Composing suicide: Narrative and suicidal behaviour

1
Composing suicide Narrative and suicidal
behaviour

• Scott
  Fitzpatrick BA (Hons)
• 
  PhD Candidate
• scott.fitzpatrick_at_s
  ydney.edu.au

2
Arguments for a narrative understanding of
suicidal behaviour

• The discourse on depression is a primary site of
  contestation in suicide research.
• The focus on individual biological and cognitive
  function is not ethically neutral.
• Cultural understandings of depression emphasise
  important socio-cultural features.
• Narrative frameworks provide us with the means
  for studying these interrelations.

3
Narrative

• A primary method for structuring experience and
  knowledge, for organizing and making sense of
  events, and for providing order and coherence to
  a possible reality.
• Provides a range of previously structured models
  with which to transform or re-describe that
  reality.
• (Prince, 2000, p. 129)

4
Suicidal behaviour and mental illness

• the mental illness tautology whereby the
  (suicidal) act defines the illness and the
  illness defines the act.
  (OConnor, 2003)
• Has limited metaphoric utility in explaining
  suicidal behaviour and results in the omission or
  downplaying of important social and
  cultural-normative features.

5
Culture and depression

• Depression Emotion or disorder?
• Normal or pathological?
• (cf. Kleinman
  Good, 1985)

6
Culture and depression

• on Aristotles account, while emotions give
  rise to affective impulses, they are generated by
  a state of mind in which factual beliefs and
  moral judgements have a central role in the
  causation and individuation of emotions
• 
  (Harré,1986, p. 2)

7
Anna

• Participants recruited through two Community
  Mental Health Centres in Sydney.

Age Contact with mental health services prior to attempt First suicide attempt No. of days between attempt and interview Diagnosis as per clinical file at time of interview
33 Yes No (2nd) 21 Depression

• Some participants in prior contact with Mental
  Health Services, others followed-up by Acute Care
  Services after being hospitalized following
  suicide attempt.

8
Composing depression and suicidal behaviour

• And then one morning the guy who sat next to me
  at work asked me if I was ok and everything just
  fell to pieces.
• I found myself just leaving work in the middle of
  the day and going home and just sitting on the
  bus on the way home and just crying.
• It just felt like someone had punched me in the
  chest. I felt like I had this gaping hole in my
  chest. It was almost like a physical feeling of
  pain.

9
A rhetoric of control

• Feminist treatments of the question of
  emotion have tended to portray emotions not as
  chaos but as a discourse on problems. Talk about
  anger, for example, can be interpreted as an
  attempt to identify the existence of
  inappropriate restraint or injustice. Sadness is
  a discourse on the problem of loss By extension,
  talk about the control of emotions, would be, in
  this feminist discourse, talk about the
  suppression of public acknowledgment of
  problems.(Lutz,1996, p.140)

10
A rhetoric of control

• Well it makes it harder for me to talk about
  because it makes me feel like they dont want to
  hear like they dont really want to know, and
  that if I do tell them the truth, that I would
  upset them.

11
Narrative, emotions and suicidal behaviour

• Subject-referring emotions always occur
  within a social matrix of goals and aspirations,
  aspirations that naturally achieve clarity and
  definition in language and often at the
  instigation of prior emotions that reveal value
  directions in our lives. Emotions can thereby
  bring us to ourselves in their demand for
  understanding they very often demand a narrative
  to be unfolded which gives meaning to their
  manifestation and, thereby, an interpretation to
  our lives. (Kerby, 1991, pp. 50-51)

12
Narrative, emotions and suicidal behaviour

• Narrative is not only a creative, but also a
  receptive-interpretive act (Kerby, 1991, p.47).
• Thus, it provides creative possibilities for
  providing coherence to lives and identities over
  time, but equally, it may present a number of
  constraints.

13
A social theory of depression and suicidal
behaviour

• Locates the sources of depression in the
  meaningful relation between self and the world.
  
• it is when a loss of value stimulates an
  appraisal of ones place in the world as being
  profoundly hopeless that prolonged and
  recognizable depression is likely to ensue.
  
• (Keyes, 1985, p.158)

14
Anna

• I find it hard to imagine things going back to
  normal. I find it really hard to imagine things
  being like they used to be. I guess I had less
  worries. I was more carefree. I was a more open
  person, more communicative.

15
Anna

• I would like to be able to be not on
  medication, and not having to see a psychologist
  once a week and a psychiatrist once a month, and
  worrying if Im going to be hospitalised and that
  kind of thing. Not being worried about having to
  take time off work without pay, or worried about
  not letting anyone at work know that things
  arent great because Im worried how theyll
  react and stifle my career opportunities because
  they think Im not going to be able to cope, or
  they dont trust that Im going to be able to do
  my job to its fullest extent.

16
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