August 14, 2014

"With the lights out, it's less dangerous... I feel stupid and contagious...."

An old song lyric evoked by the new headline "The Science Behind Suicide Contagion."
Publicity surrounding a suicide has been repeatedly and definitively linked to a subsequent increase in suicide, especially among young people. Analysis suggests that at least 5 percent of youth suicides are influenced by contagion....

There’s a particularly strong effect from celebrity suicides....The idea is to avoid emphasizing or glamorizing suicide, or to make it seem like a simple or inevitable solution for people who are at risk. 
I've noticed, in the coverage of the Robin Williams suicide, a grasping onto the belief that he felt compelled: He couldn't help it. That's comforting for survivors, and with some celebrities, everyone feels like a survivor, but it unwittingly sends the message to those who feel drawn to suicide that it's hopeless and that if you succumb, you won't be blamed; in fact, you will have made a profound statement of the magnitude of your pain, and it will fill the survivors with love and understanding (as opposed to the new load of problems and questions that you've created and escaped).

The end of the linked article — which I read after linking to the old Nirvana tune — discusses the Kurt Cobain suicide. It "bucked the pattern" — suicides decreased —  assertedly because journalists were careful to adhere to suicide prevention guidelines. There is no mention of the impact of the uniquely dramatic public performance of Cobain's widow, Courtney Love, reading his suicide letter out loud and interspersing her outraged commentary
I don't really think it takes away his dignity to read this considering that it's addressed to most of you. He's such an asshole. I want you all to say 'asshole' really loud.... God! You asshole.... And I'm laying in our bed, and I'm really sorry. And I feel the same way you do. I'm really sorry you guys. I don't know what I could have done. I wish I'd been here. I wish I hadn't listened to other people, but I did. Every night I've been sleeping with his mother, and I wake up in the morning and think it's him because his body's sort of the same. And I have to go now. Just tell him he's a fucker, OK? Just say "fucker." "You're a fucker." And that you love him.

58 comments:

tds said...

Words that should be banned in the US: 'survivor'

Ann Althouse said...

"Words that should be banned in the US: 'survivor.'"

Survivors ready? Come on in, guys! Immunity, back up for grabs. Here is how it works. Make sense?
Want to know what you're playing for? Worth playing for? Take your spots, wait for my Go! Survivors ready... go! I've got nothing for you, head back to camp. Grab a torch and approach the flame. Dip it in and get fire. This is important, because in this game, fire represents life. Once your fire is gone, so are you.

Shanna said...

Kurt Cobain's suicide was pretty much a personal tragedy for everyone I went to high school with. I am not surprised that it did not up suicides.

Ignorance is Bliss said...

The idea is to avoid emphasizing or glamorizing suicide, or to make it seem like a simple or inevitable solution for people who are at risk.

Is it just me, or is that a really poorly constructed sentence? Does it mean:

A) The idea is (to avoid emphasizing or glamorizing suicide), or (to make it seem like a simple or inevitable solution for people who are at risk).

or

B) The idea is to avoid (emphasizing or glamorizing suicide), or (to make it seem like a simple or inevitable solution for people who are at risk).

My understanding of the guidelines argues for B, but the sentence structure ( to avoid paralleling to make ) argues for A

Ann Althouse said...

"Kurt Cobain's suicide was pretty much a personal tragedy for everyone I went to high school with. I am not surprised that it did not up suicides."

Oh, I think it is surprising. The young people had internalized his songs, which were full of darkness, and they were prepared to emulate him and adopt his attitudes, plus they had lost their (anti)hero. I remember this very well, because I had 2 young adolescent sons at the time, and we had MTV's endless tribute to him on continually.

Also popular at the time was that Beck song "Loser," with the repeated lyric "I'm a loser baby, so why don't you kill me?" That was the vibe of that era.

And don't forget "Jeremy," the Pearl Jam suicide boy (which because of "MTV restrictions on violent imagery prevented Pellington from showing Jeremy putting the gun in his mouth and pulling the trigger at the climax of the video" caused many people to misinterpret what happened and believe that Jeremy was a "school shooter").

