Right to Suicide: Teen, Adult, State, Prevention (2nd Webinar on Mental Health and Suicidal Risk)

Uploaded 5/31/2021, approx. 25 minute read

Thank you for having me, esteemed colleagues.

I'm going to discuss something a lot closer to the topic of the conference. I'm going to discuss teen suicide and then I'm going to discuss the philosophical foundations of suicide and attempts to understand suicide within the context of various philosophical schools.

My name is Sam Vaknin, I'm a professor of psychology in Southern Federal University in Rostov-on-Don and a professor of finance and a professor of psychology in the outreach program of SIAS-CIAPS Center for International Advanced and Professional Studies. I'm sorry I'm obligated by my contract to state all these things, so apologies.

Let's start with teen suicide.

Teen suicide had been closely linked to social media. Social media and the devices that they run on are designed to be addictive and to condition users.

Many industry executives of social media and social media companies, many engineers who had designed the platforms, many of them that have confessed that the addictive and conditioned elements in social media are intentional, thereby design.

Addiction is always punctuated by periods of withdrawal. It's cold turkey, excruciating symptoms.

The correlation between all manner of addictions and suicide, or lesser self-destructive and reckless acts, this correlation is well documented. Exposure to screen time creates addiction, addiction may lead and often does lead to suicide.

College freshmen are overwhelmed more than ever. 41% of college freshmen in 2016 reported being utterly dysregulated and falling apart, disintegrating. This compares to 18% in 1985.

But teens also experience performance anxiety when they're on social media. This is because these are competitive ecosystems or shall we say ego systems, where one's social ranking is objectively determined by quantitative yardsticks such as a number of likes, a number of friends.

And it is publicly available for all to see, for everyone to opine on. This is enormous stress, enormous pressure.

Diagnosed anxiety among teens shot up 20% since 2007. One-sixth of all cases are classified as severe.

Peer pressure is egodystonic and often expressed as bullying or mobbing or in other forms of aggression such as black humor or brutal honesty.

And this is a toxic environment. It's a toxic environment that engenders a lot of destructive envy as well.

Studies show that teens, teenagers nowadays, are more insecure than in any previous generation. They're especially concerned about their economic future. They are asocial.

Teens prefer surfing to socializing with friends their age. Both dating and sexual activities have declined by more than 50%, 5-0% since 1985.

The teenagers of today are not used to privacy and therefore they're incapable of intimacy. They are itinerant, peripatetic, and they mature very slowly. They are three years behind on every scale of personal development.

Medically, contemporary teens are obese. They have body image problems.

Many more of these teens are on mind-altering medications or drugs.

And these are hallmarks of pathological narcissism.

Jean Twenge discovered that MMPI scores evinced a five-fold increase in psychopathology in 2007 compared to 1938.

Anxiety and depression, according to her studies, Twenge, anxiety and depression have shot up six-fold the amount of suicides among young teenage women escalated by 54% in a single decade.

Social media is amenable to mass hysteria, shared psychotic disorders now no longer a diagnosis in the DSM-5 but still very much alive and well.

On social media, there's the emergence of cults, including personality cults, nihilistic cults, suicide cults, and death cults.

One example is of course ISIS. ISIS was a child of social media.

And this proclivity is aided and abetted by two attendant phenomena.

One, catastrophizing, an end-of-days presentiment which is enhanced by two, unmooring, the profusion of fake news, truthiness, reality TV, and the narcissistic type of anti-expertise and anti-intellectualism.

Studies are unequivocal beyond a certain level. More screen time leads to reduced levels of happiness, reduced levels of life satisfaction and self-esteem, to increased manifestations of anxiety and depression.

All other off-screen activities have the opposite effect. If you do sports, if you have interpersonal interactions, if you attend religious services, if you consume legacy, print, and electronic media, including television, if you do your homework, your spiritual and mental well-being is enhanced.

