The media recently carried a story about a group of surviving transplant patients attending a large sports event. The courageous message to "fight the disease, rise from the dead" and their achievement lifted one's spirits. We also hear on a daily basis, however, about tragic suicides -- including those of couples, trios or even families. In the eyes of psychiatrists and mental hygiene professionals who devote themselves to combating suicide, such news brings about more sorrow and frustration.
The importance of suicide prevention and the theories and measures surrounding it are all too familiar. From the government down to the grassroots groups, suicide-prevention campaigns are in full swing. Everything that can be done seems to be done. What problems are there to be addressed? Who is to be blamed?
Suicide is a complex problem -- a social, cultural, psychological and psychiatric illness. It is the result of a varying composite of many factors. Efforts to prevent suicide therefore involve a multilevel mobilization of resources. Who should be held responsible? Those who choose to end their lives or the survivors?
The issue of accountability rests on both society and every individual, and especially on the public authorities who have been entrusted by the electorate.
Suicide prevention efforts should take root in every level of the educational institutions and spread from schools to communities. The goal of education on suicide prevention is to dispel the myth of death and social stigma that attends suicide. To be honest, our words far exceed our actions. There is much room for improvement.
Over the years I have been seeing numerous patients who have attempted suicide.
From my clinical experience, I find people often fall captive to the myth of death. The first such myth could be called the "myth of relief" -- patients in this category usually seek to extricate themselves from suffering, saying "death ends all my troubles," "my death can unburden others," or "I have done my duty and I can die without regrets."
The second type myth is the "myth of relations." For instance, parents placing meaning of life onto their children -- "I live for my children" or "they worry me to death." Another subdivision of this sort is lovers who attach themselves to their partners. These would say "I cannot live without my partner."
The third myth can be called the "myth of supernaturalism." This myth is colored with fervent religiosity. These patients often say "my ghost will take my revenge," "I will be a new person in my next life," or "I wish I have better fortune in my next life."
The fourth myth can be categorized as the "myth of individualism." Patients of this sort say "it is up to me to end my own life." Sometimes, they become reluctant to resume therapy, saying that "I don't want to talk anymore; this will only dilute my resolution to take my own life."
At my psychiatric clinic, I often debate with my patients over the value of life. Despite strict measures to watch over patients with a strong suicidal intent in the intensive-care room, accidental oversights and the consequences still break our hearts.
The 19th century French sociologist Emile Durkheim outlined causes of suicide in his landmark study, Suicide. According to Durkheim, a sense of anomie arises when society undergoes a change from traditional collectivism to modern individualism. An absence or diminution of ethic standards or values, anomie is often associated with social alienation and purposelessness. When malaise of anomie spreads, the suicide rate surges.
Durkheim's theory has its counterpart in modern Chinese societies -- the "theory of relations." Contrary to the mainstream value of individualism in Western societies, Chinese societies prize the value of relations. In the framework of relation theory, people are born and die in their relations. A dysfunctional relation is quick to find its place on the list of suicide causes.
In this light, our family education, mental health service and education on death should be adapted to the changing tide of time and give equal importance to local traditional thinking and global postmodern forces. We must confirm the meaning of life from a multi-dimensional perspective and thereby shatter the myth of death and suicide.
Wen Jung-kwang is the president of Taiwan Association of Psychotherapy, the chairman of the department of general and child and adolescent psychiatry at Chang Gung Memorial Hospital in Kaohsiung and a professor at the School of Medicine in Chang Gung University.
TRANSLATED BY WANG HSIAO-WEN
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