Composing suicide:
Narrative and suicidal behaviour
Scott Fitzpatrick BA (Hons)
PhD Candidate
scott.fitzpatrick@sydney.edu.au
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
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.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
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)
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
Suicidal behaviour and mental
illness
• “the mental illness tautology… [whereby] the
(suicidal) act defines the illness and the illness
defines the act.”
(O’Connor,
2003)
• Has limited metaphoric utility in explaining
suicidal behaviour and results in the omission or
downplaying of important social and culturalnormative features.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
Culture and depression
• Depression: Emotion or disorder?
• Normal or pathological?
(cf. Kleinman & Good, 1985)
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
Culture and depression
• “[o]n Aristotle’s 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)
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
“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.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
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.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
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)
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
A ‘rhetoric of control’
• Well it makes it harder for me to talk about
because it makes me feel like they don’t want to
hear; like they don’t really want to know, and
that if I do tell them the truth, that I would upset
them.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
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)
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
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.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
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 one’s place in the world as being
profoundly hopeless that prolonged and
recognizable depression is likely to ensue.”
(Keyes, 1985, p.158)
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
“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.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
“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 I’m 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 aren’t
great because I’m worried how they’ll react and stifle my
career opportunities because they think I’m not going to
be able to cope, or they don’t trust that I’m going to be
able to do my job to its fullest extent.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia
References
Andrews, M., Day Sclater, S., Rustin, M., Squire, C., & Treacher, A. (2000). Introduction. In M. Andrews, S. Day Sclater, C. Squire & A. Treacher (Eds.),
Lines of narrative (pp. 1-10). London: Routledge.
Brockmeier, J., & Harré, R. (2001). Narrative: Problems and promises of an alternative paradigm. In J. Brockmeier & D. Carbaugh (Eds.), Narrative and
identity: Studies in autobiography, self and culture (pp. 39-58). Amsterdam & Philadelphia: John Benjamins.
Brooks, P. (1996). The law as narrative and rhetoric. In P. Brooks & P. Gewirtz (Eds.), Law's stories (pp. 14-22). New Haven: Yale University Press.
Brown, G. W., & Harris, T. (1978). Social origins of depression: A study of psychiatric disorder in women. London: Tavistock
Gergen, K. J., & Graumann, C. F. (1996). Psychological discourse in historical context: An introduction. In K. J. Gergen & C. F. Graumann (Eds.),
Historical dimensions of psychological discourse (pp. 1-13). Cambridge: Cambridge University Press.
Harré, R. (1986). An outline of the social constructionist viewpoint. In R. Harré (Ed.), The social construction of emotion (pp. 2-14). Oxford and New
York: Basil Blackwell.
Kerby, A. P. (1991). Narrative and the self. Bloomington: Indiana University Press.
Keyes, C. F. (1985). The interpretive basis of depression. In A. Kleinman & B. Good (Eds.), Culture and depression (pp. 153-174). Berkeley & Los
Angeles: University of California Press.
Kleinman, A., & Good, B. (1985). Introduction: Culture & depression. In A. Kleinman & B. Good (Eds.), Culture and depression (pp. 1-41). Berkeley &
Los Angeles: University of California Press.
Lutz, C. (1985). Depression and the translation of emotional worlds. In A. Kleinman & B. Good (Eds.), Culture and depression (pp. 63-100). Berkeley &
Los Angeles: University of California Press.
Lutz, C. (1996). Cultural politics by other means: gender and politics in some American psychologies of emotion. In C. F. Graumann & K. J. Gergen
(Eds.), Historical dimensions of psychological discourse. Cambridge and New York: Cambridge University Press.
Mattingly, C. (1998). Healing dramas and clinical plots. Cambridge: Cambridge University Press.
Nussbaum, M. C. (1990). Love's knowledge: Essays on philosophy and literature. New York, Oxford: Oxford University Press.
O' Connor, R. C. (2003). Suicidal behaviour as a cry of pain: Test of a psychological model. Archives of Suicide Research, 7(4), 297-308.
Prince, G. (2000). On narratology (past, present, future). In M. McQuillan (Ed.), The narrative reader (pp. 129). London: Routledge.
Sarbin, T. R. (1989). Emotions as narrative emplotments. In M. J. Packer & R. B. Addison (Eds.), Entering the circle: Hermeneutic investigation in
psychology (pp. 185-201). Albany, NY: State University of New York Press.
Schieffelin, E. L. (1985). The cultural analysis of depressive affect: An example from New Guinea. In A. Kleinman & B. Good (Eds.), Culture and
depression (pp. 101-133). Berkeley & Los Angeles: University of California Press.
Stearns, P. (1995). Emotion. In R. Harré & P. Stearns (Eds.), Discursive psychology in practice (pp. 37-54). London & Thousand Oaks (CA): Sage.
Tatz, C. (2005). Aboriginal suicide is different (2nd ed.). Canberra: Aboriginal Studies Press.
Taylor, C. (1985). Philosophical papers 1: Human agency and language. Cambridge: Cambridge University Press.
The Centre for Values, Ethics & the Law in Medicine
The University of Sydney, Australia