Suicide in Sri Lanka

The Anthropology of an Epidemic

Tom Widger

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9781138820746
• eBook ISBN: 9781317589921
• Edition: 1
• Topic: Sciences sociales
• Subtopic: Études ethniques

Why 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, 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, tracing 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.

1 The anthropology of suicide

DOI: 10.4324/9781315743707-1

Mr Tom where are you? Come quickly. Ravi ayya has died.

Udagama youth, male, aged twenty-four

A few weeks after arriving in the peri-urban Madampe Division of the Northwest Province of Sri Lanka, Ravi, aged twenty-three, ¹ drowned in a monsoon-swollen river. It was late November 2004 and I had travelled to the South Asian island to carry out a two-year research project on self-harm and suicide in the country, where for several decades suicide rates had ranked among the highest in the world. For the past few days I had been attending a conference in the capital Colombo, and was travelling the seventy kilometres north to Madampe on board an intercity bus when I received an SMS. It was from Preshan, a mutual friend, who informed me of Ravi’s death and urged that I return as quickly as possible to attend the funeral house (maḷə gedərə), where Ravi’s body was lying in wake.

Upon returning to Madampe, I learned that the police had recorded Ravi’s death as being accidental, even though villagers were suggesting it was a suicide. By the day of Ravi’s funeral, two competing stories of how he had died were circulating the area. While close family and friends were maintaining that the death was an accident, most others in attendance were saying that it was self-inflicted. Among those who believed the death had been intentional were three of Ravi’s friends who had actually witnessed the death. Ravi, who had been drinking toddy (fermented coconut sap) and smoking ganja (marijuana), was reported to have taken a drag from his roll-up, declared ‘that was my last’, and jumped into the water. He resurfaced a short way downstream, caught up against a branch, by which time he was dead.

While for me personally coming to terms with Ravi’s sudden and tragic death had been about trying to establish whether it was an accident or a suicide, for people in Madampe a more pressing concern existed. Regardless of what kind of death it was, the more important question seemed to be who could be blamed for it, only after which people began to speculate about an appropriate classification. For my informants there was no discussion about the state of Ravi’s mental health, although there was considerable discussion about the social circumstances of his death. During the days and weeks that followed, two other accounts emerged in the wake of the accident and suicide stories. Both of those stories attempted to explain why Ravi, a ‘good boy’ (hoňdə lamay) who had done well at school and had always been polite to his elders, had met his demise under the influence of alcohol and drugs in the waters of a monsoon-swollen river. Whether an accident or a suicide, it was clearly a dangerous place to be, and people thought that Ravi should have known better. Who, Udagama villagers asked, had allowed this to happen?

The first story told, and mostly by those of Ravi’s age, simply explained how he had been in love with a woman who had broken his heart. Out of desperation, Ravi turned to toddy and ganja and cared less for his life; wilfully or not, he put himself into dangerous situations that eventually cost him his life. Many people told me that this was typical of young people in love, and that love was a dangerous thing that youth were all too ready to declare, often leading to frustrations, disappointments and deaths. Over the months that followed Ravi’s death, the woman in question was teased by her schoolmates and older boys in the village: ‘She’s very dangerous!’ Ravi’s friends would tell me, half in jest. Even before Ravi’s death, her beauty had been famous in the village, but now that she had ‘caused’ Ravi to kill himself, she was infamous. ‘Like a siren!’ one friend joked.

The second story told, in this case mostly by older men and women, was of how Ravi had been ‘abandoned’ by his mother. They explained how she had migrated to the Middle East to work as a housemaid, upon which Ravi’s father took a mistress and left home. Said to be experiencing desperation in the face of his loss of ‘mother’s love’, Ravi took up drink, drugs and other foolhardy pursuits. The stories I heard, which all placed the blame squarely on the mother, went something like this:

Ravi came from a broken home. His mother has worked as a housemaid in Saudi Arabia for the past five years, and some people say that she has a second husband there. In fact, some people say she once brought him back to visit Sri Lanka. As a consequence Ravi’s father was heartbroken and left Udagama to marry a woman who lives in Anuradhapura. Together with his younger sister, Ravi went to live with his ma:ma: [mother’s brother]. With his mother absent, Ravi lacked the love and care that would guide him along the correct path in life. He became addicted to drink and drugs and did other dangerous things that eventually cost him his life. If his mother had not been so greedy, if she had love in her heart and not only wanted money, Ravi would still be alive today.

