A Very Human Ending: How Suicide Haunts Our Species

Disgust with our own existence, weariness of ourselves is a malady which is likewise a cause of suicide.¹ The remedy is a little exercise, music, hunting, the play, or an agreeable woman. The man who, in a fit of melancholy, kills himself today, would have wished to live had he waited a week.

Voltaire, Philosophical Dictionary (1764)

Early on in the course of writing this book, I was advised to never, ever use that dreadful phrase “committed suicide.”

Such a thing implies, I was told, a criminal act: the commission of a crime. A cruel linguistic artifact from those judgment-heavy days of felo de se, when suicide really was a prosecutable offense (either against the person himself in the aftermath of a botched attempt, or as a financial punishment levied by the government against the victim’s family through seizure of goods and property), today the expression “committed suicide” still carries with it an air heavy with legalistic sinfulness. Not only does it stigmatize the mental illness, whatever it is, that’s thought to underlie the act, but it also pollutes the reputation of the dead, as it presupposes the individual’s failure to rein in the responsible defects of their character, such as selfishness, a violent nature, or cowardice.

“Do we ever say that someone ‘committed cancer’ or ‘committed heart failure,’ even when they may have lived lifestyles that contributed to such diseases?”² asks the Australian suicide prevention specialist Susan Beaton.

And speaking of failures, we should probably also do away with, say many experts, our peculiar habit of labeling sub-lethal incidents of self-destruction as “failed suicide attempts,” as well as those that end tragically in death as “successful suicides.”

“My ‘failed attempts,’” said one patient, “made me feel just like that, a failure.³ Once when I drove my car off the road, in the ER the nurse asked me if I had taken my seat belt off. When I replied no, she rolled her eyes and shook her head.”

“As health professionals,” Beaton explains, “our goal must be to reduce the taboo surrounding suicide.⁴ To do so, we must update our language.”

What are the appropriate ways to talk about this dismal matter then, you ask? The phrase “died by suicide” is preferable, suggest some mental health advocates, to the subtly larcenous “took their own life.” Or, in what is an unspeakable affront to my own ears, even if it’s not to the English language, the verb suicided is also acceptable.fn1

In any event, I’ve learned along the way that the particular terms used in suicide prevention discourse separate the dilettantes from the professionals. I do think that shifting the vernacular in these ways has admirable aims. Just between us, though, I struggle to muster up much passion for these righteous semantic feuds. They feel a little overzealous to me; and a politically correct nomenclature always risks slipping into pedantry.

Although words are powerful and they can indeed lead a recalcitrant culture by a leash into greater understanding, there’s also the faint pretext here that one is actually doing something meaningful to combat the problem of suicide simply by adopting the approved industry terms. It’s a fine discussion to have, this debate over language, but we need to pick our battles, and this one feels rather trivial to me in the overall war.

“Not sure if you’ve heard,” my friend Jack wrote to me, “that my father hung himself last August. I still can’t believe it, he actually committed suicide.”

“Oh, Jack,” I responded, as any human being would. “I’m terribly sorry.” Just imagine if my instinctive reply was instead: “Actually, Jack, it’s hanged. You mean to say that your father hanged himself. Also, ‘committed suicide’? What is this, the Middle Ages?”

The phrase “committed suicide” is obsolete, yes. It’s suggestive of sin and crime and drags with it the weight of a thousand dark years. Still, it’s the intent of the speaker that matters, and no matter how tactfully your lesson is rendered, pointing these facts out to a friend who just shared the worst news of his life with you is a pretty dubious contribution, in the scheme of things. Besides, the topic is already difficult enough to talk about.

I’m all for elevating the public discourse on suicide, of freeing it from the ecclesiastical cells and punishing court dockets where it festered for so long. But etiquette is key, and I fear if it’s not done with great sensitivity, such a supercilious language campaign will only introduce a new land mine that will make many people not dare to discuss the topic because, on top of everything else, now they’re keenly afraid of making a faux pas in their word choices.

Jack, for his part, couldn’t care less about such things. Hung or hanged, committed or died by suicide, his beloved dad is dead. What’s more important to Jack, a recently minted PhD in philosophy, is coming to terms with a devastating suicide that, from his point of view, was also not without a certain rationality.

“He was a logical thinker,” Jack told me of his father, Ross, a retired mathematics professor. “And understanding the way he thought, I think he made a logical, even if desperate, decision. He wasn’t ‘mentally ill,’ which most people mean as an inability to reason … or basically, insanity.”

Around three o’clock in the morning on August 25, 2015, sixty-five-year-old Ross took a few plentiful swigs of vodka to steel himself for what he was about to do, tightened the noose around his neck that he’d meticulously prepared, and hanged himself in the garage of his large country home, much of which he’d built lovingly with his own hands.

“Being an applied mathematician,” Jack said, “he was able to calculate weight and measure the drop and that kind of thing, to make sure it was done properly. People can get it wrong, and he did everything with extreme precision. His feet came to rest just a few inches from the floor.”

