Professor Marshall

LESSON 3: Sociology and Suicide

Sociology and Suicide

Foundations

Kastenbaum, writing about suicide, says "[t]he notion that only a certain kind of person commits suicide is a distancing strategy" (2012). What he means by this statement is that anyone is subject to the act of suicide, and further, this points to the social connection to suicide that is outside of our personal control. There are external stimuli (which sociologists call social forces) which contribute to the decision to take one's own life. Often however when we study suicide we do so from a psychological perspective, meaning that we focus on what the individual was feeling which might have led to suicide or thoughts of suicide.

The study of sociology as an overlay to the study of suicide allows us to see outside of the individual and to look for failures in the social structure as equal in their contribution to suicide rates.

Historical Arguments and Studies

An excellent reader which lays out many difficult questions about death and dying is Vincent Barry's Philosophical Thinking About Death and Dying. In this book, Barry gives an historical account of suicide through the writings of philosophers and religious authorities dating from the work of Plato. A summary of the Western arguments for and against suicide:

Suicide Pro-Con

Setting aside the philosophical and moral arguments, one of the most famous studies in all of sociology was done on the topic of suicide. From this study several key ideas, concepts and theories arose, and although the study was conducted in the late 1800s many of the ideas found in Durkheim's famous work are still used by sociologists today. Note that Durkheim was less concerned with the moral arguments for or against suicide than he was showing the connections between suicide rates and social happenings.

Some of the concepts that find their genesis in Durkheim's work:

  • Macro and Micro Sociology
  • Social Integration
  • Anomie
  • Control Theory
  • Case Study Method
  • Ecological Fallacy

We think of suicide as being an intensely personal event, and rarely do we stop to consider how important the link to social events--the structure of society--is when a person decides to commit suicide. But the earliest sociologists were concerned about the impacts of the structure on the individual, and this line of thinking gave way to the "macro-micro connection."

What are "MACRO" and "MICRO" Sociology?

One of the ways that sociologists compare and contrast the individual and the structure of society is by using the MICRO and MACRO perspectives. The micro perspective helps us to look at things from the point of view of the individual, and the macro perspective helps us to look at things from the point of view of social structures. These two concepts are important to understand as you begin to explore issues which we consider to be social problems.

Watch this video which explains the connections between the micro and macro perspectives and the concept of anomie:

Durkheim

Durkheim's Suicide was a groundbreaking book in the field of sociology. Published in 1897, it was a case study of suicide; it was unique for its time in that it provided one of the first examples of what sociological research should look like. In this research, Durkheim sets out to understand the differences in suicide rates among two different religious groups--the Protestants and the Catholics. He argues that higher rates of social control result in lower rates of suicide. To understand the limitations of Durkheim's work, we must understand the historical context of society at that time. Durkheim felt that Catholic society had normal levels of social integration and that Protestant society had low levels of social integration. In the field of sociology, social integration refers to the movement of minority or underpriviledged groups toward the mainstream. There are certain criteria which must be considered when a group is integrating:

  • Language: the minority group must adopt the language of the mainstream
  • Laws: the minority must accept the laws of society
  • Values: the minority must adopt a common set of mainstream values

Integration does not require assimilation, but it does usually require the minority group to adopt some of the mainstream culture which may be inconsistent with their own subcultural values and norms. Using Durkheim's theory regarding integration, the mainstream of society would be "Catholic" while the subcultural or minority group would be "Protestant." There are some issues with Durkheim's interpretation, and while we won't specifically cover these problems in this course (they are generally discussed in courses on sociological methods), it is important to note that they exist:

  1. Problem One: Durkheim's work did not rely on original research--he took his findings from the work of earlier researchers. This in and of itself, is not a problem, but there may have been errors within the original research which influenced Durkheim's findings.
  2. Problem Two: Later research points to Durkheim's findings only being specific to German-speaking Europeans. Since this was essentially Durkheim's "world" (remember that context is always important!), he cannot be faulted for this--the world was a much smaller place in his time.

