by Thomas Joiner
Harvard University Press, 2010
Review by Sue Bond on Oct 26th 2010
Thomas Joiner's Myths about Suicide is a powerful and important book that aims to attack the stigma around suicide, to 'expose myths' and 'shatter misunderstandings' (10). In it he continues on from his first (Why People Die By Suicide, 2005) but writes with clearer expression and less unnecessary repetition, making for a stronger book and one that better succeeds in its aims.
He divides his book into three main sections after an introduction: 'The Suicidal Mind', 'Suicidal Behavior', and 'Causes, Consequences, and Subpopulations'. There are eighteen myths he deals with throughout these chapters, with discussions of other misunderstood issues included (for example, 'slow suicide', genetics, hospitalization).
As in his first book, he emphasizes the factors that must be present for a person to consider suicide. These are perceived burdensomeness (so the person believes they would benefit others more by being dead than alive), sense of low belongingness (alienation from their community), and loss of the fear of pain and death (such as by habituation to pain, hard circumstances and dangerous situations). He applies these factors to examples of cases, making them clear and understandable.
The first myth he discusses is that those who kill themselves are cowards because suicide is the easy way out. He uses many examples of those who have attempted suicide but not succeeded because they were in fact not able to overcome that extremely strong evolutionary instinct for life. If it were an easy thing to do, more people would succeed, he argues. Another myth he demolishes is that suicide is a selfish act:
...those left behind are often convinced that those who die by suicide did not consider the impact of their deaths. This is a terrible error. Those who die by suicide certainly do consider the impact of their deaths on others, but they see it differently--as a positive instead of a negative. They are wrong, but it is their view nevertheless. (44)
He continues by explaining cognitive constriction, where intense negative emotion causes the brain to narrow its focus to the concrete and where abstract thought and impulse control are greatly impaired. This is what happens to people in suicidal states, so that they are not thinking or functioning normally. It seems obvious, but in order to counter long-standing and pervasive myths, Joiner is right to spell out the details of what happens in the suicidal mind.
The author works through his long list of these myths, giving numerous examples and thorough discussions. He includes such topics as risk factors, suicide terrorists, the suicide note, and the suicide of children.
An important section is on the myth that some people are so intent on killing themselves they cannot be stopped: Joiner argues firmly and at length on the wrongness of this attitude. He gives the example of the Golden Gate Bridge and the fact that of the people who are restrained from jumping, 'the vast majority' go on to live productive lives without attempting suicide again, by any means. The deep ambivalence that exists in the suicidal mind can swing from death to life by someone stopping them from completing the act, or by something like a barrier on a bridge, or banning firearms (162). He discusses further how good old-fashioned human contact, and having someone listen to you and take you seriously when you speak about suicide can be hugely beneficial too.
There is much interesting and vital information about the suicidal mind and suicidal behavior in this work, and it is presented in a manner that makes it approachable for the general reader, helpful for those who have a friend or family member with suicidal behavior, as well as being immensely useful for practitioners in the field of mental health. He has a conversational style that guides you through difficult material and is passionate about his subject both on a personal and a professional level: there is a history of suicide in his family. This book is written in a better style than the previous title, and I have far less negative criticisms of it. There is only one instance where the author repeats a quotation, and one strangely chosen quotation, in my opinion, from Frederick Hayek the economist. Otherwise, a highly recommended book on a subject of great importance.
© 2010 Sue Bond
Sue Bond is a former doctor and current writer, reviewer and editor working in Queensland, Australia. Her erratically maintained blog is at http://thewordygecko.wordpress.com.