On Suicide and Selfishness... (Is suicide selfish?)

I debated whether to place this here or on my personal blog.  It's an essay (in the sense of "trying"; see that heading at the link for more on what I mean), and I don't yet know what I'm going to say in the end that fits the "what could be better" theme.  (The post is also (about 5000 words, or 11 printed pages) long; this is intentional; you were warned.) But I think I'll have a few suggestions, by the end of this; I have a couple of rough ideas already... in fact, here's one such thought, right off the bat, based on the question I'm starting out with: Is suicide selfish?

Well, here's my first thought on what could be better:

The question of whether suicide is selfish or not deserves more serious discussion.

I came to the above conclusion after reading the first couple of hits, and starting to skim the third, for a google search on simply "suicide selfish".  The first two hits (for me) were rants against calling suicides (and/or suicidal people) selfish.  They were in ways nice to read, as I suppose I'm starting out leaning a bit towards "suicide is not (necessarily) selfish", and each of these was supporting that position.  But I'm not actually feeling any more ready to defend that position after reading these articles: I don't feel they really made the point well, and in particular, they didn't dig in to the question deeply enough.  And to my mind, it's still a question.  The third hit explored a variety of opinions, pro and con, but it still didn't really help me: I still don't know whether I myself would deem suicide to be a selfish act.  So, I want to explore that more.

Starting with the personal:

Why am I asking this question today?  Well, I confessed yesterday to a housemate of mine, who I've increasingly been considering a friend, that I'd had some suicidal thoughts.  Said housemate instructed me not to do that, and cited as a reason the assertion that "suicide is selfish".  I immediately, though silently, recoiled a bit.  I was saddened to hear this opinion.  Shamed a bit perhaps.  (Hmm, I'll probably need to dig in to shame in this essay at some point... I'll get back to that.  [See "Thoughts on Shame", below.])  Anyway, shame or no, it just didn't feel very good to hear these words.

When one cuts their wrist with suicidal intent
(as opposed to just making a suicidal gesture),
the "correct" way to cut is down, not across.

See, here's the thing.  I'd had a flash of suicidal thought, maybe 30 minutes before this conversation.  I'd been chopping vegetables in preparation for my making of the household's dinner [at this household, we share dinner most nights, with a rotation through the house of who makes it - or sometimes it's a bit of a group effort].  Having had a sharp (it was new) knife in my hands, and following an emotionally difficult train of thoughts (the details of which I don't even remember, but I think they had to do with rejections I've received in the past from people I'd dated, some of whom certain recent events have reminded me of), the thought occurred to me of slicing my wrists open ("down, not across"), and continuing to chop (the veggies for dinner) as I bled out.  I didn't do this, of course.  To have done it like that, I believe, would indeed have been a selfish act.  I'd have been bleeding all over the vegetables, for one thing, thus presumably making them unfit for consumption by the household.  And then obviously I'd be creating a big clean-up job for my housemates.  Not cool.  And those little points, of course, would presumably pale in comparison to the emotional pain that would be created by having housemates have to discover the corpse of their beloved (and I do believe that there's love for me here, probably from each of my housemates; it's also one meaning of my name) housemate, right there in front of them.  Or maybe they'd find me while I was still alive, and have to deal instead with figuring out how to get me medical help (as I'd presume they'd default to doing).  At any rate, I think it's quite safe to assume that it would have created a traumatic experience for whichever housemate(s) found me. And that, I would agree, is a selfish act.  In fact, it brings me to another point for what could be better:

People committing suicide would do well to consider the impacts of their suicide on others.

And granted, some do.  Some, though, do not, or do too little of it.  Or so I'm somehow imagining; I guess I don't really know how much people consider the impacts of their suicides on others.  What I do know is that it's certainly something I've spent a lot of time thinking about, and I think that's a good thing.

