A “Sickness of Our Time”: How Suicide First Became a Research Question

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In 1897, the French sociologist Émile Durkheim (1858-1917) published Le suicide: Étude de sociologie [Suicide: A Study in Sociology]. With it, Durkheim largely succeeded in achieving one of his main goals-to use an empirical analysis of the subject of suicide to launch the field of modern scientific sociology. Reading the book today, one is still impressed by its innovative methods. For example, its epidemiological approach based on international statistical data and its often surprising findings-for one, that suicide rates rose not during social crises, but rather at times when governing norms were breaking down.

While the work has been hailed as a founding text for the social sciences, historians have shown that Durkheim was perhaps less a pioneer than beneficiary of generations of research. As historian Daryl Lee puts it, the book “marks not the beginning but the culmination of nearly a century of intense anxiety and debate over the subject of suicide.”¹ What for centuries had been considered a matter for clergy, theologians, and philosophers alone to comment on became in the 19th century a problem that increasingly drew the attention of psychiatrists and sociologists. Why did things change?

If we look back to ancient Greece and Rome, philosophers there considered it a matter of debate whether it was morally acceptable to end one’s life. Intellectuals such as Socrates and Cato, both suicide completers, continued to enjoy respectable reputations after their passing. Christian Europe, however, expressed a far less tolerant attitude toward self-inflicted death. For over a thousand years, Christian thinkers shared the aversion to suicide of St. Augustine (354–430), who held the act to be an arrogant refusal to submit to God's will; it was widely accepted, He and He alone rightfully decided on when an individual’s life should come to an end. As such, suicide was deemed a crime and the bodies of suicide completers were often desecrated and their possessions confiscated.

A shift in thinking began to take place between 1500 and 1800. While intellectuals of the 16th and early-17th centuries continued to pronounce suicide to be a moral abomination, some Enlightenment figures of the 18th century like Voltaire (1694–1778) and David Hume (1711–1776) argued for its legitimacy under certain situations. Historians examining judicial and church records have shown that in between these 2 periods, local authorities throughout Europe were slowly decriminalizing suicide, believing the penalties imposed on the corpses and estates of victims an unjustified burden on family members. Popular attitudes at the time also appear to have been evolving, as people gradually attributed suicides not to moral failings or the devil, but to deep emotions such as grief.² This opened the way in the 1700s for reform-minded thinkers to begin pathologizing suicide as an expression of melancholy.³

Clinical observers and researchers began taking up the subject in the early 19th century. In 1807, Danish physician Heinrich Callisen (1740–1824) dubbed it a form of illness and others soon followed suit.⁴ This was not due to the emergence of any new clinical evidence, however. Rather, legal and judicial changes in defining criminal responsibility inspired debate within psychiatry over a range of issues: the possibility of “partial” insanities, the existence of emotional and volitional forms of madness, as well as whether suicide should be treated simply as a symptom of an altered state of mind. On the latter question, some-like the famed French psychiatrist Jean-Étienne Esquirol (1772–1840)-generally believed it to be “a disorder of the emotions,” a view a later writer in 1857 would criticize as “. . . a dangerous and serious mistake which can give rise to undesirable moral consequences.”⁵

At the time, the debate within psychiatry represented only one thread of the discussion over suicide. In the early 19th century, there was widespread perception that the incidence of suicide was rising. Whether this was so is difficult to judge. What we do know, however, is that this was exactly the moment when governments began to concertedly collect statistics on suicide as part of a broad effort aimed at developing a more empirically-informed public policy.

While interest in the regularities of birth, marriage, and death rates dated back to the 18th century, during the 1830s the field of what was called “moral statistics” was ever more drawn to deviant acts like crime, alcoholism, and suicide. For moral statisticians, like the Belgian Adolphe Quetelet (1796–1874), the fact that these morally corrupt and seeming irrational actions followed consistent patterns in their incidence, prevalence, and distribution demonstrated that human behavior-like the rest of the natural world-followed certain laws. And these laws, he thought, could be scientifically discovered and analyzed. Here was compelling proof of the need for a social science on par with the physical sciences.⁶ Thus, 2 lines of research emeged in 2 emerging fields, one rooted in psychiatry, the other in sociology. The 2 paths certainly diverged from one another: psychiatrists remained most interested in the psychopathology and treatment of individuals. Social scientists were drawn to identifying and influencing collective patterns.

