The conscious core experiential self or Me can suffer from separation panic and the pain of loneliness. Since Durkheim’s classic monograph Suicide in 1897, isolation has been connected to self-killing. In his interpersonal theory of suicide, Thomas Joiner refers to this state as “thwarted belongingness,” defined as “a dynamic cognitive-affective state . . . influenced by both interpersonal and intrapersonal factors.”32 The number of suicides that appear to be precipitated by loss of love and feelings of abandonment and isolation are legion. In one of her last poems, Sylvia Plath wrote, “They threaten / To let me through to a heaven / Starless and fatherless, a dark water.”33 The need for the other may be mammalian, but only Pascal’s “thinking reed,” who knows he will die, can turn this knowledge into a death wish or death itself.
Although a few studies have described suicidal ideation and self-injurious behavior in very young children, statistics suggest that suicide in children under the age of five is extremely rare. Of the eight boys and one girl between three and a half and five who exhibited suicidal behaviors in a 1986 study, seven were known to have been neglected and/or abused.34 In this context, it is important to acknowledge that three-year-olds are neither unreflective nor lacking symbolic tools for self-expression. Around the time mirror self-recognition arrives at eighteen months, a child begins to use the pronouns “I” and “you” in dialogue and, by thirty-two months, he has become proficient. He also becomes capable of what have come to be called “self-conscious emotions.”35 Michael Lewis regards pride, guilt, and shame as self-conscious emotions, and he contrasts them with Ekman’s list of basic emotions: sadness, disgust, joy, surprise, interest, and anger.36
Not everyone accepts this list of basic emotions, and there are many debates about when and how self-consciousness develops in children. Arguments about shame versus guilt are ongoing as well, but it is certain that by three, a child has to some degree internalized parental-cultural rules and standards, standards that are expressed and understood in different ways depending on his or her particular culture. In collectivist cultures such as China, shame has a more positive quality and more nuanced meanings than in the individualist West. A group of researchers found 113 shame-related words in Chinese.37 Every normal child develops what Freud would have called a fledgling superego. She can reflect upon and evaluate her own behavior, can represent herself to herself in language as an “I” opposed to a “you.” She has also begun to narrate her own autobiography with the help of her parents. She has gained reflective self-consciousness and the imaginative spatial and temporal mobility that accompanies it. Without this level of development, there is no self as object to annihilate in suicide. “It is a sickness peculiar to Man,” Montaigne wrote, “to hate and despise himself; it is found in no other animate creature.”38
Awareness of the self as a being in time, as a person with a past and future that can be articulated in symbolic narrative form to other people, is uniquely human, and it is predicated on the ability to view one’s self as an other. I argue that this is why other animals are not suicidal. My patient-poet turned himself into an object of ridicule, a man who couldn’t even succeed at killing himself. Perhaps his self-image was weighted with an idea of himself as a failure, a mental construct that was formed through his early attachments to intimate others, broader cultural ideas of success, and a painful gap between the way he perceived himself and what he imagined he should, could, or might have been. This dichotomy or doubling of the self—I see myself as a failed, miserable, shameful, guilty person—partakes of both conscious memory and imaginative projection.
As I have argued elsewhere, autobiographical or episodic memory and imagination are not distinct but related faculties.39 We reshape our pasts in memory, but we also shape our futures in imagination. We look forward to or dread what may happen. What does the future mean to the suicidal person? The word “hopelessness” implies the future by definition. And the future, of course, is pure fiction. We do not know what awaits us; our expectations are made from our stories of the past. Do suicidal people lack imaginative flexibility? Is their occlusion of the future linked to what the Austrian psychiatrist Erwin Ringel called “constriction,”40 to what A. Alvarez famously called the “irresistible logic of suicide” in The Savage God,41 and to Shneidman’s “tortured and tunneled logic”?42 As anyone who has read through hundreds of suicide notes is aware, the explanations for why I am killing myself are hardly uniform. There are sweet and loving notes and vengeful, nasty ones. There are notes that express exhaustion and others that communicate simply a sense of ennui.
