do No Harm."
If you have other thoughts about this, you can always write to me at ornum@earthlink.net. Thanks for your thoughts. best, bill
Divorce is a terrible experience for many of us and can trigger some of the darkest emotions. I have always admired Ignatius for his understanding of the dark nights people experience; his struggles and victories give hope to many, and your own example to others may be similarly comforting with your knowing it. Wasn't that the point of the movie "It's a Wonderful Life?"
On an academic plane, I've always wondered how much affection Ignatius got as a little Ignace, with 12 siblings and a mother whose early death left him in a sense orphaned. (Both Thomas Merton and C.S. Lewis have remarkably similar backgrounds. Interesting and uncanny. Will address this here in the future.)
So perhaps he was a person who grew up without many of those memories Kay Tooley writes about. But he was guided to feel loved in another way, and leads many others along that path. AMDG! best, bill
When I read those sections from the Catechism, I focus on the last sentence of 2282, and also think of that character of in King Lear who said, "The quality of mercy is never strained; it falls to earth like gentle rain." Thanks for writing, bill
Your comments are senstive and empathic. I recall seeing surveys that indicate 95-98% of adolescents have experienced some kind of suicidal ideation. Since we were all once teenagers, your obervations ring of truth. The saddest truth of all, as Paul Quinnett indicates, is that suicide is a forever decision, one that can't be redone. I think you are right, too, about many persons seeking death so they'll end up in a better place. best, bill
I liked this by him especially - "Understanding Suicide" .... http://www.ronrolheiser.com/columnarchive/?id=369
When I went to counseling after I was divorced, the shrink brought up me not having known my father as part of why things felt so awful. I think you're right that a person's childhood has a big effect on their resilience.
Thanks for opening up another door for me. I wasn't aware of Father Ronald; his books and writings appear highly substantial. I was touched by reading some of his thoughts on loneliness and the books he has written on this topic, as well as his masterful presentation on William Styron. I found this comment on his website especially kind: "The human heart is exquisitely fragile. Our judgments need to be gentle, our understanding deep, and our forgiveness wide." thanks, bill
Crystal, i too have found comfort in Fr. Rolheiser's books.
There is another aspect to this subject and that is the anguish felt by the relatives and friends of the person who committed suicide. One Thanksgiving when i returned home for vacation from college, I learned that a long-time dear friend of ours had killed himself. In fact, it was my father who discovered him in his truck. Like Richard Cory he had put a bullet in his head. We were all in grief, That is all we talked about. This man had been an alcoholic who could stay sober for months and then go on a binge. He often stayed with us at Lake of the Woods, helping my dad with chores. But, only when he was sober. He was like a member of the family.
He was Catholic but was not allowed Catholilc funeral or burial. I'm thinking more about him as presently I have a dear friend who attempted suicide a few years ago and is still very fragile, She was physically and sexually abused by her father . The precipitant seemed to be the cruel treatment she received from a woman manager.Several friends and I have stood by her throughout her ordeal and will continue to do so. Her partner (she is a lesbian) is as fragile as she is and is of no support. A staunch atheist, there is no comfort from religion, Maybe, we can come up with some ideas from the Theology of the Ordinary without calling it Theology. Her fragility is an ongoing worry.
Sadly, to be despondent or to experience suicidal urges can be akin to leprosy, in neighborhoods, society, and church. Acceptance just in daily life, or a kind referral to excellent professional help (sometimes this might mean accompanying someone to the emergency room or to their therapist), is a good human response. You have gone that extra step with your friend, and your presence offers more solace than words from books or magazines.
A frog collection! Neat! bill
Thanks for the invitation to contact you directly. I may take you up on it in order to avoid compromising the privacy of people to whom I might wish to refer. However, I can still discuss this subject in more general terms I think.
As David notes almost everyone has considered the idea of suicide as a solution to difficulty. However, I would doubt that most were anywhere close to making it real in the way William Styron (whom you mention above and who is the focus of the article cited by Crystal) experienced it.
I have William Styron's "Darkness Visible" on my bookshelf. I read it through once and have gone back over parts of it from time to time.
