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Suicide--freedom or constraint? How free will works in autolysis.

Introduction

Free will is the unconstrained, spontaneous, voluntary and responsible power to make a choice.

According to Aristotle (Nicomachean Ethics), the free person is free when he is his own cause ("eleutheros "--free man).

In the same sense, Leibniz says that freedom is the characteristic of the substance that is capable to determine itself (Theodicy). "Freedom consists of intelligence, which implies a distinct knowledge of the object of deliberation; spontaneity, through which we determine ourselves; contingency, which is the elimination of logical and metaphysical necessity ... The free substance determines itself according to goodness as it is perceived by the intellect, which directs it without compelling it to do something specific."

Free will is the ability of a human mind to choose the course of an action or to make a decision, without being influenced by external causes or by divine predestination.

An act of free will is a cause in itself and not an effect.

Freedom is foiled with limitation, and from this point of view, freedom is defined negatively as the absence of limits. (It is necessary to point out here that a person with insufficient intellectual development and devoid of moral judgement, is not responsible for his or her acts.)

St. Augustine was the first of the Church Fathers to make the essential distinction between freedom and free will, free will being an integral part of the mind, while freedom, identified with will, is the power to do what is chosen, the freedom of option, and he placed at the foundation of his cogitations the concept of man's absolute dependency on God.

St. Augustine thinks that the ability to determine one's acts is connected to conscious will. He connects freedom to grace and free will. Sin takes away the freedom brought by divine grace, and redemption liberates man from sin and gives him freedom.

For St. Thomas Aquinas, free will refers to the means established by will in order to fulfil one's highest goal. Free will (libertas indifferentiae) implies the lack of the necessity of will, independence and its absolute character.

Scholastic knowledge elaborated a doctrine of the freedom of choice (libertas electionis) understood as the freedom to choose one thing instead of another, separated from the free will (libertas indifferentiae), which indicates the sheer possibility of a freedom without constraint.

Calvin denies the human ability of having free choice. He upholds the doctrine of predestination according to which some people are selected for salvation by God, while other people are rejected and condemned--the damned ones.

Suicide--freedom or constraint?

Lucid or rational suicide starts from the premise of the freedom of choosing from several options, even if this person has chosen voluntary death as a solution for solving personal destiny.

The choice is free, conscious and motivated by reason. This rational way of getting out from a situation without exit is hard to understand for an external observer.

Psychiatrists have the tendency to consider almost every suicide as a result of an adjacent psychic disease.

The concept of rational suicide is evasive and controversial.

Analyzing suicidal behavior, including the rational one, Shneidman restrains very much the permission to label suicide as a rational type of suicide: "It is not a thing to do while one is not in one's best mind."

Rational suicide could well be the act fulfilled by a person who is perfectly lucid and in control of his or her mental faculties, in the absence of a mental disorder or of a serious medical condition (Siegel 2016).

Suicide is also defined as rational only in the situation when a person is able to reason correctly, having a realistic concept of the world, informed by correct data about daily events, and acting in accordance with his or her personal interests (Battin 2015).

An important criterion in appreciating an action as being rational is the ability to deduct the logical consequences of one's own actions.

Suicide belongs to the rational suicide category when the suicide act wants to avoid sufferance or is in accordance with the specific beliefs of the culture to which the person belongs.

Suicide to avoid sufferance or the loss of human dignity is found in the case of pacients suffering from cancer, AIDS or paralysis.

Research on cancer pacients has shown that most of the people who committed suicide had little tolerance to pain and to the discomfort of cancer treatment. These people also displayed the tendency to control events to the very end, and they preferred the choice of voluntary death rather than the situations of degradation or unconsciousness (Farberow, Shneidman 1961).

Rational suicide is also found in the case of people who are deeply connected to their life partners in a couple relationship, when they decide that they do not want to outlive the demise of their partner (in Romania, this is the case of the artist Irinel Liciu married to the poet Stefan Augustin Doinas). Suicide out of love after the model of Romeo and Juliet is culturally accepted in Japan.

Another variant was practiced in ancient times--the devotion suicide in which a person sacrificed oneself in order to bring the protection of gods to an army or community. It could be assimilated to the concept of "altruistic suicide" to be found with Durkheim.

In ancient times there was also the "protest" suicide, the "revenge" suicide, and the "cursing" suicide--the execratio suicide -practiced in order to attract malefic forces over an unpunished culprit.

Conclusions? Options?

What especially characterizes the self-determination of freedom is the act of will. This brings up the theme of moral responsibility (will).

John Locke explicitly made a distinction between will and action so that, supposing we want something, we are free to act or not in order to get it.

St. Augustine regards free will in a similar way: "Dei praescientia non efficit ut non libera voluntate peccemus" ("God's prescience does not prevent us from sinning freely through our free will").

But what if there is a lack of freedom in suicide?

The experience of death is integrated deep within every human being. Freud believed that in every one of us there is a self-destructive urge--the instinct of death, expressed in suicide only in extreme cases, through a combination of circumstances and factors.

The suicidal determination (the phantasmatic plan), then the motivation (giving up all hope) and the act itself is a final dissolutive catastrophe of which the body is very much afraid.

