Suicide is defined as death caused by self-directed injurious behavior with any intent to die as a result of the behavior (Cdc.gov, 2014). It is a dark word that often evokes a negative emotional response in most minds and hearts but nonetheless it has also become famous and scandalous due to its rich association with the demise of famous figures such as Cleopatra, Earnest Hemmingway and so many more. Thanks to media, suicide has become the most intriguing and sensational form of death. But away from this list of the rich and famous victims, there are thousands more of promising lives which are lost each year to this tragic form of demise. According to World Health Organization (WHO) a life is lost to the act of suicide every 40 seconds that accounts for more than 800000 every year (Who.int, 2014). It is the second leading cause of death amongst individuals aged between 10-24 years of age.
Sample Case of Suicide
Unfortunately, Alviss Kong, aged 22 years also became part of this statistic on Wednesday 13th September 2010 (Thestar.com.my, 2014). He had jumped off from his residence on the 14th floor apartment due to his distress over a recent breakup of a 4 months old relationship. It became famous due to the fact that he posted the suicide plan on his Facebook status, a few hours after which he carried it out and found sprawled on top of a car. Final photos of himself looking severely depressed with tears streaking down was tagged on Facebook along with a farewell note (HubPages, 2014). Alviss had previously attempted suicide once over a similar break up but was unsuccessful. Pouring over some articles related to Alviss, it is apparent the suicidal signs where all over the place long before he actually succeeded in taking his own life. In the aftermath predictably the question on everyone’s mind is, “Why did he decide to do it”. Thus, in this report we elaborate on four perspectives which applies best to Alviss’s tragic decision and untimely death. One should always bear in their mind that the causes for suicide often encompasses a varying combination of various perspectives, never just one.
Keeping the psychodynamic model as reference we know that Alviss was very depressed. His girlfriend was his object when we analyse according to the object relations theory and he his egos seem to be in a conflicting state of affairs. He appears to have his self-esteem connected to his former girlfriend. From the behavioural perspective it very lucid he has conditioned himself favourably towards the idea of committing suicide as the means to give him an escape route for the conflicting feeling he experiencing. Having had attempted suicide once, he had high potential to repeat it again. His negative reinforcements seems have been strengthened further. Going into humanistic perspective it is once again glaring Alviss’s desire and goals were not met in terms of belonging and love, esteem and this includes the failure of self-actualization. As for the sociocultural perspective to be discussed in this report, Alviss’s suicide appears to fall into the anomic category. Each of the mentioned perspectives are discussed further below.
Perspectives on What Causes Suicidal Behavior
2.1 Psychodynamic Perspective
Sigmund Freud is the founder of psychoanalysis and psychodynamic methodology towards decrypting psychology. His theories influenced and laid down the foundation of many works including that of Erik Erikson, Carl Jung, and Alfred Adler (McLeod, 2007). Psychodynamic approach includes conscious, preconscious and unconscious aspects. Freud believes that human thought, feelings, and behaviors are governed by the unconscious mind. Causes of these behaviors and mental processes are due to the deep-rooted problems which reside and operate beyond consciousness. Childhood experiences greatly affect the behavior and thoughts of an individual. Felitti, et al., (1998) studied that the adverse experiences a child often experiences are psychological, physical, or sexual abuse including violence against the mother; or being around household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. Adults with such adverse childhood experiences have a higher risk towards suffering depression and attempt suicide. They may even have urges to act out harmful and dangerous actions. Although such pasts reside in the subconscious level when they have grown up, they may affect the behavior unconsciously when the adult experiences flashback. Thus, this would also result in anxiety disorder, post traumatic stress disorder (PTSD) or change of personality.
Object relations theory is one of the causes that explain why people commit suicide. It emphasizes the interpersonal relationship between people and others especially mothers or caregivers and the children (IPI, Object Relations Theory). The internal objects are the people present in the children’s earlier life that influence their personality in the future. The perceptions of people and about themselves would affect their point of view on the world. Early negative development of children can influence their negative thinking in the future during adulthood as in the case of individuals who suffer from disruptive and impulsive aggressive behavior. This often can be attributed to the family’s conflict, especially between parents when the individual was a growing child. They will become aggressive and violent during interaction with others who are collectively called the external objects. Later, they gradually become depressed and result in the attempt of suicide.
Besides that, Freud believes that depression is the leading cause for one to commit suicide (Adams, 2013). The struggle between the three elements of personality such as Id, Ego, and Superego might initiate premeditation towards suicide due to the depression. Id is governed by primitive drive that need to satisfied immediately (McLeod, Id, Ego and Superego, 2008). Children who are still in the Id stage need care and love. They cannot bear or sustain abuses psychologically especially by parents or caregivers which results in a behavior with aggressive reflections. Ego causes people to suppress their emotion and instincts which in turn forces children to suppress their aggressiveness as they are aware their survival depends on the parents. Superego on the other hand makes people feel bad and guilty when something is weighed against prevailing social or moral codes. Thus, children will gradually become depressed, severely lacking in self-worth or esteem. They would not be able to appreciate and be content with the love and caring provided for, by their parents or caregivers. According to Freud, when Ego is unable to withstand the attack of Superego, the sufferer may potentially commit suicide. (Adams, 2013).
