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FINAL REPORT: Suicide in Sri Lanka: Past, Present and Future Transformations, University of Colombo, 21-22 March 2013

FINAL REPORT

Suicide in Sri Lanka: Past, Present and Future Transformations, University of Colombo, 21-22 March 2013

Introduction

Since the middle of the 20th century, rates of suicide and self-harm rose to ‘epidemic’ proportions in Sri Lanka. From the mid-1990s a series of restrictions placed on the import and sale of the most toxic agrochemicals led to a substantial decreased in the suicide rate. However, emerging evidence – much of it presented at this symposium – suggests that the rate of self-harm has increased exponentially since then. The objective of this symposium was to engage academic researchers and policy makers and intervention practitioners in a dialog concerning the socio-cultural causes and meanings of self-harm and suicide in Sri Lanka, and the implications of this for the development and delivery of effective interventions.

Methodology

The symposium was organised by Dr Tom Widger (University of Sussex) and Ms Tharindi Udalagama (University of Colombo). In February 2013 a Call for Papers (CfP) was announced via academic and policy/practice channels. The CfP attracted twelve abstracts from local and international researchers and interventionists. The resulting programme spread across two days and included five sessions, including a final roundtable debate seeking to integrate the results of discussions from the previous sessions:

Opening session:         Welcome & Plenary Address

Session 1:                    Reading Sri Lanka’s suicide rate

Session 2:                    Self-harm and suicide in ethnographic contexts

Session 3:                    Interventions: transforming suicidalities in Sri Lanka

Session 4:                    Roundtable debate

Formal invitations were sent to a list of academic and policy/practice stakeholders, including representatives of the Ministry of Health, Ministry of Social Services, and local and international NGOs. A few days before the symposium feature stories were published in the Sri Lankan press, which elicited requests for further information and/or requests for an invitation to attend. The symposium was also publicised on the website of the Forum for Suicide & Culture Research (FSCR), and via FSCR Twitter feeds. This helped to raise the profile of the symposium among local researchers.

Results of the sessions

Welcome & Plenary Address

The symposium was introduced by Dr S.M.K. Herath (Head, Department of Sociology, University of Colombo). Dr Herath reminded the audience of the importance of social scientific studies of suicide, especially in Sri Lanka where suicide rates are so high. Next to speak was Dr F.R. Metha (country representative, WHO), who pointed out the heavy psychological and social burden represented by, and caused by, Sri Lanka’s suicide and self-harm epidemic. The plenary address was given by Professor N. Fernando (National Institute of Mental Health). Professor Fernando’s talk provided a general introduction to self-harm and suicide from a global perspective. A lively debate followed concerning the relationship between suicide and mental illness, with one side arguing for a strong relationship with depression and the other suggesting only a weak correlation.

Session 1: Reading Sri Lanka’s suicide rate

The aim of this session was to establish the quantitative framework of suicide and self-harm in Sri Lanka. Three papers were presented, each exploring the rise and fall of the suicide rate from, broadly, medical epidemiological, sociological, and anthropological perspectives. Results of the session included an increased awareness that even though suicide rates have fallen, the rate of self-harm is increasing. A consensus was reached that self-harm remains a major health and social problem and renewed commitments to prevention should be made.

Session 2: Self-harm and suicide in ethnographic contexts

The aim of this session was to provide context to the quantitative picture. Three papers were presented, including two concerned with self-harm and suicide in southern Sri Lanka and one with suicide in northern Sri Lanka. The papers included discussions of suicide and gender, suicide and kinship, and suicide and war. The papers showed how acts of self-harm and self-inflicted death are caused by relational disputes and accusations of shame, and exist as a social practice rather than the consequence of deep-seated psychopathology.

Session 3: Interventions

The aim of this session was to provide an overview of suicide interventions in Sri Lanka and to assess their effectiveness. Five papers were presented, including a review of government policies and in particular the national suicide prevention strategy published in 1997. While the GoSL was lauded for being the first government in Asia to produce such a document, consensus was reached that a new policy is urgently needed and that this should include an implementing body. Building on the findings of the previous sessions, it was also generally agreed that interventions based on Euro-American approaches were unlikely to be effective in the Sri Lankan socio-cultural context.