Both sets of stories, I was to discover, fitted within well-worn theories expressed by women and men of all ages and backgrounds concerning the roots of problems and misfortunes in their lives. Their theories often explained personal and relational crises such as suicide in terms of ‘family problems’ ( pavul praʃnə), and the failure of close kin, friends, neighbours and society at large, to help people enjoy a ‘good family life’ (hoňda pavul ji:vite). The ways in which ‘a good family life’ were imagined, and the definitions and theories of suicidal practice arising from them, were always contingent on gender, generation and social class. At the same time, they reflected more popular theories about how people in general might live and die. Thus, men and women of a certain age or social status might assume themselves likely to resort to suicidal practices of certain kinds using certain methods when faced with certain problems, and equally be assumed by others of doing the same. The fact that Ravi had died in the context of love problems and/or of migration led almost everyone in Udagama to agree that Ravi had committed suicide. They further agreed that Ravi’s suicide was not only an accepted but expected outcome of such troubles. In Madampe, causal theories of suicide provided both a motivation for, and an explanation of, Ravi’s death, which only served to reproduce those theories further and direct similar kinds of suicidal practice in the future.

This book tells a story about how people in Madampe ‘live through suicide’, and in so doing how they generate social life: of how suicidal practices shape social practices and representations of society at large. By ‘live through suicide’, I mean two things. The first is how people in Madampe have lived through a period of extremely high rates of self-harm and self-inflicted death over the past few decades: a phenomenon which my informants knew all about. Their explanations of the national suicide rate spoke to general concerns about Sri Lanka’s experiences of development and globalisation in the modern period, and revolved around core narratives concerning the troubles of farmers and youth and the role of religion in their lives. The second is how people live through suicide. Suicidal practices are never simply the effects of a cause but a cause of their own effects; in Madampe, they may be understood as a manifestation of social and moral orders as well as being constitutive of those orders, and in particular imaginings of how family lives ‘ought’ to be, and what this means in social, moral and political terms. By integrating both perspectives, I show how suicidal practices give rise to suicide representations, through which people in Madampe come to make sense of their lives and the nation at large.

The Sri Lankan suicide ‘epidemic' and self-harm ‘endemic'

Suicide is a serious global health and social problem, with significant societal, economic and developmental effects. According to the World Health Organization (2012), every year almost one million people across the globe die from suicide. Over the past half-century, reported suicide rates around the world have risen 60 per cent and, based on current trends, the number of suicides will grow to 1.53 million yearly by 2020. It is estimated, furthermore, that between ten and twenty times the number of people who commit suicide, attempt suicide – elevating ‘deliberate self-harm’ to the level of a major health and social crisis outpacing that of suicide itself. The toll of suicide and self-harm on individuals, families, communities and nations is thus enormous, representing considerable levels of physical and social suffering.

Ravi’s death was just one of hundreds of acts of fatal and non-fatal self-harm that occurred in and around the Madampe Division during the twenty-one-month period of my fieldwork. On average, suicides occurred on a monthly basis, acts of self-harm on a weekly basis, and suicide threats – existing as part of everyday discourse – on a daily basis. They were in turn just a small percentage of the many thousands that occurred across Sri Lanka over the same period, and hundreds of thousands since the middle of the twentieth century – as many as 90,000 between 1983 and 1993 alone (Pradhan 2001: 383) – that have created what has been called Sri Lanka’s ‘suicide epidemic’ (Eddleston et al. 1998: 134; IRIN News 2009). During the same period that global suicide rates rose 60 per cent, the Sri Lankan suicide rate rose a staggering 870 per cent (Silva and Pushpakumara 1996: 73). Kearney and Miller (1985) showed how this rise had affected all demographic and social groups in Sri Lanka in equal measure, leading them to argue that the ‘spiral’ of suicides in Sri Lanka was being fuelled by ‘fundamental forces’ of economic, social and political change affecting all sections of society.

After 1996, however, something strange appeared to happen. First, the suicide rate began to fall, and is currently at its lowest level in more than thirty years. Second, the rate of attempted suicides began to rise, and according to some estimates by more than 300 per cent (IRIN News 2009) – i.e. at a magnitude greater than the fall of completed suicides. The fall may be understood as the consequence of government interventions restricting the import and sale of the most toxic pesticides (the most popular method of self-harm in Sri Lanka), improved access to and treatment in first aid centres, an apparently spontaneous shift away from pesticides to medicinal drugs which have a lower fatality rate (de Silva et al. 2012; Gunnell et al. 2007), and, I have argued, shifting representations in the social significance of self-inflicted death compared with non-lethal self-harm (Widger 2013). The ‘up-and-down’ behaviour of the suicide rate – the causes of which are located in ‘fundamental forces’ of social change as well as changing methods of self-harm – problematises mainstream theories of suicidal practice (ibid).

