Stay: A History of Suicide and the Philosophies Against It (Review)

CN: Suicide. (If you are having thoughts of suicide or self-harm, please call the 24/7 National Suicide Prevention Hotline at 1-800-273-8255.)

In Stay: A History of Suicide and the Philosophies Against It (2013), the historian Jennifer Michael Hecht passionately advances a secular argument against suicide. Tracing a thread of intellectual thought that has underpinnings in ancient philosophy, Hecht lays out an anti-suicide thesis that emphasizes the obligations each of us has to our community as well as our future self. Hecht weaves in history, philosophy, social science, and literature in her quest to uncover the factors that exacerbate suicide in our society. From public policy to private conduct, Hecht outlines a healthier approach to addressing the problem of suicide. Additionally, Hecht aims to counter the popular perception of secular philosophy as being permissive with respect to suicide. To the contrary, she argues, luminous thinkers throughout history have converged on a resolutely anti-suicide message.

Stay grew out of a blog post Hecht wrote in 2010. Deeply troubled by the suicides of two of her close friends, she issued a simple and adamant appeal to those struggling with suicidal thoughts:

Don’t kill yourself. Suffer here with us instead. We need you with us, we have not forgotten you, you are our hero. Stay. (xi, quoted from her original essay in Best American Poetry Journal)

The post went viral, leading to an op-ed in The Boston Globe, which in turn led to a publisher inviting her to develop these ideas into a book. The events that led up to the publication of Stay are noteworthy, because they account for some of the book’s shortcoming. Hecht describes her 2010 blog post as a “manifesto” written “in the heat of emotion” (xii). Indeed, the moral message of her 2010 post is piercingly clear, though the arguments are at best underdeveloped. Not to impugn Hecht’s aptitude as a scholar, but rarely does a manifesto withstand intellectual scrutiny unscathed. Stay attempts to preserve the inspirational qualities of its source while simultaneously being a work of scholarship, with limited success. Furthermore, when Hecht-the-scholar and Hecht-the-moralizer come into conflict, Hecht-the-moralizer wins decisively.

The first pillar of Hecht’s anti-suicide argument is that each of us has a responsibility to our community. We tend to think of our community as the group of people who we see regularly, such as friends, family, co-workers, neighbors. In the case of suicide, however, the scope of our influence extends beyond this small in-group. Consequently, Hecht broadly defines community as everyone who might come to know about—and hence be influenced by—your suicide. This definition of community can help us recognize cases when we are impacted by the suicide of someone living far away. As Hecht observes, “geography camouflages our spheres of influence” (154), making it difficult to recognize suicide clusters at a distance.

Suicide clustering a phenomenon where one suicide leads to more suicides in the community. To buttress her argument that our suicide harms the community, Hecht reviews the evidence for suicide clusters. Far from being an armchair theory, suicide clustering is a real phenomenon that has strong empirical support. Suicide clustering is sometimes called suicidal influence or suicidal contagion; Hecht opts for suicide clustering since it’s more neutral.

Stay compiles many arguments against suicide. Even so, Hecht is critical of many traditional anti-suicide messages, particularly those that portray suicidal people as selfish, cowardly, or foolish. Hecht persuasively argues that these shame-based messages are not only cruel, but counterproductive. Heaping shame onto a suicidal person is likely to exacerbate, rather than alleviate, his or her despair.

In light of this, Hecht takes care to frame her anti-suicide arguments in positive terms that affirm the reality of someone’s feelings even as they  undermine the soundness of his or her judgment. Instead of castigating the suicidal for being selfish, Hecht wants us to reassure them that everyone considers their life precious. Instead of equating suicidal thoughts with weakness, we should express gratitude for the bravery it takes to endure these pernicious thoughts.

However, in spite of her focus on affirming language, Hecht devotes a lot of time to a message that stubbornly resists a affirming spin: the fact that your suicide might trigger a suicide in the community that wouldn’t have happened otherwise. In other words, suicidal influence. Rather than handling this true-but-depressing corollary to the reality to suicidal influence with compassionate deftness, Hecht is blunt to the point of crass: “[o]ne of the arguments I hope to bring to light is that suicidal influence is strong enough that a suicide might also be considered a homicide.” (5) It baffles me that Hecht would mar her overall positive message with this cruel characterization of suicide as a kind of “delayed homicide.”