If you do social media, if you do internet, if you do surfing, if you're exposed to screen time, your depression and anxiety levels will be uncontrolled. You will have become a suicide risk.

These all the studies agree on, most notably the studies by Twenge, Lisa Wade, and others.

Social media reflect our values.

We prefer efficiency to quality, or quiddity. Universe is a quantitative world, a death count civilization which places value on inanimate objects rather than on human beings.

But some things do not lend themselves to speed or to quantity, family life, intimacy, romance, friendship, for example.

Modern technology was invented by young white males, schizoids, asocial, asexual, somewhat autistic recluses. This is the profile of the people who had invented social media across the board.

Businessmen then took over from the engineers, and they stripped the outcome of anything that stood in the way of monetizing the maximum number of eyeballs.

And the result is a psychogenic chimera. The result is a psychogenic nightmare.

It's a psychopathology engine. It creates illness.

The ever diminishing size of screens, from the cinema screen to the smartwatch, this ever diminishing size of screens has tracked the atomization of our ever more anomic and narcissistic societies.

In his book Suicide, Emile Durkheim predicted a hundred years ago that suicide rates in anomic societies would tend to increase. He was right, and not only about this.

Since 2010, suicide among teens, teenagers, skyrocketed by 31% in a single decade. It became the leading cause of death, the leading cause of death among people younger than 24.

I refer you to various sources, the Journal of Development and Behavioral Pediatrics, the National Survey of Children's Health, Higher Education Research Institute, UCLA, they have a series of publications on this issue, and Emotion, an article by Twenge, Martin and Campbell in the January 2018 issue of Emotions.

Suicide is intimately linked to depression. And there's a variety of depressive disorders, and I would like to dwell on one of them, what is known as the winter blues.

The winter blues are supposed to cause suicidal ideation, SAD, seasonal affective disorder. There is even a mental health syndrome. It supposedly is alleviated by bright light therapy, therapy using artificial sources, emulating daylight.

But suicide rates are highest, actually, in the spring. They're highest in the summer months. They are the lowest in winter.

The propensity to commit suicide increases with increasing hours of daylight, exactly opposite of what we think, exactly opposite of our vision.

Suicide is not correlated, and suicidal ideation is not correlated with any other meteorological variable, such as rainfall or temperature.

Suicide rates appear to increase with increasing hours of daylight. They show no connection to any other meteorological factors such as changing temperature or rainfall.

And surprisingly, sunlight is known to indirectly induce heightened brain levels of serotonin, a biochemical inversely linked to depression. The lower the levels, the deeper the depressive episode. Serotonin drops during winter months.

It seems that suicide has nothing to do with depression. I repeat, suicide has nothing to do with depression.

Depressed people do not commit suicide. They are too busy being depressed.

If suicide were caused by depression, suicide rates would have been highest in winter when serotonin is lowest, and depression rates are highest. But suicide peaks in spring and summer when depression rates are lowest.

Depression is a biochemical illness. One can feel hopelessness and helplessness to the point of committing suicide without being clinically depressed.

It is this feeling that is very dangerous.

That there is no satisfactory solution. No way out. That one is helpless. One is trapped. Of course it is counterfactual. There's always a way out. There's always a solution. One way or another. Always.

I refer you to the American Journal of Psychiatry, 2003, volume 160.

But suicide is a much more complex phenomenon and cannot be reduced to mental health, to psychology, to serotonin.

Suicide is a societal, cultural artifact. And this is why various philosophers throughout the ages, religious authorities, they all try to cope and deal with suicide, its various dimensions, its morality, its demographics, its deproclivities to suicide.

Who is more prone? Who is less prone? Why commit suicide? Is it ever justified? Et cetera, et cetera.

Suicide is a collective endeavor, not an individual one.

Those who believe in the finality of death, those who believe that there is no afterlife, they are the ones who advocate suicide and regard it as a matter of personal choice.

On the other hand, those who firmly believe in some form of existence after bodily death, after corporeal death, these people condemn suicide and they judge it to be a major sin.

