Sociological and Psychological Theories of Suicide (Coursework Sample)

LITERATURE REVIEW Sociological and Psychological Theories of Suicide Classical Theories Durkheim argued that each suicide could be scientifically identified as one of three general suicides types – anomic, altruistic, egoistic (Durkheim, 1897). His theoretical approach marked the first hypothesis-driven, scientifically-based approach to understanding suicide anchored in the statistical examination. This study was also the first sociological examination and traced a dichotomy between studies based on psychological theories of suicide and medical and sociological theories. (Stack and Bowman, 2009. His suicide classifications were revolutionary in that they differentiated the act of suicide objectively and assigned different motives. It is important to further explain these classifications as follows. (Alvarez, 1971; Shneidman, 1993; Joiner, 2005; Van Ordern, et al., 2008; Redfield Jamison, 1999; Maris and Maltsberger, 1992). Egoistic suicide takes place when people are not fully integrated into society, but instead are thrown at their own resources. Altruistic suicide happens when a person in the group is so thoroughly absorbed that its goals and identity become his own. Anomic suicide is the result of such a sudden change in a man's social position that he can not cope with his new situation. While Durkheim was developing a statistical-sociological approach to suicide understanding, (around late 19th - early 20th century), Freud and his colleagues in Vienna explored the intermix of personal and societal forces with suicide as a concept embedded in the human psyche. (Shneidman, Farberow, and Litman, 1983). The construction of psychoanalysis by Freud is seen by many as the beginning of the modern age of the fields of medicine and science linked to psychological and mental illness. During this period, many improvements in the treatment and care of mentally ill patients were developed. This time marks the transition from the view of suicide to be evil / demon-driven affliction to psycho-bio-mental illness. With the individual and self-reflective examination of the psyche, Freud and his colleagues were at the forefront of this transition; nevertheless, the psychoanalytic theory does not provide sufficient evidence to explain the causes of suicide (Alvarez, 1971, p.132). However, Freud was understandably a proponent (maybe the first) of self-control over time and method to end one's own life (Shneidman, Farberow, Litman, 1983; Strauss, 2009). He is amongst many infamous people in history to commit suicide, his own personal compulsion or ' psychache ' creation resulting from a long and very traumatic struggle with throat and jaw cancer, and the imminent war in Europe, the Second World War. Freud was devastated by the rise of Nazism and Fascism throughout Europe. Many hypothesized that this devastation, along with his physical health, contributed to his decision to commit suicide. Along the Freudian line, Karl Menninger described three components to suicide: (1) the wish to kill, (2) the wish to be killed, and (3) the wish to die. This concept focuses on a self-centered viewpoint and ignores the complexity that environmental, social, and biological factors may play on the development of the psyche and the consequential development of psychache. This development would be almost a century in the making as it was not until the mid-20th century with the advent of the field of suicidology, that issues of race, age, gender, and societal factors are considered as contributory to the act of suicide. Modern Suicidology The infancy of the modern era of suicidology began in the old Hall of Records, 1949, Los Angeles, Coroner’s Vault. A 31-year-old youthful psychologist was looking for files on two veterans who had committed suicide while in the care of the Veterans Administration Medical Service. What Edwin Shneidman discovered that day was a vault of suicide notes, almost 700 in total. From this discovery, he designed and implemented a randomized control trial to determine if “suicidality” could be obtained from a suicide note. The idea was to determine if suicide notes could be used as an instrument in 12 identifying motive and intent in the subject’s death (Shneidman, 1996). A blinded study was developed during which the actual suicide notes were combined with simulated notes and reviewed by Shneidman and two others. Information and conclusions were then compared to see if a pattern of behaviors and events could explain why these individuals had decided to end their lives. As a consequence of these events, the well-documented collaboration between the Los Angeles Suicide Prevention Center (LASPC) and the Los Angeles medical examiner’s office was developed, setting the example for similar entities worldwide (Curphey, 1961; Litman, Shneidman, Farberow, and Tabachnick, 1963; Shneidman, 1981, 1990; Maris, Berman, Maltsberger, and Yufit, 1992). It was during this time