Still, while the above thought also brings up some other problems, which I'll get back to [under "Having a way out"], I first want to share a bit more of my personal context for this exploration.  So, I'd had this little bit of ideation, and let it pass, without action (unless you count taking a deep breath and re-composing myself to be "action").  This is something that happens to me almost every day, at least once.  Every. Fucking. Day.  Well, almost: yes, it is a bit of an exaggeration... but really, only a bit; in the last 35 years of my life (i.e. since I was about 5; I don't really remember whether this started before that, though it wouldn't surprise me), the maths say there've been 12,784 days.  I'd guess (and it is just a guess, but a fairly informed one) that I've had suicidal (and/or a young child's closest equivalent) thoughts on at least 10,000 of those days.  What's that thing about 10,000 hours?  Well, maybe it's bunk, and certainly there's more to what makes one an expert at something.  Just realize that I'm someone who may well have spent 10,000 days thinking, for at least some portion of the day, about suicide.  And some of those days it's been a major part of my day – whether having ideation over and over again throughout the day (and, on about 6 days out of my life, even making an attempt), or, like today, as I write this blog post, simply thinking about suicide in abstract terms (usually (though not too much today, it turns out) with little flashes of ideation along the way, while mostly thinking about it in level-headed ways – or at least relatively lucid ones).  I've read multiple books on suicide: from Methods and Consequences (which you might be able to find at public libraries; or just visit the author's website), to simply memoirs that include discussion of it, e.g. An Unquiet Mind (a bit easier to find at libraries than the former).  I've read blog posts.  I've thought about the surprisingly-frequent references in movies. I've talked with friends and lovers – sometimes helping them through their suicidal times, other times having them helping me, and still other times simply discussing the subject.  I wouldn't actually call myself an expert on suicide (I haven't studied it in more than a lay person's way)... but I certainly have a significant familiarity with the topic, including (importantly) familiarity with what it's like to be feeling suicidal – or, if "suicidal" isn't something one deems to be a "feeling", then having suicidal thoughts, and the concomitant feelings that so often accompany (and/or create) those thoughts.

And it feels pretty awful, let me just say. Because not only are you sitting there, thinking that your life is shitty enough that you might be willing to end it (a thing that biological imperatives tend to push you away from, it's worth noting; this is a pretty radical (with respect to genetic predispositions) thought), but you (or at least I) layer on top of that this whole stigma about the impacts of actually doing it: how your mother will be sad, your sister might feel ashamed to talk about her brother, your friends who loved you won't understand... and of course the people (whether friends or professionals) who find you, or have to handle your body (either trying to save your life, or dealing with the corpse)....  And really, that's just a few of the impacts that suicide can have.  There's the copycat problem, the costs (monetary and otherwise) of therapy for traumatized friends and family, the emotional cost of the various pains that drove them to need that therapy, et cetera, et cetera.

The impacts are very real.  So I get it why someone might think it's a selfish act.  It certainly is an act that can have a heavy impact on others.

But I'm going to go out on a limb here and guess that I'm not alone: People think about the impacts of the suicide they're pondering.  Or at least I certainly do.  I've spent many an hour pondering what the impact would be.  And frequently, that pondering is a part of what stays my hand.  The conscience that makes a coward of me is not so much fear of an afterlife (as a fairly strong naturalist, I'm fairly confident there'll be no afterlife that I will experience), but the fear of a different sort of afterlife: the life that continues on, after I'm dead – i.e. the impacts of my death upon the living who survive me.  Hamlet (or shall I say Shakespeare?) was right to point out that it takes a pretty big dread to stop a person with the methods at hand (which I don't usually have, but have had, at times), and who is suffering the whips and scorns of a long life of pains.  And for me, at least some of that dread is the dread of hurting those I love, who would survive me.

And so (unselfishly?), I bear those fardels another day.  (And another.  And another.  Times ten thousand.)