And yet, rationally, the situation should have been reversed. It should have been easier for someone who believes in continuity after death to terminate this phase of existence on the way to the next phase of existence. Those who face void, finality, non-existence, vanishing after death, they should have been greatly deterred by suicide. They should have refrained from suicide or even entertaining the idea of suicide. Either the latter do not really believe what they profess to believe or something is wrong with rationality.

Suicide is very different from self-sacrifice.

It is not the same as avoidable martyrdom. It is not the same as engaging in life-risking activities. It is not a refusal to prolong one's life through medical treatment, euthanasia. It is not the same like overdosing or self-inflicted death that is a result of coercion.

There are many ways and forms to bring about death prematurely, but not many of them qualify as suicide.

What is common to all these is the operational mode, a death caused by one's own actions, by one's own hand. In all these behaviors, a foreknowledge of the risk of death is present coupled with its acceptance.

But everything else is so different that they cannot be regarded as belonging to the same class.

Suicide is chiefly intended to terminate a life. All the other acts that I have mentioned, they are aimed at perpetuating, strengthening and defending values.

Those who commit suicide commit suicide because they firmly believe in the finiteness of life and the finality of death. These people prefer to terminate life rather than continue life.

Suicide may be an obsessive compulsive ritual aimed at forestalling much dreaded change.

Indeed, suicide rates are highest among people whose lives are adrenaline-filled roller coasters. The more exciting, the more thrilling, the more risky, the more stressful your life is, the more likely you are to commit suicide.

Physicians, policemen, bipolar patients, borderline personality-disordered patients, they have the highest rates of suicide.

Yet all the others, the observers of suicide, are horrified by people who prefer suicide. They are disgusted by people who choose suicide. They abhor it.

And this has to do with our understanding of the meaning of life.

Ultimately, life has only meanings that we attribute and ascribe to it.

Such a meaning can be external, God's plan for those of us who believe in God. Such a meaning can be internal, some kind of meaning generated through arbitrary selection of a frame of reference or a value or a cause.

But in any case, the meaning must be actively selected, actively adopted, actively espoused.

The difference is that in the case of external meanings, we have no way to judge the validity and quality of external meanings. Is God's plan for us a good plan or not a good plan? We are not in the position to judge or know. We just take these external meanings on because they are big, they are all-encompassing and come from a good source.

A hyper-goal generated by a superstructural plan tends to lend meaning to our transient goals and structures by endowing them with the gift of eternity. Something eternal is always judged more meaningful than something temporary or temporal. If a thing of less or no value acquires value by becoming a part of an eternal thing, then the meaning and value reside with equality of being eternal, not with a thing that was endowed with meaning.

It is not a question of success. Temporal plans are as successfully implemented as eternal designs.

Actually, there is no meaning to the question, is this eternal plan or process or design successful?

Your success is a temporal thing, depends on time. It is linked to endeavors that have clear beginnings and clear ends, and eternity does not have an end or a beginning.

So this is the first requirement. Our lives can become meaningful only by integrating ourselves into a thing, a process, a being that is eternal.

In other words, continuity, the temporal image of eternity, to paraphrase a great philosopher, continuities of the essence, terminating our life at will, renders our life meaningless.

A natural termination of our life is naturally preordained. A natural death is part and parcel of the very eternal process, the very eternal thing, the very eternal being which had lent meaning to our lives. To die naturally is to become part of an eternity, part of a cycle, an uninterrupted cycle.

And this cycle goes on forever. It's a cycle of life and death and renewal.

When we interrupt this cycle with suicide, we betray ourselves, we betray what we are integrated into. We abrogate any possibility for meaning.

This cyclical view of life and the creation is inevitable within any thought system which incorporates a notion of eternity, because everything is possible, even an eternal amount of time. So are resurrection and reincarnation, the afterlife, hell and other beliefs adhered to by the eternal group of people.

