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OMEGA, Vol. 64(1) 83-94, 2011-2012
THE CULTURAL MEANING OF SUICIDE:
WHAT DOES THAT MEAN?
DAVID LESTER
The Richard Stockton College of New Jersey
ABSTRACT
Scholars sometimes stress that it is important to know the individual meaning
of suicide and the cultural meaning of suicide, but the meaning of these terms
remains unclear. The present article discusses this problem and suggests that
the individual meaning of suicide is best based on the motives for suicide,
while the cultural meaning of suicide is best rooted in the lay theories of
suicide in which the members of cultures and subcultures believe.
Colucci (2006) drew attention to the fact that theory and research into suicidal
behavior has neglected the role of culture. Suicide is typically considered to be the
same phenomenon throughout the world, and theories proposed in one region
(such as the West) are assumed to apply to other regions. In addition, Colucci
pointed out that the cultural meaning of suicide has been neglected except for
rare scholars who draw attention to this issue, such as Douglas (1967) and Boldt
(1988). However, there appears to be a great deal of confusion over what exactly
the “meaning” of suicide refers to and, more especially, the “cultural meaning” of
suicide. The purpose of the present article is to examine what these terms mean.
Colucci cited the work of Good and Good (1982) who suggested that the
meaning of an illness involves “the metaphors associated with a disease, the
ethnomedical theories, the basic values and conceptual forms, and the care
patterns that shape the experience of the illness and the social reactions to the
sufferer” (p. 148). This encompasses many separate concepts.
83
� 2011, Baywood Publishing Co., Inc.
doi: 10.2190/OM.64.1.f
http://baywood.com
THE PHENOMENON OF SUICIDAL BEHAVIOR
Cultures differ in the frequency of suicidal behavior, the methods chosen for
suicide, the distribution by age, sex, and other sociodemographic variables. Many
articles have appeared documenting the different suicide rates in a sample of
nations and differences in the suicide rates by age and sex from nation to nation
(e.g., Levi, La Vecchia, Lucchini, Negri, Saxena, Maulik, et al., 2003). Lester
(1994) found that the suicide rates of Chinese populations in China, Taiwan, Hong
Kong, and Singapore and the methods used for suicide differed greatly, while
sex ratio of the suicide rates and the variation over age was similar in all four
nations. Lester (2006) documented great variations in suicidal behavior in the
various Muslim nations of the world.
These “facts” about suicide probably have little direct relevance to the meaning
of suicide, either at the individual or the cultural level. However, a very high
rate of suicide in a nation may make the act seem less psychopathological to the
residents of the country and may become a topic of discussion in that nation.
For example, Hungary had one of the highest suicide rates in the world between
the two world wars and for many years afterwards, and it is interesting to note
in this regard that the most famous “suicide song,” Gloomy Sunday, was written
by a Hungarian (although he was living in France at the time (Stack, Krysinska,
& Lester, 2007-2008).
In addition, occasionally the most popular method for suicide may become
a synonym for the act, as in “taking the pipe” in England in the 20th Century when
suicide using domestic gas was the most popular method for suicide.
THE DEFINITION OF SUICIDE
Kleinman (1977) defined the “category fallacy” as the mistake of imposing
Western categories on the behavior in other cultures. Lester (2008) provided
several examples of cultures that define suicide differently from scholars in the
Western world. For example, according to the Mohave, a Native American tribe in
the southwest of the United States, a fetus which presents itself in the transverse
position for birth, leading to its own death and that of its mother, is viewed as
having intended to commit suicide and to murder its mother so that they can be
together in the spirit world (Devereux, 1961). Medical examiners and coroners in
the rest of the United States would not view such a still-born infant as a suicide.
Counts (1980), who has studied the suicidal behavior of women in the Kaliai
district of Papua New Guinea, noted that, in the past, elderly widows sometimes
immolated themselves on their husband’s funeral pyre. The German and
Australian colonial governors considered this behavior to be a form of ritual
murder rather than suicide, and they outlawed it. Counts, however, saw neither
term (suicide or murder) as appropriate for this custom since it differed so much
from what North Americans and Europeans regard as either suicide or murder.
84 / LESTER
Neither term describes the behavior, the interpersonal relationships involved,
or the attitudes toward the widow and those assisting in her death. Nor do they
predict how the community will respond to her death.
