Fernando Ardila, MA Philosophy University of ...

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Fernando Ardila, MA Philosophy. University of Copenhagen media, cognition and communications department. Research Analyst | Writer | Lecturer mobile - +45 ...
Fernando Ardila, MA Philosophy University of Copenhagen media, cognition and communications department Research Analyst | Writer | Lecturer mobile - +45 71 97 24 67 e-mail - [email protected] www.linkedin.com/in/Fernando-Ardila

Table of Contents Introduction ............................................................................................................................................................ 1 The Limitations of Happiness and Resurging Suicide as a Subject of Philosophical Interest

1. Necessary Context and Misleading Assumptions .................................................................4 The Happiness-Suicide Paradox Pre-Understandings: Conceptions, Misconceptions and Assumptions of Suicide Methodology and Advantages of Existential-Phenomenology Delimitations in the Suicide Experience: Unrestricting Suicide from Customary Sources

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2. Existential-Phenomenological Perspective of Suicide ........................................................ 15 A. Ontic Dimensions Suicidology: Biology, Sociology, Psychology and Case Studies Stress embodied (evidence), manifest (presence), and assimilation (correspondences) Concluding Theories and Models Regarding Suicidology

16 18 21

B. Ontology The Insufficiency of Suicidology 5 Existential Givens: Being-in-the-world-with-others, Mortality, Freedom, Thrownness, and Time Orienting Being in the world as suicidal Existential Concepts of Despair Characterized by Stress Reflecting on the Nature of Being in Suicide

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C. Experience of Suicide as an Existential Being Phenomenological Concealment of Suicide Intersubjective Experience: Suicidal Being-with-others Subjective Experience: Suicidal Being-towards-Death Existential-phenomenology suicide

37 39 42 46

3. Concluding Remarks: Happiness-Suicide Paradox ............................................................ 50 Diametric of Suicide in Polarized Mentality

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An Existential-Phenomenological Perspective on the Happiness-Suicide Paradox Introduction: Recall Albert Camus’ opening phrase in The Myth of Sisyphus, “There is but one truly serious philosophical problem, and that is suicide” (Camus, 1942, 3). Arguably, Camus intended on drawing attention to the existential question of the value of living in contrast to the value of committing suicide, bringing a dialectical relationship between committing suicide and life preservation. More contemporarily, Kay Jamison’s semi-autobiographical work Night Falls Fast, recounts her struggle with suicide and realizes its apathy in the public eye in stating “I have been impressed by how little value our society puts on saving the lives of those who are in such despair as to want to end them. It is a social illusion that suicide is rare. It is not.” (Jamison, 1999). According to the World Health Organization (WHO) suicide is globally the second leading cause of death for ages 15-29, nearly one person currently commits suicide every 40 seconds, and that number is predicted to double by the year 2020 (WHO, 2014, 3; Gvion & Apter, 2012, 3; Bertolote & Fleischmann, 2002, 6). If that prediction actualizes, that equates to an average of one death every 20 seconds and one suicide attempt every one to two seconds. Recent reports support this rising trend placing suicide as more lethal than terrorism, car accidents and homicide combined. After more than 70 years after the publication of The Myth of Sisyphus, one of the most significant philosophical texts grounded in suicide, the concept remains as both one of the most mysterious and neglected behavioral phenomena in the philosophical dimension. Did suicide stop becoming a truly serious philosophical problem? Suicidology—a scientific approach to suicide and suicidal behavior by giving reasons or causes for prevention (Pompili, 2010, 240; Kuzmanić 1 , 1)—continues to be neglected while livelier subjects receive attention. Currently, the science of happiness thrives as it progresses under the influences of positive psychology. Throughout previous decades, happiness research has gained increased attention. This field of study aims at discovering the mechanisms that cause happiness and how to implement them by utilizing multi-dimensional disciplines including neuroscience, psychology, sociology, and philosophy. This consists of standardizing traditional theories of happiness2 and synthesizing them with scientific research and statistical data such as questionnaires, observing psychological patterns, monitoring subjective experiences, and conflating them into theory. However, in recent developments, research encountered the happiness-suicide paradox. The paradox consists of how happiness or valuing happiness may produce higher suicide rates, which causes the happiness project to seemingly backfire (Bray & Gunnell, 2006; Mauss et al., 2011; Daly et al., 2011). Happiness surely represents an important aspect of physical and psychological health. How can seeking happiness produce such a paradoxical circumstance, or has happiness research reached a limit where progression somehow consists of regression? The root cause for the existence of the happiness-suicide paradox is our lack of knowledge on suicide. The primary conflict exists not in the “happiness” but in the “suicide” aspect of the paradox. After all, happiness is generally conceived as a solution or end goal; suicide, on the other hand, poses conflict. The terms happiness and suicide appear incompatible with one another: one 1

Taken from Kuzmanić’s draft paper on “suicide from an existential-phenomenological perspective.” Primarily Epicurean Hedonia synthesized with Benthamite/Millian utilitarianism and Aristotelian Eudaimonia. Both contribute to current researcher’s procedures for Subjective Well-Being (SWB) evaluations. 2

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requires existence (life) to experience happiness while the other suggests cessation of existence (death) in completion. We have a preconceived ethical notion that happiness is good and suicide is bad, leading to a series of ethical investigations concerning the value of human life. However, the actual problem does not affect ethics as much as it affects the paradox’s specific reference that greater levels of happiness causes higher rates of suicide. This is a problem that poses a challenge to happiness research’s positive psychology in its attempt to elevate the levels of happiness in various psychological/philosophical approaches. This is the result of a polarized mind directed toward happiness research and positive psychology. Focusing on what happiness is, how to make people happy, and what psychological mechanisms produce positive moods, suggests that there exists a negligence of the causes of suffering—and nobody experiences more anguish than those who desire suicide. The conflict that the happiness paradox faces extends from our lack of comprehension on the nature of suicide. Unfortunately, suicide is generally long forgotten in philosophical discussions though it has become a critically growing concern. Moreover, research concerning happiness goals has reached paradoxical conflict. A series of issues indicate that our attention requires a readjusted focus directed toward an in-depth analysis on the nature of suicide. In readjusting our focus toward a theoretical philosophical understanding of suicide not only may we uncover the causes of suicide and an explanation of the paradox, but also advance our knowledge of happiness itself. One way for understanding or advancing a comprehension of a particular term, such as happiness, is to investigate its contradicting term (Pawelski, 2013, 327). This functions in a similar manner to how understanding darkness advances our understanding of its continuum opposition, light; or how a strong national department of defense helps in protecting us while a strong national department of peace may help develop positive public opportunities and peace (ibid, 334). In the instance of the paradox, the term that contradicts happiness is suicide. This indicates an existing relationship between the two concepts. Hence, in applying an analytical investigation toward understanding suicide and its primary cause, we obtain key knowledge required for understanding the relationship it holds toward happiness. In this way, we may determine the origin of the paradox. One of the most complete work directed toward the subject of suicide is Denys deCatanzaro’s Suicide and Self-Damaging Behavior: A Sociobiological Perspective, providing an advanced perspective to a behavior neglected by evolutionary theorists. DeCatanzaro’s analysis operates under the notion that suicide, like most behavioral pathologies, is induced by stress. Exposure to stressful circumstances may render the individual with an inability to cope, leading to the breakdown adaptive mechanisms (deCatanzaro, 1981, 10). During this process, genetic predisposition and environmental factors play an integral role in influencing the individual’s unique response to circumstances, currently known as a diathesis stress model3. Emphasis is on “unique response”. DeCatanzaro lacks in reflective existential significance raising questions such as: What does suicide mean for a being moving toward death? Is stress related to anxiety and despair? What does it mean to become suicidal as opposed to being suicidal? Do we have a responsibility to ourselves or others when inflicted with thoughts of suicide? How do we inquire about suicide? Can we obtain access to this phenomena? Considering the advancing trends of the

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The diathesis stress model will be discussed in further sections.

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previously mentioned conflicts suicide pervades, it is essential to place current emphasis reflecting on the individual. Individual experiences of existence are influenced by external stimuli such as their relations to others. This alludes to the methodological aspect of the “socio” in deCatanzaro’s work. Although influenced by the social, we must not neglect the irreducibility of subjectivity in an individual’s experience. This reflects upon the uniqueness of a “biological” and genetical predisposition of a being experiencing existential circumstances in accordance to its temporal conditions. By applying an existential-phenomenological analysis to suicide, we may construct an explanation for the phenomenon and uncover stress as its primary cause due to its recurring presence. Such a methodology will lead to an understanding of suicide, its relation to happiness, and a possible explanation for the emergence of the happiness-suicide paradox. To proceed concertedly, the first section is dedicated to contextualizing primary terms. First, an in-depth explanation of the happiness-suicide paradox is required. A thorough investigation clarifies three things: what constitutes this as a paradox; what implications the paradox predicts; and who the paradox affects. Clarifying the happiness-suicide paradox allows us to conceive and relate to the issues it imposes. Second, I provide some current understandings of the term suicide. Previous attempts to define the term have been thwarted by our elusive understanding. An analysis of common conceptions will present an understanding that suicide requires intention and action and concludes in death. Conventional definitions are vague or unclear and often present an understanding out of sync with the present tense. For these reasons, the term suicide will be thoroughly contextualized in order to show that it cannot be authentically examined but suicidal behavior can. Third, I will explain the existential-phenomenological method. Existentialism is typically conceived as an attitude emphasizing that the individual is uniquely self-determining and responsible for its choices. Arguably, phenomenology is occasionally conceived as a methodological approach for analyzing subjective experiences, aiming at understanding what the experience is. I explain that these two traditions are compatible, and what existential-phenomenology consists of. Findings shall demonstrate why this method is appropriate for understanding the concept of suicide. The majority of this investigation is spent on section two. The first part argues that our investigation into suicide must begin with an ontic interpretation of existing suicidological facts. The ontics of suicide generally consists of case studies involving genetic influences, psychological related risk factors, and sociological conditions. As we shall see, virtually all suicidological current sciences that engage in suicidology significantly involve the concept “stress.” I argue that this is not coincidental but is mistakenly overlooked. Parallels from the sciences are drawn that all lead to further investigations. The second part takes the Heideggerian concept of a being-toward-death in order to produce an existential-phenomenological analysis of suicide. I argue that the existential concepts of angst, anxiety, and other current terms are synonymous with the concept stress. The analysis commences with how an existential being experiences relatedness toward others, then a subjective interpretation into how the individual lives a suicidal experience triggered by stress/anxiety. The third and final section takes the findings and exposes the dark side of happiness. This section shows the ontological inseparability of happiness and suicide. The two terms represent part of the human ontology and therefore with the presence of one, the other follows. As a result, we 3

shall see that the happiness-suicide paradox is a consequence of a polarized mind fixed on the seductive qualities of happiness while neglecting its counterpart, suicide.

1. Contextualizing and Addressing Misleading Concepts The Happiness-Suicide Paradox Before developing the appropriate context of what the happiness-suicide paradox is, it is worth explaining objective factors that constitute a paradox. Etymologically, the prefixed root of the term “paradox” is synthesized from the Greek word para-, meaning contrary to, and the suffix -dokein, meaning to think or seem4. When combined, the Greeks formed the noun paradoxon and the neuter adjective paradoxos, meaning contrary to expectation. Latin speakers adopted the term to form the noun paradoxum, meaning a “statement contrary to common belief or expectation” in the 16th century5. We currently hold a general understanding of a paradox as a logically defying claim that expresses truth. A paradox is a contradictory and logic-defying situation, concept, or statement containing truth value (thus, we may understand an oxymoron as a condensed and simplified paradox). This understanding of a paradox shares important qualities with the previously mentioned Greek comprehension of the term paradoxos. Take the theodical omnipotence paradox inquiring if God can create a rock too heavy for him to lift. At first glance, this contradictory statement and situation appear to have simple solutions; however, these paradoxes violate our initial expectation while containing some truth depending on our stance and our beliefs. This exemplifies the primary function of paradoxes in that they are generally simple to grasp yet complex because they introduce conflict, depth, and thought. Thus, paradoxes consist of both oppositional claims, situations or concepts, as well as expectations and truth. Although the happiness-suicide paradox is a relatively recent discovery, it clearly exhibits said characteristics in that it violates our initial expectations. The paradox officially emerged in the mainstream academic world in 2011. First it blatantly appeared in April under the title “Dark Contrasts: The paradox of high suicide rates in happy places” (Daly et al., 2011), then in August as “Can Seeking Happiness Make People Happy? Paradoxical Effects of Valuing Happiness” (Mauss et al., 2011) in a complementary yet subtle iteration. The former discovers the paradox in a national macroscale while the latter observes an individual microscale configuration. Accumulating interest has created an increase in attempts at ranking happiness among people and countries and has consequently suggested living environment modifications. However, Daly et al. note a puzzling anomaly, many of the happier countries have unusually high suicide rates, viz., the happiness-suicide paradox. The aim of Daly et al.’s research is to document the existence of the paradox by applying macro-data on well-being and suicide. Findings are then employed on a micro-level analysis, a method of working from the top-down. Application was restricted to Western countries and U.S. 4 5

"Paradox." Merriam-Webster.com. Merriam-Webster, n.d. Web. 2 Apr. 2016. http://www.etymonline.com/index.php?term=paradox

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states to minimize variations of cultural norms and other demographic dimensions. The research argues that with suicide, the decision to take one’s life is attributed to psychological externalities. Intricate analysis suggests that while happiness may defend one from committing suicide, others’ level of happiness is at risk. That is to say, unhappiness is affected most when surrounded by people relatively satisfied with life. When the domains that make up a subjective well-being questionnaires are compared, the findings suggest that human beings construct their norms by observing the behavior and outcomes of other people. Hence when others are in a similar position, one tends to personally pass judgement on themselves less harshly. Conversely, when others are in a more positive position, one tends to pass judgment on themselves more harshly. Due to our limited understanding of suicide, the authors are forced to rely on limited data dating back to 2002. A constructed plot graph shows the top seven happiest Western countries along the x-axis as Denmark, Ireland, Iceland, Switzerland, the Netherlands, Canada, and Austria. The y-axis depicts suicide rates. Astonishingly, with the exception of the Netherlands, the graph exhibits an unexpected positive association between happiness ranking and suicide rates. Interestingly, more current studies indicate that Daly et al.’s access to suicide rates are arguably inaccurate. Evidence indicates that accounts of suicide are actually higher than reported in Scandinavia (Tøllefsen et al., 2015), as well as in the UK, Portugal, Germany, and Switzerland (Pritchard & Hansen, 2013), making this global epidemic more severe than what figures indicate. In contrast, Greece, Portugal, Italy, and Spain rank lowest in happiness. With the exception of Portugal, these countries also unexpectedly rank lowest in suicide rates. The paradox associating high levels of happiness and high suicide rates holds true in countries with atmospheric, religiously-influenced, and culturally diverse conditions. The study observes the U.S. for its approximately homogeneous institutions dispersed throughout6 as exhibiting the practical reality of the paradox in application. After collecting life satisfaction and suicide risk data for each state, data exhibits that New York ranks 45th in life satisfaction yet possesses the lowest suicide rate. Conversely, Utah ranks first in life satisfaction yet has the ninth highest suicide rate. Overall, a positive correlation is observed in Western nations supporting the existence and relationship between opposing terms “happiness” and “suicide.” Mauss et al.’s analysis takes a bottom-up approach in applying a microscale analysis on a macroscale. Mauss et al.’s analysis departs from the initial assumption that valuing happiness should lead to positive outcomes. This departure is supported by popular belief as well as studies oriented on goal pursuit (Mischel, et.al., 1996). Seemingly, the same logic should apply to happiness, i.e., valuing happiness as a desired goal grants access to goal orientation which should result in greater happiness. Take the example of an employed worker desiring a bonus if he fulfills a quota. The goal pursuit model suggests that if the employee’s values are directed and takes action towards fulfilling the quota, the reward, considering all things fair, should be the bonus. However, closer analysis reveals complications with this line of reasoning, particularly with personal standards and evaluation. Values determine more than goals—values create 6

One should keep in mind that the authors are aware of the distinctions of cultural norms throughout the United states and warn the reader of the imperfections of this model. This argument should not be taken too far. The purposes are strictly based on the convenience of compiling data from individual states.

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standards reflected on how that person evaluates their accomplishments. For example, an individual valuing happiness may feel disappointment when attempting to replicate a positive experience, such as dining in their favorite restaurant, if such a context fails to reach expectation standards. Reasonably, valuing happiness means creating happiness standards that one may fail to live up to. Thus, under such occurrences, a paradox emerges in which the person valuing happiness feels disappointed and experiences a decrease in happiness. Two studies support this theory: the first examines the relationship between the degree individuals value happiness to well-being. Results indicate that valuing happiness under conditions of low stress produce lower levels in hedonic experience, psychological well-being, and life satisfaction, yet higher depression symptoms. This implies that valuing happiness is not necessarily related to higher levels of happiness. The second study analyzed the causal effects of valuing happiness. Subjects led to value happiness, compared to a control group, experienced lower happiness affects after being induced with a relatively positive context, a hedonic treadmill. Results indicate that valuing happiness can lead to less happiness, particularly in positive emotioninducing situations, thereby making valuing happiness a potentially self-defeating circumstance. Hence, valuing happiness threatens happiness.