When we think of suicide clusters, we tend to think of someone reacting to a real suicide in their community. However, fictional depictions of suicide also have the potential to trigger suicide clusters. To understand why the suicide of a fictional character can lead to suicides in the real world, we must examine the psychology of someone vulnerable to suicide.

First, being exposed to depictions of suicide doesn’t directly “inspire” suicides. Rather, it acts as a model for others to emulate. In other words, seeing examples of suicide “releases” latent suicidal impulses in people who are already vulnerable. According to social modeling theory, our sense of what is normal is largely shaped by the actions of those around us, particularly those we identify with. Even if we maintain our belief that suicide is wrong, seeing an example of it in our community nevertheless normalizes it to an extent. The reality of suicide clustering obliges those who write about suicide to ask themselves hard questions. For fiction writers, does your narrative demand suicide, or is it just a lazy trope? For newspaper editors, is a suicide newsworthy, or simply sensationalist? This is not to say, however, that every depiction of suicide is irresponsible. The flip-side of narrative’s capacity to inspire suicide is narrative’s capacity to model anti-suicide strategies.

When evaluating suicide through a scientific lens, scholars tend to emphasize the impact of social forces rather than specific ideas. In one sense, this is understandable. Suicide clustering is a social phenomenon, and the means of establishing cause-and-effect are fairly straightforward. At the level of individual human minds, by contrast, assessing the impact of specific ideas on on suicidal behavior is difficult. There is a lacuna in our understanding of how specific memes impact people on an individual basis. What soothes one person’s despair might exacerbate someone else’s. We should not expect to find a one-size-fits-all anti-suicide message.

According to Hecht, not only do specific ideas matter, but the impact of specific ideas can be decisive. Enlisting the suicide contagion metaphor, Hecht observes:

What is contagious is an idea. Suicide begins as an idea. Remaining alive after one has contemplated suicide also begins as an idea. It may be possible to encourage anti-suicide contagion. (171)

The best way to encourage such anti-suicide contagions is by fostering an intellectual climate in which discussions of suicide are less taboo. In such a marketplace of ideas, diverse anti-suicide thoughts can emerge and take hold in people’s minds.

Some of the most fascinating passages in Stay are those in which Hecht scrutinizes the role of suicide in our literature. Her interest in literature is two-fold. First, literary works can be historical resources, reflecting the prevailing attitudes toward suicide in the time and place in which they were written. Second, literature has often been a source of suicide contagion. One of the earliest documented examples of suicidal contagion is The Sorrows of Young Werther, a novel published in 1774 by the German poet Johann Wolfgang von Goethe. In the novel, Werther is a young man who shoots himself after a romantic failure. In the years following its publication, many European men killed themselves in the same manner as the protagonist after suffering similar misfortune.

The Sorrows of Young Werther is widely regarded as the beginning of the Romantic movement. To the present day, suicide has remained a potent Romantic metaphor. Hecht perfectly encapsulates the appeal of suicide as a literary trope, writing, “a person choosing to die or to live exists in the very crucible of human morality and meaning.” (232) Hecht revisits the suicides of many famous characters in literature, highlighting how impulsive and destructive their deaths were, even in the context of the story. In my view, Hecht succeeds at denuding these fictional suicides of their poignancy.

The second pillar of Hecht’s anti-suicide argument is that people have an obligation to their future self. Much like the community we’d be forsaking, our future self has a stake in our continued existence. After all, however dire the current situation is, things might improve in the future. Our future self might be grateful that we chose to remain alive.

As someone quite interested in the philosophy of the self and free will, it is easy to become distracted by the many arcane thought experiments and weird edge cases that typify this domain of philosophy. The crux of Hecht’s argument is that we ought not to respect the soundness of a suicidal person’s judgment. In the case of a suicidal person, the appearance of an autonomous person making a rational judgment is an illusion:

What may look like an integrated person making an impulsive move might also be seen as a person in a particular mood acting quickly so as not to allow input from him- or herself in different moods. (187)

I agree with Hecht’s description of an individual’s mind as being a parliament of competing factions. When you prevent someone from killing him- or herself, it is like intervening in a neighboring nation’s affairs when you observe that a tiny segment of the population has seized control of the nation, and is on the verge of unleashing the nuclear weapons on itself.

