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Social Trauma and Suicide in Historical Perspective

Howard I. Kushner

Résumés

Les crises économiques et le chômage en Occident sont toujours tenus pour responsables des augmentations périodiques du taux de suicide. Cette croyance est renfoncée par des études et des reportages médiatiques depuis le milieu du xixe siècle. Cette affirmation est soutenue par des données qui proviennent des statistiques officielles des suicides accomplis, malgré d’importantes preuves de leur faillibilité. À partir de méthodes et de classifications douteuses, les chercheurs insistent toujours sur le fait que les comportements et les motivations individuels peuvent être révélés par l’étude de forces sociales – et tout particulièrement économiques – plus larges. Cet article examine la persistance de ces croyances et leur impact sur la politique publique depuis Durkheim. À partir de l’ouvrage souvent cité mais rarement lu de Jack Douglas (Social Meanings of Suicide), je propose une approche alternative sur l’étiologie du suicide qui repose sur le sens social et qui remet en question les postulats essentialistes, selon lesquels les aspirations, les succès et les échecs humains portent toujours le même sens et la même définition. Ces postulats prétendent à l’uniformité culturelle des motivations et de la compréhension du suicide parmi les différents genres, ethnicités et classes.

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Notes de l’auteur

This paper is a revised version of a paper presented at “La pathologie du suicide. Pour une nouvelle histoire des enjeux médicaux et socio-politiques aux 19e et 20e siècles, Institut universitaire d’histoire de la médecine et de la santé publique, Université de Lausanne, 13 June 2016.

Texte intégral

Suicide Epidemic?

  • 1 M. Harvey Brenner, interview in Yale News, “Rising Unemployment Causes Higher Death Rates, New stud (...)

1In the last half-decade, there have been frequent reports of increases in suicide rates in developed countries often characterized as a suicide epidemic. These increases are often tied to social trauma—especially, unemployment. Most of these reports have connected less education with diminished social capital and consequent self-destructive behaviors. For instance, M. Harvey Brenner epidemiologist at Yale University and the National Institutes of Health reported a direct relationship between increasing suicide rates and employment rates for the past sixty years in the United States1.

  • 2 Anne Case and Angus Deaton, “Rising morbidity and mortality in midlife among white non-Hispanic Ame (...)
  • 3 Ibid., p. 15080-5083.

2Examining reports of rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century, Princeton University researchers Anne Case and Angus Deaton (2015) have reported an increase in U. S. mortality and morbidity for the period 1999-2013, reversing earlier mortality trends2. Case and Deaton attribute this increase as unique to the United States. The upsurge, they wrote, was due in great part to increased deaths from drug and alcohol use, resulting in fatal cirrhosis and suicide. In addition they noted that most of these increases were among those with less education and little social capital. According to Case and Deaton, the causes for these increases could be attributed to the fact that “baby-boomers” are the first in the U.S. to fear that they would be worse off than their parents. Those with only a high school education experienced a decline in real wages (adjusted for inflation). Making economic matters worse, the boomers had lost traditional defined-contribution pension plans to 401K plans subject to stock market fluctuations. Moreover, there was a significant increase in Social Security disability, the majority of which Case and Deaton attributed to social stress3.

3Despite Case and Deaton’s assertion that the causes for the increase in suicide were peculiar to American employment conditions, similar reports emerged world-wide. “Unemployment ‘triples suicide risk’” headlined the July 2003 BBC News4 reporting on a study published in the Journal of Epidemiology and Community Health by a team led by Tony Blakely of University of Otago’s School of Public Health in Wellington, New Zealand5. Based on the 1991 New Zealand census, Blakely and his colleagues, S. C. D. Collings and J. Atkinson, found that “among 25–44 year old men and women and 45–64 yearold men there was an approximately twofold to threefold excessrisk of suicide among the unemployed compared with the employed. The connection remained,” according to Blakely, “even when other risk factors such as household income, education and marital status were taken into account”6.

4Similar reports emerged on the European continent. The Institut national de la statistique et des études économiques (INSEE) and Eurostat reported in September 2013 that France had a higher suicide rate (13 per 100,000) than the European average–double that of the UK and Spain7. The authors drew on the work of the widely respected French economist Jean-Claude Delgenes, who tied this to France’s history and economic model: People who have worked for state-run companies cannot adapt to different jobs for which they were not trained and with which they cannot cope8.

  • 9 S. Tavernise, “U.S. Suicide Rate Surges to a 30-Year High”, New York Times, April 22, 2016, https:/ (...)
  • 10 Ibid.