I find it extremely difficult to accept that what Styron describes as the onset of his depression as being just a random moment of biochemical change. As I recall, he said that the depression onset was sudden as if someone had put a hood over his head and face. I would tend to think that there would be a more gradual sinking into depression from biochemical change.
Furthermore, the depression Styron experienced did not have a direct precipitating cause, such as bereavement or crushing disappointment. His thoughts of suicide were precipitated by the pain of the depression itself, since he was unable to do anything to help himself get better - in contrast to people who can reminisce about better days.
Based on my direct experience with people who experienced depressions in various forms, I would be inclined to believe that what William Styron experienced could have been the effect of otherworldly forces, even though he never says that. Obviously, it did not take an exorcism to save Styron. However, I do think that his reaching out and the loving care that resulted from it overpowered the malevolent forces that afflicted him at that time. (Are we not be inclined, as religious people, to attribute the inclination to reach out to God's intervention even when the individual does not make that attribution?)
I don't really know what to think about the exorcism ritual. I have had the sense of speaking with demons when talking with some depressed people, but what danger I felt was from the potential for physical assault and the lack of witnesses. However, I think ruling out the possibility of an external cause for all suicidal depression is too limited. Granted, attributing mental illness to Satanic possession has a bad history, but as often happens when society goes to one extreme, it compensates by going to the other.
It probably is the case, more often than not, that people who committed suicide did so with the idea that it would make things better and that this idea was not planted in their heads by Satanic forces. However, I would not rule out the possibility that some people are plagued by malevolent forces, making their experience of life truly abysmal, in order to score a point against God when these people kill themselves. I wonder if considering that possibility might not be helpful to at least some people (who are not atheists, of course).
Thanks for writing back. Your thoughts on "demonic intervention" appear to me as consistent with everything C.S. Lewis has written about the subject. Have you read "The Screwtape Letters?" It is charming and humorous and deadly serious. Simultaneously! I re-read it in 2001 after 9-11 and discovered some approaches helpful to all of us when living through and age of terrorism, as he did during the London bombings. Fascinating guy.
Having worked on a locked psychiatric until with a good number of profoundly depressed people (too many of whom later committed suicide despite top-notch care), I do think Styron's experience rings true, and sadly this may be the most difficult to come to grips with. All of us are limited by our genetics, although the shape of the lives we carve out depends on lots of other things. The right antidepressant + right dosage + good talk therapy + right therapist can make a big difference, and I think all four of these variables need to be present simultaneously, which is rarer than one might imagine.
I'm re-reading Armand Nicoli's THE QUESTION OF GOD: C.S. Lewis and Sigmund Freud Debate God, Love, Sex, and the meaning of Life. The piece I wrote on CS Lewis only garnered a handful of responses, so I thought AMERICA's readers might not have an interest in him, but Tim the editor showed me the stats and it got alot of readers. It was even picked up across the pond in a Brit paper. So I hope to write more about Lewis. Interestingly, he knows Freud better than Freud ever understood religion or Christianity.
best, bill
We have all of these well-educated scientists delving into the complexities of the human mind, seeking to understand why we do what we do, think what we think, and act how we act; seeking, presumably, the key to solving issues of human suffering, such as suicide. All the while, God has given for many, communicated through the Church, the solutions for many of these afflictions. We sometimes tear apart the television to try and fix it, when many times all we really need to do is look at the user's manual.
I have not read "The Screwtape Letters", but I will put it on my list to read. I am actually basing my opinion on personal experience - maybe personal experience motivated C.S. Lewis to write that book? I have sensed a tug of war going on in the lives of some people I have known that isn't of their own making and that they would prefer were not happening.
Where you see physical explanations, I see tempting vulnerabilities, such that someone's confusion about sexuality or history of abuse or genetic relatedness to someone with the same problem, or even recent bereavement or disappointment or physical illness, serves as a doorway. Therefore, I would see where treating these conditions closes doorways and can resolve the problem, though without necessarily innoculating the patient against future incidents.