Sidgwick, a philosopher, Sidgwick raised the second requirement and with certain modifications by other philosophers.

He said, to begin to appreciate values and meanings, a consciousness and intelligence must exist. The value of me or meaning must reside in or pertain to something outside the consciousness, outside the intelligence.

But even then, only conscious intelligent beings will be able to appreciate it.

We confuse the two requirements, we confuse the two views.

The meaning of life is the consequence of life being a part of some eternal goal, plan, process, thing or eternal being.

Whether this holds true or does not, a consciousness is called for, is needed in order to appreciate love's meaning. Life is meaningless in the absence of consciousness or intelligence.

Suicide flies in the face of both requirements. It is a clear and present demonstration of the transience of life, the negation of the natural, eternal cycles or processes. Suicide also eliminates the consciousness and intelligence that could have judged life to have been meaningful had this consciousness or intelligence survived.

Actually, this very consciousness or intelligence makes a decision in the case of suicide that life has no meaning whatsoever. To a very large extent, the meaning of life is perceived to be a collective matter of conformity.

Suicide is a statement written in blood that the community is wrong, that life is meaningless and final. Otherwise, the suicide would not have been committed.

This is where life ends and social judgment commences. Society cannot admit that it is against freedom of expression and suicide after all is a statement of freedom of expression.

Society could never accept this. Society always prefers to cast the suicides in the role of criminals or sinful people and therefore be repped of any social or civil rights.

According to still prevailing views, the suicide violates unwritten contrasts with himself, with others, with society and many end with God or with Nature with a capital N.

Thomas Aquinas said that suicide was not only unnatural because organisms try to survive, not to self annihilate, so it's not natural. Aquinas said it also adversely affects the community. It violates God's property rights.

The latter argument is interesting. God is supposed to own us. He owns our soul. Our soul is a gift.

In Jewish writings the soul is a deposit. The individual gets the soul as a deposit from God, as suicide therefore has to do with the abuse or misuse of the possessions of God, temporarily lodged or lent to a corporeal person, to a corporeal mansion.

This implies that suicide affects the eternal, immutable soul.

Aquinas refrains from elaborating exactly how a distinctly physical and material act like suicide can have any effect, can alter the structure or the properties of something as ethereal and as eternal as the soul.

Hundreds of years later Blackstone, the codifier of British law, agreed with Aquinas. He concurred the state according to Blackstone, this preeminent juridical mind. The state has a right to prevent and to punish for suicide and for attempted suicide.

Suicide wrote Blackstone is the same as murder. It's exactly murder. It is self murder and therefore it is a grave felony.

In certain countries this is still the case. Suicide is a criminal offense.

In Israel, for instance, a soldier is considered to be the property of the army and the state. Any attempted suicide by a soldier is severely punished as being attempt at corrupting army property.

Indeed, this is paternalism, and perhaps paternalism at its worst, the kind that objectifies its subjects. People are treated as possessions, as property, in this malignant mutation of benevolence. Such paternalism acts against other adults expressing fully informed consent. It is an explicit threat to autonomy, freedom, privacy and free will.

Rational, fully competent adults should be spared this form of state intervention. It serves as a magnificent tool for the suppression of dissidents in places like Soviet Russia and Nazi Germany. Mostly, such an intrusive nanny state tends to breed victimless crimes.

Gamblers, homosexuals, communists, people who commit suicide, all these people in some jurisdictions commit crimes.

But who is the victim? It's a victimless crime. All these have been protected from themselves by big brothers in disguise.

If you consume drugs, the state is trying to protect you from yourself. If you commit suicide, the state will intervene and lock you up to prevent you from committing suicide.

But why? Why is that?

Wherever humans possess a right, there is a correlative obligation to not act in a way that will prevent the exercise of such a right. The state has no right to prevent anyone from exercising their rights, has no right to do so actively by preventing it, by preventing the exercise of the right, and the state has no right to intervene passively by reporting the violation.

