11- Pridmore et al: Life and Suicide

The experience of life and completion of suicide

Saxby Pridmore1, Ahmed Naguy2, Said Shahtmasebi3

1Discipline of Psychiatry, University of Tasmania, Hobart, Australia; 2 Kuwait Centre for Mental Health, Shuwaikh, Kuwait; 3The Good Life Research Centre Trust, Christchurch, New Zealand.

Correspondence: Prof Saxby Pridmore: s.pridmore@utas.edu.au

Received: 20/5/2022; Revised: 2/6/2022; Accepted: 7/6/2022

Key words: Suicide; Suicide prevention; mental disorder.

[citation: Pridmore, Saxby; Naguy, Ahmed & Shahtahmasebi, Said (2022). The experience of life and completion of suicide. DHH, 9(1):http://www.journalofhealth.co.nz/?page_id=2772].

Abstract

Background: Over the last century the medical view of suicide (that it is always or almost always the result of a mental disorder) has prevailed. It has been refuted but it persists. We are of the view that a more realistic path to suicide can be characterized by three components 1) people may find life unpleasant and a cause of suffering, 2) death by natural causes allows escape from life-based suffering, and 3) suicide achieves an escape from life-based suffering at a time determined by the individual. Aim: To seek evidence supporting the contention that life may be unalterably unpleasant, and that suicide is selected by the individual as a means of terminating that unpleasantness, at a time of the individual’s choosing. Method: History, philosophy, literature and poetry texts of the last 2500 years were examined and statements of belief by publicly recognized individuals which supported the three assertions were collected. Results: 30 statements on life, 25 on death and 25 on suicide were selected and tabulated. There was strong agreement with each of the three assertions/facts listed above. Conclusion: Evidence from capable publicly recognized individuals (free of mental disorder) supports that some individuals find life unpleasant and a cause of suffering and choose suicide as a means of escaping their distress.

Key words: suicide; death; philosophy; history; literature; poetry

Introduction

Suicide has been known in all groups across all time. Over the last century the dominant view has been that suicide is always or almost always the result of a mental disorder. Although this restrictive view was refuted by the World Health Organization (2014), it continues to inhibit progress in the field.

It is plausible that mental disorders can trigger a proportion of suicides, but so does bereavement, financial difficulties, unemployment, relationship breakups, the onset of disability or physical illness, massive social change, and so on. It is widely accepted that acute distressing personal circumstances may also trigger suicide – multimillionaire Jeffrey Epstein, for example, hanged himself when he was in prison expecting an unpleasant future.

Major problems with the exclusive focus on mental illness as the strategy for suicide prevention has been, firstly, the failure to reduce suicides permanently; secondly, it gives celebrities, reporters and public figures an officially sanctioned script by which they can gain attention and inadvertently reinforce a faulty a faulty public mind set; thirdly, it has stymied the exploration, understanding and progress of suicide in order to develop effective prevention policies.

Death only happens once. We have little or no insight into the suffering threshold beyond which individuals may choose to bring death forward in order to relieve their torment. We do not yet understand why, when two similar individuals face apparently similar unpleasantness, one chooses suicide and the other chooses life.

In the quest for understanding, in this article we explore the path to suicide through historical and social perceptions of life and death. It is postulated the path to suicide is dependent on the following three components: 1) the lives of people may be unpleasant/produce suffering, 2) while death has disagreeable aspects, it has the capacity to end continuous unpleasantness/suffering, and 3) while the arrival of death from natural causes is unpredictable, suicide is a certain means of securing an end to unpleasantness/suffering, at a time of the individual’s choosing.

The argument begins with the contention: if life is unpleasant and unalterable using available conventional resources, the individual will consider unconventional methods for relief. It concludes with the contention: if an unplanned death provides release from unavoidable distress, a planned death becomes an option for consideration to bring relief forward.

We have sought supporting evidence for the social perception of the path to suicide from statements about life and death in the literature and recorded history. It is hoped that this paper will stimulate debate and the collaboration of international experts regardless of their school of thought.

Aim

To seek evidence supporting the contention that life may be unalterably unpleasant, and that suicide may be selected as a means of terminating that unpleasantness.