5Most recently the New York Times (22 April 2016) reported the “US Suicide Rate Surges to 30 Year High”9. This was based on data from 1999-2014 (the most recent available) that the U. S. rate rose to 13 per 100,000 highest since 1986. The study found an increase in every group except older adults. This was especially elevated among women aged 45-64 whose rate jumped by 63 percent, making it close to male rates. Men of the same age group reported a 24 percent increase10.

  • 11 Putnam quoted in “U.S. suicide rate surges to a 30-year high”, New York Times, April 22, 2016.
  • 12 Ibid.
  • 13 Ibid.

6According to Harvard University Public Policy professor Robert Putman, the reasons for this increase were attributed to “links between poverty, hopelessness, and health”11. Suicide among middle-aged, explained Julie Phillips, a professor of sociology at Rutgers University, reflects social changes such as the decline of marriage rates among the less educated12. For instance, unmarried middle-aged men were 3.5 times more likely to suicide while unmarried females were at a 2.8 times greater risk. Contributing to these risks was an increase in divorce rates and social isolation. Thus, when the economy got worse suicide increased. All of this could generally be connected to disappointed expectations of social and economic wellbeing among educated white males (baby boomers), who turned to suicide rather than seeking help. Evidence for these claims, asserts Centers for Disease Control and Prevention (CDC) epidemiologist, Alex Crosby, is “that suicide was highest when the economy was weak. One of the highest rates in the country’s modern history, he said, was in 1932, during the “‘Great Depression, when the rate was 22.1 per 100,000, about 70 percent higher than in 201413’”.

Historical Perspective

  • 14 G. Zoroya, “U.S. Military suicides remain high for 7th year”, USA Today, May 4, 2016.
  • 15 H. Braswell and Howard I. Kushner, “Suicide, social integration, and masculinity in the U.S. milita (...)

7In addition to the reports discussed above, over the past decade there has been an outpouring in the media of a great increase in suicide in the American military service14. Increasingly these suicides have been attributed to post-traumatic stress disorder. Much of this discussion has centered on attempts to reduce the risk of suicide among active duty and recent military veterans15.

  • 16 Sebastian Junger, Tribe, On Homecoming and Belonging, New York, Hanchette Group, 2016.
  • 17 H. Braswell and Howard I. Kushner, “Suicide, social integration, and masculinity in the U.S. milita (...)
  • 18 Howard I. Kushner and C. E. Sterk, “The Limits of Social Capital: Durkheim, Suicide, and Social Coh (...)

8Not all veterans who experience trauma commit suicide. Those who do not, writes journalist Sebastian Junger in his 2016 widely cited book Tribe, On Homecoming and Belonging, actually find that military service is protective16. The difficulties many veterans face upon returning home from war, Junger insists, do not stem from the trauma they have experienced, but from the individualist nature of American society. From this perspective modern society is the killer. Junger’s conclusion is not entirely novel nor is it not supported in extensive historical research17. We will return to military suicide later in this paper, but for now it is important to recognize that military suicide rates have been and continue to be more elevated than that of the rest of the population, since statistics were first collected on military suicides in the mid-nineteenth century18.

9This takes us back to the assertion that economic depression, unemployment and social dislocation increase suicide rates because, similar to Junger’s analysis, they disrupt social integration–that is, familial/paternal authority. This has been a persistent belief since the eighteenth century.

  • 19 Il y a longtemps qu'on a dit que la folie est maladie de la civilisation.” Jean-Étienne Esquirol, (...)
  • 20 Howard I. Kushner, “Suicide, gender, and the fear of modernity in nineteenth-century medical and so (...)

10Much like today, the New York Times warned in an 1859 editorial of an “Epidemic of Suicide from Urban life.” That modernity allegedly causes increases of suicide and mental illness, especially among women who adopt masculine gender roles, was a mainstay of nineteenth-century observers. Urbanization, according to this view threatened social cohesion, resulting in increased suicide. As Étienne Esquirol wrote in 1820: “madness is the disease of civilization”19. As I have written elsewhere, this was a widely held assumption made by a long list of European, British, and American social commentators including Jean-Pierre Falret, France (1822), Forbes Winslow, Britain (1840), Amariah Brigham, USA (1845), Adolphe Quetelet, Belgium (1848), Brierre de Boismont, France (1855), Louis Bertrand, France (1857) Enrico Morselli, Italy (1881), and Thomas Masaryk, Czechoslovakia (1881)20.

  • 21 Émile Durkheim, “Suicide et natalité. Étude de statistique morale”, Revue philosophique de la Franc (...)