I am sure you have had more encounters with troubled people than I have (I don't think I could handle it, because I am not patient enough-I remind my sister-in-law, who is a family counselor, of Dr. Phil), but I suspect that at the point at which you met them they had already succumbed, rather than being where they could go either way and were struggling, not understanding it and trying to keep it secret.
I used think that what I am believing was superstition. It isn't what I was taught, and I have questioned whether I have misinterpreted my experience. In any case, I tend also to believe that death is not the end of the process of determining who ends up where for eternity. Presumably, a point for Satan would only come from someone actually choosing suicide as a way to turn away from God.
I have heard anecdotal evidence sayingn that practicing Catholics are less prone to carry out suicides and those words you and others have heard may have been heard at a deep level. Yes, there's a good owner's manual, read out loud each day everywhere in the world. bill
I'll let any theologians out there answer your questions. The teaching looks to me like an excellent one, hopefully immutable.
What you write about has been happening in Oregon for many years.
Here is something I wrote on the blog at AMERICAN MENTAL HEALTH FOUNDATION. I hope it isn't too controversial here as I know we try to avoid judging candidates on the basis of their stance on one issue, but here I am reporting on what is going on in Oregon and I will let others offer their thoughts. Wikipedia has a good article on the so-called Death with Dignity Legislation.
Despite Association Endorsement, Oregon Psychologists Against Election of Senator
by Dr. William Van Ornum
October 8, 2010 9:41am
Filed under:
News
The Association for the Advancement of Psychology has endorsed Ron Wyden (D-Oregon) for U.S. Senate because of his stance on increasing reimbursement rates for psychologists under new Medicaid regulations.
Not all psychologists in Oregon are happy with this endorsement in view of Wyden's past efforts in voting for and blocking efforts to repeal Oregon's Death With Dignity Act.
Psychologists play an important part in the Death With Dignity process, interviewing potential persons to see if they have any high levels of depression or other problems which would prevent them from making a "rational choice."
It will be interesting to watch this particular Senate race as the November election approaches.
When responding to David's description of "extreme physical discomfort", I had in mind situations which nearly all of us encounter in our lifetimes. The case mentioned in The Tablet is incredibly complex and I do not know enough about bioethics to offer any opinion. I believe this is one reason specialists within the Church are being trained in what will be a very needed speciality in year to come. My heart goes out to anyone who has to be involved in a decision such as the one mentioned in the Tablet. bill
On the other hand, the situation described in The Tablet article involves removing someone's ventilator, without which the individual will presumably die by gradual suffocation. It would not be a way that I would choose to die, but it does not avoid the suffering that would be part of the natural process. Furthermore, in the case of Karen Ann Quinlan, the removal of the ventilator did not end her life, so there is always the possibility that death would not be the result - something that is not quite a miracle, but that is not what was expected either.
I don't have the theological expertise, just like I don't have psychological training, but it would be my guess that it is a less controversial situation when the individual making use of life support technoligies is able to make the decision himself than when the decision is being made on behalf of someone else. It seems to me that a lot of people tend to believe the Church is the business of making everything black and white, but the problem it faces is actually how to protect the Catholic perspective so that Catholics can live according to it in a world in which it is largely not understood.
There could come a time when society sets a standard for quality of life that if it is not being met will be considered legitimate grounds for ending one's life. This is already justification for abortion. Not only that, but there could be social pressure to do so even if one is willing to endure suffering and does not feel oneself yet called by God.
Thank you for each of the well-written postings. I will highlight where you wrote about people choosing "where they could go either way." Some writers have called this "suicidal ambivalence" and one of the goals of treatment is to bring the person out of this difficult period. Paradoxically, psychiatrists must be very careful when prescribing medication-when some people are severely depressed and lethargic ("psychomotor retardation") they lack the energy to carry out any suicidal plans, but when they start to feel a little better and gain emotional energy, often after the antidepressants begin to take effect, there is real danger and high risk beause now they have the energy to act on their despair. I have the hghest respect for any mental health professional who has even one suicidal person on their caseload. It is an extremely high level of responsibility and there are no guatantees even the best treatment or profrssional can prevent a person whon truly and deeply wants to commit suicide from doing so.
bill
ps I want to thank all participants on this thread for the high level of respect which has been displayed in every posting, and the complexity of thoughts and experiences and thoughts presented. tx amdg bill
I appreciate your compliment. When I write, particularly in your area of expertise, I often worry that you will read criticism into what I am writing. In this set of replies, especially, I hope you are not thinking that I am saying that you psychologists should be telling people they are being plagued by demons, though I do think you should not only consider their belief that they are as being their frame of reference instead of an actual objective reality.