"After the Columbine High School massacre in 1999, MTV and VH1 rarely aired the video, and mention of it was omitted in retro-documentaries such as I Love the '90s. It is still available on the internet, on websites such as YouTube…. The video was included in MuchMusic's list of the 12 most controversial videos. The reason was because of the topic of suicide, and recent school shootings. The scene of Jeremy with the gun in his mouth was not shown."

Ann Althouse said...

"Is it just me, or is that a really poorly constructed sentence?"

The latter.

For one thing, the comma is a mistake, no matter which meaning was intended, but there's an unacceptable ambiguity created by the use of the word "avoid" and a failure to repeat it (or a synonym for it).

Ignorance is Bliss said...

I think you could also fix the ambiguity by replacing to make with making, thus paralleling emphasizing and glamorizing as things to avoid.

Anonymous said...

I believe Courtney Love had Cobain killed so the letter reads differently to me.

William said...

Svetlana Stalin and Jane Fonda both offer examples of the late blooming flowers of suicide. Svetlana's mother committed suicide when she was a child. She was told that her mother had died, but not that she had committed suicide. Svetlana learned of the suicide only years later when she was studying English and read about it in an old copy of Time magazine. Svetlana felt betrayed not just by her mother, but by her father who had kept the information from her. This is my interpretation, but perhaps she felt betrayed not just by her father but by the fatherland. At any rate. she was a very poor Soviet citizen and defected to the West........A similar experience happened to Jane Fonda. Her mother committed suicide and that fact was kept from her. Jane found out about her mother's suicide only when she read about it in a fan magazine article about her father......I think a similar dynamic of betrayal and alienation occurred with Jane. Henry Fonda was not so identical with the state as Joseph Stalin, but he was an American patriarch. He played such iconic roles as Tom Joad, Abe Lincoln, and Mr. Roberts. If you distrusted him, you distrusted America. And Jane must have distrusted him. Patriotism and the patriarchy are intimately connected,......So there you have it. The suicide of Svetlana's mother resulted in a propaganda victory for the West, and the suicide of Jane Fonda's mother resulted in a propaganda victory for North Vietnam. It all balances out in the end,

Anonymous said...

To be clear: I don't think Courtney Love had anything to do with Robin Williams' death. Two different things.

Anonymous said...

Nah. That didn't mean shit. Courtney is and was psychotic and there is not much love for her. I'm not a Courtney hater, but it is what it is. She's like a giant neon billboard that the assholes survive and/ or flourish while the good go down or at least function under a heavier burden.

There was a weird suicidal urge in that time period and that culture. I was suicidal. My friends were suicidal at times. If anything, Kurt was a reason to hang on when he was alive. When he killed himself, a tension was released in a whole group of people. It really felt like he was a scapegoat that broke a spell. The urge dissipated. Much of what he took shit for is normal today (openly pro-gay during a homophobic time in music, for example). The pictures of his body may have helped bring it home the nature of the act.

Suicide or attempts can indeed wake up an asshole neglectful family just like a major illness can. I know a mom who completely devoted her life to her teen daughter after her attempt. Quit her job, the works. Her daughter is now super successful, more than the sibs that didn't get that attention. Not popular to say at the moment, but Mother Love still means a lot. (One reason why old times mother worship of sons could be such a self-fulfilling prophecy.)

I guess I don't know anyone who thinks suicide is glamorous. Especially at Robin William's age you'd be very aware that you'd be creating a corpse, rather than anything that would really be invested in family or public reaction. Some suicidal people feel they'd be freeing loved ones in the long run - which can be true.
It's very hard to make a corpse out of yourself, you know, even when you really want to.

I also deeply feel that it is the person's call ultimately. There are many things they could do alive that would cause blame and recrimination also. Ultimately, blame hurts the person so negatively invested in another person's actions, not the assholes anyway. And why would you make the sensitive ones burden greater? That won't help.