11These writers insisted that women in the labor force results in social disintegration of family and often suicide. Thus, the family (like Junger’s military) provides social integration and paternalism, serving as the primary defense against social disintegration. This thinking came together in the analyses of Émile Durkheim (1858-1917), who argued that the incidence of marriage, divorce, homicide, or suicide could be predicted if the social forces that determined them could be identified21.

  • 22 Howard I. Kushner and C. E. Sterk, “The Limits of Social Capital: Durkheim, Suicide, and Social Coh (...)
  • 23 Émile Durkheim, Le suicide. Étude de sociologie, Paris, F. Alcan, coll. Bibliothèque de philosophie (...)
  • 24 H. I. Kushner and C. E. Sterk, “The Limits of Social Capital: Durkheim, Suicide, and Social Cohesio (...)

12As sociologist Claire Sterk and I have written elsewhere, Durkheim’s hypothesis was and remains the basis for much of modern sociology, philosophy, and public health assumptions for predicting risks for suicide in specific populations22. Durkheim’s (1897) Suicide: A Study in Sociology serves as exemplar of his wider theory. Social disintegration, according to Durkheim, resulted in increases in suicide rates. “When a society is disturbed by some painful crisis or by beneficent but abrupt transitions, it is momentarily incapable of exercising this [moral] influence; thence come the sudden rises in the curve of suicides”23. Durkheim’s Le Suicide formed the theoretical basis for almost all sociological studies of suicide that followed24.

  • 25 Ibid., p. 1140.
  • 26 Ruth S. Cavan, Suicide, Chicago, University of Chicago Press, University of Chicago sociological se (...)
  • 27 Howard I. Kushner, American suicide: a psychocultural exploration, New Brunswick, Rutgers Universit (...)

13Studies linking suicide with economic trauma adopted Durkheim’s theory of social disintegration, relying on official statistics of completed suicides in order to search for individual motives, something that Durkheim rejected25. This was especially evident in the influential studies of the so-called Chicago School of sociology in the 1930s. Emblematic was Ruth Cavan’s 1928 study Suicide, which asserted that suicide rates were highest where social support organizations were weak26. That was because there were fewer impediments to an individual’s acting on the belief that suicide was a legitimate solution to personal problems. But Cavan could not demonstrate that those who committed suicide actually lived in less stable social settings than those unemployed who did not kill themselves27.

  • 28 Andrew F. Henry and James F. Short, Suicide and homicide; some economic, sociological, and psycholo (...)
  • 29 Howard I. Kushner, American suicide: a psychocultural exploration, op. cit., p. 68-69.

14Moving beyond the ecological theories of the Chicago School, sociologists Andrew N. Henry and James F. Short’s (1954) Suicide and Homicide argued that fluctuations in the business cycle lead to increases in homicide or suicide. A decrease in frustration leads to diminished violence. Whether frustration results in suicide or homicide depends upon the “preference” of one’s reference group28. But Henry and Short could not link suicides or homicides reported during economic downturns to individuals who were directly affected by these business cycles. Thus, the frustration/aggression model rests on questionable assumptions that frustration automatically transformed into aggressive behavior29.

  • 30 Louis I. Dublin, Suicide: A Sociological and Statistical Study, New York, Ronald Press, 1963; Howar (...)
  • 31 Howard I. Kushner, American suicide, op. cit., p. 67-68.

15In 1963 Louis I. Dublin, chief statistician for the Metropolitan Life Insurance Company, published his influential and comprehensive, Suicide: A Sociological and Statistical Study. Dublin’s main focus was to identify those at greatest risk for suicide, a population the insurance industry was eager to identify. Dublin was not persuaded that Henry and Short’s frustration/aggression hypothesis provided a robust predictive model. “Suicides,” wrote Dublin, “are precipitated by [the] economic and social maladjustments under which we all live”30. He pointed especially to unemployment as a factor that causes suicide to multiply, but his data revealed that economic conditions were proximate causes for only part of the population. Dublin conceded that “countless persons, faced with what appear to be the same provocations, do not commit suicide.” Thus, he was forced to conclude that “the suicidal drive in the last analysis is from within the individual rather than from without”31.

  • 32 Ronald W. Maris and Bernard M. Lazerwitz, Pathways to suicide: a survey of self-destructive behavio (...)

