Societal realities of suicide

As someone whose formal education ended at secondary level, I am frequently astonished to discover, in the course of my continuing…

As someone whose formal education ended at secondary level, I am frequently astonished to discover, in the course of my continuing project of self-education, the extent to which long-established ideas become forgotten by an ostensibly educated society, writes John Waters

Often, reading texts others have supposedly absorbed as part of their education, I encounter an explanation for something that perplexes contemporary society, but which, despite abundant plausibility, is no longer canvassed.

Undoubtedly there are ideological aspects to this phenomenon, whereby certain analyses have been substituted with banalities that serve the cultural needs better. But if I respond to instinct and draw attention to some such forgotten hypothesis, I will be accused of parading my lack of education: "Sure everyone knows about that!" This suggests that social amnesia is not accidental, but requires careful policing.

A good example relates to suicide. I have written often about the idiosyncrasies of this society's response to the phenomenon of suicide, which has exhibited consistent patterns since the early 1990s, when I first signposted the studied avoidance of the overwhelming male domination of the suicide statistics. Recently, I have observed, in tandem with a gradual willingness to acknowledge this dimension, a new tendency to explain suicide as a psychiatric phenomenon.

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In a typical instance, this newspaper last week reported that there were 17 suicides in Co Clare last year, 16 of them males, a marginal increase on 2005. Half the report was taken up with comments from a local psychiatrist, Dr Moosajee Bhamjee, who inevitably presented the issue in psychiatric terms. His analysis concerning the overwhelmingly male nature of the problem was: "Men don't seek help because of pride and because they have difficulty talking about their feelings." This is now such a ubiquitous cliche in public discourse as to be virtually unchallengeable.

Thus, in an ostensibly educated society, the organs of formal societal discourse manage to promote an analysis that has long ago been disproved. This process works by repetition, obviously, but more fundamentally by repeated choices - invisible, deniable and mostly unconscious - which drive discussion down a particular avenue to the exclusion of others.

Not only is Dr Bhamjee's thesis eminently rebuttable, but the idea that a psychiatrist in general practice is necessarily any more qualified to talk about suicide than any intelligent person was demolished 111 years ago by Émile Durkheim in his book, On Suicide, a vast and fabulous work of research and analysis, which stands to this day. His theory derives from the conundrum of how it is that, if each suicide is due to particular individualised (eg psychiatric) circumstances, there are consistent patterns in the statistics of specific societies.

Each society is different from others, but, year-on-year, each repeats approximately the same pattern. From this he deduced that the social element of suicide holds the key, with individual circumstances in specific suicides being pretexts for something that occurs for unacknowledged reasons at an unconscious level. Social tendencies, collective passions, he stressed, are not metaphors but forces in their own right which act on individual consciousness. Individuals, by uniting, form new psychic beings, which have distinctive ways of thinking and feeling. The suicidal individual's sadness, Durkheim wrote, "comes from outside, not, however, from this or that incident in his life, but from the group to which he belongs".

Durkheim deduced that there were three distinct elements in the phenomenon of suicide: egotistic, altruistic and anomic, each reflecting a strand of societal reality - crudely, individual personality, patriotism and progress. These forces pull humankind in opposing directions, but when balanced in society, serve to moderate suicidal tendencies. The relativity of these forces is the sole variant in the equation.

Durkhein concluded: "If some individuals in a single moral milieu are affected and others not, this must, at least in general, be because the mental constitution of the former, such as nature and events have made it, offers less resistance to the suicidal current. But while these conditions can contribute to determining the particular individuals in which this current is embodied, neither its distinctive characteristics nor its intensity depends on them. It is not because there are a certain number of neurotics in a social group that there will be a given number of suicides every year. Neurosis only means that some will succumb rather than others."

One of the traps of our obsession with psychiatry is that, whereas the discipline deals with individual casualties of a social phenomenon, the collective context of suicide escapes practitioners who look only at individuals because, by definition, the source of suicide exists in the collective sphere. And yet, our public culture withholds any possibility of understanding this broader picture, confining our understanding to the individualised analysis. The social thought-process operates to hide from society that the social exists.