Pre-Understandings of Suicide: Conceptions, Misconceptions and Assumptions Suicide as a conceptual phenomenon has puzzled academics. Generally, suicidologists perceive suicide as an unexplainable riddle because it contradicts survival instincts (Sanchez, 2010). It is not bewildering for suicidologists or investigators to experience a variety of narrow fragmented perspectives lacking in context. Providing an all-encompassing and sufficiently captivating definition of suicide seems to evade full comprehension of the term due to mystery, evasiveness, and fractured consensus. The inability to fully grasp suicide is best understood by one who is suicidal. Suicidal individuals hold an intimate relationship to their experience that contradicts biological survival impulses that make the experience virtually ineffable. Why is one’s suicidal behavior impossibly difficult to communicate accurately? What is the meaning of suicide? What does the term represent? Is it something rational or irrational? Before advancing, the term requires context by observing conventional views and orienting these views with its original meaning. The term suicide has a complex history. It originates from the Neo-Latin word suicidium meaning “deliberately killing oneself.” Suicidium takes the Latin prefix sui- meaning “of oneself” and -cidium meaning “a killing” to form this relatively modern conjunction in the mid-late 17th century7. However, before entering into the English lexicon, the public referred to suicide under alternative linguistic expressions. In the late-16th century, the term “self-murder” was converted from the previous use of the term “murdering-oneself” in English and Romantic languages. The movement of the term “murdering-oneself” to “suicide” purposefully occurred to decriminalize the act by distinguishing the former as voluntary from the latter as involuntary actions, in order to 7

http://www.etymonline.com/index.php?term=suicide

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accommodate developing theories of autonomy. Efforts to decriminalize self-murder proved unsuccessful as the concept of suicide, despite compassion to victims, adapted to modern forms of social criticism regarding killing oneself relating to moral and pathological judging (Bähr, 2013, 629). As of today, the term “suicide” is generally stigmatized indicating preconceived reflections upon the appraisal of the individual’s persona accompanied with negative criticisms. Possible approaches to resolve such conflicts include speculatory work on suicide or parasuicide’s (attempted suicide) intent by examining their past and interrogating witnesses as well as associates (Fairbairn, 1998, 159-160). However, developed theories remain speculative due to the lack of accessible introspection of intent in successful suicides deterred by stigma. It has even been argued that lack of dependable introspection regarding intent suggests an additional necessary shift in linguistic expressions, including eliminating the terms themselves (Fairbairn, 1998, 163, 164). Linguistic discordances challenge attempts aimed at discussing the meaning of the term, supporting the claim that it is presumably direct but ridden with complexity. For this reason, popular definitions require analysis as well as an inquiry into the rational nature of the act. Suicidologists currently accept the following definitions of suicide: a) intentionally taking one’s life and ending in death; b) suicide involves an “intent” to die and a “deliberate” act inducing death (deCatanzaro, 1981, 14); c) “a death is a suicide when it occurs as a consequence of an intentional self-inflicted injury” (Rosenberg et al., 1988); d) “[s]elf-initiated, intentional death” (Ivanoff, 1989); e) “[t]he definition of suicide has four elements: (1) a suicide has taken place if death occurs; (2) it must be of one’s own doing; (3) the agency of suicide can be active or passive; (4) it implies intentionally ending one’s own life” (Mayo, 1992); f) suicide is “psychache” viz. unbearable dramatic disturbances of the mind, caused by thwarted or distorted psychological needs (Shneidman 1993, 145); g) “[s]uicide is, by definition, not a disease, but a death that is caused by a self-inflicted intentional action or behavior” (Silverman & Maris, 1995); h) “[t]he act of deliberately killing oneself” (WHO, 12, 2014); i) “an act with a lethal outcome which the deceased intentionally performs with the knowledge or expectation of the lethality of such an action” (De Leo et al., 2004). The provided definitions represent a majority of our views of suicide. By chronologically tracing the definition, one can observe the variety of assumptions, understandings, preconceptions, and transitions reflected upon the original meaning, viz., “deliberately killing oneself,” with the exception of Shneidman who does not include death. Before the outcome of death, each view uniquely holds two traits in common: intention and behavior. From these definitions, sparse models of suicide have developed explaining how or why suicide occurs, including: the scientific model suggests that uncontrollable genetic factors predetermine suicide; the Cry For Help theory claims that people do not wish to commit suicide, but instead are attempting to reach out to others to reduce their distress; Sociogenic theory suggests that social forces cause suicide; the Diathesis-Stress model suggests a tripartite interaction between biological predisposition (diathesis), life-encounters with one’s environment (stresses), and buffers between the individual and the mental illness (protective factors) (Pompili, 2010, 235). From DeCatanzaro to De Leo, each definition, theory, and model holds in common an intent, behavior, and a biological end (except for Shneidman) in their own unique forms. The terms for biological death appeals to “death,” “die,” “lethality,” and “ending life.” Each account attempts 7

to characterize or produce an explanation of intention. The language used for intention includes the direct use of the term “intentionally,” “intent,” “knows the result,” “choosing,” and “deliberate[ly].” Lastly, the victim’s intent is always directed to their own behavior. The terms for behavior include “doing something,” “act,” “action,” “self-infliction,” “self-initiated,” “one’s own doing,” and “performed by the person.” The provided models and theories are constructed to explain the circumstances that led the victim to develop the intent that convinces them to perform the act which concludes in the experience of death. In the simplest biological explanation, these three elements interact to produce the limitations for the concept “to deliberately kill oneself” as suggested by suicidium. The tripartition constituting suicide allows us to proceed in comprehending the rationality behind the deed. Investigations into the underlying rationality of suicide are most popular because they engage with pre-understandings. Arguments in favor of the rationality of the act are supported by the mentioned models and theories that attempt to explain what causes suicide. Each model must presuppose that some rational content is involved in order to justify the action through a theoretical systematic process. In addition, the fact that one must have foreknowledge of death as an outcome indicates that one must have actively favored death, suggesting the presence of some rational contemplation. On the contrary, existence supports evidence for life-preserving principles that constitute the most fundamental trait of biology, thus suggesting that any suicide is irrational for contradicting our life-preserving mechanisms. While some argue whether suicide is rational or irrational, others claim the terms are nonsensical designators or that the concepts inappropriately polarize suicide and suggest a middle ground. Some claim that rationality is future oriented, i.e., one must have sufficient knowledge of and concern for protecting one’s own interests, yet suicide victims have no future. Therefore, attributing rationality or irrationality is otiose (Cowley, 2006, 497). Others argue that suicidal acts exist between autonomy and heteronomy, suggesting that suicide is partially rational and irrational (Schlimme 2013, 212). These arguments for/against the rationality of suicide are context-specific. From the point of view of the victim, suicide may occur with or without approving the correctness of the action (ibid, 212) and it involves intelligent cognitive mechanisms such as foreknowledge and shifting interpretations of intent and behavior. Since suicide is context-sensitive, correctness of the act does not require approval, and is relatively intelligent, suicide exists between rationality and irrationality, but never completely one nor the other. The term suicide has retained most of its original meaning, i.e., deliberately killing oneself, but has never lost its negative implications; rather, these have transformed into a modern stigma that secretly judges the individual’s mental state, morality and persona. Today, most discussions turn to linguistic analyses that attempt to extrapolate the meaning of “deliberate.” While suicide is represented by intent, a behavior, and death, these traits characterize an individual’s unique existence, i.e., for suicide to exist the individual must exist. Hence, suicide relates more to life than to death (Kuzmanić, 4), and thus should give priority to investigations of one’s life. Additionally, suicide resides somewhere between an autonomous rational act and a heteronomous irrational act causing obstacles for the individual to rationally communicate suicidal behavior. An analysis of the way in which an individual is oriented and experiences the world as a suicidal being is required 8

to accurately comprehend suicide. Such an approach for analyzing the individual’s worldly orientation and experiences as a suicidal being is found in existential-phenomenology, as we shall see.

Methodology and Advantages of Existential-Phenomenology The concept of suicide is typically directed toward a single agent (in cases of group suicides, the source of the act is typically conceived as individual intents shared by a group). In other words, one makes the subjective choice to commit suicide for any given reason suggesting that it is an issue of one’s current condition (Pompili, 2010, 239). Deciding to commit suicide is deeply and emotionally unique, making it closer to the experience of being in love than a heart disease. Each person subjectively experiences the complex conditions or personal psychic pains that make their death a relevant circumstance to suicidal individuals. Complexities are so unique that individuals find their mental state difficult, if not impossible, to communicate due to linguistic limitations and the particularity of one’s history and psychological experience; not to mention the stigma associated with suicidal behavior. An individual’s relation to their life conditions and experiences must be taken into consideration in order to develop a theory regarding suicide. An existential-phenomenological approach to such an intimate experience functions best in performing this endeavor. What do the terms “existential” and “phenomenological” mean and what do they refer to? How do these terms interact with one another? What does such a methodology consist of? How does this method apply to suicide? This section aims to answer such questions by first looking at existentialism, then phenomenology to contextualize methodology. Existentialism The coining of the term “existentialism” arguably emerged in the mid-20th century with the existential philosophers Jean-Paul Sartre and Gabriel Marcel. However, existentialism is rooted with Søren Kierkegaard and Friedrich Nietzsche, who were primarily concerned with the truth of subjective experiences as opposed to calculable objective truths. Calculable objective truths were conceived as a failing attempt to grasp unique experiences of existence because they were far too removed from humanity. Existentialism became known as a philosophical attitude that prioritized the individual’s subjective position as a self-determining being responsible for its own choices in relation to the conditions of existence. Heidegger refers to the existence of the individual aware of and able to reflect on Being (Heidegger, 1996, 58; Cohn, 1997, 12) that is pre-reflectively understood as a manifold of body, spirit, and soul (Heidegger, 45) as Da-sein, generally translated to “Being-there” or human existence. When the question of being is presented, it is beings asking the question of being, suggesting that there is an entity asking and reflecting on the question. That which is already present is Da-sein. Da-sein is the “there of being” (Cohn, 1997, 12; Edo Pivčević, 1970, 110) or what is already present and defining itself by its possibilities of its being (Heidegger, 41). Da-sein 8

From now on, all Heideggerian quotes and references refer to Joan Stambaugh’s 1996 translation of Being and Time unless specified.

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is expressed as Being-in, but Being-in requires a constitution (ibid, 51). Since Da-sein is already present in the world, it is a priori “being-in-the-world” (ibid, 50) suggesting that being and world cannot be extrapolated from one another (indicated by hyphens) because any questioning being must already be in the world to inquire. To determine Da-sein’s unique position as a determining being, existentialism correspond to ontological traits, which are sometimes known as existential themes or givens of existence (Cohn, 1997, 13). Existential givens include: 1. Being-in-the-world – For Heidegger this is the inescapable involvement with everything there is, indicating how we are part of the world. We do not enter the world because the world is there a priori. Da-sein is being-there and ‘there’ is always in the world. 2. Being-in-the-world-with-others – ‘Being-in-the-world-with-others’ refers to intersubjectivity or unescapable relatedness one holds to other Da-seins. Because one cannot opt to exist in a world without others, choosing isolation is a response to how one relates to them. Being is always being with others. 3. Thrownness – ‘Thrownness’ refers to our ‘abandonment’ (Sartre, 2007, 25) that limits Da-sein’s control over existence. Da-sein is brought into its thereness not of its own accord (Heidegger, 262), and finds itself in unchosen circumstances that represent particular facts of an unchangeable history called its ‘facticity’ (52). Facticity cannot change; attitude toward it can. 4. Mortality – Da-sein exists with the condition of death therefore it is inseparable from its ontology. While one is alive death exists. Beings always move toward death, which Heidegger calls ‘being-toward-death,’ implying that all moments of living are also moments of dying. Mortality is our temporality. With life comes death, thus ending all of Da-sein’s possibilities. 5. Choice – Choice refers to the inevitable condition of choosing. Abstaining from choosing is a choice. Sartre claimed “man is nothing other than what he makes of himself” (2007, 22) emphasizing inevitable circumstances of choosing and our response to them. Making choices eliminates other possibilities for Da-sein and may produce anxiety or creativity. 6. Embodiment – Embodiment refers to the Cartesian mind-body split. Being is in the world and is synthesized of a bilateral operation of body and consciousness of the physical and nonphysical. 7. Space – Space refers to unmeasurable spatial proximities of being-in-the-world. Something once experienced near may be experienced distant. 8. Time – The concept of time refers to subjective experiences of time relations. Time is multidimensional in that we do not simply move from one instant to the next; we carry the past into the present to anticipate the future (Cohn, 13). 9. Mood – Heidegger uses Stimmung, often translated to mood; however, it is closer to meaning 'attunement’. Mood reveals the world and allows responses to other beings because it is the way the being is situated in the world that allows it to react as the world discloses itself (Inwood, 1999, 130, 132). For example, through anxiety, a mood, one becomes aware of thrownness. These existential givens constitute the being of all beings (Heidegger, 11). Existing beings interact with the mentioned characterizing themes that situate existence. Hence, existentialism is 10

generally an ontological endeavor; it explores the intrinsic aspects of being and responses9 to the ‘givens’ that create the individual’s specific world (Cohn, 1997, 12). Ontic (distinguished from ontology) is a description of the specific ways an individual is10 in the world (ibid). Since Da-sein is physically oriented and existentially responsive, emphasis is placed on the terms is for ontic and response for ontology. For ontic, the term is refers to investigating the ‘aboutness’ of existing as a being in the world. By observing the physical structure of the individual’s existence, explicit facts and characteristics are extrapolated, thus providing an ontic way of characterizing one’s existence. Ontic design looks to the sciences whilst relying on empirical, factual evidence to relate physical phenomena and substrata to a descriptive understanding. Heidegger reminds us that ontological investigations begin with an ontic understanding, giving first priority to the ‘aboutness,’ i.e., interactions with objective situations, and second priority to introspective analysis, i.e. subjective involvements. However, both are required for existentialism to have a firm understanding of Dasein’s relatedness to experiences. Hence, existentialism is fundamentally an ontological engagement. While existentialism is concerned with the experience of existence, phenomenology is concerned with the process of experience, whether it exists or not, making it an appropriate companion. Phenomenology Phenomenology is a methodology developed by Edmund Husserl to understand phenomena. Phenomenon is rooted in the Greek term phainesthai, meaning “to show itself,” while phainomenon, meaning “what shows itself, the manifest” derives from phainesthai (Heidegger, 25). In correspondence to phainonemon and phainesthai, the term phenomenon may be conceived as “what shows itself in itself, what is manifest” (ibid, 25). That which is showing itself, however, may only appear to be showing itself, suggesting something hidden behind the appearance. When a phenomenon appears as something, it makes a reference to itself without necessarily showing what it is. For example, a beverage may appear like coffee but, closer examination may prove otherwise. Therefore, appearances are phenomena, i.e., something showing itself, but phenomena are not appearances, i.e., that which shows itself is not in itself but an appearance of it or a semblance (ibid, 25). Appearances possess the possibility to conceal. Phenomenology assists in resolving this conflict. The suffix of phenomenology is the Greek term logos meaning “which lets something to be seen” (ibid, 29). Phenomenology means “to let what shows itself be seen from itself, just as it shows itself from itself” (30). Heidegger draws attention to the suffix “ology” and draws a comparison to the terms theology, the science of God; biology, the science of life; and sociology, the science of community, to remind us that phenomenology is the science of phenomena (ibid, 24). As mentioned in the existential discussion, ontics refers to the sciences. Hence 99

My own stress is added to indicate the importance of the term in relation to ontological investigations. Stress is again added here to indicate the presupposed existence of the individual indicating that ontic investigation refrains from placing emphasis on intrinsic enquiry and focuses more on the stationary conditions that may apply quantifying apparatuses, e.g., what is existence of the individual as opposed to what it is to be an existing individual 10

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phenomenology is extensively concerned with ontics, science. Heidegger mentions that “ontology is possible through phenomenology,” (31) supporting the ontic priority over ontological-existential investigations. The reason this occurs is because all investigations of being commence with the experience of what is given, what already is and what Da-sein is conscious about. It is through the experience of a phenomena that the question of Being is raised. Just as the what is the content of phenomenological research characterizing it as methodology, the how is an ontology clarification. Phenomenologists are invested in what is disclosed to them in the conscious experience (Schlimme, 2013, 212). Phenomenologists explore the process of experience and what it gives to the subject. Hence, the phenomenological method is capable of providing explanations of experiences structured in the subjective perspective (Schlimme, 2013, 212; Pompili, 2010, 240). Considering the uniquely intimate experience of suicide, phenomenology possesses appropriate tools for describing the suicidal content. The structure of the phenomenological method is roughly as follows. The phenomenological process begins with a step called epoché. Epoché is an ancient Greek stoic term meaning “suspension of belief” (Cohn, 1997, 34). For phenomenology, epoché is the “universal depriving of acceptance,” “inhibiting,” “putting out of play all positions already taken toward the already given Objective world” (Husserl, 1960, 20). This procedure brackets aside all biases. Suspending beliefs is distinguished from denying beliefs. Denying beliefs involves rejecting that something may be known. Epoché allows potentially undermining philosophical ideas to be placed aside to investigate phenomena as given to one’s experience. Abstaining from prejudices is a common practice in serious investigations. Recall the discussion of embodiment: thinking involves thinking about something. Husserl states, “Conscious processes are also called intentional; but then the word intentionality signifies nothing else than this universal fundamental property of consciousness: to be consciousness of something” (Husserl, 1960, 33). What he means to say is consciousness is always directed toward something, intention. This is an example of bracketing off all presumptions and centering on consciousness. Centering on the properties of consciousness and bracketing beliefs allows one to gain undistorted access to descriptive traits of consciousness. The process exhibits that consciousness is aimed toward a target, which is represented by the term intention. Phenomenologists are then interested in describing the process of experience directed toward phenomena and how it reveals itself to consciousness. In other words, to describe the intentional experience to the best of its ability. The process targets the experience using epoché as the initial step to isolate the phenomenon. Epoché maintains separate unexperienced phenomena away from the experienced phenomenon. Phenomenologist may “describe how an experienced giveness is given in one’s own conscious experience” (Schlimme, 2011, 212). Phenomenology draws on the sciences, relating experiences of mental life to empirical data. Existential-phenomenology Placing forth a descriptive comprehension of traits and concepts held by existentialism and phenomenology, a developed clarification of the structure of existential-phenomenology may be formulated. Recall that existentialists deal with the experience of intrinsic dimensions of being and 12

our orientation within them. Phenomenologists deal with the science of the process of giveness in immediate experience regarding that which lets itself show itself in itself. Both are interested in experience. However, existential-phenomenology deals with the phenomenon of existence as a being-in-the-world. The emphasis existential-phenomenology places on the experience of existence originates from the divergent views between existentialism and phenomenology. Existentialists are concerned with the phenomenon of existence and generally reject commencing in epoché. Epoché suspends all, including the existence of the being. The procedure detaches the individual from the world—a move that existentialists generally reject. Existentialists are most concerned with the individual’s experience of existence and less concerned with disclosing the essence of experience. For the existentialist, the individual is understood as a being-in-the-world thrown and engaged in choice, mortality, etc., capable of reflecting on the totality of being. Due to the inextricable nature of being and existence, existentialism abstains from suspending existence. If existence is being-in-the-world, then how the individual is conceived is affected. Sartre’s claim “existence precedes essence” (Sartre, 2007, 20) is complimentary to phenomenology but conflicts with Da-sein. For Sartre, existence is divided from the individual by making essence a precursor of existence. Splitting the two provides the opportunity for epoché to become a viable technique that detaches the individual from the world. For Heidegger, Da-sein is understood onticontologically, i.e. he moves from the ontic level down to the ontological plane (Macann, 1993, 64). In this understanding, Heidegger means to say that there is an objective and subjective characteristic to being. The objective world and subjective experience make up a being-in-theworld, viz., Da-sein. Heidegger turns the phenomenological constitution of the subject back to itself using an ontological grounding of phenomena to establish that the subject is inseparable from the world as an ontic-ontological being. In other words, we understand ourselves as beings through the physical and introspective analysis. Here, the manifold of Da-sein composed objectively and subjectively suggests that the essence of a being is its existence. Since existence is being-in-the-world, it holds a relation to its physical world and to other subjects, granting it an existential-phenomenological dimension, i.e., an individual is experiencing the world from a unique position. This relatedness constitutes one of various existential qualities discussed above, which suggests that relating to others is not a question but a given. The manner one experiences relatedness to one’s specific conditions in relation to their existence constitutes the primary component of the existential-phenomenological process. Existential-phenomenology begins with an ontic-ontological understanding of individuals as being-in-the-world governed by the givens of existence. It is the duty of the existentialphenomenologist to accept the individual as an embodied being in the world. In doing so, the researcher must aim to comprehend the individual’s private existential situation and analyze the experienced phenomenon. Existential-phenomenology places the individual back to the center of experience neutralizing all prejudgments except the givens. In other words, existentialphenomenological rationalizations generally produce strong subjective outcomes tailored to the individual. In this sense, it attempts to understand responses to the experience of or attempts to disclose phenomena grounded on the indissoluble themes of existence. Psychotherapy has adopted 13

this as an effective form of treatment to alleviate or empower those troubled by (post)modern symptoms—nihilism, excessive anxiety, depression, guilt, despair, alienation, purposelessness, etc.—by earnestly confronting the givens, such as death, suffering, loneliness, loss, responsibility, finitude, etc.