I would like to add that my experience was such that there were phenomena involved in preventing people from carrying out their intentions that were recognized by the parties involved as otherworldly. I have encouraged people to seek out professional help instead of involving myself, and I can see where widely believing that otherworldly influences are causing a person's problems can be counterproductive. However, when I approach the situation with the belief that the situation might be being influenced by otherworldly forces, both good and evil, I am more effective in managing the situation.
I have made the effort, in one case, to call the possibility of what you describe to the attention of someone's caregivers because I feared that the individual would not be inclined to share that about himself. Probably, you will say that people in your profession are always alert to signs, but some people are very good liars; they have a self-image to protect. I would also say that the effect you describe could enable a person to become aggressive toward someone he views as the enemy - yes?
Thank you for being so attentive to the comments here; I wish more of the America contributors would do the same instead of exhibiting the "Talk amongst yourselves," attitude that most project by their absence.
For me, this blog is less about expressing my opinion and more about learning from others.
With sincere appreciation,
Mike
You are most welcome and I greatly appreciate your feedback. I learn a great deal from these discussions we have and often find myself following up on readers' suggestions to learn more about many topics. We certainly have a richness of thought, talent, and faith among AMERICA's subscribers and it's great to be able to create a community of sorts on the Web. I always look forward to the comments and thoughts after making a posting. best, bill
Cessation of pain-physical and/or psychological-is an understandable motive connected with despair and despondency. Two other concepts which seem to add to my understanding of particular persons are sheer emptiness-the utter, total, lack of connection with others, a searing loneliness that goes beyond what most of us mean by the term, as well as Beck's notion of hopelessness, that utter feeling that things will never get better. "My God, my God, why have You forsaken Me?" includes all these elements.
In too many persons the alcoholism or drugs magnify the emptiness, hopelessness, and pain by the manner in which these chemicals drive the person away from human support. They can also break down judgment so that persons in the midst of suicidal ambivalence will act out on their desire rather than hold back, knowing that this too shall pass. The concept of "demons" as metaphor certainly is an apt one because people who are in the midst of chemical dependency truly are not acting in the manner of their best selves.
From what I have seen AA and the other programs like CA and NA offer the great empathy and availability of other members 24/7, almost like a human blanket of caring and hopefulness. Wise professionals refer clients for whom AA is appropriate to these programs.
A particularly difficult problem, relevant to suicidal persons, is those who are drinking or using chemicals as a self-treatment for depression, despair, or varieties of bipolar disorder. When they are detoxed, the original despair and depression come back full force, or stronger. AA has changed it's "no chemical" stance over the years to encourage its members to use psychiatric medication and assistance, but they note that it's important to find a practitioner familiar with AA.
I hope I've answered your questions in enough detail, please let me know if there is more you'd like me to address. Thanks for your feedback, too, and perhaps we should add Freud to our prayers, or maybe hope that all along he led a deep spiritual life God understood and appreciated. Thanks, too, for your thoughtful comments on all the different blogs. best, bill
We may be headed toward an area where I lack knowledge and competence. I myself have never been in a situation, nor have I heard an account from someone else directly, where I had any inkling that some other powerful force, other than natural ones, may be at work. So instead I must listen and try to make sense of everything I hear and see in the wider world, which is how I define empiricism. William James brought a talented mind to these topics in "The Varieties of Religious Experience." As noted before, I think mental health workers from the Western worldview are going to need to learn more about these things when they work with severely troubled persons in the Caribbean and Africa. Thanks again for your thoughts and have a good weekend. best, bill