Recently, some scholars, especially in Europe, have expressed doubts that
people engaging in nonfatal suicidal behavior have self-destruction as their aim,
and they have begun calling the behavior “self-poisoning” or “self-injury” (e.g.,
Liisanantti, Ala-Kokko, Dunder, & Ebeling, 2010; Novacek, Jotkowitz, Delgado,
Shleyfer, Barski, & Porath, 2005; Ramon, 1980). The semantic implication is
that nonfatal suicidal behavior is not “suicide.” Since in most cultures women
engage in more nonfatal suicidal actions than do men, this renaming of
nonfatal suicidal behavior as self-injury makes “suicidal behavior” less common
in women than it was hitherto.
Other suicidologists, on the other hand, include a wider range of behaviors
under the rubric of “suicidal behavior.” For example, Menninger (1938) classified
behaviors such as alcoholism, drug abuse, and anorexia as chronic suicide since
the individuals were shortening their lives by their behaviors. Menninger also
classified such behaviors such as polysurgery, self-castration, and self-mutilation
as focal suicide, a behavior in which the self-destructive impulse is focused on
one part of the body. These behaviors are often gender-linked. For example,
anorexia is more common in women whereas illicit drug abuse is more common in
men. Canetto (1991) has speculated that adolescents may respond differentially
when under stress, with girls choosing nonfatal suicidal behavior more while boys
choose drug abuse more. The use of Menninger’s categories would change greatly
the relative incidence of nonfatal suicidal behavior in women and men.
Clearly, the definition of suicide in a culture has implications for the meaning
of suicide. In a recent study, Lester and Frank (2008) found that only 59% of
a sample of American undergraduate students viewed a protest suicide (such
as a self-immolation carried out to protest a government decision) as suicide, and
only 70% viewed a suicide bomber as suicidal. Indeed, suicide bombers are
viewed as martyrs rather than as suicides by many people in Muslim nations
(Abdel-Khalek, 2004).
THE MOTIVES FOR SUICIDE
When we refer to the motives for suicide we are asking why do people engage in
the behavior. Menninger (1938) suggested three motives: the desire to escape from
life (“to die”); the desire to punish oneself by committing suicide (“to be killed”);
and the desire to cause pain to others (“to kill”). Farberow and Shneidman’s
(1961) book on attempted suicide was called The Cry for Help, indicating clearly
what they thought was the motive behind many acts of attempted suicide.
Several writers have proposed classifications of suicide. Reynolds and Berman
(1995) examined ten proposals for a classification of suicidal acts, including
those from Durkheim (1897), Menninger (1938), and Baechler (1979). They
CULTURAL MEANING OF SUICIDE / 85
presented 484 cases of suicide from Baltimore (in the United States of America)
to judges and asked the judges to classify each of the suicides into these
10 typologies. Reynolds and Berman found a good deal of overlap between
the typologies, and they identified five subtypes which described 86% of the
suicides: escapist, confused, aggressive, alienated, and depressed/low self-esteem.
It would be most interesting to take any of these typologies, or better still,
that identified by Reynolds and Berman, and classify samples of suicides from
different cultures. This might provide clues as to the meaning of suicide in
those cultures.
Menninger’s typology focuses on what is going on the minds of suicidal
individuals—what their desires are for engaging in the behavior. This approach
may help us understand the meaning of suicide for the individual, but it does
not help us understand the cultural meaning, unless everyone in the culture has
the same desire (or desires) for engaging in the behavior, which is very unlikely.
However, cultures may differ in the relative frequency of individual motives.
In one culture, the desire to escape may be common, whereas in another culture,
the desire for self-punishment may be common. No study has yet investigated
such cultural differences in motives.
THE PRECIPITANTS FOR SUICIDE
A common answer to the question of why an individual committed suicide is to
mention the precipitating event. This person’s marriage just ended; this person
just lost all their investments and was facing poverty. This approach has not
been of much interest for researchers into suicide, and data on precipitants are
rarely collected at a cultural level. Japan does make an effort to categorize every
suicide for the precipitant. Lester and Saito (1998-1999) noted that, in 1990 in
Japan, the precipitating event was: illness, 43.7%; alcoholism and mental illness,
17.1%; economic hardship, 8.6%; family problems, 7.9%; job stress, 7.2%;
relationship problems, 2.7%; and school problems, 1.3%. Joiner (2006) has
proposed that feeling that one is a burden to others is a major causal factor in
suicide, and this may account for the high incidence of illness as a precipitant
for suicide in Japan.1
India also attempts to classify each suicide. Using government documents,
Lester, Agarwal and Natarajan (1999) noted that the precipitating events of
suicides in India in 1990 were categorized as: dreadful disease, 12.8%; quarrels
with parents-in-law, 6.2%; quarrels with spouse, 5.8%; love affairs, 4.7%; and
poverty, 2.5%. However, in India, 16.2% had no known cause, and 39.0%
were classified as “other.”