A few months later, after the materials from the scene had been processed, an ill-informed police officer notified Jack that they’d be sending him, as his father’s legal representative, all of the collected items: letters, names and addresses of intended recipients of the suicide notes, the cell phone … even the noose itself.

“It beggars belief, doesn’t it?” Jack remarked about the noose. “But when I got to the police station, they reneged on that and kept it. I was actually a little disappointed I didn’t get it. I wanted to chuck it in a river. Or, I don’t know … Dad had actually left me a set of instructions called ‘Possessions and Final Instructions.’ His wife’s lawyer strenuously dismissed these instructions as ‘not a legal document’ … as if his words were not clear on his intentions. So, I also pictured myself throwing that noose on a courtroom floor, saying, ‘That’s not a legal document either, but it makes it pretty clear what his intentions were!’”

The prospect of handling that intimate object of his father’s demise was just one of many surreal experiences Jack has had to face. Like so many others who’ve lost a loved one to suicide, he soon found himself doing the gritty detective work … comparing the alternate versions of suicide notes that his father had typed out on his laptop—some angry, some more composed—mulling over possible double meanings in emails and text messages (“I’m literally at the end of my rope” is one such line that still haunts Jack), interrogating everyone who saw and spoke to his father those last few days, even retrieving deleted messages from his phone, all in an attempt to piece it together, to somehow comprehend how it had all gone so terribly wrong for the man he so admired.

Jack’s sleuthing was done alongside a formal coroner’s report, a standard course of action for suicides that aims to assess whether a police inquest is warranted. Also, the regional mental health-care team that had treated Ross prior to the “serious adverse incident” (aka the suicide) was audited to ensure that everything was indeed done by the book. Taken together, a picture began to emerge of a brilliant but complicated man whose pride had been deeply wounded upon discovering that his new wife lied to him about a previous relationship.

“Dad was a passionate person. He was sensitive, but also had a temper,” Jack told me. “I’d been on the receiving end of his wrath before.”

This time, though, it was his wife who bore the brunt of it. And this time, words swelled into a blow and her fleeing the scene. A passing driver was flagged down in front of the couple’s home. The police were called. She had a fat lip. Now a trial was pending. The court mandated that Ross and his wife be separated until the hearing. She went to stay with family abroad. He was left to stew alone in that big country house.

“When I heard what had happened, the situation he was in, I immediately thought ‘That’s it,’ said Jack, who lives in another city, far away from his father’s place. “Because I know what he’s thinking … he knows he can’t forgive her for it … even if he did, he won’t be able to live with all that had happened. It was a nasty row. Anyway, I actually thought, ‘That’s it, there’s no way he’s coming out of that.’”

“Dad,” he said, “you’re not thinking of doing anything stupid, are you?”

And Ross outright denied it. “He sent me a text saying, ‘I have no intention of taking my own life at all. I’m not in any danger. Stop interfering.’ They’re the parent, you know,” Jack explained to me. “Even though you’re thirty-nine years old, or whatever, you’re made to feel like you’re the little kid and don’t know any better. So, you sort of think, ‘Nah, he wouldn’t do that, because he says he’s not going to do that.’”

“I was always checking in with him during this time, and he was just very unresponsive. You’d kind of have to jolt him into replying. And when he did, it would just be very short. ‘How are you doing, Dad? How are you feeling?’ I’d text him. And I’d get a single word back—‘dark.’”

When his father stopped responding altogether, Jack and his aunt (Ross’s sister in Canada) grew alarmed and called the authorities for a welfare check. When the police showed up at his house, Ross was his normally affable, professorial self; he agreed to let them take him to the hospital for an assessment. “He was compliant. He said, ‘Yeah, no problem, whatever you need to do,’ and they took him straight to the psych ward for an evaluation.”

Jack showed me the “Serious Adverse Incident Report” for his dad’s case. It included details from the consultation with the resident psychiatrist that fateful night at the hospital. The document illustrates just how challenging it can be, even for trained professionals, to accurately assess a person’s suicide risk.fn2 “The subject was relaxed in manner and spontaneous in conversation,” reads the report.

He spoke about the devastation of his wife leaving and the humiliation of the pending court case but he was positive about the future …. Presented as casually dressed and well-kempt. His face was flushed, there was good eye contact and rapport was established. He was a good historian …. It was felt by the team that the subject did not suffer from a mental illness but was experiencing a reaction to a situational stressor …. He was very articulate and talking in detail about his life. The Consultant Psychiatrist confirmed that the subject was sad and heartbroken but not clinically depressed. The subject readily acknowledged that everything would be okay if the charges were dropped and his wife agreed to reconcile, i.e., it was a situational remedy, not mental health treatment, which was required.

The psychiatric nurse advised that Ross be admitted overnight. But around 1 a.m., Ross phoned Jack to say that he wanted to go home. Jack cautiously agreed; he felt that keeping his father at the hospital against his will would only make matters worse, adding yet another “situational stressor” into an already volatile mix. So, Ross went home, as he wished, with prescriptions for diazepam (for his anxiety) and zoplicone (a sleep aid) in his pocket.