The deconstruction of the Ego ...

Shneidman (1993) noticed that in the case of suicide the presence of frustrated psychological needs is essential. The individual needs to get rid of the negative internal emotions, which is achieved through cognitive deconstruction.

In this effort to free oneself / to escape, the individual cognitive abilities are deficient, because they do not allow for an adequate solving of the problem and consequently they do not regulate the associated emotions.

Deconstruction is characterized by focus on actual movements and sensations and on important short-term goals (stringent daily needs).

Cognitive deconstruction leads to the diminishing of behavior inhibition, with a difficulty to control dangerous impulses and risky behavior, including suicide.

The weakening of impulse control explains a series of danger factors for suicide--drug abuse, self-mutilation and other behavior with a vital risk potential. The result is the constriction of thought--one of the 10 "commonalities" enumerated by Shneidman.

Common features of suicidal behavior

1. The specific aim of suicide is to seek a solution

2. The specific aim of suicide is to stop consciousness

3. The specific stimulus of suicide is intolerable psychological pain

4. The specific stressor in suicide is psychological frustration

5. The specific feeling in suicide is helplessness-despair.

6. The specific attitude in suicide is ambivalence.

7. The specific cognitive status in suicide is constriction.

8. The specific action in suicide is escape.

9. The specific interpersonal act in suicide is the communication of intention.

10. The specific behavior act in suicide is the persistent maintaining of behavior patterns.

The components of Shneidman's cube

Shneidman (1993) says that suicide is the consequence of overwhelming, uncontrollable psychological pain called psychache, defined as psychological pain attaining an intolerable intensity. Shneidman also says that psychache results from frustrated psychological needs, with a reference to the psychological needs identified by Murray (1938) and classified in two categories--primary or viscerogenic (based on biological needs) and secondary (of a psychogenic nature). He makes a distinction between modal needs serving the definition of the individual's personality, characteristic to emotional functioning and relating to daily events, and vital needs, essential for life, the frustration of which will lead to considering suicide as an option.

Shneidman (1993) includes all these needs in 4 categories:

1) love /acceptance and belonging are frustrated;

2) self-control / excessive helplessness and frustration (connected to the need to succeed);

3) the self-image is attacked and there is a need to avoid shame, defeat, humiliation and disgrace;

4) the loss of significant relationships, accompanied by mourning.

A fundamental component of constraint is the feeling of the impossibility of freeing oneself (unable to escape) from the situation, generated by difficulties in profitably solving one's life problems, especially those related to relationships.

SHAME--as a motivation of suicide

The untouchable, incompatible ideals of the ego are major causes of shame, being associated with vulnerability to suicide. The development of a self-ideal is essential for regulating self-esteem.

Shame is the most significant emotional experience to be found in the case of suicidal patients, other emotional experiences associated with suicide, such as depression, guilt, psychic pain or anger being secondary to shame (Lansky 1991).

Shame is the emotion associated with the failure to fulfil important aspirations or goals. It is the response to other people's feedback suggesting incompetence, inefficiency and the inability to influence an event. In this sense, it seems to come from the inability to overcome

internal and external challenges. It is hard to distinguish from helplessness.

From a cognitive perspective, we will notice a deficit in the updating of autobiographical memory, with a mnestic content focused on negative events and failure experiences when the person happens to be being in embarrassing, unfavorable situations. The generalizing memory (of the disaster) is at the root of the cry of pain model (Williams 1996).

The third component--the impossibility of escape (there will be no rescue)--works through the tendency to project present defeat onto the future, thus opening the way for the clinical symptomatology of despair and depression.

Negative emotions (perturbations) bring out of balance the scales of free choice, pushing the person towards the onerous exchange between intolerable sufferance and immediate, though irreversible escape.

Acknowledgements. The text was translated by Irina Chirica, PhD.

References

Battin M (2015) The ethics of suicide: Historical sources. Oxford: Oxford University Press.

Durkheim E (2002) Suicide: A study in sociology. London: Routledge.

Farberow NL, Shneidman ES, eds (1965) The cry for help. New York: McGraw-Hill.

Lansky M (1991) Shame and the problem of suicide: A family systems perspective.

British Journal of Psychotherapy 7(3): 230-242.

Murray HA (1938) Explorations in personality. Oxford: Oxford University Press.

Shneidman ES (1993) Suicide as psychache: A clinical approach to self-destructive behavior. London: Jason Aronson.

Siegel A J (2016) Suicide prevention by smartphone. The American Journal of Medicine 129(8).

Williams JMG (1996) The cry of pain. London: Penguin.

Author Contributions

The author confirms being the sole contributor of this work and approved it for publication.

Conflict of Interest Statement

The author declares that the research was conducted in the absence of any commercial or financial relationship that could be construed as potential conflict of interest.

Doina Cosman, MD, PhD; Clinical Professor of Psychiatry; Iuliu Hatieganu University of Medicine; Cluj-Napoca, Romania; doinacosman@gmail.com

Caption: Shneidman: The suicide cube model
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Author:Cosman, Doina
Publication:Romanian Journal of Artistic Creativity
Article Type:Essay
Date:Sep 22, 2018
Words:1942
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