In many cases, not only is suicide consented to by a competent adult in full possession of its faculties, the suicide also increases utility, both for the individual involved and for society at large.

The only exception is, of course, where minors or incompetent adults, the intellectually challenged, the mentally insane, these people, when they are involved in committing suicide, attempting suicide, and suicidal ideation, we should protect them. At that point, a paternalistic obligation does seem to exist.

I use the cautious term seems to exist because life is such a basic and deep-set phenomenon that even the incompetent can fully gauge its significance, even they can make informed choices and decisions in some respects.

In any case, no one is better able, better positioned to evaluate the quality of his or her life and the ensuing justification of a suicide. No one is more competent. No one is more competent than the mentally competent person.

Only the person himself or herself can make this judgment and decide whether to commit suicide or not. And no one has the moral or legal right to intervene.

The paternalistic, the people who espouse state paternalism, they claim that no competent adult will ever decide to commit suicide. They say no one in his right mind chooses this option.

This contention is, of course, nonsensical, counterfactual, obliterated by history and by psychology.

But the derivative argument seems to be more forceful. Some people whose suicides were prevented felt very happy that they are still alive. They felt elated to have the gift of life back.

Isn't this sufficient reason to intervene?

Well, absolutely not. All of us are engaged in making irreversible decisions, and sometimes we regret these decisions, but we should not be prevented from making them. For some of these decisions, we are likely to pay very dearly.

Is this a reason to stop us from making decisions? Of course not. Should the state be allowed to prevent a couple from getting married because of genetic incompatibility? No. Should an overpopulated country institute forced abortions? No. Should smoking be banned for the higher risk groups? No.

The answers are clear. The answers are negative.

So there is a double moral standard when it comes to suicide. People are permitted to destroy their lives, but only in certain permissible, prescribed ways.

If you want to commit suicide, you can smoke yourself to death. That's okay. You can drink yourself to death. That's okay. But you cannot hang yourself. That's not okay.

And if the very notion of suicide is immoral, if suicide is even criminal, why do we stop at individuals? Why not apply the same prohibition and the same logic to political organizations such as countries, to groups of people, to institutions, corporations, funds, not-for-profit organizations, international organizations?

All these have a right to disband. All of them have a right to go bankrupt. All of them have a right to shut down their doors.

Isn't this the equivalent of suicide on the collective level? Why don't we prohibit this as well?

And of course it's a slippery slope. It fast deteriorates to the land of absurdities long inhabited by the opponents of suicide.

Suicide is a choice. And as we have no right to limit the choice, other choices, we have no right to limit this choice.

We may institute cool-off periods. We may institute counseling. We may try to provide different angles. We may try to aid and abet suicide among vulnerable groups.

But ultimately, if the individual has made up her or his mind, if it's a competent adult, he has, she has the right to terminate her life. It is her life after all.

Thank you for listening.

Yes, I can hear you. Thank you.

You would have to speak a bit slower because the line is interrupted constantly.

There are many, many myths about suicide.

And the most dominant myth is an ideological myth.

It's the myth that if we only improve the lot of people materialistically, if we provide them with work, if we provide them with material goods, this is a prescription for happiness. And it's an antidote to suicide.

Suicide is a collective communal act. The person who commits suicide is sending us a message.

I no longer feel loved. I no longer feel embedded in anything larger than myself. I don't have a family. I don't have a community. I don't have friends. I don't have a church. I don't have God.

So people who commit suicide had actually committed social suicide and psychological suicide way long before they had taken their body away.

It is this that we should monitor.

We should intervene not in suicide because suicide is a libertarian choice.

And no one has a right to take your choice away from you. Not even the state. Not even your loved ones. Not even your children. No one. You are the master of your body.

We have accepted this for women. We say the woman is a master of her body. She can commit abortion.

We should accept it for the whole population. You want to commit suicide for the whole population. You want to commit suicide, you have a full right to commit suicide.

