Suicide And Its Prevention
( Originally Published 1908 )
ONE of the most sinister omens of our time is the alarming growth of self-murder.
Everyday observation appears to confirm the depressing figures of the statisticians. Not a day passes but the newspapers report successful or unsuccessful attempts at self-destruction; the popular novel reflects the prominent place suicide has taken in the modern consciousness; the ever-recurring discussion as to whether and under what circumstances suicide is ever justifiable points in the same direction. Here is a state of matters that must challenge the attention of the philanthropist, the minister of religion, the psychologist, the educator of youth and indeed every lover and helper of his kind. We cannot shelve the problem by referring it to the alienist's province on the assumption that suicide is a symptom of insanity. Although we now know that brain-disease, especially melancholia, often leads to suicide, there is no necessary connection between the two so that the suicide must be always diagnosed a madman. For the number of suicides in different countries are in no fixed proportion to the number of the insane. Moreover, insanity is equally common among men and women, whereas there is only one female to every three male suicides.
Perhaps the most pathetic element in the statistics is the increasing prevalence of the malady among children. M. Proal shows that in 1879 out of 5,114 suicides in France thirty-seven were under sixteen years of age, and that in 1902 out of a total of 8,716 the children numbered fifty-nine. Professor Eulenberg of Berlin has counted in twelve years 1152 child-suicides in Germany, while the high schools of Russia alone supply in one year the appalling total of 337. "Fifty years ago," says Strahan, "child-suicide was comparatively rare, but during the last quarter of a century it has steadily increased in all European states, and at the present day is lamentably common in all." ' This increase of child-suicide has also been pointed out by G. Stanley Hall. The main causes are jealousy, a desire to be revenged on some one who has injured or insulted the youthful suicide, educational overstrain, the failure of the world to meet the claims made upon it. A The child commits suicide impulsively, never deliberately: the unformed mind, swayed by grief or pain and without any strong realization of the meaning of life and death, is unable to inhibit the suicidal tendency. The blame for the great mass of child-suicide must be put on the environment, moral, social, and physical. Constant ill treatment, improper diet, inadequate sleep, favoritism, harsh punishment, lack of sympathy with and understanding of the child mind—these create a psychic atmosphere in which death seems preferable to life. With the removal of these causes, we may expect to witness a great diminution of this heart-sickening evil.
In young manhood and young womanhood the most frequent cause is disillusion. This is the period of life when hope and imagination run riot. Anything and everything is possible: the limitations of life are not yet realized. When schooltime is over and the stern realities of the world have to be faced, the youth undergoes a critical and sifting experience. 8' Many feel that they are inadequate to the duties of life some are moreover worried by an evil conscience; weakened in fact or fancy by dissipation; strained, it may be, by having to pass through the stages of religious readjustment of the creed of childhood ' find life tedious, monotonous, and disappointing, and are thus inclined to ennui and even melancholy. The mind has been cultivated and the will weakened by inaction, so that when everything depends upon energy it collapses in despair. As the demands of life become complex and severe with advancing culture and civilization, the need of specialization and drudgery, this breaking into the harness of business, profession, and the conventions of society seems unreal or cruel fate, against which the soul rebels. All these conditions are copiously illustrated in the lives of adolescent suicides, and rare is the earnest soul who has not at this stage at least coquetted with thoughts of self-inflicted death. " Suicide is thus a sign of weakness, of relaxation of the moral fiber, and its growing prevalence indicates that there are causes at work which are slowly sapping the forces of national character.
What are some of these causes?
We must, of course, distinguish between the irrational suicide, the unconscious instrument of his own destruction, and the genuine suicide who consciously and with full knowledge of the consequences of his act violates " the canon 'gainst self-slaughter." We are not here concerned with suicide as an episode in the history of mania, melancholia, fixed ideas or psychasthenic impulse. The causation and prevention of pathological suicide belong to the province of the psychiatrist, and with the advance in the scientific comprehension of insanity we may hope for a mitigation of one of its saddest phenomena. On the other hand it ought to be noted that such an authority as Morselli traces only one third of all suicides to brain disease: the great majority are referable to causes more or less open to therapeutic treatment.