16In a 1981 book, Pathways to Suicide: A Survey of Self-Destructive Behaviors, sociologist Ronald Maris suggested that the limitations of his predecessors to create a model to predict both risk and etiology could be overcome by focusing on “suicide careers.” In his novel and inclusive model, suicidal ideation could be identified by examining the intersection of experiences with attitudes and behaviors that in combination increased the risk of individual suicides32. These included factors such as lack of non-suicidal alternatives:

- Availability and acceptability of suicide as solution to real or perceived conditions
- Individual unfitness–biological, psychological, or social–for life’s struggles
- Weak tolerance for adaptation to problems
- Addiction
- Aging
- Negative interpersonal relationships

  • 33 Howard I. Kushner, American suicide, op. cit., p. 70-72.

17Although Maris’s arguments are creative and comprehensive, his list is so inclusive that it could be read retrospectively into any suicide’s life33.

  • 34 29 Glyn Lewis and A. Sloggett, “Suicide, deprivation, and unemployment: record linkage study”, Brit (...)

18Meanwhile the connection between increasing suicide rates and unemployment persisted; indeed, it meshed with many of the factors that Maris had identified as suicide risks. For instance, researchers Glyn Lewis and Andy Sloggett, examining suicide rates among the unemployed in England and Wales, reported a higher risk for suicide during 1983-1992 among those who were recorded as unemployed in the 1981 census compared to those then recorded as employed. “Association between suicide & unemployment”, they concluded, “is more important than the association with other socioeconomic measures”34.

  • 35 Isacsson, G., “The Conclusion of a Causal Link Between Unemployment and Suicide Cannot be Drawn”, L (...)
  • 36 Ibid., p.1283.

19However, like so many that preceded them, Lewis and Sloggett could not validate the exposure they assumed. In a letter to the British Medical Journal (20 January 1999), the Swedish researcher Göran Isacsson argued that Lewis and Sloggett’s claim “of a causal relationship between unemployment and suicide cannot be drawn” because exposure (to employment) was not validated35. The “subjects recorded as unemployed in 1981,” wrote Isacsson, “may have been employed during the 2-11 years thereafter, and vice versa”. Lewis and Sloggett, according to Isacsson, seem to have conflated unemployment with the “fact that suicide is overrepresented among people with mental disorders (including alcohol and substance abuse)”36. Thus, it is likely that many of the “unemployed” suicides, the unemployment in 1981 as well as the subsequent suicides were consequences of their mental disorders.

  • 37 David Lester and B. Yang, “Unemployment and Suicidal Behavior”, Journal of Epidemiology and Communi (...)
  • 38 Ibid.

20A more recent Blakely study, according to David Lester and B. Yang, provides “excellent support for the association between unemployment and completed suicide at the individual level,” but the data is “more reliable at the individual than at the aggregate level”37. Based on their data of fourteen nations for the period 1950-1985, Lester and Yang “found a positive association between unemployment and completed suicide rates in only 10 nations and this association was statistically significant in only four nations”38.

  • 39 Isacsson, “The Conclusion of a Causal Link Between Unemployment and Suicide Cannot be Drawn”, in op (...)
  • 40 D. Ezzy, “Unemployment and mental health: a critical review”, Social Science & Medicine, July 1993, (...)

21Indeed, a number of studies have suggested that unemployment may have protective features for some populations and individuals. For instance, Isacsson reported that “unemployment rates in Sweden increased 5-fold from 1990 to 1994 while suicide rates fell 14% during the same period”39. D. Ezzy found that unemployment does not always impact negatively on mental health. In fact, he found that the psychological wellbeing actually improves for some people who become unemployed40.

22Despite criticisms such as these, the assumption that unemployment leads to increases in suicide continues unabated. Why? The reason is that the claim is based on a compelling social theory (Durkheim), rather than the data, which, on the one hand is almost always questionable and, on the other, can easily be interpreted in ways that undercut the conclusions drawn from it. Thus, we must return to Durkheim to examine the classification system he created and its influence on the data that emerged.

Durkheim Revisited

  • 41 Émile Durkheim, Suicide: A Study in Sociology, New York, Free Press, 1951. p. 44. Italics in origin (...)
  • 42 Christian Baudelot et Roger Establet, Durkheim et le suicide, Paris, PUF, 1984, p. 50, and p. 74-75 (...)

23Durkheim defined suicide as “death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result41. However, Durkheim’s analysis relied on official suicide statistics that were collected without regard to his definition. For instance, those who sacrificed their lives for others were never recorded in official statistics; those whose deaths resulted only “indirectly” from their acts generally did not appear in the statistics either42. Indeed, Durkheim must have known that those officials charged with the determination of whether an act was a suicide almost always labeled antisocial (socially disintegrative) acts as suicide, while they almost never called a socially sanctioned (integrative) behavior (heroism) suicide. The unquestioned assumption that suicide was an antisocial act was, after all, why Durkheim had chosen it as an indicator of social pathology in the first place. Apparently, Durkheim never considered the possibility that the belief–shared by official statistics collectors and interpreters of suicide–that suicide was antisocial behavior had, a priori, distorted suicide statistics.