Method

We examined historical, philosophical, literature and poetry manuscripts and selected statements of belief (verbal and written) by named and publicly recognized individuals which support the above three assertions. These were arranged under the following headings: Life, Death, and Suicide.

Results

We located 30 relevant statements in which the authors confirmed that life could be unalterably unpleasantly distressing, 25 which confirmed that an unplanned death (should it occur) could halt suffering, and 25 which confirmed that suicide (which has the advantage of temporal predictability) could similarly halt suffering. These are listed below.

Life

We are encouraged by politicians, other leaders, and the advertising industry to adopt a positive view of life. Nevertheless, many individuals have a negative view. Every individual and their circumstances are different – while some may have been dogged by simple bad luck, many have experienced unfairness and exploitation, some find fitting in with others to be difficult and unpalatable.

We present 30 relevant statements.

We commence with the Buddhist teaching that life involves “unavoidable suffering”.

  1. “The noble truth of suffering (dukkha): birth is suffering, aging is suffering, illness is suffering, death is suffering; union with what is displeasing is suffering; separation from what is pleasing is suffering; not to get what one wants is suffering.” Dhammacakkappavattana Sutta (600-500 BC)

The remaining statements come from Western thinkers.

  1. “No one is happy all his life long.” Euripides (485-406 BC)
  2. “Never to have been born is much the best” Sophocles (497-406 BC)
  3. “No lot is altogether happy.” Horace (65-8 BC)
  4. “We rarely find anyone who can say he has lived a happy life and who, content with his life, can retire from the world like a satisfied guest.” Horace (65-8 BC)
  5. “As for life, it is a battle.” Marcus Aurelius (120-180 AD)
  6. “Man that is born of woman hath but a short time to live, and is full of misery.” Book of Common Prayer (1549)
  7. “Life is a tragedy.” Sir Walter Raleigh (1552-1618)
  8. “For all the happiness mankind can gain

Is not in pleasure, but in rest from pain.” John Dryden (1631-1700)

  1. “Life is the desert, life the solitude; Death joins us to the great majority.” Edward Young (1683-1765)
  2. “A man should be mourned at his birth, not at his death.” Montesquieu (1689-1755)
  3. “The finest day of life is that on which one quits it.” Frederick the Great (1712-1786)
  4. “Life is a comedy to him who thinks and a tragedy to him who feels.” Horace Walpole (1717-1797)
  5. “Life is a malady in which sleep sooths us each sixteen hours; it is a palliation; death is the remedy.” Nicolas Chamfort (1741-1794)
  6. “Life is deeply steeped in suffering, and cannot escape from it; our entrance into it takes place amid tears, at bottom its course is always tragic, and its end is even more so.” Arthur Schopenhauer (1788-1860)
  7. “Good-bye, proud world! I’m going home: Thou art not my friend, and I’m not thine.” Ralph Waldo Emerson (1803-1882)
  1. “For life in general there in but one decree: youth is a blunder, manhood a struggle, old age a regret.” Benjamin Disraeli (1804-1881)
  2. “Unquestionably, it is possible to do without happiness; it is done involuntarily by nineteen twentieths of mankind.” John Stuart Mill (1806-1873)
  3. “O suffering, sad humanity!

O ye afflicted ones, who lie

Steeped to the lips in misery,

Longing, yet afraid to die.” Henry Wadsworth Longfellow (1807-1882)

  1. “We come and we cry, and that is life; we yawn and we depart, and that is death.” Ausone de Chancel (1808-1878)
  2. “My life is one horrid grind.” Charles Dickens (1812-1870)
  3. “All religion, all life, all art, all expression come down to this: to the effort of the human soul to break through its barrier of loneliness, of intolerable loneliness…” Don Marquis (1878-1937)
  4. “We’re all of us sentenced to solitary confinement inside our own skins, for life.” Tennessee Williams (1914-1983)
  5. “Don’t look forward to the day when you stop suffering. Because when it comes you’ll know that you’re dead.” Tennessee Williams (1914-1983)
  6. “Life is (I think) a blunder and a shame.” William Ernest Henley (1849-1902)
  7. “Life is a long lesson in humility.” J M Barrie (1860-1937)
  8. “It’s common knowledge that life isn’t worth living, anyhow.” Albert Camus (1913-1960)
  9. “In such a world as this, depression is rational, rage is reasonable.” Fay Weldon (1931-)
  10. “Dear World, I am leaving you because I am bored. I am leaving you with your worries. Good Luck” George Sanders (1906-1972)
  11. “Everyone struggles. Each life comes with a long catalogue of pain.” Gary Shteyngart (1972-)

Death

Death has been a matter of much religious comment and expression of fear and dread by the secular community. However, it has also been frequently described as a welcome release from the trials/distress of life.

