Thursday, December 4, 2008

Censoring Suicide

Well-meaning anti-suicide groups publish "media guidelines" that promote myths and increase the pain for survivors of suicide.



In London, Paul Day's compelling, emotionally dense frieze was pulled from a rail station because it depicted a skeleton driving a train and a commuter "wobbling precariously" close to the tracks - alluding to suicide by train.

Pepsi apologized for, and retracted, ads (published in a German magazine) that depicted a "lonely single calorie" committing suicide. The self-appointed censor who received the apology indicated that electronic communication will help him carry out his inquisition into commercial art: "The lesson here is that social media has eyes everywhere and the network to make sure that advertisers can no longer hide stuff in niche markets," said Chris Abraham.

Art, advertisements, and video games that deal with suicide - entry points for conversations about suicide among ordinary people - are unjustly criticized, censored, and destroyed. There is only one appropriate way to speak of suicide, one appropriate attitude toward it, and all others are quickly suppressed. This is not the case for other controversial topics - murder, race, gender, drug use - nor should it be. Suicide is tabooed in a unique and unfortunate way.

Joan Wickersham, author of The Suicide Index and daughter of a suicide, thinks that more conversation about suicide would be a good thing:
"I think there is a kind of shame and a kind of taboo attached to suicide," she says. "We would prefer to think it doesn't happen. I think we have to acknowledge it does happen. We have to acknowledge that it's a mystery, that we don't understand it very well. I just wanted to give a sense of what it is really like to go through this."

Wickersham says there is a reluctance to talk about suicide, adding, "I would love to see more honest conversation about it."["World Suicide Prevention Day seeks to raise awareness," Voice of America.]

Contrary to Wickersham's goal, "honest conversation" about suicide is suppressed in the media when a suicide occurs, often based on well-intentioned but flawed "media guidelines" published by anti-suicide groups. In addition to the fact that these guidelines promote the ethical position that suicide is wrong, I see two major problems with these guidelines: one, they promote myths about suicide as if they were facts; two, they increase the guilt of survivors by portraying suicide as preventable.

The "Media Guidelines for Suicide" on suicide.org advise reporters as follows:

Emphasize the number one cause for suicide:

The number one cause for suicide is untreated depression.

And then indicate that depression is treatable, and thus anyone suffering from depression needs to receive IMMEDIATE help.

This is in contrast to the scientific studies, which show that depression only slightly increases the risk for suicide - a fact which in itself carries little weight, since suicidality is one of the possible criteria for diagnosing depression. According to Thomas Joiner (Why People Die by Suicide, p. 195-196), borderline personality disorder and anorexia nervosa are far more predictive of suicide than depression; BPD has a 10% lifetime risk of suicide and a 50% lifetime rate of at least one very severe suicide attempt.

Even given a slight correlation between depression and suicide, it's overstating the case to say that depression causes suicide - even Thomas Joiner would not agree with that, as stated. It would be more accurate, but less satisfying, to say that the desire to die, coupled with the acquired ability to die, is the leading cause of suicide.

The suicide.org guidelines also recommend using the "fact" that "Over 90% of the people who die by suicide have clinical depression or a similar mental illness when they die." I have extensively attempted to debunk this statistic, but the comfortable idea that suicide is caused by mental illness is hard to dislodge and unlikely to be questioned too closely.

Other "media guidelines" offered by suicide.org range from silly to intrusive to "whoa, thought police":

Do not begin a television newscast with a suicide story.

Do not place suicide stories on the cover of newspapers or magazines.

Never portray suicides as heroic.

Never say that a suicide "ended pain" or "ended suffering." Suicide CAUSES excruciating pain for suicide survivors.

Also, people need to be alive to feel relief from pain. Suicide CAUSES pain.

Do not use the terms "successful suicide" or "committed suicide." Use the term "died by suicide" instead.

The term "committed suicide" is NOT accurate and is VERY hurtful to those who have attempted suicide and to suicide survivors. Say "died by suicide."

The media guidelines proposed by suicide.org strictly fit the definition of politically correct bullshit I proposed in an earlier piece: they express majority opinion in a manner unconcerned with truth, and have the function of a moral taboo to protect an important cultural narrative from negation.

The guidelines promulgated by the National Institutes of Mental Health are much more harmful, however, in that they function to increase the pain and guilt experienced by people close to a person who committed suicide. The message promoted by the NIMH guidelines is that suicide is always preventable, and there are always warning signs. The guidelines advise reporters that

Studies of suicide based on in-depth interviews with those close to the victim indicate that, in their first, shocked reaction, friends and family members may find a loved one’s death by suicide inexplicable or they may deny that there were warning signs. Accounts based on these initial reactions are often unreliable.

That is, there are always warning signs; push family remembers until they "remember" the politically correct story. Reporters are advised to ask survivors questions such as

  • Had the victim ever received treatment for depression or any other mental disorder?
  • Did the victim have a problem with substance abuse?