But is it really unselfish to live on?  Even as I live, I know the pain that I experience creates pain in others: whether it's those with whom I'm close enough to let them know I'm feeling suicidal, or even just to know (and some can simply see) that I'm in pain: These people worry about me (they tell me so).  They, then, experience a type of pain, because of me.  I've heard their stories, some of them.  I've seen their tears.  I've seen it written on their faces, tears or no.  And I've seen it written in their words to me.  Perhaps it is unselfish that I "grunt and sweat under a weary life"... but it's definitely not without impact on those around me.  So there's impact, either way.  Whether I commit suicide, or whether I live on, there's impact.  Can the impacts be weighed?  I don't know how to answer that.  I do know that there are times when I think the impact would be less if I were to go, than to stay.  Ten days ago, as it happens, I had a time when I was thinking some thoughts about suicide, and I had the thought, which I promptly wrote down in a note to myself (just because I thought it was interesting): "In the long run, I truly believe this will be better for everyone." Of course, I didn't actually attempt suicide at that point (I wasn't really even all that close to it).  I was just reflecting on it, and had that thought along the way.  Reflecting on it now, I'm not sure if I agree with the thought.  It was just something that I was considering as a possible note, for if and when I ever did commit suicide.  Something that, I think, would have some truth to it, even if I don't wholly accept it as true, so I imagined writing it down.

I've thought long and hard about suicide notes – whether to leave one, and what to say in one, if I did.  For someone like me, who truly does want to be unselfish about things, and is simply struggling to figure out how to do that, it's a hard question.  Whatever note one leaves, it'll probably never really capture the intricacies of things.  So maybe you don't even try.  Maybe you come up with something succinct like the above, and say nothing else.  Or, as a guy I knew in high school scrawled in the sand near the site of his self-hanging, a little quip from that same Hamlet speech I quoted above: "to sleep, per chance to dream".  Perhaps he had a dread of the afterlife.  Perhaps, given that he went through with his life, he hoped to see one.  I don't know.  And even though I didn't know him all that well, or consider him particularly much of a friend (certainly we hadn't stayed in touch, in the two years between high school graduation and his death), I still wonder what it was like for him.  And I know that, no matter what I do or don't say if and when I ever commit suicide, that people will have such wonderings (or, probably, very different wonderings; more on that in a moment) about what it was like for me, about why I did it, etc.

My wonderings, I think, are different from most, though.  I think (given what I've heard from people) that most folks wonder how someone with such promise (Stith was an olympic-hopeful) could ever come to such a place.  I wonder, instead, how others didn't see what I saw, when I got to know him a little bit through being in a drama class with him some 5 years earlier, and through a few minor interactions otherwise: someone who had a lot of pain, under the surface.  Maybe I'm wrong to think that; maybe I was projecting my own feelings onto him.  Or maybe, as someone who's lived a life filled with emotional pain, I'm more in tune to the hints of it, that we try to hide, and saw an inner experience that those who were closer to him failed to see.

And why do we hide the pain?  Oh, many reasons, I expect.  One of them being the stigma of it.  Which I think maybe brings me back to the shame thing:

Thoughts on Shame

In Dialectical Behavior Therapy (DBT), "shame is justified" when there is an actual risk that you might be ostracized from a social group that's important to you.  I think of that in terms of anything from a social group who you depend upon for your survival (in this day and age, perhaps coworkers, for your income), or simply who you feel a strong emotional connection to (one example for me is the local polyamory groups, in various cities I've lived in), or even just a single individual: a romantic partner, or close friend.  Whatever the "group", though, the interesting thing to me here is that it doesn't matter whether whatever you might do to create the shame situation is something that you feel is right or wrong; what matters is how the "group" will perceive and respond to it.  And right now, in our society, I think it's pretty safe to say that shame is justified for anyone seriously considering suicide: because people will distance themselves from you, if they hear that you're suicidal (I've certainly had that experience, anyway).  Or they'll effectively threaten a distancing, by telling you that you're being "selfish" – a general trait that's often going against the norms for a group, and thus (I believe) precisely the type of thing that the shame response has evolved to handle: preventing someone from doing things that would cause the group to cast one out.  And yet shame is exactly a trigger for suicidal thoughts and feelings, so to think it in the first place ultimately "justifies" having even more such thoughts.

But how fucked up is it that one who's thinking of checking out (an idea I'm using in the way described in Coercion and its Fallout [library]) – of life, and therefore of whichever group(s) might be relevant – might feel shamed back in to a group that might very well be a big part of causing (or at least extending) the pain that's creating the urge to check out?  I don't know, is it just me who sees a bitter irony there?  And with the impact of shame that can bring about further suicidal thinking?

