What is suicide?

In the last 2 years, two friends of mine took their lives. Today I want to write about their suicides. I want to write about them, even though I know that part of my post is likely to be controversial.

First, it was one of my schoolmates. We were not close friends, but we were friends, we often sat at the same desk. But we studied at different universities, so I didn’t see him much, occasionally at one or two reunion parties. I learnt the news about his death from his ex-wife. The story I heard was one of a man who didn’t know what to do with his life after the divorce, disliked, probably disrespected, with his personal and professional life in tatters. So finally, he committed suicide (this is the phrase which was used – possibly, because there is no debate in Poland about the expression ‘commit suicide’, possibly because this is the word that fitted best). The story had very little sympathy; his suicide was not debated.

The other suicide was different. A doctor, at the peak of her career, very popular with her friends, raising an early-teenage child on her own. One night, when she was on her own, she had too many tablets, rinsed down with too much alcohol. When we (a circle of her close friends) learnt about her death, we could not believe it. Yes, we knew she was not very happy in her personal life, yet, despite that some of us are psychiatrists and clinical psychologists, we didn’t see anything. Very quickly, we started talking about her death as an accident. Somehow, suicide didn’t fit, she couldn’t, could she? But, perhaps inevitably, the suicide story came anyway, but it was a story  with much love and sympathy, perhaps also with some doubt.

And so, we have two stories of suicide and they cannot be more different. One is full of bitterness, the other full of sympathy and love. One simply accepted suicide almost (and I stress ‘almost’) as if it didn’t matter, the other explored, nuanced, hesitated. Two suicides and yet, they couldn’t be more different.

I was recently reminded of these stories when I saw a number of tweets and blogs criticising the expression ‘suicide bomber’ (I’m deliberately not giving links). Basically, the argument goes, suicide is an act growing out of despair, suffering, pain and there is none of this in a callous act of indiscriminate killing of people who simply happen to walk by. In the first, killing oneself is an end in itself, in the other it is a by-product of murder. While the first often engenders sympathy, the other provokes disgust, hatred, and fear.

I think the argument is well made. No, you cannot put my two friends next to a person who was hell-bent on killing a number of others. And yet, when I read the argument, I thought… but what about suicidology? You see, I think the current dominant definitions of suicide do not actually make a distinction between the two. Consider the definition by the Centers for Disease Control and Prevention.

Death caused by self-directed injurious behavior with an intent to die as a result of the behavior.

The World Health Organisation says that:

Suicide is the act of deliberately killing oneself.

And here is the problem. According to these definitions, and many others, in fact, what both my friends and the ‘suicide bomber’ did was suicide. If you define the act of suicide only through death – the result of your actions, you will have created a highly heterogeneous category in which very different acts are made to sit together, however uncomfortably.

And that’s my first point – the source, well, a source for expressions such as ‘suicide bomber’ is, in my view, the dominant discourse of suicidology, which homogenises a variety of acts, intentions, behaviours and perceptions into one ‘suicide’. Quite commonsensically, it doesn’t make much sense. But in my view it’s not only about ‘suicide bombers’, it’s also about, for example, ‘extended suicide’, ‘altruistic suicide’, as well as attempting, crucially, to tease out the difference between what my two friends did. Or maybe did. Yet, as long as suicidology is firmly keen on number crunching, such a possibility is slim. A point I made recently in my polemic with Lancet Psychiatry.

But there is another point I want to make, probably a controversial one. It’s about the differences in the two stories of my friends’ suicides. As I said above, one was full of bitterness, lack of interest, the other was its opposite. In the former, suicide became a whip with which the person, who was disliked and disrespected, was lashed. After all he did it to us. In the other story, suicide became a way to understand, it was cried over, it became embodiment of pain.

And so, as we, hopefully, make distinctions between suicides, let’s not use the word as a judgement on those we like or dislike. Both my friends killed themselves, two tragedies with which their close ones and many others will live for years to come (some of the stories are too heart-wrenching to tell). Those tragedies do not need value judgement.

 

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