Session 4: Roundtable debate

The aim of the debate was to address the theme of the conference – what are the social and cultural challenges of suicide prevention in Sri Lanka, and how might they be overcome? – by building of the results of the past two days’ discussions. Six panelists took part, representing the GoSL, local and international suicide prevention organisations, and academia. Results of the debate included calls for greater communication and collaboration between academic researchers and interventionists, and for greater commitments to research targeting the needs of policy and practice experts. It was also expressed that interventionists rely too much on Euro-American approaches to understanding suicide and suicide prevention, and that greater attempts should be made to engage with socio-cultural approaches relevant to the Sri Lankan context.

Outcomes of the symposium

The symposium generated a large amount of interest. Among those who presented at or attended the symposium, there was keen enthusiasm to maintain the momentum started and to forge lasting networks of researchers and prevention experts. To facilitate this, the presentations were made available on the FSCR website. Selected papers will be published in English, Sinhala, and Tamil as part of a special issue of the University of Colombo’s sociology journal.

Among policy/practice stakeholders the symposium provided further impetus to start new projects. The World Bank, in particular, has showed a strong interest to build on the results of the symposium. The Development Partners Secretariat requested a one-page brief to distribute amongst donor organisations and INGOs in order to raise further awareness of the issue. A few days later, the organisers and WHO met with the World Bank’s Senior Health Specialist to discuss how intervention programmes could be taken forward and these meetings are still continuing.

Overall the symposium demonstrated that a large network of researchers and policy/practice experts exists in Sri Lanka, which until the event had not met or had the chance to hear about each other’s work. The symposium suggested that there is significant potential to develop a consortium of experts to conduct policy/practice orientated research studies and develop socio-culturally relevant suicide interventions. As a direct result of the symposium several stakeholders are now in discussions about how this might happen.

Suicide and the ‘Poison Complex’: Toxic Relationalities, Child Development, and the Sri Lankan Self-Harm Epidemic

Widger, T. (2015). Suicide and the ‘Poison Complex’: Toxic Relationalities, Child Development, and the Sri Lankan Self-Harm Epidemic. Medical Anthropology, DOI:10.1080/01459740.2015.1012616

Suicide prevention efforts in Asia have increasingly turned to ‘quick win’ means restriction, while more complicated cognitive restriction and psychosocial programmes are limited. This paper argues the development of cognitive restriction programmes requires greater consideration of suicide methods as social practices, and of how suicide cognitive schemata form. To illustrate this, the paper contributes an ethnographically grounded study of how self-poisoning becomes cognitively available in Sri Lanka. I argue the overwhelming preference for poison as a method of self-harm in the country is not simply reflective of its widespread availability, but rather how cognitive schemata of poison – a ‘poison complex’ – develops from early childhood and is a precondition for suicide schemata. Limiting cognitive availability thus requires an entirely novel approach to suicide prevention that draws back from its immediate object (methods and causes of self-harm) to engage the wider poison complex of which suicide is just one aspect.

Suicide in Sri Lanka: The Anthropology of an Epidemic

Suicide in Sri Lanka-book coverWhy people kill themselves remains an enduring and unanswered question. With a focus on Sri Lanka, a country that for several decades has reported ‘epidemic’ levels of suicidal behaviour, this book develops a unique perspective, linking the causes and meanings of suicidal practices to social processes across moments, lifetimes, and history.

Extending anthropological approaches to practice, learning, and agency, anthropologist Tom Widger draws from long-term fieldwork in a Sinhala Buddhist community to develop an ethnographic theory of suicide that foregrounds local knowledge and sets out a charter for prevention. The book highlights the motives of children and adults becoming suicidal, and how certain gender, age, and class relationships and violence are prone to give rise to suicidal responses. By linking these experiences to emotional states, it develops an ethnopsychiatric model of suicide rooted in social practice. Widger then goes on to examine how suicides are resolved at village and national levels, and traces the roots of interventions to the politics of colonial and post-colonial social welfare and health regimes. Exploring local accounts of suicide as both ‘evidence’ for the suicide epidemic and as an ‘ethos’ of suicidality shaping subjective worlds, Suicide in Sri Lanka shows how anthropological analysis can offer theoretical as well as policy insights.

With the inclusion of straightforward summaries and implications for prevention at the end of each chapter, this book has relevance for specialists and non-specialists alike. It represents an important new contribution to South Asian Studies, Social Anthropology and Medical Anthropology, as well as to cross-cultural Suicidology.

