New Freakonomics Radio Podcast: “The Suicide Paradox”

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Jacques-Louis David’s painting The Death of Socrates (Photo: Wally Gobetz)

If I were to ask you what’s more common in the U.S., homicide or suicide, what would you say?
Homicide is certainly a lot more prominent; it’s constantly in the headlines and in our public consciousness. But the fact is that suicide is more than twice as common as homicide. The preliminary numbers for 2009, the most recent year for which we have data, show there were roughly 36,500 suicides in the U.S. and roughly 16,500 homicides.

So why don’t we hear more about suicide? In part because it is a very different type of tragedy. Murder represents a fractured promise within our social contract, and it’s got an obvious villain. Suicide represents –- well, what does it represent? It’s hard to say. It carries such a strong taboo that most of us just don’t discuss it much. The result is that there are far more questions about suicide than answers. Like: do we do enough to prevent it? How do you prevent it? And the biggest question of all: why do people commit suicide?

Those are just a few of the questions we address in our latest Freakonomics Radio podcast, “The Suicide Paradox.” This is the third of five hour-long podcasts we’ll be releasing over the coming weeks. Some of you may have heard them on public-radio stations around the country, but now all the hours are being fed into our podcast stream. (You can download/subscribe at iTunes, get the RSS feed, listen live via the media player above, or read the transcript here.) I have to say, many of the answers we found were surprising. And the topic in toto, while obviously a difficult one, is fascinating.

David Lester, a suicidologist without peer.

You’ll hear a good deal from David Lester, a professor of psychology at Richard Stockton College of New Jersey who is considered the dean of suicide studies. He has an astonishing 2,500+ academic citations in total, more than half of which concern suicide. He is also president-elect of the American Association of Suicidology. His interest in the death goes back to his childhood in wartime England:

LESTER: The classic bomb that came over was called a buzz bomb because it was buzzing and that meant that the engine was going. Once it stopped buzzing it meant it would drop and maybe hit your house. My mother says that even as a toddler I was very concerned about them, I would listen for them. And actually she said that I would hear them before the air raid warnings went off, and I would warn everybody about a buzz bomb, and I would rush into the air raid shelter.

So, you know, as a graduate student in America, I started doing work on the fear of death and suicide without thinking of the genesis of it. And then ten years ago I remembered this picture of this little toddler who’s very worried about buzz bombs and hiding from them probably without a material concept of death, but obviously perhaps, laying the seeds of some interest that manifested itself later in life. And I’ve become a thanatologist in general, and a suicidologist in particular.

Lester may know more facts about suicide than just about anyone alive – and you’ll hear lots of them — but he is humble in the face of its causes:

LESTER: First of all, I’m expected to know the answers to questions such as why people kill themselves. And myself and my friends, we often, when we’re relaxing, admit that we really don’t have a good idea why people kill themselves.

The episode also features Steve Levitt, wondering why there aren’t more suicides than there are, and a fascinating story from the linguist Dan Everett, author of Don’t Sleep, There Are Snakes: Life and Language in the Amazonian Jungle, who tells us about the Pirahã tribe’s feelings about suicide.

An Amazonian tribe called the Piraha has all kinds of problems, but suicide is unheard of. (Photo courtesy Dan Everett)

Matt Wray

The Temple sociologist Matt Wray, whom you may remember from a podcast about the high suicide rate in Las Vegas (see his related paper here) discusses the American “suicide belt”:

WRAY: The American suicide belt is comprised of about ten western states, this sort of wide longitudinal swath running from Idaho and Montana down to Arizona and New Mexico. … So, yes the inner mountain west is a place that is disproportionately populated by middle-aged and aging white men, single, unattached, often unemployed with access to guns. This may turn out to be a very powerful explanation and explain a lot of the variance that we observe. It’s backed up by the fact that the one state that has rates that is on par with what we see in the suicide belt is Alaska. If Alaska were contiguous with the U.S. it would really have to be considered part of this western suicide belt.