Durkheim rejects as inadequate all purely individual and particular causes and throws the whole emphasis on sociological conditions. In the first place, suicide is not hereditary. What can be inherited is a temperament or a mental disease which may predispose toward without necessitating self-killing. Repeated suicide in the same family can be accounted for by the law of imitation, of suggestion by contagion or as the result of insanity. The remembrance or the spectacle of the tragic end of his relatives becomes in the suicide the source of an irresistible impulse. Behind the common action lies a common psychopathic taint. Again, Morselli's theory that climate has an effect on suicides cannot be proved. Suicide is not most frequent in the hot months as is popularly supposed. The fact is, it increases regularly from the beginning of the year and reaches its maximum not in the hottest months but in the month of June, from which point it gradually decreases, reaching its minimum in December. In other words, suicide in-creases with the increasing length of the day because, as the day grows longer, the social. life, the currents and cross-currents of human relations grow, in intensity. For the true causation of suicide we are, according to Durkheim, to look at the connection of society with the individually From this point of view we discern three chief types. (1) The "egoistic" suicide. In this class voluntary death is caused by the relaxation of family, social, and religious ties. A morbid individualism throws off the restraints of the collective life of the household or the community. The statisticians say that in a million husbands with children there are 205 suicides, in the same number without children there are 470; of a million wives without children there are 157 suicides, with children 45 ; of a million widows without children 1004, with children 526. As the domestic ties are relaxed, suicide mounts up. So, too, with the national life. As long as the national consciousness lies dormant the crime of self-murder is frequent, but as soon as the spirit of patriotism is stirred, as in war time, men are taken out of themselves and feel themselves part of a larger whole, with the result that Iife is too precious to be gratuitously flung away. The same thing is true of the pressure on the individual of an institutional, dogmatic, traditional religion. Here solidarity takes the place of individualism. Take Ireland, for example, which is mainly Roman Catholic. It has the honor of having the lowest suicide roll among all civilized countries: and. within its borders Protestant Ulster produces two suicides for every one in the Roman Catholic provinces. In the Protestant countries, Germany and Scandinavia, the number of suicides is far higher than in Italy or Spain, the rate in Germany being five times as great as that in Italy.. A recent writer says that "this probably points to the dark and hopeless Calvinistic principles of predestination, and also to the need of guidance in mental disquietude, the divine touch of human sympathy, of which every soul at some time is in need, being met, more or less well, by the system of confession." i A much more probable explanation is that Catholicism is far more strongly "intergrated" than Protestantism, that in the former the collective life counts for more than in the latter, and so tends to suppress the individualism which in an unhealthy form gives birth to suicide. There is no confessional in the Jewish communion, yet the Jew is as little disposed to suicide as the Roman Catholic. The orthodox Jew also finds his life hedged round with minute legal observances and but little is left to his own judgment.
(2) The "altruistic" suicide. Here we have a phenomenon the exact reverse of that which has just been described. " An excessive social consciousness as well as an insufficient sense of personality may lead to suicide. Among primitive peoples where the tribal consciousness swallowed up the individual, suicide was frequent. And to-day India is the classic land of suicide permitted through a sense of religious exaltation, an overstrained feeling of the utter nothingness of the personal as compared with the universal soul. In a similar way is to be explained the high rate of military suicide. The soldier is a member of a closely organized group; he holds his life at the service of others: he obeys without dispute: and this moral and intellectual abnegation tends to make the spirit that is the natural soil of altruistic suicide. (3) The " anomic suicide. This type is the creation of disturbances in the social organism whereby social control gives way and individual hopes and desires overstep the limits set by circumstance and cannot be satisfied. Great individual or financial crises whether of want or of prosperity are contemporaneous with an increase in the suicide rate simply because they are crises, perturbations in the social order. Men are no longer under normal rules and so are hurried by their lawless feelings into suicide. Then again in domestic crises such as the death of husband or wife, or the fact of divorce, we find suicide increases greatly.