Cultural, social, and medical equity could provide lasting solutions to Sri Lanka’s suicide epidemic

Following a decade of decline, Sri Lanka’s suicide rate – once amongst the highest in the world – is reported to be on the rise once again. It’s too early to tell whether this is a temporary blip or the beginnings of something more serious. But what is known is that the fall in the suicide rate was the result of ‘means restriction’ – chiefly sales restrictions placed on the most toxic pesticides – and not the result of falling levels of suicide attempts per se. In fact, the evidence suggests that the number of suicide attempts has actually increased in the same period, with suicidal behaviour remaining a leading cause of serious injury and death in youth and older persons in Sri Lanka. Continue reading

Suicide in Sri Lanka: Understanding the Crisis

Suicide and deliberate self-harm represent significant health and social crises in Sri Lanka, placing extraordinary burdens on individuals, families, communities, and public services. By the final decade of the 20th century, the Sri Lankan suicide rate was one of the highest in the world; since then the rate has dropped, but rates of deliberate self-harm have significantly increased. The cause of the fall in the suicide rate was mainly the result of means restrictions – banning the most toxic pesticides used in self-harm – and improved health services implemented from the late 1990s, as well as an apparently spontaneous shift to medicinal drugs as a popular method of self-harm, which have a lower fatality rate. This briefing note aims to provide an overview of suicide and self-harm in Sri Lanka in relation to rates, demographic and social patterns, causes, and interventions.

Continue reading

Publication

Reading Sri Lanka’s Suicide Rate

Tom Widger

By the final decade of the twentieth century, rates of suicide in Sri Lanka ranked among the highest in the world. However, in 1996 the suicide rate began to fall and was soon at its lowest level in almost 30 years. This decline poses problems for classic sociological theories of suicide and forces us to question some fundamental assumptions underlying social scientific approaches to the suicide rate. Drawing from sociological, medical epidemiological, historical, and anthropological secondary sources as well as 21 months of original ethnographic research into suicide in Sri Lanka, I argue that there are four possible readings of the country’s suicide rate. While the first three readings provide windows onto parts of the story, the fourth—a composite view—provides a new way of thinking about suicide, not just in Sri Lanka but also cross-culturally. In so doing the paper poses questions for how the relationship between suicide and society might be imagined.

Event

Suicide in Sri Lanka: Past, Present, and Future Transformations

21-22 March 2013

University of Colombo, Sri Lanka

Rates of suicidal behaviour have existed at ‘epidemic’ proportions in Sri Lanka for several decades, and in recent years there has been a marked increase in the number of ethnographic and other qualitative researchers investigating the problem. However, to date there has been little opportunity for qualitative researchers to present their findings in dedicated forums and this has reduced opportunities for debate and the development of collaborative projects as well as scope for impacts on practitioners and policy makers.

The aim of this symposium is to provide an opportunity for anthropologists, sociologists, and public health specialists employing ethnographic and qualitative methods to share the results of on-going research, recently completed research, and research proposals currently in the planning stage. The objectives will be to:

  • Provide an overview of current anthropological/ethnographic research into suicide in Sri Lanka underway, and debate empirical and theoretical issues and themes;
  • Discuss ethical and practical issues and challenges faced when studying suicide ethnographically, including how to ensure the wellbeing of researcher and research participants; and
  • Debate, as part of a roundtable discussion, how anthropological studies of suicide can inform the development of more culturally relevant treatment and prevention programmes.

The theme of the conference is past, present, and future transformations. We are interested in the concept of transformation in both temporal and social dimensions.

