151 six suicides in the Old Testament: Quotations from the Bible are from The Revised Standard Version (New York: Thomas Nelson & Sons, 1946, 1952).
152 “In the same manner”: Sprott, English Debate, 147.
153 “the splendid martyrs”: Eusebius, The History of the Church from Christ to Constantine, trans. G. A. Williamson (New York: New York University Press, 1966), 344.
153 “No City escaped punishment”: Donne, Biathanatos, 60.
153 “rejoicing and exulting”: Eusebius, History of the Church, 202.
153 “Amachus, give orders”: Fedden, Suicide, 121.
153 “Let fire and cross”: Eusebius, History of the Church, 146.
153 fate of St. Simeon Stylites: For an extensive and graphic description of martyrdom, see Menninger, Man Against Himself. Wrote Menninger, “Upon examination, the components of the self-destructive urge in asceticism and martyrdom are apparently identical with those which we found to determine actual suicide—the self-punitive, the aggressive, and the erotic” (p. 125).
153 “Lo! For these thirty years”: Ibid., 119.
154 getting out of hand: Aspiring monks who despaired of winning the battle between celibacy and nature often chose suicide by more direct means. The biographer of Pachomius, a young monk who applied asps to himself in an unsuccessful suicide attempt, wrote that in this struggle with the devil “many have destroyed themselves; some, bereft of their senses, have cast themselves from precipices; others laid open their bowels; others killed themselves in divers ways” (Fedden, Suicide, 125). Still others, as Gibbon put it, “judged it the most prudent to disarm the tempter” (Ibid., 126). Castration, the church eventually realized, was a partial suicide. A church canon later declared, “He that gelds himselfe cannot be a Clerke, because he is an Homicide of himselfe, and an enemy to Gods creature.” (Quoted in Donne, Biathanatos, 133). Perhaps the most revered of all martyrs were the numerous Christian women who preferred death to defilement by heathens. Fifteen-year-old Pelagia, fearing for the loss of her chastity, jumped from a roof to escape a Roman soldier and was canonized for her suicide. “God cannot be offended with this, when we use it but for a remedy,” observed St. Ambrose (Ibid., 148).
154 “If it is base”: E. Westermarck, Christianity and Morals (London: Macmillan, 1939), 253.
154 “monstrous”: Quotations are taken from St. Augustine, City of God, trans. H. Bettenson (Harmondsworth, England: Penguin, 1984), 26–39.
156 “Let him who hath murdered himself”: Dublin and Bunzel, To Be or Not To Be, 245.
156 “The madman, or the idiot”: Fedden, Suicide, 138.
156 “life is a gift”: Aquinas’s arguments against suicide are found in T. Aquinas, Summa Theologiae (New York: McGraw-Hill; London: Eyre & Spottiswoode, 1975), 38: 30–37.
156 the start of the fourteenth century: Dublin and Bunzel pointed out that because of Church prohibitions, civil penalties, and the general stability of institutions and customs in the Middle Ages, individual suicide was practically unheard of during the eight hundred years between Augustine and Aquinas. Yet outside the tight framework of the Church there were sporadic bursts of self-destruction. In the Middle Ages demonic possession was the explanation for most mental disorder, and suicide was considered the ultimate evidence of the devil’s work. It has been estimated that in the 250 years prior to the end of the seventeenth century, at least one hundred thousand women were accused of witchcraft, tortured, and burned at the stake. Accused women often sought a less painful and humiliating end by taking their own life. Ironically, their suicides were usually interpreted as proof of their collusion with the devil.
Chapter III Renaissance and Enlightenment: “It Is His Case, It May Be Thine”
158 “Thou, constrained”: G. Pico della Mirandola, “Oration on the Dignity of Man,” in E. Cassirer, P. O. Kristeller, and J. H. Randall Jr., eds., The Renaissance Philosophy of Man (Chicago: University of Chicago Press, 1948), 225.
159 “Death is a remedy”: Unless indicated otherwise, quotes in this paragraph are from Montaigne, The Essays of Montaigne, trans. J. Florio (New York: Modern Library), 308–20.
159 “All the wisdom”: R. Noyes, “Montaigne on Death,” Omega 1 (4) (1970): 315.
159 “lest men far and wide”: D. Erasmus, The Colloquies of Erasmus, trans. C. R. Thompson (Chicago and London: University of Chicago Press, 1965), 360.
159 “people who lived next door”: D. Erasmus, The Praise of Folly, trans. H. H. Hudson (Princeton: Princeton University Press, 1941), 41.
160 “But yf the dysease”: T. More, Utopia. ed. J. C. Collins (Oxford: Clarendon Press, 1904), 100.