Side note: David Sedaris is an ass and his family sounds horrific. He just seems to have doubled down on his general asshatness. You never know, but Doesn't look like there was any growth there.

The Crack Emcee said...

"I've noticed, in the coverage of the Robin Williams suicide, a grasping onto the belief that he felt compelled: He couldn't help it. That's comforting for survivors, and with some celebrities, everyone feels like a survivor, but it unwittingly sends the message to those who feel drawn to suicide that it's hopeless and that if you succumb, you won't be blamed"

WOW - you really don't get it do you? We live with this and that's how it is - why insist on something else?

Oh yeah - because the lie makes YOU feel better.

Don't care - it's still a lie,...

mrs.e said...

"And why would you make the sensitive ones burden greater? That won't help."

Along those lines, if a close friend or relative suffered from clinical depression and committed suicide as a result, who am I to say that my subsequent pain was greater than theirs?

Also, I came across a piece from Rob Dreher, this morning and found this paragraph to reflect my own thinking:

Some people — like Robin Williams — are not going to be able to save themselves, or be saved, for the same reason that some people who are thrown into the water bound by knots they did not tie will drown. I could be wrong about this, but I trust in the mercy of God in the case of poor souls who suffer so much that they cannot see any other way to relieve their pain.

The Crack Emcee said...

The last time I saw Courtney Love, in person, she was in the basement of a nightclub banging my bipolar friend on a desk.

Having her for a wife had to be depressing,...

William said...

I admired Robin Williams' talent, but I was a grown up when he first came on the scene. I was never really a fan of his in the way I was of Woody Allen. Perhaps as a consequence of this, I felt far more betrayed by the Allen scandal than I felt depressed by the Williams' suicide. I think a lot of younger people who grew up with Mrs. Doubtfire and Jumanji have a more intimate relationship with Williams and process his death in a different way. His suicide doesn't haunt me, but there are others who see his ghost.

Shanna said...
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Shanna said...

Oh, I think it is surprising. The young people had internalized his songs, which were full of darkness, and they were prepared to emulate him and adopt his attitudes, plus they had lost their (anti)hero.

But they didn't emulate him. I think it is because people were so personally connected to the whole thing. It is fascinating, looking back.

madAsHell said...

They used to take the pregnant girls out of high school for much the same reason. You don't want to glamorize out-of-wedlock pregnancy.

CStanley said...

MadAsHell brings up a good point. When iis it appropriate to use shame as a tool to affect behavior outcomes? And in which situations is it effective?

I would say there's a high probability of poor efficacy in a situation where a person isn't thinking rationally. On what evidence do we assume that suicidal people are thinking about how they'll be viewed after their suicide? Does this really weigh into the decision making?

James Pawlak said...

Suicide is: The ultimate personal choice; A denial of hope; And, a way of improving the human genetic pool.

Birches said...

As I said before in the other thread, I agreed with you and I used a family member's suicide attempt and mental illness as a reason for not glamorizing suicide.

I thought about it a bit, and then thought, "hey I might be wrong about this," so I asked my mom, who deals with my family member's mental illness much more intimately than I do. She completely agreed. Defeatist talk about suicide can trigger more suicidal thoughts for some.

Depression and suicidal thoughts aren't the same for everyone.

Birches said...
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HoodlumDoodlum said...

I think the tension is between viewing someone primarily as a victim one the one hand and on the other wanting to use (societial) shame or moral opprobium to discourage suicide generally.

John Lynch said...

This is true of mass shootings, too.

John Lynch said...

Depression is about life and death. On a daily basis you have to decide whether to be alive that day. When you sit and do nothing, especially things that have to be done, you're deciding to be dead for the day.

I keep pounding away at the idea of choice in mental illness because, even when choice doesn't exist, it's the only way to live. If you can't make choices, and how you feel is outside of your control, then you are not alive. You might as well die. Well-meaning people who make excuses for death aren't helping.

Life is work. It's struggle. Depression is giving up because it's too hard.

Freeman Hunt said...