The psychologist Matthew Nock and his colleagues point out that simply asking someone if they’re suicidal isn’t usually very effective. “This approach is limited,” write the authors, “by the fact that people often do not know their own minds and is especially problematic in measuring suicidal thoughts because people often are motivated to deny or conceal such thoughts to avoid intervention or hospitalization.”⁵ In fact, just as Ross did, up to 78 percent of those who die by suicide explicitly deny suicidal thoughts in their last verbal communications before killing themselves. In hindsight, Jack believes his dad had every intention to end his life, even then. “When he made a decision, he made a decision,” he told me. “So anything he’s saying or doing is a decoy; it’s going to be putting you off the scent.”

To help clinicians determine which patients are most at risk of suicide, Nock and his associates have developed a clever predictive tool that works by revealing a person’s camouflaged suicidal feelings. The tool is a variant of the Implicit Association Test (IAT), an established measure in the field of social psychology that identifies people’s implicit—or hidden, and possibly even subconscious—mental associations about various topics. In Nock’s version, participants sit down at a computer and see words associated either with “death” (such as die, dead, deceased, lifeless, suicide) or “life” (alive, survive, live, thrive, breathing) flash on the screen before them. Alongside these death-or life-related words are terms denoting either the attributes of “me” (I, myself, my, mine, self) or “not me” (they, them, their, theirs, other). The faster the participants push a button to link these concepts together, the stronger the mental association. Therefore, faster responding on the “death”/“me” blocks relative to the “life”/“me” blocks are taken to be suggestive of the person’s suicidal feelings.

In 2010 Nock and his colleagues administered this five-minute computerized test to 157 adult patients who’d checked into a large psychiatric emergency department, most while they were still in the waiting room. Following up with these patients six months later, the predictive capability of this simple IAT procedure proved to be impressive. “The presence of an implicit association with death/suicide,” the authors discovered, “was associated with an approximately six-fold increase in the odds of making a suicide attempt in the next six months.”⁶ By contrast, the emergency room doctors who’d seen these patients got it completely wrong—despite their training, they failed to spot those most at risk of suicide.fn3

Administration of the IAT to gauge suicidal intent has yet to be adopted as standard clinical practice. Unfortunately, it wasn’t done in Ross’s case. Still, the psychiatrist had been concerned enough to recommend a term of daily home-care visits to Ross’s house by a crisis counselor. One of the things weighing on everyone’s mind was the sobering fact that Ross had made a suicide attempt twenty years earlier, when he was forty-five.

“I would have been in my early teens then,” Jack told me of that earlier attempt. “He thought he was going to lose his job at the university. I remember him sitting at the dinner table, doing the maths, thinking out loud about his life insurance, and saying something like, ‘If I die, you’ll all be better off.’ I guess he was thinking about some insurance windfall for his family. He’d gone into the garage and tried to do it with exhaust fumes, but my mum heard the car and got him out before anything happened. I think he went on holiday somewhere with my uncle, did a bit of fishing, came back, and it all worked out in the end.”

“What do you mean?” I asked Jack. “How did the situation resolve itself?”

“That’s interesting,” I point out. “I mean, at the time that he tried to kill himself back then, he must not have even considered the possibility that things would actually work out to his advantage. He must not have been able to see that as a potential outcome.”

This time, though, with his second marriage rapidly dissolving and likely assault charges to boot, it would be a very different outcome. When the crisis counselor phoned to arrange a fifth home visit, she was surprised to hear Ross’s estranged wife pick up.

His sister had asked the authorities to do another welfare check, and when police arrived, they’d found Ross hanging in the garage. The police then called his wife, who’d just returned from abroad the evening before, and had her come over to identify the body.

Multiple versions of suicide notes, most of them meant for Ross’s estranged wife, were carelessly left accessible on an old laptop at the scene—all of which were also sent to Jack on a memory stick.

“Some were clearly typed out in a rage,” said Jack. “And some were well thought out. I think he meant her to see the more considered one, not the angry ones. But yeah, she probably saw all of them.”

He showed me the notes. Even the more “watered-down” versions were pulsing with animus.

“It seems to me this upcoming court case was really getting to him,” I told Jack, trying to look at the whole situation in context. “He must have felt very ashamed?”

“Oh yeah,” Jack replied. “It’s all through his emails, that he didn’t think he had it in him. But he was so maddened by [his wife’s deceit] that he lashed out …. He’s got this hearing looming, ten days from when he died. And the final thing on that day, what really pushed him through the roof, was that he found out he was being appointed a senior barrister. And he’s never been in trouble with the law before, you see. All of a sudden, he finds out he’s going from a junior barrister to a senior barrister, and in his head, this was terrifying [because of the perceived seriousness of his offense]. He’s going around in circles, saying, ‘I wouldn’t be in this mess if it wasn’t for your lying’ … that kind of thing. So he oscillates between seeing himself as the innocent party and the guilty party. At any rate, his second marriage was partly intended to spite the first, with my mum, but it was ultimately, in his mind, an epic fail. There was no hiding it. Word would get out.”

