Suicide—English Style

SUICIDE—ENGLISH STYLE* GEORGE DAY, M.A., M.Dj Let us plunge straight in. During 1968 in England and Wales there were at least 36,000 attempted suicides: one every twelve minutes; ofwhich some 4,584 were successful: say one every two hours. Both these official figures are understatements, for only when evidence is incontrovertible do coroners direct a verdict of suicide. For instance, people who take overdoses oftheir pills at bedtime are presumed to have done so by mistake in a state ofbarbiturate-induced confusion, and indeed this might seem quite plausible. In Roman Catholic communities, where suicide is held to be a mortal sin, perhaps fewer people commit it; certainly the registered rate is suspiciously low. Overall last year in Great Britain the rate was 9.4 per 100,000. Just a few more fascinating facts and figures I have boned up from the literature: Worldwide the suicide rate is generally highest in the groups with the highest standard ofliving: the tycoon class with yachts, excess of motor cars and swimming pools; it diminishes pari passu with income, and is lowest among the underprivileged. It is also seasonal, the highest rate being not in the sadness ofautumn or the weariness ofwinter but in the spring and early summer, reaching its peak in May orJune. This obtains not only in Great Britain but, more curious still, in Scandinavia, when the long-awaited sun first brings comfort and warmth to the lightstarved populace. In the antipodes the corresponding months are November and December. Why do people commit suicide? One of the stock verdicts we used to hear—and still sometimes hear—is, "Suicide while ofunsound mind." But let me state categorically that you don't need to be bonkers to com- * An address given to the Ipswich Institute ofFamily Psychiatry, October 1970. t Mundesley, Norfolk, England. 290 George Day · Suicide—English Style Perspectives in Biology and Medicine · Winter 1971 mit suicide; but you do have to be pretty desperate, and hopeless, and lonely. It is sometimes referred to as "the coward's way out," but I think you will agree that this is an utterly unfair generalization. I need hardly remind you of Captain Oates of Scott's expedition, who walked out into the blizzard believing that his companions had a better chance ofsurvival if they were not burdened by a sick man; or of captured members of Resistance Movements, who crunch their cyanide capsules, fearing that under torture they may give way and incriminate their fellows. Nearer home we find elderly folk—suffering from incurable and progressively incapacitating illnesses, the nursing of which stultifies the home-life of their nearest and dearest—will sometimes opt out of life before love turns to numb disgust and impatience. Suicide can be altruistic. But here we must enter a caveat. One of the symptoms of depressive illness (about which I shall be talking at greater length presently) is a conviction ofworthlessness, ofbeing a burden to others, ofbeing "better out ofthe way." As a mood it may be whollyjustified, for illness does make its victims a pain in the neck to all bystanders. No home can be really happy that harbors a depressive, as the patient may be well aware. But the underlying illness in this case can at least be alleviated and generally cured. Let us now address ourselves to the seven ages ofman: The babe in arms and the toddler never wittingly commit suicide; but I suspect that many of us at sometime during the kindergarten age have felt, when the grown-ups or the siblings have been particularly tiresome, "I'll kill myself and then everybody will be sorry." But it is never implemented. It is rarely even spoken aloud and thus communicated either as a protest or a piece of blackmail. By suppertime we shall have forgotten all about it. But this same motivation can determine events at a later age in the immature : About a couple ofyears ago I interviewed a young married woman, a silly girl widi a history of previous suicidal gestures—slashed wrists, overdosage of aspirin—who was again threatening suicide. She had brought with her another rather dumb girl for moral support—or rather...