Why People Die By Suicide

by Thomas Joiner

  simistic teenagers reported low depression while pregnant (perhaps

  because of the belief that connection to the baby and the baby’s fa-

  ther would solve ongoing problems), but reported high depression

  postpartum (perhaps because, in addition to the usual physiological

  and psychological challenges of childbirth, the idea that motherhood

  would solve ongoing problems was not confirmed).85

  If failed belongingness is implicated in suicidality, one might pre-

  dict that twins enjoy some protection from suicide, given the belong-

  ingness inherent in twinship. If fact, there is evidence to support this

  prediction. Using population-based register data from Denmark, re-

  searchers found that twins have a reduced risk of suicide. The suicide

  rate among the more than 21,000 twins, as compared to nontwins,

  was 26 percent lower for men and 31 percent lower for women.86

  Some studies have found mental illness to be slightly more common

  among twins than among singletons. Twins’ belongingness may off-

  set the risk for suicide conferred by slightly higher rates of mental

  disorders.

  The loss of a parent relatively early in life appears to confer risk for

  suicide later in life. In Eskimos in the Bering Strait region, the major-

  ity of a sample of suicide attempters had lost a parent during child-

  hood.87 Close to half of a sample of famous people who died by sui-

  cide experienced loss of a parent before age eighteen.88 Researchers

  The Desire for Death ● 127

  compared the records of patients with borderline personality disor-

  der who had died by suicide to living control patients with border-

  line personality (a stringent comparison, because some proportion

  of the living control patients were at elevated risk for later suicide by

  virtue of their borderline personality disorder diagnosis). The sui-

  cide group experienced childhood losses such as death of a parent

  more frequently than the control group.89 There are of course alter-

  native explanations to the link between early separation from a par-

  ent and later suicidality in the child (especially if the parent’s death

  was by suicide, in which case genetics would be implicated), but a di-

  minished sense of belongingness from losing a parent is one viable

  viewpoint.

  Immigration and Suicide

  Like separations from parents, separations from a “mother country,”

  according to a belongingness view, might be associated with height-

  ened suicidality. The very high rate of suicide in Buenos Aires, Ar-

  gentina in the late 1800s was attributed to massive immigration, with

  a high rate of suicide among foreign-born males.90 In a study of

  nearly lethal suicide attempts by 153 people and 513 matched con-

  trols, participants were asked about changing residence over the past

  year. Changing residence in the past year was associated with a nearly

  lethal suicide attempt, as were specific dimensions related to the

  move, such as distance and difficulty staying in touch.91 All of these

  aspects of moving are associated with a sense of disconnection.

  National Tragedies and Suicide

  In times of acute national crisis, people pull together, and belong-

  ingness should thus increase. According to my model, then, national

  crises, despite their negative aspects, should nevertheless suppress

  suicide rates. There are data to support this view, at least regarding

  three salient national tragedies in the United States. First, suicide

  128 ● WHY PEOPLE DIE BY SUICIDE

  rates in response to the assassination of President John F. Kennedy

  were investigated. In the twenty-nine U.S. cities included in the re-

  port, no suicides were reported during November 22–30, 1963. By

  contrast, several suicides occurred during November 22–30 of years

  before and after 1963.92 Second, in the two weeks preceding the Chal-

  lenger disaster in 1986, there were 1,212 suicides in the United States;

  in the two weeks following the disaster, there were 1,099. Third, al-

  though detailed suicide rates are not readily available for the period

  following the terrorist attacks of September 11, 2001, calls to 1-800-

  SUICIDE, a national toll-free suicide crisis hotline, plummeted from

  an average of around 600 calls per day to around 300 per day—an

  all-time low—in the days following the attacks.

  An additional documented phenomenon that conforms to this

  pattern is decreased suicide rates during times of war.93 Regarding

  war, in their classic study, Dublin and Bunzel stated, “Contrary to

  what might be expected, times of disorganization and chaos such as

  prevail during a war apparently do not increase that personal disinte-

  gration which leads to a larger number of self-inflicted deaths. It

  would seem that the all-engrossing, unaccustomed activities and the

  enlargement of interests to include more than the ordinary petty

  concerns of a limited circle of family and friends absorb people’s en-

  tire attention and prevent them from morbid brooding over individ-

  ual troubles and disappointments . . . There is no time during war to

  indulge in personal or imaginary worries.”94 They go on to document

  relatively low rates of suicide during the American Civil War and the

  Franco-Prussian War.