160 “his hand did quake”: E. Spenser, The Faerie Queene, ed. P. C. Bayley (Oxford: Oxford University Press, 1966), 1: 195–99.
160 M. D. Faber has pointed out: M. D. Faber, “Shakespeare’s Suicides: Some Historic, Dramatic and Psychological Reflections,” in Shneidman, Essays in Self-Destruction, 30–58.
161 “the disease of head-long dying”: This and the quotations in the following two paragraphs are from Donne, Biathanatos, 62, 50, 47, 17–18.
161 “thirst and inhiation” and “because I had the same desires”: C. M. Coffin, ed., The Complete Poetry and Selected Prose of John Donne (New York: Modern Library, 1952), 375–76.
162 “I wonder if Biathanatos”: Alvarez, Savage God, 155–56.
162 “because it is upon”: Coffin, Complete Poetry, 387.
162 “hevy, thoghtful, and wrawe”: G. Chaucer, The Canterbury Tales, ed. W. Skeat (New York: Modern Library, 1929), 581.
162 “If there be a hell”: For Burton quotations, see Burton, Anatomy of Melancholy, 281–88.
163 “There be two sorts”: Faber, “Shakespeare’s Suicides,” 31–32.
163 preached three sermons: A description of Neser’s work can be found in G. Rosen, “History,” in Perlin, Handbook for the Study of Suicide, 18.
163 an English country clergyman: Quotations in this paragraph are from Hunter and Macalpine, Three Hundred Years of Psychiatry, 1535–1860, 113–15, and Fedden, Suicide, 185.
164 “as cruelly as possible”: Fedden, Suicide, 142.
164 “brought through the town”: Dublin and Bunzel, To Be or Not To Be, 207.
164 “harled through the town”: Westermarck, Christianity and Morals, 255.
164 “until he be persuaded”: H. Silving, “Suicide and Law,” in Shneidman and Farberow, Clues to Suicide, 83.
165 “The body is drawn”: Moore, Full Inquiry, 1: 304.
165 “the worst kind of murder”: Kushner, Self-Destruction in the Promised Land, 15.
165 “felloniously and willfully”: The case of Abraham Harris can be found in Noble, “Glance at Suicide.”
165 “Wheresoever you finde”: Donne, Biathanatos, 93.
166 “is now growne so common”: Sprott, English Debate on Suicide, 32.
166 “Cato was not so much” and “What Cato did”: Fedden, Suicide, 240–41.
166 three hundred suicides: MacDonald, Mystical Bedlam, 278.
166 “These actions, considered”: Winslow, Anatomy of Suicide, 319–20.
167 “To be happy or not to be”: Gruman, “Historical Introduction to Ideas,” 99.
167 “When I am overcome”: For quotations in this paragraph, see Montesquieu, Persian Letters, trans. C. J. Betts (Harmondsworth, England: Penguin, 1987), letter 76, pp. 152–54.
167 “Every man has a right”: For Rousseau’s discussion of suicide, see letters 21 and 22 in Julie ou la Nouvelle Héloïse (Paris: Garnier-Flammarion, 1967), 278–91.
168 “his goods are given”: Fedden, Suicide, 224.
169 “Each one has his reasons”: Ibid., 204.
169 “We kill ourselves”: Ibid., 237.
169 “It is a decision”: Ibid., 205.
169 “If suicide be criminal”: For Hume quotations, see Hume, “On Suicide,” in Essays Moral, Political and Literary, 585–96.
171 “The carcass,” “sons of perdition,” and “contribute somew
hat”: Sprott, English Debate on Suicide, 122.
171 “It might not only”: Moore, Full Inquiry, 1: 339.
171 “Many of those”: These and other quotes in this paragraph are found in Hey, Three Dissertations, 179–80, 208.
171 “Freedom, then”: Gruman, “An Historical Introduction,” 97.
172 “The rule of morality”: I. Kant, Lectures on Ethics, trans. L. Infield (Gloucester, Mass.: Peter Smith, 1978), 152.
172 “The causes of misery”: De Staël quotations are drawn from M. de Staël, The Influence of Literature Upon Society (Hartford: S. Andrus & Son, 1844), 99–112.
173 “The excuse of not being”: Moore, Full Inquiry, 1: 324.
173 “A penniless poor dog”: Ibid., 1: 323–24.
173 the result of its reputation: For material in these two paragraphs, see Bartel, “Suicide in Eighteenth-Century England.”
173 “We do not find”: Montesquieu, The Spirit of Laws, rev. ed. trans. T. Nugent (New York: Colonial Press, 1899) 1: 231 (bk. 14, chap. 12).