Delimiting Suicide A discussion of existential-phenomenology may raise questions of how a being engaged in suicide—with intention, exhibiting a behavior, ending with death—relates to the method. Why not rely on ontic designs that allow mainstream science to take possession of and to explain suicide? Why are existentialism and phenomenology independently insufficient for explaining suicide? Suicidology is the science of suicide that borrows empirical evidence from biology, sociology, psychology, and other sciences. It is fundamentally engaged in objectively answering the what and why of suicide. As previously mentioned, an aim of suicidology is to define suicide, as in: “what is suicide?” Suicidology also aims in producing reasons for why, as in “why does one commit suicide?” It confides that in answering the why, it will prevent future suicides. In other words, suicidology attempts to systematize, formulate, and standardize a notoriously mysterious behavior. Problems exists in this ambition suggesting the need for an approach from another angle. The first noticeable problem with a suicidologist’s approach involves the presuppositions in intention and action in relation to suicide. Earlier analysis disclosed common factors among definitions of suicide that coincide in intention and behavior. In accepting intentional decisionmaking as an obvious force, guiding action, it presupposes the individual is implementing an action specifically aimed at suicide (Honkasalo & Tuominen, 2014, 3). Claiming that the individual will bring his/her death, assumes an autonomous uninfluenced decision from external conditions. The assertion that the individual’s action is precisely aimed at committing suicide assumes an objective target for all suicidal individuals: death. This may not be the case in some instances. These presuppositions extend from pre-understandings to the question of “what is suicide?” Suicidologists overlook asking “how is suicide?” or “how is being in suicide?” Questions such as these are existential-phenomenological in nature. Moreover, suicidology not only presupposes deterministic factors, but also overlooks existentially significant circumstances. The suicidologists presuppose that in answering why, it will solve and prevent people from committing suicide. They fail to take into consideration qualitative traits such as the unpredictability and complexities in behavior. Producing reasons why people commit suicide removes the unique experience of the individual and personal context under which it occurs. However, such rationalizations undeniably provide benefits for preventing some suicides by revealing distinct risk factors involved in biology, psychology, and sociology. Such reasons merely combine intentional choice and risk factors, yet fails to fill the gap between risk factors and the individual occurrence (Honkasalo & Tuominen, 2014, 6). Suicidology neglects the individual’s personal conception of the world, an existentially significant inquiry. Such neglect occurs by prejudging the question of why, viz., their pre-understandings have prejudged the topic and have determined questions. Consequently, suicidology unnecessarily delimits the subject of 14

suicide to what and why questions, thus hindering others from engaging with the phenomenon in enrichening perspectives. Such delimitations produce an unsatisfying understanding of suicide. Suicidologists contend that suicide includes death. From a Heideggerian perspective, it is irrational to refer to death as something waiting independent from Da-sein. Recall that existence includes the condition of being-towards-death wherein instances of living are instances of dying. Death is ontological, a condition of being, not an event externally encountered. Being-towarddeath is an existential condition Da-sein exists in, finalized in death. Thus, suicide possesses existential-ontological dimensions. It must be clarified that in the context that follows, suicide as a phenomenon refers to beingin-suicide (Kuzmanić, 2). Suicide exists so long as Da-sein exists, making suicide uniquely related to one’s existence and inextricable from ontology. Successful suicides clearly have no voice and lack communicative properties. To overcome the unpredictability of suicide and bypass platitude explanations, we must have an impossible discourse with those who completed suicide (Honkasalo & Tuominen, 2014, 17). There is no direct access to these individuals, only witnessed accounts. We are left with no choice but to study those who are suicidal and how they relate to suicide. Suicidal individuals delimit the focus to how Da-sein is in relation to suicide. The closest we may come to studying suicide is examining the nature of suicide in Da-sein, granting us access for understanding the conditions and nature of the being-in-suicide.

2. Existential-Phenomenological Perspective Ontic Dimensions of Suicide As previously mentioned, preliminary grounds for ontological research have their departure on ontics. Ontics depend on the sciences for interpretative understandings of empirical evidence regarding phenomena. Meanwhile, ontological investigations target the experience of being-in. Existential analyses bring about ontological investigations grounded in ontics; however, ontics require clarification (Heidegger, 11). Hence, suicide as a phenomenon may potentially be understood either ontically or ontologically. Ontics pre-understands being. It produces the preparatory groundwork by interpreting scientific knowledge that amounts to the basic constitutions of suicide. Ontology utilizes ontic interpretations to produce an original understanding that reconciles the meaning of being with factual evidence. This strikes into the core of existential experiences such as being-in-suicide. Synthesizing ontic with ontological conceptions of being brings forward a full scope of suicide comprehension. Before proceeding into an ontological investigation, guidance found in the structure of ontic design is required.

Biology, Sociology, Psychology, and Case Studies 15

Ontic understandings, the sciences, typically approach suicide sociologically, biologically, and psychologically. The purpose of each branch is to uncover scientific characteristics relating to suicide in an effort to find its root cause. Case studies contribute to research by using controlled experiments. Within each of these sciences are interdisciplinary sub-specialties. For example: biology relates to genetics and biochemistry; psychology relates to psychopathological, and psychophylaxic factors; sociology relates to cultural, socio-ecological, and interpersonal factors. These disciplines generally intersect because of suicide’s complexities. For instance, a socio-biological study examined the interplay between inheritable biological factors, particularly genes, and environmental risk factors combining biology with social ecology (Mandelli & Serretti, 2013). The study aims at investigating gene and environmental interactions and their effect upon major depression and suicidal behavior. Researchers follow two claims from previous studies arguing that those with major depression disorder are most prone to suicide and suicidal ideality; and suicide development is plausibly genetically transmitted. Delimiting genes led researchers to find significant correspondences with a serotonin-transporting gene, SLC6A4, particularly the short variant S-allele in 5-HTTLPR, and major depression11. Since those with major depression are most prone, scientists determined that 5-HTTLPR is substantially responsible for instances of suicide. For this gene to become expressive, stressful life events are required. Gene-environment theory suggests that stressful life events in conjunction with adverse environmental factors increase the risk of developing suicidal behavior and 5-HTTLPR plays a major role. In another relatively recent publication, researchers investigate two neurological circuits which are biologically associated with pleasure and its polarity, major depression disorder (Loonen & Ivanova, 2016). Investigators postulate two subset components of depressive disorders: ‘worrying,’ a cognitive disorder constituted by dysphoria (the inability to relieve oneself from distress); ‘lust,’ disorder described by anhedonia (the inability to attain pleasure from enjoyable activities). Neuroimaging provides promising evidence suggesting that depression is based on a dysfunction of neuro-circuitry, particularly in the limbic system’s extrapyramidal basal ganglia which corresponds to ‘lust’ disorder, while the limbic basal ganglia corresponds to ‘worrying’ disorder. The former contains circuits responsible for seeking hedonic experiences such as cravings, sex, drugs, and social pleasures; hyperactivity causes anhedonia. The latter contains circuits responsible for seeking relief from environmental stresses; hyperactivity causes dysphoria. If the mentioned studies prove reliable, a correlation should exist between neurobiological circuitry of the limbic region in the brain and the serotonin transportation system, thus causing major depressive disorders, which is accepted as a reliable indicator for suicide. Current treatments include the pharmaceutically prescribed antidepressants SSRI’s and SNRI’s used to interfere with physiological functions of serotonin activity. The top 11 consumers of anti-depressants of 2011, beginning from the highest, includes: Iceland, Australia, Canada, Denmark, Sweden, Portugal, 11

Other genes and alleles affect suicidal behavior, while others effect major depression, and sometimes both. However, the research showed either a minimal effect or association with environmental risk factors. Serotonin transporting gene SLC6A4 is most prominent and continues to fall under speculation in biological investigations.

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UK, Finland, Belgium, Spain, and Norway (OECD, 2014). Disconcertedly, Scandinavian countries are high consumers of anti-depressant medication. 12 However, according to previous studies adults consuming anti-depressants do not express significantly higher suicidality; adolescents and children are at twice the risk (Sharma et al., 2016). What is more disturbing than evidence indicating that anti-depressants double the risk of suicide in youths is the finding that many clinical trials underreport or misidentify adverse effects. Biological chemistry accounts for approximately 45% of suicides, leaving 55% to psychology (OEDC, 2014; Nock, 214, 157), e.g., romantic grief or shame, yet both require life events as stimuli. Psychology receives a significant share of attention in investigating suicide due to its role in recognizing anxiety, stress, and depression’s effects on mental health. A 2015 Norwegian study analyzing maladaptive perfectionism interviewed colleagues of young perfectionist adults without a history of suicide nor disorders, yet completed suicide (Kiamanesh et al., 2015). A pattern emerged. Each case maintained a fracturing of a façade: inability to preserve an idealized condition; followed by a total loss of coping ability in which solvable problems were perceived as unsolvable, causing expressions of negative behaviors; then total escape, wherein suicide appears as complete release from conflicting feelings. In contrast, adaptive perfectionists settle by applying coping strategies to such situations and accepting failures or viable solutions. Escape from self theory is a psychological hypothesis that psychache, e.g., anguish or shame (Shneidman, 1993, 145), causes desires to escape oneself13 (Wijsbek, 2010; Baumeister, 1990). Shneidman argues that suicide is caused by unbearable psychological pain resulting from guilt, shame, humiliation, loneliness, fear, or angst. The individual attempts suicide as an escape from self when psychache exceeds personal limits of psyche pain. Wijsbek refers to the case of a quiet woman with a cruel past, Ms. Boomsma, who found meaning and integrity in her two sons. The death of her children provided the conditions to desire escape from herself. Baumeister argues that failures to fulfill standards or expectations are internalized and pain ensues when inadequacies are realized in self-awareness. Self-awareness of shortcomings causes the individual to seek an escape from such adverse effects, found in cognitive destruction: suicide. According to WHO, on average 900,000 people commit suicide each year, affecting an estimated 60 people per suicide, which means that approximately 48 million people worldwide experience suicide bereavement per year. A British study tested over 3000 respondents under the age of 40 who were exposed after the age of 10 to bereavement of friends or family (Pitman et al., 2016). Studies show that those bereaved by suicide were significantly more probable of attempting suicide than those who experienced bereavement from natural causes, while those bereaved by sudden unnatural causes were not affected. Interestingly, perceived stigma led to a nonsignificant association between suicide bereavement and negative outcomes, indicating a reduced motivation for self-help. That same year, a Swedish study aimed at determining the association between post-stroke suicide or suicide attempts to socioeconomic status (income, civil status, education, and country 12

Discussed in later chapters. The investigations regarding the concept of ‘self’ occupies an especially controversial position in philosophy and other studies. The discussions of self I refer to here are consistent with the author’s conception. 13

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of birth) and time after stroke for over 220,000 patients (Eriksson et al., 2015). Ages between 1854 had a six times higher risk than 85-year-old patients. Men were highest at risk. Socioeconomic groups of single (compared to married/cohabiting), low-level education, and lower income patients have a higher risk for post-stroke suicide attempt. Another interesting set of socio-phenomena include the Werther effect (Phillips, 1974) and Papageno effect (Niederkrotenthaler, 2010). The Werther effect is copycat suicides named after Goethe’s novel The Sorrows of the Young Werther. The Werther effect is a social phenomenon determining that media dramatizations of suicide, especially of celebrities, cause rates to increase. In contrast, the Papageno effect supports the Werther effect yet also shows that when the media reports someone resolving their problems in another manner or when suicide is not glorified, rates decrease. Examples include: subway suicides in Vienna starting in 1983 to 1987; the 1930’s Hungarian song “Gloomy Sunday” influenced an estimated 200 suicides; and cultural honor in suicide for Hungarians. One does not need to dig deep to find instances of individuals attempting or committing suicide influenced by social status or disparages, economic conflict, social resistance, deprivation, alienation, humiliation, shame, betrayal, and other social or economic forces. One may summarize the scientific discoveries of suicide as such: all individuals enter the world biologically predisposed to experience socio-dynamic life events causing the person to react in a manner corresponding to their personal biological, but more significantly, their psychological background. Clinical psychologists claim that life events are the primary cause of mental disorders and genetics play a minimal role (Knapton, 2016). Predetermined biological and psychological dysfunction generally reacts to external stimuli situated in adverse life events including unemployment, child abuse, or alienation, causing mental disorders (bipolar disorders, personality disorders, and depression). Within the biological, social, and psychological intertwinement exists empirical evidence substantiating an imperative focus on external stimuli, particularly stress. DeCatanzaro prompts us to remember the meaning of pathology as “factors producing coping difficulties” (10) arguing that stress factors precede conditions of suicide. Stress produces coping difficulties that when sufficiently intensified produce a sense of inescapable stress and hopelessness which disintegrate psychological coping mechanisms.

Stress embodied (evidence), Manifest (presence), and Assimilation (correspondences) Ontic traverses occupy an objective position in the suicide of the individual. Gene- and neurochemistry-derived mechanisms are shown to influence biological dispositions, making some more vulnerable than others. Malfunctioned psychoprophylaxic and cognitive state of affairs activate biologically dispositional vulnerabilities. Such state of affairs is externally identified in cultural and socio-ecological conditions extending from sociologically organized events. Each disciplinary comprehension holds in accordance an expressive response to stress. DeCatanzaro states that “stress and coping failure appear to facilitate diverse forms of life-threatening behavior” (190). The futile attempt to cope is in itself an experience of stress. In addition, each case study

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referentially devices stress either implicitly or explicitly. This suggests that stress interjects as a critical mechanism in influencing the formulation of suicide. Recall the opening case study investigating the genetic S-allele 5-HTTPLR’s responsibility for triggering suicidal responses via environmental factors. The study indicates that early adversity and acute or chronic stress, e.g., loss, separation, alienation, occupational stress, poor social support, etc., are outcomes of genetic traits and environmental interactions. Adverse genes responsible for suicidal behavior are triggered by stressful life situations. Stress developed from the individual’s personal biological perspective in conjunction with environmental interplay constitutes a pivotal role for psychopathologies. Depending on the biology of the individual and the quality of encountered stress, the individual may detrimentally express suicidal behavior. Stress plays a potentially life-altering presence in this study. The following study concentrated on neuronal circuitry. Researchers correlate anhedonia, ‘lust’ disorder, to the extrapyramidal basal ganglia and dysphoria, ‘worry’ disorder, to the limbic basal ganglia. Findings show that hyperactivity to extrapyramidal basal ganglia brings about anhedonia while hyperactivity to the limbic basal ganglia region causes dysphoria. The term hyperactivity represents stress. Excessive stress exerted to these, causes ‘lust’ or ‘worry’ disorders. While biochemistry and neurobiology exhibit the presence of stress either directly or implicitly in biological components, its manifestation may also be observed in psychologically-related predicaments. The Norwegian case study on perfectionism determined that adaptive perfectionists strictly self-evaluate performances held in an idealized standard but refrain from remaining fixed on constant negative self-appraisal and possess flexible stress-management strategies. Maladaptive perfectionists also evaluate their performances in a strict ideal standard but remain anchored to self-doubt and negative self-appraisal, leading to a lack of psychological mechanisms disabling them from dealing with defeat. Maladaptive perfectionists fracture with unbearable strains of irreversible defeats and failures to the self. They experience the strain, pressure, and tension, viz. the stress, of emotional turmoil of ruptured ideals. Coping inability causes them to linger on a “allor-nothing” mentality. In this mentality, they take the weight of the predicaments’ stress upon their shoulders, claiming full responsibility until coping mechanisms shut down. Perpetually-pressing stress causes the individuals to turn to a total escape from painful and seemingly unsolvable situations in the form of suicide in search of serenity, freedom, and/or love. Throughout the process, maladaptive perfectionists experience an immense quality of destructive stress. How one experiences themselves is consistent with the following cases of psychache, integrity, and self-awareness. In the instance of psychache, the individual endures excessive psychological strain caused by shame, guilt, alienation, anxiety, etc. that crosses the threshold, thus leading to the search for an escape from their own psychology. Ms. Boomsma’s inability to recover from complete loss of integrity and conception of her self 14, which she identified with her role as a mother, led her to cross the limit of her psychological tolerance for pain in the manner of psychache. Baumeister’s view of the individual’s painful awareness of shortcomings which in turn 14

As indicated by the author.

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are adversely internalized as a search for cognitive destruction, follows the same pattern of the manifestation of excessive stress. Identity loss, superfluous psyche pain induced by external matters, excessive acceptance of responsibility, or cognitively damaging self-criticism, all embody an excess of stress placed upon oneself extending from one’s interaction with the world. Under the sociological classification of suicide, social effects on bereavement open the discussion. The previously mentioned study on suicide bereavement indicates that the 10- to 40year-old individuals subjected to the loss of an acquaintance are at an increased risk of suicide after the fact. Those bereaved by suicide as compared to natural or other forms of unnatural deaths experience poor social functioning and occupational resignation. Such adverse outcomes are believed to be generated from perceived stigma. Stigmas deter motivations for help seeking, belongingness, and relief of burden. It is through this social influence that stress presents itself. The bereaved individual typically desires alleviation from such distress yet social pressures seemingly thwart such assistance. Tension exists between the individual’s mental health care and the social implications that result from being affected by an associate’s suicide. The suggestion is that social network factors plausibly contribute to premature death by implicitly exerting stress with unwritten standards and expectations. Social forces hold an ideal standard for the individual that the person is pressured to meet, otherwise social consequences ensue. In sociological studies, socioeconomic factors such as income, civil status, and education accounted for exhibited existential distress. Single individuals as well as those in lower socioeconomic conditions, such as low income and poor education--particularly young males between the ages 20 to 54--are at six times greater risk for suicide. The existential anguish of the subjects is due to meek socio-related obstacles because external pressures place demands for younger individuals which health issues fail to realize. This incompatibility causes psychosocial disturbances creating pressures in a manner that is crippling. Functional debilitations in post-stroke conditions such as cognitive and physical impairment, as well as existential distress such as feelings of hopelessness, seemingly affect younger adults more than their elders. These mental and physical reductions in opposition to social demands impose stress upon young post-stroke patients. Perpetual exertion swells into an intolerable quantity of stress and escape by self-caused death may occur without proper psychosocial support. A final indication of social atmospheric stress is the Werther effect. The Werther effect describes a social phenomenon where media accounts of suicide produce a domino-like trend that elevates the suicide rate. Social media plays a crucial intermediary factor between an incidence of suicide and the public. The fact that individuals take a cue from those who have previously committed suicide may indicate a current underlying pathological condition, such as bereavement disturbance or adaptive distress, to a shifting environment. Studies suggest that media interference affects how individuals experience being in the world. In such mediation, coverage is responsible for distributing various forms of pressures, stresses, or anxieties in mass media outlets. More recent instances of suicide involving stress include: 27 April 2016, an article titled 14-Year-Old Hanged Herself After Posting Video Clapping Back at Her Bullies, accounts for the death of a young teen named Destiny Gleason from Missouri. Her mother’s testimony claims Destiny entered a new school where she struggled for months with social acceptance. She was 20

plagued, demeaned, and sexually exploited by a group of six students until she broadcasted her hanging. On 2 May 2016, An Asylum Seeker is Badly Injured After Setting Herself On Fire On Nauru reports a Nauruan woman seeking Australia’s asylum from a toxic environment in Nauru allegedly created by Australia. The woman set herself on fire in an effort to restructure strict Australian immigration laws impeding on her and other refugees’ safety. 2 May 2016, High-flying head hunter whose business was struggling hanged herself after she was rejected for a ‘less stressful’ job at Boots, inquest hears, accounts for the death of Smita Pandya, 46, who hanged herself in Bristol. She attempted, and failed, to leave a stressful consultancy firm in the aviation industry, which exerted commensurable stress and, in turn, led her to awaken and pursue suicide. Or Greenland’s suicidal epidemic, accounted in The Arctic Suicides: It’s Not The Dark That Kills You, wherein after World War II, Denmark’s attempt to develop the country led villages to shut down, forcing people into cities where they dealt with prejudices, culture clash, forced adaption (homes, education standards, language acquisition, etc.) and altered customs (collective hunting and trading to a mandatory politically industrialized economy). Towns disappeared, homes abandoned, dreams demolished, and prejudices against villagers created—all stress-related conditions originating from colonialism, placing Greenland as the country with the highest suicide rate. Every recent example mentioned is united by various forms of stress, in social, political, or occupational atmospheres. To attain greater insight on suicide, greater emphasis should be placed on the nature and exertion of stress.