Traditionally, the academic study of suicide has been the concern of sociologists and psychologists, who have addressed self-destructive behaviours as a normative phenomenon: that is, as a problem universally definable and measurable. This may be understood as reflecting the status of suicide in European thought, traditions of which have come to shape understandings of suicide in particular ways (Hacking 1995; Giddens 1965; Minois 1999; Staples and Widger 2012). Since the European Middle Ages, there has been a long debate – first among religious scholars, moralists, philosophers and administrators, and from the nineteenth century within and between the emerging disciplines of sociology, psychology and psychiatry – concerning the proper representation of suicide. The term itself was only coined in the seventeenth century, taken from the Latin sui (of oneself) and caedes (murder) (Minois 1999: 182). It passed into English usage first, then French, and by the eighteenth century Spanish, Italian and Portuguese (ibid.: 183). Prior to that, the terms ‘self-murder’ and ‘self-homicide’ were used instead. Acts of self-murder or suicide were variously regarded as affronts to God, natural law or society, and thus deemed a criminal act. By the nineteenth century, an argument had erupted between two new professions, moral statistics (a precursor to modern sociology) and psychiatry, with the one locating suicide in social deviancy and the other in mental pathology (Hacking 1995).

Figure 1.1 The Sri Lankan suicide rate, 1948–2008 (source: after Gunnell et al. 2007: 1236; raw data kindly provided by David Gunnell. Additional data obtained from Sri Lanka Sumithrayo at www.srilankasumithrayo.org/statistics-a-data (accessed 16 July 2012)).

A central and on-going controversy ever since has thus been where to locate the causes of suicide: in macro-level social forces or internal emotional states. Social scientists have tended to argue for the former, and psychologists and psychiatrists for the latter. For the French sociologist Emile Durkheim (1951), who was writing at the end of the nineteenth century, suicide in Europe was best understood as the malady of a broken, egoistical and anomic society. Durkheim (1951: 210) argued that the suicide rate could be read as an artefact created by the ‘suicidogenic current’: the conditions in society that compel individuals to end their own lives. Durkheim posited that the suicidogenic current fluctuated according to degrees of social integration and moral regulation within society. With one or both too strong or too weak, the suicide rate rose or fell depending upon conditions and experiences of what he termed egoism, anomy, altruism and fatalism. Egoistic suicide was produced by a lack of social integration, which exposed individuals to suicide because they lost adequate levels of social support for dealing with their problems. Processes of social change that led people to lose their moorings in the social world, and thus their sense of belonging to a social group and the moral regulation that came with it, produced anomic suicide. Altruistic and fatalistic forms of suicide, for their part, were produced by strong social integration and moral regulation respectively, and for this reason were assumed to be only found in traditional, small-scale societies. Altruistic suicide was compelled not by some individual problem but rather by a sense of commitment to the group, while fatalistic suicide followed in contexts where individuals were so constrained by their social position that they could envisage no other life when that position disappeared.

In psychology and psychiatry, however, it has been the pathology of the individual that has garnered attention, with suicidal behaviour considered perhaps the most tragic manifestation of troubled minds. While social scientific studies of suicide almost inevitably locate their roots in Durkheim, even if they soon depart from him, in psychology no such obvious founding figure exists. The psychoanalytic tradition and even Freud himself had little to say on the matter (Alvarez 2002). Freud’s early formulation was concerned with the status of suicide as a kind of violence and thus an ‘internalised’ form of homicide. A later formulation may be found in Freud’s discussion of the ‘life drive’ (Eros) and the ‘death drive’ (Thanatos), in which suicide becomes a manifestation of the ‘death wish’. It was the early formulation that became most influential during the mid-twentieth century and appeared in such influential wo...

Table of contents

• Cover Page
• Half-Title Page
• Series
• Title Page
• Copyright Page
• Table of Contents
• List of figures
• List of tables
• Preface
• Acknowledgements
• Transliteration
• Abbreviations
• 1 The anthropology of suicide
• 2 Of villages, courts and clinics
• 3 Suicide there, suicide here
• 4 Relational flows
• 5 Suffering, frustration, anger
• 6 One life, one love
• 7 The Black Demon
• 8 The search for compassion
• 9 The suicide process
• Glossary
• Bibliography
• Index