86 / LESTER
1 I would like to thank an anonymous reviewer for this suggestion. Lester (2010) has
noted that feeling that one is a burden to others seems to be a factor in women becoming
suicide bombers.
If these data were collected for cultures as a whole, and if standardized
categories were adopted, then cultures could be compared for the relative
frequency of the precipitants, and this might give some clues as to the cultural
meaning of suicide. For example, if almost half of the suicides in Japan are
precipitated by illness, then suicide in Japan may typically be an escape from
physical pain and suffering.
THE PSYCHODYNAMICS OF SUICIDE
Another possibility is that the meaning of suicide in a culture is related to
the psychodynamics of the suicide in the culture. Hendin (1964) described the
psychodynamics of suicide based on qualitative data that he obtained by visiting
and interviewing people in Scandinavian countries. In Denmark, Hendin noted
that guilt arousal was the major disciplinary technique employed by Danish
mothers to control aggression, resulting in strong dependency needs in their sons.
This marked dependency was the root of depression and suicidality after adult
experiences of loss or separation. Reunion fantasies with lost loved ones were
common in those committing suicide. In contrast, in Sweden, a strong emphasis
was placed by parents on performance and success, resulting in ambitious children
for whom work was central to their lives. Suicide typically followed failure in
performance and the resulting damage to the individual’s self-esteem.
The psychodynamics of suicide as described by Hendin are obviously related
the motives for suicide and to the precipitants for suicide, but they are more
in-depth and meaningful. However, it might be quite difficult to replicate Hendin’s
methodology for a larger sample of cultures.
ETHNOMEDICAL THEORIES
Good and Good (1982), mentioned above, suggested that the meaning of an
illness may be grounded in part in “the metaphors associated with a disease,
the ethnomedical theories, the basic values and conceptual forms, and the care
patterns that shape the experience of the illness and the social reactions to the
sufferer in a given society” (p. 148). In the Western world, currently, the physio-
logical and genetic basis of psychiatric illness is the major perspective or model.
Government funding for research into this area goes primarily to physiological
research. “Nature” is winning over “nurture,” a major change from the 1960s
when nurture ruled.
Other cultures, however, sometimes have very different theories of mental
illness, such as soul loss, possession by evil spirits, or sins against the cultural code
of conduct. Although anthropologists have documented these theories in some
cultures (see Kiev, 1964), there has been no systematic study of these theories
and no coding system proposed for the theories in a sample of cultures. These
theories would also be related to the differences in care patterns mentioned by
CULTURAL MEANING OF SUICIDE / 87
Good and Good. Does treatment involve medication, counseling, expiation, or
atonement for sins?
LAY THEORIES OF SUICIDE
Strauss and Quinn (1997, p. 6) suggested that the meaning of a behavior is
the interpretation evoked in a person by an event. The cultural meaning is the
interpretation of the event evoked in people as a result of their similar life
experiences. This implies that the meaning of suicide does not reside in the
individual who commits suicide, but rather in those who experience the suicides
of others; that is, in the attitudes of the culture toward suicide and in the lay
theories of suicide present in that culture.
In her account of suicide among females in Papua-New Guinea, Counts (1988)
has illustrated the ways in which a culture can determine the meaning of the
suicidal act. In Papua-New Guinea, female suicide is a culturally-recognized
way of imposing social sanctions. Suicide has political implications for the
surviving kin and for those held responsible for the events leading women to
commit suicide. In one such instance, the suicide of a rejected fiancée led to
sanctions being imposed on the family that had rejected her. Counts described
this woman’s suicide as a political act that symbolically transformed her from
a position of powerlessness to one of power. The problem with this report by
Counts, for the purposes of the present article, is that she did not estimate the
frequency of suicide committed in these circumstances or to what extent the
culture accepted such a socio-political implication of suicide.
Lester and Bean (1992) devised a questionnaire to assess whether respondents
think that suicide is caused by intrapsychic, interpersonal, or societal stress.
Voracek, Loibl, Egle, Schleicher, and Sonneck (2007) devised a questionnaire
to explore the extent to which respondents believe that suicide is genetically
caused. These lay theories of suicide would appear to tap the cultural meaning
of suicide, and it would be interesting to give these questionnaires to samples of
residents in different cultures.2
It is likely, although presently not documented, that members of a society
may have several competing lay theories of suicide and, furthermore, that these
lay theories may differ by sex, age, social class, ethnicity, and subculture within
a society.