2.2 Behavioral Perspective
Behaviorism is the scientific study of observable behavior on the premise that behavior can be induced to learn S-R (Stimulus-Response) units (McLeod, 2007). According to Clarke-Steward and Roy, “Behavioral approach is an approach to psychology emphasizing that human behavior is determined mainly by what a person has learned, especially from rewards and punishments.”(2012). It focuses on how the environment can actually influence a person’s behavior. Behaviorists suggested that all behaviors are learnt and behavior is an outcome or result in response to the stimuli in the environment. There are two early theories proposed to explain how a person can learn from the environment. Ivan Pavlov, a Russian physiologist who discovered “Classical Conditioning” and B.F. Skinner who introduced his theory called “Operant Conditioning”. Classical conditioning is the response that occurs automatically to one stimulus and then is transferred to a new stimulus by pairing the two stimuli whereby operant conditioning uses reinforcements in order to achieve an expected response (Hubpages, 2014). In simpler understanding, stimulus for Classical Conditioning is provided prior to the response whereas in Operant Conditioning the stimulus is given after the response.
One of the major reasons that leads an individual towards suicidal behavior negative reinforcement. It is a term used by B.F. Skinner in his “Operant Conditioning” theory. Again, it is seen in escape and avoidance conditioning. This happens when a person or animal learns to form responses that put an end to aversive stimulus (Clarke-Steward and Roy, 2012). For instance, persons who suffers from depression or any mental illness, are more likely to get involved in the path of attempting suicide because they think it is the best way to put an end to their suffering. People who want to commit suicide more often than not have traces of abnormality when it comes to their patterns of thought, emotional reaction and behavior. Some can be seen to have a history of suicidal attempt before they re-attempt suicide. According to Caruso, some people erroneously believe that once someone attempts suicide and fails or is scuttled, he or she will not do it again.
The reality is that he or she is likely to attempt suicide again at some juncture in the future. Their behavior is driven by continuing negative reinforcements that strengthen them to suppress the possible positive response derived earlier in the aftermath of an unsuccessful attempt. Thus, such people engaged in the act of suicide once more, often successfully.
Therapies are indeed available to correct such behaviors, a person who attempted suicide before should undergo two types of therapy; One is operant conditioning also known as behavior modification and the other is cognitive behavior therapy. Behavior modification focuses on modifying and correcting one’s behavior whereas cognitive behavior therapy stresses on the detachment, away from certain thought patterns which drives them into attempting suicide. Behavior therapists would help individuals in developing a new kind of knowledge or experiences in order to replace the ones before. This potentially eliminates the root cause or at least alleviates their negative psychological leanings.
2.3 Humanistic Perspective
What is humanistic perspective? According to Bernstein (2012), “Humanistic psychology perspective is an approach to psychology that views behavior as controlled by the decisions that people make about their lives based on their perceptions of the world”. This can be explained when one sees people who are cruel in a society, they will perceptive that all the people in the society are bad and cruel. Thus, they will become more scared and fearful to live in the society. Based on this suicide theory, a junior student who is bullied now will think that all the seniors are same and they will always bully the juniors. This view was formed based on his or her perception towards the world. He or she may commit suicide when unable to cope with the bullying stress anymore. Humanistic perspective helps us to understand human nature and its behavior. Some psychologists see behavior as being determined primarily by each person who have their own capacity to choose how they want to act and think. Humanistic psychologists believe that a person’s behavior is closely connected to their feelings and self-concept.
The two researchers who contributed to this humanistic perspective are Abraham Maslow and Carl Rogers. Abraham Maslow believes that people are motivated by the hierarchy of needs. Under this hierarchy of needs, the lower needs requires to be satisfied before the higher ones. Maslow’s hierarchy of needs is arranged starting from physiological needs at the bottom, followed by safety needs, belongingness and love, esteem needs and the highest is the self-actualization needs. This can be seen when a person does not get love and attention from their spouses, parents and friends which results in them feeling that they are useless as no one care or value them. So this will lead them to end their life as they would think their life has no meaning. While Carl Rogers proposed a theory of self-concept which will lead to self-actualization, he believed that everyone can achieve their goals and wishes that they set in their lives.
According to British Humanist Association (BHA) (2007), humanists believe that fulfilment is very important in a human’s life. Humanists think that it is important to respect human’s happiness and their personal needs. They also believe when such needs or happiness are denied or taken away, various facets the mind get into conflict with one another causing an individual to strongly consider ending their lives. Humanistic psychologists found that some people commit suicide because they had already formed a perception that their life has no meaning and it is absolutely hopeless. People who can’t find meaning in their lives will undergo depression which later leads to suicide as they can’t take the pain anymore. Humanistic perspective focuses that every individual has the right to make their own decisions. Humanism views that the environment promotes the self-actualization of an individual. It gives rise to responsibility as the individual person has to focus on interacting and reconciling with existential elements. It gives meaning to their life. People who have strong believe in religion usually perceive that suicide is wrong because they think that life and especially death matters are to be left in God’s hands. They will usually consider the wishes of the people around their lives and the negative consequences of committing suicide. That is why suicide is considered wrong and a selfish act by many people. BHA (2007) stated that the humanistic psychologists believed people commit suicide because this is the only available option left for them to feel nothing and escape the suffering.