However, I doubt that emphasizing the rights of one’s future self will be an effective deterrent to suicide. In subjective terms, our relationship to our future self can feel as remote and inconsequential as any given relationship to someone in our community. If you’ve ever tried to exercise control over your diet, you understand how it can be a struggle to act in the best interest of your future self even on a matter as simple as resisting a piece of candy. An even more apposite analogy can be made to drug addiction, which causes someone to not only discount the interests of their future self, but to knowingly engages in self-destructive behavior mandated by their self of the present moment.

Speaking of addiction, Hecht highlights the impulsiveness at the heart of many, if not most, suicides. Nowhere is this impulse component starker than in accounts of people who have attempted suicide. Many report regretting their decision the moment after they made it. There are even anecdotes about people who have jumped off a bridge, and say they remember feeling regret in the moments before hitting the ground. The fact that it is possible to commit such a final act for rash and frivolous reasons undermines the Romantic vision of suicide as a profound philosophical statement undertaken after calm contemplation. Moreover, these accounts reveal that despite our perception of suicide as the product of personal choice and innate disposition, the role of luck can be decisive. If you have a single suicidal impulse in your entire life, and you just happen to be crossing a bridge at the time, you are terribly unlucky.

On the surface, the phenomenon of suicidal influence seems to indicate that we should suppress discussion of suicide in public discourse. After all, however well-meaning you are, or vociferously anti-suicide your message is, merely reminding people that suicide is a possible course of action will exacerbate the problem. Hecht strongly disagrees this interpretation, arguing instead that we should talk more frankly about suicide. Hecht makes a two-pronged argument in favor of greater openness regarding suicide. The first is a refutation of the knee-jerk interpretation of suicide clusters:

From a practical standpoint, too, it makes sense to give thought to these issues. If we try to suppress the whole subject, if we quarantine suicide from our consciousness and from public conversation, we run the risk of suddenly confronting it, alone and unarmed, when we are most vulnerable. It is much better to remember that this is part of the human experience and to avail ourselves of the conceptual barriers to suicide that have been provided through history. (234)

Secondly, Hecht argues that the difference between an appropriate and an inappropriate discussion of suicide is context. The best response to bad representations is not to discourage any representations, but to insist on better representations. Hecht writes, “[j]ust as caring and realistic discussion of suicide can help curtail suicide influence, sensitive, informed depictions of suicide in media can do the population good rather than harm.” (171) Hecht provides an example: “In one study of three television movies including a suicide, suicide increase after two, both of which concentrated their attention of the suicide victim. The one that was not associated with a rise in the suicide rate concentrated on the grieving parents.” (171) It is both possible and necessary to treat suicide in a way that neither glamorizes nor trivializes the issue. Fortunately, by most standards, media representation of suicide has improved dramatically in response to evidence and advocacy.

Echoing the classic use/mention distinction in philosophy, Hecht underscores the difference between thinking suicidal thoughts and contemplating suicide as a topic. Hecht’s argument that context matters when discussing suicide had the side-effect of relieving my own guilt about being interested in this topic. Embarrassing as it sounds, it was gratifying to be reassured that my academic interest in suicide was not a macabre fascination with death, nor some nebulous internalized suicidal desire. It seems strange that an interest in suicide is regarded as unseemly in a way that an analogous curiosity about serial killers is not. There are entire television networks seemingly dedicated to true-crime documentaries about disturbing murders. Some of these programs are trashy, prurient, and exploitative—like the salacious tabloid stories about the suicides of celebrities—but others are not. Just as there are ways to tell stories about suicide that are respectful and illuminating, there are ways to study suicide without meriting worry.