  • 43 Émile Durkheim, Suicide, op. cit., p. 258, also see p. 246 and 252.
  • 44 Émile Durkheim, Suicide, op. cit., p. 241-258, esp. p. 246, 252, 258.
  • 45 Ibid., p. 276.
  • 46 Most subsequent studies, even those that claim to reevaluate Durkheim's Suicide, have ignored fatal (...)

24Although Durkheim described four types of suicide–altruistic, egoistic, anomic, and fatalistic–he elaborated only the first three and assigned the fourth, fatalistic, to a footnote. Because Durkheim wanted to demonstrate that the rate of suicide provided a way to measure social pathology, his typology was created to uncover the “regular and specific factor[s] in suicide in our modern societies”43. As Durkheim defined them, both anomie and egoism resulted from the collapse of traditional restraints and, thus, their incidence could be used as an index for social pathology: the rate of anomic suicide measured alienation, while the rate of egoistic suicide measured the decline of self-restraint. Altruistic suicide, on the other hand, reflected socially sanctioned self-sacrifice and, as such, provided the base rate of suicide against which Durkheim could contrast the increase of suicide brought on by the breakdown of social integration (which he attributed to anomic and egoistic behavior) 44. Although the construct of altruistic suicide makes theoretical sense, such acts (heroism) were never reported as suicides. There could be almost no fatalistic suicides because Durkheim claimed that “it has so little contemporary importance and examples are so hard to find […] that it seems useless to dwell upon it”45. As a result, subsequent studies ignored fatalistic suicide46.

25Durkheim followers have focused on suicide, anomie and egoism–ignoring altruism and fatalism. But highest rates then and now are among the military, which he labeled altruism, sacrificing one’s life for another. The lowest reported rate was among women (and children), but if attempted suicides are included they are higher than even in the military. Durkheim’s definition of fatalistic suicide as resulting “from excessive regulation,” whose “passions [were] violently choked by oppressive discipline,” seemed to describe nineteenth-century military and women’s lives perfectly. Durkheim’s typological definitions should have led him to classify military and female suicide as fatalistic. Thus, suicide was tied to over-integration, fatalism, rather than to social disintegration, anomie.

Turning Durkheim Upside Down

  • 47 Roger Lane, Violent death in the city: suicide, accident, and murder in nineteenth-century Philadel (...)
  • 48 Ibid.

26Roger Lane’s 1979 study, Violent Death in the City: Suicide & Social Integration, turned Durkheim’s social disintegration theory on its head47. As nineteenth-century black Philadelphians became more socially integrated, their homicide rates declined and their suicide rates increased. Social integration increases suicide rates because anger is internalized. Social disintegration results in higher homicide rates because anger is externalized. The effect of social trauma is mediated by a person’s sense of identification or lack of identification with their wider environmental-social meaning and family48.

  • 49 Jack D. Douglas, The social meanings of suicide, Princeton, Princeton University Press, 1967, p. XI (...)
  • 50 Official suicide statistics, derived from state and federal reporting, are based on compilations of (...)
  • 51 Jack D. Douglas, The Social Meanings of Suicide, op. cit., p. 271-283, 155. Italics in original.

27In 1967 sociologist Jack Douglas, published Social Meaning of Suicide, a book that most researchers cite, but apparently few have read. Douglas examines the impact of social events, reminding us that individual behavior is determined always by the meaning that individuals give experience and events49. Researchers who rely on official suicide statistics50 are locked into the assumption that social meaning is the same for everyone; “that aspirations, failure, etc., are everywhere defined in basically the same manner […] so that there are no cultural differences in these matters, or in suicidal matters, between classes”51.

  • 52 Ibid.

28Individual reactions and behaviors in the face of economic downturns, Douglas insists, depend on social meaning which an individual attaches to unemployment or dominant social values52. Qualitative data (coroners’ reports, interviews with suicide survivors, suicide attempters) suggests that when only a few individuals lose their jobs, they may be a greater risk for suicide because they are more likely to internalize the job loss. When large numbers lose economic status or employment, they are less likely to internalize the loss and, therefore, less likely to kill themselves.

Conclusion: From Populations to Individuals

  • 53 Émile Durkheim, Suicide, op. cit., p. 277-278. Durkheim’s study sometimes was ambiguous on this iss (...)