Despite the limitations above, Durkheim's study is still mentioned as a classic study in the field of sociology, and fits well with the sociological study of death and dying. Some of Durkheim's important findings:

  • Suicide rates are higher in men than women, although married women who remained childless for a number of years ended up with a high suicide rate
  • Suicide rates are higher for those who are single than those who are married
  • Suicide rates are higher for people without children than people with children
  • Suicide rates are higher among Protestants than Catholics and Jews
  • Suicide rates are higher among soldiers than civilians
  • Suicide rates are higher in times of peace than in times of war (the suicide rate in France fell after the French Revolution and the overthrow of Louis Bonaparte; war has also reduced suicide rates: after war broke out in 1866 between Austria and Italy, the suicide rate fell by 14% in both countries)
  • The higher the education level, the more likely it was that an individual would commit suicide, however Durkheim established that there is more correlation between an individual's religion and suicide rate than an individual's education level; Jewish people were generally highly educated but had a low suicide rate

Durkheim defines suicide as "...all cases of death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result." (1897)

As mentioned in the short video above, he set about identifying and defining four subtypes of suicide:

Durkheim's Four Subtypes

These four types of suicide are based on imbalances in the measure of social forces: social integration and moral regulation. For example, Durkheim noted that when there were high levels of anomie in a society, more suicides would occur. Likewise, when there were high levels of obligation, suicide rates would decrease. His study has been criticized as an example of the ecological fallacy (EF), which is a phenomenon which occurs when aggregate level data is used to describe individual behavior--again, this is a term which is more fully defined and discussed in sociology courses on research methods and data analysis, but it is important also to understand from a layperson's perspective.

I often refer to the ecological fallacy as the "sample size of one." The EF happens when we over-generalize and use only two or three cases to support our argument. Simply because you have an experience with something does not make it true for the entire population.

Example: "Well I know a person who gets Welfare assistance and every day I see him driving around in a fancy car! I know that, based on what I've seen, most people who get Welfare are abusing the system and really what we need to do, as a country, is make it so that people who use Welfare have to work and don't get as much money!" 

Aside from the fact that the statement above is NOT supported by research, it is not "proper" to use individuals to describe the group--or vice versa, to use the group to describe the individual. Using the macro to explain the micro, or the micro to explain the macro is an example of the EF. It causes us problems because we cannot explain the individual by looking at the group, nor can we expect the group to behave like the individual does.

Durkheim uses AGGREGATE level data on suicide to assert that the reasons why INDIVIDUALS commit suicide are divided into these four categories. The use of MACRO level properties to explain MICRO level behaviors is often misleading. Some scholars contend that Durkheim intended his study to be used to sociologically explain suicide, not to explain the suicides of individuals. If he did not intend to explain suicide from a sociological point of view, and was instead looking to define and describe individual behavior, then things are somewhat problematic, as his findings really cannot be confirmed (we cannot ask the dead why they chose to commit suicide). Nonetheless, this study is still seen as an example of how the study of social forces can be important for us to understand (while the discussion on whether or not an ecological fallacy was actually committed by Durkheim is still being debated, for this course, this is as far as we'll take the discourse on this topic). Again, we must bear in mind that Durkheim was alive in the 1800s when sociology was in its infancy--we do what we can with what we know, and when we know more, we do better. Sociological research methods were in their early stages when Suicide was completed, and we must consider this in our analysis of the weaknesses of Durkheim's work.

If you would like to read more about Durkheim's study, CLICK HERE for an excerpt from Robert Alun Jones' Emile Durkheim: An Introduction to Four Major Works, in which Jones gives us some additional insight into Durkheim's famous work.

