What are the conditions that lead to suicide? The loss of hope, guilt, the absence of a choice, and overpowering grief are just a few of the human conditions that may lead to suicide.
What are the conditions that lead to suicide? The loss of hope, guilt, the absence of a choice, and overpowering grief are just a few of the human conditions that may lead to suicide. At a macro-level, wars may render families asunder and leave members losing the hope and desire for survival while at a micro-level families may fail to provide necessary support to each other in times of difficulty and experience the disastrous effect of chosen death. Circumstances like debilitating diseases with no positive prognosis and the development of depression understandably lead patients to the active seeking of ways to end their lives.
Circumstance as a rationale
As World War 2 drew to an end, Hitler realized that the Allies were gaining power over his armies. Rather than being caught by the Allies and ‘paraded by Mussolini’, Hitler chose suicide as did some of his closest aides (Giblin, 2002, p. 214). The absence of a choice and the circumstances that prevented escape made the choice of suicide the better one. Given the history, Hitler would have been treated with ignominy and would have met a horrible death.
A patient undergoing treatment for depression or a disorder that has led to depression may choose to end the ongoing suffering by committing suicide. In this case, the rationale for suicide arises from the absence of possible medical support or the extenuating circumstances of the ailment. A 70-year old who has lost the ability to do the activities of choice and must live in abject pain and dependence on caretakers may rationally choose to end the dependence. A patient of recurrent cancer episodes may choose death over the disturbances caused by medical treatment and operations. Werth (p. 6, 1999) considers the varying descriptions of rational suicide and concludes that a person who chooses this route must be in a ‘hopeless’ condition, makes a learned decision after appropriate consultation with specialists and family members and takes a rational decision that is based on facts. This is a possible justification for the argument in favour of euthanasia.
There are possible circumstantial justifications for suicide and mature consideration allows one to appreciate the appropriateness of the choice. In the first case, the escalation of events had a devastating effect on Hitler’s sense of insecurity but the final decision and action were taken in an unemotional and planned manner. In the second case, family prevarications and spurious intent can dilute the relevance of the legal right to end a life and lead to a universal negation of the choice. This does not take away from the rationale of choosing to end life when life has lost all meaning.
Mental health care and suicide
As a psychologist and clinician in mental health care, I most often experience that it is my duty to assist patients as far as possible to prevent suicide. In mental health, suicide is often associated with mental illness, and in many cases we see people whose mental imbalance has created a form of “blinders” that prevent a wider perspective. Depression is described by many as a dark tunnel with no end. Frequently life supporting perspectives is overshadowed by depression.
In some respects, you could say that mental health is the ability to take on ever more perspectives on life’s dilemmas, and maintain this ability under stressful circumstances. Conversely, mental illness may be a restriction in the number of perspectives that people can keep in mind regarding themselves and their opportunities. As a therapist you will strive to intervene in a way that makes room for new attitudes and ideas in the depressed mind. You will avoid imposing your own preferences or “worldviews” on the client, but still try to create space for multiple perspectives in the other. The idea is that life lived on narrow or single-minded ideas easily become destructive and harmful. Multiple perspectives create nuances and more spacious attitudes, which might act as suicide prevention. But this applies to people who suffer from mental illness that clouds their judgment, and may be not so much in cases where people see death as the best option based on “logical reasons”. But to distinguish the two groups, is no easy task.
Attitude as a reason
Some people seem to carry an inherent lack of desire for life. Are they born with this or does it develop at some point? A young girl from a loving family attempts suicide because she feels unloved though, paradoxically, she knows she is loved. A man decides against the continuation of life because his girlfriend has walked out on him. Do these circumstances indicate the absence of hope? Yet, the protagonist experiences feelings and personal verbiage that consist of hopelessness and futility. Victims of brutality, war and similar circumstances come out alive, though scarred, and wish to return to the business of living with yearn for the return of happiness. What makes the difference between the jilted lover and the scarred victim in the desire to continue living?
In his book, Frankl (1946) describes the harsh conditions of life in the concentration camps and the unifying desire to see their loved ones that drove prisoners to fight to survive. Yet, every once in a while, the will to continue to live broke and the author observed that death soon followed. In such cases, despite harsh treatment, an inmate would lose hope and died soon afterwards. ‘The prisoner who had lost faith in the future – his future – was doomed… he lost his spiritual hold… let himself decline and become subject to mental and physical decay.’(1946, p. 71)
The compromised surroundings provided a strong context for suicide, yet some continued to live on in the hope of better.
The search for meaning
When I read Frankl the first time, I was both shocked and uplifted. What amazed me most in relation to his observations in the concentration camp, was his theory about who died and who survived. One might expect that man under marginal conditions would fall back on a kind of “survival of the fittest” and that those who grabbed the most food and most benefits would survive. But Frankl paints a slightly different picture. It was not the greedy that survived, but those who in some way managed to keep their “humanity.” Those who continued to believe in the goodness of man, something bigger than themselves, an opinion or an idea of the good, tended to survive according to Frankl. Humanity, kindness, care and the search for meaning was thus more life-maintaining than selfishness when faced with scarce resources. A similar story is found in Sartres chronicle about Brunet. In this book, it is only when the protagonist loses his “ideology” that he seriously suffers from depression and hopelessness to the degree of self destruction.
The ability to create hope, the ability to create meaning and faith in something better is probably decisive factors in how we manage to live and sustain life.
While Nietzsche claimed that man is characterized by the will to power and Freud talked about our drive for reproduction (sex), Frankl talks about man`s search for meaning as the strongest force. No matter how terrible the circumstances are, the belief in something greater might be the key for survival. Such a theory points to the possibility that those who take their lives because of persuasive argumentation (the rational suicide), still find themselves in a situation where they have lost something they can get back, that is the ability to invest meaning in life. The question is thus whether the pain, disability and recurrent tumor are factors that can be overcome by something as abstract as the “will to meaning”. Such an argument might shed a different light on our attitude towards euthanasia or our tacit acceptance of suicide under certain circumstances.
The attitude of self-pity justification
Self-pity arises for the dreariest or most valid of reasons. The absence of a welcoming smile, disregard from surrounding people, stray statements made out of turn, social rejection as a validation for one’s feeling of lack, continued victimization can cause an individual to implode. The notion of continuing injustice by factors beyond one’s control can make the individual enter into a morass of despondency and loss of hope. The search for alternatives shuts down and possibility of positive action is ignored. Loudon Wainwright (1965) discusses the rush of feelings that came up as he contemplated suicide at a brutal boot camp. The regimen was torturous; the climate hot and the surroundings were extremely uncomfortable. He writes that a rush of ‘full-bodied hate and self-pity’ in conjunction with the sharp sting of homesickness brought up an insane and uncontrollable desire to jump under a running truck. This was followed by ‘a feeling of relief and reprieve’ when the truck moved on without him under it.
It is this feeling that makes the difference between survivors of the worst circumstances and the ones who adopt the attitude of suicide as an option. Unlike the rational approach to suicide, the only rationale here is the presence of negative feeling and the rejection or the absence of perspectives or events that may assuage those feelings.
Frankl, Viktor (1946). Man’s Search for Meaning.
Gibbon, Edward (Digitized, 2008). The History of the Decline and Fall of the Roman Empire. Harvard University.
Giblin, James (2002). The Life and Death of Adolf Hitler. Harcourt.
Wainwright, Loudon (1965). The Suicide that Lives in All of Us. Life Magazine.
Werth, James L. (1999). Contemporary Perspectives on Rational Suicide. Psychology Press.