Suicide is perhaps one of the most researched, discussed and disputed areas in psychiatry. Historically, it has sometimes been seen as a sociological issue, a moral one, or something mediated by culture or religion. It has not always been regarded as the province of psychiatry. John Weaver, attempts to bring a historian's eye to this most complicated of topics in the period 1900-1950. He uses medical and social documents, personal testimony, including suicide notes and individual's own descriptions from a number of different time periods and countries in order to weave together (no pun intended) an impression of the social, cultural and personal fabric in which the social, cultural and personal meanings of suicide may be better understood.
Weaver is particularly concerned with what he calls the common-law world; the everyday experience of people, rather than the dramas of high politics or an interest in the grand narrative of history. He himself acknowledges that this may be a shaky platform on which to build an analysis, but it is a vital one. Nevertheless, it is in these details that a wealth and richness appears, some of it tremendously (and appropriately) sad, some perplexing and some so intimate that even reading it makes one feel privileged.
In his consideration of meaning in suicide he looks at two major perspectives; the personal and the social. What, he asks, can we learn about an individual's experience by the notes left behind? And what can we learn about societies and cultures by the terms and tones in the official documents and records of the time? Finally, and this may be what concerns the reader most, what can we therefore learn about ourselves and the society in which we live?
He acknowledges the huge amount of academic output concerning suicide over the past 150 years, as well as some of the methodological challenges he faced. He notes the many epistemological problems; just what are we talking about? And are we always talking about the same thing? How is it possible to extract the obvious political and moral bias that will creep into the documentation? How to account for the choice and implications of the words used? Does the term "moral defective" tell us more about the writer or the subject?
He also tackles questions of interpretive science and the tensions that a positivist viewpoint may bring. He asserts that we cannot always know what is unspoken in the silent thoughts of a person, and yet the call of the logical positivists (do not speak of what you cannot know) is not helpful either.
Weaver adopts what he terms a pragmatic approach to truth and accepts that "its real determination ... will emerge from reviews and debates that this inquiry should provoke. He tries very hard to distinguish motives (the "because of" of acts) and intentions (their "in order to"). Is suicide an existential act?
He considers whether or not suicide should be seen as a social act or an individual matter and in this offers a persuasive critique of Durkheim's functionalist approach which is worth reading on its own.
He wonders why it is that some people commit suicide and others, whose life circumstances may be truly terrible, do not. He does not really enter into Camus' argument that the real question is why we do not commit suicide rather than why we do, but he recognizes that some "latter day Jobs", as he calls them, live on through what may seem to be unbearable circumstances
He is also puzzled, and here he admits to a lack of knowledge, by the impact of mental illness. Is suicide necessarily and always an indication of mental illness? Do individuals who are not mentally ill commit suicide? His consideration of psychosis (and we know that a significant number of people with a developing psychosis attempt suicide) is not that of a mental health professional. He professes to be uncertain, and that is perhaps how it should be. But he inquires intelligently and sensitively.
He also tries to grapple with a number of empirical questions. Why, he asks, do suicide rates tend to be consistent over time and yet vary so markedly in different countries? Why is the rate in Greece so low and the rate in Hungary so high, with the rates in Australia, Canada, USA and UK somewhere in the middle? Are the official records reliable? Who decides between misadventure and suicide? Are some accidents more accidental than others? What can account for the different rates between age groups and the sexes? What of different populations within the one country such as aboriginal and indigenous peoples?
The documents that he considers come from a variety of sources and this is a clear strength of the book. Weaver says that he summarizes the records of almost 7000 deaths through the coroners' records from Queensland and New Zealand. It may not be a definitive work, but it is careful, scholarly and most of all sensitive and humane. Even amongst all the numbers and court reports, the death certificates and the newspaper accounts, the academic treatises and the sheafs of archives there is a human story to be told and Weaver always manages to keep this in the reader's mind.
There are limitations to the study in that he only considers documents up to 1950, and so readers who may be looking for contemporary analysis will need to look elsewhere, but it is meant to be a history and it serves that purpose well. It may be arguable that much has changed in the last 60 years, but suicide, its meaning and contexts are still things we struggle with today – just as we always did – perhaps, just as we always will.
Weaver's work is a very noteworthy addition to the literature. It is a compelling and often personal, first person account of one of the great questions of human society. It will prove to be a great resource not just to specialized scholars but to all students of the human condition. Weaver should be congratulated for bringing these stories to a wider public and we should be grateful to him. A fine book.
© 2010 Mark Welch
Mark Welch, Ph.D., British Columbia