  • Past: How have suicide in Sri Lanka, and the Sri Lankan suicide rate, transformed across time? Over the second half of the 20th century, the suicide rate spiralled to epidemic proportions, before significantly falling after the mid-1990s. While sociologists attributed the rise in the suicide rate to macro-level forces of social change (Kearney & Miller 1985), epidemiologists associated the fall with controls placed on the most lethal pesticides, which had hitherto accounted for the majority of suicide deaths (Gunnell 2007). However, in recent years there have been growing reports that levels of both self-harm and suicide are increasing once again (IRIN 2009; Bandara 2012; Senerathna 2012; Silva 2012), calling into question the efficacy of pesticide control measures. Meanwhile, state and lay narratives of suicidality have equally transformed, informing each other through looping processes (Widger 2012b).
  • Present: How does suicide transform social relations? However meanings of suicide might have transformed across time, in everyday practice in the contemporary moment they often cohere with established narratives (Marecek 1998, 2006; Marecek & Senadheera 2012). Self-harm and suicide can be understood as offering transformations at the personal and inter-personal levels. On one level, suicidal practices offer a means of redress for powerless people – an avenue for expression and communication which works by ‘putting the idea of death into other people’s minds’ (Widger 2009, 2012a). But on another level, suicidal practices offer ways of transforming psychological and social statuses and positionalities and as such, the fabric of sociality itself. Performed as much to create as to negate (Widger 2012b), suicidal practices in Sri Lanka can be understood as driving social change through ‘a thousand cuts.’ Engagements with suicidal behaviour can be understood as commentaries on society at large (Hewamanne 2010).
  • Future: In what ways might suicide in Sri Lanka be transformed? If suicide is the by-product of a self-harm endemic, how can the endemic be addressed? Much of the literature would seem to suggest that suicidal practices are intractable: they are not caused by discreet illnesses which can be treated through direct interventions but rather are the product of social structures, cultural traditions, and deeply ingrained ways of understanding and acting in the world. Given this, it is not as clear what might work, as it is what does not work – perhaps it is time to reevaluate how we consider the possibility of suicide prevention, beginning with the very terms we use.

Paper submissions (30 minutes in length) are invited which engage with these or similar themes.

Please contact Dr Tom Widger (t.widger@sussex.ac.uk) for further information!

Publication

Precarious ethics: Toxicology research among self-poisoning hospital admissions in Sri Lanka

Salla Sariola & Bob Simpson

Self-harm using poison is a serious public health problem across Asia. As part of a broader effort to tackle this problem, medical research involving randomised clinical trials are used to identify effective antidotes among patients who have ingested poison. On the basis of ethnographic material collected in rural hospitals in Sri Lanka between 2008 and 2009, this article describes the conduct of trials in this unusual and difficult context. It outlines three subject positions crucial to understanding the complexity of such trials. At one level, self-poisoning admissions might be thought of as abjects, that is, stigmatised by actions that have placed them at the very limits of physical and social life. They have seriously harmed themselves in an act that often leads to death, marking the act as a suicide. Yet, this is the point when they are recruited into trials and become objects of research and experimentation. Participation in experimental research accords them particular rights mandated in international ethical guidelines for human subject research. Here the inexorable logic of trials and morality of care meet in circumstances of dire emergency.

Publication

Suicide in South Asia: Ethnographic Perspectives

The June issue of Contributions to Indian Sociology is a special issue entitled, ‘Suicide in South Asia.’ Guest editor James Staples writes in his introduction:

“This volume has its roots in a two-day international workshop,
‘Ethnographies of Suicide’, which was held at Brunel University in West
London, UK, back in July 2008. The 15 papers presented there drew on
fieldwork from across the world, with contributions from Afghanistan,
Israel, Japan, South Africa, Greece, Portugal and the UK. It was noteworthy,
however, that a third of the papers, as well as an additional film
presentation, all focused on work that had been conducted in South Asia,
particularly in India and Sri Lanka. Despite having recently begun fieldwork
on suicide in the region myself—in Andhra Pradesh—until I organised
the conference I had been unaware of the wider interest in the topic
among fellow South Asianist scholars, and began to realise that there
was a strong case for bringing more of this work together in a single collection.” (1)

‘Girl Still Burning Inside my Head’: Reflections on Suicide in Sri Lanka

Malathi de Alwis

“This chapter reflects on why suicide has become such a pervasive phenomenon in Sri Lankan society by engaging with the extensive scholarly literature that exists on this subject. Rather than trying to provide some overarching, mono-causal explanation, it seeks to illuminate the complexity of the issue and the varied and nuanced ways in which we might try to apprehend it, be it in conjunction with homicide or political conflict, social change or sexual anomie, restraint or collectivism. While problematising our re-course to the ‘work of culture’ and reading statistics against the grain, this chapter also highlights gendered dimensions and broader conceptual strands where we may not have thought to seek them.”