Concluding Theories and Models Regarding Suicidology From the biological, psychological, and sociological findings, diverse interdisciplinary manners for understanding suicide in an ontic, viz., objective, dimension emerges. Four primary systems of suicidology come about: 1) primarily extending from biological investigation, we attain a predestination model claiming that we are biologically predisposed to commit suicide. A predestination model combines, for example, neuro mechanisms where monoamines stabilization such as serotonergic S-allele 5-HTTLP and neuro-circuitry determine if the individual commits suicide. For this reason, SSRI’s are popular to properly stabilize serotonin levels by inhibiting transportation and function of neuro activity to deter one’s predisposed fate. The sociogenic model draws on sociological findings claiming that societal factors are responsible for suicides. Sociogenic models appeal to socio-ecology with media interventions, social status, societal expectations, and discriminations. As pointed out, the Werther and Papageno effect prove that social media’s distribution of information holds responsibility for triggering mass psychopathological hysteria, as well as how low social status, income, poorly educated, and bereaved suicides cause vulnerabilities to escape conditions. A cry-for-help model attends to the idea that individuals do not wish to commit suicide; rather, their actions act as signals to alert others of their distress in an effort to request aide. A clear instance was observed in bereavement where individuals in crises refrain from reaching out for a helping hand due to stigma and various social impediments. This effect is noted in Ms. Boomsma,

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as she reached out for a physician-assisted suicide after bereaving for the loss of her children, integrity, and self. Notice that each discipline, model, and level of understanding overlooks an ontological assessment of suicide and pre-understands it as an event where one’s death is eventually met. This occurs because suicidologists engage ontically. Each ontic approach pre-reflectively assumes that components of suicide, such as neurochemistry, psychopathological, or ecological determinants, are absolute and necessarily end with death. This is necessary for ontics because it operates under empirical conditions; however, this neglects the uniqueness of suicide, i.e., the context of what living with suicide is like for the individual. While one who is suicidal may agree with the facts, they may disagree with the understanding of what suicide is, or what it is like. Suicidology lacks in substance and depth. The ontic portion may assist in objectively explaining what the method of procedure is, yet fails to comprehend how it is to be in suicide as a being-in-the-world because it circumvents the essence as supposedly aimed at by a what question. If suicide is nothing more than the ontic-based explanation of biological dispositions inherited or developed, then the explanation avoids personal responsibility for one’s choices and behavior. It encourages the suicidal individual to distance themselves from the condition and accept their physiological makeup as a dominating force they must surrender to. In addition, other non-suicidal individuals are allowed to distance themselves away from the condition itself by claiming that this is just how the suicidal person is, thereby sidestepping any further attempt to understand or assist others. In a Heideggerian perspective, the suicidology models are fundamentally incomprehensible. Their empirical view of death as a biological demise that will one day be encountered implies that death is not present while living. On the contrary, death is an inherent aspect of being human as determined under the conditions of existence, i.e., something each person will one day meet and a fact of existence, not a distant and external event to be encountered. Suicide is something we act out while we are living and death is a condition of life, a certainty, which all human beings inherit at birth. One who is old enough for birth is old enough to die at any moment, and when that moment occurs, death is the ontological state Da-sein will subsume (Heidegger, 228). Suicide exists ontologically as long as one exists, granting suicide an ontological dimension. Human ontology is grounded in existence and existence possesses many conditions for being. Hence, our attention must be turned inwards towards the existence of the individual. In order to address being-in-the-world-with-suicide, the existence of how Da-sein relates to suicide requires analysis.

Ontology

The Insufficiency of Suicidology As discussed, suicidology is concerned with questions that limit our understanding of suicide. Coming from a Heideggerian perspective, suicidology pre-judges suicide by neglecting 22

thorough reflection on the term. Suicidology limits questions of suicide in a pre-judged what and why way, as in “what is suicide?” and “why do people commit suicide?” believing that somehow answering these questions will prevent it. According to Heidegger, these questions can only be answered ontically: as an act of voluntarily killing oneself. To develop an incisive understanding of suicide, it is important to be more open in order to avoid predisposing questions of suicide to too limited an understanding. Therefore, it is more important to ask questions that precede asking what and why by asking how, as in “how is suicide for someone being in the world?” Inwood asserts there are two main ways of understanding being: existentially or predicatively (Inwood, 1997, 15). The existential decides that an entity ‘is.’ The predicative decides what an entity ‘is.’ Both reference the ‘is’ of an entity; however, both are distinguished by the terms that and what. Before asking what suicide ‘is’ in a predicative fashion as most suicidologists do, it must first be established that suicide ‘is,’ viz., the existence and the nature of suicide. By asking how suicide can be, the ‘is’ of suicide is addressed because, as mentioned, suicide exists if the person exists. Hence, how can suicide be within the existence of the individual? Understanding the ‘is’ of suicide addresses the ontology of suicide, the being of suicide that is. This is a feat beyond the scope of ontic approaches; however, it is well situated in ontology. Since suicide occurs when an individual behaves in such a way that brings about suicide, the existence of the suicidal individual requires analysis.

Five Existential Givens: Being-in-the-world-with-others, Mortality, Freedom/Choice (anxiety), Thrownness, and Time “Da-sein is grounded in its existence” where “the ‘substance’ of human-being is…existence” (Heidegger, 110). By this, Heidegger means Da-sein’s capability to question itself derives from its concern of its existence in the world. In addressing the there-of-being, Da-sein, the existence of the individual is pre-conceptually understood in reference to being in the allencompassing world. The world is the a priori surrounding structure where Da-sein resides and discussions about it are organized. Da-sein then must encounter the existential givens presented in the world where it finds itself in how it behaves towards it (Heidegger, 112). As a being (sein) confronting issues in the world, Da-sein is understood as being-in-the-world. It is in the world where Da-sein is pre-conceptualized where existence is grounded, and obtains its essence. Because Da-sein determines the “I” (Heidegger, 110), it confronts affairs in the world. It has a private nature which returns to the individual understanding of one’s own Da-sein. One’s own Da-sein is distinguished from another. Only one being can spatially “be-there.” Personal decisions open new possibilities in confrontation to worldly affairs effecting the being’s future possibilities. It is through the unfolding of future possibilities that Da-sein exhibits existential dimension as a forward-pressing quality where possibilities unfold. Da-sein’s experience of affairs is in relation to the world. Da-sein as being-in-the-world belonging to the individual has its existence in the world. Existence bestows Da-sein with conditions for being-in-the-world with oncoming issues. Regardless of uniqueness, e.g., one’s world as an academic, football player, or biologist, all 23

existences share certain themes. These existential conditions as previously discussed include: being-in-the-world, intersubjectivity, mortality, choice, thrownness, embodiment, space, time, and mood. These existentialles constitute the ontological structure of the individual, how the individual is oriented in the world. Simply, Da-sein is being-in-the-world and is being-in-the-world-withothers, where it is thrown into a world of space and time, has a body, is emotionally ‘attuned,’ is forced to make choices, yet is limited by death15. Da-sein’s relatedness to these qualities determine how the individual is ontologically oriented. How the individual responds to these qualities of existence determines how the person is in relation to an experience such as being-in-suicide. When the topic of suicide is discussed, we actually often mean suicidal. In the question “why did Smita commit suicide?” one is actually inquiring about her life while she was living that essentially led to her premature death. In asking “what is suicide?” one is asking about a living being’s experience of suicide. Since suicide is a phenomenon experienced while living, it belongs to existential-ontology, for it may belong to the individual as long as the person exists. This realization suggests that suicide is an individual consideration of a living person planning or attempting suicide and not a completed suicide. In relation to suicide, five themes are particularly emphasized that essentially affect Da-sein: mortality, choice, being-with-others, time, and thrownness. Concreted grounding, while referring to the ontic case studies and recent incidences of suicide, must occur because Da-sein is grounded on its existence in the world. Further, since each case of suicide concerns Da-sein and its personal life, an ontic starting point is a proper point of departure for elucidating what being-in-suicide is (Kuzmanić, 5), giving the existentialontological understanding of suicide a worldly proportion. Being-in-the-world-with-others Existentialism is not concerned with speculations into the existence the other. In fact, part of existence means being in the world occupied with other beings. One cannot choose to live in a world without people. Therefore, existence, or being-in-the-world, means being-in-the-worldwith-others. For existentialists, the question of higher priority is how the individual relates to others. One may choose to live in physical isolation. Even isolating oneself from others is still an indication of how the individual chooses to relate to others. Beings are indissolubly being-in-theworld-with-others, even if they choose to relate with physical isolation in a remote island, or selfalienation. Da-sein is an individualistically solitary being with a unique existence; it is also beingwith-others. The individual retains its unique existence in Da-sein, yet prevents the individual from falling into solipsistic beliefs. How is suicide related to being-with-others? Studies have shown that the most effective deterrents to suicide are the natural or the synthetic solution. The synthetic solution involves administering low dosages of buprenorphine, opium, in order to reduce the perception of social rejection (Yovell, et al., 2015). The opioid is meant to physiologically alter the individual’s sense perception of intersubjectivity. Hence, the individual’s relatedness to others remains unmodified; however, the drug produces the impression that the individual’s existential circumstance is treated. Regardless, outcomes have shown promising results in dramatically reducing suicide risk, yet not 15

For more information, refer to pages 12-14.

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without the risk of opioid abuse. Due to such risks, pharmaceutical regulatory interventions would be necessary, considering the addictive quality of opioids. The natural remedy against developing suicidal behavior includes engaging in positive social interactions, which includes a listening ear, pleasant discourse with a confidante, or immersing oneself in positive social atmospheres (Deci & Ryan, 2001, 146; Steger & Kashdan, 2009; World Happiness Report, 2013; Hecht, 2013, 222; WHO, 2014, 44). Building and maintaining positive social relations is a common suggestion often overlooked. Most suicide prevention techniques endorse government intervention, education, utilizing health professionals and group assemblages, or the cultivation of strong personal relationships to buffer the impact of external stressors (WHO, 2014, 43-44). Each factor represents interpersonal involvement by either seeking educational contributions, political involvement, or establishing personal companions. For existential therapists, the public world of social dimensions with relations and interactions is referred to as Mitwelt (van Deurzen 2002, 62). The natural approach suggests refining socialization skills or establishing a relational affair with others given that one exists in a reliable social environment. The synthetic method does not modify the suicidal individual’s social conditions, but temporarily alters the person’s neurochemical transportation system to shift perception. It is one’s Mitwelt that is at the heart of the matter in both suicide deterring techniques, for they aim at repairing how the individual relates to others as previously exhibited as a factor for being-in-suicide. Recall Missouri’s Destiny Gleason’s premature death on April, 2016. Her broadcasted suicide is a result from relentless bullying. The group of bullies led to an eclipse of Destiny’s Mitwelt, i.e., severe disconnection and alienation from others. Mortality Existentialists are not concerned with if we die but when and how we relate to it, illustrating their acceptance of death as a given of existence. Mortality refers to the existential quality of beingtowards-death in that all beings are finite. Da-sein is understood ontic-ontologically, meaning a being has a physical body that is preconditioned for death. As temporal beings, we exist between birth and death for we are always moving closer towards death in the ontological conception of being-toward-the-end. However, since Da-sein is ontologically predisposed with death and a being who will die, it is constantly moving towards the end, death, until it finally takes over. Death is the state of being at the end of Da-sein’s being-towards-death (Heidegger, 239). It is the exploration of how the individual relates to mortality that provides the ontological context for death that is importantly linked to authentic existence. For Heidegger, nobody can take death as an existential phenomenon away from Da-sein, including Da-sein itself (ibid, 223). Existing means dying because a priori to death is life as a determining state. However, it is through death that Heidegger argues that we may attain an authentic existence. By authentic existence, Heidegger means Da-sein’s relatedness to death without concealing or evading it, i.e., one’s attitude toward one’s own death. This involves liberating the individual from others’ influence so that one may die one’s own death by becoming aware of and confronting the factual experience of its imminence and individuality (Inwood 1999, 45). As a result, the individual’s authentic relatedness with death will provide the proper motivation required to behave “self-responsibly” 25

that would otherwise be restricted by others’ influences. However, Da-sein always oscillates between authentic and inauthentic attitudes. Inauthenticity conceals ontology from Da-sein with an ontic understanding of death in everydayness. By standardized definitions, suicide and death axiomatically go hand in hand. It is a kind of relatedness one has to death while contemplating suicide. As stated earlier, suicide without death is suicidal; however, as argued, when we discuss suicide, we actually refer to an existing individual with a plan to escape existence. For instance, “why did Destiny commit suicide?” is asking about the motivating forces in Destiny’s life, i.e., her ontology. Suicide then exists as an idea or plan of Da-sein. In this understanding of suicide as idea, Da-sein is existing. Existence is a mode of being that is forward moving, opening various possibilities for Da-sein. Death eliminates all future possibilities for Da-sein. Hence, suicide is Da-sein’s attempt to eliminate all future possibilities by converting death as a possibility into an actuality, expediting a premature death. For Heidegger this constitutes an inauthentic attitude to one’s death since the individual disguises or transforms the possibility of death into an actual event, rather than establishing a relatedness in which it remains a possibility. Existential psychotherapists generally refer to the private world of psychological dimensions including thoughts, feelings, and aspiration identified as one’s own as Eigenwelt (van Deurzen, 2002, 78). In suicide bereavement one confronts a basic and raw reality of life. According to WHO, those bereaved by the suicide of friends or family experience alterations of social dynamics that cause the increased risk for developing mental disorders and suicide risk (2014, 35, 40). Current studies of suicide bereavement have narrowed the age group to 18-40. It is one’s relatedness to the facticity of life, one’s Eigenwelt, that is at issue. Individuals bereaved by suicide are brought nearer to a relatedness of death, thus human temporality becomes more transparent. Those bereaved by suicide express inauthenticity. Mourning for the loss of another is an authentic concern of Mitwelt. The experience of relatedness to death concerns Eigenwelt, concealment or escape from which is inauthentic. If the attitude of the bereaved is authentically expressed toward death, then suicide would act in a life-affirming manner. The individual’s awareness of the ontological condition would cause a confrontation, rather than an escape, with death in a liberating manner where the person is unhindered by its ontic certainty and ontological disposition. Choice Existence is inextricable from choice. Sartre holds that “man is nothing but what he makes himself” (22), corresponding to Heidegger’s description of Da-sein as possibilities and facticity (40, 52). Sartre’s conception that beings “make themselves” refers to a present state directed towards the future. It is in the present that our bestowed options reveal themselves and where our choices effect our future possibilities. By no means does Sartre imply that the past can be altered, which is in agreement with Heidegger’s notion of facticity. Facticity is the fact of how Da-sein actually is in the world, i.e., the way being-in-the-world understands itself through the destiny in which it is bound. Existential therapists refer to facticity as a quality of Umwelt, i.e., the natural world with physical dimensions, because of its subjectively based and immutable variations to its disposition and factual physical environment (van Deurzen, 26

2002, 63). Facticity refers to the conditions one is born or finds oneself in, e.g., one cannot choose what culture, family, or privilege they are born into. Facticity is in correspondence with Sartre’s implication that a being is powerless to change its past; however, a being has the capacity to choose how it relates to it. However, since Da-sein is ontically inseparable from existence, and existence is a forward moving structure that presents and unfolds possibilities, Da-sein is its possibility (Heidegger, 40). Da-sein as being-in-the-world in facticity means that one cannot choose what condition they wish to be born in and possibility means it is perpetually in the realm of uncertainty. One can choose to relate to one’s own being and respond to choice that is self-deterministically formulated as a mode of authenticity, as opposed to falling into absorption of the world and losing one’s quality as an autonomous being (Inwood, 1999, 23). An important aspect that envelops the majority of all existential themes 16 is anxiety. Anxiety is characterized by various constituents such as angst, hopelessness, helplessness, psychache, or despair in an attempt to enframe a particular state of mind associated with desperation. A destructive form of anxiety emerges when the individual either cannot relate to or the relationship to the anxiety is excessively unstable. A creative form occurs when the individual reconnects to their being alive. An authentic choice-making experience causes a sense of anxiety, which makes fear possible because Da-sein exists in uncertainty and strays from the everydayness of choice. The fear extends from intimate inner-exploration and choosing without relying on the choices of others to determine one’s selection. Introspection causes Da-sein to bring forward and understand itself because authentic choosing causes a relational experience where Da-sein confronts itself and its unexpected possibilities in the world. However, Da-sein exists in the world as uncertain possibilities so that all reflective experiences of relatedness are experiences of uncertainty, viz., anxiety. Anxiety is encountered in reflections of relation. Hence, anxiety is an individual experience where Da-sein is shown its “being free for the freedom of choosing and grasping itself” (Heidegger, 176). Because choice is in requisite linked to anxiety and is a subjective experience, all choices are existentially unique in relation to Da-sein and its unfolding of possibilities. Choice is frequently traced to suicide under polarized discussion of autonomy vs. heteronomy, rationality vs. irrationality, or morality vs. immorality. Anxiety is unnecessarily taken to be pathologically tied to suicide. From the perspective of the freedom to choose, anxiety emerges as an inevitable theme of existence leading to enquiry of how one relates to it. Biological dispositions, such as genetic physiological inheritances as in the previous discussion of the major role of 5-HTTLPR in suicide, represents a facticity, i.e., they predetermine presented choices and relations to them. 5-HTTLPR is found in most people, yet how it functions varies from person to person due to environmental components. Recall that Umwelt is the existential category of the natural world. Da-sein has an individual immutable dimension that constructs part of its natural world. How we relate to our own physical, biological components affect how we experience decision making. An awareness of one’s own natural disposition often leads to taking certain measures of finding the means for self-care to retain an openness for 16

Da-sein has the capacity to choose how to relate to being-with-others, mortality, thrownness. In this context, it will be limited to choice.

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possibilities. Those lacking relatedness to their own disposition are under its influence and lose life-affirming relations to their existence, thus closing off future possibilities. In other words, the situation makes them believe they have been deprived of choice and such biological explanations are overly deterministic. It is Da-sein’s specific Umwelt that is at issue, i.e., how one relates to one’s physical and biological facticity. Thus, having an authentic relationship with one’s own biological constitution influences Da-sein’s current understanding of choice and how it experiences those choices in suicide. Time World time is ontic. It is the understanding that the world and all physicality are presented in a dimension that moves within the frame of a perpetual force of continuous duration sometimes called eternity. This is distinguished from Da-sein’s existential experience of time. One may find time or may lose time. Finding or losing time, is an indication that Da-sein relates to temporal time in a subjective manner. A separation of world time as objective and existential time in the subjective sense exists in distinction. World time is the dimension everything operates under and presents itself; existential time is how one relates to time itself. Time as existential is how we conventionally relate to and perceive time, granting it an ontological and multidimensional quality of Da-sein. Mortality refers to the ontological characteristic of the gradual erosion of being. Da-sein’s existential authentic relatedness to mortality perceives time as something finite because of its possibility that death may overtake it at any moment. Time then becomes subjectively understood as a demarcating existential characteristic for the possibilities of Da-sein, i.e., Da-sein and time in relatedness to one another find meaning in death (Alweiss, 2002). Authentically, Da-sein constructs choices based on this realization that bring it closer to its own life. Temporal individuals under the realization of its finite possibilities, attains an increased intimate encounter with itself as such. As a temporal being-towards-death refusing to flee from each choice tailored to its own particular and temporal circumstance, the individual in authentic relatedness interacts with the situation in full disclosure. Hence, an existential perspective of time is subjective, affecting the individual’s present condition in terms of mood, perception, and forward thinking. Time is fundamentally an aspect of Eigenwelt where the individual internally struggles with how their world is shaped, eroded, and reshaped. Those being-in-suicide have a special relatedness to time distinguished from those who are not. It is widely held that depression is the greatest mediator of suicide risk; however, current arguments have shifted speculations toward the individual’s perception of hopelessness (Schlimme, 2010, 238). Hopelessness involves a future prospect in which the individual loses trust that it will bring changes in their condition as observed in maladaptive perfectionists, while depression is a present state. Maladaptive perfectionists’ threestep process (cracking façade, loss of coping, and total escape) is a constant relationship to a future time where their ideal is shaped, eroded, and ends. Da-sein’s ontology holds a certain relatedness to time. For maladaptive perfectionists, time is in relation to themselves, their past, their goal, and their future condition. It is in the disruption of these relationships that they shift to a sense of hopelessness before committing suicide. A care for themselves and others vanishes, thus stripping Da-sein of the recognition of choices except for escape by actualizing the possibility of death. 28

Thrownness Thrownness is the term used to call unchosen worldly conditions and circumstances we find ourselves in the world. Referring to the previous discussion, sometimes we are not free to choose. For instance, we are thrown into being, thrown into a body with a particular biology, thrown into the inevitability of death, thrown into a certain culture and a particular point in time. Decision-making circumstances are situated in a thrown condition. Choices are often made in situations produced by an unchosen previous set of events based on inter-relational context. The importance of thrownness begins with response. Often Da-sein finds itself in circumstances where a choice is demanded. Circumstances for choices vary from one time-period to another. An event as such typically develops without Da-sein’s consent or awareness. For example, nobody chose to become embodied in the body they currently inhabit; nobody chose their parents; and certainly Da-sein encounters unwarranted and heteronomous formed conditions. In such conditions a particular subjective attitude is requested from Da-sein, a response. It is how Da-sein responds that is of interest. If unchosen circumstances of thrownness gain control over Da-sein, the individual falls into the belief that they have no choices and into the danger of developing potentially harmful attitudes such as confusion, lifelessness, or resentment (Cohn, 1997, 126). Because such adverse effects may develop in ignoring the conditions of our thrownness, it is imperative to recognize our thrown situation and establish authentic relatedness to abolish the threat of disturbances they may cause. Hence, the individual may require authentic reflection on the conditions it was thrown into so it may remedy certain adverse conditions. Thrownness is then understood as a physical environment the individual finds itself in, therefore belonging to Umwelt. It may cause a dramatic effect on the individual’s psychic, social, and/or physical world. While thrownness is a relatedness to Da-sein’s ‘given’ conditions e.g., being-inthe-world, interrelations, mortality, and time, it is highly involved with choice. As exhibited with choice, anxiety is rooted17 in thrownness into a world we did not choose. It is thrownness that suicide consistently addresses. Biological case studies address physiological conditions that the individual did not choose to inherit. They are thrown into such a physical condition where their Umwelt is challenged. Psychological advances in suicide consistently refer to psychological disorders or events that disturb the self. The individuals often did not choose to befall under such adverse circumstances that compromises their Eigenwelt, i.e., ego, integrity, or hopes, nor did they choose to respond in such destructive manners. Sociological references to ecological and socio-economic conditions that increase suicide risks exhibit individuals who did not choose cultural or social circumstances where their Mitwelt eclipses. An eclipse of Mitwelt also applies to the individuals from the previously mentioned studies who find themselves in overly stressful occupations or pressed by the necessity to adapt to new environments. Although each unfortunate event resulted in fatal outcomes, it is important to realize every individual responded to each unique situation with suicide.