We present 25 relevant statements.

  1. “Unjustly men hate death, which is the greatest defence against their many ills.” Aeschylus (525-456 BC)
  2. “Call no man happy till he is dead.” Aeschylus (525-456 BC)
  3. “I am faint with envy of all the dead.” Euripides (485-406 BC)
  4. “Death may be the greatest of all human blessings.” Socrates (470–399 BC)
  5. “Death is not grievous to me, for I shall lay aside my pains by death.” Ovid (43 BC-18 AD)
  6. “Man should ever look to his last day, and no one should be called happy before his funeral.” Ovid (43 BC-18 AD)
  7. “Death, they say, acquits us of all obligations.” Michel Eyquem de Montaigne (1533-1592)
  8. “Sleep after toil, port after stormy seas,

Ease after war, death after life does greatly please.” Edmund Spencer (1552-1599)

  1. “Death pays all debts.” English proverb (17th century)
  2. “We die every day; every moment deprives us of a portion of life and advances us a step toward the grave; our whole life is only a long and painful sickness. Jean Baptiste Massillon (1663-1742)
  3. “When it comes (death) it is an alleviation to mortals who are worn out by suffering.” Pietro Metastasio (1698-1782)
  4. “Death is the liberator of him whom freedom cannot release, the physician of him whom medicine cannot cure, and the comforter of him whom time cannot console.” Charles Caleb Colton (1777–1832)
  5. “Oh Death, the poor man’s dearest friend, The kindest and the best!” Robert Burns (1759-1796)
  1. “Death came with friendly care;

The opening bud to heaven conveyed,

And bade it blossom there.” Samuel Taylor Coleridge (1772-1834)

  1. “Death comes to set thee free;

Oh, meet him cheerily

As thy true friend,

And all they fears shall cease,

And in eternal peace

Thy penance end.” Baron de la Motte Fouque (1777-1843)

  1. “How wonderful is Death,

Death and his brother Sleep!” Percy Bysshe Shelly (1792-1822)

  1. “Come lovely and soothing death.” Walt Whitman (1819-1892)
  2. “Nothing can happen more beautiful than death.” Walt Whitman (1819-1892)
  3. “Life is the jailer, death the angel sent to draw the unwilling bolts and set us free.” James Russell Lowell (1819-1891)
  4. “The thought of suicide is a great comfort: by means of it one gets through a bad night.” Friedrich Nietzsche (1844-1900)
  5. “Ain’t it grand to be blooming well dead.” Leslie Sarony (1897-1985)
  6. “I still go up my 44 stairs two at a time, but that is in hopes of dropping dead at the top.” A E Houseman (1859-1936)
  7. “What is there to say, finally, except that pain is bad and pleasure good, life all, death nothing.” Gore Vidal (1925-2012)
  8. “For the unhappy man death is the commutation of a sentence of life imprisonment.” Alexander Chase (1926-?)
  9. “Once you’re dead, you’re made for life.” Jimmy Hendrix (1942-1970)

Suicide

From the time of Plato, more than two thousand years ago, much was said and written about how God gave us life, and that it was sinful to suicide, because this meant the individual was rejecting a gift from God. To make the point from a less obviously religious position, the claim was repeatedly made that suicide was reprehensible because it was an act of cowardice. Those two statements are less commonly encountered currently. At the same time, however, and up to the present day, large numbers of publicly recognised people have supported suicide as a means of escaping distress.

We present 25 relevant statements.