Some commentators see studies of lay theories of suicide as really studies of
attitudes toward suicide and, indeed, there is an overlap in these two issues.
However, a typical attitude toward suicide scale, suicide as the Suicide Opinion
Questionnaire (Domino & Perrone, 1993) has items (such as myths about suicide)
in addition to items exploring the respondent’s views about the causation
of suicide.
88 / LESTER
2 Martin Voracek (personal communication) is presently engaged in such a study.
THE ROLE OF VALUES
Good and Good (1982) mentioned values as relevant to the cultural meaning of
suicide. Kelleher, Chambers, Corcoran, Williamson, and Keeley (1998) classified
49 countries as to whether they had religious sanctions against suicide or not.
They found that countries with religious sanctions against suicide were less
likely to report suicide rates to the World Health Organization and, for those
that did report, their suicide rates were lower than suicide rates in countries with
no religious sanctions.
Stack and Kposowa (2008) used a measure of the acceptability of suicide in
31 nations, obtained through surveys of the population (Inglehart, 2000), to
show that the suicide rates of those nations were positively associated with the
level of acceptability of suicide in those nations. It is, therefore, possible to obtain
cross-cultural measures of the acceptability of suicide.
METHODOLOGICAL ISSUES
Reference has been made above to research that could be conducted in one or in
samples of cultures in order to explore the meaning of suicide. There are of course
many methodological issues that make such research difficult to conduct and
make the results difficult to interpret. These problems include construct bias in
which it is assumed (incorrectly) that a term has the same meaning in all cultures
(Ratner & Hui, 2003), measurement problems such as translation issues and
item bias (assuming that the items are equivalent in reliability analyses), different
response styles in different cultures such as acquiescence response sets (Duh
& Chen, 2007), and the problem of obtaining samples from different cultures
that are equivalent. There are many discussions of these methodological issues
such as that by Ratner and Hui (2003) cited above.
AN ILLUSTRATIVE CASE
Meng (2002) presented the case of the suicide of a woman in rural China
which she saw as throwing light on “the meaning of suicide.” It also illustrates
the confusion over the definition of “meaning.”
Meng reported the case of Fang, who killed herself by drowning at the age of
32. Her marriage was a love marriage, which is the basis of about 13% of
marriages in rural China, and her parents-in-law never accepted her. Although
Fang was the wife of a first-born son, her parents-in-law gave preference to the
wife of a younger son. Fang tried but failed to please her parents-in-law. After the
birth of two sons, the couple moved to their own house in the family compound,
and Fang became more hostile and confronted her parents-in-law more often.
Fang’s husband supported his parents and hit and punished Fang for insulting
his parents. Fang was socially isolated in the village, having come from a distant
village, and she remained an outsider. Fang coped by seeking spiritual assistance,
CULTURAL MEANING OF SUICIDE / 89
making friends outside of the family, converting to Christianity, and running
away. After one last fight with her parents-in-law and punishment from her
husband, Fang slipped away and killed herself.
The precipitating events for this suicide are quarrels with her in-laws and
domestic violence. The community viewed the suicide in different ways. The
in-laws viewed Fang’s suicide as “a foolish act,” for it caused the family a
financial cost and a loss of reputation. Fang’s parents saw Fang’s suicide as a
“forced decision.” They blamed Fang’s in-laws, destroyed furniture in the in-laws’
house, and demanded a very expensive funeral and headstone for Fang in
her in-laws burial plot. The villagers gave Fang’s suicide a mystical interpre-
tation, believing that she was taken by a ghost, a belief which served to avoid
blaming Fang or her in-laws and to avoid a sense of responsibility themselves
for Fang’s suicide.
Meng, however, viewed Fang’s suicide as changing Fang’s social status in the
community. After her suicide, Fang’s parents-in-law had to bow to her memory
and mourn for her; that is, to accept her and treat her as they never had during
her life. Thus, her suicide could be viewed as a form of symbolic revenge on her
in-laws for their mistreatment of her.
Only Fang’s husband truly mourned his wife.
What then is the meaning of Fang’s suicide? The personal meaning is
unknown. The precipitating event was “family problems.” Meng hypothesized
that Fang’s suicide was an act of symbolic revenge, but we do not know whether
this was in Fang’s mind at the time of her decision. Perhaps we should define
the concept of “the meaning of suicide for the suicidologist”? From the details
presented, including the fact that Fang ran away several times but returned
because she missed her children, her suicide seems to fit Menninger’s escape
motive. Fang tried running away as a means of escape, but this failed. Death
achieved escape for her. To understand the personal meaning of a suicide for the
deceased individual, we need a substantial suicide note or a diary that provides
insight into this meaning.