Jennifer Michael Hecht is perhaps uniquely qualified to write a book on suicide. As the author of Doubt: A History, she has the secular-humanist bona fides to reassure skeptical readers that she harbors no hidden sympathy for religious nonsense. Her philosophical background notwithstanding, Hecht insists that her anti-suicide arguments apply irrespective of your beliefs about religion and the afterlife. Without conceding the truth-claims of religion, Hecht concedes that religious opprobrium for suicide probably did have a deterrent effect. However, she counters, religious justification is no longer necessary, since there now exists an equally forceful secular argument against suicide:

Pythagoras taught that each of us is stationed at a guard post, responsible for attending to it until we are dismissed. Plato would borrow the idea, which remained a cogent metaphor for centuries. (25)

This metaphor is very agreeable to Hecht’s thesis, and she refers to it frequently. It spotlights the potentially horrible consequences your death will have on your community. As with staying alive, standing watch isn’t necessarily fun, but you must do it anyway.

Hecht is confident that this metaphor will prove just as efficacious as religious commandments at discouraging suicide. After all, it has all the same elements, just switched our with secular terms. Instead of being rewarded with an eternity in heaven, you will receive gratitude from your community for having protected them. Correspondingly, the terror of hell is replaced by the fear of being posthumously dishonored by the community that you deserted. It’s worth noting that the guard post metaphor presupposes a community that you depend on to such an extent that the ignominy and material deprivation that you’d experience their absence would be devastating. Moreover, the guard post metaphor ignores the fact that suicide is often provoked by the community. A toxic community can be worse than no community at all.

It is impossible to talk about suicide without discussing the rise of individualism. Until recently in human history, one couldn’t survive as an individual. Survival depended on foregoing one’s own interests to serve the interests of the community. This changed with the development of complex modern societies. Now, the state and the market can provide the rudiments of an autonomous life, enabling someone to live independent of any community. The balance of power has shifted toward the individual. According to this analysis, any effective anti-suicide argument should appeal to one’s self of being an individual rather than a community member. Inasmuch as the metaphor of the guard standing watch relies on the traditional view of the community as essential for one’s livelihood, it is apt to be dismissed.

Alongside her arguments about our obligations to the community and our future self, Jennifer Michael Hecht endeavors to undermine the widespread perception that “secular philosophy is without exception open to suicide.” (232) Far from being mere anti-secular propaganda, Hecht contends that this permissive attitude is the dominant opinion in secular circles. Even if Hecht has cherry-picked quotes favorable to this interpretation, I was nevertheless surprised that these arguments existed at all. I consider myself fairly knowledgeable about secular philosophy, and I was not aware of many of these nuanced anti-suicide messages.

But why is there a consensus in modern secular culture about the acceptability of suicide? In Hecht’s assessment, the secular community’s permissive attitude toward suicide is a historical accident, rather than a logical extension of core philosophical beliefs. In Hecht’s account, Enlightenment philosophers (notably Voltaire and Hume) defended suicide as part of a wholesale rejection of religious doctrine. In essence, Hecht charges early secularists with throwing the anti-suicide baby out with the religious bathwater. At first, I was dismissive of this possibility, because in my mind the entire secular worldview—including its attitude toward suicide—seemed like a coherent system built up from basic principles, unshaped by historical contingencies. For Hecht to write that early secularists might have praised suicide for contrarian reasons aroused cognitive dissonance. But then I remembered that the same phenomenon seems to have taken place with spiritual experience, which was disparaged as part of a wholesale rejection of religious belief. Currently, Sam Harris and other secularists are trying to disentangle spiritual experience from religion. As a big supporter of the secular spirituality project, the thought that Hecht might be engaged in a complementary project led me to think her position was more credible.

This absence of credible dissenting views is one of Stay’s major flaws. “Writers through history have given us conceptual barriers to suicide with which we ought to be familiar, as a culture.” (12) While I completely agree that we should all be apprised of the best arguments against suicide, I also think we should be aware of the serious modern philosophers who have put forward nuanced arguments about how suicide is sometimes permissible. For example, consider the provocatively titled Better Never to Have Been: The Harm of Coming Into Existence (2006), by the philosopher David Benatar. I have not read Benatar’s book, but if my understanding of the thesis is correct, the advisability of suicide is somewhat ancillary to the fundamental question of whether existence is preferable to non-existence. Judging from the reviews, Benatar’s book is part of a lively debate in academic philosophy.