29Durkheim was reluctant to move from predicting suicide rates to explaining individual behavior: “Each victim of suicide gives his act a personal stamp which expresses his temperament, the special conditions in which he is involved, and which, consequently, cannot be explained by the social and general causes of the phenomenon53”. But most sociologists who followed him called on Durkheim’s methods and theory to identify the etiology of individual suicides.

30As I have been suggesting throughout this essay, there are alternative interpretations of the connection between social trauma, social capital, and suicidal etiology. These are based on qualitative analysis of individual data (interviews, coroners’ reports) before applying quantitative analysis. And, they require reinterpretation of Durkheim’s typology of anomie, egoism, altruism, and fatalism.

31Translation of quantitative data into individual motives is problematic because we cannot assume that each unit of datum (the individual suicide) acts just like every other unit in response to external forces such as social trauma. Social, economic, and political events have different social meanings for each person and group in a population.
Population (quantitative) studies of suicide can be given individual social meaning only through qualitative analysis. That is, through history.

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Bibliographie

Baudelot Christian and Establet Roger, Durkheim et Le Suicide, 1st ed., Paris, PUF, 1984.

Blakely T. A., Collings S. C. D. and Atkinson J., “Unemployment and Suicide. Evidence for a Causal Association?”, Journal of Epidemiology and Community Health, 2003, 57 (8), p. 594-600.

Braswell H., and Kushner H. I., “Suicide, Social Integration, and Masculinity in the U.S. Military,” Soc Sci Med, 2012, 74 (4), p. 530-536.

Brenner M. Harvey, “Rising Unemployment Causes Higher Death Rates, New study by Yale Researcher Shows”, interview in Yale News, 23 May 2002, p. 1-2.

Case Anne and Deaton Angus, “Rising Morbidity and Mortality in Midlife among White Non-Hispanic Americans in the 21st Century”, Proceedings of the National Academy of Sciences, 112 (49), 2015, p. 15078-15083.

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Delgenes Jean-Claude, “Le suicide ne doit pas faire exception au traitement de l'information”, Le Huffington Post, September 9, 2016. URL : http://www.huffingtonpost.fr/bloggers/jean-claude-delgenes/

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Ezzy D., “Unemployment and Mental Health: A Critical Review”, Soc Sci Med, July 1993, 37 (1), p. 41-52.

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Isacsson G., “The Conclusion of a Causal Link Between Unemployment and Suicide Cannot be Drawn”, letter to editor, BMJ, 1998, 317, p. 1283.

Junger Sebastian, Tribe: On Homecoming and Belonging, New York, Hanchette Group, 2016.

Kushner Howard I. and Sterk Claire. E., “The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion”, American Journal of Public Health, July 2005, 95, p. 1139-1143.

Kushner Howard I., American Suicide: A Psychocultural Exploration, New Brunswick, Rutgers University Press, 1991.

Kushner Howard I., “Suicide, Gender, and the Fear of Modernity,” in David Wright and John Weaver (eds.), Studies on Suicide and History, Toronto, University of Toronto Press, 2008, p. 19-52.

Kushner Howard I., “Suicide, Gender, and the Fear of Modernity in Nineteenth-Century Medical and Social Thought”, Journal of Social History, 1993, 26, p. 461-490.

Kushner Howard I., “Women & Suicidal Behavior: Epidemiology, Gender, & Lethality in Historical Perspective”, in Silvia Sara Canetto and David Lester, Women and Suicidal Behavior, New York, Springer Publishing Co., 1995, p. 11-34.

Lane Roger, Violent Death in the City: Suicide, Accident, and Murder in Nineteenth-Century Philadelphia, Cambridge (Mass.), Harvard University Press, 1979.

Lester David and Yang B., “Unemployment and Suicidal Behavior”, Journal of Epidemiology and Community Health, 2003, 57, p. 558-559.

Lewis G. and Sloggett A., “Suicide, Deprivation, and Unemployment: Record Linkage Study”, BMJ, (Nov 07) 1998, 317 (7168), p. 1283-1286.

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Notes

1 M. Harvey Brenner, interview in Yale News, “Rising Unemployment Causes Higher Death Rates, New study by Yale Researcher Shows,” 23 May 2002, p. 1-2.

2 Anne Case and Angus Deaton, “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century”, Proceedings of the National Academy of Sciences, 112(49), 2015, p. 15078-15083.

3 Ibid., p. 15080-5083.

4 http://news.bbc.co.uk/2/hi/health/3102933.stm

5 Tony A. Blakely, S. C. D. Collings and J. Atkinson, “Unemployment and suicide. Evidence for a causal association?”, Journal of Epidemiology and Community Health, 57(8), 2003, p. 594-600.

