Why People Die By Suicide
Page 7
the excitement that only exists when there is danger—the ground-
work for catastrophe is laid down. Just as NASA administrators
became inured to a very real danger, so too, I will argue, potentially
suicidal people lose the danger signals and alarm bells that should
accompany self-injury. When self-injury and other dangerous expe-
riences become unthreatening and mundane—when people work up
to the act of death by suicide by getting used to its threat and dan-
ger—that is when we might lose them.
This is a novel approach to understanding suicidal behavior, but
the same idea appears to have occurred to Voltaire almost three hun-
dred years ago. Voltaire was thinking about the death by suicide of
the Roman orator Cato, and he wrote something that I’ve come to
see as revelatory: “It seems rather absurd to say that Cato slew him-
self through weakness. None but a strong man can surmount the
most powerful instinct of nature.” The simple but compelling idea
here is that the first step to death by suicide is to grapple with the re-
sults of eons of evolution, to grapple with one of nature’s strongest
forces—self-preservation.
This viewpoint also appears in the writings of Arthur Schopen-
The Ability to Enact Lethal Self-Injury Is Acquired ● 49
hauer. Schopenhauer points out that the fear of death, rather than the
love of life, encourages people to continue. He believed that bur-
dened people would think seriously of suicide, were this a purely
negative act. But suicide involves the destruction of the body, and
Schopenhauer believed most are incapable of this. The eminent
suicidologist Edwin Shneidman wrote, “Each day contains the threat
of failure and assaults by others, but it is the threat of self-destruction that we are most afraid to touch.”2
Shneidman’s words were illustrated by the controversial and dis-
turbing case of Florida death row inmate John Blackwelder. On May
26, 2004, Blackwelder was executed for the murder of Raymond
Wigley, Blackwelder’s fellow inmate. At the time of the murder,
Blackwelder was serving a life sentence without the possibility of pa-
role for a series of convictions for sex crimes. Blackwelder claimed
that he strangled Wigley, pleaded guilty to first-degree murder, and
waived all appeals, all because he wanted to die by suicide but could
not bring himself to do so. According to Blackwelder (a suspect
source, it should be acknowledged), killing someone else (and com-
mitting a series of sex crimes) was not beyond him, but suicide was.
It may be that few people want to die by suicide, but also, and
perhaps more important, that even fewer people can. Self-injury,
especially when severe, has the potential to be painful and fear-
inducing. Who can tolerate such high levels of pain, fear, and the
like? The view taken here is that those who have gotten used to
the negative aspects of suicide, and additionally, who have acquired
competence and even courage specifically regarding suicide, are the
only ones capable of the act—anyone else is unable to complete sui-
cide, even if they want to.
Karl Menninger noticed this fact in passing; he said, “One sees
people who want to die but cannot take the step against themselves
. . . like King Saul and Brutus [who] beseech[ed] their armor bearers
to slay them.”3 Menninger provides another example, a great poet of
50 ● WHY PEOPLE DIE BY SUICIDE
Italy “who longed for death in exquisite rhymes ever since he was
a boy and was the first to fly in abject terror from cholera-stricken
Naples.”4
Robert Lowell said that “if there were some little switch in the arm
which one could press in order to die immediately and without pain,
then everyone would sooner or later commit suicide.”5 Lowell is
probably mistaken—he neglects how scary death is to most people,
but his remark does imply that without such a “little switch,” suicide
is difficult to do.
Alfred Alvarez also pointed out that in some warrior societies that
worship gods of violence and uphold ideals related to bravery, sui-
cide was viewed positively. For the Vikings, for example, the Feast of
the Heroes never ended in Valhalla. “Only those who had died vio-
lently could enter and partake of the banquet. The greatest honor
and the surest qualification was death in battle; next best was sui-
cide.”6
Even in the United States in the twentieth century, some accorded
those who died by suicide a measure of respect. In a poem entitled
“By the Road to the Contagious Hospital,” William Carlos Williams
wrote, “The perfect type of the man of action is the suicide.” Poetry
like this falsely romanticizes or glorifies suicide, but as good poetry
tends to, the lines contain an important truth: suicide does require
an extreme and difficult form of action.
I happen to view suicide as anything but glorious or romantic. Re-
call that my dad died by suicide. We have to grapple with the balance
between not glorifying suicide on the one hand, and on the other
hand, pointing out a process that is akin to courage and that is impli-
cated in suicide. How does one get used to and become competent
and courageous regarding suicide? In a word, practice. People who
have hurt themselves before (especially intentionally but also acci-
dentally), who know how to work a gun, who have investigated the
toxic and lethal properties of an overdose drug, who have practiced
The Ability to Enact Lethal Self-Injury Is Acquired ● 51
tying nooses, and who can look someone in the eye and show resolve
about following through with suicide, are viewed here as at substan-
tial risk for suicide.