  1. “Better die once for all than to live in continual terror.” Aesop (620-564 BC)
  2. “Death is not the worst evil, but rather when we wish to die and cannot.” Sophocles (496-406 BC)
  3. “Dishonour will not trouble me, once I am dead.” Euripides (485-406 BC)
  4. Plato (423–348 BC) was opposed to suicide but wrote it was permissible in response to “painful misfortune” and “irremediable and intolerable shame”.
  5. “Many a good man may weep for his death.” Horace (65-8 BC)
  6. “Anyone can take away a man’s life, but no one his death; to this a thousand doors lie open.” Seneca (4 BC-65 AD)
  7. “Sometimes death is a punishment; often a gift; it has been a favour to many.” Seneca (4 BC-65 AD)
  8. “An honourable death is better than a dishonourable life.” Tacitus (65-120 AD)
  9. “In all you say and think, recollect that at any time the power of withdrawal from life is in your own hands.” Marcus Aurelius (121-180 AD)
  10. “To be, or not to be: that is the question:
    Whether ’tis nobler in the mind to suffer
    The slings and arrows of outrageous fortune,
    Or to take arms against a sea of troubles,” William Shakespeare (1564-1617)
  11. “It is silliness to live when to live is torment, and then have we a prescription to die when death is our physician.” William Shakespeare (1564-1617)
  12. “I know death hath ten thousand several doors For men to take their exit.” John Webster (1578-1638)
  1. “We are in the power of no calamity while death is in our own.” Sir Thomas Browne (1605-1682)
  2. “We all labour against our own cure, for death is the cure of all diseases.” Sir Thomas Browne (1605-1682)
  3. “I have a hundred times wished that one could resign life as an officer resigns a commission.” Robert Burns (1759-1796)
  4. “His heart was breaking, breaking

Neath loads of care and wrong;

Who blames the man for taking

what life denied so long?” Arthur Wentworth Eaton (1859-1937)

  1. “You’ll never take me alive said he Drowning himself by the Coolabah tree.” A B Patterson (1864-1941)
  1. “Where happiness fails, existence remains a mean and lamentable experience.” George Santayana (1863-1952)
  2. “And when the women come out to cut up what remains

Jest roll on your rifle and blow out your brains.” Rudyard Kipling (1865-1936)

  1. “a suicide is a person who has considered his own case and decided that he is worthless and who acts as his own judge jury and executioner and he probably knows better than anyone else whether there is justice  in the verdict.” Don Marquis (1878-1937)
  2. “I will die and, with me, the weight of the intolerable universe” Jorge Luis Borges (1899-1986)
  1. “The suicide has judged…that to live will be more miserable than to die.” Graham Greene (1904-1991)
  2. “There is but one truly serious philosophical problem and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy.” Albert Camus (1913-1960)
  3. “Suicide…is about life, being in fact the sincerest form of criticism life gets.” Wilfred Sheed (1930-2011)
  4. “Every suicide is a solution to a problem” Jean Baechler (1937-) French academic and author. Suicides1975

Discussion and Conclusion

The first question to ask is whether this is an accurate/reasonable means of seeking information regarding the experience of life and the probability of suicide being considered as a means of escape from unalterable unpleasantness. We believe this to be an accurate/reasonable means. A related question is, can we be sure these people are telling the truth and not intending to attract attention to themselves by making dramatic, insincere statements? The people making these statements are all named and well known (except for one 17th century proverb); they were almost all believed to be honest and to have valued their reputation for capability and credibility.

Looking at the statements about life, those from the Dhammacakkappavattana Sutta (which gives a clear account of suffering being a universal life experience) are believed to have come from the Buddha immediately after he gained enlightenment. Another source, The Book of Common Prayer (which describes life as “full of misery”), must be considered honest/reliable. Charles Dickens stated, “My life is one horrid grind” – he was a very famous, credible, hard-working man – it is most unlikely he would have made this public statement if it did not reflect his beliefs.

Was it necessary to include the section on death? Possibly not. The argument could be simplified – that there is evidence that life can be difficult and suicide is an obvious means of escaping that experience. However, death is much broader than suicide, and observations on the matter have been made as far back as the Classical Greek and Roman scholars from Aeschylus to Ovid. Aeschylus (525-456 BC) stated, “Unjustly men hate death, which is the greatest defence against their many ills”. Much more recently, Rock musician, Jimmi Hendrix (1942-1970) stated, “Once you’re dead, you’re made for life”. While a section on death is not imperative to our argument, it adds depth and authority.

