• April 23, 2014

Stopping Suicide

Stopping Suicide 1

Justin Sullivan, Getty Images

A study following up on 515 people who were stopped from jumping off the Golden Gate Bridge found that 25 years later more than 94 percent of them were still alive or had died by causes other than suicide.

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Justin Sullivan, Getty Images

A study following up on 515 people who were stopped from jumping off the Golden Gate Bridge found that 25 years later more than 94 percent of them were still alive or had died by causes other than suicide.

Last year, New York University's Elmer Holmes Bobst Library was given a poignant adjustment. Built in 1972, the library was designed around a central atrium; visitors moved through the stacks by walking on balconies that looked down on a hypnotic, Escher-like marble floor. It was a triumph of engineering grace, though some people found it uncomfortably vertiginous. That was the worst of it until, in September 2003, a student jumped to his death. A month later, another student did the same. In response, NYU put up plexiglass barriers. Then, in 2009, a student scaled a barrier and jumped from the 10th floor. Now the balconies are lined with gold-hued screens.

What's happened at Bobst is indicative of a wider trend. Suicide is on the rise. A million people take their own lives each year; suicide exceeds murder as a cause of death, in the United States and worldwide. The annual suicide rate in America hit 30,000 a decade ago; it's now approaching 40,000.

Consider the problem in terms of American campuses. In a 2006 study of 26,000 students from 70 colleges and universities across the country, more than half reported having suicidal thoughts. A 2011 study showed suicide to be the second-highest cause of death among undergraduates, behind motor-vehicle accidents. One common estimate is that 1,300 college students kill themselves a year.

At NYU and elsewhere, physical barriers are being erected to combat suicide. But what about a conceptual barrier, a secular argument for why suicide is morally wrong? (Here I speak only of despair suicide. Outside a belief that life and death are only to be handled by a god, there is no good reason to force a person to endure a protracted and excruciating death, or to exist in an endless vegetative state.) We need such an argument to counteract the belief that suicide is morally neutral, even the right of every individual. Michel Foucault, for instance, argued that everyone has the right to suicide regardless of health or well-being.

That view has spread beyond the realm of philosophy. Google "suicide and choice" and you'll find many claims by ordinary people that suicide is a right, that because your body is yours alone, the choice to die at any stage should be yours.

This view has its roots in a historical turf war between Christianity and secularism—and in a great many misunderstandings. Christianity's rejection of paganism made it too quick to see the ancients as pro-suicide, when in fact they produced a great deal of writing against the act. And though the Christian ban on suicide has no doubt saved many lives, it is a philosophically weak argument, no deeper than a prohibition by God.

But the secular rejection of Christianity's simplistic antisuicide arguments took a wrong turn. Secularists based a moral decision on a fight with religion rather than on a consideration of suicide on its own terms. This has led secular moderns into a dark fatalism. There are in fact very good secular reasons to reject despair suicide, reasons with deep roots in Western culture. Why have we lost touch with them?

It is not obvious that Christianity would be firmly set against suicide. Neither ancient Greeks, ancient Romans, nor ancient Hebrews categorically rejected suicide. Socrates, the ancient world's most famous suicide, did caution his followers that suicide is wrong unless one is compelled by an outside force. Still, for most ancients, suicide was not illegal, generally tolerated, and sometimes praised. Indeed, Lucretia's suicide was, for many centuries, considered the act that began the Roman Republic. After being raped by a prince, she told her husband and father to tear down the political system that led to her violation. She then took her own life, becoming a paragon of virtue, family honor, and courage.

Christianity did not initially reject suicide either. In fact, Jesus' death was understood by many as voluntary. In the Book of John, Jesus says: "No man taketh [my life] from me, but I lay it down of myself." Then came the martyrs. Some did not want to die, but many did. "I am yearning for death with all the passion of a lover," wrote Ignatius of Antioch. The early church historian Eusebius chronicled myriad martyrdoms, and praised a mother and her virgin daughters for killing themselves to avoid the sin of sex—though it was the threat of rape that moved them to end their lives. The rage for martyrdom went on for centuries.

The church's view of martyrdom began to change around the time that Constantine made Christianity legal, in 313. Augustine of Hippo argued against suicide, in part, to distinguish Christian culture from ancient Greece and Rome. He may also have been motivated by compassion. The idea that God wants you to live was a way to keep people from allowing their saddest moments to murder them. In time, suicide came to be seen as the work of the devil, and an attempt as grounds for excommunication. Thomas Aquinas's take in the 13th-century Summa Theologica was subtle and expansive: Suicide is cruel to the community, it is cruel to oneself, and God has ordained against it.