Nevertheless, there were points where the interests of the 2 groups overlapped. Both statistician André-Michel Guerry (1802–1866) and physician Brierre de Boismont (1797–1881), for instance, separately took it upon themselves to classify and analyze the motivations of those committing suicide. Pouring over the letters, notes, and writings of thousands of victims, they sought out trends that might be common among those attempting to kill themselves.

But what continued to worry many analysts in both camps, however, was what seemed to be the shockingly high suicide rate in contemporary society. Thomas Masaryk in his 1881 study of the topic put it bluntly: suicide was “the sickness of our time.” It appeared to be not just an epidemic in, but also endemic to the modern world. What was one to make of this?

The growing influence of Darwinian evolutionary theory moved some to search for answers there. The physician and writer Max Nordau (1849–1923) argued that the rising suicide rate reflected a more general pattern of “degeneration,” an evolutionary regression of the human race caused by society’s neglect of the moral and hygienic health of civilized peoples.⁷

Others, however, wondered whether the evolutionary connections between humans and other animals meant that suicide could be found in other species. Scottish alienist William Lauder Lindsay (1829–1880) believed so. A critic of the use of mechanical restraints and an advocate for psychotherapy in asylums, Lindsay argued that evidence showed that animals did commit suicide just like humans, not as “the simple product of malady, but of malady aggravated by mismanagement.” In other words, it was due to neglect and abuse. The famous British psychiatrist Henry Maudsley (1835–1918) begged to differ. He categorically dismissed the notion of animal suicide. Non-humans, he contended, lacked the capacity to deliberately seek their own deaths, and he criticized Lindsay for sacrificing scientific assessment in the service of a “spirit of romance.”⁸

Others saw less value in evolutionary arguments, opting instead to focus on recent historical changes. Durkheim entered the debate, emphasizing the impact modern secular and consumer values had on unmooring individuals from their familiar moral anchors. He was hardly the first to argue along these lines. Almost 2 decades earlier, the Italian physician Enrico Morselli (1852–1929) published Suicide: An Essay on Comparative Moral Statistics (1879), in which he related contemporary suicides to the rise in the unsatisfied desires and unregulated self-gratification characteristic of modern life.

By century's end, many researchers concluded that suicide represented not so much an illness as a symptom–a response by some to the challenges posted by living in the modern world.

Dr Eghigianis Associate Professor of Modern History and Former Director of the Science, Technology, and Society Program at Penn State University; he is also Section Editor for Psychiatric Times' History of Psychiatry.

References:

1. Lee D. Accounting for self-destruction: Morselli, moral statistics, and the modernity of suicide. Intellect Hist Rev. 2009;19:337.

2. Watt JR. Introduction: toward a history of suicide in early modern Europe. From Sin to Insanity: Suicide in Early Modern Europe. Ithaca: Cornell University Press; 2004: 1-8.

3. Bähr A. Between self-murder and suicide: the modern etymology of self-killing. J Soc Hist. 2013;46:620-632.

4. Goldney RD, Schioldann JA, Dunn KI. Suicide research before Durkheim. Health Hist. 2008;10:73-89.

5. Berrios GE, Mohanna M. Durkheim and French psychiatric views on suicide during the 19th century: a conceptual history. Br J Psychiatry. 1990;156:1-9.

6. Porter TM. The Rise of Statistical Thinking, 1820-1900. Princeton: Princeton University Press; 1986.

7. Pick D. Faces of Degeneration: A European Disorder, c 1848-1918. Cambridge: Cambridge University Press; 1989.

8. Ramsden E, Wilson D. The suicidal animal: science and the nature of self-destruction. Past Present. 2014;224:201-242.