Ep. 205: Suicide with Dr. Drew (Durkheim et al) (Part One)

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We are rejoined by Drew Pinsky to discuss philosophical, psychological, and sociological readings on suicide.

Is suicide ever morally permissible? If it's a symptom of mental illness rather than a chosen behavior, is it even appropriate to morally evaluate it?

Last time Drew joined us, he helped us add clinical depth to an area that we'd already talked about philosophically. For suicide, while Drew has dealt with hundreds of suicidal patients, we only had one previous episode for him to bring his expertise to bear on: #4 on Camus's "The Myth of Sisyphus" (1942). We reread this short version to reflect on the relationship between suicide and the meaning of life. For the rest, we tried to read widely from history:

• First, Dylan summarizes two letters by Seneca: 70. "On the Proper Time to Slip the Cable"and 77. "On Taking One's Own Life." As a Stoic, Seneca rejects the fear of death and says that what's important is not to keep living, but to live well, so suicide is morally permissible whenever the story of your life has reached its natural conclusion, when continuing to live would be dishonorable or otherwise not worth the effort.
• Second, Seth talks about Arthur Schopenhauer's "On Suicide," published in Studies in Pessimism (1893). While Schopenhauer points back to the age of Seneca as having a more sensible attitude toward suicide than the Christians who considered it immoral, he also thinks it involves a mistake: You're being tormented by unfulfilled desire, and your task should be to withdraw from this kind of deceptive willfulness, whereas killing yourself is actually an exertion of your will, an attempt to improve your situation that actually leads to there being no situation left for you to improve.
• Wes then takes us to Sigmund Freud's "Mourning and Melancholia" (1915), which also depicts suicide as confused: We think of it as an attempt to escape suffering, but really it's an aggressive act, but toward an object—our image of another person—which we've taken into ourselves due to a fear of being angry at this other person. For more on this essay, listen to Wes's (sub)Text episode on it. To provide additional historical developments in psychoanalytic literature re. analyses of suicide, Wes also recommended "On the 'Longing to Die' " by Kate Friedlander (1938), "Suicide and the Hidden Executioner" by Stuart Asch (1977), and a 2009 survey, "Psychoanalytic Theories of Suicide" by Elsa Ronningstam et al.
• The first reading apart from Camus we identified for this episode was Emile Durkheim's groundbreaking work Suicide (1897), and we read his introduction plus Ch. 2 section IV, Ch. 3 section VI, and Ch. 5 sections II and III, which Mark quickly summarizes. This was pretty much the first work of modern sociology and sought correlations between suicide rates and social characteristics of suicides: sex, religion, country, marital status, economic status, etc. Buy it or try this online version. This book will be covered more thoroughly in the follow-up discussion on this episode between Mark and Wes. For a quick introduction to the book, try this lecture.
• Looking for correlations, and hence risk factors and potential predictors, is pretty much what psychology is primarily concerned with in this area today, and we read two multi-author psychology articles from 2017: “Risk Factors for Suicidal Thoughts and Behaviors: "A Meta-Analysis of 50 Years of Research” (2017) by Joseph C. Franklin et al, and “Annual Research Review: Suicide Among Youth—Epidemiology, (Potential) Etiology, and Treatment” (2017) by Christine B. Cha et al. You may wish to listen to this episode of the Very Bad Wizards podcast featuring Matthew Nock, who was a co-author on both of these papers.
• To introduce us to the various philosophical questions involved in this topic and generate a few of the above readings, we read the Stanford Encyclopedia of Philosophy article on suicide by Michael Cholbi and the Wikipedia article on the philosophy of suicide.

In those latter survey articles, you can see that there are many paths that we could have taken with this, and I also put out some feelers on Facebook (here and here) that generated a lot of additional good suggestions. The basic issues of defining exactly what acts count as suicide and looking at the current political issues of right-to-die laws and physician-assisted suicide weren't of very much interest to us, as they're a bit too easy: Of course someone terminally ill should have the right to have a doctor help end his or her life, and we wouldn't morally condemn such a person. But if we admit that, then where's the dividing line in what situations are so bad that suicide is rational vs. the more ordinary situations of depression, anxiety, and often temporary states of risk? Are we ever in a position (in the absence of extreme circumstances) to rationally choose suicide, or by definition is anyone who's capable of it not in a position to think rationally on this issue? For a systematic exploration of this issue, try lectures 24–26 of Shelly Kagan's Open Course from Yale on Death. Another good source was Freakonomics Radio on suicide.

Visit DrDrew.com. He has interviewed Wes and Mark. To actually listen to these, visit drdrew.com/player/dr-drew-podcast, then type in either "w" or "lin" into the search bar, and you should see the respective episodes to play; for some reason if you type in more of our names, these episodes don't appear among the options.

The suicide prevention hotline is 1-800-273-TALK, FYI.

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Durkheim picture by Genevieve Arnold.

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