From the very beginning, Jack has made it clear to me that he thinks his dad’s decision was rational, logical. Yet poring over those suicide notes to his wife, I admit to Jack that “rational” isn’t the first word that comes to my mind.

“What I mean by that,” he explained to me, “is when people think suicide, they think mental illness straightaway, which is what annoyed me, because everyone was so quick to jump on that boat. There was a clear logic to what he did. He weighed up his options, he said, ‘Here are my options: it’s forgive and move on,’ or forgive knowing that he’s tried that before and it doesn’t work in his head, that he wouldn’t be able to live with it. So, he’s weighed up Option A or Option B. It’s ‘here are the facts.’ Suicide seemed to him a logical decision. Can’t live with it, so may as well end it. I don’t mean ‘rational’ as in a good decision. He did look at the future, and whatever way he looked at the future, it was blank.”

“I am, I have concluded,” writes Ross in one of his suicide notes, “an innocent, naïve, idealistic fool … I don’t blame the world but my own inflexibility within it.”

Jack’s analysis of his dad’s decision making actually strikes at the heart of centuries of philosophical debate surrounding the ethics of suicide. And a heated debate it’s been. Taking religion out of the equation, do we have the “right” to kill ourselves or even, in some cases, a moral duty? Or is suicide always, unequivocally, wrong? Is it always the sign of a mentally ill mind, or can it sometimes be characteristic of a rational and healthy one?

Today, even asking such questions evokes anxieties, and understandably so. But historically, the range of views on this gray matter has been vast and fierce. In ancient Greece, the Stoics treated suicide as the act par excellence of a cultivated thinker. Seneca famously wrote in his matter-of-factly titled “On the Proper Time to Slip the Cable,” for instance, that “a wise man will live as long as he ought, not as long as he can.”⁷

As soon as there are many events in his life that give him trouble and disturb his peace of mind, he sets himself free …. The best thing which eternal law ever ordained was that it allowed to us one entrance into life, but many exits. Must I await the cruelty either of disease or man, when I can depart through the midst of torture, and shake off my troubles? This is the one reason why we cannot complain of life: It keeps no one against his will …. Live, if you so desire; if not, you may return to the place whence you came …. If you would pierce your heart, a gaping wound is not necessary; a lancet will open the way to that great freedom, and tranquility can be purchased at the cost of a pin-prick.

And yet, more than fifteen hundred years after Pliny the Elder argued that suicide was a “supreme boon” and the one act that even the gods couldn’t perform, the philosopher Immanuel Kant, who seems to have had a thorn in his paw on this particular topic, countered that it was, by contrast, the only thing that placed man lower than the animals. “If he disposes of himself,” writes Kant, “he treats his value as that of a beast ….⁸ We are free to treat him as a beast, as a thing, and to use him for our sport as we do a horse or a dog, for he is no longer a human being; he has made a thing of himself, and, having himself discarded of his humanity, he cannot expect that others should respect humanity in him.” It’s almost as though, by making nonreligious moralistic arguments against suicide, scholars such as Kant are screaming at corpses in a futile attempt to validate their own existence. But they might as well protest the insouciance of stones; suicide is one of the few social acts for which, in the end, the individual does not have to face society.

Throughout the written ages, almost every influential thinker has at least ventured an opinion on the subject of suicide. From Plato being horrified by any man who would “slay his own best friend” to Nietzsche being consoled through many a dark night by the thought that suicide is always an option, most of the heavy hitters have chimed in.⁹ Ultimately, it’s a matter of taste, really, which argument appeals to you most. Yet, as a psychologist, asking whether suicide is morally wrong or right feels almost irrelevant to me … and for the nihilist in me, it’s a sort of vacuous query anyway. Is there any inherent reason to live a life assailed by troubles? Well, no. Not really. As that straight-talking infidel of the British Renaissance David Hume put it in his essay on suicide, “the life of a man is of no greater importance to the universe than that of an oyster ….¹⁰ I am not obliged to do a small good to society, at the expense of a great harm to myself. Why then should I prolong a miserable existence, because of some frivolous advantage, which the public may, perhaps, receive from me?”

Still, I don’t know about you, but I find myself in a difficult place when reading people like Seneca and Hume on suicide. Yes, they make sense. A little too much sense, if you know what I mean. Don’t forget that when we’re suicidal, our reasoning capabilities are seriously impaired in the ways we’ve seen, and as such, any level-headed attempt to crunch the numbers—expected future happiness quotients, quantified harm and benefits to loved ones, informed estimates of unexpected outcomes—can be subject to tragic miscalculations.

Clever as he was, Ross got the numbers wrong when he tried to kill himself at age forty-five. By his own admission, he had the best years of his life after that. And to my mind, at least, there’s no reason to think that he didn’t get it wrong when he actually did end his life at sixty-five.

It’s not that there aren’t rational suicides. There are; of course, there are. When twenty-year-old Ryan Lock, a young Brit who’d joined Kurdish freedom fighters in Syria, found himself surrounded by Islamic State militants in the northern city of Raqqa in December 2016, he turned his gun on himself. We all know what ISIS does to its hostages. But it would be a stretch to say that Lock was “suicidal” in the way that term is normally used.