Well, and allow me to talk now a little about a distinction that I make in different types of suicidal thinking: On the one hand, there's someone who's just gone through a particularly tough moment of their life, and is temporarily distraught about something or other, and through their distress, they aren't thinking so clearly, and they're hurting, so they think of suicide.  When these cases turn into actual suicide, to me, it's a tragedy.  I think most folks would agree with me, here.  The "permanent solution to a temporary problem" is sad to see happen, because, well, it was a temporary problem, and now that person won't live to see it resolved, when it pretty clearly could or would have been – or at least would have lost its gravity over time.

But there's another kind of suicidal person.  A person like myself, who, while surely experiencing temporary problems at various times, and having those problems lead to thoughts of suicide, also has a grander difficulty: Through whatever set of circumstances (be it genetic, or because of childhood abuse, or whatever), this person is someone who has a fairly chronic experience of intense emotional pain.  Yes, there are times when things aren't so painful.  There are times when such a person experiences joy.  Maybe those times are even frequent.  And it's easy, as an outsider, to look at such a person and see them as happy, and to think of whatever pain they may experience as a temporary problem.  But let me tell you, as someone who isn't feeling much pain in the moment I'm writing these words, that the pain is, none the less, a fairly ever-present thing.  A persistent thing.  And when it's bad, it's really bad.  And given the connections between psychological and physical pain, and in particular the similarity of brain response to each, I can tell you: chronic pain sucks – even when you're not actively feeling it, because even then, you're aware of it enough that you have to sort of plan for it.  You have to keep track of your spoons, as it were.  You have to actively work to avoid the situations that cause that all-too-painful sense of shame: that self-same emotion that both pushes you to want to check out, and pulls you towards sticking around; towards not being "selfish".  And even if you, like me, do a certain degree of embracing the pain, and finding the wonderful things (empathy, art, a desire to make the world better, ...) that can come from it... it's still bloody painful.

So, can there be another way?  I think maybe there can.  Let's start a new section.

Having a way out

There's a fascinating documentary by Terry Pratchett on "Choosing to Die".  Sadly, the two uploads of it that I'd known about online have been pulled on copyright grounds, but if you're sufficiently interested in this topic, I highly recommend digging deeper and finding a way to watch it.  (I found another instance of it on YouTube now.  Given the copyright issues [and my presumption that the copy I found, too, will get pulled at some point], I won't link to it; just go find it and watch it if you're so inclined.  Briefly, though, Pratchett has been diagnosed with Alzheimer's disease, and is struggling with the question of whether, when, and how to possibly make the choice for an assisted suicide.  This is a decision he is allowed to make, because he has a chronic physical illness. Those with even a history of mental illness are were not allowed to use the service.  [EDIT: 2019-05-06: looking at the latest from Dignitas, it seems they've changed their policies!  Apparently now they will at least consider cases of folks with chronic mental health diagnoses.  Interesting!!])

Unfortunately (to my thinking, though I expect many will disagree), someone like me – who has been diagnosed with, among other things, chronic depression (I was first prescribed anti-depressants while still in high school, and given such a diagnosis long before that, I think) – is unable to get services from the "right to die" organization that Pratchett explored in his documentary. Dignitas says on its FAQ (I also confirmed it in an e-mail interaction, because other things they say seem like they might have allowed for it in some cases; not so much, it turns out) that those with "mental illness and/or psychological problems" cannot get the type of help that Pratchett was exploring getting.  And at some level, I can understand this... They're going for people making informed consent and a rational decision.  If decision-making and related abilities are impaired by things like depression (an interesting question, not (to my satisfaction, at least) fully answered), then clearly, there's good reason to be wary of considering a depressed person's decision to die to be an informed and rational one.  But can we go so far as to discount this ability entirely?  Even if their decision-making ability is impaired, do we not allow them the autonomy to make choices for themselves?  I would assert that in cases that are clearly acute (read: temporary), that removing autonomy is worth the cost, if it can get someone through the temporary problem and get them to a happier place, where they truly no longer wish to die.  When a condition is chronic, though, even when we consider that chronic is not synonymous with permanent, I would assert that some allowance for autonomy deserves to be given, and that a person deserves the dignity of being able to make decisions about their own life – up to and including a decision to end it.

