Transcript A Sociology of Suicidology David Webb Victoria University [email protected] Revisioning Institutions Change in the 21st Century Annual Conference of The Australian Sociological Association (TASA) La Trobe University, Beechworth.

A Sociology of Suicidology
David Webb
Victoria University
[email protected]
Revisioning Institutions
Change in the 21st Century
Annual Conference of
The Australian Sociological Association (TASA)
La Trobe University, Beechworth Campus
December 8-11, 2004
TASA Conference 2004
A Sociology of Suicidology
Slide:
1
Research Question and ‘Method’
Why is my experience of suicidality absent from suicidology?
‘Method’:
–
–
–
detailed, first-person (phenomenological) description of one
person’s lived experience of suicidality
use first-person story as an analytical tool or ‘prism’ through
which the discipline of suicidology is examined for gaps
requires a socio-cultural critique of suicidology
Other aims/methods of PhD (not this presentation):
–
phenomenology seeks a better understanding of the lived
experience of suicidality
No attempt at generalisations, new theory … or ‘treatment’
TASA Conference 2004
A Sociology of Suicidology
Slide:
2
Academic/Professional Discipline of Suicidology
Three ‘parent’ disciplines:
sociology:
psychology:
psychiatry:
Durkheim - anomic, egoistic, altruistic suicides
Shneidman - ‘psychache’
DSM and biological psychiatry
(not the psychoanalytic tradition - e.g. Freud’s thanatos,
Menninger’s selbsmort, or Hillman’s Suicide and the Soul)
Comprehensive Textbook of Suicidology:
–
–
–
“the science of self-destructive behaviors”
“surely any science worth its salt ought to be true to its
name and be as objective as it can, make careful
measurements, count something”
“suicidology has to have some observables, otherwise it runs
the danger of lapsing into mysticism and alchemy”
TASA Conference 2004
A Sociology of Suicidology
Slide:
3
Dominant Discourse of Suicidology
Dominant discourse of suicidology can be seen in:
–
–
the literature - texts, journals, conferences etc
the key participants - i.e. most influential (on gov’t policy etc)
1. The ubiquitous epidemiological study - Durkheim’s legacy
–
–
–
–
population studies to identify ‘at risk’ demographic groups
the search for risk and protective factors
so far only weak predictors of individual suicides
strongest predictor - previous suicide attempt
2. The medical (i.e. psychiatric) model of ‘mental illness’
–
–
DSM for diagnosis
biological psychiatry for treatment
[3. Psychological - i.e. mental rather than brain ‘disorders’
–
marginalised by psychiatry though (sadly) following it]
TASA Conference 2004
A Sociology of Suicidology
Slide:
4
Dominant Discourse - Modern Psychiatry
1. Diagnosis - The DSM, ‘Mental Illness’ and Depression
“Depression is the major cause of suicide” (e.g. beyondblue)
Bob Goldney’s “real estate analogy” of suicide:
– “The most important contributing factors to suicidal
behaviors are depression, depression, depression”
– “depression is the most common diagnostic condition
associated with suicidal behavior”
– Confuses correlation with causation: equivalent to saying flu
caused by a runny nose and a cough
2. Treatment - Biological Psychiatry
The ‘chemical imbalance of the brain’ school of psychiatry
Maris: “Put Prozac in every major city’s water supply”
• is he joking … or only half-joking?
TASA Conference 2004
A Sociology of Suicidology
Slide:
5
What is a Discipline?
“… disciplines are sets of individuals, socially related, differentiated in
status and power. They offer their own systems of social control which
sanction some forms of behaviour and reward others. They develop
norms and value systems. They have mythologies which legitimate their
structures and belief systems. They have rituals which re-enforce them.
They have socialising and induction processes which not only impose
acceptable measures of conformity, but like all such effective socialising
processes objectify and internalise the limits of behaviour so that to the
socialised they appear good, just and rational. The disciplines are
established in a social environment. … Finally, like all social entities,
their present life is conditioned by their past. The past offers them a
paradigm within which acceptable forms of evidence, acceptable
questions, acceptable criteria of judgments, acceptable languages of
communications and acceptable modes of transmission from one
generation to another, have a cultural and social form.” (Greg Dening)
TASA Conference 2004
A Sociology of Suicidology
Slide:
6
The Wider Suicide Prevention Community - 1
The ‘back room’ participants at suicide prevention conferences:
– psychosocial services - incl. ‘talking therapies’ (psychology)
– drug and alcohol - ‘dual-diagnosis’ and ‘comorbidity’
– complex trauma (Post-Traumatic Stress Disorder - PTSD)
• childhood abuse - sexual, physical, emotional
• victims of crime - esp. domestic violence
• indigenous, rural blokes, refugees, returned soldiers, jails etc
Biopsychosocial approach - the ‘state of the art’:
– disability rather than illness
– recovery rather then treatment
– sought after by consumers but minimal access to services
– marginalised by biomedical model of psychiatry
TASA Conference 2004
A Sociology of Suicidology
Slide:
7
The Wider Suicide Prevention Community - 2
‘Suicide survivors’ :
–
–
–
–
those bereaved by suicide
unique and difficult form of grief
known to be at increased risk of suicide themselves
strong voice in suicidology - in contrast to ‘consumer-survivors’
Governments:
– looks to suicidology for policy guidance
– massive subsidies to biomedical interventions (Medicare, PBS)
– non-biomedical services in constant financial crisis and getting
worse, despite demand from consumers
The Media:
– vital role for suicide to come out of closet as public health issue
– severely constrained by guidelines … from suicidology
TASA Conference 2004
A Sociology of Suicidology
Slide:
8
What’s Missing from Suicidology? ...
Suicidal ‘thinkers’ (contemplators, attempters)
– the first-person voice of the subjective, lived experience
– the phenomenology of suicidality: “What is it like to be suicidal?”
– contrast with 1st-person voice of ‘suicide survivors’
Concepts of self:
– the ‘sui’ in suicide - both victim and perpetrator
– suicidology’s most central concept
– parent disciplines’ concepts of self often contradictory
Spirituality:
– recognised ‘spirituality gap’ between those struggling with
suicidality and professionals we seek help from
– spiritual values and needs often vital to sense of self
– also potential pathway to recovery
TASA Conference 2004
A Sociology of Suicidology
Slide:
9
And Why?
An obsolete commitment to the myths of modernity:
• the “false epistemology” of DSM and bio-psychiatry
• pathologises/medicalises human distress and suffering
• denies subjective truths - phenomenology, self, spirit
• locates pathology in (the brain of) the individual
• colonisation of the psyche by science/medicine/psychiatry
The politics of vested interests and exclusion:
• ‘evidence based’ medicine and the politics of funding
• ideological, illegitimate, oppressive and harmful
TASA Conference 2004
A Sociology of Suicidology
Slide:
10