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by Jesse Bering
University of Chicago Press, 2018
Review by Roy Sugarman on Nov 20th 2018

Suicidal

Psychologists write often about suicide, but seldom about why they, despite being successful, think about suicide.  Recently, given the prominence of Kate Spade and Anthony Bourdain and others, I have been asked again and again as to why someone, who is otherwise seemingly basking in the glory of success, as Bering was, would contemplate and even go ahead taking their own life. The awkward answer I give is that they reach a point in their lives where they realize they are living out of sync with their values, and don't know how they got there. It is a sure way to misery, and many do it, having to then pivot to realign with their values, but that isn't always easy. Jessica McClintock was also famous for her line of perfume, but before things could go pear-shaped, she gave up her lines and disappeared into the sunset, I imagine to pursue her values which didn't seem to include hanging in until death seemed an option.

And so it is with Bering, focusing on why people, fleetingly depressed or miserable, find themselves in circumstance which they never expected to confront, and contemplate suicide even in the absence of a significant mental or physical illness. 5% with depressive illnesses will take their own lives, but half a percent of 'normals' do so as well, caused by 'psychache'.

For Bering, success at 35 meant moving with his boyfriend from Northern Ireland to Ithaca, and taking up writing seriously after the start of a promising career, and then failing somewhat to maintain his momentum, contemplating the tree branch in the backyard and a noose. If our goals and how we get to them reflect on our intrinsic motivation, namely how our values are expressed in what we do, then he began to yearn for a sense of purpose, envying those who had one, no matter how humble their lives compared to his life and work, e.g. Erotic Vomiting and other salient topics for an academic. That did not mean his success didn't continue to progress, but just that his private and public lives jarred.

This distress was however substantially hidden, determined to go to his grave with his thoughts rather than make them public, or share them at all. The person who commits suicide leaves their psychological skeleton in the survivor's emotional closet, he quotes.

Delving further into human exceptionalism, he discusses whether the records of animal suicides can be taken at face value, or do they just reflect our projection of seemingly unique human qualities onto animals post-Darwin?  Darwin of course would note that anything perilous to the species' progress in the face of the forces of evolution would not be supported: and yet suicide may be a hardwired capacity in some more than others. Bering speculates that specialized neurons in our self-reflective forebrains, densities beyond those possessed by animals, confer the potential for suicide upon us, more so than animals' brains might. We're the Ape that Jumps!

This may not fly in the face of evolution. As he discusses it, based on research by others, suicide may not merely eliminate the chance of our genes passing along down the chain, but may enhance the chances for others who are related to pass on the close replicas of ours, hence the thought, others would be better off if we were gone, like a worker ant or bee sacrificing their fertility for the sake of the tribe. Woodpeckers and others may do the same.  The word 'adaptive' in the evolutionary sense does not have to denote success for the individual, as in anhedonia in depression for instance, or nausea in vomiting, but it does confer an evolutionary advantage for the species, and so it stays as part of the repertoire of human emotions. The rumination and withdrawal of depression may in reality lead to a solution, even a neurotic failure to identify one, and hence getting on with life: taking medication, is, in the Darwin sense, counter-productive. As with his discussion of the value of the word adaptive, so here too is a conundrum as to what we can do with suicide and depression. Are these functional, and hence adaptive, as if they are altruistic.

Joiner and others would argue that the devastation left behind cannot be altruistic, but perhaps it is: the argument that the depressed and suicidal person is no longer a burden and others can move on, no matter how that 'burden' is perceived, alive or gone. For Joiner and colleagues it is the height of psychopathology, or others, a natural response to a perceived failure of a future orientation.

The prejudice issue remains here too: research is presented to show that people would rather date someone who was terminal or from an unfamiliar or unfavorable culture than someone who had tried suicide.

Against this background he returns to his own life, his coming out as gay preceded by attacks of significant angst and imagining the worst, a letter to an unrequited love dominating his first decent into suicidality. It also made him surprised to investigate some writers on suicide had no idea, beyond their academic interest, what it really felt like, being articulate on the subject with none of his personal experience to call on.

