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Yes, indeed, that’s true … but only in works of fiction. Tellingly, the only documented cases that I can find that were clearly “die on a whim” suicides are from fictional sources. In his 2006 book Cliffs of Despair, Tom Hunt quotes the eminent sociologist Durkheim on this point: “the suicidal tendency appears and is effective in truly automatic fashion, not preceded by an intellectual antecedent. The sight of a knife, a walk by the edge of a precipice, engender the suicidal idea instantaneously and its execution follows so swiftly that patients often have no idea of what has taken place” (p. 66). This passage reminds Hunt of a suicide he has read about … in fiction. “This reminds me of Anna Karenina’s impetuous lunge under the wheels of a train.” The French poet and polymath Paul Valery wrote, “The victim lets himself act and his death escapes from him like a rash remark … he kills himself because it is too easy to kill himself.”
This is simply not how it works in the real world, else there would be millions more suicides per year as people glance at knives and trains and the like. This is a pervasive and entrenched misunderstanding about suicide, and I wonder if its source may be that early scholars and writers, like Durkheim and Valery, took at least some of their cues from the likes of Shakespeare and Tolstoy, forgetting that these men, while undeniably great, wrote fiction.
A death that occurred in June 2008 – and the reporting of it – illustrates well how ingrained is the idea that it is common for someone to die in spur-of-the-moment fashion. A man in his late twenties went on a skydiving trip with a few other people in New York State. As is often the case on such trips, he went just to ride along in the plane and to take pictures; he did not intend to skydive, had no training in it, and had no parachute or other gear for it. At an altitude of 10,000 feet, after three people with parachutes jumped, so did the man, whose impact caused damage to a house below.
Initial reports of an incident like this are often sketchy and therefore can imply many misleading things. This incident was no exception. First, it was intimated that the man was part of a group of friends who were skydiving enthusiasts. The reality, by contrast, is that the man was socially isolated and talked his way on to the plane; he was not friends with the three skydivers. Second, initial news of the incident suggested that the three parachuted skydivers jumped in turn, and then the man, who was up and about in the plane, suddenly jumped too. In reality, as the last of the three chuted jumpers exited the plane, the man was still buckled in his seat. The pilot then began to close the door, and as he did so, the man quickly undid his restraints, struggled with the nearly closed door and the win, and before the stunned pilot could react with much force, the man had jumped out of the plane. (Had the pilot been able to attempt more of an intervention and had a struggle ensued, the man may have been saved, or else both men would have been pulled out of the plane, and the pilotless plane would have crashed, perhaps injuring or killing those on the ground.)
The most misleading aspect of initial reports of the incident, however, was the implication that the man simply jumped on impulse. Further investigation of this tragedy demonstrated that this was quite untrue (as I would argue it always is … except, again, in fiction). According to subsequent newspaper reports, “For months, [the man] had unnerved some of his co-workers in the seafood department at [a grocery store] in Schenectady. He asked the same question frequently, the assistant manager remembered. He said, “If you had to die, would you rather jump off a building or jump out of a plane without a parachute?”” Moreover, the man had been to the airstrip the week before, asking to go on one of the flights to take aerial photographs for a class assignment. He had arrived too late, however, and the pilot told him to come back the next week – which he did, for the fatal flight. Still further indication that the man had planned this out and thought it through in considerable detail was that, as he fell to his death, he appeared calm and did not flail, according to the pilot.
Somewhat in contrast to most myths and misunderstandings about suicidal behaviour, this one on “death on a whim” rides the wave of a large amount of reasonable theorising and empirical work … but it’s still a myth. For example, in his book The Myth of Sisyphus, Camus wrote, “Rarely is suicide committed (yet the hypothesis is not excluded) through reflection” and “An act like suicide is prepared within the silence of the heart, as is a great work of art. The man himself is ignorant of it. One evening he pulls the trigger or jumps.” These statements are mistaken in the assertion that people are unaware of their developing plans for suicide – on the contrary, people who end up dead by suicide are the most deliberate in their plans. Not only are the statements wrong, they compound the error by romanticising suicide, implying that it is akin to an artistic act that brews in a person’s heart until its sudden artistic expression. Those who have been to suicide death scenes will not view this perspective charitably.
The empirical literature on the role of impulsivity replicates these same errors, repeatedly documenting a real but misunderstood connection between impulsive personality features and suicidal behaviour, and thereby reifying the view that suicide on a whim is not only a real phenomenon, but a common one.
It is neither. An English coroner, who was interviewed about the death by suicide of a 15-year-old boy who hanged himself with a belt in his bedroom, gets a little closer to the truth. He stated, “The actual act is not pre-meditated although the mental preparation, with hindsight, can be seen to be there.” The problem with this statement is that the actual act is quite often premeditated, but the insight of the coroner’s statement is important too: Mental preparation for the eventual act of suicide is an essential characteristic of the phenomenon.