I can cite abundant anecdotal evidence that practice and increas-
ing fearlessness amplifies suicidal behavior. The life and death of the
musician Kurt Cobain illustrates the key role that newly acquired ca-
pabilities can play in self-destructive behavior. Cobain was tempera-
mentally fearful—afraid of needles, afraid of heights, and afraid of
guns. Through repeated exposure and practice, a person initially
afraid of needles, heights, and guns later became a daily self-injecting
drug user, someone who climbed and dangled from thirty-foot scaf-
folding during concerts (at which times, incidentally, he would yell,
“I’m going to kill myself!”), and someone who enjoyed shooting
guns. Regarding guns, Cobain initially felt that they were barbaric
and wanted nothing to do with them; later he agreed to go with his
friend to shoot guns but would not get out of the car; on later excur-
sions, he got out of the car but would not touch the guns; and on still
later trips, he agreed to let his friend show him how to aim and fire.7
Cobain died by self-inflicted gunshot wound in 1994 at the age of
twenty-seven.
Another compelling example appeared on the Public Radio Inter-
national show This American Life. The narrator read from a diary entry regarding some of his own experiences with suicidal behavior: “I
wonder
why all the ways I’ve tried to kill myself haven’t worked. I
mean, I tried hanging; I used to have a noose tied to my closet pole.
I’d go in there and slip the thing over my head and let my weight go,
but every time I started to lose consciousness, I’d just stand up. I
tried to take pills; I took 20 Advil one afternoon, but that just made
me sleepy. And all the times I tried to cut my wrist, I could never cut
deep enough. That’s the thing, your body tries to keep you alive no
matter what you do” (italics added). Later diary entries described how the narrator doused himself with gasoline and set himself on fire; he
52 ● WHY PEOPLE DIE BY SUICIDE
survived, badly burned.8 Jim Knipfel, in his memoir Quitting the Nai-
robi Trio, wrote of his past suicide attempts: “It was clear that it was cowardice that had kept me from going all the way before. I had
never succeeded because I didn’t have the nerve . . . No matter how
hard I tried, nothing worked. I threw myself down a flight of stairs,
drank bleach, cut my wrists, stepped in front of buses, all to no
avail.”9 These examples illustrate Voltaire’s “most powerful instinct of
nature” as well as the progression that allows people to do extreme
things in attempting to overcome it.
Richard Heckler noted a similar example. “I was trying to slash my
wrists. It was really difficult, because I hadn’t previously realized that
it was so hard to cut your own flesh. It’s tough stuff and I ended up
beating on my wrist with a knife for a long time to get it to go numb.
It hurt so much to cut.”10
Shneidman’s case example of Beatrice implies much the same thing.
Beatrice wrote, “I know now that slitting my wrists was not as poetic
nor as easy as I imagined. Due to blood clotting and fainting, it is ac-
tually difficult to die from such wounds. The evening dragged on
with me busy reopening the stubborn veins that insisted upon clot-
ting up. I was patient and persistent, and cut away at myself for over
an hour. The battle with my body to die was unexpected, and after
waging a good fight, I passed out.”11
Incidentally, Beatrice’s statement deserves emphasis. It is easy to
find instances in the media or on the Internet in which suicide is ro-
manticized and glorified. Glorification can be dangerous, because
others may be emboldened to try suicide. Still, a kind of courage is
implicated in suicidality, and this fact must be faced for a full under-
standing of suicidal behavior to develop. Indeed, an interesting con-
ceptual consideration involves the definitions of courage and fear-
lessness, and their relation to suicidal behavior. The psychologist
Stanley J. Rachman12 defined losing fear in the face of a true threat as
fearlessness, whereas he defined courage as an approach behavior (to
The Ability to Enact Lethal Self-Injury Is Acquired ● 53
the threat), even in the context of fear. Those who develop the capac-
ity for serious suicidal behavior might become more fearless (if fear
actually decreases), or they might become more courageous (if fear
persists but they are better able to tolerate it), or both.
The idea of grappling with the self-preservation instinct can also
be seen in examples of people who initiated serious suicidal behavior
and then instantly regretted it. Some people who have jumped from
high places and survived report that they very much regretted the act
in midair. For instance, as previously noted, a New Yorker article in 2003 by Tad Friend quotes a man who had jumped off the Golden
Gate Bridge and survived: “I instantly realized that everything in my
life that I’d thought was unfixable was totally fixable—except for
having just jumped.” Another Golden Gate Bridge survivor, quoted
in the same article, said, “My first thought was What the hell did I
just do? I don’t want to die.”