17

Although not exclusively.

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Orienting Being-in-the-world as suicidal The worlds of Da-sein (intrapsychic, social, and physical worlds) and their previously discussed constituents most significant to suicide have been accentuated to give priority to specific themes dealing with suicide in existentialism. However, this still does not suggest how we should conceive of the suicidal individual. If suicide is an existential-ontological condition, orienting being-in-the-world as suicidal is a reflection on the existential-ontological significance of existing in the world as a suicidal being that interconnects occurrences of suicide. Before proceeding, Dasein as an existing being situated in the world must be oriented with suicide. If being-in-the-world is existence, it means ontologically being in the world as an existing individual. Being is characterized by Da-sein in its literal translation, i.e., there being or, as some prefer, the there of being (Cohen, 1997, 12; Pivčević, 1970, 110). Special emphasis is placed on the term there (Da-). As such, the there where being is, as the current analysis finds itself, is in the world. The world is the place that Da-sein inhabits and it is the world where the there-ness of Dasein indicates. However, the world is ontic or ontological. In the ontic sense, the world is the planet inhabited by physical objects where the activity of all organisms occurs and to which they are bound. Ontologically, on the other hand, world refers to familiarity of one’s reality where things are knit together and form a unified world by expressing meaning (Inwood, 1999, 247). World, then, is demarcated by the individual where it may expand or retract and where all activities occur. It is in the ontological sense that the individual’s world unfolds, thus disclosing Da-sein’s relatedness to its reality and itself. Da-sein in ontological relatedness to its world has a particular significance to the system of objects. All things are interconnected in a unified manner that anchors Da-sein’s world. All things in the person’s world constitutes world, yet all things are in relation to one another; e.g., a wrench refers to tools; tools to excavated metals; nuts, bolts, construction, wood; work, employment; and other referential worldly significances that expand or detract in familiarity. Dasein’s relatedness to itself is disclosing. Objects of familiarity are significant to Da-sein based on their role in its world, involving reasons of relatedness to them. How Da-sein relates discloses the relationship it has toward the world, thus exhibiting characteristics of Da-sein. Da-sein means being and being means existing; and existing means confronting and grappling with the mentioned existential themes. However, the most critical existential themes corresponding to suicide are being-with-others, mortality, choice, time, and thrownness. These five themes have been observed and pointed out to impact the individual. Yet, these they are ontological, everybody carries them. Those who commit suicide must then possess a unique relatedness to the mentioned existential givens that overshadows that person’s world(s) (Mitwelt, Eigenwelt and Umwelt). When an individual relates to one or all of these givens in such a way that Da-sein exists in suicide as a way of being, reorientation occurs. When Da-sein is reoriented, special names are given in an effort to capture this state as a way of being. One such name is “life of suicide” which defines being-in-the-world-in-suicide as the situation in which the act-as-possibility emerges and develops a life of its own (Farber, 2000, 134). The “life of suicide” is an attempt to overcome the obstacle of causality that a psychological 30

understanding of suicide encounters. Specifically, it confronts the false assertion that suicide may be psychologically understood as a chain of causations traced forward and backward as motives are attributed to each cause. This identification of suicide aims at dodging the trap of preunderstandings by examining suicide as a possibility of being. As such, the existential concept of despair, the loss of hope (ibid, 141), is emphasized as a demonic force that eclipses the individual’s worlds of existence (time, being-with-others, choice, mortality), transforming perspectives of truth to despairing truth and perspectives of logic to despairing logic. The individual attains a new image of being, in relation to despair, that shifts worldviews and encounters. Simultaneously, common actions that may have had meaning become meaningless, producing a paralytic effect and excessive focus on the present states and neglect for the past and future. Other efforts in re-orienting suicide as a way of being is found in placing a primary focus on intention, in acting rather than the consequences following an action (Fairbairn, 1995, 14). Efforts that aim to characterize suicide through emphasis on the intentional component may be referred to as the “intentionality of suicide.” The “intentionality of suicide” typically aims at unifying various characteristics to accurately define suicide in order to overcome terminological disparities. Engaging in characterizing suicide in this fashion originates from contextual conflict. Many suicidologists foster and reinterpret theories of the “intentionality of suicide” as a way to universally bind together all clarified instances of intentional acts of suicide, whether concealed or disclosed, and to psychologically analyze potentially suicidal individuals in an effort to identify suicides. Common to all “intentionality of suicide” theorists is the property of possibility found in a range of possible intentional acts (Fairbairn, 1995, 13). By a possibility in intentional act, they refer to the notion that the individual means to act in one way although it is possible for them to have acted in another way. Fundamentally, these theorists desire to unify all instances of suicide under a single description by attempting to delineate the concept of intention as a way to ascribe a particular behavior. Often, this serves as a method to distinguish successful suicides from failed suicides; however, theorist face semantic issues. In light of their locutionary differences, all “intentionality of suicide” theorists generally refer to the behavior of a living, existing human being and to what they secretly disguise or openly expose. Therefore, theorists’ examination of suicidal beings is actually making reference to a being-in-the-world-in-suicide. A third and final indication of an attempt to re-orient the individual as a being-in-suicide involves centering on the self. Escape from self theory (Baumeister, 1990) is a psychological analysis that evaluates an organized process of desiring suicide as an escape from being oneself. Psychological constructivists adopt a fatalistic trajectory toward suicide and anxious suicidal theories (Neimeyer, 2010, 152-153). The former describes an active pursuit to an active choice while the latter refers to a personal crisis triggered by a life event that induces anxiety. Escape from self theory, fatalistic trajectory theory, and anxious suicidal theory all represent different ways of existing in the world as a being who is in suicide. Escape theory organizes a procedure before suicide, how the individual is being in relation to one self, that would make death preferable. Fatalistic trajectory toward suicide constructs a way of being in relation to a self-determined choice. Anxious suicidal theory constructs a life of a suicide in relation to anxiety. All idiosyncratic 31

expressions refer to the life, the existence, of the individual as a being who is in the world and addresses how each relates to their brand of suicide. Therefore, each occurrence is being-in-theworld-in-suicide and concerned with expediting their own death. Suicide is a way of being-in-the-world. However, there appears to be a linguistic confusion in the nature of the use of the term suicide in relation to the presented re-orientations that are of time-tense concern. Suicide is a term commonly used to refer to an individual who has already died or desires to die due to our pre-reflective conceptions. In saying “Destiny’s suicide,” her death is implied, viz., she is no longer being. It makes no sense if suicide is something that can only occur as long as the individual exists, is being. Therefore, when this expression is used, it must refer to the life of Destiny while existing, being-in-suicide. Relatedness of the individual to suicide in the mentioned ontological sense is conventionally defined as being suicidal. However, the term suicidal also refers to the wish to expedite one’s own death, viz., a desire to die. Desiring to die is a hyped form of being-in-the-world-in-suicide since both characterize a way of being. Therefore, being suicidal is being in suicide as a being-in-the-world. Reducibly, suicide is the orientation of being-in-the-world as a suicidal being. When the term suicide is used, implicitly we mean suicidal.

Existential Concepts of Anxiety Characterized by Stress Existentialists notoriously employ the term anxiety, which is often used synonymously with or contextually reconstitutes despair, angst, or dread. However, these terms have a particular vernacular in conventional language. Anxiety, angst, despair, and dread have a negative connotation in the public understanding; they bring on imagery of loss, hurt, desperation, and hopelessness in public use. For existentialists, these set of terms indeed produce adverse effects; however, they may also have beneficial byproducts. Existentialists explain that anxiety (which shall be used to represent angst, despair and dread) may cause a sense of legitimate realization of one’s conditions, where freedom, possibility, or choices disclose themselves if one can existentially calibrate it properly to see through anxious haze. Existentialists righteously argue a generous position for such bleak terms. The trouble with these terms ensue when they enter the public domain in a relatedness consistent with convention. When such terms enter the public sphere, as with suicide, there exists a preconceived understanding of the term anxiety only available to a restricted circle of scholars, making instances of anxiety difficult for the general population to identify. Few efforts aim to contextualize the everydayness existentialists attempt to convey. This lack of contextual relatedness renders people who experience or enter into circumstances probable of anxiety, without proper identification. Without proper identification, what is there to diagnose? For reasons such as inter-linguistic flexibility, I argue for understanding anxiety through the comprehensible lens of stress for its linguistic mobility, its gradient of intensity, and its ability to retain its general meaningfulness under conjugation (e.g. anxious/anxiety and desperate/despair)18.

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When anxiety is conjugated into its present state anxious, some meaning is lost.

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An existential usage of anxiety includes Sartre’s term, despair, as “our limits for reckoning only with those things that depend on our will, or our set of probabilities that enable action” (Sartre, 2007, 34). The “limit for reckoning” is Farber’s mediation of despair into “loss of hope” (141) in that despair is the loss of hope for things that depend on our will or possibilities for action. Both are oriented as prospecting a future toward possibilities. Kierkegaard calls anxiety (frequent translations: dread or angst) as “the dizziness of freedom” (Kierkegaard, 1980, 61). The dizziness is the anxiety when freedom, or choice, is encountered. Heidegger discusses angst as an attunement of being-in-the-world that individualizes and enables anxiety and fear yet may reveal to Da-sein its freedom (Heidegger, 175, 176). Anxiety is a term used to describe a state. The terms also share a theme of choice (freedom) in one’s possibilities as a derivative factor for their state. Anxiety does not necessarily apply to objective material matter but may refer to abstract circumstances. One may experience anxiety over one’s future, or an impending death, or open possibilities, yet the anxiety may not be directed toward a particular object. For existentialists, these are metaphysical concepts concerning being. The terms refer to a state of being and concentrate on delineating it, the state of being anxious. Essentially, these terms possess the ontological function of circumscribing Da-sein’s worlds. Some go so far as to ascribe this state of helplessness, hopelessness, and psychache as a desperate state of mind (Schlimme, 2011, 213). However, appointing the term desperate falls into the same conflict as applying anxious or angst. It provides little insight into what internal or external forces cause such a state. For example, when pondering one’s mortality, why might anxiety emerge and from what? Why can choice create anxiety? We may rely on Hobfoll’s cultural analysis of stress to acquire the substantial context lacking. Cultural analysts have declared that we live in the Age of Anxiety, also interpreted as the Age of Stress, in reference to defining elements of a temporal position in culture (Hobfoll, 1998, 3, 6). It is not accidental that both anxiety and stress are interchangeably employed to define our cultural paradigm. Each age is dominated with certain values. For example, the Stone Age placed stone (weapons, fire, idols, and construction) in the center of its civilization. The Age of Reason placed reason, by mathematics, as the means to truth, logic, and natural laws in the center of its civilization. Following the trajectory, the last 100 years has seen World War I and II, the atomic bomb, the Cold War and politics, newspaper coverage, art, and films that have reflected upon postwar fears. Economies were exhausted to produce bombs, institutions practiced bomb drills, and the reality of threat produced anxiety as the daily order for fear of loss and harm for our values. Stress and anxiety appears to be the law of the age. However, can the two terms be so closely related? To verify, the term stress requires delineation to understand its meaning and contextual references. Stress is commonly presented in an ontic sense. Often it has its basis on biology, psychology, sociology, and other sciences and refers to a pressure exerted upon the individual. In biology, this is a threat to resources required for survival. In psychology, stress is a personenvironment interaction that endangers well-being. In sociology, status commodity demands result in stress. A common theme uniting the three views is the subjective interaction of the individual to its environment. However, our environment is a socially determined world that we are thrown 33

into. It determines our preferences, for example as exhibited in the Stone Age, where stone was of value. In our current condition, values include resources that ensure survival (food and water), cultural tools for protection (employment and knowledge), and status (title, neighborhood, luxuries). Stress is then ontically defined as “the state in which valued goals are threatened or lost, or where individuals are unable to create the necessary conditions for obtaining or sustaining these goals” (Hobfoll, 1998, 28). Stress is predicted to occur when 1) resource loss is threatened; 2) resources are actually lost which help sustain the individual; 3) when individuals do not receive reasonable gain for themselves or their social group after resource investment is made, characterizing it as a loss (Hobfoll, 1998, 45-46). Stress is a challenge on resources experienced as pressure. Within this delineation, stress is the interaction of the individual with its environment, entailing that stress is exerted by any number of subjective circumstances yet generated and sustained by one’s cultural environment. Stress is not attributed to just one circumstance; rather, individuals experience a sense of stress depending on his/her subjective relatedness to their cultural interactions. While stress may have a subjective property on the individual, this does not indicate that general theories of stress cannot be formulated. Various cultures exert distinguished forms of stress upon the population. For instance, while Eastern cultures are generally known to pressure social success for the sake of the individual and familial prestige, Western cultures generally encourage attaining individual sustainment. By knowing the culture, we may know the stressors. Of course, variations and differences may occur; however, considering the values of the Age of Anxiety, it is not irrational to claim that obstacles of attaining or sustaining health, employment, or access to food may threaten one’s conditions, thereby producing stress on some level. What similarities may be drawn between anxiety and stress under these descriptions? Both are about something. Stress is being stressed about something as anxiety is being anxious about something. Stress and anxiety possess intentionality directed toward a concept or thing, such as stress or anxiety about losing employment. The symptoms are similar. A sense of stress about employment may cause the individual to enter a state burdened with pressure. In this state, the gravity of the circumstance may produce an excessive pressure where stress transforms from a minor incident to an extreme one. In such an instance, the stress may paralyze the individual causing her to “reach the limit of reckoning” or evaluate and affirm choices thereby overcoming the “dizziness” of their freedom. Hence stress, like anxiety, has beneficial aspects in that it could cause the individual to evaluate their existence, situation, or choices. As with anxiety, stress is experienced multidimensionally, such as minor anxiety, in which the condition may require action, but is non-threatening; or extreme, in which one experiences a sense of urgency to attend to the internal effect of what the anxiety/stress refers to. Although stress is primarily rooted in ontic distinction, it may have an ontological meaning, as well, that is vastly available and encompassing. Perhaps stress deserves to be viewed in a different lens that may be applied to the power of exertion related to cultural distinction. In doing so, we may predict stress and anxiety not as simply an interaction of individual or environmental agents but as both. Gradients of stress describe circumstances encompassing a majority of 34

experiences in which extreme stress may cause hopelessness, helplessness, and despair by breaking down mental coping mechanisms. However, ontologically, stress is the force encountered when uncertainty of choice emerges, when livelihood is threatened, or when values are compromised, in which case we are being stressed by the given situation, concept, or thing. Just as anxiety may move the individual into a state of desperation (anxiousness), stress may produce the same results. In the ontological understanding, the term stress may substitute anxiety yet retain its subjective appeal.

Reflecting on the Nature of Being in Suicide In essence, suicide is Da-sein’s relatedness to itself. Da-sein is an existing entity, characterized as being-in-the-world. yet being-in-the-world is an ontological constitution of existence. As a being existing in the world as a suicidal, certain conditions apply. The suicidal individual is in a particular relation to its own being-in-the-world, that is, being-in-the-world-withothers, suggesting that it is in a constant relatedness to its Mitwelt. Even if Da-sein chooses isolation, it cannot be the case that being enters the world without others; rather, Da-sein chooses how to relate to them. This addresses the concept of choice. The awareness of freedom to choose, such as in how to relate to others, may cause dizziness. The dizziness is the experience of the freedom to choose, which is characterized as anxiety. However, the conventional view of anxiety holds negative connotations, unless accessed existentially, and is often limited and inflexible. An alternative term is the ontological understanding of stress. Stress is multifaceted in its linguistic usage: “I am so stressed,” “you are stressing me out,” “my job has placed an unbearable amount of stress on me and I have exceeded my limit” are gradient ways of addressing stress on many levels, yet the term is conjugated in various ways. In conjugation, the nomenclature maintains its significance and original meaning depending on the context or personal appraisal legitimizing degree of intensity. Therefore, if the individual encounters the dizziness of freedom, they actually experience a form of stress caused by choice, which varies based on individual differences that may be predicted by cultural values. Culture as a deterministic convention is an example of thrownness. A being is thrown into a heteronomous culture or unique situation where choices are demanded and suicide obtains. It is in such thrownness that the suicidal may come to believe that they have no control over their existence or choice regressing them into a paralytic state of stress. In thrownness, Da-sein existentially inherits time and mortality, in which Da-sein experiences itself as a temporal being. The individual’s relation to time is a subjective experience rather than a worldly understanding where mortality becomes apparent. Since Da-sein is a temporal being in relatedness to time, it is constantly directed toward death as being-toward-death. In Da-sein’s transience, Da-sein may produce life-affirming choices or become paralyzed by the ontological condition as a temporal being. It is here that the individual may take the inauthentic route of a life-denying approach in which Da-sein can choose to eliminate all its possibilities by actualizing death in the form of expediting temporality.

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What can be extrapolated in the existential-ontological relation to being-in-suicide? Suicide is a behavioral disposition in the world in relation to five themes of existence. If Da-sein is initially thrown into a certain social world and particular contextual circumstances that shape what is valuable yet produce obstacles for attaining/sustaining them and convert them into stress, suicide must be primarily tied to experiences with the worldly affairs. However, it is this social aspect that particularly affects how the individual relates to the five givens, for it is socio-culture that sets the condition, determines resources that are of value, and often throws us into conflicting situations that impede attaining or sustaining those resources. Perhaps an existential-ontological insight into suicide criticizes external (worldly) conditions more than the individual herself, such as declining resilience to common social interactions leading to emotional crisis (Gray, 2015) or deplorable labor conditions leading to mass suicide (Moore, 2012). Since the individual is thrown into a particular world, it is presented with certain choices and enveloped with stress-causing experiences. Perhaps the Age of Anxiety is a coercive circumstance in which the freedom to choose is a catch-22. If this is the case, our choices involve what flavor of stress is chosen and how much is unbearable. Typically, the greatest weight produces the greatest outcome of resources. This requires a fundamental understanding of oneself and evaluating oneself against all stress-related circumstances. In this characterization, there exists a relation between the individual as being-inthe-world and a relation to its external conditions.