I’m reminded of a passage from Valerius Maximus’s Memorable Doings and Sayings in which the author describes what strikes me as a perfectly sane end-of-life custom among the Massilians (first-century inhabitants of what is now the South of France).¹¹ Older individuals who were still in good health could preempt the ravages of age by appealing to the senate for permission to end their life. “The enquiry is conducted with firmness tempered by benevolence,” wrote Valerius, “not suffering the subject to leave life rashly but providing swift means of death to one who rationally desires a way out.” Typically, they’d be given poison compounded of hemlock, which was otherwise kept under close guard. Such a custom likely originated in Greece, the author surmises, and he recalls having once witnessed on the island of Kea the following extraordinary scene:

A lady of the highest rank there but in extreme old age, after explaining to her fellow citizens why she ought to depart from life, determined to put an end to herself by poison …. Having passed her ninetieth year in the soundest health of mind and body, she lay on her bed, which was spread, as far as might be perceived, more elegantly than every day, and resting on her elbow she spoke: “… may the gods whom I am leaving rather than those to whom I am going repay you because you have not disdained to urge me to live nor yet to be witness of my death. As for me, I have always seen Fortune’s smiling face. Rather than be forced through greed of living to see her frown, I am exchanging what remains of my breath for a happy end, leaving two daughters and a flock of seven grandchildren to survive me.” Then, having urged her family to live in harmony, she distributed her estate among them, and having consigned her own observance and the domestic rites to her elder daughter, she took the cup in which the poison had been mixed in a firm grasp. After pouring libations to Mercury and invoking his divine power, that he conduct her on a calm journey to the happier part of the underworld, she eagerly drained the fatal potion. She indicated in words the parts of her body which numbness seized one by one, and when she told us that it was about to reach her vitals and heart, she summoned her daughters’ hands to the last office, to close her eyes.

Recall Edwin Shneidman’s maxim: “Never kill yourself while you are suicidal.”fn4

“Well, fine,” Jack interjected when I tried to argue this point in relation to his father’s suicide. “But why do you assume that just because emotions are involved, one is irrational?”

Still, even Jack gets irked by the venerable members of his own pantheon. “These grand moralizers kind of get me incensed,” he told me. “Because most of them are up in their ivory towers, and they’ve actually no bloody idea what it’s like to be close [to suicide]. They’re talking about stuff they don’t know about. They just literally do not know. The objective, factual reality, what we are dealing with, involves actual states of mind and actual people and actual states of affairs. And they’re all so different! You can’t stretch a blanket over them with a fictional idea of what constitutes right and wrong.”

The astonishing range of opinions regarding the ethics of suicide has implications beyond philosophy, too. Numerous studies have uncovered a correlation between a society’s acceptability of suicide and its suicide rates. That is, even after adjusting for religious beliefs, those nations that tacitly endorse suicide as an individual right, or personal choice, have more suicides per annum than those in which the cultural attitude is more disapproving. This is why some suicide prevention experts caution that we should think twice before trying to eradicate the taboo of suicide entirely. I don’t usually quote fiery early Puritan preachers favorably, but Increase Mather, responding to some clergy members wanting to reassess the church’s unforgiving outlook on suicide, might have had a point when he wrote that “lest by being over-charitable to the dead, we become cruel to the living.”

A few decades ago, the rabble-rousing anti-psychiatrist Thomas Szasz, best known for his book The Myth of Mental Illness, argued against suicide prevention—or at least, what he saw as the American tradition of forcibly interfering, often by involuntary hospitalization, with the death wishes of suicidal people.¹³ Even if it’s a bad, impulsive decision, Szasz reasoned, suicide is a “fundamental right” and, aside from giving them counsel and helping them to see the error of their ways, we shouldn’t impose our own iron will on someone who wants to end their life. No more than, say, we’d physically prevent someone we care about from making other bad decisions, like getting married to the wrong person. “The phrase ‘suicide prevention,’” Szasz wrote in a 1986 article published in American Psychologist, “is itself a misleading slogan characteristic of our therapeutic age ….¹⁴ The term prevention, especially when coupled with suicide, implies coercion.” Szasz suggested that a more effective approach would be a return to treating suicide as a moral, rather than a medical, question. Just because we have the right to kill ourselves, he argued, doesn’t mean it’s a good idea. “Where there is no freedom, there is no responsibility,” Szasz explained.¹⁵

I object to our present policies of suicide prevention because they downgrade the responsibility of the individual (who is typically called a “patient” or “client” even if he or she rejects such a role) for the conduct of his or her own life and death.

In practice, however, morality isn’t so straightforward. While Szasz was busy railing against suicide prevention efforts, the widow of a fellow psychiatrist who’d been seeing Szasz as a patient sued him over the death of her husband. Six months after Szasz had instructed the man to stop taking medication (lithium) for his bipolar disorder, the patient hanged himself; but that was only after he’d repeatedly struck himself in the head with a hammer and slashed his own neck.¹⁶ fn5 The lawsuit against Szasz was settled out of court.