Thus, according to Durkheim, we are to look for the origin of suicide in social causes alone. And undoubtedly there is much truth in this contention. Suicide is a social fact and is powerfully affected by social relations. Yet the theory does not explain the whole phenomenon. For the question arises, Why does one individual resist the social influence and another succumb to it ? The answer must be found in personal, concrete, particular causes without which the social factors are an inadequate ex-planation. These causes in the main are alcoholism, worry from domestic or financial trouble, shame and fear of disgrace; boredom or weariness of lifer neurasthenia and other nervous disorders, insomnia, crime, extreme poverty, incurable disease, frustrated ambition, and disappointed love. No one of these factors by itself will account for the increasing suicide rate: they act and re-act upon each other and form a malign complex which it is impossible to disentangle. Hence the difficult and intricate nature of the problem. It cannot be attacked from one side only: the combined forces of the social reformer, the minister of religion, the schoolmaster, and the physician must be directed with scientific aim against the evil. The true prophylactic must be at once medical, philanthropic, moral, and religious. From a sociological standpoint it is sad to reflect that with all the increase in wealth and comfort which the nineteenth century has witnessed, extreme poverty still holds millions in its merciless grip. In London, according to Mr. Charles Booth, one out of every eight persons is just above the starvation line. Without home and without friends the world has few attractions for the man who is tempted to quit it. High in the scale of causation must be placed the growing drug-habit. Men unable or unwilling to bear patiently the strains and stresses of business, and women fretful and petulant under domestic cares, become the victims of "worry." Hence the growth of a neurotic, disordered temperament with its myriad attendant mischiefs. Weakness, lack of self-control, has resort to those pretended redeemers from misery, alcohol, morphine, cocaine and other narcotics; and the last state of the sufferer is worse than the first. "The unfortunate," says Dr. Saleeby, "seeks to drown his care in drink, to stifle it with morphine, or to transmute it with cocaine. A noteworthy fact of the day is the lamentable increase of self-drugging, not only amongst men but also amongst women — the mothers of the race that is to be. Alcohol and morphine and cocaine, sulphonal, trional, and even paraldehyde, these and many other drugs are now readily — far too readily — accessible to the relief of worry and of that sleeplessness which is a symptom of worry and is a link in the chain of lamentable events to which worry leads. These are friends of the falsest, as none know better than their victims. Hence borderland cases, misery, suicide, and death incalculable." 1 And again: "year by year, worry and fear and fretting increase the percentage of deaths that are self-inflicted — surely the most appalling of all comments upon any civilization." 2 But behind these facts lies another of deeper significance, though one which does not appear in the statistical tables — the weakening of hope through loss of faith in God and in a future life. It is obvious that only the man who has convinced himself that death ends all can risk the chance, in which so many of his fellow-men believe, that it does not end all, and, rather than bear the troubles that he has, prefers those that he knows not of. The advance of science which while diminishing our faith in God increases our fear of microbes, the practical materialism of the time which regards pleasure the greatest good and pain the worst evil, the general religious unrest created in part by modern criticism, and in part by the failure of ecclesiastical Christianity to heal the deeper sores of the age these forces tend to sap belief in a life beyond the grave. When grief or misery or shame befall the modern man,
" Now more than ever seems it rich to die,
If society is, as popular writers teach, the mere product of an evolutionary process with no deeper ground of existence, it is clear that the would-be suicide cannot be answered when he asks : "What claim has society upon me? It has flung me aside as an outcast, a hopeless derelict, a victim to a blind law of Survival of the Fit and Death of the Unfit. In voluntarily laying down my life am I not really furthering the apparent order of the world?" But as long as the individual retains a living faith in God he knows that his life has a sanctity, a permanent worth quite apart from the attitude of society towards him. In the deepest ground of his being he belongs to God, and on the basis of this consciousness he realizes that be belongs to society and may not withdraw from it without its consent. As a matter of fact, however, very few suicides reason deeply about their taking off. "Philosophic suicides" are very rare in our time. Perhaps the latest is that of Weininger, the youthful genius who wrote "Sex and Character" in which he strips humanity of its last vestige of the ideal and exposes it in all its stark and naked animalism. After finishing the book he saw no reason for remaining in such a world and blew himself out of it by means of a bullet.
In view of what has been said it is clear that the cur-rent proneness to suicide can be greatly reduced, for discerning clearly some at least of its causes we can attack and modify or remove them.