I also think we must acknowledge this: the reasons for suicide are not always mad. In some cases, the future has vanished. Contrary to the reiterated myth, inmates in the Nazi death camps did end their own lives, and fellow prisoners who had chosen not to kill themselves aided them.43 The people on September 11 who decided to jump to their deaths rather than be immolated in the burning towers were hardly out of their minds. Their decisions reverberate with Cato’s famous sentence: “I am master of myself.” Rather than allow a monstrous other to murder me, I choose to kill myself. With my last gesture I am able to see myself as a person of action and dignity, not as a victim. The suicide of Jean Améry—who was born Hans Mayer in Vienna, fought in the French Resistance, was captured, was brutally tortured by the SS, was deported to Auschwitz, and survived—may be seen as a delayed and complex version of this same phenomenon, a form of defiance in the face of insane reality, of taking charge of his narrative and ending it. In At the Mind’s Limits, he wrote, “I am a Jew . . . I mean by that those realities and possibilities that are summed up in the Auschwitz number.”44
Antonin Artaud, who did not kill himself, wrote, “If I commit suicide it will not be to destroy myself but to put myself back together again . . . By suicide, I reintroduce my design in nature, I shall for the first time give things the shape of my will.”45 Suicide as the means of controlling the story of one’s life. In his wrenching work The Umbilicus of Limbo, Artaud described the vertiginous dislocations of his mounting schizophrenic psychosis: “A shifting vertigo, a sort of oblique bewilderment which accompanies every effort, a coagulation of heat which grips the entire surface of the skull or is cut into pieces. . . . One must speak now of the disembodiment of reality, of that sort of rupture that seems determined to multiply itself between things and the feeling they produce in our mind, the place they should take.”46 For the disintegrating self, the willed, decisive act of suicide may indeed appear, not just as an escape, but as a momentary return to wholeness. In the tender, cogent letter left for her husband before she drowned herself, Virginia Woolf wrote, “I feel certain I am going mad again. I feel we can’t go through another of those terrible times,” and then, “I know that I am spoiling your life, that without me you could work.”47 Woolf writes that she has begun to hear voices, but her decision to die is anticipatory of complete breakdown. I will not face a future that is like the past. Her letter displays a quality Thomas Joiner believes is present in all suicides—“perceived burdensomeness,” the belief that beloved others will be better off without you.48 No doubt, this is often present. But I do not think it holds true for every suicide.
In the diary he kept during the last year of his life before his suicide, Cesare Pavese wrote, “One does not kill oneself for love of a woman, but because love—any love—reveals us in our nakedness, our misery, our vulnerability, our nothingness.”49 As in Kane’s play, erotic shame permeates Pavese’s diaries. Love is a mirror of a sorry social self. He sees himself as an abject thing through his own eyes and the eyes of a beloved object, but she is a feminine abstraction, like the “you” in Kane’s play, not a particular person. For Pavese death has a luxuriant, seductive lure, a palpably pleasurable masochistic frisson, perhaps related to his dead mother, whom he felt had rejected him, but he does not actively worry that he is a burden to others. Woolf, too, had a troubled relation with her mother, who died when the writer was thirteen. “She has always haunte
d me,” she wrote in a letter.50 What Pavese and Woolf shared was not perceived burdensomeness but a tormented dialectical relation to the other.
We all experience sadness, loneliness, anger, shame, guilt, and pride. Every person has moments of helplessness and hopelessness, but when do these feelings begin to generate suicidal thoughts or ideas? As imaginative beings, we have all fantasized about our deaths, but when is there a turn toward action? “All it takes is a little courage . . . Not words. An act,” Pavese wrote in his final entry. “I’ll write no more.”51 It does take mental preparation and courage to kill yourself. One has to be integrated enough to act—as Artaud knew. People immobilized by depression do not kill themselves. They are too depressed. How can we measure the distance between thought and act? When does suicidal become suicide?