6 Ibid., p. 594. Employment was associated with 6 percent of all suicides. The team acknowledged that mental illness was a factor in approximately 50 percent of all suicides.

7 http://www.thelocal.fr/20130910/why-france-has-such-a-high-suicide-rate. Also see Jean-Claude Delgenes, “Le suicide ne doit pas faire exception au traitement de l'information” Huffington Post, September 9, 2016, http://www.huffingtonpost.fr/bloggers/jean-claude-delgenes

8 Ibid.

9 S. Tavernise, “U.S. Suicide Rate Surges to a 30-Year High”, New York Times, April 22, 2016, https://www.nytimes.com/2016/04/22/health/us-suicide-rate-surges-to-a-30-year-high.html

10 Ibid.

11 Putnam quoted in “U.S. suicide rate surges to a 30-year high”, New York Times, April 22, 2016.

12 Ibid.

13 Ibid.

14 G. Zoroya, “U.S. Military suicides remain high for 7th year”, USA Today, May 4, 2016.

15 H. Braswell and Howard I. Kushner, “Suicide, social integration, and masculinity in the U.S. military”, Social Science & Medicine, 74(4), 2012, p. 530-536.

16 Sebastian Junger, Tribe, On Homecoming and Belonging, New York, Hanchette Group, 2016.

17 H. Braswell and Howard I. Kushner, “Suicide, social integration, and masculinity in the U.S. military”, op. cit., p. 530-536.

18 Howard I. Kushner and C. E. Sterk, “The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion”, American Journal of Public Health, 95, July 2005, p. 1139-1143.

19 Il y a longtemps qu'on a dit que la folie est maladie de la civilisation.” Jean-Étienne Esquirol, "De La lypémanie ou mélancolie," [1820], Des maladies mentales, vol. 1, Paris, 1838, p. 400-401.

20 Howard I. Kushner, “Suicide, gender, and the fear of modernity in nineteenth-century medical and social thought”, Journal of Social History, 26, 1993, p. 461-490; Howard I. Kushner, “Suicide, Gender, and the Fear of Modernity”, in D. Wright and J. Weaver (dir.), Studies on Suicide and History, Toronto, University of Toronto Press, 2008, p. 19-52.

21 Émile Durkheim, “Suicide et natalité. Étude de statistique morale”, Revue philosophique de la France et de l’étranger, 26, 1888, p. 446-463; Émile Durkheim, De la division du travail social, Paris, F. Alcan, 1893.

22 Howard I. Kushner and C. E. Sterk, “The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion”, op. cit., p. 1139-1143.

23 Émile Durkheim, Le suicide. Étude de sociologie, Paris, F. Alcan, coll. Bibliothèque de philosophie contemporaine, 1897, p. XII.

24 H. I. Kushner and C. E. Sterk, “The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion”, op. cit.

25 Ibid., p. 1140.

26 Ruth S. Cavan, Suicide, Chicago, University of Chicago Press, University of Chicago sociological series, 1928, p. XXVII.

27 Howard I. Kushner, American suicide: a psychocultural exploration, New Brunswick, Rutgers University Press, 1991, p. 65-66.

28 Andrew F. Henry and James F. Short, Suicide and homicide; some economic, sociological, and psychological aspects of aggression, Glencoe, Free Press, 1954.

29 Howard I. Kushner, American suicide: a psychocultural exploration, op. cit., p. 68-69.

30 Louis I. Dublin, Suicide: A Sociological and Statistical Study, New York, Ronald Press, 1963; Howard I. Kushner, American suicide, op. cit., p. 67-68.

31 Howard I. Kushner, American suicide, op. cit., p. 67-68.

32 Ronald W. Maris and Bernard M. Lazerwitz, Pathways to suicide: a survey of self-destructive behaviors, Baltimore, Johns Hopkins University Press, 1981, p. XXII.

33 Howard I. Kushner, American suicide, op. cit., p. 70-72.

34 29 Glyn Lewis and A. Sloggett, “Suicide, deprivation, and unemployment: record linkage study”, British Medical Journal, 317(7168), 1998, p. 1283.

35 Isacsson, G., “The Conclusion of a Causal Link Between Unemployment and Suicide Cannot be Drawn”, Letter to Editor, BMJ, 317, 7 November 1998, p. 1283.

36 Ibid., p.1283.

37 David Lester and B. Yang, “Unemployment and Suicidal Behavior”, Journal of Epidemiology and Community Health, 57, 2003, p. 558.