Experience of Suicide as an Existential Being Heidegger states that a phenomenon sometimes “presents itself in itself” as semblance in which it appears to be, thus presenting itself yet disclosing itself not making it known (25-26). This begs the questions, when is there being-in-suicide but appears as though there is none? Where is it hidden? Must one be depressed to commit suicide; why do some depressed people commit suicide but not all? Do happy people commit suicide? We may imagine a person who has had a fulfilling life with riches, friendship, experiences, family, and a rewarding career, who recognizes their blessed life. In self-reflection they may decide to commit suicide to bring their fortunate life to a dramatic end, thus avoiding unpleasant failures, psychasthenia, and social interplay. What is the phenomenology of the existential being in suicide? To answer this, it must first be investigated how and where suicide is concealed.

Phenomenological Concealment of Suicide In the commencement of this analysis, statistics were presented declaring that suicide rates average at approximately one million worldwide, with that number expected to nearly double by the year 2020. In justification of the prediction, consider a May 2016 article Suicide Epidemic In America Alarming: Why Are people Killing Themselves; or April 2016 Suicide in the U.S. on the rise, with spike for girls age 10-14; April 2016 U.S. suicide rate has increased drastically since turn of the century; April 2016 US Suicide Rates up 24 Percent Over 15 Years, CDC Finds; March 2016 Suicide Isn’t Just an Older Man’s Problem; and October 2015 Life and death under austerity. 36

Recent reports entail that suicide rates are predictably escalating especially in the U.S., UK, and Australia. Concordantly, recent reports claim that Scandinavian suicide deaths have been misreported (Tøllefsen et.al., 2015). Although minimal reclassification occurred, suicide is perceived as hidden and potentially miscomprehended across many Scandinavian countries. Further evidence expands that strong indications of under-reported suicides concealed as undetermined or accidental deaths exist in UK, Portugal, Switzerland, Sweden, Denmark, Germany, Greece, and the U.S. (Pritchard & Hansen, 2014). While the study found that this mostly pertains to females, many countries exhibit a hiddenness of suicide. Ample evidence justifies an escalation in both suicide rates and concealment. Where is suicide hidden and how is it concealed? This line of enquiry asks: where is there suicide in instances when it seems like there is not? In the presumed Age of Anxiety, suicide may be hidden in the happiest of people and veiled in stigma. Claims suggest that many who think about suicide or suicidal mental disorders desist from actually going through with the act, such that one is capable of suicide without desiring suicide (Van Orden, 2010, 7, 18). Recall that in the ontic sense, suicide pertains to the individual that is already dead, therefore there is no direct access to the individual. Hence we must look at the life of how the being is in suicide by examining existing behaviors and the life of the individual. It is not uncommon to discuss suicide with loved ones and receive confident responses dismissing suicide as subject matter of personal application, or to be misdiagnosed with a nonsuicidal disorder, or to encounter an intelligent, athletic, privileged young adult who takes their own life. Such is the case for neuropsychological suicidologist Federico Sanchez. Many suicidologists, including Sanchez, believe that stigma in society leads to inaccurate statistical reports of under-reported suicide and misdiagnoses (Sanchez, 2010, 11; Pitman, 2015). However, socially stigmatizing suicide is a cultural invention. Some cultures glorify suicide, such as traditional Hungarians; others, such as the Amazonian Piraha tribe, do not conceive it. Stigma is an aspect of relating to being-in-the-world-with-others that prevents individuals from behaving in a particular manner as unwritten law. If the convention is broken, the standard results are shame, guilt, humiliation, or alienation. Such consequences may produce devastating effects causing the individual to initiate or manage the concealment of suicide in order to avoid demeaning social exposition. Pharmaceutical medication may alter the devastation of stigma transgression, not resolve it, by reducing the effect but still be perceived as stained with violation. Even so, if sufficiently concealed, anti-suicide medication may never reach the individual. The suicidal individual may feel reluctant to confess suicide ideation for fear of being humiliated, appearing powerless, or possessing insufficient reason to justify such behavior, such as in the wealthy and privileged. Ironically, many more developed countries with greater privileges sometimes trend higher in the suicide scale than developing neighbors. For example, geographically, the U.S. ranks 50 as highest suicide rate, while Mexico ranks 137, and Canada 70 (WHO, 2012)19 (naturally, sometimes the inverse is true, such as Germany ranking 77, Austria at 19

http://apps.who.int/gho/data/node.main.MHSUICIDE?lang=en

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54, Poland at 24). Perhaps this is due to an inherent cultural openness, empathy, or understanding amongst the population. However, it seems as though suicide creeps in the darkness of society searching for even the happiest of victims, who are confronted with conflicts and jeopardizes personal values. Recall that conflicts that compromise resources and values cause stress. Violating cultural stigma, such as admitting suicide behavior, commonly produces humiliation or guilt. Personal degradations such as these are in relation to Mitwelt, i.e., to the world of others. Stigma is always socially constructed in unwritten laws that infringes on and plausibly results in shame from others. The suicidal individual is then appointed guilt for his/her own shortcomings, whether it be suicide bereavement, uncontrollable biological dysfunction, mental disorder, etc., when suicide is stigmatized. The person is held responsible for their own mental health and well-being. If the resources for attaining or sustaining well-being fall short, the individual encounters stress. Stress is admitted, but stigma abstains one from confessing the stress is unbearable to the brink of beingin-suicide, thereby concealing it. The social consequences threaten status and valued resources in blaming the individual for their inadequacy for personal sustainability in individualistic cultures, especially those that declare that the individual inherits the infinite opportunities to succeed at birth. Status is linked to social appraisal, weighing the value of the individual, in which material things linked to status determine how much emotional reward that person will receive. To preserve possible access to values and resources, the person is forced to conceal their being. It appears that suicide is substantially induced and concealed in stress: the stress of losing employment without a replacement; the stress of maintaining health when resources are impeded; or experiencing the pressure of rejecting assistance in excessively stressful circumstances because they compromise wealth, social status, and opportunity. Recall the mentioned colonization of Greenland discussing that it is not the arctic winters that are to blame for suicide, but the disturbance of the Inuit culture instead. Accounts describe how dreams transformed from becoming a talented hunter/trader to factory labor and corporate employee, or how forced relocation led to deserted homes and leaving their old self behind. The majority of the Inuit Greenlandic population rightfully did not trust help-seeking services because those services belonged to the colonizers. Expectedly, suicide rates spiked. It became an unspoken problem, the elephant in the room. During the forced adoption process, culture and way of living, stress, became concealed throughout society. Actions exhibited a request for help gone unheard until Atsa Schmidt and Anda Poulsen organized a single support group for people bereaved or troubled by suicide, which developed into Greenland’s first suicide assistance facility. In such support groups, the stigma vanished—all participants were understood as affected by suicide. In the support groups, the veil of suicide was removed, stress was unpacked, and citizens in proximity generally benefitted from the ability to expose their vulnerabilities, generally disallowed outside of the support group’s environment. However detrimental as stress may seem, it also possesses beneficial properties. While some Inuit Greenlanders suffered severe trauma, others utilized the situation to develop the linguistic requirements, absorb an alternative culture, and expanded psychological boundaries. Native Greenlander, Anda Poulsen, forced himself to adapt yet continuously faced suicidal 38

thoughts, considering his line of work exposes him to the pains encountered by friends, family, and children. Thus concealing his suicide and redistributing it in Nuuk drum dancing as a form of coping. For Anda, stress fortunately played a role in involving himself in social work, diplomatically mediating the primary culture with those suicidal. It also motivated him to reflect on himself to discover a coping mechanism that reconnected him to his roots as a native Greenlander. In the given incident, suicide may be concealed within a population; however, there are individual instances as well. Consider the individual instance of Smita Pandya, who committed suicide after failing to attain a “less stressful” job. Although not recorded as a suicide for unclear intentions, she had been battling with depression for over 10 years until she was found hanging in her home with a letter rejecting her attempt to swap her current stress-ridden career to a less stressful one. Others were unable to desist her suicide because she sufficiently concealed her demeanor. Otherwise, we may reasonably assume that family or friends would have prevented the incident. Essentially, stress destroyed her by thrusting her to being-in-suicide. The Greenlandic and Smita’s event represent suicide concealment. Both remind us of our vulnerabilities. Perhaps on a social scale, we take ourselves and our capacity to endure inconsiderable intersubjective interactions without repercussions for granted. Suicide prevails as a concealed behavior, making it notoriously complicated to identify; it remains obscure and expresses itself through stress while cultural stigmas create the conditions to cause the stress to become excessive to the degree of suicide. However, both paradigms share one crucial component: intersubjective interference.

Intersubjective Experience: Suicidal Being-with-others Existence means inheriting Mitwelt as a world of being-in-the-world-with-others. Previously, assertions stated that existence in suicide is linked to a relation to one’s Mitwelt. This does little to explain why research shows why Muslim-identified countries have the lowest suicide rate compared to those identified with other dominant world religions and atheism (Bertolote & Feischman, 2002) or why when countries go to war the male suicide rates in that country significantly drop (Sanchez, 2010, 41). Speculation attribute this declination of suicide rate to collective individual’s authenticating relations to Mitwelt, in which an intensified relation to one’s community occurs. Muslim countries are found to have a tightly-knit social community which provides those within with certain resources and personal life meaning. In times of war, it is thought that patriotic impulses spike, thereby bringing people together and generating an intensified relatedness to one’s community and nation. Intersubjectivity refers to the existence of the individual between conscious minds—of two or more subjects (friends, community, culture or society). Earlier delineations discussed Da-sein’s holism in material and immaterial properties, mind, body, spirit and its spatial-temporally beingthere in the world. A ‘given’ of the existence of Da-sein is foremost acquiring relatedness to beingin-the-world-with-others. Da-sein takes possession of intersubjectivity at birth. What is the experience of being-in-the-world-with-others that causes suicide? 39

The Interpersonal Theory of Suicide provides a sustainable and comprehensive model that allows us to obtain insight into the intersubjective experience of being-in-suicide (Van Orden, et.al., 2010). Previous theories lack precision in predicting suicidal behaviors by holding certain mental disorders and risk factors responsible that statistically hold low suicide rates within the group, therefore having low predictive qualities. Interpersonal Theory of Suicide takes the position that a combined development of a hopeless state of thwarted belongingness and self-perceived sense of burdensomeness, along with the capability (not desire) for suicide, cause individuals to develop alarmingly high risk for self-murder. The theory assimilates the most substantial risk factor for suicide, namely: family conflict, mental disorders, history of previous suicide attempts, physical illness (HIV/AIDS, terminal cancer), social isolation, unemployment, and stressful life events (childhood trauma, homelessness). Social isolation constitutes a crucial risk factor. When the need to belong is hindered, it may be reinterpreted as thwarted belongingness. Belongingness carries two factors: positive and long-term interaction with the same people. If obstructed, loneliness and the absence of reciprocated care occurs, bringing about an obstruction to cognitive and behavioral mechanisms, yet a higher awareness of stimuli connected to social belongingness called perceptual ‘narrowing.’ To test this hypothesis, laboratory tests indicated the presence of high levels of thwarted belongingness accompanied with perceived burdensomeness in suicidal individuals. Perceived burdensomeness is consistent with the risk factors family conflict, unemployment, and physical illness, due to their association with negative life events. Family conflict may bring about feelings of burdensomeness and dispensability to family members, primarily affecting developing youths. Unemployment and physical illnesses (e.g., brain cancer) may strain family sustainability, giving the individual the impression of self-perceived burdensomeness. Burdensomeness produces two factors: self-hatred and self-appraisal as flawed and liable to others. Perceived burdensomeness and thwarted belongingness were consistently observed in suicide notes, validating the involvement of these two factors. Finally, if the previous factors reach a degree of hopelessness, one gains the capability for suicide. Desire/intent is insufficient to proceed with the act of self-murder because suicide requires conquering the fear of pain and death. The theory argues that the individual must be capable of engaging with suicide by elevating pain thresholds and conditioning. Through continuous exposure, such as in unsuccessful suicide attempts, the individual may raise tolerance for pain and overcome their fear of death. Studies showed that those who were commonly exposed to painful experiences held a higher tolerance for pain. Meanwhile, additional tests between suicide idealizers without attempted suicide and suicide idealizers with attempted suicide exhibited a higher sense of fear for individuals who had not attempted suicide. Further, impulsive behavior exposes the individual to greater risk-taking behavior, thus habitually elevating risk for painful or typically fearful experiences. Hence, intent or desire is inadequate criteria for engaging in suicide; one must also possess the psychological capacity by losing all fear of repercussions. Intersubjective theory of Suicide plays a crucial role in child development and substantially affects adult minds. The experiences children attain in family matters mold their plastic minds. The theory states that negative experiences in family conditions influence the child’s mind into 40

perceiving themselves as burdensome, resulting in lowered self-esteem, self-hatred, and seeking solutions; they ask themselves, “how can I help fix this situation that I am burdening?” One response may involve physically escaping by searching for alternative living situations. Another response may be remaining in a household where one’s self-image involves the manifestation of a stress factor. The child perceives themselves as a strain, a factor of stress unintentionally exerted upon others. It is important to note that the child impresses stress upon and perceives themselves as a stress upon others. Consistent with previous discussions, the child may stigmatically conceal thoughts regarding their burdening. If this environment advances, the concealing child risks developing mental disorders linked to their burdensomeness, such as chronic thoughts of pessimism, social isolation, learned helplessness, or personality disorders. However, perceived burdensomeness is multidimensional, as it possesses gradient experiences. Family may not undo past conflictual occurrences, for it is in the domain of facticity. Interceptive communication may reduce the degree of stress on the child. The family may halt, reduce or remove the progression of perceived burdensomeness before it advances into a critical state of hopelessness, given proper attention. Hence, children require positive attention from beloved family members to experience belongingness and reduce suicide risks. In contrast, minds capable of high-level abstract thinking experience burdensomeness in a world expanded. Conventionally, adults encounter broader exposure to the world demanding wider ranges of interpersonal relation. Responsibilities for employment, wealth, education and status are prominent factors of one’s existence. Engagements with others is prioritized as a resource for attaining such factors. Burdensomeness is then perceived as a counter-productive concept for retaining social integration. Since burdensomeness is perceived as an imposed stress upon others and additional stress is typically unwanted, it is often physically removed. Effects include selfhatred--“I could not maintain employment, therefore I must be a terrible person”—or self appraisal as flawed to the degree of liability to others--“I failed those who rely on my income, therefore something must be wrong with me.” Burdensomeness works against the individual causing further strain on obtaining and supporting valued resources offered by interpersonal engagements. Those fortunate to obtain resources that elevate status often receive emotional rewards in the form of praise (e.g., purchasing a new vehicle is often rewarded with commendation). Hence, the fortunate individual gains greater access to belonging and diminishing preexisting burdensomeness. A perceived sense of burdensomeness is the stimuli required to activate biological mechanisms (genes, neurocircuitry). Here, one’s existential worlds become increasingly significant. Perceiving oneself as a strain to others has been argued to cause negative effects that may not necessarily result in isolation. One may experience a sense of belongingness yet believe they burden others, e.g., a wounded soldier or inmate. Self-appraised burdensomeness originates from interactions and relatedness with being-in-the-world-with-others. Burdensomeness is internalized as shame for oneself, as indicated by personal defect as a responsibility to others, thereby disclosing a factor that could register genetic and bio-neuro activity. The particular cultural conditions that cause burdensomeness regard the intersubjective phenomena that activates certain biological dispositions, including being-in-suicide. As burdensomeness is multidimensional, degrees vary suggesting individual and social responsibility for contributing to a person’s beingin-suicide by impeding on their efforts to attain a perceived burdenless existence. Evidence 41

suggests that being-in-suicide is a cultural issue; that is to say, burdensomeness is determined by others. Concordantly, thwarted belongingness is linked to psychological and social ontic investigations of suicide. Escape from self theories and socio- factors declare that personal or societal factors are primarily responsible for producing the conditions that cause suicide. The individual’s relationship to themselves may cause the desire for psychological escape. Socioeconomic risk factors for suicide include: civil status (single), poor education, and low income. Thwarted belongingness is tied to loneliness and unreciprocated care. The development of these disclose critical risk factors: isolation, unemployment, and stress. Isolation is directly related to a single living situation; unemployment directly effects income and indirectly affects education and civil status access; stress involves thwarted attempts to enhance socioeconomic conditions. Hopeless perceptions of escape from threatening conditions may lead to the desire to escape oneself. Since one is culturally denied access to psychological needs, belongingness is not a luxury but a cultural resource that thwarts suicide by providing the means to access education, livable income, and access to others to sustain positive long-term relationships. The theory takes the existential notion that we are not simply isolated individuals. In praxis to the daily intersubjective relatedness, the behavior individuals receive from others determines their psychological stability, health, and access to necessary resources/values. Family conflict, unemployment, and illness were presented as stress factors that prevent us from valued resources for the benefit and survival of ourselves and others. According to Interpersonal Theory of Suicide, these mentioned factors also represent the most crucial suicide risk factors. The individual’s intersubjective experience with others has cognitive and behavioral consequences that may determine ease of access to resources. If obstructed, the risk of suicide increases. If accessibility is available (although the resources are necessary, the Age of Stress suggests that necessary resources are not given but earned, indicating that stress in some form must be endured), suicidal behavior may falter. Hence politics’ influence in socioeconomic involvement determines cultural relations to deterring and causing suicide.