173 a letter to a friend: A. A. Lipscomb, ed., The Writings of Thomas Jefferson (Washington, D.C.: Thomas Jefferson Memorial Association, 1904), 11: 64. In a letter dated February 8, 1805, Jefferson observed, “I prefer much the climate of the United States to that of Europe. I think it is a more cheerful one. It is our cloudless sky which has eradicated from our constitutions all disposition to hang ourselves, which we might otherwise have inherited from our English ancestors.”
174 “No urgent motive”: Moore, Full Inquiry, 1: 343.
174 “in order to avoid”: Winslow, Anatomy of Suicide, 79.
174 “With the greatest pleasure”: Ibid., 133.
174 “There are little domestic news”: W. S. Lewis, ed., Horace Walpole’s Correspondence (New Haven: Yale University Press, 1941), 35: 236.
175 “By this conviction”: Winslow, Anatomy of Suicide, 86.
176 “practised it as one”: Alvarez, Savage God, 204. My description of the Romantics owes much to Alvarez’s chapter “The Romantic Agony,” 194–205.
176 “We swung between madness”: Ibid., 204.
Chapter IV Science: Moral Medicine and Vital Statistics
177 “hypertrophy of the poetic organ”: Choron, Death and Western Thought, 159.
178 “Whatever may be the cause”: R. Hunter and I. Macalpine. eds., A Treatise on Madness and Remarks on Dr. Battie’s Treatise on Madness (London: Dawsons, 1962), 36–37.
178 “Few, perhaps, are aware”: Winslow, Anatomy of Suicide, 136–37. Of course, it is likely that many young suicides were caused not by masturbation but by guilt over the act.
178 “Suicide presents” and “the treatment of suicide”: Choron, Suicide, 63.
179 “A lady, shortly after”: For this and the following two quotations see Winslow, Anatomy of Suicide, 174–75, 203.
179 “A pint every hour”: Galt, Treatment of Insanity, 212.
179 “Once in a while”: M. Fuller, “Suicide Past and Present: A Note on Jean-Pierre Falret,” Life-Threatening Behavior 3 (1) (1973): 62.
179 holding the patient under: Bucknill and Tuke, Manual of Psychological Medicine, 465. Referring to this treatment, Bucknill and Tuke quote Pinel approvingly: “One must blush at this medical delirium, worse, perhaps, than that of the madman whose reason it was to restore.”
180 “travelling, agreeable society”: Winslow, Anatomy of Suicide, 166.
180 “I should as soon”: Bucknill and Tuke, Manual of Psychological Medicine, 473.
180 “How many females”: Galt, Treatment of Insanity, 341.
181 “As no rational being”: Winslow, Anatomy of Suicide, 222. In the debate over whether suicides were insane, many nineteenth-century writers complained that suicides in their day lacked the heroism and cool rationality of the ancient Greeks and Romans. One physician asserted that 10 percent of classical suicides were insane and 90 percent were rational, while 10 percent of nineteenth-century suicides were rational and 90 percent were insane.
181 “I am far from from supposing”: T. Chevalier, Remarks on Suicide (London: 1824), 4.
181 “Two cases have occurred”: Mathews, “Civilization and Suicide,” 474.
181 “We know, as a fact”: This and the following quotes in this paragraph are from Strahan, Suicide and Insanity, 188, 30, 75, 78.
181 “All the superstitious fear”: Fedden, Suicide, 260.
182 “Agnis Miller wieff”: Shneidman, Deaths of Man, 115–16.
182 “I dare ensure”: Quote and information in this paragraph may be found in J. Graunt, Natural and Political Observations made upon the Bills of Mortality (Baltimore: Johns Hopkins University Press, 1939), 31–36.
183 “The evil frequently appears”: Masaryk, Suicide, 48.
183 “On this area”: Morselli, Suicide, 37.
184 “extremes of heat and cold”: Strahan, Suicide and Insanity, 154.
184 “Suicide and madness”: Morselli, Suicide, 72.
184 “Nationality has a noticeable effect”: Masaryk, Suicide, 121.
184 “A very low suicide frequency”: Ibid., 42.
184 “The frequency of suicide”: Morselli, Suicide, 102.
184 “From whence this fact proceeds”: Ibid., 76.
185 a German priest calculated: S. Gargas, “Suicide in the Netherlands,” American Journal of Sociology 37 (5) (1932): 698.
185 “The certainty of the figures”: Morselli, Suicide, 16. At the time it was believed that suicide was virtually unknown in “primitive” societies except in cases of “economic” suicide. Then in 1984, Alfred Vierkandt, a German sociologist, reported mass suicides among tribes in New Zealand and in Madagascar, and since then studies have found suicide in primitive societies throughout the world.
187 an entire society may experience anomie: Prior to the fall of the Berlin Wall in 1989, West Berlin had one of the highest suicide rates in the world, more than twice that of West Germany as a whole. Alienated not only geographically but spiritually, culturally, and politically, it was the embodiment of anomie.
