Robert Litman, L.A. Crisis Center Co-Founder, Dies at 88

From left, Norman Farberow and Robert Litman

[Editor’s note: I apologize for being late in reporting on the passing of one of the founders of the first suicide prevention crisis center in America. FJC]

An announcement of the Feb. 14 death of Dr. Robert Litman — at age 88, of acute leukemia — came to the membership of the American Association of Sucidology in a letter from the organization’s executive director, Lanny Berman:

Bob was co-director and chief of psychiatry at the Institute for Studies of Destructive Behaviors and the Suicide Prevention Center in Los Angeles, a pioneer in the development and implementation of the psychological autopsy (with Ed Shneidman and Norman Farberow), and one of this country’s first and foremost forensic suicidologists … Bob’s psychoanalytic perspective and research interests ranged from the study of equivocal suicides, to the study of bondage deaths, to Freud’s contributions to our understanding of suicide. Norm Farberow described Litman as, “a free spirit cloaked in psychoanalytic trappings, always intellectually adventuresome and inquisitive.” This, and much, much more, he surely was.

In Litman’s obituary, Los Angeles Times reporter Valerie J. Nelson writes,

The idea for a suicide prevention center came from two Veterans Administration psychologists, Edwin S. Shneidman and Norman L. Farberow, who persuaded Dr. Litman, over drinks in Beverly Hills, to help establish it. Then director of the psychiatric unit at what is now Cedars-Sinai Medical Center, Dr. Litman had written a paper on how to deal with suicide on a hospital ward. His interest in the subject was sparked by the death of his high school best friend, Thomas Heggen, who wrote the book and play “Mister Roberts” and whose death in 1949 was ruled a probable suicide. Although worried that the response to the proposed suicide center would be overwhelming, Dr. Litman signed on.

Related SPNAC posts:

• “Edwin Shneidman’s Meditations on Death Are Full of Life” on March 1, 2009 at http://tinyurl.com/ShneidmanMeditations
• “Suicide Prevention Pioneer Edwin Shneidman Dies at 91” on May 18, 2009 at http://tinyurl.com/PreventionPioneer

[The abridged URL for this post is http://tinyurl.com/LitmanObit .]

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Suicide Prevention Pioneer Edwin Shneidman Dies at 91

(Genaro Molina, Los Angeles Times)

By Franklin Cook, SPNAC Editor

Edwin S. Shneidman–a heroic figure in the field of suicide prevention, a man whom I often call the father of modern suicidology–died Friday at his home in West Los Angeles at age 91.

Los Angeles Times senior editor Thomas Curwen followed Shneidman’s life, and in an obituary today, summarizes highlights of his career and his thinking about the nature of suicide and its prevention:

Shneidman, one of the founders of the Los Angeles Suicide Prevention Center, believed that two simple questions — “Where do you hurt?” and “How may I help you?” — could begin to unlock the suicidal impulse.

Shneidman, along with Norman Farberow and Robert Litman, established the center in an abandoned tuberculosis hospital on the grounds of Los Angeles County Hospital in 1958. Staff members offered counseling and support over the phone to the depressed and suicidal. It represented a radical idea in mental health care in America.

Research into suicide — and suicide itself — was largely shunned and stigmatized. In time, the Suicide Prevention Center captured the popular imagination in movies and books and became a national center for studying the enigma of suicide.

Shneidman viewed suicide as a psychological crisis and — as did Albert Camus — as the “one truly serious philosophical problem.”

“Suicide is a complex malaise,” Shneidman said. “Sociologists have shown that suicide rates vary with factors like war and unemployment; psychoanalysts argue that it is rage toward a loved one that is directed inward; psychiatrists see it as a biochemical imbalance. No one approach holds the answer: It’s all that and more …

“You don’t understand psychopathic murder by slicing [Jeffrey] Dahmer’s brain, and you won’t get E=MC2 by slicing Einstein’s brain,” he says. “Unfortunately, it’s in the mind. And the mind is not a structure. It is an ephemeral concept.”

Another excellent remembrance of Shneidman is available on Huffington Post: In “A Good Man, A Good Death,” Dr. Mark Goulston summarizes his “long time mentor and beloved friend[‘s]” view on what constitutes a good death, as well as providing several additional links to material about Shneidman.