I have argued here that the cultural meaning should focus on the reactions
of others to the suicide. But, in Fang’s case, we have three cultural meanings—for
her family, for her in-laws, and for the villagers. (The commentator on the case
may also perceive a different cultural meaning.) Thus, the cultural meaning for
suicide is unclear. Furthermore, there has been no survey in this rural community
of their theories of and attitudes toward suicide, the results of which can be
compared with surveys in other communities in China and around the world.
DISCUSSION
Of all of the possibilities discussed above, the motives for suicide seem to me to
provide the best basis for the individual meaning of suicide. Although Menninger
(1938) proposed a set of motives, the number of motives in such a classification
90 / LESTER
needs to be increased, and cross-cultural studies of the frequency of these motives
in different cultures would be welcome. The typology proposed by Reynold and
Berman (1995), based on 10 typologies proposed by expert suicidologists, may
be the best for this purpose.
Boldt (1988) stressed the importance for the understanding of suicidal behavior
of conceptualizing suicidal behavior in terns of cultural normative values.
The meaning of suicide varies from culture to culture—whether it is seen as a
psychotic act, a ritual obligation, or a human right, for example. The problem
with this lies with the adjective “normative.”
All too often sociologists and anthropologists decide ex cathedra what lies
behind a behavior in a society or a culture. For example, Durkheim (1897) decided
that slaves commit fatalistic suicide. He produced no evidence, no data, to
back up this assertion. Because he was an expert on the sociology of suicide,
he expected us to accept his assertion. Similarly, Counts, whose analysis of
female suicide in Papua-New Guinea was discussed above, asserted that it was
a political act to increase the status of a low status woman. Again, since Counts
is an expert, we are expected to accept this meaning of suicide without there
being any data to support it. It is provocative and useful for such assertions
to be made. However, it is important that such assertions be empirically tested
by future researchers.
I would argue that the cultural meaning of suicide can be ascertained only
by interviewing a representative sample of individuals in the various cultures in
order to assess their attitudes toward suicide. In modern research, this has often
been labeled as the study of lay theories of suicide. Furnham has studied lay
theories of many behaviors (Furnham, 1988), including schizophrenia (Furnham
& Bower, 1992), heroin addiction (Furnham & Thomson, 1996), and suicide
(Knight, Furnham, & Lester, 2000), but so far only in Western nations. This
type of research needs to be extended to other cultures.
It must be recognized that there may not be simply one cultural meaning of
suicide in any given culture. Many cultural meanings may be present in the
culture, and different cultural meanings may exist for different subgroups of
the culture, such as women and men, the young and the elderly, those of different
social class, and, in multicultural societies, those of different ethnicity. The
cultural meaning of suicide may change over time, and there may be different
cultural meanings for different types of suicidal acts, such as protest suicide,
suicide bombers, and assisted suicide in the terminally ill.
Some individuals behave deviantly in their culture, departing from cultural
norms. Thus, the individual meaning of a suicide may differ greatly from
the cultural meaning if the suicidal individual is a deviant in the culture.
After all, Durkheim’s (1897) notion of anomic suicide is that those committing
such suicides are less bound by the cultural values and norms of their
society. On the other hand, those who adhere to the values and norms of
their culture often try to frame their suicide to fit into those values and norms.
CULTURAL MEANING OF SUICIDE / 91
Since suicides are breaking the sacred trust of life, individuals who are
going to kill themselves have to reconcile their image of a to-be-trusted
person with the fact that they are about to break that trust through their act
of suicide (Jacobs, 1967). Jacobs noted that often their suicide notes attempt
this justification by noting their long history of distressing crises and their
belief that death is the only solution, constructing a rationalization that they
are to-be-trusted people, and making some provision that their problems will
not recur after death (for example, by stating that God will understand their
choice of suicide).
Finally, as Boldt (1988) recognized, the cultural meaning of suicide may
change over time, and so longitudinal studies of lay theories of suicide must be
carried out in cultures.
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Direct reprint requests to:
David Lester, Ph.D.
Distinguished Professor of Psychology
The Richard Stockton College of New Jersey
101 Vera King Farris Drive
Galloway, NJ 08205-9441
e-mail: [email protected]
94 / LESTER
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