A study from Australia is typical in this domain of study, in that it collects valuable and interesting data but then tends to misinterpret them. The researchers interviewed people in the emergency room, as soon as possible after they were admitted after surviving a suicide attempt. The study found that 51 percent of the participants who attempted suicide reported contemplating the act for ten minutes or less; an additional 16 percent reported thinking about it for less than thirty minutes. The lead researcher stated, “the research dispels the myth that suicide attempts are always a pre-meditated, long-planned act.”
But it does nothing of the sort. Leaving aside the 33 percent or so who thought about their impending attempt for more than thirty minutes, let’s focus on the 67 percent who did not. What the study demonstrated was that, for these 67 percent, the time frame in which they reported thinking about suicide approaching their attempt lasted, at most, thirty minutes. People’s self-reports about such things can be unreliable, but regardless, what the study leaves unaddressed – and this is crucial – are the hours and days and weeks and months and – in some cases – years during which the participants may have thought about suicidal acts.
An analogous thing happens regarding many things for which people make advance plans. Take wills, for instance. There are people who make a will decades before their deaths, and then they don’t think about the will again – it is taken care of. People make plans for vacations, and then don’t necessarily think about the vacation until they’re hurriedly packing and leaving to go. In both of these examples, impulsivity really was not a major factor. Plans can be made well in advance, and then, as it were, taken off the shelf at a later date.
Similarly, people who die by suicide have thought of the possible methods and locations and so forth well in advance, often years in advance. A recent case I am familiar with illustrates this tragic reality. A man of approximately fifty years of age is struggling with chronic depression. During the worst of his depression, he has ideas about suicide, either involving medication overdose or self-inflicted gunshot wound. In psychotherapy, he articulates these ideas fairly clearly, but also is certain that he has no plans to actually carry though with plans for suicide. He is ambivalent about psychotherapy, and drops out against the therapist’s advice. Approximately three years later, he re-engages psychotherapy, still depressed, but now seemingly less suicidal than before. He dies several days later by self-inflicted gunshot wound.
On the surface, this could be counted as an “impulsive” suicide. The person states no clear plans for suicide, yet relatively shortly thereafter, dies. It is even possible that the person pondered his impending death for less than thirty minutes beforehand, which would thus qualify him as an “impulsive” suicide in the study mentioned above. But the man had thought of death by self-inflicted gunshot wound many times over the years; his plan was “on the shelf” and it takes virtually no time to take a plan like this back off the shelf. The man died after a process that took years; to view this as impulsive is to neglect all but the act itself, when the act was just a part of something that had been going on for a long time.
Of course, another issue with the Australian study mentioned above is that the focus was on suicide attempts, not on deaths by suicide. The same “on the shelf/off the shelf” process can apply to both, but it is very likely that clearly lethal behaviour gives people much more pause than less lethal behaviour. There are instances of this in the film The Bridge, the documentary that captured several people’s deaths by suicide at the Golden Gate Bridge. Several of those who died showed understandable hesitation – the lethal nature of what they were contemplating gave them pause. In at least one case, the hesitation led to being rescued (filmmakers called authorities about people who worried them); tragically, in many other cases, the urge toward death prevailed and overcame the fear and hesitation.
And in still other cases, there was little hesitation at all. Were these, therefore, impulsive suicides? Not at all. These were people who purposefully made their way to the bridge (after previous visits, in all likelihood, as in the case of the poet Weldon Kees). Even those who had not previously visited had very likely envisioned the scene, and had thereby mentally steeled themselves to the fearsome prospect.
One of the myths covered elsewhere in this book – the one on why people might make plans for a job interview in a few days or dinner with a friend and then die by suicide – might exacerbate this myth on impulsive suicide. “Impulsive suicide” does fit the facts of such cases in a way – the person made the plans for the dinner or the interview genuinely, but then the impulse to suicide came up suddenly and intervened. As discussed in that section, however, a much more plausible explanation is that people contemplating suicide are deeply ambivalent, and so simultaneously make plans for life and death. In the vast majority of cases, life wins, in part because the will for it is so strong (evolution has seen to that). But in a few tragic cases, the plan for suicide wins out over the plans to keep living and to keep having job interviews, dinners, and the like.
The suicide of President William J. Clinton’s childhood friend and White House adviser, Vince Foster, was of this sort. Despite wildly irresponsible speculations to the contrary, Foster died by self-inflicted gunshot wound. The day before his death, he had agreed to go out with his wife the next night, and had agreed to a business meeting the day after that. Yet on the day of his death or perhaps before, Foster secretly took a gun out to his car in an oven mitt. On the day of his death, he drove out to a secluded area of a park and shot himself. To imagine that Foster’s death was impulsive is to ignore all of the facts in what was by far the most investigated suicide in the history of the world. (Multiple congressional inquiries were conducted into his death, as well as multiple additional forensic investigations.) It is also to ignore the character of Vince Foster; he was a thoughtful and deliberate person. No one who knew him would have described him as impulsive.