Well-meaning people who make excuses for death aren't helping.

A hundred times this.

CStanley said...

Well-meaning people who make excuses for death aren't helping.

Aren't helping what, exactly? What is the goal that you see being thwarted here?

CStanley said...

I keep pounding away at the idea of choice in mental illness because, even when choice doesn't exist, it's the only way to live. If you can't make choices, and how you feel is outside of your control, then you are not alive. You might as well die. Well-meaning people who make excuses for death aren't helping.

Life is work. It's struggle. Depression is giving up because it's too hard.


I know this is not your intention but the first paragraph I quoted here actually argues that people who feel depressed to the degree that they can't function and feel that they have no viable choices, might as well kill themselves. Reread it and see if you see that.

Yes, of course, we should try to find the hope, try to find the way out. But for cripes sake, when at a certain point, the person has lost the ability to do that.

One of the problems I have with the arguments some of you are making is that by putting so much responsibility on the suicidal person, you are actually removing some responsibility from the loved ones, and doctors and therapists, and society in general.

Yesterday I was thinking that this attitude was harsher on the family and loved ones because they'd likely prefer to feel sympathy for the lost person. But now that I think about it, maybe in a lot of cases the opposite is true. After all, if we all agree and affirm that Kurt Cobain was a "fucker" then it wasn't Courtney's fault. And if Robin Williams was also a "fucker", too weak and cowardly to face his demons by himself, then it is his fault he made this awful choice alone in that bedroom while his wife slept somewhere else.

John Lynch said...

Gah.

Yeah, that's the point I'm making. If you rob people of choice because they are mentally ill, you are taking away their life. This unintentionally enables suicide.

When you hold people accountable for their choices, they have agency, and by extension they are alive.

Being "mean" and "heartless" (which I've been called many times when I write about suicide) is giving people the respect of being accountable for their own choices. When we treat people as children, unable to control their own actions, it's demeaning, disrespectful, and encourages the behavior we want to prevent.

The respectful behavior we have when someone dies from an accident or illness is correct. We should not let the respect we naturally have for the dead be hijacked when someone murders himself. The outcome- death- is the same, but the method is unnatural and wrong.

Suicide is bad. I think it's far more common than it should be (I'm willing to admit that there might be some exception, somewhere). Treating it as anything other than individual choice makes it happen more often.

John Lynch said...
This comment has been removed by the author.
Charlie said...

I hope to go the rest of my life without thinking about Courtney Love.

Freeman Hunt said...

Aren't helping what, exactly? What is the goal that you see being thwarted here?

Dissuading suicidal people from committing suicide.

C Stanley said...

Yeah, that's the point I'm making. If you rob people of choice because they are mentally ill, you are taking away their life. I'm pretty sure it's not up to me. It either is so, or it's not. I don't know what causes the physiological effects of this illness, but we don't get to debate whether or not those effects are real.

This unintentionally enables suicide.
Where is the evidence of this? (Same question for Freeman.)

mrs.e said...

I've noticed, in the coverage of the Robin Williams suicide, a grasping onto the belief that he felt compelled: He couldn't help it. That's comforting for survivors, and with some celebrities, everyone feels like a survivor, but it unwittingly sends the message to those who feel drawn to suicide that it's hopeless and that if you succumb, you won't be blamed

I guess a person without a monster living inside their head would not be able to imagine the need to hide from one. But there are a lot of us out here that do. It's a different world living with something that wants to destroy you.

RW warded this off for a long, long time. Why is it so hard to give him credit for that?

Freeman Hunt said...
This comment has been removed by the author.
CStanley said...

@Freeman- that is, truly, very good, and I don't mean to be an ass about it but frankly it is anecdote and not evidence, I think it's especially important to note that any post hoc analysis in this situation has a completely skewed sample to examine.

To some extent we may be talking past each other because I agreed with your comment yesterday about the importance of having another person as a plan to live for. I think I disagree with the extent to which you put that responsibility on the sick person, although I may be misinterpreting that.