‘I drank it to put an end to me’: Narrating girls’ suicide and self-harm in Sri Lanka

Jeanne Marecek and Chandanie Senadheera

“Sri Lanka experienced a spiral of suicides in the 1980s and 1990s, with deaths rising to nearly 48 per 100,000 in 1995. Although reported rates of suicide have declined since then, the incidence of suicide and deliberate self-harm remains high, especially among young people. Data on hospital admissions showed that the number of adolescent girls admitted for deliberate self-harm more than doubled between 2001 and 2007. We conducted in-depth interviews with girls in the south of Sri Lanka who were hospitalised for deliberate self-harm. The interviews revealed several common themes in the girls’ accounts of the circumstances that prompted self-harm episodes, their motives and emotions, and others’ responses. Most episodes involved accusations and disputes regarding the girls’ sexual comportment and heterosexual relations. They often involved harsh scolding and beatings by parents. Themes in the girls’ accounts included anger, disappointment, shame, and acute distress; descriptions of their self-harm as an expressive act directed toward others; and disavowal of responsibility for their actions. We suggest that the rise in girls’ self-harm results from the clash between emergent expectations that young women hold regarding advanced education, heterosexual relations, and out-of-home employment and traditional ideals of appropriate feminine comportment and sexual respectability held by their parents.”

Suicide and the morality of kinship in Sri Lanka

Tom Widger

“Ethnographic research amongst Sinhala Buddhists in community and clinical settings in the Madampe Division, northwest Sri Lanka, suggests that local understandings and practices of suicidal behaviour reflect the kinship structure. In particular, acts of self-harm and self-inflicted death arise in response to the breaking of core kinship rights, duties and obligations, or as a challenge to inflexibility or contradictions within the system. In either case, the morality of kinship is closely associated with the causes of suicidal behaviour, as the ‘inevitability’ or ‘evitability’ of kin relationships is negotiated and lived in practice. This article analyses how local political economies give rise to particular kinship and moral conditions, with special attention paid to those between household (gē) members and brothers-in-law (massinā).”

The suicide niche: Accounting for self-harm in a South Indian leprosy colony

James Staples

“This article analyses the circumstances under which attempted suicide became an increasingly common possibility of thought and action among the young, healthy generation of people who had grown up in the South Indian leprosy community where I conducted long-term fieldwork, despite suicide remaining relatively uncommon amongst their leprosy-affected, and often physically disabled, parents and grandparents. Alert to the pitfalls of analytical approaches that either privilege over-arching structural explanations—like those favoured by Durkheim—or, conversely, give too much credence to individual agency and psychology, my analysis here attempts to chart a course through these polarities. It does so by drawing both on Ian Hacking’s ‘ecological niche’ metaphor—to explore how particular configurations of events and circumstances, at different times, might render suicide related behaviour more or less likely among different groups; and on Pierre Bourdieu’s notion of the ‘habitus’—to consider how particular sets of bodily dispositions might generate certain styles of attempted suicide and self-harm.”

Suicide in a central Indian steel town

Jonathan Parry

“Over the past 15 years ‘farmer suicides’ have occasioned grave public concern; and it has recently been claimed that Chhattisgarh has the highest incidence in the country. This article suggests that the representation of such cases as the major public policy problem to do with self-inflicted death is politically inflected and that there are good grounds for supposing that—at least in certain pockets—the urban suicide rate is as high, if not higher. In the industrial area around steel town of Bhilai, this has risen dramatically over the last 20 years and it is the aristocracy of public sector labour that is significantly most susceptible. This is ultimately attributable to the liberalisation of the economy and the consequent downsizing of this workforce, which has led to a crisis in the reproduction of class status. Such workers are privileged; think of themselves as different from the informal sector ‘labour class’ and fear sinking into it. Suicides are significantly under-reported and the official statistics are systematically inflected by fear of the police and the law, which encourage both concealment and the deliberate obfuscation of likely motives, and almost certainly increase the ‘lethal probabilities’ of suicide attempts.”