Still another issue that plagues studies like the one from Australia mentioned above involves the role of alcohol and drugs. In the Australian study, 29 percent of those who harmed themselves had been drinking at the time. Of this subgroup, almost all of them (93 percent) reported that they had planned their attempts for less than ten minutes. A common interpretation of such reports is that alcohol fuels impulsive behaviour. An alternative interpretation, and one that I think is more plausible in light of the totality of evidence on suicidal behaviour, involves two facts: 1) as already noted, people can take well-developed and well-considered plans from months or years ago “off the shelf,” and doing so takes very little time; and 2) regarding the specific role of alcohol, those who have been drinking are not necessarily accurate reporters of what they were thinking at the time; alcohol is likely to cloud memories related to how long one pondered an attempt before acting on it.
The study from Australia produced valuable data, and it is quite representative of larger problems in the field, problems that the study itself of course did not cause – but there is one remaining complaint I have about it. The study found that about one-fifth of the participant continued to feel suicidal twelve hours after their suicide attempt; this was interpreted to mean that suicidal impulses are short lived. But this is the wrong interpretation. Most people who attempt suicide – including those who ponder the act for many months or years – do not feel suicidal after the attempt. Indeed, to my knowledge, all those who have survived a jump from the Golden Gate Bridge ceased feeling suicidal even as they plummeted toward the water. It is not that their impulse came and went; rather, their will to live was shocked back to the forefront by the primal fear of death they experienced as they fell.
According to a 2006 news report, the coordinator of mental and brain disorders for the World Health Organisation commented accurately on a similar phenomenon, but then wrongly interpreted it. He stated, “We have very good studies interviewing people between the act of ingesting pesticides and their deaths. More than 95 percent are desperate when they learn they are going to die.” This is quite right – the desperation arises from the fear of death. He then went on to state that “nearly everyone” who died by suicide acted on impulse. This is quite wrong, and the fact that prominent people within the World Health Organisation have this wrong is a clear indication of the power and pervasiveness of myths and misunderstandings about suicide, and the urgent need to dispel them.
It is impressive just how pervasive this myth is. As reported in the Kennebec [Maine] Journal in 2004, a psychiatrist said many smart and compassionate things about the nature of suicide, including that not having a suicide barrier on a bridge in Augusta, Maine represented a public health menace. He then added, inaccurately in my view, that jumping from a bridge is often an impulsive act undertaken without planning. The briefest glance into the lives of those who have died by jumping from the bridge would demolish this view, as would interviews with those who walk on the bridge – including extremely impulsive people – with no intention or even the foggiest conception of wanting to jump. It is not impulsivity or some kind of whim that differentiates those who jump from the bridge from the hordes of people who cross and do not jump. Rather, it is that the tragic few who jump do so in a culmination of a process of thinking about suicide for months and years, a process fueled by mental illnesses, especially mood disorders, schizophrenia, and borderline personality disorder.
Here is how it actually works, with no involvement of whims and the like. In early 2005, well-known “gonzo journalist” Hunter S. Thompson died by self-inflicted gunshot wound in his Colorado home. Thompson’s son stated afterward that the family had known for at least ten years that this would be Thompson’s cause of death. The son told the Rocky Mountain News, “I’ve known for many, many years that this is how Hunter would go. It was just a question of when. This was a big surprise and I didn’t expect it to be now, but the means was exactly as we expected.”
The death by suicide of television news reporter Christine Chubbuck also illustrates how suicide is not in essence impulsive, though the final act can have impulsive qualities, leading people to misattribute impulsivity to the entire suicidal process. Chubbuck died by self-inflict gunshot wound on the air, as she was reporting the news. Chubbuck had been open with her family about feeling depressed and suicidal; she attempted suicide by overdose four years before her death and frequently discussed the incident.
A few weeks before her death, she sought the permission of her station to research a story on suicide. In conducting interviews for the piece, a police officer told her that a particularly lethal means of suicide was a shot to the back of the head (rather than the temple) using a particular caliber gun with specific kinds of bullets. A week before her death, she told a colleague that she had bought a gun, and she joked with him about killing herself on the air.
On the day of her death, Chubbuck insisted that she needed to read a newscast to open the talk show program she hosted, which was not her usual opening. Part of the news copy contained her report of her impending suicide. A recurring feature of the show as for Chubbuck to do puppet shows, and she had a bag of puppets for his purpose. On the day of her death or possibly even before that, she had placed a gun in the puppet bag.
