In his recent Chronicles article “Suicide Permitted,” Jack Trotter argued that the conventional response to America’s teen suicide crisis is misguided, largely because it fails to come to grips with the near collapse of traditional levels of social integration in our society. Moreover, a purely therapeutic response is untenable absent any recognition  of the religious dimension out of which any stable and enduring social integration must occur. The following email exchange grew out of a response to Trotter’s piece by Dr. Boris Vatel, a practicing psychiatrist in Indiana.

Hello Jack, 

I hope you are well. Your online article in Chronicles on teen suicide reminded me of an article written by prominent psychiatrist and one-time editor of Psychiatric Times, Dr. Ron Pies, on this very topic. He wrote that the prohibition on suicide is primarily social and that a loss of one member of society is ultimately a loss to all. I would be the last to deny that suicide leaves a huge, gaping, and poorly healing wound in the hearts of family and friends of those who take their own lives. However, the ultimate prohibition against suicide cannot rest solely on such grounds. There are, after all, people who are all alone in the world and whose deaths (natural or otherwise) no one will mourn or even notice. There are elderly folks who have outlived everyone they were ever close to and who have no living relatives. If they feel so inclined, why should they not take their own lives? Why should a person sentenced to be executed tomorrow morning or a forgotten castaway on an uninhabited island refrain from suicide?

No, the answer must be inclusive and apply to all cases. And that answer must be transcendental in its essence: not necessarily Christian (although it helps) but recognizing the sacred or holy nature of life—given to us and not ours to take. One would argue that such reasoning would also prohibit taking the lives of others, and it must. In Christian terms, so long as you live as a human being you can repent of taking the life of another. In the case of self-murder, repentance may not be possible at all.

A patient of mine recently asked me the following: Why is it that people who choose not to continue with useless cancer treatments and end up dying are given a “celebration of life” but those who die by suicide are not treated the same way? “Because,” I said to her, “it is murder, no less than taking the life of another human being.” Until that moment, I had never actually thought about it this way. Not to mention that this whole notion of a “celebration of life” in such circumstances is absurd as it deprives those who should be grieving of the opportunity to do just that. Death is a terrible and irrevocable loss that ought to be followed by mourning.

But that the loss of social fabric and, therefore, loss of meaning is contributing to the suicide epidemic is, no doubt, also true.  Although the most valid reasons against the taking of one’s life are ultimately transcendental in nature, even secular societies that have greater social cohesion and foster a sense of purpose, belonging, and meaning are not plagued by suicide, especially among the young.  By the way, it is a known fact that suicides drop drastically when people are faced with war, starvation, and natural disasters—may God save us from such trials. Yet it is such trials that seem to arouse in individuals a collective sense of self-preservation. Ironically, affluence in the absence of purpose or meaning often tends to bring on lassitude, malaise, and the sort of psychiatric disturbances often found in the first world.  

I just wanted to put in my five cents’ worth regarding this topic since many of my own patients struggle with suicidal ideation.

Best,

Boris

Boris,

Regarding the suicide problem, I do agree that the “social” argument is not in itself sufficient, which is why I brought in the transcendental argument near the end of my original piece. You make excellent points about certain cases where the social argument may seem nonsensical or less than compelling. You mentioned the elderly, who may feel isolated and unwanted, or, as a hypothetical, a solitary castaway on some distant island. You ask, “If they feel so inclined, why should [such people] not take their own lives?” I assume that the question is rhetorical, since the context makes it clear that you do have an answer to that question—the transcendental answer—but that you pose it as a way of suggesting that the social argument (our obligations to others) would fall on deaf ears in cases like these.

In fact, the spread of the pro-euthanasia movement in the West reveals that such cases are not really isolated or exceptions to the rule (as I was initially tempted to argue). Today, many millions—not only the isolated elderly and the terminally ill, but teens in despair, too—have acquired something like an immunity to the once prevalent idea that we are all in this together, that the choice to throw off the will to live rather than to endure (as Faulkner so often stressed as a primary virtue) is a moral affront to those who chose to continue the struggle against death.

On the other hand, I do think that if our social fabric were not now such a tattered and fragile thing, our suicide rates would be “normal,” but instead we are facing something that can only be regarded as an unprecedented crisis, and not only among teens. Do you agree?

Best,

Jack

Hello again, Jack –

Thank you for replying. With regard to your observation that our social fabric is a tattered and fragile thing, sometimes I think that we are all witnesses to the process of decomposition of a very large animal that was once thriving and very much alive. What we have today is truly a feast of death, and the rising suicide rates only reflect the truly suicidal mindset of the ruling elites in the West. The encouragement of mass migration via porous borders, the deconstruction of such notions as nation/nationality, gender “fluidity,” of what constitutes marriage/family, the celebration of fetal death as a triumph of personal freedom, and open talk about the desirability of significantly reducing the world’s population—this is all death-talk. These are ideas not merely of a senescent, dying culture but of a frankly suicidal culture that is hostile to life, to all that is healthy, fertile, and normal. These ideas are not new, but having been introduced into society some decades ago, they are now bearing their logical, poisonous fruit. The epidemic of mental illness and the rising suicide rates are but reflections of a larger problem. Our ruling elites wish for death, either consciously or unconsciously. By their deeds you will know them. Yes, the crisis is much bigger than teen suicide. Although, speaking quite literally, when its young kill themselves off, a society has no future. 

Best,

Boris

Boris,

Thanks for your most recent comments. You very eloquently identify a critical problem that afflicts not only North America but most Western societies—that is, what you term our “feast of death.” I couldn’t agree more that the symptoms you mention (uncontrolled immigration, the decomposition of nationality in favor of a vacuous globalism, the collapse of gender norms, the obsession among our elites with abortion rights, the collapse of the family and gender norms) are all evidence of a kind of cultural death wish. 