Farmers’ suicides and the state in India: Conceptual and ethnographic notes from Wayanad, Kerala

Daniel Munster

“This article reflects on the challenge of making ‘farmers’ suicides’ an object of ethnographic inquiry. This challenge is not just a matter of methods, ethics and access but also a matter of categorical choices involved in studying this over-determined and politicised category of self-killing. Drawing on fieldwork in the Wayanad district of Kerala, the article argues that ‘farmers’ suicides’ are not self-evident types of rural death, but become reified and visible through the state’s enumerative practices. This state-defined category, conveyed and scandalised by the media, rests on a connection between suicide and—–an equally reified—‘agrarian crisis’. The ethnographic endeavour of ‘chasing’ the elusive object of farmers’ suicides may destabilise this seemingly self-evident link. Despite this, farmers’ suicides have taken on a political life of their own. They have become a constructed yet real interface for the reworking of the relationship between state and rural citizens in liberalising India. The Indian state has launched unprecedented relief and rehabilitation measures in response to the suicide crisis. This article makes a strong case for grounding the study of farmers’ suicides in ethnographies of agrarian practice and the local developmental state.”

The volume ends with an Endnote by Isak Niehaus, Comparing South Asian and South African Suicide. Niehuas argues:

“Contemporary ethnographers and anthropological researchers face a dual
challenge. On the one hand, we are admonished to guard against treating
our units of study as self-contained, island-like entities, immune from
broader forces and from connections with global impact (Appadurai 2000;
Hannerz 1996). On the other, Marshall Sahlins sounds a stern warning
about ‘endangered specificities’ in the social sciences today, suggesting
that the imposition of external analytical frameworks might well cloud
out, or even annihilate, valid local cultural constructs, perspectives and
understandings (Sahlins 1996; Smith 2002). Our challenge is to situate
our units of study within broader analytical frames without losing sight
of local contours and dynamics. It is to tread softly and to steer a careful
balance, elucidating both the generalities and particularities of our research
information”.

Publication

Ethnographies of Suicide: Special Issue of Culture, Medicine and Psychiatry

The June 2012 issue of Culture, Medicine and Psychiatry is a special issue entitled, ‘Ethnographies of Suicide.’ As guest editors James Staples and Tom Widger write in their introduction:

“This special issue…comes at the end of a century of sporadic anthropological interest in suicidal behaviour, building on the groundwork established by scholars such as Malinowski (1949) and Bohannan (1960), but also going much further. Focusing on the act in its more ‘everyday’ occurrences while speaking to issues of ‘protest’ and ‘escape’ (that also have resonances for our understanding of ‘suicide bombing’ and euthanasia), it attempts to mark out a distinctive theoretical approach that draws from long-term ethnographic research…conducted in diverse locations across the globe, including Mexico, Canada, England, South Africa, Palestine, Afghanistan, India, Sri Lanka, Singapore and Japan. By highlighting how the ethnographic method privileges a certain view of the subject, we aim to go beyond the sociological and psychological approaches that define the field of ‘suicidology’ to engage with suicide from our informants’ own points of view—and in so doing cast the problem in a new light and new terms.” (185)

Guest Editorial: Situating Suicide as an Anthropological Problem: Ethnographic Approaches to Understanding Self-Harm and Self-Inflicted Death

James Staples and Tom Widger

More than a century after Durkheim’s sociological classic placed the subject of suicide as a concern at the heart of social science, ethnographic, cross-cultural analyses of what lie behind people’s attempts to take their own lives remain few in number. But by highlighting how the ethnographic method privileges a certain view of suicidal behaviour, we can go beyond the limited sociological and psychological approaches that define the field of ‘suicidology’ in terms of social and psychological ‘pathology’ to engage with suicide from our informants’ own points of view—and in so doing cast the problem in a new light and new terms. In particular, suicide can be understood as a kind of sociality, as a special kind of social relationship, through which people create meaning in their own lives. In this introductory essay we offer an overview of the papers that make up this special issue and map out the theoretical opportunities and challenges they present.