During the show, Chubbuck covered a few news items, and then turned to a shooting that had happened the day before in the local area. The station had footage of the restaurant shooting, but the tape jammed. Chubbuck shrugged and stated, “In keeping with Channel 40’s policy of bringing you the latest in blood and guts, and in living colour, you are going to see another first, an attempted suicide,” at which point she took out the gun and shot herself behind the right ear.
To view Chubbuck’s death as impulsive flies in the face of all the facts. She had been suicidal for years, had spoken openly of it, had attempted suicide before, had bought a gun and “joked” that she might shoot herself on air, had stowed the gun in her bag, and had prepared newscopy about her own suicide. And yet, there was a somewhat impulsive element: Chubbuck could not have known that the tape would jam at that point, and so her choice of timing occurred then and there. This is a classic scenario that confuses so many, professionals included. Her plan had been months in the making; her plan to enact it was decided during the news program, the only one in which she changed the usual procedure of the show; the only thing that had not been decided was the exact moment, and that decision did appear to be made on the spur of the moment. The mistake many have made regarding scenarios like this is of the cart and horse character: To view a death like Chubbuck’s as impulsive is to assign primacy to that spur-of-the-moment decision as to when to pull out the gun, instead of focusing on all the plans that led up to that moment.
My doctoral students and I conducted a study on this issue (Witte et al., published in a 2008 issue of the Journal of Affective Disorders). We used data sets collected from 1993-2003 by the Centers for Disease Control and Prevention (CDC) on health-related behaviours among high school students (grades 9-12). Questionnaires from students attending over 700 schools across the United States were obtained; a total of 87,626 were completed between 1993 and 2003.
We focused on distinct groups of adolescents, with “groups” defined by their answers to two questions regarding suicidal behaviour. The first question was, “During the past 12 months, did you make a plan about how you would attempt suicide?” The second was, “During the past 12 months, how many times did you actually attempt suicide?” Happily, most adolescents neither attempted suicide in the past twelve months nor endorsed making a plan for doing so, and these kids were excluded from our study. We then focused on two groups, both of whom reported suicide attempts: 1) those who reported no plan for a suicide attempt but nonetheless did attempt suicide – “impulsive attempters” (n=1,172); and 2) those who reported both making a plan for a suicide attempt and attempting suicide (n=4,807). We asked which of these two groups is the most generally impulsive?
We found that individuals who had planned and enacted their suicide attempt were significantly more likely to have engaged in other impulsive and risky behaviours than those who had attempted suicide without prior planning. The planful group was more generally impulsive than the impulsive group! As a result, the study undermined the “spur of the moment” view of suicide by showing that those who had the most impulsive personalities were also the most planful when it came to suicidal behaviour.
If the “spur of the moment” view of suicidal behaviour held water, the group who attempted impulsively should be at least as impulsive as the group that planned and attempted. If, on the other hand, the role of impulsivity in suicidal behaviour exists because impulsive people are exposed to repeated painful and provocative experiences (which in turn can steel resolve for serious self-injury), the planful group should show the most impulsivity, which is what happened.
Some other points worth noting: Less than a quarter of all attempters in the sample attempted “impulsively,” indicating that impulsive suicide attempts are not the norm, at least not among adolescents, a group who are widely viewed as impulsive. If “spur of the moment” phenomena were prominent, one would expect that a higher proportion of suicide attempts would be made without prior planning. But this certainly was not the case, and this in a sample that was extremely large and representative of U.S. adolescents.
Some of our analyses were limited only to those whose suicide attempts required medical care. All the same results held with this subgroup. Earlier I criticised the study from Australia for relying on self-report and pointed out that the study was related to suicide attempts, not deaths by suicide. In fairness, some of these same limitations apply to our study on U.S. teens.
Except in the fiction of authors like Shakespeare and Tolstoy, people do not die by suicide on impulse. On the contrary, the extremely fearsome and often painful prospect of bringing about one’s own death requires previous experiences and psychological processes that take months – at least – to accumulate. Those who end up dead by suicide have thought the act through many times, often in detail – only this allows them to carry out something so drastic and so final. Even this is often not enough. The vast majority of people who ideate about suicide do not attempt, and even fewer die by suicide. Now, it is true that certain deaths by suicide contain impulsive details, as we saw, for example, regarding the death of Christine Chubbuck. These impulsive details have confused many, and this confusion I believe is pernicious. It is pernicious because the idea that suicidal acts come out of the blue undermines attempts to study, assess, treat, and prevent them. If suicidal behaviour is part of a process that can be understood and tracked, there is hope of intervening. If, on the other hand, suicide mysteriously materialises out of the mists, what’s the use? Suicide is tractable, and we owe it to the memories of those who have died already and to those who are at risk in the future to make it more so.