Shneidman addressed this topic, stating, “I believe that people
who are actually committing suicide are ambivalent about life and
death at the very moment they are committing it. They wish to die
and they simultaneously wish to be rescued.”13 I would state it somewhat differently. People who die by suicide not only desire it but also
have developed the capacity to enact lethal self-injury; nevertheless,
even in people who have developed this capacity to the extreme, they
retain some fear of suicide because it flies in the face of the extremely
powerful push for self-preservation. This fear produces the wish to
be rescued.
Other examples illustrate this point. A man who jumped into the
water leading up to Niagara Falls in 2003 said that he changed his
mind the instant he hit the water. “At that point,” he said, “I wished I
had not done it. But I guess I knew it was way too late for that.” He
survived the plunge over the falls, and now feels he has a new lease
on life. Menninger wrote, “Every hospital intern has labored in the
emergency ward with would-be suicides, who beg him to save their
54 ● WHY PEOPLE DIE BY SUICIDE
lives.”14 Harry Stack Sullivan described people who had ingested bi-
chloride of mercury: “One is horribly ill. If one survives the first days
of hellish agony, there comes a period of relative convalescence—
during which all of the patients I have seen were most repentant and
strongly desirous of living.”15 Unfortunately for these patients, an-
other phase of several days of agony then resumes, usually ending in
death. The fear of death by suicide is so powerful that it returns even
in people who have suppressed it enough to imbibe bichloride of
mercury, to jump off the Golden Gate Bridge, or to go over Niagara
Falls.
Suicide is undoubtedly a fearsome thing, and people on the verge
can be brought back for this reason, as demonstrated by these news-
paper clippings noted by Menninger: “1) In Fort Lee, N.J., O. P. wrote
two farewell notes, climbed up on a railing of a bridge, ready to jump
250 feet to death. As he teetered, Policeman C. K. shouted, ‘Get down
or I’ll shoot.’ Down got O. P. 2) In Denver, T. S. burst out laughing
when a $1 pistol he had bought to kill himself exploded and sent a
bullet bouncing off his chest. Calmed by police, T. S. announced he
would try to go on living.”16
The life and death of the poet Weldon Kees also illustrate the
evolving competence and fearlessness involved in serious suicidal be-
havior. Several days before his death, Kees mentioned to a friend that
he had been contemplating a jump to his death from the Golden
Gate Bridge. In fact, Kees continued, he had gotten so far as to put his
foot on the rail, but could not bring himself to put his foot over
the edge of the rail. Soon after this conversation, Kees disappeared;
the California Highway Patrol found his car in a parking lot near
the bridge, keys still in the ignition.17 Kees’s body was never recov-
ered, which is common with those who jump from the Golden Gate
Bridge.
Kees worked up to the act of death by suicide. He took at least one
preparatory trip to the bridge (the one he mentioned to hi
s friend).
The Ability to Enact Lethal Self-Injury Is Acquired ● 55
Odds are that there were other such trips. Through these visits, Kees
habituated to the fear that initially kept him from even putting his
foot over the rail. Jon Hilkevitch wrote in the July 4, 2004 edition of
the Chicago Tribune of the death a thirteen-year-old girl who was
struck by a train. Her death was ruled a suicide, in part because her
friends stated that they had pulled the girl from the same tracks
months earlier.
Menninger reported on the death by suicide of a former state exe-
cutioner. The newspaper article describing the death said, “The iron
nerve which enabled [the executioner] calmly to send 141 men to
their deaths in the electric chair during his career . . . stayed with him
to the last.”18 I think this newspaper report gets it right, more so than
Menninger, who attributed the suicide to the man’s guilt over the ex-
ecutions. An explanation emphasizing guilt—like those emphasizing
psychache or hopelessness—does not explain the very low rates of
suicide among people who have the putative causal factor (whether
guilt, emotional pain, or hopelessness). By contrast, an explanation
emphasizing the acquired capability to enact self-injury fits the exe-
cutioner, who had ample time to habituate to pain and death (espe-
cially since he was working in the 1920s and 1930s). Why don’t all
executioners die by suicide, then? For the same reason all racecar
drivers don’t. They can stare down death. They could enact it, but the
vast majority do not want to.
The death of another poet, Hart Crane, also illustrates the ex-
tended process by which people work up to the act of death by sui-
cide. Crane died at age thirty-two by jumping off a cruise ship into
the Atlantic Ocean.19 He was on his way back to the United States
from Mexico, where he had spent a year or so. From approximately
age sixteen until his death, Crane attempted suicide at least six times.
One of these attempts involved Crane being physically restrained
moments before jumping off a tall building, and another involved
him being physically prevented from jumping off the cruise ship the
56 ● WHY PEOPLE DIE BY SUICIDE
day before his death. Crane had had the opportunity to get used to
the idea of jumping to his death.