Control Theory

Durkheim's work gave way to CONTROL THEORY, which comes from the work of sociologists Walter Reckless (1973) and Travis Hirschi (1969). Control theory is used in the sociological study of crime and deviance, and here we must note that suicide is considered deviant behavior. Any behavior that goes against social norms (and which may or may not have laws which prohibit it) is deviant. And, our definitions of deviance change over time--just a few decades ago, homosexuality was considered deviant behavior by most Americans. Getting tattoos and face piercings have, in our past, been deviant behaviors. Today suicide is considered deviant by most Americans.

Control Theory states that behavior is caused not by what the individual is exposed to in society, but rather by what a person wants at a particular point in time. According to Reckless, weak social systems result in deviant behavior; deviant behavior occurs when external controls which are placed on behaviors are weak. According to control theory; people act rationally, but if someone is given the chance to act deviant they will. Explaining control theory in terms of Durkheim's work on suicide, we can see that control theory defines suicide as a deviant behavior, and that rates of suicide (deviance) are influenced by situations where the controls or bonds of society over the individual are considered "weak." Anomic suicide falls into this category--social control is weak due to the structure of society experiencing failures--therefore the suicide rates increase.

Control theory stresses how weak bonds between the individuals and society free people to deviate or go against the norms. People who have weak ties engage in crimes/deviance so they can benefit, or gain something that is to their own interest. This is where strong bonds make deviance more costly--deviant acts may appear attractive to individuals but strong social bonds stop most people from committing the acts. Deviance is a result of extensive exposure to certain social situations where individuals develop behaviors that attract them to avoid conforming to social norms. Social bonds are used in control theory to stop individuals from committing deviant behaviors which stray from social norms.

Now, you may be asking the questions: well, how is suicide beneficial to the individual? Wouldn't the act of suicide be so abhorrent that people wouldn't want to do it?

According to psychologist Alex Lickerman, there are six reasons why people commit suicide:

  1. Depression. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that suicide is an escape from feelings of hopelessness. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like "Everyone would all be better off without me" to make rational sense. They shouldn't be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it's simply the nature of their disease. Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing.
  2. Psychosis. Malevolent inner voices often command self-destruction for unintelligible reasons.
  3. Impulse. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is often genuine, but whether or not they'll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.
  4. A cry for help. These people don't usually want to die but do want to alert those around them that something is seriously wrong. They often don't believe they will die, frequently choosing methods they don't think can kill them in order to strike out at someone who's hurt them, but they are sometimes tragically misinformed.
  5. Philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision, often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren't depressed, psychotic, maudlin, or crying out for help. They're trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless.
  6. Mistake. This is a recent, tragic phenomenon in which typically young people, for example, flirt with oxygen deprivation for the high it brings and simply go too far.

However we cannot simply look to psychology (a micro aspect) to tell us the whole story of suicide. As far as sociology is concerned, this would only paint half a picture. According to the lecture notes of sociologist John Hamlin, who interprets the work of Walter Reckless (table below), we should look not for what CAUSES suicide, rather what PREVENTS suicide from happening. In doing so, we can again see (as did Durkheim) how the macro level impacts the individual.

Internal Buffers - Are aspects concerning self control and self management (herein resides psychology, socialization processes and symbolic interaction theories). These are things that YOU control or which are a part of YOU and only YOU and which would prevent suicide

External Containment - Refers to the influence of social institutions (the institutions of the family and religion, for example) This is particularly true in societies characterized by mechanical solidarity (socialization processes are also present here, as well as macro level theories which stress the importance of the structure upon the individual). These are things which are a part of the GROUP and which you internalize as important and which could prevent suicide

  1. a favorable image of self in relation to other persons, groups, and institutions;
  2. an awareness of being an inner directed, goal oriented person;
  3. a high level of frustration tolerance;
  4. strongly internalized morals and ethics;
  5. well developed ego and super ego
  1. a role structure which provides scope for the individual;
  2. a set of reasonable limits and responsibilities for members;
  3. an opportunity for the individual to achieve a status;
  4. cohesion among members, including joint activity and togetherness;
  5. sense of belonging (identification with the group);
  6. identification with one or more persons within the group;
  7. provision for supplying alternative ways and means of satisfaction (when one or more ways are closed)

Note:

  • Weak containing systems result in deviation
  • Internal containment is more important in larger industrialized societies whereas external is more likely in small societies
  • Assessment tools can be designed to measure both external and internal systems
  • Reckless' theories are not to be applied at the extremes of deviant behavior--remember that sociologists look for the NORM and try to identify what deviates from it
  • Reckless also maintains that unlike many other approaches, one can determine the macro from looking at the micro (individual) This is quite a different approach from the vast majority of sociologists and could be interpreted as a problem of the EF.