  Statistical bulletins put out by Metropolitan Life Insurance Com-

  pany in the 1940s also show low suicide rates during World War II. A

  bulletin from 1942 states, “The death rate from suicides among the

  policyholders of the Metropolitan Life Insurance Co. for 1942 is

  practically the same as for 1941 and is with one exception the lowest

  on record. Likewise, 1941 suicide rates in England were 15%, in Ger-

  The Desire for Death ● 129

  many 30% below the 1939 level. Wartime drop in suicide rates is a

  general phenomenon observable even in neutral nations. The phe-

  nomenon is ascribed to economic forces and such psychological

  forces as forgetting one’s petty difficulties and finding a new purpose

  in rallying to the defense of one’s country.”

  A postwar bulletin put out in 1946 read, “The downward trend

  characterizing the suicide death rate in this country during the war

  was abruptly reversed following V-E Day.” Thus, nationally absorb-

  ing incidents, whether they are tragedies or wars, tend to suppress

  suicide rates, probably because they pull people together. In the case

  of war, the pulling-together effect appears to fade as the war ends.

  Does Being a Sports Fan Have Anything to Do with Suicide?

  The camaraderie and sense of belongingness from being a fan of

  sports teams can be considerable, especially under conditions of suc-

  cess (as many who have lived in university towns have observed

  when the university wins a national championship). It is interesting

  to consider, then, whether teams’ success affects suicide rates; from

  the present perspective, it might, in that increased belongingness

  should be associated with lower suicide rates.

  Believe it or not, some studies suggest a connection between sports

  teams’ performance and suicide rates. One study assessed the
suicide

  rates as they related to success of professional sports teams in twenty

  U.S. metropolitan areas from 1971 to 1990. Results showed that the

  team making the playoffs and winning a championship both were re-

  lated to a decline in the local suicide rate.95 Another study examined

  the association between a soccer team’s defeat (high-profile defeats

  of Nottingham Forest in 1991 and 1992) and deliberate self-poison-

  ing. The accident and emergency records of a university hospital

  were examined, and results indicated an excess of deliberate self-

  poisoning incidents during the time frames following the defeats.96

  A third study postulated that a long run by hockey’s Montreal

  130 ● WHY PEOPLE DIE BY SUICIDE

  Canadiens in the Stanley Cup playoffs is a time when people in Que-

  bec experience increased informal interpersonal contact, and that

  this would serve to suppress the suicide rate in the area. By contrast,

  when the Canadiens are eliminated early on, the study hypothesized

  that interpersonal contact (belongingness) would be relatively less,

  and the suicide rate might increase. One of the study’s clearer results

  was an increase in the suicide rate in young men in Quebec when the

  Canadiens were eliminated from the playoffs early on.97

  It appears that sports teams’ poor performance can affect suicide

  rates. Can good performance do so as well? My students and I re-

  cently conducted three studies to see if sports-related “pulling to-

  gether” is associated with lower suicide rates.98 In the first study, the

  suicide rates in Franklin County (Columbus), Ohio, and Alachua

  County (Gainesville), Florida were correlated with the final national

  ranking of the local college football teams—the Ohio State Buckeyes

  and the Florida Gators, respectively. These teams are of substantial

  concern to the local population. Given the effect that these teams’

  success has on their communities, we expected that there may be

  an association between the teams’ final national ranking (which is

  known by early January of a given year) and the suicide rate in that

  year. In fact, we found that suicide rates in both Franklin County and

  Alachua County were associated with national rankings of the col-

  lege teams, such that better rankings were related to lower suicide

  rates.

  In the second of our three studies, we made a prediction regarding

  the “Miracle on Ice,” when the U.S. Olympic hockey team upset the

  Russians, the world’s dominant hockey team at the time. This oc-

  curred on February 22, 1980. It is fair to say that the 1980 U.S. Olym-

  pic hockey team’s surprising victory over the dominant USSR team

  captured the country’s attention. In fact, twenty-two years later, the

  players were the final torchbearers for the Salt Lake Winter Games,

  and there was a 2004 movie about the team entitled Miracle. The vic-

  The Desire for Death ● 131

  tory itself was amazing, but its resonance was heightened by the

  geopolitical climate at the time. On February 22, 1980—the date of

  the “Miracle on Ice”—the Iran hostage crisis was in its 111th day,

  and the Soviet Union’s invasion of Afghanistan was approximately

  thirty days old. The victory, both in and of itself and because of its

  symbolic qualities, clearly exerted a “pulling together” effect on peo-

  ple in the United States. We therefore expected that the U.S. suicide

  rate might be particularly low on February 22, 1980 as compared to

  other February 22nds before and after. In fact it was—fewer suicides

  occurred on the day of the “Miracle on Ice” than on any other Febru-

  ary 22 in the 1970s and 1980s.