So how about you? Would you identify as a moralist, a libertarian, or a relativist when it comes to your feelings about the appropriate way to respond to a suicidal person?¹⁸ If you’re a moralist, this means that you perceive suicide to be inherently wrong and that it should be prevented at all costs. Libertarians, by contrast, are on the other side of the spectrum. For them, none of us is under any societal obligation to remain alive, and we certainly shouldn’t be forced to live when, as autonomous free agents, we’ve carefully weighed our options and have concluded that death is the lesser harm. So-called zero suicide initiatives, in the view of many libertarians, are overly “paternalistic,” another one of those morally loaded terms. Finally, the relativist says, in essence, “Well, it depends.”

Previously, I asked Roy Baumeister if he thought his six-stage model of suicidal thinking, which we saw in chapter 4, could be a valuable tool for those working in the field of suicide prevention.

“Well,” Roy hedged, “if we say that suicide is an outcome that should be prevented at all costs, that there’s no justification, people should never kill themselves, then yes, knowing the process is useful. I was never quite persuaded by that. Maybe it’s my libertarian streak.” He continued:

I remember going to a conference once. I was invited to give a talk on suicide and, going in, there were all these signs and posters about having a vigil and a meeting about how to prevent suicide. My wife was with me and I said, “Oh, okay, I guess they’re against it.” In other words, I’m trying to understand it but I never took the position that I’m unequivocally against suicide or trying to prevent all people from killing themselves. I don’t know what the moral duty is. If you talked a person out of suicide and the person went on to be miserable for many years, that would sort of be your fault, you inflicted all that suffering on that person. So, I don’t presume to know what’s right for other people.

I once heard a disturbing story about a sleep-deprived cardiologist who, after a stressful day at work, became unhinged and bludgeoned his own pet dog in the backyard with a croquet mallet when it wouldn’t stop barking. Then, realizing the gravity of what he’d done, the man went into his house and shot himself in the head.

I’m not proud of it, but my initial thought on hearing this account was not one of compassion for the human life lost. Instead, because dogs are my emotional weakness, I saw the man’s suicide as a sign of a just world. “What a bastard,” I thought. “Good riddance.”

But that’s the thing about people who kill themselves over some heinous transgression. It’s only after they’ve done so that we’re able to realize that, feeling as they so clearly did about their misdeeds, these were precisely the types of redeemable people who shouldn’t have ended their lives this way. After all, it’s those who aren’t particularly bothered by their harming of others—or perhaps they simply don’t care that the world knows what they’ve done—who are far more likely to harm others again.

It’s a pity that the scales of justice tilt so heavily in our minds in favor of a person’s worst-ever deed; the accumulated weight of their whole complex life story, including all the good they’ve ever done, becomes, in comparison, morally irrelevant. It was brutal and unspeakably cruel what he did to that dog, yes, but how many other lives had that cardiologist saved, or might have saved to come? My mind, admittedly, has trouble with such math.

Likewise, Jack’s father did a despicable deed by striking his wife in the heat of the moment. Domestic violence is shameful, and Ross’s behavior was arguably unforgivable. Victims of intimate partner assault are at a significant risk of suicide themselves. And yet, isn’t reducing the entirety of Ross’s identity to that split-second decision a shallow measure of the man? “I just blew a gasket,” Ross wrote in his farewell letter to his son. “I did a bad thing frightening her and I am sorry.”

Shortly before his suicide, Ross had designed a groundbreaking electromagnetic device that could reliably detect car bombs from a safe distance, an innovation that promised to save countless law-enforcement and civilian lives in war-torn regions across the globe. It’s a project that would come to nothing without his direction and expertise. As Jack and others continue to grieve Ross’s loss, he’s remembered as an ingenious but imperfect man whose life, and potential, were worth cumulatively far more than his death.

“Dad was a huge part of my life,” Jack said. “A sort of golden aspiration. When he went, I felt like I had no point in living anymore, either.”

In the end, I think, we can philosophize about the ethics of suicide—and if there are ever any social situations that would make it a rational or logical act—as long as there are flawed human beings who find themselves suddenly, unexpectedly, facing a terrifying future in which their reputation and identity has been permanently stained by an act they regret. But love isn’t philosophy. And when we truly love someone, we would do anything to persuade that person that suicide is not, in fact, the only option. The truth is, we’d hold that fallen person’s hand through Hell on earth.

I’ve always had a thing about cemeteries. As a kid, my father would sometimes give into my begging and take me to a small derelict graveyard at the top of a hill just behind our neighbor’s home. I couldn’t have been more than six or seven at the time. We were living in a D.C. commuter suburb of Virginia then. The cemetery was a tiny windswept enclave where the residents had, so far, managed to fend off the urban sprawl swallowing up their once-remote town, filling their plentiful pastures with cheaply manufactured homes, and bulldozing their forests to make room for soccer fields and throughways into the capital.

Sure, the cemetery was overgrown and it was hard not to trip over the fast-food wrappers and empty beer cans left by the teens who liked to hang out there and smoke pot, but to me, this was a magical place. It was a fellowship of bones and secrets and sorrows. There I’d stand, squeezing my dad’s hand while gazing with a kind of innate wonder at the drab white stones that reminded me of broken teeth.