Veralyn Williams

And Veralyn Williams reports on places where there’s a paucity of suicides: African-American communities. As it happens, blacks are only about half as likely to kill themselves as whites. (When it comes to murder, meanwhile, blacks are nearly six times more likely than whites to die.) There are just three places in the U.S. where the overall homicide rate is higher than the suicide rate: Louisiana, Maryland and the District of Columbia. It’s not a coincidence that these are also places with large African-American populations. Donna Barnes, who founded the National Organization for People of Color Against Suicide, tries to explain why there’s such a huge black-white suicide gap:

BARNES: Okay, it’s very easy when you are stressed and you don’t want to live anymore and put yourself in harm’s way and somebody will take you out. We get angry. We get irritable. We do things, we engage in reckless behavior more so than say, the dominant culture. And those are signs of depression. And many times we will externalize our frustration meaning that we’re going to take it out on other people. And then you might have more folks maybe from the dominant culture who internalize their frustration and take it out on themselves. We have been socialized to believe that a lot of our disadvantages are based on our surroundings — racism, discrimination and all of that. So it’s really easy, for us, when we become frustrated and we look at what’s going on around us, to take it out on the environment and other people rather than ourselves.

We also look into whether suicide is contagious. Radio veteran Sean Cole filed a fascinating piece on this topic. It includes an account of how an 18th-century Goethe novel called The Sorrows of Young Werther proved to be suicidogenic. You’ll hear from the sociologist David Phillips, whose paper “The Influence of Suggestion on Suicide: Substantive and Theoretical Implications of the Werther Effect” can be found here:

PHILLIPS: My students and I were the first to provide modern large scale evidence that there is in fact such a thing as copycat suicide. And we called this, I called it, The Werther Effect.

You’ll also hear from Thomas Niederkrotenthaler, a medical professor and founding member of the Wiener Werkstaette for Suicide Research in Austria, about a recent example of the Werther Effect in Vienna. A related Niederkrotenthaler paper, “The Role of Media Reports in Completed and Prevented Suicide: Werther v. Papageno Effects,” can be found here.

We also travel to Hungary, where suicides have always been more common than just about anyplace else on earth, and try to understand why. Freakonomics Radio producer Suzie Lechtenberg files a report that centers around a song, “Gloomy Sunday,” that’s come to be known as the “Hungarian suicide song.” It was written by Rezso Seress (who committed suicide himself); it’s been performed by everyone from Billie Holiday to Bjork. The suicide scholar David Lester has noted Hungary’s suicide problem:

LESTER: When I go to Hungary, it’s very interesting. They talk about suicide all the time. You know, they’ll be pointing out a statue and say look at that statue, oh the sculptor committed suicide. I’ve actually played to my students all the national anthems of Europe and the Hungarian national anthem was one of the most depressing national anthems. So there seems to be something about the Hungarian culture that is depressive, and suicidogenic.

In Hungary, you’ll hear from the psychiatrist Zoltan Rihmer, who is consumed with understanding Hungary’s high suicide rate, and from Ágnes Rácz Nagy, a psychiatrist in a town called Kiskunhalas, which used to be the suicide epicenter of Hungary. But in recent years, an intensive suicide-prevention plan, including the distribution of low-cost anti-depressants, helped drive the rate down.

The final segment of the suicide hour explores the question of when, or whether, suicide is a rational act. You’ll hear Freakonomics blog contributor Dan Hamermesh discuss his 1974 paper “An Economic Theory of Suicide”:

HAMERMESH: I was always very bothered by the notion that suicide’s a problem of rich people. And that always struck me as an economist as being really stupid since I believe rich people are generally going to be happier, utility is higher, income goes up, you should be less likely to kill yourself.

You’ll also hear the philosopher Margaret Battin talk about how the view of suicide as a rational act has evolved substantially over history, especially since the time of the Stoics, and Margaret Heilbrun, daughter of the Virginia Woolf scholar Carolyn Heilbrun, talking about the maddening, puzzling decision her mother made about taking her own life.

It will be interesting to see the response to this radio hour. As we started producing it, several people told me they were uneasy at the notion of even addressing a topic as loaded as suicide. I empathized with them, especially since so many people have lost a loved one to suicide. But the fact that the topic hasn’t been explored and explained in proportion to its importance only heightened my interest. I’d like to thank the many people who helped produce this episode, particularly Suzie Lechtenberg and Bourree Lam, as well as the many wise and kind people who did interviews. Although I’ve never been deeply affected by a suicide, I’ve gained a new appreciation and empathy for the many who have, and wish you all the comfort possible.