  These first two studies, as well as the previous literature on sports

  phenomena and suicide, leave open the possibility that suicide rates

  are lower at times of success not because of pulling together, but be-

  cause of a sense of increased efficacy, vicariously obtained through

  the team’s success. The studies on national disasters are not compati-

  ble with this possibility; nevertheless, in our third study, we were

  able to address it directly in the domain of sports by examining the

  number of suicides occurring in the United States on Super Bowl

  Sunday, as compared to suicides occurring the Sunday before and

  after. Though approximately a third of the U.S. population watches

  the Super Bowl, the majority are not devoted fans of either of the

  teams in a given Super Bowl; thus the “vicarious efficacy” explana-

  tion would not be a convincing explanation for any Super Bowl ef-

  fect. We predicted that suicide rates on Super Bowl Sundays would be

  lower than on comparison Sundays, but only from the mid-1980s on,

  when the Super Bowl was firmly entrenched in the national con-

  sciousness as an occasion for social gathering (not just for men, but

  for women too, in part because of the advertising and spectacle asso-

  ciated with the game—a phenomenon that took hold in the early- to

  mid-1980s).99 This was precisely what we found.

  Although none of these three studies alone provides conclusive ev-

  132 ● WHY PEOPLE DIE BY SUICIDE

  idence that sports-related “pulling together” increases belongingness

  and thus leads to reduced suicide rates, taken as a whole these studies

  provide converging evidence that is consistent with the hypothesis.

  This is particularly true when it is considered together with the di-

  verse and converging lines of evidence (on twins, parents, poets,

  Faulkner, etc.) relating low belongingness and suicidality.

  Fans of teams that have not won championships in decades may

  be wondering where they fit in here. A prominent example involves

  fans of the Chicago Cubs (though having grown up in Atlanta, I

  would point out that I can count major Atlanta sports champion-

  ships on one finger, whereas people in Chicago have fared far better).

  Would I predict high suicide rates in Chicago because of the Cubs?

  My answer is no, and again, it has to do with belongingness. There

  is a kind of camaraderie inherent in the Cubs’ plight, and Cubs

  fans have pulled together, much as people do for serious tragedies.

  Another interesting example, of course, is the Boston Red Sox. Like

  the Cubs, their fans were long-suffering . . . until the fall of 2004, that is, when the Red Sox won the World Series. When detailed suicide

  data are available for this period in Boston, it will be very interest-

  ing to see whether the success of the Red Sox suppressed local sui-

  cide rates.

  Belonging to Death

  In the previous chapter, I noted that people who are far along the tra-

  jectory toward suicide come to see death in a very peculiar light; they

  use terms like “beautiful” and “graceful” when describing it, and

  seem to fuse concepts of death, destruction, and waste, on the one

  hand, with life, sustenance, and nurturance, on the other hand. I be-

  lieve this can only happen once someone has lost the visceral fear of

  death—in other words, has acquired the ability to enact lethal self-

  injury, as described in the last chapter. Thwarted
belongingness may

  The Desire for Death ● 133

  also be implicated. As people lose connections to others, they may

  start to form connections to the idea of death. Consider, for example,

  the quotations in Chapter 2 from Sylvia Plath’s poem “Edge” and

  Richard Heckler’s interviews with suicide survivors.100 In such exam-

  ples, there is no mention of other people; the connection is to death

  and its symbols.

  Some people do, however, merge the need to belong with

  suicidality. In the September 13, 2003 issue of Asia Times Online,

  reporter Suvendrini Kakuchi wrote, “Japan, a suicide-prone country,

  is grappling with a new trend—a spate of Internet-related suicides

  linked to websites where young people, who are total strangers, can

  contact one another to plan their deaths.” The article continues, “The

  latest incident was reported in May, when a 24-year-old man and two

  women, 23 and 20, met for the first—and last—time at a train sta-

  tion, got into a car together and drove to a wooded area where

  they asphyxiated themselves.” The Japanese media reported they

  had accessed a suicide website, and a letter left by the man in the car

  revealed they had become acquainted for only one reason—“just

  wanted to die together, nothing else.” By the logic of the model pre-

  sented here, I assume that these people’s need to belong was

  thwarted, which contributed to their desire for death. But it is a testi-

  mony to the power of the need to belong that even in suicide, some

  people want company.

  Similarly, in Jon Hilkevitch’s Chicago Tribune article in 2004 on

  recent suicides on subways and other rail lines, he wrote, “Almost

  always, suicide victims peer into the locomotive cab in their final

  moments. They stare right into the eyes of the engineer, perhaps

  reaching for a last human connection.” An engineer said of a recent

  suicide, slowly shaking his head, “He looked up at me right when I

  hit him.” The engineer continued, “I’ve heard other engineers say

  [people committing suicide] look at you. I don’t know why they do

  134 ● WHY PEOPLE DIE BY SUICIDE

  it. I sure wish they wouldn’t, because the picture stays with you. You

  try to forget about it, but you don’t ever, really. It ain’t easy.”

  How Do Burdensomeness and Thwarted Belongingness