I think that the focus on what should happen at the end stage is misplaced. Some of the discussions, I think, should involve people who suffer from chronic depression but are in remission, to form a plan and find strategies to stay as mentally healthy as possible. That's the only way, I believe, to really have an effect on suicide rate (as opposed to saving a few individuals on a person by person basis, which is of course important but can only be done through one individual being there for another, and what we type on a blog is meaningless.)

Freeman Hunt said...

Where is the evidence of this?

Studies on suicide and locus of control.

Here.

(I put "elderly" in this search because if you leave it out, a bunch of studies on suicide and locus of control for adolescents come up, and I figured people would argue that an adolescent is not the same as a 60 year old man.)

Shanna said...

Well-meaning people who make excuses for death aren't helping.

I agree that there is a bit of line here that people are crossing on one side or the other - things like 'he is free from pain now' probably don't help, but I think some of the comments go too far in the other direction.

It's a complicated issue.

Freeman Hunt said...

I reconsidered my earlier comment and deleted it. The data is available in studies elsewhere, so my earlier comment is needless.

CStanley said...

I think Mrs. e has it right on both counts.

1. One of the most effective facets of treatment for many mental illnesses is to isolate the illness as something alien to the person's "self". This is the only way they can fight against it without feeling shame. Note that this is much different than saying that the person doesn't have agency, in fact it is the only real way to help them recover agency.

2. There should be more credit given to someone who has struggled with this for years, and there were likely many other occasions where he fought off the impulse, until one time he didn't. I suppose some people will then say that the previous successes prove that he could have, but that ignores the waxing and waning and the long term wearing down of one's faculties. We also don't know in any given case what pharmaceuticals were involved, which coulda the issue of culpability even further since it's pretty clear that there is a correlation sometimes.

CStanley said...

Locus of control has a lot to do with anxiety and depression, so it's clearly important. What isn't so clear is how to help people achieve higher degrees of internal control, and in definitely don't think shame is the way to go about it.

Freeman Hunt said...

What isn't so clear is how to help people achieve higher degrees of internal control

It seems obvious, however, that telling them over and over that they are not in control is unhelpful or even harmful.

CStanley said...

This is where we are talking past each other, because that is not something I have advocated.

The point Mrs E brought up is most relevant. If the disease itself is externalized, then treatment can be focused on developing the internal control over this invader. Your approach doesn't allow room to conceptualizer it that way.

What I would then say to someone who might be prone to suicidal ideation, is that if they allow the disease to take over then they might end up losing this control, but with treatment and a support system and.a plan, they can beat it. Those decisions all need to happen proactively though, which is why I don't think it is a mistake to speak of the suicides as having lost the ability to choose .

John Lynch said...

Depression Quest on Steam.

A depressing, unironic, game about depression. For free, because no one would buy it.

Freeman Hunt said...

What I would then say to someone who might be prone to suicidal ideation, is that if they allow the disease to take over then they might end up losing this control, but with treatment and a support system and.a plan, they can beat it.

A setup for failure since on one's first bad day he will be primed to think, "Oh, there it goes. It's taken over. I can't stop it now."

John Lynch said...

No external force can beat depression, because it's experienced subjectively. You can't fix depression without the cooperation of the depressed, and the whole problem is that depressed people don't help themselves.

That's what depression is- being irrationally unhappy and self-destructive. Depression is choosing death over life, by barely living at all.

People outside can help, and should, but it isn't enough without the depressed person taking control and responsibility for their own life.

It's not really a disease because it can only be cured by the person who has it.

The Depression Quest game I just linked to illustrates the dynamic pretty well. The player makes choices about what to do in difficult situations. Some choices are not possible because of the depression, but you can still make bad choices. "Good" choices in the game are those that engage with other people. "Bad" choices are those that lead to giving up on life and pushing other people away.

CStanley said...

"Not really a disease"

You couldn't be more wrong. The problem is we don't yet know how to cure it, so we blame the afflicted for not having the will to cure themselves.

Do you know anything about the neurochemistry?