Tales of Decline: Reading Social Pathology into Individual Suicide in South India
Jocelyn Lim Chua

In the south Indian state of Kerala, the nation’s so-called suicide capital, suicide can often appear self-evident in meaning and motivation to casual onlookers and experts alike. Drawing on explanatory accounts, rumors, and speculative tales of suicide collected between 2004 and 2007, this article explores the ontological power of certain deaths to assert themselves as always-already known on the basis of perceived and reported demographic patterns of suicide. I demonstrate the ways suicides are commonly read, less through the distinct details of their individual case presentations than “up” to broader scales of social pathology. Shaped by the intertwined histories of public health intervention and state taxonomic knowledge in India, these “epidemic readings” of suicide enact a metonymy between individual suffering and ideas of collective decline that pushes the suicide case to fit—and thus to stand for—aggregate trends at the level of populations. Focusing on how family navigated the generic meanings and motivations ascribed to the deaths of their loved ones, I argue that the ability of kin to resist, collude with, or strategically deploy epidemic readings in their search for truth and closure hinged significantly on their classed fluency in the social, legal, and bureaucratic discourses of suicide.

Suffering, Frustration, and Anger: Class, Gender and History in Sri Lankan Suicide Stories
Tom Widger

This paper explores competing stories of suffering, frustration and anger that shape the performance and reception of suicidal behaviours in contemporary Sri Lanka. Drawing from the results of 21 months of ethnographic fieldwork, I show how suicidal acts fit within broader narratives of class and gender experience and expression that draw from contemporary and historical ‘folk’ and ‘state’ discourses. Debates over whether suffering, frustration and anger are legitimate socio-effective states to exhibit come to determine the kinds of claims and counter-claims that suicidal people on the one hand, and those charged with their treatment and management on the other, can make with regard to the efficacy of suicide as a means of social action. Through such debates—not only what it means to be suicidal in Sri Lanka but also what it means to be middle class or working class, male or female, etc. are made and remade anew.

Chol Understandings of Suicide and Human Agency
Grace Imberton

According to ethnographic material collected since 2003, the Chol Mayan indigenous people in southern Mexico have different causal explanations for suicide. It can be attributed to witchcraft that forces victims to take their lives against their own will, to excessive drinking, or to fate determined by God. However, it can also be conceived of as a conscious decision made by a person overwhelmed by daily problems. Drawing from the theoretical framework developed by Laura M. Ahearn, inspired by practice theory, the paper contends that these different explanations operate within two different logics or understandings of human agency. The first logic attributes responsibility to supernatural causes such as witchcraft or divine destiny, and reflects Chol notions of personhood. The second logic accepts personal responsibility for suicide, and is related to processes of social change such as the introduction of wage labor, education and a market economy. The contemporary Chol resort to both logics to make sense of the human drama of suicide.

Suicidal Performances: Voicing Discontent in a Girls’ Dormitory in Kabul
Julie Billaud

Female suicide in Afghanistan has generally been given economic and psychological explanations. More rarely has its social dimension been analysed. In this paper, I underline the communicative potential of Afghan women’s suicide in the ‘post-war/reconstruction’ context. I highlight its ambiguous symbolic power and its anchorage in the subversive imaginary universe of women’s poetic expression. I argue that while reproducing certain cultural ideas about women’s inherent emotional fragility, women’s suicide also challenges the honour system in powerful ways and opens possibilities for voicing discontent. I qualify female suicide as the ‘art of the weak’ (De Certeau 1980, 6), a covert form of protest, a performance—in the sense of Bauman (2004)—that builds upon traditional popular ‘knowledge’ about gender in order to manage the impression of an audience and make women’s claims audible.

Behind the Statistics: The Ethnography of Suicide in Palestine
Nadia Dabbagh

As part of the first anthropological study on suicide in the modern Arab world, statistics gathered from the Ramallah region of the West Bank in Palestine painted an apparently remarkably similar picture to that found in Western countries such as the UK and France. More men than women completed suicide, more women than men attempted suicide. Men used more violent methods such as hanging and women softer methods such as medication overdose. Completed suicide was higher in the older age range, attempted suicide in the younger. However, ethnographic fieldwork and detailed examination of the case studies and suicide narratives gathered and analysed within the cultural, political and economic contexts illustrated more starkly the differences in suicidal practices between Palestinian West Bank society of the 1990s and other regions of the world. The central argument of the paper is that although statistics tell a very important story, ethnography uncovers a multitude of stories ‘behind the statistics’, and thus helps us to make sense of both cultural context and subjective experience.