A difficulty comes in, though, when trying to judge between the acute and the chronic.  Even a chronic disorder will have acute flare-ups.  And I think there's value to society in having an organization which might assist someone to carry out a suicide be careful about who and when they allow themselves to assist.  But are there benefits to assisting someone with a chronic mental-health condition?  I think there are:

It seems to me that if someone who (because of chronic depression, anxiety, traumatic stress, or the like (or all of the above)) would want to end their life was given a way to do so in a rational, considered, planned way, that this could create all sorts of opportunities to mediate the difficulties of the "selfishness" of this decision, among other problems. Having watched, through Pratchett's video, a person take their own life, by way of swallowing a lethal cocktail, I can say that to watch such an act is not without emotional impact (on the watcher).  But the impact is mediated, substantially I think, by a couple of factors: First, we know (we are shown in the documentary) that the decision is one that has been considered over time.  We know something about the inputs to the decision.  We can't, of course, know the exact details of the mental state of the person, but we can see evidence that they've considered things, that they understand that it will be difficult on those who love them, and that they've considered that impact, regret it, and even made the decision with input from said loved one(s).  And we know that a mental health professional has made an evaluation of whether this person is making this decision in a lucid way.  We also can see that the loved ones have had time to prepare themselves for this, to say goodbye... and even to hold their beloved's hand (or body) as they go.

Can we do that with a more customary suicide?  Generally not.  I actually have a close friend who has, in principle, agreed that she might go with me somewhere into the woods or something, to be there with me for my suicide, should I ever come to a considered decision to go that route.  This gives me great comfort, in ways: The idea that I might feel some love in the end, and feel close to someone, would be a great relief from the isolation I all-too-often feel in the world (especially when I'm feeling suicidal).  Isolation that increases when I'm told that my act would be a selfish one; for if it is a selfish act, then it's clearly one I must do on my own, if I'm to do it at all.  And maybe I won't do it... I haven't thus far, despite several attempts.  (Side note: Having learned helplessness around suicide itself is... a deeply depressing state of affairs; it is often some learned (through hard lessons) helplessness that's played a role in making me feel suicidal; to then feel helpless about even ending things, well... that's tough, when I'm at my worst.  But I digress.)

If I could have an option where I could make a careful decision to end my life, and have that decision be one that's expressed to friends, family, loved ones, and even acquaintances... To give those people a chance to make a plea for me to stay, and give their reasons; for me to carefully consider their pleas; for them to say goodbye, if I stuck to my decision; to request that I return some item that I've forgotten I had borrowed from them; or to return something to me, or give me a chance to change the loan into a gift; to ask me questions – whether it's some secret recipe of mine, or whether there was anything they could have done differently to change my decision: All (or at least many) of the things that the survivor of a traditional suicide might regret their inability to do, given the loss of the person with whom it would need to be done... To my mind, having such opportunities prior to the execution of a suicide would greatly lessen the "selfishness" of the act.  And so I deem that the world would be better if more people agreed with the following:

People should have a path to suicide that includes consultation with, and input from, those around them, and allows them to tie up loose ends before they go, and to have a "safe" and effective way of dying.

If we could settle our estates while living; say our goodbyes and give hugs; let people know that it wasn't their fault (or, perhaps sometimes, that it was, at least in part, but to say so to their face, and face their reaction)... If we could do these things, and have suicide not be a stigmatized action, but merely a thing that some people opted to do, and that those surrounding them could express their agreement or disagreement with, and perhaps try to influence the decision... This, then, would allow a different situation than what we have now:

Right now, if one decides to commit suicide, one is pretty much obligated (that one friend of mine is a rare one indeed – and far enough away, that it might prove impossible to go to her) to go it in complete isolation, without support, without love, and with the very real risk that if their attempt is discovered prior to completion, it will be interfered with, and great efforts will be made to keep the person alive, against their wishes.  (While some do make suicidal gestures hoping to be saved, that's not the situation I'm speaking of here; I'm speaking of a genuine and considered attempt to end one's life.)