The church was draconian in its proscription—torturing the corpses of suicides, confiscating the suicide's estate, sometimes leaving families destitute. Across Western culture, there was little or no tolerance for suicide.

Centuries later, in early modern Europe, the great artists and authors of the era were rethinking this stance. Shakespeare wrote only two long poems, one of them about Lucretia. He says it was a mistake for her to kill herself, but his nuanced attention brought the subject to the fore. Likewise Romeo and Juliet was not exactly pro-suicide, but it served as a romantic advertisement for it. Cleopatra was never more eloquent than when she held an asp to her chest. Hamlet rejected suicide, but gave the English language its most famous invitation to contemplate the matter. "To be, or not to be?" Suddenly, that was the question.

In the decades leading up to the Enlightenment, there were reports of "freethinking clubs" that rejected all religious rules, including the prohibition of suicide. The open-minded questioning of religion became increasingly associated with an acceptance of suicide.

The defense of suicide was taken up most forcefully by David Hume in Britain and Baron d'Holbach in France. In their writings, neither man dwelled on the horror that a suicide can bring to family and friends, nor did they consider that suicides, if saved, might get over their misery, averting a tragic error. Hume poked fun at the church, arguing that if death were entirely the purview of God it would be a sin to avoid a stone that falls toward our head. D'Holbach pitied those forced by their belief in God to endure sadness rather than end their lives at will.

Both Hume and d'Holbach considered suicide a valid escape from misery. That view, now a defining stance of secular culture, is a mistake and needs rethinking. Secularists go wrong when they allow the rejection of religious ideas to determine their own ideology.

Secularists have done this before and corrected for it. Bertrand Russell, for example, anticipated that monogamous marriage would happily fade away as religion declined. It didn't turn out that way. Russell came to believe that there are strong social and emotional reasons to embrace monogamous marriage. It may not be for everyone, but most secularists no longer see ending traditional marriage as a goal. Thomas Jefferson once wrote a letter to his nephew urging him to "Question everything" and if that leads the young man to end up not believing in God, Jefferson assured him that he would find reason enough to be virtuous for the way that it makes others feel about him and the way it makes him feel about himself. In other words, morality comes from human nature and community, not religion.

When secular thinkers have looked at suicide on its own terms, outside of their debate with religion, many have come to the conclusion that it is wrong. Ludwig Wittgenstein wrote that if anything is prohibited, suicide is; and if suicide is permitted, everything is. The basis of morality is more than not harming others. Rather, we are all responsible for maintaining human meaning. Simply to live can be a moral act, an act of generosity and kindness. In Wittgenstein's terms, it is an act that recognizes and reinforces the very notion of right and wrong. To live despite the urge to succumb to despair is the most fundamental gift we can offer each other, and those who give it deserve our deepest respect.

No matter how much of a burden a person thinks he is, it is nothing compared to the burden of his suicide. People do wrenching damage to their communities when they kill themselves. Studies have shown that when parents of children under 18 kill themselves, their children are three times more likely to kill themselves than children who make it to 18 with both parents alive. When one person in a community kills him or herself, the suicide rate in that community spikes. Sometimes it is called "suicidal clusters," sometimes "suicidal contagion," sometimes "social scripting," but the sociology, epidemiology, and psychology literature clearly shows that if you kill yourself it is likely that others will follow you into the grave.

Suicide contagion has been most exhaustively studied in high schools and colleges. It seems that the first suicide normalizes suicide for those who follow; victims give each other the idea that suicide is an acceptable way to deal with problems.

If you want your niece, or your fellow soldier, your sorority sister, or fellow poet, to make it through their dark nights, you have to make it through yours.

Studies of media portrayals of suicide suggest that news stories and fictional works about suicide can cause a rise in the local suicide rate. One study, published in the New England Journal of Medicine, looked at three television movies that included suicides and found that suicide increased after two, both of which concentrated their attention on the suicide victim. The movie that was not associated with a rise in the suicide rate concentrated on the grieving parents. Ideas can influence people both toward and away from death.

Suicidal influence is so strong that if you want your niece, or your fellow soldier, your sorority sister, or fellow poet, to make it through their dark nights, you have to make it through yours. Those who have suicidal thoughts must know that resisting them is an act of generosity equal to that of running into a burning house and rescuing a child. Rejecting suicide saves more lives than one's own.