In my opinion, there is no more profound explication of the nature of suicide and, simultaneously, no more practical outline of the principles to consider in effecting its prevention than is found in Shneidman’s “Ten Commonalities of Suicide,” which appear in his classic The Suicidal Mind:

1. The common purpose of suicide is to seek a solution: A suicidal person is seeking a solution to a problem that is “generating intense suffering” within him or her.
2. The common goal of suicide is cessation of consciousness: The anguished mind of a suicidal person interprets the end of consciousness as the only way to end the suffering.
3. The common stimulus of suicide is psychological pain: Shneidman calls it “psychache,” by which he means “intolerable emotion, unbearable pain, unacceptable anguish.”
4. The common stressor in suicide is frustrated psychological needs: A suicidal person feels pushed toward self-destruction by psychological needs that are not being met (for example, the need for achievement, for nurturance or for understanding).
5. The common emotion in suicide is hopelessness-helplessness: A suicidal person feels despondent, utterly unsalvageable.
6. The common cognitive state of suicide is ambivalence: Suicidal people, Shneidman says, “wish to die and they simultaneously wish to be rescued.”
7. The common perceptual state in suicide is constriction: The mind of a suicidal person is constricted in its ability to perceive options, and, in fact, mistakenly sees only two choices-either continue suffering or die.
8. The common action in suicide is escape: Shneidman calls it “the ultimate egression (another word for escape) besides which running away from home, quitting a job, deserting an army, or leaving a spouse … pale in comparison.”
9. The common interpersonal act in suicide is communication of intention: “Many individuals intent on committing suicide … emit clues of intention, signals of distress, whimpers of helplessness, or pleas for intervention.”
10. The common pattern in suicide is consistent with life-long styles of coping: A person’s past tendency for black-and-white thinking, escapism, control, capitulation and the like could serve as a clue to how he or she might deal with a present crisis.

SPNAC readers may download a copy of “10 Commonalities” that is formatted as a handout.

Related SPNAC post: “Edwin Shneidman’s Meditations on Death Are Full of Life”

Please also see Curwen’s 2001 feature story about Shneidman and his work in the Los Angeles Times Magazine, “Psychache.”

[The abridged URL for this post is http://tinyurl.com/PreventionPioneer .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Poet Sylvia Plath’s Son Dies by Suicide in Alaska at Age 47

Sylvia Plath and her son Nicholas

[Editor’s note: The stories linked to below include brief descriptions of suicide.]

The well-known depression and suicide of poet Sylvia Plath in 1963 has been grievously followed this week by the suicide of her son Nicholas Hughes, 47, an evolutionary biologist in Alaska.

A statement by Hughes’s sister, Frieda Hughes, is quoted in a story in the [London] TimesOnline,

“It is with profound sorrow that I must announce the death of my brother, Nicholas Hughes, who died by his own hand on Monday 16th March 2009 at his home in Alaska. He had been battling depression for some time.”

The TimesOnline story covers Plath’s legacy, including her literary career, her struggle with mental illness, and her marriage to Ted Hughes, who became England’s Poet Laureate. It also includes an insightful observation from Paul Farmer, who directs Mind, a U.K. mental health charity.

“Suicide is a much more complicated event than simply being a question of genetics, but there is some evidence that if a member of your family has taken their life there can be a higher risk of people doing the same. However, it is often absolutely to do with what’s happening in the here and now rather than any urge that is more deeply rooted.”

There is also a story in the New York Times about Nicholas Hughes and his family.

[The abridged URL for this post is http://tinyurl.com/PlathSonDies .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Edwin Shneidman’s Meditations on Death Are Full of Life

Edwin Shneidman is the father of modern American suicidology. (Photo by Liz O. Baylen, Los Angeles Times)

[Special notice: Dr. Shneidman passed away on May 15, 2009. Please see “Suicide Prevention Pioneer Edwin Shneidman Dies at 91.”]

By Franklin Cook, SPNAC Editor

I invoke the name of Edwin Shneidman almost every time I speak publicly about suicide–which is quite often–and in fact have saved a special place for him in the midst of a particular section of the ASIST (Applied Suicide Intervention Skills Training) workshop I’ve delivered dozens of times in the past three years.

I look out at the workshop participants as I begin to explain the unbearable pain that is experienced by victims of suicide, and I say, “Edwin Shneidman, the father of modern suicidology in America, created a word to describe that kind of pain: He called it psychache.”

Then I refer to Shneidman’s “Ten Commonalities of Suicide” and define psychache as “intolerable psychological pain.” We discuss what it must feel like to be someone who is thinking of suicide, how that sort of pain might make a person feel so desperate for relief or escape that he or she would lose contact with the natural–and powerful–human urge to stay alive and might kill himself or herself.

Whether I am speaking to ASIST trainees, to survivors of suicide loss attending a support group, or to community coalition members planning local suicide prevention initiatives, I refer to Dr. Shneidman in that way — as “the father of modern suicidology” — and such scenes as those came to mind this morning as I read a wonderful article by Thomas Curwen in yesterday’s Los Angeles Times.

Curwen’s article is a meditation on death, with its subject being one of the world’s foremost experts on the topic.

He lies on the side of the bed, sleepy, unshaven, his hair mussed. He never asked to live to be 90, to see the breadth of his life diminished, the allure of the world fallen further out of reach. He is ready to die.