There are a few humanistic therapies available for helping suicidal individuals. A humanistic psychologist will use gestalt therapy to an individual who attempted suicide because of the disturbance they had in their past. Gestalt therapy helps an individual to focus on present rather than on their past. Another therapy which can overcome the suicidal tendency is the family therapy. In this therapy, the families or relatives will spend some time with each other to talk about the problems that is going on within the family such as divorce and so forth. By undergoing this therapy, it will strengthen one’s relationship with their families and thus help to solve the various plaguing issues psychologically. The third therapy is the existential therapy which helps a person to find meaning in their life. It also helps to face the anxiety which often overcomes them. It focuses on their responsibilities and encourages them to make their own decisions. This can prevent one from attempting suicide because this therapy helps a person find meaning within themselves. Client-centered therapy is also another humanistic approaches. Here, the individual can talk to therapist openly and honestly as the therapist does not judge him or her and all informations are kept private and confidential. This helps reduce the burden in their heart. Client-centered therapy assumes that the client holds the key to psychological health and happiness.
In conclusion, humanistic psychologists believe that people who can control their decisions and their perspectives towards the world can prevent them from contemplating suicide.
2.4 Sociocultural Perspective
Sociocultural theory is a psychological theory that stresses on the significant contributions that society makes to individual development. According to Lev Vygotsky, each function in the child’s cultural development appears twice, first on the social level, which means between people or interpsychological and next, on the individual level which means inside the child or intrapsychological (1978). Sociocultural theory focuses on the impact of cultural beliefs and attitudes on how instructions take place other than the influence of adult and peers on individual learning (Cherry, 2014).
Emile Durkheim’s sociocultural view on suicide argued that suicide probably depends on how a person is attached to social groups such as family, religious institutions and community and the risk of suicide will be lower if a person intricately belongs to the group (Durkheim, 1897) He also developed a few categories of suicide such as egoistic, altruistic, and anomic suicide. According to him, egoistic suicides are committed by an individual over whom society has less or no impact on his or her live because the person is totally detached from the society. As an example, a retiree who is living alone might feel like he or she is totally isolated from the society, friends or family. Altruistic suicides are committed by persons who are so devoted to their society that they deliberately sacrifice their lives for its assumed well-being. As an example, the Jain religious community allows suicide by starvation, also known as ‘sallekhana’, which was linked to the attainment of ‘moksha’, a total freedom from the cycle of life and death. This is still practiced to this day (Tukol & Institute, 2014). Sati in Hinduism, where a woman immolates herself on the pyre of her husband rather than living as a widow (Rajiv Radhakrishnan, 2012). Through her sacrifice, she releases herself and family members from the painful cycle of birth and rebirth which is assumed to benefit her family (Csuchico.edu, 2014). The last category is anomic suicide which is the outcome from the lack of regulation of the individual by society (Durkheim, 1897). This literally means that some sort of change might have occurred in the society where the rules or the environment had changed and the people feel confused or they are unclear of the way in which to handle the changes and therefore they finally committed suicide (Spaulding and Simpson, 2014). As an example, a country is economically facing an increased inflation, therefore a person who is unemployed in the country will feel the stress of massive financial burden and feel helpless to handle it. When they fail to fit in or adapt to the changes they decide to commit suicide.
Societies that are experiencing turmoil and conflict as exemplified by political violence and long-standing civil war in Sri Lanka did lead to higher suicide rates. Social changes brought through globalization, modernization, economic commotion, or new political systems can also lead to such rise in rates. The fall of the Soviet Union for example, caused the increased rate of drug and alcohol abuse leading to some of the highest suicide rates in amongst Eastern European countries. (Reiss & Dombeck, 2014)
Suicide take huge toll on mankind. This is evidence by WHO report which states that suicides annually represent 1.3 percent of total disease burden (Who.int, 2014). Despite the alarming numbers and increased efforts for prevention, society has somewhat grown comfortable with suicide. As mentioned earlier, the perspectives affecting an individual come in a mixed bag and to help such afflicted individuals, the approaches required would be multi-pronged. Any therapy or methodology if used in isolation from the other methods would not yield the required result (Mcleod, 2014). It is also very important to rope in the participation of the family and society at large to tackle and reduce suicide rates. In considering Malaysia, we are still very far from giving prominence to the mental health or status of individuals. The awareness is lacking in the populace and they is a dearth of qualified personnel for treating or providing efficient therapies. Most importantly the stigma attached to a person who wishes to seek help must be eliminated through awareness programmes and education.