 Which of the Above Prevents Suicide?

As you can see, there are several categories on this list that give us explanations to the question I posed. Most of these reasons point to the individual suffering some physical or mental anguish which makes suicide seem a "good" alternative to living. However, to point solely to the psychological aspects of suicide presents an incomplete argument: we must also consider how the individual internalizes the rules, norms, laws and standards (components of the structure). If you are considering working in a field where you may be in contact with persons considering suicide, you must consider both the micro and the macro forces at play in the decision making process.

Whatever it is that helps us to understand the structural or individual components of suicide is helpful to reducing the suicide rate--physical, mental and environmental factors ALL play important roles to the individual considering suicide. The more we understand about it, the better prepared we are, as a society, to help.


Epidemiology of Suicide in the US

Suicide is the 10th leading cause of death in developed countries. It occurs at every age, and encompasses people from all walks of life. Sociologists would assert that the modernization of the world (i.e., from the begining of the Industrial Revolution to today in the West) has had something to do with suicide rates. The original works of some of our early sociologists points to modernization as a vehicle which disconnects members of society from each other and from society in general. Does modernization impact suicide rates?

Does the structure of society play a role in suicide rates? Research supports that it does. In modern societies we may lose the strong, meaningful, personal connections that we have to others and this may be a factor in one's desire to commit suicide. In societies which have not yet industrialized, a strong collective consciousness exists--all members of the community are invested in the wellbeing of others. An interesting statistic about suicide is that which accompanies geography--wide open spaces where there is less density of people (such as Wyoming and Alaska) have higher suicide rates than do places which are more densely populated. On first glance, this seems to contradict the information in the video above, but if we consider that people who live in rural areas today often have minimal connections to society (perhaps living on ranches and farms with little regular contact with others), we can see "space" and "place" have an impact on suicide rates.

All of us have some level of integration into society--some more than others. Individuals are also impacted by the condition of society--is the economy weak or strong, are there enough jobs for everyone? Or, are we experiencing an economic recession/depression? Bad economic times contribute to suicide rates (see the above discussion regarding Anomic Suicide). The time immediately following a disaster (man-made or natural) also presents a higher suicide rate than normal, and this may be associated with the depression and feelings of hopelessness that happen in the aftermath of traumatic events such as the 9-11 terrorist attacks, or Hurricane Katrina, for example.

Suicide Rates over Time

People who are weakly integrated into society have a higher risk of suicide. When society is "disorganized" and chaotic, suicide rates increase.

Suicide and Social Integration

The study of suicide rates is an important part of the heritage of sociology. As noted, Durkheim examined macro-level variations in suicide rates in an effort to explain how certain parts of the social structure could contribute to suicide and define it as a "social fact." In the case of differences in religion, Durkheim argued that the low rate of Catholic suicide in Catholic countries was related to a high degree of social integration (as people were strongly integrated into the hierarchical religious community of the Catholic church). On the other hand, Durkheim attributed the relatively high rate of suicide in Protestant societies to a state of egoism where there was greater emphasis on the individual and a lower degree of social integration of believers into the Protestant faith.