Andreas Moser

A suicide is not such a bad thing: http://andreasmoser.wordpress.com/2010/09/15/world-suicide-prevention-day-on-10-september/

Jin

Hi,

I listened to this podcast on NPR a few weeks ago for the first time and it hasn't left my mind since. I was fascinated by the subject matter, though I have to admit: it made me think about a song I wrote a few years ago that delt with the topic of suicide. In particular the song examines how it's presented to us as news: depending on who the person is can decide if that person will be presented nobly or not after death and if the act of suicide is noble or not.

Anyway, I wrote a song entitled "Suicide is for Seekers" over two years ago and it's kind of sat on ice. I didn't know what to make of it or what to do with it. While I believe suicide is a personal choice, the podcast made a great point: it's not best to present that as the "best" option. Anyway, I wanted to leave a link in case anyone wanted to take a listen. It's the first song on the page.

http://www.reverbnation.com/play_now/song_10666679

I thank you for your time and for the great podcast. Thanks.

Jin

[WORDPRESS HASHCASH] The poster sent us '0 which is not a hashcash value.

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Mary

Just read the article and haven't listened to the podcast yet, but it seems these days the topic of suicide has to include the west's new trend of encouraging suicide. A good place to start is: http://www.firstthings.com/blogs/secondhandsmoke/2011/10/19/the-duty-to-die-advances/

LeighAnne

Great podcast! I shared it with my class and they ate it up. Keep up the great work!

Vicki

Thank you for making this podcast. I lost my uncle to suicide in 2010. He was like a big brother to me and his death has been devastating. I've been struggling with the big questions of: "why did he do this?" "What could I have done to prevent it?" "Was there something that I said/did or didn't say/do that contributed?"

I know logically and rationally that the answers to all those questions is "nothing". So, I found this podcast oddly comforting. You weren't judgmental or critical of those individuals that struggle with depression and have the misconception that the world will be a better place without them. What they, like my uncle, don't realize is they were burdened with demons that prevented them to realize that they did, in fact, make a difference. That is the ultimate tragedy.

I don't usually publicize his cause of death when I tell people he passed away. It's not out of shame or embarrassment. When they press, I tell them "he took his own life." Frankly, I don't want people to feel bad for ME. In some cases, some people have actually said those dreaded words to me, "That is so selfish! Suicide is such a selfish thing." What they don't realize, is people like my uncle suffered from mental illness, and his death is no different of an outcome for those that die from cancer or other diseases. There's just more social acceptance and sympathy for family members left behind to those diseases than there is of mental illness. I'm not taking anything away from them, I'm pointing out we're the same.

If I can summarize my experience in 1 word, it would be "relief". That may seem like an odd choice of words. Here's why I chose it: my uncle is now relieved. He is at peace, no longer fighting all those voices of negativity and whatever else was haunting him. For anyone who knew him, he would have seemed like the least likely person to commit suicide. He was the life of the party, funny, always telling jokes, just a wonderful person. There was also a very dark side, as well, that only a few of us saw and did everything possible to help this person who couldn't seem to get out of his own way. Sadly, not all the financial resources and support from friends/family can prevent suicide. We, his friends and family, don't have to worry any more - and in a way, that is a relief. Now that worry has been replaced with a feeling of loss. I'm not sure which one is worse. There's not a day that goes by that I don't wish he was here again. Although, when I think of his struggles and how hard life was for him, in a way I wonder if he's in a better place now, at peace.

Thank you for taking time to read this. Honestly, this is the first time I've written anything about what happened. This has been very cathartic for me, and I hope you don't mind I've shared all this with you.

~vicki
(PS - miss you JK!!)