Subjective Experience: Suicidal Being-towards-Death The primary concern of the Interpersonal Theory of Suicide is the individual’s dynamic of Mitwelt. The theory emphasizes an awareness of itself in intersubjective relatedness; for example, the person’s liability, inflicting stress, reciprocation of care, and alienation. Social isolation has devastating effects on one’s economic, educational, and prospective possibilities that influence status and perceptions. Hence, it is Da-sein’s ontological relatedness at the heart of the matter, viz., the being’s relatedness of itself to itself as determined by external circumstances. Interpersonal Theory of Suicide states that in a vast majority of cases, perceptions of liability are “misperceptions amendable through therapeutic modification” (Van Orden et al., 2010, 13). If the person misperceives its own liability towards others, that person must possess a certain relatedness to others. However, thwarted belongingness represents an additional component responsible for suicide risks that holds an experience of relatedness to others that may cause alienation. Indications 42

depict misapprehensions of relatedness the individual holds. The questions are then raised, what is it like to be-in-suicide as a being thrown in the world with others, who is limited by mortality, and forced to confront choices in a temporal-relational atmosphere? How does stigma force the individual to conceal being-in-suicide? Schlimme’s subjective phenomenological model argues that being-in-suicide requires three characteristics for a desperate individual: consciousness of oneself, consciousness of mortality, and (most critically) certifiable knowledge of suicide as a last resort for changing desperation (Schlimme, 2011). The characteristics can be existentially reinterpreted as being-inthe-world, mortality, and choice. For Schlimme, consciousness for oneself suggests that suicide always possesses some minimal aspect of self-determination (autonomy). However, desperation causes a cognitive and behavioral modification called ‘narrowing’ (e.g. indifference, selfinefficacy, hopelessness, conflicting interests, etc.), that disrupts perception of choice, thus reducing peripheral vision and choices causing heteronomous behavior. Additionally, Schlimme believes the cause of the desperate state is irrelevant because most states are similar. Is not the source of desperation key for recognizing, avoiding, and defending against excessively negative conditions? Interpersonal Theory of Suicide highlights two pre-suicide factors, thwarted belongingness and burdensomeness qualified as hopeless. Schlimme delineates the individual’s suicidal state with three traits: consciousness of self, mortality, and the knowledge of the possibility for suicide as a final resort for change. Suicide is pre-symptomatically a state of despair equated with hopelessness (ibid, 213). Additionally, the crucial characteristic of a “final resort for change” suggests the individual is hopeless in generating change with every possibility except suicide. Finally, analysis of psychiatric disorders most responsible for suicide--depression, schizophrenia, and alcoholism-show that the majority do not commit suicide. Those who do reported hopelessness, leading research to conclude that hopelessness is a stronger indicator of suicide than depression (Pompili, 2010, 238). This is due to the discerning timely nature: depression is a pessimistic individual concerned with the now and hopelessness is one concerned with the future. Therefore, hopelessness is not about how the individual currently feels, but about perceived trust for the future to provide change. However, it is important to understand the what of hopelessness; what causes hopelessness is responsible for being-in-suicide. Hopelessness is not always a negative condition or an unhappy position. Experiences of hopelessness may cause replacement of goals with superior aspirations—or the individual may possess an apathetic attitude, inconsistent with sorrow. From a compatibilist’s perspective, context of the individual’s condition in the world determines survival or ruination of hopelessness. However, hopelessness is always phenomenologically intentional—it is always hopeless about something. Culture determines the valued resources of a society (e.g., The Stone Age, Bronze Age, Age of Enlightenment, etc.) which, if impeded, causes stress. Valuable resources are fundamentally socio-economically (wealth, status, employment, etc.) based. Excessive stress creates mental conflict that may manifest into a severe pathological or physical illness. Valued resources are perceived as valuable because the individual believes they assist in enhancing their 43

prevailing existence in opportunities and psychic needs (self-esteem, glorification, belongingness, etc.). Because we have culturally-determined resources, we have pre-reflectively shaped values that enhance survival strategies. Therefore, hopelessness is directed towards the external world which in turn supplies stressful conditions. To recognize and defend against stressful life events as conducive to suicide, Pompili supports the ancient Greek aphorism “Know Thy Self” (2010, 235). The reason this is of value is because suicide begins with the person. It invites the individual to initiate a phenomenological analysis starting with them and their relatedness to the world. For example, if the person is in extreme stress or desperation, it is knowledgeable to first recognize this condition and evaluate the cause. The individual may choose to tinker with levels of relatedness or perhaps abandon the situation altogether. This holds true for biological dispositions. Awareness of one’s physiological conditions may offer cues for avoidance, or where to tread carefully, and why. Hence, extensive value exists for understanding condition-producing stresses that accumulate hopelessness, as well as how one is ontic-ontologically oriented. If we turn to biology, it provides us with valuable ontic understandings of the agent. Biology represents a predisposition in a culture that probes responses from individuals with stress infliction. Since biological dispositions vary, some people are more susceptible to suicide because of distinctive physiological systems; some suicide, others do not. However, biology is a facticity of our conditions. Without consent, Da-sein is thrown into the body it inhabits. From this we extrapolate that the individual who experiences ‘narrowing’ due to biology is remedied with medication or therapeutic consultation. Previous discussions mentioned reports stating that over 50% of the people suffering from suicide do so due to non-biological factors suggesting the necessity for therapeutic intervention. Only under 50% of suicide sufferers require medication. However, those who suffer from physiological imbalances, if they “know themselves,” may consider cautious measures for living a particular existence with certain relations tailored to their needs. This may prove difficult so long as the mentioned stigma against suicide continues forcing concealment. Stigma, then, typically rests in the back of the individual’s mind, depriving them from exhibiting vulnerability from a stress-induced hopeless state. Affirmative diagnosis or therapeutic labeling becomes a facticity of the individual which may cause shame, humiliation, or an admittance of fragility in relatedness to others. Mitwelt relations (e.g., romantic relationships, trust, friendships) are more threatening to suicide than animal attacks, car accidents, and violence combined (WHO, 2014). Romantic love affairs, disloyal friendships, or bullying, etc. represent feelings of betrayal, shame, or humiliation that may lead to lasting conditions or pathologies. This is because the individual’s Mitwelt becomes subservient to painful experiences. Mitwelt is such an integral part of our existence for it determines virtually all opportunities for physical well-being and psychological maintenance, health, and well-being. If cultivated, alienation may manifest into disorders contributive to suicide, such as Typus Melancholicus (melancholy type). Symptoms include: over concern for others, excessive sense of liability, submissiveness, emotional insecurity, etc. (Macdonald & Naudin, 2014, 32). Notice the intensity the individual relates to others in Typus Melancholicus. More acute relationships typically produce the most destructive psychological 44

effects. This extends from both the cultural resource of being valued by others and the individual’s psychological investment squandered or abused by others, demonstrating our psychological vulnerability and the relevance for positive relations to others. It is others that typically enhance the individual’s esteem and sense of value and it is also others that deprive it of hope. The tragic suicides of Smita Pandya and Destiny Gleason represent the important role of others. Both victims sought acceptance in their social worlds in two distinct cultures, yet the subjective suicides occurred with corresponding traits. Both held a value for others: Smita for salvation from unbearable stress in another company, Destiny in assimilating into a belongingness at school. Investment, rejection, and social assault from Mitvelt represented a denial of psychological needs for self-value, self-efficacy, and belongingness, which may have acted as life-saving rights. However, persistence of relentless stress transforms into hopelessness. Hopelessness alters psychology causing restricted peripheral vision of altering or escaping given conditions. As perceptual narrowing transpires, salvation appears in the final form of suicide. This occurs in subjective relation with one’s existence in a particular culture. The facticity of the individual plays an imperative role in how life events affect a person. However, life events are external, relational, and concealable. The individual may believe the tragically stressful life event is positive, thus falling into inauthenticity by failing to take selfresponsibility for the circumstance and concealing it from oneself/others. Regardless, each individual possesses a unique history and a certain biological disposition that partially determines influence of life events. Life events are the world of the individual (Mitwelt, Umwelt, Eigenwelt). Most of the world is linked to a world of social interactions that share certain values that act as resources to advance or sustain the individual. It is the denial or adversity to achieve the possession of such resources that produces stress. Therefore, stressful life events are circumstances in a person’s life that hinder the attainment or protection of valued resources (both psychological and biological). These resources are earned in Mitwelt. Unbearable stress induced by Mitwelt causes extreme distress, responsible for thwarting needs that may reach the tipping point and manifest into a state of hopelessness. Hopelessness alters behavioral and cognitive mechanisms to the degree that being-in-suicide occurs, unless certain preventative measures are taken. Once beingin-suicide occurs, the individual’s mental alteration perceives existence in an alternative lens.

Existential-phenomenology of Suicide Freud explains that suicide is the murderous impulse for another directed inward. In melancholia, an object is lost and the ego recreates a representation of that which is lost inside the self, living in the ego. Since the desire to kill perpetuates yet the objective representation is lacking, it turns the desire to itself (Volkan, 2009, 95-96; Sanchez, 2010, 16). This is transference in which one concept is substituted for another—the body of self destruction is actually the other. Must the individual truly desire the death of another to desire the death of themselves? An existential-phenomenological understanding asserts that Freud’s process is erroneous. For existentialism, the body of destruction represents what the self is relationally directed to. It is the individual’s relation to the object/concept that disturbs the individual. For example, Freudian 45

psychoanalysis of a snake may be translated as a transference of a phallic symbol which represents the actual subconscious concept referentially attributed by the individual. Existentialphenomenology takes the snake as just that, yet inquires the relationship the individual has to snakes (Umwelt), such as with previous encounters, personal meaning, or value. It does not attempt to convert the snake into a symbol of masculinity. Existential-phenomenology does not approach Da-sein’s relation to the world by substituting one concept/object for another, such as in suicide risk in bereavement. Suicide risk from suicide bereavement is about the relatedness to the loss of the victim—not about Da-sein’s desire to kill the person lost. Therefore, suicide involves related experiences to worldly phenomena as they are or appear. Suicide is no exception. Suicide is more about our own ontological-existential relatedness to the world and worldly phenomena. The conditions of the existence of Da-sein and the experience of how Da-sein relates to the world under those conditions is of utmost importance for understanding how the individual is. As claimed, the existential givens of time, mortality, thrownness, intersubjectivity, and choice substantially influence the transition into and the experience of the being of suicide. For Schlimme, the key component constituting being-in-suicide is a desperate being’s knowledge for the possibility to commit suicide as a final option for change. This refers to choice, stress, and alludes to time and mortality. Knowledge for the possibility of suicide is the freedom to choose suicide--a primary ontological component of existential-phenomenology. The notion of a final option refers to stress of the ‘narrowing’ of possibilities to a final choice, i.e., anxiety for no more options. Desperate states and final options for change suggest hopelessness for future change if desperation implies hopelessness for a future solution. For this to occur, Da-sein must be aware that it possesses a capacity for death i.e., mortality. However, intersubjectivity has a crucial role in suicide that cannot be extracted from the existence of the individual, as demonstrated by Van Orden et al. While Schlimme pays close attention to Eigenwelt, Van Orden argues for the significance of Mitwelt. Virtually all suicidologists agree that suicide does not concern one factor but a combination of factors, appealing to its complexity. A synthesis exists under the proceedings of existential-phenomenology. All individuals are thrown into existence and into a variety of situations in which a particular body is occupied. Naturally, the embodiment of the individual is biologically based, suggesting that certain physiological mechanisms will respond to particular stimuli. Some are fortunate to have a balanced biological disposition while others do not. Those on one extreme suffer excessively. Too much suffering often refers to maladapted coping mechanisms to biologists; however, most successfully refrain from suicide. Those who suffer too much often experience traumatic upbringing and develop personality disorders. Individuals on the opposite spectrum insufficiently suffer. Typically, we imagine the sheltered, privileged type without stress, challenges or suffering. Stress and suffering are important in developing self-responsibility, i.e., an authentic existence in which goals are met, values are achieved, and psychological growth occurs. For example, Van Orden et al. revealed that those with unmet belongingness possess heightened motivation to connect with others and have an elevated detection for stimuli relevant to belongingness (2010, 11). Therefore, the proper level of suffering is subjectively tailored to the 46

individual based on the facticity of their thrownness; that is to say, different people are thrown into a particular body which is thrown into a certain culture and find themselves thrown into a range of situations. Da-sein has no control on how it is thrown, e.g., what family or culture it wishes to be born into, but it has the capacity to establish a relatedness to its thrownness. One aspect that is certain is Da-sein will be thrown into a particular culture where it must exist in intersubjective relatedness. How Da-sein establishes its relatedness to others is perhaps the most fundamental and influential characteristic that disrupts the experiences of existence that move Da-sein into being-in-suicide. Suicide is not a primordial desire to self-annihilate nor the hidden urge to kill another; it emerges with exposure and interaction with certain activity. Suicide concerns Da-sein as a being that carries a certain ontology existing in the world, as well as how it relates to its organization and management. The way things are organized is dependent on the culture. Culture is a stage of civilization in which behaviors, norms, and values are shared. Da-sein is thrown into culture where certain values are pre-established. These values are resources required for survival which act as secondary resources in order to attain primary resources (education, status, etc.) or protection for oneself and significant others. Values differ from judgment. Judgements are reflective evaluations based on interests, i.e., a relatedness established by the individual [consciousness], while values are pre-reflective and automatic [unconscious] (Schlimme, 2011, 216). When Da-sein is thrown into the world and into a particular culture, it is thrown and exposed to the pre-reflective values of that society that protect survival and interests. The valued resources of a culture produce stress. Denying or hindering Da-sein of its ability or simply concealing the tools required for protection causes stress. Stress alters Da-sein’s consciousness, hence its behavior. Da-sein’s ontological characteristics are under the influence of stress. Under the influence of stress, Da-sein re-establishes its relatedness to time, mortality, choice, and being-in-the-world-with-others, often in an inauthentic fashion. Obtaining, sustaining, and protecting valued resources involves intersubjective interaction yet induces stress. Wealth, status, education, shelter, health, nourishment, and psychological needs are possessed externally within the construct of one’s cultural paradigm. Thwarted resources escalate levels of stress producing superfluous exertions that may devastate the individual’s existential condition or benefit it. As mentioned, how the individual governs these stresses has a subjective relation based on the thrownness of their existence. Those well-off with the proper tools, privileged with security, wealth, education, etc., will succeed, thus benefiting from the condition of suffering stress. Others proceed in suffering by accumulating stress and move toward tragic states. Those who advance in shouldering the stress find themselves in a crossroad: acceptance or concealment. Both attitudes fail to unburden the stress; however, the consequences differ. Acceptance of stress is perceived as a display of vulnerability. The social consequences are disclosed in the relatedness between the individual and others. Others often view the individual as a failure for her inability to withstand the pressure, resulting in shame or humiliation. However, it is the interaction with others that impose the obstruction that causes the goal to be unmet. For example, a desire for purchasing a decent meal or a gift for an offspring but being unable to because of unavailable employment. The physical consequences may be cruel, but the psychological 47

consequences are ruinous. Continuous encounters or one significantly abhorrent encounter of thwarted attainment of valued resources, considerably those linked to psychological needs, have the power to cause excessive stress. Excessive stress, viz., unbearable stress, is perceived as acceptance of defeat. Unbearable stress is the tipping point that leads Da-sein to the state of hopelessness. This perception extends from the stigma that surrounds suicide. More common than encountering acceptance of stress is concealing stress. We exist in an Age of Stress and overlook this condition. This suggests that stress affects Da-sein’s existence. Stress is the theme of culture resonating from capitalism. Therefore, there is no need to resist stress but accept it as the condition of culture. Hence when Da-sein encounters stress, unspoken expectations require the individual to conceal, i.e., do not complain but tolerate. Concealment occurs because it is interpreted by others as an excuse. Therefore, the individual is trapped in declaring incapability and being perceived with reduced value or in hiding their condition and aiming to overcome it before it accumulates to excessive levels. It is uncommon to encounter individuals admitting to excessive levels of stress because stigma shrouds the concept. Excessive stress causes Da-sein to enter a state of hopelessness. Excessive stress is known to cause perceptual ‘narrowing’ because its persistent presence raises difficulties to focus one’s consciousness away from the circumstance. Repeated exposure reflectively incapacitates the individual and judgment is reshaped, gradually shadowing consciousness. When reflective conscious abilities sufficiently narrow to the confinement of lesser options, hopelessness for altering one’s condition sets in (such behavior is perceived in maladaptive perfectionism, although maladaptive perfectionism is not necessary to experience narrowing). Typically, we attribute exercising choice to consciousness (Shepherd, 2011, 922). Choosing involves consciousness of self-responsibility. Perceptual narrowing occurs with stress that eclipses consciousness which causes choices to appear absent from one’s periphery resulting in an absence of hope for change. Suicide literature recognizes the significance of hopelessness yet rarely attempts to discuss the aboutness of hopelessness, what Da-sein is hopeless about. Certainly, Da-sein is hopeless about something of value. As argued, values are culturally grounded and resourceful to psychological and physical well-being. For Van Orden, the individual is hopeless about belongingness and burdenlessness. However, belongingness and burdenlessness are intersubjective means for physical and psychological fulfillment. Belonging and acceptance (Mitwelt) by others is the primary means for acquiring resources. Yet, it is others that consistently deny or hinder valued resource acquisition. Therefore, Da-sein is hopeless about the acquisition of vital resources due to social prohibition or obstruction. However, hopelessness produces additional grim consequences for Da-sein. Hopelessness in Da-sein cause existential-ontological inauthenticity. Hopelessness convolutes Da-sein’s ontological relatedness, causing time, mortality, and choice to distort. For Da-sein, hopelessness is hopeless about attaining physical or psychological resources. It perceives an absence of future choices for attaining the value. This places Da-sein in a time relation to the desire. Da-sein relates to the fulfillment of its goal in the negative. No foreseeable future, no possibility exists for Da-sein, in which the resource may be obtained. As a final resort, suicide 48

appears as a remedy; however, this is typically a concealment where suicide resides. Da-sein misconceives its future possibilities. Considering the effect of ‘narrowing,’ misconceiving future possibilities as there being an absence of options comes easily for those in hopelessness. As Heidegger reminds us, Da-sein is possibility (40). He means that Da-sein as existing is futureoriented and thereby inherits various versions of being. Being is not complete as long as one exists. Therefore, in regards to hopelessness, the absence of future possibilities for change is an illusion and Da-sein stands in inauthentic relation to time. Hopelessness is a state of being that provides the entrance for being-in-suicide. Death from being-in-suicide is not a remedy, but an inauthentic ontological relatedness to time in which the individual chooses to eliminate all possibilities. Utter hopelessness also influences choice. Ontological relatedness to time touches upon this existential-ontological trait. Recall that choice creates stress. The individual may find herself choosing between two or more desirable options. The individual may select one, select none, or perhaps create synthetic choices. Essentially, the individual is confined to that particular instance to make a selection while another instance may present itself with similar arrangements. Existentially, this is a new situation with a similar organization but with a new history, distinct time period, and perhaps a distinct mode of attunement. Hopelessness conceals Da-sein from this perception. Rather, after hopelessness leads Da-sein into being-in-suicide, choices are in relatedness to an absence of choice. As with time, Da-sein is in inauthentic relatedness to choice in believing that they are under the dominion of being-in-suicide and perceiving death as their final choice for change/escape. This is another outcome of ‘narrowing,’ emphasizing the dangers of utter hopelessness. The individual typically has other possibilities, such as leaving the situation, but may feel bound to the sinister predicament in a sense of exaggerated self-responsibility. Or the individual may attempt to neutralize its relatedness so that unperceivable options open into new possibilities thus broadening its perceptual narrowing. Expediting Da-sein’s mortality is an inauthentic relatedness to choice and time, for Da-sein is under the influence of hopelessness, providing the individual with false impressions that withholds her of possibility. When cultural conditions cause hopelessness in acts of resource acquisition, Da-sein’s mortality discloses itself by becoming exposed and exploited. Hopeless endeavors to advance oneself often seem meaningless in conceiving of the struggle as having no effect for one’s future (time) and in a perceived deprivation of choice. Suffering loses its value when efforts go unrewarded, viz., when culture denies the individual access to valued resources. As beings with a past which is utilized in the present to apply on the future who are hopelessly denied of this liberty for authentic self-determination, death seem preferable. Death is a fact of existence yet a possibility for Da-sein. As long as one is living that person will die, yet as long as Da-sein is, within its possibilities it will one day not be. Expediting death robs Da-sein of this and all possibilities. Thus, being-in-suicide is a relation to Da-sein that threatens to deprive it of its possibilities. Central to the experience of being-in-suicide is valuable resource acquisition in the form of physical and psychological needs. Such physical needs typically include primary survival resources, such as food and shelter, but also wealth, transportation, and employment for obtaining and protecting needs. Psychological requirements include social status, education, belongingness, self-esteem, and even the ability to distance oneself from circumstances that threaten resource loss. 49

However, the predicament involves cultural and societal obstacles that cannot be resolved simply by financial investment in poverty, health, or consumer goods. Being-in-suicide is a reminder of the Age of Stress and cultural status we inhabit where we find an absence of hope, meaning, and acceptance. Perhaps happiness is a luxury of existence created by compassion that we find in short supply, and minimizing suffering should be our first priority. So long as a stigma remains, suicide will remain concealed as cloak and dagger, the rational and the irrational, the judge and the executioner. As long as suicide is hidden from others in the world, assistance and compassion will never reach those in dire need.