“Look,” said my father, “this little boy wasn’t much older than you when he died.”

Still, this unexpected truth, that death seized not only the frail and old, but even those everlasting ones—children like me—must have sat uncomfortably in my subconscious. Because it was around this same time, too, that I had the dream.

Many of us have that one special dream from our childhood … that one terrifying but mysterious journey into the numinous, that nightmare whose images and the powerful emotions they evoked we can still recall as clearly today as the moment we awoke, startled, in its raw wake, our hearts thumping in our chests and our thoughts alive with the echoes of its horrible wonder. Such dreamscapes are mostly ineffable things, since they are felt by the child at an almost cellular level, and any attempt to communicate them to others, to carve out their power in words, are frustratingly ineffective. That said, I’ll do my best to share mine here, because the dream seems to have forecasted the contours of my life story as a psychologist, how I view the problems of being human, and my approach to suicide.

In this dream of mine, I was the sole audience member seated center stage in a grand old theater of gilt and rose. Although my recollections are undoubtedly colored by my adult imaginings, as I waited there, restless with anticipation, I remember hearing distant voices and the tinker of musical instruments, an invisible orchestra preparing for the opening scene. The lights dimmed, the orchestra reared up with a dramatic overture, and the curtains parted to reveal a very familiar-looking stage setting. There on theatrical display was a reconstruction of my childhood bedroom, but one in which the artificiality of the scene was clearly meant to be noticeable, in that aspects of hyperrealism were deliberately offset by cardboard features. There in that cardboard bed was the character of me, sleeping soundly and dreaming, well, the very dream I was dreaming.

As I observed this oddly emotive scene from my vantage point in the audience, the atmosphere began to change … the interstitial music darkened in tone, it felt as though there were a precipitous drop in altitude, and I became aware of something unpleasant about to happen. That’s when I saw it. Through the stage bedroom window, as the oblivious me slept undisturbed, a ghost hovered just outside. Backlit by the glow of a cardboard moon, it peered in at the me in bed, floating in space, rapping ever so delicately against the glass. It wasn’t just any ghost, either. It was the ghost of me. That is to say, me too. Or rather, me three.

Our minds are magpies that gather up random bits and pieces of our day-to-day lives, weaving together the emotional litter, subliminal percepts, and cognitively processed scraps to create bedazzling nocturnal stories and images. When pulled apart, my dream was certainly no more than that, perhaps made up of those cemetery visits, which also happened to coincide with my supporting role as a Hanukkah dreidel in a first-grade winter play. But even if I forgo any supernatural explanations for the dream, this strangely visual portrayal of my splintered ego has nonetheless stuck with me all these years. I’ve summoned it as a metaphor on occasion, as it helps me to see things in a different light. And sometimes, when we’re contemplating suicide, a shift in perspective is exactly what we need.

Consider the angle of the dream. Yes, there are three versions of me—the one in the audience, the one onstage, and the one beyond—but I could see things only from my point of view. That is, my perspective in the dream was that of the onlooker, the solitary audience member watching from afar. With only one set of eyes, I could not simultaneously be the character on the stage and the observer watching the character on the stage and my ghostly self. Sometimes, when it comes to dealing with the most difficult moments of our lives, I think this is precisely where we should try to position ourselves: in the audience, not on the stage, or beyond. We feel the emotions of the actors as if they are ours—that’s the object of good theater, after all, to stir up intense feelings, so much so that the shock may even startle us awake in our seats. This ongoing drama of our lives provides us with meaning and we’re happily deluded by it. But the spectator is also aware of his separateness. He has perspective. He is, in a sense, untouchable from the chaos of the act he observes.

Usually, this stage-seating effect happens automatically as a natural defense mechanism. When we’re in a suicidal state, however, we temporarily lose that reflective, lifesaving outer eye of the interested onlooker who is simply there to see where the story goes. Instead, we become our characters, trapped on the stage, overwhelmed by affect, and myopic in our vision. As such, we are vulnerable to the chaos that consumes them; we become acutely aware of those cardboard edges, the threadbare stitching of the costumes being worn, the whole enveloping artifice of the social roles that we play. We forget that the frightening presence loitering outside that promises a life beyond the already impossible, fantastical one we’ve been given is in fact part of the set as well, a specter illuminated by a cardboard moon.

What we sometimes must remind ourselves is that the scene will change. It always does. And although we can’t always consciously intervene in the process and insert ourselves back into the audience to watch our own life story playing out, we will, sooner or later, find ourselves in that safe space again. This is an important point for those of you who, like me, are simply incapable of finding succor in religion or any other belief system in which human suffering is conceived as meaningful … that is to say, with some intelligent agency behind it.

“I don’t know how you can go on thinking life is meaningless,” someone said to me recently. “Seriously, what’s the point of even getting up in the morning if there’s no purpose to it all?” But I can no sooner choose to believe than others can choose not to. If I had any say over the matter, I’d hold a very different view of reality. I’d choose to believe that our fates were indeed meant to be, that everything happens for a reason. Besides, being an atheist is like being surrounded by people who are in the middle of a role-playing fantasy game and you can’t get them to just be serious for a minute—and, really, who wants to be a buzzkill?