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Patricia

We had an attempted suicide in our family. I always wondered if knowing the huge cost of hospitalization we incurred, and subsequent cost of therapy, or the severe anxiety that has dogged us all in the wake of this event would be a deterrent to a future attempt. Everything has changed for us. I didn't hear you mention the horrible effect that suicides and attempts at suicides make on their families. The survivors you mentioned seemed to take it all in stride, perhaps because the cases I heard were older people. In the case of a young person, the cost is not just to him, but to his family. (I didn't hear the entire program)

James H

I was sitting in my car with my friend at a vista-overview parking area overlooking the Golden Gate bridge. It had been a long day of a fair amount of sight-seeing, so we were resting up for awhile before we headed back that night for about an hour trip home. So a police car came up and did a full searchlight- highbeams, take the ID, etc., on us, and the officer came up with the story of the number of jumpers from the bridge as his pretext for his classic animal stalking behavior.

I know from personal commercial structural construction that the cost to put up such things as simple and largely effective anti-suicide fences and wires on bridges is tiny compared to the cost of the bridge, but affects the bridge's aesthetics and is typically considered a low priority "punch list" item.

So this got me wondering as to who benefits from all these suicides. All the suicide watch patrols surely, and oddly the bridge visitor center and related tourism places since the bridge becomes even more magnified in the human psyche as a symbolic icon when there are, IIRC, 1000 suicide deaths associated with it.

Would all that economy whither to some degree if suicides dropped to zero year after year?

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Vlad

I've been doing a lot of thinking about this subject matter lately and started putting together this spreadsheet with some interesting results:

https://www.facebook.com/media/set/?set=a.10151299182191488.519699.502061487&type=1

Here are the two sources of my Table Data (Using 2007 data)

http://www.suicidology.org/c/document_library/get_file?folderId=228&name=DLFE-392.pdf
http://www.bradycampaign.org/xshare/pdf/scorecard/2007/2007_scorecard_rankings.pdf

Vlad

I will now try to measeure "Suicide Attempts" to see the success ratio of FIREARMS vs any other method and the "Number of Attempts"... Jumping off of bridges, cliffs or buildings should also have high success ratios, however, it takes much more effort duting those "dark moments" to go to one of those places and make that effort.

Sandy Davis

Hi,

I'm a former economics student. Great podcast!

I was surprised that you didn't make (or at least didn't vocalize) the connection between an increase in the quality of life and the apparent decrease in the VALUE of life. It seems that in nations were survival is hard, whether it be due to epidemics or what have you, being able to keep yourself alive is valued more. It's almost as if there is a much higher level effort or input into the "production" of staying alive in places where survival is difficult and therefore it is seen as a larger investment than in places where life is much easier. So maybe life is valued in terms of the amount of work it takes to maintain it. If it's as easy to kill yourself as it is to stay alive, then it would seem as though both options might be valued equally.

Just a thought...

David Lawrence

International comparisons are difficult because the quality of death classification differs greatly across the world. Death events that, in some places, would be recorded as suicide are instead listed as unintentional or of unknown intent. Even here in the USA, the quality of cause-of-death data can differ by location because the person making the death classification may have no training in medicine--much less forensic medicine. Many counties have coroners who don't have specialized training, were elected or politically appointed. Especially in counties with low populations where social / political considerations may outweigh the value of the truth; the thoroughness of the investigation and accuracy of the classification may be inferior to that in other jurisdictions. A death caused by a single-vehicle car crash, a fall from a high place, a poisoning, a gunshot, etc. can simply be classified as unintentional or of unknown intent.

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Joxy

A close member of my family committed suicide. Shattered the family, destroyed lives, left a fallout that we have not recovered from over 20 years later.
It is a selfish act, selfish in that - yes - you may no longer wish to live, but that means YOU need help, and there is help out there, if you only look. You take the time to plan the death, why not take the time to seek help? You are not solving problems you are creating a clusterbomb of new ones, which will never be resolved.
Much more support is needed for those with suicidal tendencies, and certainly more support for the survivors.

rationalrevolution

There isn't necessarily anything wrong with suicide. I think the biggest reason I wouldn't do it would be out of consideration for my family members and any potential insurance reasons, but if you don't have family, then that obviously is less of an issue.

I think the biggest reason people don't commit suicide is social connections, unless of course you are talking about a culture like Japan, where in fact people commit suicide DUE TO social pressure.