And it's undoubtedly true that some who attempt suicide (even with full sincerity in their intent at the time) end up glad to have failed, I can also say with authority that some who survive are upset by that outcome:

Waking up after the unconsciousness of the crash from an overdose of Adderall, after having written 37 pages of (mostly chicken-scratch-looking) writing about why I had made my decision, and what it meant to me, and then recording a couple of hours of audio (after my body ceased to allow me to write) of me trying to dictate further thoughts, and then eventually of my troubled breathing, when I failed to be able to do even that... well, waking up was a proverbial slap to the face.  I really hadn't wanted to wake.  I'd had the hope, as I lost more and more control of my body, and felt unconsciousness approaching, that it really would end forever.  But then I woke up.  I relive this reawakening (on a smaller scale) on many days, when I wake up from regular sleep, wishing I could instead sleep that infinite sleep of death.  Dismayed to once again face the light of day, that others claim to take so much joy from.  Granted, some days I take joy in it, too, in ways... rarely if ever have I had the simple thought, though, that I'm glad to be alive.  When I do feel gladness, it invariably comes from something more specific going on.

Wrapping things up

I think I'm nearing the conclusion of this "attempt", this essay.  There's more I'd like to discuss – about failed attempts (at suicide), access to reliable methods, the problems I see with methods like what Dignitas uses, about the selfishness or not (that's a question I don't have a clear answer to, too) of saying that suicide is selfish, about over-population, and altruistic suicide, and... much much more.  And I still don't feel like I have a solid answer to the opening question.  But it's time to face the current day that I have in front of me, some 8 or so hours of writing (and related research, and editing) later than when I first woke up into it.

Thank you for reading.  I'll thank you even more if you consider my thoughts in a thoughtful manner, and, should you be so inspired, write down (or otherwise communicate) your own thoughts, and post them in response (either as a comment; or as a blog of your own, which you may link to or not, as you see fit; or as a personal message to me).  Ultimately, I think the key is for us all to talk about this more.  To have it out there, discussed, debated, considered... these would, I think, be things that would make the world a better place.  And I think they might help to prevent a lot of tragic suicides, actually... and enable some sensible ones.

---

Addenda:

1. 2015-05-25: I'd opened more of those search results earlier, and had a few open that I hadn't read yet.  I just now read this one and think it's worth a read.  It brings me closer to an answer to the question... though still not quite there.  Either way, though, it has some useful thoughts.
2. 2015-05-25: Also, I think it's worth noting that the original broadway cast recording of the Sondheim play Assassins has a track called November 22, 1963, which portrays an interaction between John Wilkes Booth and Lee Harvey Oswald, and addresses some, err, "interesting" thoughts on Suicide, let's just say.  I found a copy on youtube (check the link, maybe it'll still be there), or you could get the whole recording – lots of interesting stuff in there, beyond just that track, too... though that one is by far the most powerful, to me.
3. 2015-05-30: Hmm, the fourth hit is pretty interesting!  I only wish they'd let me read both pages... oh, maybe I can.  Indeed, the first paragraph of the second page is profoundly interesting; partial excerpt, with emphasis added: "Friends and family ... often consider [suicide] to be deeply selfish. This is understandable because the bereaved are often convinced that the decedent did not consider the impact of his or her death on those left behind. However, those who die by suicide certainly do consider the impact of their deaths on others; but to them, death is a positive rather than a negative outcome. This is wrong, but nevertheless, it is the view of the person who attempts suicide."  I will also add that saying that seeing death as a positive outcome being "wrong" is a value judgement, that seems to be being made as though it were a factual claim.  It's probably factually wrong that the perception of the death by those around the deceased will be a positive one, but even that could be in error in some cases: For example, one of the differences in how I think about suicide (and how I thought about Stith's death, for example), is that I often view it with envy and respect.  So....... yeah.