Suicide is a small division of death. Sophocles (496-406 BC) stated, “Death is not the worst evil, but rather when we wish to die and cannot”. Poignantly, Sir Thomas Browne (1605-1682) stated, “We are in the power of no calamity while death is in our own”. Importantly, in 1975, academic Jean Baechler stated, “Every suicide is a solution to a problem”. Thus, the persistent medical view that all or almost all suicide is the result of a mental disorder is steadfastly refuted.

For the last half century there has been great interest in preventing suicide – with large amounts of money and energy spent. This has almost exclusively focused on medical diagnoses, assessments and treatments. Unsurprisingly, there has been no improvement in suicide rates. Nor does the above analysis offer an obvious path forward. People find life difficult/painful, the knee-jerk reaction of giving warm support and attempting to teach individuals to be more “resilient”, is unlikely to provide the desired results. The above information suggests things will not change until there are changes in culture at various levels.

On average, between two-thirds and three-quarters of all those who complete suicide have had no contact with mental health services (Hamdi et al., 2008; Ministry of Health, 2016; Shahtahmasebi, 2003). We know very little about this group, but many of our “experts” are happy to label them mentally ill. The remainder of those complete suicide do so in spite of receiving psychiatric intervention. We must also consider whether suicide is always undesirable and should always be prevented. Perhaps, as we find the topic of suicide unpleasant, we automatically, precipitously wish to totally expel it from the world. Voluntary assisted dying is gaining acceptance around the world, beliefs and attitudes change over time and we need to re-visit our beliefs and responses from time to time.

Conflict of Interest: none

Reference

Hamdi, E., Price, S., Qassem, T., Amin, Y., & Jones, D. (2008). Suicides not in contact with mental health services: Risk indicators and determinants of referral. J Ment Health, 17(4), 398-409.

Ministry of Health. (2016). Office of the director of mental health annual report 2015. Wellington: Ministry of Health.

Shahtahmasebi, S. (2003). Suicides by mentally ill people. ScientificWorldJournal, 3, 684-693.

World Health Organization. (‎2014)‎, “Preventing suicide: a global imperative”. World Health Organization. https://apps.who.int/iris/handle/10665/131056

Notes

Aeschylus (525-456) Ancient Greek tragedian.

Aesop (620-564 BC) Greek fabulist.

Marcus Aurelius (120-180 AD) Roman emperor and Stoic philosopher. Meditations.

Book of Common Prayer (1549) – the short title for various prayer books used in the Anglican Church.

Jorge Francisco Isidoro Luis Borges Acevedo. Known as Jorge Luis Borges (1899-1986) Argentine short-story writer, poet, translator. The Suicide 1975.

Jean Baechler (1937-) French academic and author. Suicides1975.

J M Barrie (1860-1937) Scottish novelist and playwright. Little Minister 1891.

Sir Thomas Browne (1605-1682) English polymath/author – science, medicine, religion.

Robert Burns (1759-1796) Scottish poet and lyricist. Man was made to Mourn 1784, and a letter 1788.

Albert Camus (1913-1960) French philosopher, novelist. The Outsider 1942.

Sébastien-Roch Nicolas, known as Nicolas Chamfort (1741-1794) French writer and aphorist.

Ausone de Chancel (1808-1878) French writer and colonial administrator.

Alexander Chase (1926-?) American journalist and editor. Perspectives 1966.

Charles Caleb Colton (1777–1832) English cleric and writer.

Samuel Taylor Coleridge (1772-1834) English poet. Epitaph on an infant.

Dhammacakkappavattana Sutta –  a Buddhist text believed to be a record of the first sermon given by Gautama Buddha (circa 563-483 or 480-400 BC).

Charles Dickens (1812-1870) English writer and social critic.

Benjamin Disraeli (1804-1881) British Prime Minister and novelist.

John Dryden (1631-1700) English poet and literary critic. The Indian Emperor 1665.

Arthur Wentworth Eaton (1849-1937) American clergyman, historian, poet. The Suicide 1907.