But really, I don't have a problem with suicide and think that it often makes perfect sense.

But we have to differentiate between "rational suicide", and "depression" induced suicide.

I think that teenagers committing suicide IS a tragedy that we should work to try and prevent, because these suicides are typically the result of hormonal mood swings and irrational thinking and strong teen emotions that will pass.

The case is similar for depressed adults, especially parents.

But, if you look at people in prison or people in insurmountable debt or people who have done really bad things or the elderly or the terminally ill or the chronically disabled, then I think suicide can make lots of sense for those people.

I really don't understand why we even try to prevent suicide in prisons, although I do understand that if we were too permissive with suicide in prison it could become an excuse to just allow conditions to deteriorate and intentionally drive people to suicide, but really, if I were in prison for life, or on death row and i were guilty and knew I wouldn't get out, I'd want to commit suicide.

I also think that suicide when you are elderly or terminally ill is actually empowering. Why shouldn't we die on our own terms? If I were 90 years old and in bad shape, I think my ideal would be to go sky diving and then not open my parachute (of course no one is going to let a 90 year old with no experience go sky diving, so...) I'd want to do it over the water, with weights on, so there would be no issues, I'd just sink to the bottom and be gone.

I think we have to stop treating all suicide the same, and acknowledge that in some cases, suicide should be perfectly acceptable.

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Bob Allen

This story, particularly the conclusion expressed at the end comparing the Pirahã's quality of life vs. that of most of the listening audience, promulgates what I believe is a false valuation. The expectation that more well-off people in our society are less inclined to suicide equates economic well-being to physiological well being. Just as economic cost models are only now being developed to include environmental impacts, the comparison of 1st world and 3rd word cultures too often fail to "account for" human happiness (aka fulfillment).

As Daniel Pink and the several studies he cites point out, economic well-being only contributes to a personal sense of well-being on the bottom of the scale. That is, if you're worried about where your next meal is coming from or if you're going to be able to make the rent, you're considerably less likely be pondering how you can fulfill an intrinsic desire to learn and grow or contribute to a greater good. OK, that argues for wealth equating to happiness, but again, only on the bottom. What happens once a sufficient level of economic well-being is achieved to eliminate these anxieties, when one feels "safe"? That's a whole different study and arguably will turn out to be driven by entirely different factors.

I would really love for Freakonomics to do an entire show on false economies. I've heard only very brief mention of a recent effort by a group of universities that are revisiting (perhaps trying to redefine) economic models to include the costs of impact on natural resources. This is only one example. Omitting human happiness from economic models is another. I believe these factors matter because they impact the long term picture.

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Nancy

My sister committed suicide a year and half ago. I got involved in a suicide survivors support group. There were people who lost children, wives, husbands, fathers, mothers and brothers. They were from different ethnic backgrounds, ages and socio economic status. Many like me were shocked that our loved one would resort to such an extreme measure. I think it is important that this topic be discussed. More is needed for treatment and prevention. Thank you for such an extensive exploration on the topic.

Corinne Dionisio

I think a big part of why suicide is more widespread in affluent communities are connections. We've evolved to be part of a whole and without deep meaningful bonds to others in our community life begins to feel vapid. Poverty forces us to make connections for the sake of survival. For example you may rely on friends for shelter, daycare, food, etc... Every time you receive help in some manner it binds you to a reciprocal social contract with whoever helped. It also means that when people do not honor that contract it becomes personal. This would explain increased crime rates in poverty dense areas as well. On the other hand wealth gives you autonomy. You don't need or expect help from anyone. In fact, help can feel a lot like an assault on your privacy. Your a free agent. You don't need anybody and nobody needs you. We're just not wired to live that way. We're debilitatingly social creatures. This would explain why teens seem to be so angsty in the Rocky states and why suicide is especially prevalent among single middle aged white males. For the teenagers they have no need to reach out at a time when their biological clock is telling them to find a niche for themselves outside their family. For older white males they have enough savings, or if not, enough experience to find a job that can finance a comfortable life style. What's more, they have no family to provide for, no one to make them feel needed. And if you don't make a difference in anyone's life and no one makes a difference in yours... Well what's the point?

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