CStanley said...

A setup for failure since on one's first bad day he will be primed to think, "Oh, there it goes. It's taken over. I can't stop it now."

Sure, much better to have a person who already feels worthless to be primed to think that they will be branded as an attempted murderer for considering suicide, that will make them want to fight it off, for sure.

Or, you know, maybe we both mean something a bit more nuanced.

William said...

Further thoughts on the consequences of the suicide of Jane Fonda's mother: Later in life Jane married Ted Turner. Ted Turner's father had also committed suicide so they had that it common. My guess is that it was some kind of bonding experience that drew them closer together. In any event, it was the most successful marriage Jane had. So there was some good that came out of her mother's suicide......It was definitely a one off though. If you're thinking of committing suicide to increase your daughter's chance of marrying a billionaire, the odds are unfavorable. I submit the example just to show the incalculable consequences of a suicide in the family.

Rockport Conservative said...

My dad died of Parkinson's in 1989. There have been many improved drugs for the disease since that time. With the announcement that Williams had Parkinson's I am wondering if a drug he was taking added to to his depression and literally tipped him over the edge. I would like to see some research into the current drugs as they relate to depression.

Lydia said...

A 23-year-old book by William Styron about his own clinical depression, Darkness Visible: A Memoir of Madness, might be worth a read. A look back at it in the Guardian is here. His description of it as a "howling tempest in the brain" stands out.

Ann Althouse said...

"I guess a person without a monster living inside their head would not be able to imagine the need to hide from one. But there are a lot of us out here that do. It's a different world living with something that wants to destroy you."

If you are living you have not succumbed to the hopelessness. You are fighting, and you should fight.

William said...

On the other hand, look at it from Ted Turner's viewpoint. He got stuck in a marriage with Jane Fonda. That might have been tolerable in her Barbarella years, but he got to share her later years when she combined all the admirable qualities of a political activist and Jesus freak in one dynamic combo. His father truly laid a heavy burden on his son when he committed suicide and set his son on a course that ended in marriage with Jane Fonda.

Lydia said...

Now we learn that Williams was also in the early stages of Parkinson. Damn, he really hit the winning trifecta, didn't he?

Lydia said...

Sorry, Rockport Conservative, I didn't see that you'd already mentioned his Parkinson's.

CStanley said...

If you are living you have not succumbed to the hopelessness. You are fighting, and you should fight.

I think this Is a really good sentiment, one which should be uttered far more frequently than it is.

Lots of people with anxiety and depression tend to mistakenly blame other people and external events for their dark moods. Telling them that this is their fault is unhelpful, but telling them that there is a physiological cause, within themselves but not of themselves, gives them an appropriate target for them to fight against.

And for others, whether their close friends and family or society in general, to recognize their small daily victories can really help. It's a constant struggle.

CStanley said...

Also, I think that one of the less recognized aspects is how much anxiety is intertwined with the more serious cases of depression. Maybe that's part of the disconnect- perhaps if you've suffered clinical depression but don't have the anxiety component, you don't see why it is different for others.

I suspect that people with plain depression may at times become suicidal, but probably in response to serious life stressors. So there would be a tendency to still have the intact survival instinct, to seek out help or dig down deep for self help to overcome the impulse.

Anxiety can involve components not unlike psychosis, in that there is delusional self talk. This is what makes it so dangerous because the suicidal person can actually be convinced that his loved ones will be better off if he dies.

This is only my opinion but I do speak from a position of experience in various contexts. And I do see that the researchers are moving somewhat in this direction, recognizing that some symptoms such as psychosis are in a continuum with various disorders (overlap of mood disorders and schizophrenia, for example) so my hope if that they start untangling it and finding new ways to help.

Paul Ciotti said...

Will Durant in one of his many volumes about the ancient world mentions one country where young women suddenly began a rash of copy-cat suicides. The inspired solution of the city fathers? They immediately decreed that any woman who commits suicide will first be carried naked through the marketplace before being buried. Durant says that stopped the suicides cold.