Postcolonial Suicide Among Inuit in Arctic Canada
Michael J. Kral

Indigenous youth suicide incidence is high globally, and mostly involves young males. However, the Inuit of Arctic Canada have a suicide rate that is among the highest in the world (and ten times that for the rest of Canada). The author suggests that suicide increase has emerged because of changes stemming in part from the Canadian government era in the Arctic in the 1950s and 1960s. The effects of government intervention dramatically affected kin relations, roles, and responsibilities, and affinal/romantic relationships. Suicide is embedded in these relationships. The author also discusses the polarization between psychiatric and indigenous/community methods of healing, demonstrating that government-based intervention approaches to mental health are not working well, and traditional cultural healing practices often take place outside of the mainstream clinics in these communities. The main questions of the paper are: Who should control suicide prevention? What is the best knowledge base for suicide prevention?

Gendered Endings: Narratives of Male and Female Suicides in the South African Lowveld
Isak Niehaus

Durkheim’s classical theory of suicide rates being a negative index of social solidarity downplays the salience of gendered concerns in suicide. But gendered inequalities have had a negative impact: worldwide significantly more men than women perpetrate fatal suicides. Drawing on narratives of 52 fatal suicides in Bushbuckridge, South Africa, this article suggests that Bourdieu’s concepts of ‘symbolic violence’ and ‘masculine domination’ provide a more appropriate framework for understanding this paradox. I show that the thwarting of investments in dominant masculine positions have been the major precursor to suicides by men. Men tended to take their own lives as a means of escape. By contrast, women perpetrated suicide to protest against the miserable consequences of being dominated by men. However, contra the assumption of Bourdieu’s concept of ‘habitus’, the narrators of suicide stories did reflect critically upon gender constructs.

Mad, Bad or Heroic?: Gender, Identity and Accountability in Lay Portrayals of Suicide in Late Twentieth-Century England
Christabel Owens and Helen Lambert

Suicide research has relied heavily on the psychological autopsy method, which uses interviews with the bereaved to ascertain the mental health status of the deceased prior to death. The resulting data are typically interpreted within a clinical diagnostic framework, which reinforces psychiatric assumptions concerning the ubiquity of mental illness amongst those who take their own lives. The ways in which informants reconstruct the past and the meanings they attach to events preceding the suicide are rarely examined. This paper uses qualitative methods to analyse the narratives given by bereaved people in an English psychological autopsy study, in order to understand how they made sense of a family member’s suicide. Some clear differences between the portrayal of male and female suicides emerged. The paper discusses the gendering of agency and accountability in relation to the differential medicalisation of male and female distress in the UK, and suggests that a preoccupation with mental illness in suicide research may have obscured other culturally normative understandings of self-accomplished death.

Ritual Vicissitudes: The Uncertainties of Singaporean Suicide Rites
Ruth E. Toulson

In this article, I examine how Singaporean Chinese families and funeral professionals work together to ritually manage the meaning and consequences of a death by suicide. While the now dated literature on Chinese mortuary practice emphasizes the formality and rigidity of death rituals, during fieldwork I noted many moments of confusion within ritual, moments of innovation, when relatives broke away from the already uncertain ritual script, and moments of deceit, when relatives conspired with funeral directors to hide the reason for a death. Through an examination of three funerals for suicide victims, including two cases in which the fact that the death was a suicide was hidden, I suggest that a focus on moments of confusion and of innovation paradoxically better captures the dynamism and efficacy of Chinese funeral rituals: here indeterminacy is indispensable to ritual form.

Suicide and the Afterlife: Popular Religion and the Standardisation of ‘Culture’ in Japan
Mary Picone

For an overwhelming majority of commentators, including many anthropologists, ‘Japanese culture’ is still associated with a positive view of suicide. Western-language writings have contributed by feedback loop to perpetuate this stereotype. Besides the local ‘samurai ethic’, Japanese Buddhism is also said not to prohibit taking one’s life. However, the most popular examples of heroic self-sacrifice, from the Edo period to WWII, are fraught with covert contradictions. From ancient times to the present religious practitioners of all sorts have maintained that suicide creates unhappy, resentful spirits who harm the living. This article discusses many examples of a diverse series of narratives, from spirit medium’s séances to drama to contemporary films, in which the anguished spirits of suicides are allowed to express themselves directly. After the figures rose alarmingly in the late 1990s various religious organisations have attempted to fight the stigma suffered by bereaved family members and have introduced new interpretations and new rituals.

Explaining Suicide: An Afterword
Jean La Fontaine