As with Kate and Anthony and others, he acknowledges that most people who kill themselves have actually lived better than average lives until that time. Falling off the ladder when you have climbed higher than most is more painful it seems, as with Dan Vickerman, a rugby player from my neck of the woods (mentioned by Bering who lives close by now) and who is an ex-South African as I am.  Crossing The Line is a group here, who look after ex-athletes who suffer from that painful loss of athlete identity, leading in many cases to the suicide of someone like Dan, who took his life last year. Australian presses refuse to cover such cases, or any suicides, predicated on the fear of perceived permission resulting: however, the Kate and Anthony and other non-local stories will make the press.

Such cases prompted myself and my colleagues to create Be A Looper, a free to air app that keeps potential suicides connected with 5 meaningful others, trusted allies who can be alerted to distress by a single swipe on the screen. Relatedness, mentioned earlier in the book, as well as the modelling of suicide or conversely the modelling of vulnerability (via Chain Diffusion) all contribute to such losses to society. Another aspect is the risk of injury and then opioid addiction which is now contributing to the emergence of athletes' faces on Face Book with the family alerting the world to yet another death owed to failing or failed expectations.  What does add to this picture is attributing the vicissitudes of life to some deep personal failing. FB and other social media contribute to the idea that most of us are happier in contrast, and the would be suicide is unique, and the negative issues are not part of most people's lives, but unique to the individual and thus their fault.

Similar to this idea is the neurotic's focus on the self, an ego-centeredness that is princess and pea-like in the inability to deal with discomfort by being distant from it, rather than immersed and obsessed with the high self-awareness of the anxious or depressed person focusing on their every bodily sensation. Authors have written on the negative affect that dominates, such as that written on by Wallace: faced with the risk of burning in a building such as during 911, and the terror of falling to your death out the window, one is weighing up both as terrors, neither is a solution, but one is the lesser of two horrifying choices. Hence as Wallace did, one kills oneself, not welcoming the terror of death necessarily, but seeing it as better than the terrors of the future. The same applies to self-injurious behavior: the relief of cutting is worth the pain of cutting.

Cognitive Deconstruction is another aspect to be considered, perhaps the most intriguing. Time slows and thought becomes concrete. The concrete is more tolerable than the abstract it seems, and dominates suicide notes, a paucity of ideation. This collapse of the abstract attitude, a continuing deconstruction, leads to impulsivity where no complex argument is deemed rational or has a braking effect on the suicidality.

He takes all these elements and applies them in the above sequences to the stages illuminated in the now famous diary of 17 year old deceased Victoria McLeod, who took her life in Singapore. Similar to this is his reference to the Netflix series, the subject of much controversy, 13 Reasons Why. The creators argued effectively that his graphic portrayal of Hannah's suicide would not spark copycats. However, he refers to a German show called Death of a Student; the repeated scene of the suicide did indeed cause a spike in young people's suicides, in the same manner as the movie, and when it was re-run, the same spike occurred.  Following the release of 13 Reasons Why, 900,000 to 1.5million more searches for suicide-related topics occurred.

Contagion is real, hence the Australian press' aversion to publishing news of such deaths, and especially the details. The suicide rate jumped 12% in the month following Marilyn Monroe's death.

So Bering's book is filled with the fascinating detail one would expect of a great researcher, one who has been there and almost done….that…. and also someone who can write in an entertaining and engaging way. It is a book for everyone, and sad enough given the target matter, but also informative without being cold, distant, boring, crammed. He gets across a tremendous amount of detail and anecdote, and makes this worthy of being a best seller.

If you are distressed after reading this or triggered, phone your local helpline or present at an emergency room. Stay true to your values in life, and if you are miserable, spend some time seeing if your life and your values have parted company. Accept negative feelings will come and go, and live your life from now on in keeping with what is vital, cherished to you.

 

© 2018 Roy Sugarman

 

Dr Roy Sugarman, Director: Applied Neuroscience, Performance Innovation, Team EXOS Arizona, Co-Inventor: Be A Looper (www.bealooper.com)




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