This is not a new insight. Aristotle wrote, in his Nicomachean Ethics, that killing oneself is a crime against the community. Hermann Hesse said the suicidal person must struggle against suicide as a kleptomaniac must struggle against stealing. In Jean-Jacques Rousseau's Julie, or the New Héloïse, a heartbroken young man writes a letter expressing his desire to kill himself—citing the famous ancient suicides, and claiming that he is expendable because he has no children or other dependents. The older man to whom he writes responds with fury. As a mourning friend, he himself would suffer, and the girl his friend is so upset about would suffer too. There is always, reminds the older man, some good one can do no matter how useless one feels at a given moment.

A main feature of depression is that it feels like it will never end, but it almost certainly will. Life can change to a remarkable degree. There are times in one's life when the main job is to live through it, trusting that better days will come.

To do this it is extremely helpful to decide before that moment comes that suicide is not an option. You cannot choose to not feel pain, and you cannot choose to not think about killing yourself, but you can choose to not do it. Many studies have shown that the vast majority of people who attempt suicide are later very grateful that they failed; most people never try it again. A study following up on 515 people who were stopped from jumping off the Golden Gate Bridge found that 25 years later more than 94 percent of them were still alive or had died by causes other than suicide. Another study, over 37 years, found that only 13 percent of suicide attempters did eventually kill themselves; about a third of those studied reported that their initial attempt was an act of impulsivity.

Interviews with people who have jumped from bridges and survived tell us that moments after they leapt they wished they had not. We know from myriad 911 calls that many people who overdose on pills realize soon after that they want to live. The part of you that wants to kill yourself is only one small part of you. Refuse to let it kill you.

Suicide is not inevitable. Consider the NYU library screen. There is good evidence that such measures reduce suicide rather than merely redirect it. Stopped from jumping off an iconic "suicide bridge," people generally do not go to another bridge. When Britain was faced with a rash of suicides by acetaminophen overdose in the 90s, it was mandated that only small packets of the drug could be marketed and that the pills must be packaged in bubble seals that are difficult to open. The total suicide rate declined. When Britain moved from the kind of gas oven that Sylvia Plath used to kill herself to one in which you couldn't die in that way, the total suicide rate declined. It is worth noting that half of all suicides in the United States involve guns, and slightly over half of all gun deaths in the United States are suicides. Gun control would surely lower these numbers.

Undoubtedly such preventative measures work in part because suicide can be impulsive; the urge is short-lived. If people can make it through their worst moment, they tend to survive. They will also survive if they believe that suicide is not an option.

Interviews with people who have jumped from bridges and survived tell us that moments after they leapt they wished they had not.

The religious injunction that God considers suicide to be a sin has kept people alive. People have left records of being tempted by suicide, but rejecting it as ignoble and wrong. Their stories have a triumphant sound to them—they are clearly glad that they made it through.

Secular philosophers, too, have rejected suicide. Wittgenstein was suicidal for much of his life. The idea that morality begins with the refusal of suicide was an original thought, but Wittgenstein also cited the reasoning of Arthur Schopenhauer, who had vehemently rejected suicide a century earlier. Three of Wittgenstein's four brothers killed themselves. Ludwig, however, never did.

We live in an era of antidepressant and antianxiety medication and relatively broad access to mental-health care, and yet the suicide rate rises sharply. The mental-health community cannot fix this alone. Worldwide, about half of the one million suicides every year never get professional help; others receive up-to-date care and do it anyway. We need a cohesive secular argument against suicide. The first step to creating that is to retire the idea that we are each free to end our lives. The meaning of life is bigger than the individual.

I teach at NYU sometimes, and I've asked students what they think about the library screen. A few said they missed the feeling of being able to end it all at any time. I tell them about what a suicide does to those left behind; about taking a kind of oath of loyalty to existence; about rejecting suicide with the same moral clarity with which they reject homicide. Some balk, but more than one student has told me that these ideas make them feel safer.

For their sake, and for our own, we must see that we can reject religious authoritarianism and still conclude that suicide is a terrible moral offense. We must cultivate gratitude for those who are tempted to kill themselves, but who, for the sake of others, and in a commitment to hope, find a way to stay alive.

Jennifer Michael Hecht teaches poetry in the graduate writing program at the New School in New York. She is the author, most recently, of Stay: A History of Suicide and the Philosophies Against It (Yale University Press).

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