that tools such as the ‘psychological autopsy’ were developed and accepted for the use in both suicide and unequivocal deaths. A psychological autopsy is a tool for collecting data on those subjects that have committed an act of suicide or suicide attempt (Leenaars, 1988; Maris et al., 1992; Shneidman, 1985, 1996). Information is gathered using what in public health is known as a mixed-methods approach. This data is collected through a series of interviews with survivors of the victim and consists of gathering information about the victim, such as traumatic events, emotional turmoil, physical issues, and psychological states of mind. This information is then converted to a survey/protocol for data collection purposes, that allows for qualitative and quantitative analysis once enough cases have been investigated. The psychological autopsy is discussed because it symbolizes the contribution that these early pioneers in suicidology have made. They developed the tools, frameworks, and very vocabulary that are imperative to investigating suicide and suicidal behaviors. Before examining these constructs of a public health view of suicide, we must discuss the evolution of the psychological and behavioral theories on suicide, as they developed into the branch known as suicidology. There are currently many social and psychological theories that attempt to explain the complexity of suicide and suicidal behaviors. Historically, theorists from Durkheim (1897) to Farber (1968) base their theoretical explanations on social influence. Freud (1920) was a proponent of the idea of a “death drive” as a quest for meaning from the achievement of a balanced or nirvana-esque state of mind. As described before, Menninger (1938) introduced the idea of an individual’s desire to kill or be killed. In more current times, Maris (1981) attempted to relate lethal contingencies (lethality of planning), negative interaction, early traumatic relationships, abortive life state transitions, sex deviance, race/ethnicity, social mobility, drug and alcohol use, hopelessness, depression, and meanings of life. Stephens (1984) ascribed that “motives can be viewed as social constructions which permit the individual and others to assign meaning and acceptability of the suicidal act.” Shneidman’s (1981) efforts have been well documented, and his view can be summarized by looking at the current state of suicide in western culture. He states that suicide is a conscious act of self-induced annihilation best understood as a multidimensional malaise in a needful individual who defines an issue for which the suicide is perceived as the best solution. Cutter (1998) describes the development of suicidal theory in terms of the current literature to be the notion that all victims of self-injurious behavior are seeking to accomplish an objective of some kind. He goes on to say that the net effect is to alter the victim’s own perceptions of existence. This occurs through actions that are a variety of self-injurious behaviors intended to accomplish cessation of awareness. Para-suicidal individuals share this in that the verbalizations, threats, gestures, or self-mutilation are also efforts to achieve changes in perceived reality and self-awareness. Through these behaviors, the suicidal and parasuicidal victims appear to be supposing a development past the point of termination, rather than merely a cessation of turmoil. Cutter (1998) goes on to identify three necessary and sufficient conditions for a suicidal event to occur, the three sides to the triangle of the Suicide Prevention Triangle (SPT): 1) There must be enough psychological pain (psychache). 2) The desire to die must outweigh the desire to live. 3) There must be a method of self-injury available. These three factors are sufficient to cause a self-injurious behavior (Cutter, 1998). Cutter’s requisite of the wish to die being greater than the wish to live is reflected in a variety of similar theoretical developments. Baumeister (1990) suggests a social psychological account of suicide that seeks to remove the self from the harshness brought about by comparing oneself to others. Baumeister’s social psychological account of suicide proposes that suicide attempts are the result of a desire to alleviate aversive self-awareness. Further, he posits that suicide is a result of an effort to escape from the pain involved with the self-awareness and recognition of embarrassment as an acknowledgment of failings when compared to others. Secondary influences of this state stem from outside attention and affect, which act to increase the emotional response of this self-awareness. It is a method of escape from this increase in emotional state that Baumeister suggests is the impetus for attempting suicide. Escape theory focuses on those factors that motivate suicide with emphasis on social psychological factors and unfavorable self-comparisons. There are six requirements under Baumeister’s Escape Theory of Suicide that compel an ...