38 Ibid.

39 Isacsson, “The Conclusion of a Causal Link Between Unemployment and Suicide Cannot be Drawn”, in op. cit., p. 1283.

40 D. Ezzy, “Unemployment and mental health: a critical review”, Social Science & Medicine, July 1993, 37(1), p. 41-52.

41 Émile Durkheim, Suicide: A Study in Sociology, New York, Free Press, 1951. p. 44. Italics in original. See Durkheim, Le suicide. Étude de sociologie, Paris, PUF, 1986, p. 5. Italics in original.

42 Christian Baudelot et Roger Establet, Durkheim et le suicide, Paris, PUF, 1984, p. 50, and p. 74-75. Also see Howard I. Kushner, “Women and suicidal behavior: epidemiology, gender, and lethality in historical perspective”, in S. S. Canetto and David Lester (dir.), Women and Suicidal Behavior, New York, Springer Publishing, 1995, p. 11-34.

43 Émile Durkheim, Suicide, op. cit., p. 258, also see p. 246 and 252.

44 Émile Durkheim, Suicide, op. cit., p. 241-258, esp. p. 246, 252, 258.

45 Ibid., p. 276.

46 Most subsequent studies, even those that claim to reevaluate Durkheim's Suicide, have ignored fatalistic suicide. For instance, in their attempt to “lire Le suicide, pour en extraire une méthode d'analyse aujourd'hui encore applicable au suicide et à d’autres faits sociaux”, Baudelot and Establet review only the “trois grands types de suicides […] le suicide égoïste […] le suicide altruiste,” and “le suicide anomique” ; In fact, their study never mentions fatalistic suicide. It is, therefore, not surprising that they have concluded that Durkheim’s assertion that men were more suicidal than women has stood the test of time. Baudelot et Establet, Durkheim et le suicide, in op. cit., p. 10-11, see also p. 99-103. Also see Baudelot and Establet, “Suicide : l’évolution séculaire d’un fait social”, Économie et statistique, 1984, 168, p. 59-70.

47 Roger Lane, Violent death in the city: suicide, accident, and murder in nineteenth-century Philadelphia, Cambridge, Mass., Harvard University Press, 1979, p. XIII.

48 Ibid.

49 Jack D. Douglas, The social meanings of suicide, Princeton, Princeton University Press, 1967, p. XIV.

50 Official suicide statistics, derived from state and federal reporting, are based on compilations of Coroners’ Reports that are notoriously unreliable because, among other things, they lack uniform definition. Data collection often is influenced by unspoken assumptions about what constitutes a suicide. The classification of an act as a suicide is idiosyncratic; it reflects what a society or culture believes constitutes a suicide. In addition, they exclude attempted suicide. Most studies acknowledge unreliability of suicide statistics, but ignore their own warnings.

51 Jack D. Douglas, The Social Meanings of Suicide, op. cit., p. 271-283, 155. Italics in original.

52 Ibid.

53 Émile Durkheim, Suicide, op. cit., p. 277-278. Durkheim’s study sometimes was ambiguous on this issue. Italics added. For instance, later in his text (p. 300) he asserted: “There is nothing which cannot serve as an occasion for suicide. It all depends on the intensity with which the causes have affected the individual.”

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Howard I. Kushner, « Social Trauma and Suicide in Historical Perspective », Criminocorpus [En ligne], La pathologie du suicide, Communications, mis en ligne le 14 mai 2018, consulté le 27 mai 2018. URL : http://journals.openedition.org/criminocorpus/3845

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Auteur

Howard I. Kushner

Howard I. Kushner is the Nat C. Robertson Distinguished Professor of Science & Society Emeritus at Emory University in Atlanta, Georgia and the John R. Adams Professor of History Emeritus at San Diego State University. At Emory, Kushner held joint appointments as Professor in the Department of Behavioral Sciences and Health Education in the Rollins School of Public Health, in Emory’s Programs in Human Health and in Neuroscience and Behavioral Biology, as well as in the Graduate Institute of Liberal Arts. At SDSU, Kushner is also Adjunct Professor in the Graduate School of Public Health. In 2015, he joined the Laboratory of Comparative Human Cognition in the Communications Department of the University of California, San Diego.
Kushner’s current research focuses on the possible connections between handedness, laterality, and learning disorders. He is author of five books, including On the Other Hand: Left Hand, Right Brain, Mental Disorder, and History (Johns Hopkins University Press, 2017), A Cursing Brain? The Histories of Tourette Syndrome (Harvard University Press, 1999), American Suicide: A Psychocultural Exploration (Rutgers University Press, 1991), and numerous articles on the history of suicide and addiction.

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