Ralph Waldo Emerson (1803-1882) American Transcendentalist, philosopher, poet. These words come from a poem “Good-bye”, which he wrote in his later years. The poem has sometimes been misunderstood to indicate preparation for suicide, in fact, he was simply indicating his withdrawal from public life.

Euripides (485-406 BC) Classical Athenian tragedian.

Frederick II aka Frederick the Great (1712-1786) King of Prussia.

Graham Greene (1904-1991) English novelist and journalist. The Comedians 1966

James Marshall “Jimi” Hendrix (1942-1970) American musician, singer, songwriter. Verbal statement 1968.

William Ernest Henley (1849-1902) English poet, critic, editor. Waiting 1902.

Horace (65-8 BC) Real name: Quintus Horatius Flaccus. Roman lyric poet.

A E Houseman (1859-1936) English classical scholar and poet. Letter to Laurence Houseman 1932.

Rudyard Kipling (1865-1936) English journalist, novelist, poet. The Young British Soldier 1895.

Henry Wadsworth Longfellow (1807-1882) American poet. The Goblet of Life 1842.

James Russell Lowell (1819-1891) American poet and diplomat. ‘Tis Sorrow Builds the Shining Ladder Up 1854.

Donald Robert Perry Marquis aka Don Marquis (1878-1937) American author, playwright, poet.

Jean Baptiste Massillon (1663-1742) French Catholic Bishop.

John Stuart Mill (1806-1873) English philosopher. Utilitarianism 1863.

Michel Eyquem de Montaigne (1533-1592) French philosopher.

A B Patterson (1864-1941) Australian author and poet. Waltzing Matilda 1895.

Pietro Antonio Domenico Trapassi, better known by his pseudonym of Pietro Metastasio (1698-1782) Italian poet.

Charles-Louis de Secondat, Baron de La Brède et de Montesquieu, generally simply referred to as Montesquieu (1689-1755) French judge, historian, philosopher. Persian Letters 1721.

Friedrich Nietzsche (1844-1900) German philosopher.

Publius Ovidius Naso. Known in English as Ovid (43 BC-18 AD) Roman poet.

Plato (423–348 BC) Ancient Greek/Athenian philosopher. Laws circa 360 BCE.

Sir Walter Raleigh (1552-1618) English statesman, soldier, writer and explorer.

George Sanders (1906-1972) British actor. Suicide note 1972.

Jorge Agustín Nicolás Ruiz de Santayana y Borrás. Known in English as George Santayana (1863 –1952), Philosopher, poet and novelist. Life of Reason, Introduction and Reason in Common Sense 1905.

Leslie Sarony (1897-1985. British songwriter. Name of song 1932.

Arthur Schopenhauer (1788-1860) German philosopher. The World as Will and Representation 1818.

Seneca (4 BC-65 AD) Roman Stoic philosopher.

William Shakespeare (1564-1617) English playwright and actor. Othello 1603; Hamlet 1609.

Wilfred Sheed (1930-2011) English-born American novelist. The Good Word 1978.

Percy Bysshe Shelly (1792-1822) English Romantic poet. The Cloud 1820.

Gary Shteyngart (1972-) Soviet-born American writer.

Socrates (470–399 BC) Ancient Greek philosopher. Often referred to as the Father of Western Philosophy.

Sophocles (497-406 BC) Classical Athens tragedian.

Edmund Spencer (1552-1599) English poet. Epithalamion: an ode written to his bride on their wedding day 1594.

Publius Cornelius Tacitus. Known in English as Tacitus (65- 120 AD) Roman historian.

Gore Vidal (1925-2012) American novelist, wit and critic. Esquire magazine 1970.

Horatio Walpole, 4th Earl of Orford, better known as Horace Walpole (1717-1797) English writer, art historian, man of letters, and politician.

John Webster (1578-1638) English dramatist. The Duchess of Malfi 1623.

Fay Weldon (1931-) English author and playwright.

Walt Whitman (1819-1892) American poet essayist journalist. Starting from Paumanok 1860; When Lilacs Last in the Dooryard Bloom’d 1865.

Tennessee Williams (1914-1983) American playwright. Orpheus Descending 1957.

Edward Young (1683-1765) English playwright and poet. The Revenge 1721.