All his life he has studied this moment — from those who killed themselves and those who tried, from philosophers and colleagues, students and intimates — and its lessons hold no real surprise.

The article is enriched by an illuminating photo-audio essay by photographer Liz O. Baylen, in which Shneidman–in his inimitably straightforward way–shares his view of the nature of death:

There is no spirit or soul. I will be dead, get that through your thick head. I will be dead, and I “live” in my children, in my DNA, in my books, in my reputation: It’s as simple as that.”

Curwen looks back at Shneidman’s early writings on death, beginning with his 1973 book Deaths of Man, which challenged the views of Elisabeth Kubler-Ross:

The end of life isn’t, as she proposed, defined by a succession of stages, one following the other, denial to acceptance, but instead a “nexus of emotions … a hive of affect, in which there is a constant coming and going.”

It was an auspicious moment. “Deaths” was a finalist for a National Book award in science. He was celebrated and feted. But the momentum faltered. Placing mental anguish in a social, cultural or familial context fell out of vogue. Prescribing pills became easier.

While the L.A. Times article is framed by Shneidman’s anticipation of death, it is just as much a meditation on life:

No one has to die, he is fond of saying; it will be done for you. It’s living, however, that takes effort — to weather the sleeplessness and worry, the relinquishing of pride, the dependency upon strangers, the plea for respect and the struggle to remember …

Death is quite simple. Life is more mysterious, and he never tires of its wonderments: How he — a Jew at that — survived the war, how he and a girl from the corn country of Illinois fell in love and married and had four children and such a long and happy life …

The night stretches before him with so many endless hours, and sleep will come, if at all, in the early dawn. Until then, there is some writing he would like to do.

Shneidman’s latest book is A Commonsense Book of Death.

For more on his concept of psychache, see the 2001 L.A. Times article by Curwen titled “Psychache,” in which Shneidman says,

“Suicide is a complex malaise. Sociologists have shown that suicide rates vary with factors like war and unemployment; psychoanalysts argue that it is rage toward a loved one that is directed inward; psychiatrists see it as a biochemical imbalance. No one approach holds the answer: It’s all that and much more …”

“For me, today, the central data to elicit from a potentially suicidal person are not a family history, a spinal tap assay, a demographic accounting or a psychoanalytical session,” he says. Rather, his approach is to listen closely while asking a patient two basic questions: “Where do you hurt?” and “How may I help you?”

[The abridged URL for this post is  bit.ly/edshneidman .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Lukas Writes New Book on Suicides in His Family

ORIGINAL ARTICLE — USA Today offers an article with four brief reviews of books on mental illness, one of which tells the story of TV producer and director Christopher Lukas’s loss of his mother and brother to suicide.

In Blue Genes, Lukas movingly describes what it was like to grow up the child of a suicide … He also describes his loving but complex relationship with his brother … This memoir also affirms the joy Lukas has found in being a husband and father.

The Wall Street Journal Digital Network features an interview with Lukas about  Blue Genes and his family’s experience with suicide. Lukas is also the author, along with psychologist Henry Seiden, of Silent Grief: Living in the Wake of Suicide.

The other books featured in the USA Today article are Hurry Down Sunshine, by Michael Greenberg; Stalking Irish Madness, by Patrick Tracey; and Scattershot: My Bipolar Family, by David Lovelace.

Suicide Prevention Champion Not Re-elected To Senate

ORIGINAL ANNOUNCEMENT — The Portland Oregonian announces that Sen. Gordon Smith (R-Ore) lost his bid for re-election in Tuesday’s vote.

Smith conceded the close race to Democrat Jeff Merkley this morning. A video of his comments captures a touching moment of him and his wife Sharon, both champions of the suicide prevention movement in America, standing side-by-side as he answers a question about his proudest accomplishment in Congress.

If you had to single one out, it would be the Garrett Lee Smith Memorial Act. This [serving in the Senate] is a job that takes its toll on families, and in my son’s name, we were able to do a great thing that is every week saving the life of a  young person. I’m very proud of that.

The Garrett Lee Smith Memorial Act was signed into law by President George W. Bush in October 2004, 13 months after the Smiths’ son died of suicide. The legislation provides funding to states and tribes as well as to colleges for youth suicide prevention programs, and it also supports the Suicide Prevention Resource Center, which provides technical assistance to suicide prevention projects in communities across the country.

Sen. Smith wrote a book about his son in 2006, Remembering Garrett. In the prologue, he says

In writing this book, in becoming a soldier in the battle against youth suicide, I am violating the last thing Garrett asked of me. He wrote in his suicide note, “Put me in the ground and forget about me.”

Forgive me, son, but I cannot forget about you. This is our story.

[The abridged URL for this post is http://tinyurl.com/ChampionNotElected .]

[Related SPNAC post: “Several Mental Health Champions Missing from 111th Congress“