I am frankly unable to comment on the accuracy of the philosophy presented in Stay. I read one review of Stay that charged Hecht with misunderstanding Kant’s categorical imperative. I have no idea whether this criticism is valid, and, if so, whether it undermines her interpretation of Kant’s attitude toward suicide. I can, however, comment of the effect of the philosophical sections on a reader unfamiliar with the finer points of philosophy. The philosophy of these books is not the self-conscious, analytical, and impersonal stuff of academic treatises. Stay is philosophy in a literary style. Undoubtedly, people will derive inspiration from some of the passages, but such inspiration does not depend on having a strong understanding of the underlying philosophical principles.

Considering how most public discussion around suicide concerns terminally ill people, Hecht draws a distinction between despair suicide and what she calls end-of-life management:

this book is chiefly about despair suicide, rather than what might be called end-of-life management. People who are fatally ill and in terrible pain are dealing with different issues and may certainly be seen as altering the way that their illness kills them, rather than actually taking their own lives. (11)

It is understandable that Hecht would want to distance her thesis from the exigencies of modern politics, but I found this distinction to be perfunctory and dubious. Hecht must know that there are agonizing conditions that aren’t terminal but nevertheless deserve to be called ‘fates worse than death’. I would never dream of telling a person with locked-in syndrome, for instance, that I knew better than they did whether their life was worth living. I wish Hecht had dealt with this objection earlier, and more comprehensively. The unstated coda to the advice of “stay” is “stay, because maybe you will feel better in the future.” This is not the case for those who are locked in. The real revolution in the secular morality has an emphasis on the actual determinants of suffering and well-being, rather than intuitively attractive but philosophically shallow notions of preserving life irrespective of whether it is actually worth living.

Perhaps Hecht reasoned that the subset of people seeking physician-assisted suicide represented a tiny fraction of all the people contemplating suicide, so dwelling on these cases would muddle the moral message for the bulk of (possibly suicidal) readers. It’s true that people tend to exaggerate the scope of their own suffering, and might therefore locate their despair along the same continuum as someone with a painful, degenerative, and terminal disease. If people judge that their personal despair is so irrevocable that it falls into the latter category, they might leap to the assumption that their own suicide is justified.

Toward the end of the book, Hecht reveals that is not ignorant of this gray area between despair suicide and end-of-life management. In the final chapter, Hecht finally acknowledges the nuance:

Of course, there are times when a person suffers from despair so intensely and for so long that it can seem merciful to let him or her end life. Perhaps there’s a level of emotional anguish that is more reasonably considered alongside painful fatal illness in regard to the appropriateness of suicide. There are many things that we say are wrong that yet have some exceptions. (231)

This concession did a lot to endear me to the book. Her position is scarcely different from mine at all. Consider how different this is from her attitude in the blog post that inspired this book:

I’m issuing a rule. You are not allowed to kill yourself. (x)

This is a rare case in which I forgave the author for eschewing nuance in the introduction. Hecht was put in a difficult situation. However rigorous of a scholar Hecht is, she was certainly aware that vulnerable people were going to reach for her book as a life-line. By front-loading the book with sweeping injunctions against suicide, it has the effect of nudging such people in the right direction. To that end, Stay feels calculated to be as welcoming as possible. I have long maintained that every book has the potential to be a self-help book, and Stay is no exception.

It is generally considered illegitimate to comment on an author’s tone. Unlike facts and logic, tone is subjective. ‘Tone-trolling,’ as it is known, violates your responsibility as a reader to be charitable in your interpretation. Despite all this, Hecht’s characterization of suicide as “delayed homicide” made me bristle:

One of the best predictors of suicide is knowing a suicide. That means that every suicide is also a delayed homicide. (x, quoted from her original essay in Best American Poetry Journal)

How dare she imply that someone who has killed herself has the moral status of a murderer! (Not all homicide is murder, of course, but most people will conflate the two.) Though never stated it so plainly, the logic behind “delayed homicide” seems to be, “if you are contemplating suicide, you ought to feel so guilty about the possibility that your decision will indirectly result in the death of someone else that you should stay alive to prevent this from happening.”It resembles a threat: if you kill yourself, you will be blamed for the deaths of other people. Death will be no respite from disgrace. Even if the logic of this meme seems watertight, it remains to be seen whether such a message will actually have the intended effect.

