'Suicidology's cultural turn, and beyond'
Many anthropologists are probably familiar with Émile Durkheim’s (1951) famous study of suicide as a societal phenomenon. However, fewer anthropologists may be familiar with the field of suicidology, a branch of research devoted to examining not only the act of self-killing, but also risk factors, related prevention strategies, and interventions. Suicidology – or what may be thought of for critical purposes as mainstream suicidology – often takes a psychopathological approach to suicide and suicide prevention. Emerging as an academic field over the last fifty years, mainstream suicidology has predominately viewed suicidal thoughts and acts as symptoms of mental illness, particularly depression. This framework gives way to medical, psychological, and social interventions, such as pharmaceutical treatments and hospitalization. Mainstream suicidology has focused on identifying risk factors for suicidality, studying constructs such as hopelessness, the need to escape, deep psychological pain, feelings of not belonging, and burdensomeness. Positivistic and quantitative studies are privileged, repeating and reifying emphases on pathology, the individual, and a science orientation (Marsh 2016).
Earlier this year, practitioners and researchers united from all over the world to organize efforts and dialogue toward a more open and inquisitive suicidology. If the current paradigm is so inclusive of suicide experience then how is it we see little improvement in suicide rates, and even sometimes drastic increases? Should suicide always, usually, or ever be conceptualized solely as mental illness or sickness? How can we engender and disseminate deeper understandings of this phenomenon? Hosted by the Czech Academy of Sciences, ‘Suicidology’s Cultural Turn, and beyond’ attempted to address these questions on 19–20 March 2016 at the picturesque Vila Lanna in Prague, Czech Republic. Organizers temporarily labeled the field ‘criticalsuicidology’, calling into question current models of suicide research, prevention, and even classification. Presenters challenged what they view as narrow, potentially flawed, dominant models of prevention and intervention, and the very ways in which suicide is conceptualized: as an preventable phenomenon, and as an experience generalizable across cultures, locations, and human groups. This more recent field of critical suicidology seeks to understand salient cultural and political aspects of suicide, using qualitative approaches to contextualize the phenomenon as it occurs throughout the world.
Disciplines represented included anthropology, philosophy, linguistics, clinical and community psychology, journalism, social work, and more. Informants and research sites seemed as diverse as speakers’ disciplines. However, research questions seemed dominated by anthropological thinking, often beginning with the understanding of psychopathology as just one way to understand self-killing behaviors and associated meanings, rather than an empirical universal truth.
Several presenters demonstrated the power of culturally relativistic perspectives – suicide as a phenomenon to be studied understood within the context of individual cultures – and how these perspectives could deepen and broaden knowledge and intervention strategies. This local knowledge showed success and new potential for culturally relevant suicide prevention and intervention, eschewing the ‘one-size-fits-all’ approach of mental illness treatment that mainstream suicidology offers. In Michael Kral’s (Wayne State University) research with the Inuit and Leslie McGregor’s (Whitefish River Community Health Center, Canada) work with a Canadian First Nation community, grassroots community organizing has led to successful interventions designed and implemented by the community members themselves. Kral and McGregor showed that in these communities participant-organized youth programs, community education about warning signs, and returns to traditional ceremony and ritual seem to have affected the rate of attempted and completed suicides. Where and when such efforts were implemented the rate of suicides in these communities dropped substantially, in one instance to zero. Similarly, data from a seven-year qualitative study conducted by Joseph Osafo, Charity Akotia (both of University of Ghana), Birthe Loa Knizek, and Heidi Hjelmeland (both of Norwegian University of Science and Technology) led these researchers to recommend stigma-reduction programs particular to Ghanaian concepts of morality. Difficult and problematic as the concept of ‘culture’ can be to pin down, presenters at this conference showed the value and variety of rich, local understandings of suicide that can be obscured by adherence to studying dominant, supposedly unifying constructs fitting into a mental illness framework.
Others approached the study of suicide through historical analyses, deconstructing the current dominant paradigm of self-killing as always wrong and something one always needs to be saved from or treated for. Margaret Battin (University of Utah) presented myriad sources showing variance in ethical positions throughout time, attempting to complicate and intensify traditional ethical debates surrounding the question of whether what is called ‘suicide’should also be called ‘wrong’ in all cases. Maria Teresa Brancaccio (Maastricht University) and David Lederer (National University of Ireland Maynooth) used historical sources to trace the origin of suicide intervention to life-saving techniques, funding, and philosophies. They posited that humane societies providing rewards for citizens saving drowning victims in eighteenth-century Europe may have shaped current medical and legal frameworks implicit in suicide intervention and suicidology. These and similar qualitative studies problematized singular definitions of ‘suicide’ and showed the complex historical and political aspects of self-killing.
An anthropologically informed suicidology seems best obtained through widening epistemological approaches to include more constructivist methodologies. Thus, many presenters directly challenged what they considered dogmatic epistemology and philosophy at work in suicidology with the hope of shaping a new future. Ian Marsh (Canterbury Christ Church University) sought to problematize current constructions of suicide that claim experiences of suicide can and should be reduced to universal variables, offering anthropological lenses such as personhood and agency to work in expanding and modifying these constructions. Johnny Morris (University of Victoria) showed how studying narratives might contribute to shifts in policy and practice through research that questions dominant discourses of power, race, and neoliberal ideology within suicidology. Borrowing from discussions of ethics, wonder, and knowledge in continental philosophy, Katrina Jaworski (University of South Australia) envisioned a critical suicidology that uncouples morality and ethics. She suggested critical suicidology could avoid the pitfalls perceived in mainstream suicidology, such as moralizing and medicalizing the suffering and pain of suicide, and by adopting an ‘ethics of wonder and generosity’ going forward in study and practice. Jennifer White (University of Victoria) also offered visions of what critical suicidology may look like going forward, beginning with the work of answering the ‘who, what, when, and how’ of critical suicidology’s future in troubling and transforming mainstream thought and action.
This was revisited at the close of the conference, when co-organizer and host Ludĕk Brož (Institute of Ethnology, Czech Academy of Sciences) led the group in a discussion addressing questions raised over the two-day event. How will critical suicidology go forward? What are the short-term and long-term goals for affecting mainstream ideologies? Must critical suicidology always exist; will a critical view always be necessary in consideration of dynamic and diachronic cultures and contexts? Will this field even embrace the label of ‘critical suicidology’or adopt something less subversive and deterministic in relation to mainstream suicidology? The group decided to begin by drafting a mission statement to be included on a forthcoming critical suicidology website where those engaging in critical research and perspectives can communicate, share, debate, and possibly even publish papers online.
About the author
C.M. Cassady is pursuing a joint PhD in social work and anthropology at Wayne State University in Detroit, MI. Her research focuses on human experiences with chronic illness and the end of life, including interventions through community organizations and the analysis of language ideology and meaning in discourses on physician-assisted dying.
Durkheim, Émile. (1897) 1951. Suicide: A Study in Sociology. John A. Spaulding, trans. New York: The Free Press.
Marsh, Ian. 2016. ‘Critiquing Contemporary Suicidology’. In Critical Suicidology: Transforming Suicide Research and Prevention for the 21st Century, edited by Jennifer White, Ian Marsh, Michael J. Kral, and Jonathon Morris, 15–30. Vancouver: University of British Columbia Press.