187 “Lack of power”: Durkheim, Suicide, 254.
187 “suicide varies inversely”: Ibid., 209.
187 “are very often combined”: Ibid., 287.
187 “social facts must be studied”: Ibid., 37–38.
188 “When we learn”: Friedman, On Suicide, 110.
188 “Thus the unconscious”: Ibid., 119.
188 “the decisive factor”: Ibid., 71, 76.
188 “No one kills himself”: Ibid., 87.
188 “Let us suspend”: Ibid., 141.
188 Robert Litman has pointed out: Much of my discussion of Freud is drawn from Litman, “Sigmund Freud on Suicide.”
188 “I have long since resolved”: E. Jones, The Life and Work of Sigmund Freud (New York: Basic Books, 1953), 1: 132.
189 “In the two opposed situations”: S. Freud, Mourning and Melancholia (1917), in J. Strachey, ed., Standard Edition of the Complete Psychological Works (London: Hogarth Press, 1953–65), 14: 252.
189 “A patient over whom”: S. Freud, The Psychopathology of Everyday Life (1901), in Strachey, ed., Works, 6: 3.
189 “We find that impulses”: S. Freud, Totem and Taboo (1913), in Strachey, ed., Works, 13: 154.
189 a kind of inverted murder: Freud might also have agreed with the English comedy troupe Monty Python, who observed that “a murder is nothing but an extroverted suicide.”
189 “After long hesitancies”: S. Freud, An Outline of Psycho-Analysis (1940), in Strachey, ed., Works, 23: 148.
190 “We find that”: S. Freud, The Ego and the Id (1923), in Strachey, ed., Works, 19: 53.
Chapter V Faith, Hopelessness, and 5HIAA
193 the NYSPI researchers: The work of NYSPI on serotonin can be found in J. J. Mann et al., “Evidence for the 5-HT Hypothesis of Suicide: A Review of Post-Mortem Studies,” British Journal of Psychiatry (Supplement) (8) (1989): 7–14; Underwood et al., “Morphometry of the Dorsal Raphe Nucleus”; Mann et al., “Serotonin Transport
er Gene Promoter”; Arango et al., “Genetics of the Serotonergic System”; Underwood et al., “Serotonergic and Noradrenergic Neurobiology”; Arango et al., “Serotonin 1A Receptors”; and Boldrini et al., “More Tryptophan Hydroxylase.” For a concise overview of the field, see J. J. Mann and V. Arango, “The Neurobiology of Suicidal Behavior,” in Jacobs, Harvard Medical School Guide, 98–114. See also J. J. Mann and V. Arango, “Neurobiology of Suicide and Attempted Suicide,” in Wasserman, Suicide, 29–34. And V. Arango and M. Underwood, “Serotonin Chemistry in the Brain of Suicide Victims,” in R. W. Maris, M. M. Silverman, and S. S. Canetto, Review of Suicidology, 1997 (New York: Guilford Press), 237–50. A few of the details in my description of NYSPI’s work have been taken from media accounts, in particular Ezzell, “Why?” For an extensive and extraordinarily lucid discussion of chemical and biological factors in suicide, I recommend K. R. Jamison’s Night Falls Fast, 163–212.
193 “the emotional seat belt”: J. Mann, Psychiatric News, April 7, 2000, www.psych.org/pnews/00–04–07/serotonin.html.
194 “sadness, anxiety, moral dejection”: Solomon, Noonday Demon, 286.
194 “surgery of the soul”: New York Times, June 7, 1937, in Whitaker, Mad in America, 116.
194 Robert Whitaker cites: Ibid., 73–138.
195 suicide and serotonin: Much of my description of Åsberg’s work is drawn from Pines, “Suicide Signals.” See also Åsberg et al., “5-HIAA in the Cerebrospinal Fluid.” And Åsberg, “Neurotransmitters and Suicidal Behavior.” For an interview with Åsberg, see the American Foundation for Suicide Prevention Web site at www.afsp.org/about-us/asberg.htm.
196 “the more lethal”: Ezzell, “Why?” For the study, see Oquendo et al., “Positron Emission Tomography.”
196 Mice with low serotonin: The information on serotonin and animal studies can be found in Jamison, Night Falls Fast, 185–89, and Solomon, Noonday Demon, 254.
197 four to six times higher: Psychiatric News, www.psych.org/pnews/98–01–19/suicide.html.
197 massive Danish study: P. Qin et al., “Suicide Risk in Relation to Family History of Completed Suicide and Psychiatric Disorders: A Nested Case-Control Study Based on Longitudinal Registers,” Lancet 360 (9340) (2002): 1126–30.
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