The resemblance to the threat of punishment in the afterlife did not escape Hecht’s notice. In fact, it seems to have been her intent. In her original blog post, she writes:

In the West, in the past, the dominant religions told people suicide was against the rules, they must not do it, if they did they would be punished in the afterlife. People killed themselves anyway, of course, but the strict injunction must have helped keep a billion moments of anguish from turning into a bloodbath. (Best American Poetry Journal)

I doubt there will ever be a secular incentive to live that matches the religious fear of everlasting torment. Even so, Hecht is certainly right that an absolute rule against suicide would stop a great many of the impulsive suicides I mentioned earlier. But what about the people in excruciating, intractable pain who, rather than taking their own lives, persisted in living? I cannot help but worry about the religious believers who, holding to this injunction, endured torture, chronic pain, or  degenerative disease beyond the point most modern people would seek physician-assisted suicide. If you are like me, and believe that certain situations are so intractably agonizing that suicide is a rational response, such religiously-motivated endurance would result in a loss of well-being.

Upon further reflection, I wonder why my reaction to the “delayed homicide” formulation was so negative. In other contexts, I am very willing to equate direct action with indirect action. When someone buys meat, for instance, I consider him or her partly culpable for the maltreatment of the slaughtered animals. In principle, I don’t think anyone should be immune from criticism –including the dead– but heaping scorn onto a person who has just killed him- or herself feels uncouth—literally adding insult to injury. Hecht should know that if the traditional shame-based messages to discourage suicide don’t work, then this sophisticated form of shaming is unlikely to work either. Public health authorities have already tried similar shaming messages to curb obesity and addiction, and such efforts have been shown to be ineffective or even counterproductive.

Another reason I doubt the effectiveness of the “delayed homicide” formulation is that it is based on probabilistic evidence. Suicide clusters can be demonstrated in a large population, but in any given case you might be lucky, and everyone in your community might remain resilient in the aftermath of your death. Furthermore, this label would successfully discourage suicide only in someone who was sensitive to the welfare of their community; someone outraged by their community might take perverse solace in the fact that their death will trigger suicides in the community. It is necessary to reckon with the phenomenon of suicide clusters when crafting public policy, but as an anti-suicide meme it may be counterproductive.

If I had to recommend a single passage from the book, it would be the conclusion. It represents the best aspects of the book while downplaying its weaknesses. It stands on its own merits as an uplifting anti-suicide message. You can read it here. It clarifies that in spite of the peremptory rhetoric at the beginning, the central mission of this book has been to educate people on the history of arguments against suicide:

I believe fiercely in the position I have here put forward, but rather than seeking to convince everyone that my position is the only correct one, I am seeking to make sure that alongside arguments in favor of the right to suicide, people are also aware of this argument that we must endeavor to live. (231)

This is not as banal as it first appears. In fact, this the best encapsulation of her thesis, since it communicates the value of spreading knowledge without any moral posturing. In the end, Hecht is absolutely right that one should die for lack of knowing these arguments.

I have no doubt that there are people for whom “it will bring solace to know that there is a philosophical thread extending over twenty-five hundred years that urges us to use our courage to stay alive.” (232) However, do not mistake this book for a disinterested overview of the history of suicide and the philosophy surrounding it. Stay is an explicitly anti-suicide book, eschewing scholarly nuance in favor of righteous passion. Hecht is unforgivably cursory in her consideration of dissenting voices. By hiding important caveats at the end of the book, one can reasonably conclude that the author wanted her audience to come away believing that despair can never become severe enough to justify suicide. I am tempted to recommend Stay solely on the basis of its writing quality. Hecht’s lucid prose, replete with delightful metaphors, is a pleasure to sift through. The book will be especially engrossing to anyone who appreciates the classics, especially the mythology and art of the ancient world. I submit that Hecht’s exploration of suicide in Shakespeare stands on its own merits as compelling literary analysis. Despite its limitations, Stay has whet my intellectual appetite. I look forward to reading a more comprehensive and academic treatment of the topic, such as Suicide: The Philosophical Dimensions, by Michael Cholbi.