Durkheim also examined the institution of the family, both as a source of social integration and as a buffer against the desire of individuals to commit suicide. For instance, Durkheim observed that some parts of France were characterized by larger families and tended to have lower rates of suicide than did areas with smaller families. He reasoned that the greater "density" of social relations in larger households protected against excessive individualism and egoistic suicide (and this argument lends itself to the discussion above regarding higher rates of suicide in less dense--and less social--geographic locales). Durkheim also found a relationship between marital status and suicide, in which married persons over the age of 20 generally have lower rates of suicide than do their single or widowed counterparts. After conducting additional analyses, Durkheim concluded that men in particular benefit from the integrative influences of marriage whereas suicide rates for married women are reduced only when they have children. What does this mean? It means that marriage is "good" for men and childbearing/rearing is "good" for women. Again--a note of caution--we must take this information historically and contextually. While in contemporary time this kind of statement may ruffle our feathers quite a bit, remember that sociologists, when conducting research, are charged with reporting the reality of what society IS, not what we think it SHOULD BE.

Below note the differences in suicide rates by sex, ethnicity and age. This information may shed some light on theories about the social connection to suicide rates. What do you think might be some of the cultural and social/structural forces which contribute to higher suicide rates for some groups? Conversely, what conditions may be promoting stronger social integration and lower rates for some groups in the U.S.? 

Suicide Rates by Sex

Suicide Rates by Ethnicity

Suicide Rates by Age

Trends and Patterns of Suicide in the United States

Although Durkheim's data showed relatively low rates of suicide for teenagers and extremely high rates among older men, particularly those who were single or widowed, he did not devote much attention to the role of social integration with regard to age-related suicide patterns.

Suicide rates in the United States today vary dramatically by age (less than 14 versus 85+) as well as by sex and ethnicity. In recent years, the suicide rates for white men aged 65 and over have been substantially higher than in any other category.

Two status groups—white and black men between the ages of 15 and 24—experienced relatively sharp increases in suicide rates from 1960 to 1990. Did social and political changes of the 1960s and 1970s affect the degree to which these younger men were integrated into American society? Some forms of deviant behavior, such as illegal drug use and violent crime, increased during parts of this historical period. The use of illegal drugs peaked in the late 1970s and early 1980s, and violent crime generally increased until the early 1990s. Since then, the suicide rate among younger men has declined as have rates of drug use and violence. The extent to which these parallel trends in suicide and other forms of deviant behavior correspond to historical changes in social integration or other underlying conditions in the U.S. is an intriguing question for research (for instance, see O'Brien and Stockard 2006) and once again points to the importance of Durkheim's original study and its ongoing impacts on the sociology of suicide today.

There have been a few recent developments in the field of sociobiology which can lead us to think about connections between suicide and age. Neuroscientists have recently discovered that the brains (specifically, the prefrontal cortex, which governs our ability to differentiate among conflicting thoughts, determine differences between "good" and "bad" and to predicit the consequences of our current activities) of people under the age of 25 are less developed than had been thought in the past (Ernst, et al, 2009). There are differences in the development of the prefrontal cortex between teens who have committed suicide and those who have not. This biological advance shows that there may be a connection between suicide and age that was previously not known.

Declines in drinking and illegal drug use probably played a role in decreasing rates of suicide during the 1990s, especially for young men. In addition, a number of researchers have explored the impact of steep increases in the use of antidepressant medications on the reduction of suicide rates in the U.S. during the 1990s and early 2000s (Olfson et al. 2003; McKeown et al. 2006). However, evidence from other societies, such as some Scandinavian countries, indicates that suicide rates began to decline prior to the widespread use of antidepressant drugs (Reseland et al. 2006). In other words, the recent drop in suicide rates is not simply due to the introduction of new and better drugs to treat depression and other mood disorders. As Durkheim suggested, we need to look beyond individualistic explanations based on psychological or pharmacological factors to account for the complex and changing "social facts" of the epidemiology of suicide.


Conclusion

As you can see, we can only scratch the surface with the short amount of time we have to learn about sociological connections to suicide. One thing is clear: sociology offers a unique perspective on this seemingly intimate and personal decision. You are encouraged to continue to learn about this subject, in particular if you plan to work in a social service occupation.