1. Our age is marked by sympathy with pain and misery. But too often the spirit of compassion gives birth to a pseudo-sentimentalism which in the long run is more cruel than strict justice. In a proper reaction against the barbarous laws of an earlier time dealing with suicide, we have gone to an undue extreme of leniency. Coroner's juries repeat from day to day the charitable false-hood, "suicide during temporary insanity," and as a result the deed is regarded with sympathy rather than with horror, and others on the brink of temptation are encouraged to commit the rash act. Doubtless juries are influenced by consideration for the grief and shame of the living, but they are the spokesmen of the law and of society and owe a duty to the dead as well. They should help to build up in the public mind, and especially in the thoughts of the young, a dread and detestation of the crime which would serve well the despairing and the tempted in their hour of need. And they would do this if they abandoned the senseless formula in vogue and returned, whenever the evidence warranted them in so doing, to the older verdict of Felo de se with' a rider expressing condemnation of this "crime against oneself." It has been recently suggested that the body of the responsible suicide should be buried at midnight in silence.
2. But legal and social penalties of themselves will not cure the evil. Suicide, as has been said, is generally a sign of moral weakness. We must start, then, with in-fusing into our educational system a stronger ethical tone. The notes of self-control, of duty, of self-abnegation must be struck more loudly and insistently. A young naval officer shortly before ending his life writes to his parents: "I trust I shall be forgiven for the great trouble I shall bring upon all of you; but I feel I cannot longer live. . . . When I look back on life I see, that if I had exercised only a little self-control, I should never have done this." In the great majority of suicides a defect of moral training in youth is to be observed. Hence Morselli is right so far when he says that the cure lies in developing in man the power of well-ordered sentiments and ideas by which to reach a certain aim in life; in short, to give force and energy to the moral character. A well-balanced, reasonable character is the best safeguard against suicide. Not in the school only, but in the home also, is this to be formed. It is within the power of the humblest to train their children in habits of poise, of industry, of duty, of unselfish service, of temperance in eating and drinking, of total abstinence so far as stimulants are concerned. And this is done by example even more than by precept. The conscious education of the child is by no means the whole of his training; it is in the sub-conscious region, as modern psychology teaches, that impressions, memories, thoughts are being stored up to find resurrection at a later day. It has happened more than once that a man tempted to suicide has been saved by the sudden flashing up from the depths of the subconscious of a phrase or an idea or the remembrance of a long-forgotten face eloquent of goodness and patience, and he has turned once more to take up the burden of life. We know now that the most fugitive impressions leave traces on the child's imagination. The psychic atmosphere of the home more than anything else shapes for us life and destiny.
3. Modern psychology has shown what a powerful role suggestion plays in life. Man has been defined as a "suggestible animal". And perhaps the greatest medium of suggestion is the newspaper. There are many weak individuals who take their standards of action from the popular prints: and when they read the pathetic story of some unfortunate self-destroyer with minute and sensational description of the pistol, the rope or the poison with which the tragic deed was consummated, their vanity is fired and they too would win the pity and the notoriety such a death attracts. The fixed idea, the dominant thought, often ends in a mad deed. This is a commonplace of mental pathology. Every newspaper should simply publish a suicide's obituary giving, as in the ordinary "Deaths" column, name, date of death, age and place of residence. Still further, newspaper editors who rise to the dignity of their calling as molders of public opinion should, as opportunity offers, seek to raise the tone of popular thinking in this matter by showing the anti-social character of the crime and by calling attention to those tendencies in the body politic that make for its occurrence.
4. The social reformer can do much to stem the tide of moral and physical degeneration of which suicide is merely a symptom. All drugs, stimulating and narcotic, should be made more difficult of access. Take alcohol, for example. It is now established beyond question that there is a close relationship between drunkenness and suicide. Denmark, with the highest consumption of alcohol, has the highest death-rate from suicide. In Switzerland, from one fourth to one third of the suicides, in various provinces of France from one fifth to one third, and in Belgium one third are referred to alcoholism. The only country in Europe with a declining suicide rate is Norway, and it is significant that in the same country, owing to the' operation of the Gothenburg system, there is a declining rate of consumption of alcohol per head. One of the crying social needs of the time, especially in England and America, is temperance reform. The powerful organization of the liquor trade is a menace to the well-being of the people, subordinating as it does larger national questions to its own requirements. As Lord Rosebery has said: "If the State does not soon control the liquor traffic, the liquor traffic will control the State." In America the saloon system as a whole is a moral plague. All the forces that make for suicide are entrenched behind it and appear to defy the utmost efforts of civilization and philanthropy. The weakness of temperance advocates lies in their dissension: each party cries up its own panacea and has no patience with other points of view. They must close up their ranks on some practical basis of union, however far short of the ideal such a basis may be; and they must devise some substitute for the saloon and public-house which at present act as centers of natural and necessary social intercourse. There are other social problems demanding solution. The poorer districts of our large cities give the greatest contribution to the suicidal list. Hence the need for sanitary and hygienic measures, the establishment of free gymnasiums and baths, the better housing of the poor, in a word, for the humanizing and uplifting of the masses sunken in squalor and physical wretchedness.