The message is that there were warning signs that, had the family cared enough to look, would have revealed the suicide's intentions so that the suicide could have been prevented. Unfortunately, this serves to increase the guilt of survivors, legitimize increasingly coercive suicide prevention tactics, and increase the survivors' sense that the suicide was a tragedy because it was "preventable."

The problems I identify - promoting false information and unnecessarily increasing survivors' guilt and pain - are in addition to the harm to the marketplace of ideas that is done in the name of curbing the controversial phenomenon of suicide contagion. A single ethical idea is given precedence over all others, and false facts are repeated in the name of protecting it, and of protecting the institutions that depend on it ("Mention that Suicide.org is available 24 hours a day for anyone who is suicidal," advises suicide.org).

Update: zarathustra at MentalNurse discusses media treatment of suicide in "How should the media report suicide?"

9 comments:

  1. My favorite has to be:

    The term "committed suicide" is NOT accurate and is VERY hurtful to those who have attempted suicide and to suicide survivors. Say "died by suicide."

    WTF? Is the idea that suicide is a symptom of a disease and thus never a choice? Does anyone actually believe this?

    I'd be interested in how you define "well-intentioned."

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    Replies
    1. "WTF? Is the idea that suicide is a symptom of a disease and thus never a choice? Does anyone actually believe this?"

      All sorts of people believe this. Probably most. It's delusional, and it's common, as delusions tend to be.

      But I don't entirely blame them in this case. They're responding to pervasive propaganda.

      Delete
  2. Exactly - you hear this kind of bullshit (in the formal sense) all the time in writing relating to suicide. (Parenthetically, I'd love to study the relative prevalence of bullshit in discourse on various topics.)

    "Commit suicide" is the natural phrase. Yeah, you also commit crimes, but that's not the only use of the verb "commit." "Died by suicide" is so forced and contrived that it calls attention to itself - probably what the self-appointed thought police here are after.

    Does anyone actually believe that suicide is exclusively a disease process and never a choice? Some people are committed to this idea, but I think that's different from saying they really believe it. There's a high degree of cognitive dissonance involved when most people think about suicide. (Cognitive dissonance, I'd bet, is highly correlated with bullshit.)

    ReplyDelete
    Replies
    1. "Does anyone actually believe that suicide is exclusively a disease process and never a choice? Some people are committed to this idea, but I think that's different from saying they really believe it."

      Well, yes, that's quite possible. But then cognitive dissonance so common in people. Do most religious people actually believe in an afterlife? Then why do they care so much about not dying? Why would they even be sad for their child if their religious, faith-believing, innocent child dies?

      It would mean their child is in heaven. What's sad about this?

      But people know, on another level, their child doesn't exist anymore. Our human brains our complex. Most people are delusional -- believing in ghosts or astrology or angels or demons or witches (if you're Christian and believe the Bible is literally true, you also believe in witches) or jinn, or Thor or Wotan or Zeuss or Appolo or L. Ron Hubbard of Joseph Smith or Moroni or ... you get the point ...

      And they would say that a person who actually realizes we're animals, as all evidence shows, and there's probably no afterlife, as no evidence shows, and is unhappy and doesn't want to live for another 30 or so odd years of mixed sorrows and some joys is crazy?

      Well, what do they imagine -- do they think any choice I could possibly undertake will allow me to live forever?

      Because there isn't one.

      It's a matter of balancing pains and pleasures, and I know a f--- of a lot more about that where I am concerned than they do.

      So, of course, they'd force me to live, effectively torturing me. Out of compassion.

      Dumb delusional apes. (we're all apes) (literally)

      Delete
  3. Well-intentioned - intending to do good as one sees "good." One can act from good intentions, but still cause harm because of (a) a poor conception of what is "good" or (b) poor implementation.

    The Rieff book says that a survey around 1960 found that 90% of cancer doctors at that time would not even tell their patients that they had cancer (to avoid their "losing hope"). That's well-intentioned. And probably very harmful.

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  4. "depression causes suicide"

    And broken bones cause casts.

    ReplyDelete
  5. Mariah - it's funny how despite the fact that I firmly believe in the right to suicide, despite all my arguments that suicide is basically a valid moral choice, you in particular I can't help wanting to convince to go on living and that it gets better (at least to get through college and maybe grad school - college fucking rocks).

    I regularly get emails from people trying to cheer me up and convince me that life is great, and I generally see it as disrespectful, if well-intentioned. But I definitely understand the sentiment. I hope that's not disrespectful toward you.

    Anyway, I like the conciseness of your comment even though I'm hypocritically inclined to try to RESCUE YOU from the sentiment behind it.

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  6. As a suicide survivor i found it most meaningful reading this blog. I have noticed that so called specialists gets notably silent and narrow minded when explaining my conviction that my attempt was well-intentioned, not a cause of a sudden stroke of mental disorder. This blog reflect that honest reflection i have been missing. Thanks a lot!

    ReplyDelete
  7. Precise step-by-step instructions on how to end your life painlessly (not tested by me, obviously):

    http://www.youtube.com/watch?v=8mCW7xuCFEQ

    ReplyDelete

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