The internal drumbeat of obsessional thoughts about suicide may appear as an irresistible argument for death, may in fact help push the thinker toward the deed, but it is a leap to assert that these cognitions cause suicide. In Suicide as Psychache, Shneidman devotes an entire chapter to Pavese, in which he analyzes the writer’s faux syllogisms, oxymoronic thinking, and confused predicates, what he calls the “styles or patterns of mentation or logic that intensify the probability of a suicide.”52 Nevertheless, at the end of his chapter, Shneidman offers the following caveat: “Suicide is a complicated deed. It is not due to faulty logic.”53
And yet there are therapies for suicidal people founded on this very idea. Cognitive behavioral therapy is a common treatment for people at risk for suicide. On the website for the American National Association of Cognitive-Behavioral Therapists (NACBT), I found the following statement: “CBT is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations and events.”54 The central notion here is that our perceptions of events, not the events themselves, are instrumental in how we live our lives. Three forces aligned to create CBT. First, the psychoanalyst Alfred Adler’s “fictional finalism,” his idea that people are more influenced by their conscious goals and hopes for the future than by their pasts and the myriad unconscious forces within them. Second, behaviorism, the theory that a human being is molded into shape almost entirely by positive and negative stimuli from the environment, and third, the “cognitive revolution” that began in the 1960s, which understood the mind as a computational machine.
In this rationalist model, emotions occur only after we have judged a thing in our environment to be good or bad. Known as the appraisal theory of emotion, it effectively turns emotions into cognitions. As Jesse Prinz writes in Beyond Human Nature, “For appraisal theorists, emotions are not feelings at all. They are thoughts.”55 Kierkegaard, speaking through his character Judge William, is acute on the subject: “Despair is an expression of the total personality, doubt only of thought.”56 To reduce suicide to a behavior that results from maladaptive thinking strikes me as simplistic in the extreme. It equates the intolerable emotion of suicide with its tortured and tunneled logic, despair with doubt.
In The Emotional Brain, the neuroscientist Joseph LeDoux writes, “Consciously accessible appraisal processes cannot be the way, or at least not the only way, the emotional brain works.”57 He maintains that an emotional response such as fear may take one of two routes, what he calls the low road (I hear a boom near me; I freeze and then run like hell) or the high road (I hear an explosion, realize that the sound is from a firecracker, understand I am in no danger, and calmly resume what I was doing). The former is an immediate limbic response; the second is reflective, tamed by higher cortical processes. But let us say I am a traumatized person who was shot in the gut after I was mugged. In this case, my knowledge that I am hearing the noise of a firecracker may make little difference. My HPA axis is already in high gear, and I am flooded by horrifying motor-sensory flashbacks of the shooting that are at once uncontrollable and wordless. They have no symbolic representation of any kind.
In a serious review of the theoretical grounding of CBT, Chris Brewin (2006) acknowledges that the therapy originated “to bring about positive changes in erroneous cognitions,” that it is “primarily rationalist in its formulation of patients’ thinking,” and that its goal is to promote “constructive, reality-based reasoning.”58 The faith that an application of reason can neaten up disordered minds assumes that once a person is confronted with “true” mental representations rather than “false” ones, he will see the error of his ways and conform to “reality.” If we open our toolbox and retrieve the right wrench, we can fix the human machine’s abnormal processing. I am not alone in thinking that this is itself a kind of faulty logic and that it fails to grasp the totality of what has gone awry in human beings who are suffering in one way or another.
A weak theoretical model does not necessarily produce ineffective treatments, however. By addressing what CBT’s founder, Aaron Beck, calls “automatic thoughts,” a person in the grip of suicidal fantasies may find another avenue of self-reflection, one more flexible and open to future possibility. After all, classical psychoanalysis and psychoanalytically based psychotherapy are devoted to bringing unconscious repetitive patterns and behaviors to consciousness so they can be addressed and changed. In psychotherapy, the patient is continually rewriting her narrative so that it makes sense, but this sense is not purely intellectual, it is embodied and felt. The road to insight involves both the narrating I and the experiencing Me. Beck devised a “hopelessness scale,” twenty questions that are intended to measure a person’s degree of despair and his risk for suicide. Surely, these questions can capture something important about a person’s state of mind: If there is nothing better ahead for me, why live?