5. The teacher whether by pen or by voice will do well to-day to emphasize the folly of suicide. A good dinner, a few hours' sleep, an offer of employment, a few sympathetic words, will often change a man's psychological climate and raise him from the depths of despair to the heights of hope and expectation. He is indeed foolish who permits himself to be the victim of an impulse so easily vanquished. Even on a purely utilitarian view of existence the self-slayer is guilty not so much of a crime as of a colossal blunder. He throws away the whole for a part. Is life a game in which the chances have gone against him? He is, in quitting the game, committing an act which is stupid and shortsighted. For if only he keeps a stout heart and refuses to surrender to the impulse of the coward, he may turn his misfortune into a means of ultimate gain.
6. Has Christianity any message to the intending suicide? Up till now the Church, as the official exponent of Christianity, has contented herself with denouncing suicide as a crime and imposing varying ecclesiastical penalties. But we now know that there are moral and psychical causes of the crime which it is the task of the Church to help ameliorate or remove. Men are discouraged and fear more than they hope. In the early Christian ages it was this discouragement that found comfort and consolation in the Gospel of the Nazarene, and as Christianity gained the mastery of the Roman Empire suicide almost wholly disappeared. Has religion any power to hold back the hand of the suicide to-day?
In many instances the real root of the mischief lies in the moral region. Perhaps it is an enslaving vice, a cowardly fear, a lost faith, a nervous collapse and fruit of shame or worry or disgrace. Such suffering should find sympathy and consolation at the hands of the Christian minister. He ought to be able to soothe the harassed spirit, to bring peace to the conscience, to kindle hope, to create faith, to dispel all that is evil, injurious, and inharmonious in the sufferer's life and mind. Equipped with the deeper insight into the nature of the soul and its relations to the nervous system which psychology has given him, it is his to dissipate the clouds of distress and discouragement with the breath of a vital faith and a boundless optimism. The Founder of Christianity was not only the greatest of teachers : He was also an ever-successful physician. Unhappily His followers not knowing what to make of his healing ministry for the most part ignored it. With the recovery of this new thing which Christ brought with him into the world, the moral misery that makes suicide possible cannot live. Never was the world more ready than today to hear the word of a religion that has power, and, hearing, to obey. For men dimly surmise that in the spiritual realm there are healing and reconciling forces, and in blind enough ways are earnestly trying to grasp and utilize them. There are deep instincts in man which rebel against a Gospel of despair. We see them at work in the creations of new religions such as Christian Science, New Thought, Spiritualism and so forth, in the wide-spread revolt against materialism in philosophy and in medical science, and in the strange fascination which oriental theosophic speculations are exercising over the practical-minded Englishman and American. It is not the fault of Christianity but of its popular exponents and interpreters that so many are turning away from the historic creed of Christendom to the latest quasi-metaphysical systems — arms that are shortened and cannot save. The need of the hour is the advent of prophetic spirits who will unveil to the eyes of their contemporaries the hidden resources of the Christian Gospel and will show this faith to be the one impregnable barrier against the inroads of pessimism and despair. In the light of mod-ern science and more especially of psychological science, the great truths of Christ — a God truly personal and able to hold fellowship with the creatures of his hand, the imperishable worth of the soul, the organization of human life into a veritable Divine Kingdom on earth, — take on new and profounder meaning, and yet await practical application to the actual needs and the standing discouragements of humanity. Around these great ideas lie the perspective of the infinite. Because of them human life is seen to have issues that pass beyond time and place. Faith in God and in His purposes, a healthy reverence for what unimagined mysteries and experiences may lie behind the veil, are the forces that will stand a man in good stead when overcome by misfortune or tempted by cowardice.
"Brutus and Cato might discharge their souls