The thing is, it doesn’t matter what we believe; when we’re emotionally healthy, we can’t help but live our lives as if they’re meaningful. It just … happens. We may know better, but we’re still beautifully deluded. That’s the power of the human brain; it’s what helps us sober rationalists drag our absurd carcasses out of bed every day and keeps us from jumping off the nearest bridge at the slightest inconvenience. When it comes to suicide, the existence or nonexistence of God is far less consequential than the tumult of our social lives.

In the end, there are no satisfying answers. That is the truth about suicide. Still, we need to find a way to live with the inherent ambiguity of the subject matter. And that—living comfortably with uncertainty—is something of a lost art. For some, suicide is a tragedy; for others, it may offer salvation. But to pretend it’s anything other than morally complex will do none of us any favors. So, let us scratch our heads gracefully. Perhaps that’s the best and most honest thing we can do when it comes to the philosophical quandaries of suicide.

If we want to actually save lives, including our own, that’s another thing entirely. There is much we can do. On the more practical side, be aware of environmental triggers—literally. In some parts of the U.S., where the chances of finding a gun in the home (the place where, incidentally, most suicides occur) are about as good as finding a carton of milk in the fridge, there’s no better predictor of suicide than simply having access to a firearm. In a yearlong study of new California gun purchasers, suicide was the leading cause of death, accounting for 25 percent of that group’s fatalities.¹⁹ Although women aren’t as likely to go out and buy a handgun, when they do, they’re more likely to turn it on themselves; of the female subset of those deceased California gun owners, over half were suicide victims.

Controlling access to the means of suicide has demonstrable effects on suicide prevention. In one Inuit community in the Canadian Arctic about a decade ago, there were so many hangings among teenage boys that the local housing authority decided to remove the closet rods from every home. “Hanging in most cases took place at home during the night when the family was asleep,” explained the psychologist Michael Kral, who studied this group of indigenous people.²⁰ “[It was] from the closet bar with the clothes pushed to the right and the noose tied on the left side … with the victim facing the wall.” Suicide-proofing the home environment this way might sound too simple, some would say impractical, to be very effective. But it worked. According to Kral, the town went from having the highest rate of suicide in the region to zero suicides four years running. Adding catalytic converters to the standard vehicle exhaust system has made the old closed garage-door suicide method almost obsolete.²¹ In European countries where suicide by drowning was a major problem, mandatory swimming lessons for young children in the 1980s has correlated with fewer such adult deaths in recent years. Bridge barriers erected at suicide jumping hot spots in New Zealand and Australia have also proven effective deterrents.²²

The point is that when you make it a pain for people to die by their first-choice method, they don’t necessarily just find another way to go about it. This is especially true for impulsive, unplanned suicides, the type most often found among children and adolescents. “Many young suicide attempters report that they spent only minutes between the decision and the actual attempt,” explains the psychiatrist Urs Hepp.²³ “As impulsive suicide attempters use more violent methods, such as firearms, hanging and jumping, this [shows] the importance of restricting access to highly lethal methods.”

Another important lesson that researchers in this area have learned is that what makes someone “successful” isn’t success, but how they cope with failure. One of the most valuable things we can do for children is to help them navigate emotionally through their various disappointments, not prevent their having them. Shielding children from all misfortune does them not only a disservice, but potentially places them at risk for maladjustment when the inevitable major crisis arises in their adult lives. Perfectionism can become deadly. So, if you’ve got kids or plan to have them, let them fail from time to time, and teach them that it’s part and parcel of being human. Failure is a gift that may save their lives someday.

Finally, as I’ve tried to argue throughout this book, I believe we’re also better equipped to face our own periodic suicidal feelings simply by remaining ever aware that we are social animals—cerebral beasts whose mental machinery has evolved to be so finely attuned to the stuff of other people’s thoughts that sometimes our very existence hangs in the balance of what we think others think of us. This quirk of our psychology, of being the natural psychologists of the animal world, is the ultimate burden of being human—the thorn in the crown of our consciousness. Although there’s no way to “turn off” this basic social cognitive function so that our emotions are no longer a product of the opinions and judgments of other people, we can at least seek out like-minded allies who value and appreciate us. Sometimes, in fact, one is all we need: a single fellow human being who acknowledges our social suffering. In short, a friend who ventures to love us despite us.

It works the other way too, of course. Consider, in closing, a cautionary tale for strangers. (Never underestimate the effect of altruistic strangers; a discrete kindness from someone we don’t know has mysterious healing powers.) You may have heard this story before as some apocryphal offering, but in fact it’s true, as verified by a journalist in the New Yorker as happening back in the seventies. After a lonely Bay Area man killed himself by jumping off the Golden Gate Bridge, his psychiatrist and the county’s assistant medical examiner entered the dead man’s apartment.²⁴ A suicide note had been left on a bureau. “I’m going to walk to the bridge,” it read.