3. Concluding Remarks: Happiness-Suicide Paradox Diametric of Suicide in Polarized Minds The substantial influence of culture in producing excessive subjective levels of stress is responsible for arousing hopeless conditions that diminished perceptual choices to the extent of causing suicide contemplation. It comes as no surprise that individualistic cultures find lesser success rates than collectivistic cultures in happiness pursuits (Ford et al., 2015). Mitwelt affects all aspects of physical and psychological experiences of well-being in existence. Current individualistic cultures and those moving toward individualism are at greatest risk for escalated suicides. Happiness research neglects strategies for well-being that includes suicide rates, psychiatric morbidity, and hospitalization (Bray & Gunnell, 2006). This occurs because most researchers themselves possess perceptual narrowing focused on positive psychological effects. Increasing awareness of this polarized mentality has recently emerged without serious attention. Social psychological researchers recently found that prioritizing happiness is associated with depression and bipolar disorder (Ford & Gruber, 2014; Ford et al., 2015), emphasizing the paradoxical effects of happiness pursuits. Speculations predict this effect to occur because culture shapes emotions and desires. This tragic outcome extends from thrownness into a predetermined society with preexisting values individuals must adopt for basic survival, hedonic pleasures, and flourishing. The true question of happiness is “what are the negative consequences of happiness?,” (Cahn & Vitrano, 2015, 71) for even happiness has diametrically negative consequences. Happiness produces an extraordinary effect for uniting happy people, thus maintaining a polarized view on countries, communities, and individuals. However, there exists a surplus of company on the dark side of life that can be saved, partly by becoming aware of the community of sufferers (Hecht, 2013, 220). Members of the community of sufferers with bipolar disorder and depression, for instance, represent a majority of those at highest risk for suicide because they are ostracized from happier communities. However, many sufferers value their adversity because it may bring about growth, development, depth, and wisdom. Sufferers attempt an existential investment of hope for a prosperous future, particularly in educational and psychological dimensions. Suffering is not an existential defect but an existential-ontological actuality in relatedness to time for self-improvement that deserves proper attention and assimilation. 50

While the community of sufferers remains ignored, happiness has remained the focus of progressive research, and a reliance on positive psychology, often referred to as the science of happiness, has led to a perpetuation of the polar view. Yet, positive psychology is questionable as an authentic and credible science. Social psychologists have analyzed positive psychology and its drawbacks, thus implementing a non-polarized view on the subject matter, revealing its encouragement of positive individualism using tautological mantras (Pérez-Álvarez, 2012). By positive individualism, authors mean a development of secularized metaphysics that opens to selfhelp literature excessively focused on the individual as a separate entity, thus increasingly neglecting being-with-others. Positive psychology is contextual as determined by one’s existential condition and relies on pseudoscientific mantric claims insinuating that well-being improves health, i.e., happiness causes well-being. Such epidemic mentality produces a population indiscernible from those with manic disorders and pressures those under extreme stress, unemployed, alienated, etc. to be inappropriately happy. Such pressure is an additional stress and if happiness is not grasped, the individual is guilty for their incompetence. The individual is psychologically punished and ostracized as positive psychology prevails. If previous studies are accurate, this places a society in danger of transforming into an individualistic culture primed for escalating suicide rates by forcing individuals to conceal their pain. In exchange, others are falsely lead to believe they exist in a happy environment because the sufferer is responsible for their own happiness, an additional false belief that illegitimately extracts Da-sein from being-with-others. As mentioned, the question that should guide all happiness related endeavors is “What are the negative consequences of this attractive pursuit?” If none are found, the question has not been pondered sufficiently (Cahn & Vitrano, 72). In the instance of happiness goals, happiness has the capacity to divide a culture into an individualistic society that perceptually restricts a fundamental and critical aspect of existence, being-in-the-world-with-others. By diagnosing suicide in an existential-phenomenological methodology, it becomes apparent that the happiness-suicide paradox is a cultural outcome that affects intersubjective interactions by over-individualizing the population using ‘happiology.’ People then focus on their own level of stress and well-being, while developing an inauthentic relation to Mitwelt. The individual’s relatedness to time, choice, death, others, and thrownness are fundamentally linked to experiences with Mitwelt. High suicide rates in happy countries are a result of a cultural fracture that individualizes people as they are pressured to reciprocate positive mantra even in the most inappropriate circumstances. Such responses appoint unnecessary burden of stress on the individual. As presented, stress has the capability to arouse suicide, depression, or other disorders. Furthermore, those who chose not to adopt the effects of happiology are typically conceived as inferior and shamed for their defect. They become a burden to others and are denied belongingness. Because this social pressure exists, it is common to encounter individuals who falsely proclaim their happiness and conceal their actual sentiments.

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References

Alweiss, Lilian. "Heidegger and `the Concept of Time'" History of the Human Sciences 15.3 (2002): 117-32. Web. Baumeister, Roy F. "Suicide as Escape from Self." Psychological Review97.1 (1990): 90-113. Web. Bähr, Andreas. Between “Self-Murder” and “Suicide”: The Modern Etymology of Self-Killing. Oxford University Press: 2013. Beauchamp, L. Tom. “Suicide” Matters of Life and Death. Ed. Tom Regan. New York. 1980. Bertolote, José Manoel, and Alexandra Fleischmann. "A Global Perspective in the Epidemiology of Suicide." Suicidologi 7.2 (2002): 6-8. Web. Brandt, B. Richard. Morality, Utilitarianism, and Rights. New York, New York. Cambridge University Press: 1992 Bray, Isabelle, and David Gunnell. "Suicide Rates, Life Satisfaction and Happiness as Markers for Population Mental Health." Social Psychiatry and Psychiatric Epidemiology Soc Psychiat Epidemiol 41.5 (2006): 333-37. Web. Cahn, Steven M., and Christine Vitrano. Happiness and Goodness: Philosophical Reflections on Living Well. New York: Columbia UP, 2015. Print. Camus, Albert. The Myth of Sisyphus, and Other Essays. Trans. Justin O'Brien. New York: Vintage, 1991. Print. Cohn, Hans W. Existential Thought and Therapeutic Practice: An Introduction to Existential Psychotherapy. Sage Publications, 1997. Print. Cowley, Christopher. "Suicide Is Neither Rational nor Irrational." Ethical Theory and Moral Practice 9.5 (2006): 495-504. Springer. Web. Daly, Mary C., Andrew J. Oswald, Daniel Wilson, and Stephen Wu. "Dark Contrasts: The Paradox of High Rates of Suicide in Happy Places." Journal of Economic Behavior & Organization 80.3 (2011): 435-42. Elsevier. Web. De Leo, D., Burgis, S., Bertolote, J., Kerkhof, A. D. M., & Bille-Brahu, U. (2004). Definitionsof suicidal behavior. In D. De Leo, U. Bille-Brahe, A. D. M. Kerkhof, & A. Schmidtke (Eds.), suicidal behavior: Theories and research findings (pp. 17-39). Washington DC: Hogrefe & Huber. DeCatanzaro, Denys. Suicide and Self-Damaging Behavior: A Sociobiological Perspective. New York: Academic, 1981. Print. Deurzen, Emmy Van. Existential Counselling & Psychotherapy in Practice. London: Sage Publications, 2002. Print. 52

Durkheim, Emile. Suicide: A Study in Sociology. Trans. John A. Spaulding and George Simpson. The Taylor & Francis E-Library. 2005 Ekeberg. "Are Suicide Deaths Under-reported? Nationwide Re-evaluations of 1800 Deaths in Scandinavia." BMJ Open 5.11 (2015). Web. Eriksson, Marie, Eva-Lotta Glader, Bo Norrving, and Kjell Asplund. "Poststroke Suicide Attempts and Completed Suicides: A Socioeconomic and Nationwide Perspective." Neurology 84.17 (2015): 1732-738. American Academy of Neurology. Web. Fairbairn, Gavin J. Contemplating Suicide: The Language and Ethics of Self-harm. London: Routledge, 1995. Taylor & Francis E-Library, 2005. Web. Fairbairn, Gavin J. "Suicide, Language, and Clinical Practice."Philosophy, Psychiatry, & Psychology 5.2 (1998): 157-69. Project MUSE. Johns Hopkins University Press. Web. Farber, Leslie H. "Despair and the Life of Suicide." The Ways of the Will: Selected Essays. New York: Basic, 2000. 133-56. Print. Ford, Brett Q., Amanda J. Shallcross, Iris B. Mauss, Victoria A. Floerke, and June Gruber. "Desperately Seeking Happiness: Valuing Happiness Is Associated With Symptoms and Diagnosis of Depression." Journal of Social and Clinical Psychology 33.10 (2014): 890-905. Web. Ford, Brett Q., Iris B. Mauss, and June Gruber. "Valuing Happiness Is Associated with Bipolar Disorder." Emotion 15.2 (2015): 211-22. Web. Ford, Brett Q., Julia O. Dmitrieva, Daniel Heller, Yulia Chentsova-Dutton, Igor Grossmann, Maya Tamir, Yukiko Uchida, Birgit Koopmann-Holm, Victoria A. Floerke, Meike Uhrig, Tatiana Bokhan, and Iris B. Mauss. "Culture Shapes Whether the Pursuit of Happiness Predicts Higher or Lower Well-being." Journal of Experimental Psychology: General 144.6 (2015): 1053-062. Web. Gray, Peter. "Declining Student Resilience: A Serious Problem for Colleges." Psychology Today. Sussex, 22 Sept. 2015. Web. Gvion Y, Apter A. Suicide and suicidal behavior. Public Health Reviews. 2012;34: epub ahead of print. Hecht, Jennifer Michael. "Suffering and Happiness." Stay: A History of Suicide and the Philosophies against It. N.p.: Yale UP, 2013. 209-23. JSTOR. Web. Heidegger, Martin. Being and Time: A Translation of Sein Und Zeit. Trans. Joan Stambaugh. Albany, NY: State U of New York, 1996. Print. Helliwell, John F., Richard Layard, and Jeffrey Sachs, eds 2013. "World Happiness Report 2013." New York: UN Sustainable Development Solutions Network Hobfoll, Stevan E. Stress, Culture, and Community: The Psychology and Philosophy of Stress. New York: Plenum, 1998. Print.

53

Honkasalo, Marja-Liisa, and Miira Tuominen. "Introduction. Varieties of Suicide: Inquiring into the Complexity of Human Experience." Introduction. Culture, Suicide, and the Human Condition. Ed. Marja-Liisa Honkasalo and Miira Tuominen. New York/Oxford: Berghahn, 2014. 1-26. Print. Husserl, Edmund. Cartesian Meditations: An Introduction to Phenomenology. Trans. Dorion Cairns. The Hague: Martinus Nijhoff, 1960. Print. Inwood, Michael J. A Heidegger Dictionary. Oxford, UK: Blackwell, 1999. Print. Inwood, Michael J. Heidegger: A Very Short Introduction. Oxford: Oxford UP, 1997. Print. Ivanoff, Andre. "Identifying Psychological Correlates of Suicidal Behavior in Jail and Detention Facilities." Psych Quart Psychiatric Quarterly. 60.1 (1989): 73-84. Web. Jamison, Kay R. Night Falls Fast: Understanding Suicide. New York: Knopf, 1999. Print. Kiamanesh, Parvin, Gudrun Dieserud, and Hanne Haavind. "From a Cracking Façade to a Total Escape: Maladaptive Perfectionism and Suicide." Death Studies 39.5 (2015): 316-22. Web. Kierkegaard, Søren. The Concept of Anxiety: A Simple Psychologically Orienting Deliberation on the Dogmatic Issue of Hereditary Sin. Trans. Reidar Thomte. Ed. Albert Anderson. Princeton, NJ: Princeton UP, 1980. Print. Knapton, Sarah. "Mental Illness Mostly Caused by Life Events Not Genetics, Argue Psychologists." Telegraph. Telegraph Media Group, 28 Mar. 2016. Web. Kuzmanić, Marija. “Suicide from an existential-phenomenological perspective”. UP PINT. Koper, Slovenia. Li, Norman P., and Satoshi Kanazawa. "Country Roads, Take Me Home… to My Friends: How Intelligence, Population Density, and Friendship Affect Modern Happiness." British Journal of Psychology(2016): n. pag. Wiley Online Library. Web. Loonen, A.J.M., and S.A. Ivanova. "Circuits Regulating Pleasure and Happiness in Major Depression." Medical Hypotheses 87 (2016): 14-21. Web. Macann, Christopher E. Four Phenomenological Philosophers: Husserl, Heidegger, Sartre, Merleau-Ponty. London: Routledge, 1993. Web Macdonald, Charles J. H., and Jean Naudin. "The Construction of the Suicidal Self in Phenomenological Psychology." Ed. Marja-Liisa Honkasalo and Miira Tuominen. Culture, Suicide, and the Human Condition. New York/Oxford: Berghahn, 2014. 29-45. Print. Mandelli, Laura, and Alessandro Serretti. "Gene Environment Interaction Studies in Depression and Suicidal Behavior: An Update." Neuroscience & Biobehavioral Reviews 37.10 (2013): 2375397. Web. Margolis, Joseph. Negativities: The Limits of Life. Columbus. 1975. pp. 23-36

54

Mayo, D.J. (1992). What is being predicted?: The definition of “suicide.” In R. Maris, A. Berman, J. Maltsberger, & R. Yufit (Eds.), Assessment and prediction of suicide, (pp. 88–101). New York: Guilford. Mauss, Iris B., Maya Tamir, Craig L. Anderson, and Nicole S. Savino. "Can Seeking Happiness Make People Unhappy? Paradoxical Effects of Valuing Happiness": Correction to Mauss, Tamir, Anderson, and Savino (2011)." Emotion 11.4 (2011): 767. National Institute of Health. Web. Mischel, W., Cantor, N., & Feldman, S. (1996). Principles of self-regulation: The nature of willpower and self-control. In E. T. Higgins & A. W. Kruglanski (Eds.), Social psychology: Handbook of basic principles (pp. 329–360). New York: Guilford Press. Moore, Malcolm. "'Mass Suicide' Protest at Apple Manufacturer Foxconn Factory." The Telegraph. Telegraph Media Group, 11 Jan. 2012. Web. Neimeyer, Robert A. "Suicide: A Personal Construction." Suicide in the Words of Suicidologists. Ed. Maurizio Pompili. Hauppauge, NY: Nova Science, 2010. 151-54. Web. Niederkrotenthaler, Thomas, Martin Voracek, Arno Herberth, Benedikt Till, Markus Strauss, Elmar Etzersdorfer, Brigitte Eisenwort, and Gernot Sonneck. "Role of Media Reports in Completed and Prevented Suicide: Werther v. Papageno Effects." The British Journal of Psychiatry 197.3 (2010): 234-43. Web. Nock, Matthew, ed. The Oxford Handbook of Suicide and Self-injury. New York/Oxford: Oxford UP, 2014. Print. OECD. (2014), Antidepressants consumption, 2000 and 2011 available), in Making Mental Health Count, OECD Publishing, Paris.

(or

nearest

year

Orden, Kimberly A. Van, Tracy K. Witte, Kelly C. Cukrowicz, Scott R. Braithwaite, Edward A. Selby, and Thomas E. Joiner, Jr. "The Interpersonal Theory of Suicide." Psychological Review 117.2 (2010): 575-600. Web. Pawelski, James O. "Happiness and Its Opposites." Oxford Handbooks Online (2013): 325-36. Web. Pérez-Álvarez, Marino. "Positive Psychology: Sympathetic Magic."Papeles Del Psicólogo 33.3 (2012): 183-201. Web. Phillips, David P. "The Influence of Suggestion on Suicide: Substantive and Theoretical Implications of the Werther Effect." American Sociological Review 39.3 (1974): 340-54. JSTOR. Web. Pitman, Alexandra L., David P J Osborn, Khadija Rantell, and Michael B. King. "Bereavement by Suicide as a Risk Factor for Suicide Attempt: A Cross-sectional National UK-wide Study of 3432 Young Bereaved Adults." BMJ Open 6.1 (2016): n. pag. Web. Pivčević, Edo. Husserl and Phenomenology. London: Hutchinson, 1970. Print.

55

Pompili, Maurizio. "Exploring the Phenomenology of Suicide." Suicide and Life-Threatening Behavior 40.3 (2010): 234-44. The American Association of Suicidology. Web. Pompili, Maurizio. "Exploring the Phenomenology of Suicide." Suicide and Life-Threatening Behavior 40.3 (2010): 234-44. Web. Pritchard, Colin, and Lars Hansen. "Examining Undetermined and Accidental Deaths as Source of ‘Under-Reported-Suicide’ by Age and Sex in Twenty Western Countries."Community Ment Health J Community Mental Health Journal 51.3 (2014): 365-76. Web. Rosenbaum, Stephen E. "How to Be Dead and Not Care: A Defense of Epicurus." The Metaphysics of Death. Ed. John Martin Fischer. Stanford, CA: Stanford UP, 1993. 119-34. Print. Rosenberg, Mark L., Lucy E. Davidson, Jack C. Smith, Alan L. Berman, Herb Buzbee, George Gantner, George A. Gay, Barbara Moore-Lewis, Don Harper Mills, Don Murray, Patrick W. O'carroll, and David Jobes. "Operational Criteria for the Determination of Suicide." Journal of Forensic Sciences J. Forensic Sci. 33.6 (1988): 1445-455. Web. Ryan, Richard M., and Edward L. Deci. "On Happiness and Human Potentials: A Review of Research on Hedonic and Eudaimonic Well-Being." Annual Review of Psychology 52.1 (2001): 141-66. Web. Sanchez, Federico. Understanding Suicide and Its Prevention: A Neuropsychological Approach. Xlibris: USA. Amazon, 15 June 2010. Web. Sartre, Jean-Paul. Existentialism Is a Humanism (L'Existentialisme Est Un Humanisme): Including, a Commentary on The Stranger (Explication De L'Étranger). Ed. John Kulka. Trans. Carol Macomber. New Haven/London: Yale UP, 2007. Print. Saxena, Shekhar, Etienne G. Krug, and Oleg Chestnov. Preventing Suicide: A Global Imperative. Luxembourg: WHO, 2014. Print. Science X. "Under-reported Suicides May Be Hiding or Compounding the Tragedy." Bournemouth U, 2015. Web. Schlimme, Jann E. "Sense of Self-determination and the Suicidal Experience. A Phenomenological Approach." Medicine, Health Care and Philosophy Med Health Care and Philos 16.2 (2013): 21123. Springer. Web. Sharma, Tarang, Louise Schow Guski, Nanna Freund, and Peter C. Gøtzsche. "Suicidality and Aggression during Antidepressant Treatment: Systematic Review and Meta-analyses Based on Clinical Study Reports." Bmj 352.I65 (2016): n. pag. Web. Shepherd, Joshua. "Free Will and Consciousness: Experimental Studies." Consciousness and Cognition 21.2 (2012): 915-27. Web. Shneidman, Edwin S. "Commentary: Suicide as Psychache." The Journal of Nervous and Mental Disease 181.3 (1993): 145-47. Web.

56

Silverman, M.M., & Maris, R.W. (1995). The prevention of suicidal behaviors: An overview. Suicide and Life-Threatening Behavior, 25, 10–21. Steger, Michael F., and Todd B. Kashdan. "Depression and Everyday Social Activity, Belonging, and Well-being." Journal of Counseling Psychology 56.2 (2009): 289-300. Web. Tolhurst, William E. "Suicide, Self-Sacrifice And Coercion." The Southern Journal of Philosophy 21.1 (1983): 109-21. Web. Tøllefsen, Ingvild Maria, Karin Helweg-Larsen, Ingemar Thiblin, Erlend Hem, Marianne C. Kastrup, Ullakarin Nyberg, Sidsel Rogde, Per-Henrik Zahl, Gunvor Østevold, and Øivind Volkan, Vamik D. "Not Letting Go: From Individual Perennial Mourners to Societies with Entitlement Ideologies." On Freud's "Mourning and Melancholia" (Contemporary Freud: Turning Points & Critical Issues). Ed. Thierry Bokanowski, Sergio Lewkowicz, and Leticia Glocer. Fiorini. London: Karnac, 2009. 90-109. Print. Wijsbek, Henri. "‘To Thine Own Self Be True’: On The Loss Of Integrity As A Kind Of Suffering." Bioethics 26.1 (2010): 1-7. Web. World Health Organization. Figures and facts about suicide. Geneva: World Health Organization; 1999. Yovell, Yoram, Gali Bar, Moti Mashiah, Yehuda Baruch, Irina Briskman, Jack Asherov, Amit Lotan, Amihai Rigbi, and Jaak Panksepp. "Ultra-Low-Dose Buprenorphine as a Time-Limited Treatment for Severe Suicidal Ideation: A Randomized Controlled Trial."American Journal of Psychiatry AJP 173.5 (2016): 491-98. Web.

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