At the same time, I suspect simply sitting across from someone who wants to help you has a therapeutic quality. It is hard to know how many suicides have been thwarted by a conversation with a sympathetic friend or therapist. In an essay on suicide published in 1796, John Watkins recommended listening and understanding as a cure. We must expand his masculine emphasis to include women, but otherwise, his words remain relevant: “Many a poor creature, who has plunged himself into irretrievable ruin, might have lengthened out a useful life, if he had been enabled to have unbosomed himself, with safe conscience, to some good man, experienced in the ways of the world, the varieties of temptation, and the powers of consolation.”59 This is surely true. I doubt very much, however, that someone like Jean Améry would have been turned in another direction through dialogue.
Treatments of all kinds—CBT, psychoanalysis, and psychotherapy of many stripes—may succeed with some and fail with others. One day, during my stint as a writing teacher, I walked into the ward and knew instantly that something was wrong. Staff members were talking in low urgent voices. Several patients seemed wildly agitated. One was crying loudly in a chair. My supervisor explained that not long after his release from the hospital, a former patient had walked to the subway, thrown himself under an oncoming train, and died instantly. Had he been prevented from killing himself that day, he might have tried on another day and succeeded. Then again, I have read many accounts of people who mean to kill themselves, fail, and never make a second attempt. The brother of a friend of mine leapt off a balcony, was severely injured, but lived. After a long recovery, he is working and, according to my friend, “doing okay.”
Other people are far more ambivalent about dying. On an online site called Reasons to Go On Living, I found a poem titled, “My Third (or Fourth) Suicide Attempt,” which begins, “I laid in the back of the ambulance / the snow of too many doses of Ativan dissolving on my tongue.” The writer wakes in a locked room in a “psych ward” and watches a woman “manically drawing on the windows with crayons . . . as if she were coloring us all.” The last two lines of the poem are: “And I thought / I am so glad to be able to see this.” It made me think of the young man with whom I began this essay, the one who wrote a jocular poem about how he had failed at death. He, too, was glad to pick up his pen and write.
There is no simple answer to suicide, no easy way to explain it or prevent it. I am convinced, however, that it always “has something to do with the other.” It occurs in a zone between people and turns on the profound need every person has to be recognized. It may involve tender or brutal feelings or both at once. It can be rational or mad. And it always involves the imagination, the self as other, the self seen as an object of love or hatred, pride or shame. Without this doubling of the self, without reflective self-consciousness, there is no one to kill.
Subjunctive Flights: Thinking Through the Embodied Reality of Imaginary Worlds
* * *
LET us begin with a man. I will call him O. O reclines in a chair in his living room and begins to read Emily Brontë’s Wuthering Heights. The characters he finds inside the novel are made of printed words and printed words only, but their identities for O as his eyes scan the pages are not composed of a sequence of signs or blocks of text. They are also images of persons in mental space. The degree to which these mental images are wan or vivid depends on O’s visualizing and other imaginative sensory capacities, but the clichéd notion that a character comes alive on the page should be thought through with some care. Unlike watching a film or looking at a portrait or photograph, reading a novel entails a transformation of abstract symbols into mental images of being and, once we are literate, the conversion seems to be instantaneous. O’s relation to the book and the book’s characters is a particular form of intersubjectivity, developed through his imagination. The relation between reader and book is not a relation between me and a thing, an it, but between me and a kind of you, one that will not change and will not answer questions. Nevertheless, reading a novel is an encounter with the symbolic traces of a living human consciousness.
A Woman Looking at Men Looking at Women Page 52