Dying to be heard
Defining the act of suicide in Sri Lanka as a means of communication, US psychologist Jeanne Marecek says the problem has to be seen from a social context rather than from a clinical one as in the West
Prof. Marecek first arrived in Sri Lanka in 1988 as a Fulbright scholar to the University of Peradeniya. Having assisted in the initiation of the first Department of Psychology at the University, she has been closely involved in the growth of the field as a specialised subject in Sri Lanka
At present she is working with a group of people in Galle, attached to the Karapitiya Hospital, to study suicide in young teenagers, amongst whom incidences of self-harm have been increasing. They hope to counsel the young people who are admitted to hospital after acts of self-harm, and also to speak to families about care at home after such an incident has occurred.
What is it that drives someone to take his or her own life? Is suicide really the end of a long road of despair — or an unpremeditated act of anger or distress? Jeanne Marecek, Professor of Psychology at Swarthmore College, Pennsylvania has been studying the issue of suicide in Sri Lanka for almost 20 years, and feels that in this country, suicide is a 'niche disorder' — one that arises from psychological conditions that occur at a particular time and place.
Although the rates have decreased since 1995, when Sri Lanka had the dubious distinction of having the highest suicide rates in the world, it is still a major concern, especially among young people. Overall, more men die of suicide than women, but this difference gets smaller as you get into younger age groups.
"It is important to focus on one group of people at a time," explains Prof. Marecek, since, especially in Sri Lanka, suicide is really a matter concerning social situations and should be understood in the context of social groups.
Defining 'suicide' as death that is deliberate and self inflicted, and 'self-harm' as a deliberate attempt to injure oneself, she avoids the use of terms such as 'suicide attempt'. Such a term would indicate that whoever lived had 'failed' in their attempt, and it isn't right, she points out, to call the survivor a failure, or the one who has died, a 'success'.
Why do they do it?
Mala*, a young teenager, was teased in school by a girl who said Mala was married. Ashamed and angry, Mala drank insecticide when she got home that day.
Frank*, arrived at his little daughter's birthday party, completely drunk. His wife refused to take him into the house. Frank returned a few hours later with a weapon, destroyed several objects in the home, and then killed himself.
Why do people commit suicide? Too often, says Prof. Marecek, Western theories and explanations are taken as the universal standard. For instance, many people believe that clinical depression or similar psychological disorders are the main reasons behind suicide. This, however, is not true of Sri Lanka, where suicide is concentrated in rural areas and is rarely understood in terms of mental illness.
Apart from the economic instability and numerous other hardships that the villagers undergo, inter-personal conflicts and family disputes are often found to lead to suicide or acts of self-harm. According to Prof. Marecek, a number of culture-specific relational and emotional practices also contribute.
For instance, the prohibitions in displaying overt anger or other emotions which are not considered seemly in local society can result in repressed feelings that emerge in a single violent act. For women, a violation of their sense of modesty or shame — 'lajja or lajja baya' — can have devastating consequences, such as in the case of Mala. When norms of family and gender hierarchies are breached, such as when Frank was sent away by his wife, the resultant conflict may again lead to such acts.
Most of these people, explains Prof. Marecek, are trying to re-establish something they have lost — self-respect or dignity — by their acts. Categorising suicide into 'Monologue Suicide' (where the person is isolated, in despair, and trying to escape from themselves) and 'Dialogue Suicide' (where the act is directed at someone else, as a means of communication), she says that suicide in Sri Lanka usually falls into the latter category.
A desire for revenge or anger fuels many of these acts, which are unpremeditated, in contrast to the theory that those who commit suicide usually think about it for a long period beforehand. Prof. Marecek points out that 70% of the people who took poison thought about it for approximately just four hours before doing so.
Suicide and Sri Lankan women
Rashmi*, was the focus of some unpleasant gossip in her office. A co-worker had been spreading rumours that Rashmi was involved in a sexual relationship with the manager. Unable to bear the snide remarks and the slur on her reputation, Rashmi resorted to suicide.
Social life in Sri Lanka, says Prof. Marecek, has always been highly gendered and focused around generational and other hierarchies. However, with the influence of global forces and understanding of world wide economic changes, the role of rural women has been changing.
With more of these women finding employment — particularly in the Middle East, or in local garment factories — they have gained economic power, new opportunities for self expression and self determination, as well as more of a say in family affairs. While these jobs have provided an escape route from unpleasant home conditions — the drunkard husband, the abusive father — they have also led women to question their traditional ideas of what it means to be a 'good girl'.
Unfortunately, says Prof. Marecek, some women resort to self-harm or suicide as a means of navigating this moment of deeply unsettled cultural uncertainty.
How to deal with the issue
There is a lot of 'psy-talk' or psychological discussions among the urban elite in Sri Lanka on how to tackle the problem of suicide and self-harm, says Professor Marecek. Most of this is focused on Western ideology — raising self-esteem, teaching better coping and problem solving skills, etc.
"This improving of self is a very Western idea that doesn't make sense in Sri Lanka," says Prof. Marecek, adding that this individualistic approach ignores the other side of the conflict — the fact that something is very wrong in the family or the social situation. "Can you tell the wife of a drunkard that the problem lies with her, that she should try to improve herself, but it's ok for the husband to continue drinking?"
Therefore she feels that a more social approach should be taken to tackling the problem in Sri Lanka, and that the conflict needs to be addressed first, since suicide is a result of that conflict.
Finding ways to combat alcoholism and domestic violence, or to build solidarity among social groups to deal with issues like teasing or gossip, would be far more practical than only addressing the individual. Since 85% of suicide and self-harm cases involve poisoning, especially of pesticide, other practical measures include locking up poisons at home, avoiding the sale of pesticides to young children, or those who are obviously not farmers, and educating the public on what to do in a case of poisoning.
Names have been changed to protect the privacy of the