No doubt these developments, which seem to be reaching a point of no return, are driven primarily by the loss of the transcendental dimension in our societies. I would call it an implosion of the capacity for grasping, at least intuitively, the possibility of a realm that exists beyond our immediate material concerns. Or perhaps it is not so much a failure to “grasp” such a dimension as it is our prideful abandonment of an eternal moral order that makes demands upon us that we refuse to recognize. 

It seems to me, however, that the analogy between a suicidal or self-destructive culture, on the one hand, and rising rates of teen suicide, on the other, is not altogether convincing. The cultural and political “suicide” engaged in by our elites has been going on for some decades, but the rates of teen suicide have only just begun their dramatic spike in the last 20 years or so. Why the delay? Are you suggesting that the poisonous effects of the culture have only just recently seeped down into the ranks of our teens?

Another point I was going to make earlier has to do with the role of the social sciences. As I mentioned in passing in the original article, Emile Durkheim gave primacy of place to religious belief and ritual, but only insofar as it reinforced social solidarity. As an atheist, like Marx, he refused to recognize that the transcendental object of such beliefs (whether Christian or otherwise) was real. What mattered was that people believed.

Thus, Durkheim and his early followers promoted a purely social (or “secular”) transcendence in which society itself becomes a quasi-divine referent. While Marx looked forward to a time when a classless society would no longer have any use for the trappings of religion, Durkheim, a wiser man, seemed to assume that intellectual and political elites had an obligation to refrain from attacks on popular belief systems. Yet he does not appear to have anticipated how quickly those beliefs would be eroded by modernity.

Did the practitioners of the social sciences at some point abandon Durkheim’s reticence on this subject? Was here some turning point at which sociologists and social psychiatrists decided collectively that religion had to be jettisoned entirely, that it had become an obstacle to social health and solidarity?

Best,

Jack

Jack,

We would be in danger of oversimplifying things by ascribing rising suicide rates among the young to one cause only. In medical jargon there is such a term as “multi-organ system failure” which is used to describe a situation in which the organism as a whole is dying as a result of simultaneous or successive failure of several vital organs. God built into the human body a great deal of reserve and the organism can absorb significant insults without immediately succumbing to illness. However, chronic, repeated injury or a serious-enough acute event such as severe trauma or overwhelming infection, may deplete the body’s reserves and lead to collapse. What I was trying to say in my earlier communication was that our social organism has entered an accelerated state of decline as a result of gradual depletion of reserves. By reserves I mean such institutions, rituals, and traditions as enable a society to thrive or at least to maintain functional stability.

While such processes of depletion may have begun some time ago, the observable effects are becoming more and more apparent. Although all of us suffer the consequences, that the young should be particularly affected is not surprising. After all, youth is a time when we begin to forge what in time becomes a mature identity, when questions of meaning are especially vital, when perceptions are at their most acute, and when there is a sense of urgency and immediacy to suffering not tempered by years of experience. If it is true that the processes of decay began decades ago but have assumed an accelerated rate, is it any wonder that the mental impairment of the young has become increasingly prevalent over time? Consider the events of the past few years, the … vertigo-inducing effect of constant immersion in social media, and the reality-dissolving experience produced by blurring of the real and the virtual—are not the young affected most by these destructive forces?

From a practical standpoint, I do not disagree that a shared system of beliefs is vital to ensuring that a society has a future—providing, of course, that such beliefs are life affirming and not death-oriented. As Christians we may and should argue that the ultimate value of a human life and thus society as a whole is that we are made in the likeness and image of God, and that our individual and collective destiny is to be ever closer to Him. However, one can conceive of a secular society with a collectivist mindset in which an individual sees himself as important to the functioning of the whole social organism, as performing a vital function from childhood to old age, and as being responsible for and proud of performing such a role. While I believe that the ultimate argument against suicide is a religious one, I should think that a society described above would be less likely to produce individuals who are meaning-deficient and are thus prone to take their own lives. As Christians we may object to this sort of “secular transcendence” on a philosophical basis but even such a society would likely be more resilient and future-oriented than the one we are currently living in. Western societies have typically embraced a more individualistic mindset which worked so long as it was founded on a shared Christian foundation. Now the foundation is gone and all that’s left is the individualist mindset, adrift in the sea of existential despair and meaninglessness. Without being grounded in transcendence of either kind such a society gradually breeds more and more people who simply do not know how to live among their own kind and tend to be either autistic or antisocial.

I am not sure that psychiatrists ever collectively believed that religion was essential to social health and solidarity. Whether one considers European psychiatry with its objective-descriptive basis, or contemporary psychiatry grounded in what is called “neuroscience,” all these enterprises have been explicitly secular and materialistic. Lips service has been paid to “spirituality” but only as a sort of crutch or a “coping skill” that some people may need to help them get by. The cornerstone idea of neuroscience is that mind and consciousness are ultimately reduced to the brain and its various functions, poorly understood as they may be for now.

Collective psychiatry also tends to reflect the values of that society in which its practitioners live. In keeping with that fact, contemporary psychiatry is about offering people chemical solutions to existential problems. Judging by what we see around us, this does not appear to be very successful. And this is not so due to lack of access to care. More psychiatrists will not solve the existential crisis of our society. A solution must lie elsewhere.

Best,

Boris

Editor’s Note: At the author’s request, the last paragraph of the first letter from Boris Vatel has been edited in order to provide greater clarity and context than was conveyed in an off-the-cuff letter to a personal friend.