But we should try to minimize the phenomenon. And the only way to do this is to interfere in the much earlier stages where people drift away from support networks, where they drift away from communities, where they drift away from groups, where they no longer belong, where they are atomized, where they are anonymized.

In other words, we have to attack loneliness. We have to attack loneliness.

Then the only way to attack loneliness is to force people to reengage other people, to integrate with other people. And the first crucial step of this is to substantially restructure online life.

This is the biggest threat. Online life is the biggest threat.

We need to restructure the way social networks work. We need to restructure the way entertainment is delivered and so on and so forth. So as to force people to engage with other flesh and blood living, breathing human beings.

Absolutely. It's the only prescription, the only recipe against suicide.

People are poor. Therefore, the lowest suicide rates, the lowest suicide rates are among the poorest nations.

The highest suicide rates are among the richest nations. It's a fact.

The lowest suicide rates are among people whose lives are integrated with other people because they have no choice.

They have no leisure, no leisure time. They must collaborate with other people. They must engage with other people. They must rely on other people. They are embedded in structures and systems and communities and so on because the resources are so scarce that everyone has to share for everyone to stay alive.

That's simple.

We have created self-sufficiency. And self-sufficiency is the recipe for suicide. When you become self-sufficient, you have no more reason to live.

There is one more question. We can give the answer for that answer.

Thank you.

There's a question here by Shreya Pandey.

I have a question for Sam. Like you said, smoking and drinking to death is okay but not hanging yourself. Can't we make the things like we shouldn't think about suicide and there should be some device which can measure pressure, like mental pressure, and save them from committing suicide?

The fact is that long before anyone commits suicide, they broadcast distress to other people. Every suicide attempt is preceded by multiple times of announcements. The person who is about to commit suicide usually says, I'm feeling bad. I want to end my life. I'm about to commit suicide.

People send out signals to other people, to institutions, to mental health practitioners, to neighbors, to friends, to colleagues. People send out signals long before they commit suicide.

It is just that we are so desensitized. We are so self-centered that we don't pick up on these signals.

We have our own problems. Depression has become so ubiquitous, so all-pervasive, that virtually everyone is depressed. Everyone has anxiety, so we don't see it as anything special.

We all have lately suicidal ideation. Suicidal ideation has become very prevalent.

So the value of the signal is depreciated because everyone says, oh, I wish I were dead.

Then when someone really means it, we don't pick up on it. We don't pick up on pre-suicide signals.

We need to be very alert. And when anyone mentions death in any way, repeatedly and consistently and continuously, we need to step up and help them in any way possible.

Usually, usually, just having a talk, just lending a listening ear, a shoulder to cry on. Usually, it's more than sufficient.

It's shocking how little is needed to reverse the decision for suicide. How little is needed. It's absolutely shocking.

That's why, for example, hotlines, suicide hotlines, are very, very successful. On a suicide hotline you call, you talk to someone for 20 minutes. You don't want to commit suicide after that.

Suicide is a symptom. It's like fever. Suicide is a symptom of the disease of loneliness, the disease of atomization, the disease of disconnection from fabrics, social fabrics, social safety nets, social institutions. It's a symptom. It's not a disease.

So we can take care of the symptoms. We can take care of the symptoms, but we need to tackle the disease itself. And it's a social disease.

Suicide is a social act. Social act, actually anti-social act. It's not an individual act. It's a message. I give up on you, the person who commits suicide.

He's telling society, I'm giving up on all of you. I'm giving up on all of you. I'm giving up on other people. I'm giving up on my family. I'm giving up on my friends. All of you let me down. All of you did not help me when I needed help. I'm giving up on society, giving up on humanity.

It's not an act of self-destruction. It's an act of total separation. It's a goodbye act. Goodbye. I'm out of here. Stop the world. I want out.

Thank you so much, sir. Thank you. Thank you.

Thank you.

Thank you. I have, unfortunately, to go and I apologize to the future participants, but thank you very much for listening. Have a nice day, everyone. Th

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