Suicide. The hidden side of modernity

Baudelot, C. and Establet, R. Suicide. The hidden side of modernity . Polity Press : Cambridge , 2008 xiv+210pp. £16.99 ISBN 13: 978-0-7456-4057-0 (pbk) 13:978-0-7456-4056-3 (hbk) It should come as no surprise to readers of this journal that the influence of Durkheimian constructs and propositions is pervasive throughout this monograph on the relationship between society and suicide, written by two French sociologists. The starting point is an assessment of the evidence in support of Durkheim’s propositions that ‘poverty protects’ and that any economic crisis, ‘even when it results in greater wealth’, leads to an increase in suicide. According to the authors, the historical data suggest that, while wealth and suicide were positively correlated in the 19th century, in the 20th century ‘the suicide rate fell or stagnated when purchasing power increased [and] rose when purchasing power declined’ (p.57). While there were many societal changes, including ‘creative individualism’ (construction of the collective around recognition of personal competencies and qualities) and self-realisation, which increased protection against suicide, these were outweighed by aggravating factors, such as lower levels of fertility, higher rates of divorce, an increasingly ageing population and decline of religious observance, all of which weakened traditional family ties and broader social capital, which in turn tended to increase suicide risk. Analysis of the relationship between social class and suicide shows that the U-shaped pattern (higher suicide incidence among those at the top and bottom of the socio-economic hierarchy) of mid-20th century USA gave way in later years to an inverse relationship: the lower the socio-economic position (individual level) or the more disadvantaged the locality (aggregate level), the higher the suicide rate. The authors explain this displacement of ‘suicide’s centre of gravity’ (p.147) towards the lowest socio-economic groups by emphasising the ‘greater protection for the Ruling Classes’ (see chapter 8) through more effective sociability and social integration (‘The social hierarchy of sociability … reaffirms the social hierarchy of suicide’ [p.149]) and (mental-)health promoting, psychosocial and material features of their working lives (e.g. high decision latitude, less job insecurity, lower threat of redundancy and better living conditions). The general argument is illustrated throughout by a considerable amount of empirical data and rich case studies of a wide range of topics. I would particularly single out for honourable mention the analyses of the ‘Soviet exception’, namely why the countries of the former socialist bloc have the highest suicide rates in the world (chapter 5), and the ‘spectacular … transformation’ (p.101) of the relationship between age and suicide over the past three decades (chapter 6). On the other hand, the methodological rigour of the book could have been strengthened by a more sophisticated approach to data analysis (there is too much reliance on bivariate correlation, when use of more complex, multivariate techniques would have reduced the risk of model misspecification) and an early decision to treat male and female suicide separately (given the very different trends and patterns by gender, as highlighted by the authors themselves). More thorough proof reading would have eliminated various irritating mistakes, such as poorly labelled tables, failure to cite sources for tables/graphs, and giving correlation coefficients as negative when they should be positive. At times the translation is somewhat clumsy and possibly incorrect. The authors are to be congratulated on successfully avoiding any hint of the sociological imperialism which led Durkheim to reject all attempts to relate suicide to psychological or individualistic factors. At the outset, they remark that ‘the sociology of suicide teaches us nothing about suicide insofar as it is an individual tragedy’ (p.8). In their conclusion (especially pp.183–7) they highlight the evidence (introduced in earlier chapters) of the important role played by excessive alcohol consumption and mental illness, especially depression, in individual suicides. ‘It is no longer possible,’ they state, ‘to deny the importance of individual factors…. The forces, impulses and crises that provoke suicide or that are associated with it are primarily individual’ (pp.184, 190). Noting the difficulty of reconciling ‘the sociologist’s telescopic view and the psychologist’s microscopic view’ (pp.186–7), the authors claim that ‘the sociologist and the psychiatrist are both right about suicide. Their respective bodies of knowledge complement one another, but they cannot communicate because their arguments are based on different scales’ (p.187). The willingness of two sociologists to accept the validity, legitimacy and value of different disciplinary perspectives on suicide is as refreshing as it is unusual. I have long been struck by the relative failure of suicide to reciprocate the respect shown by psychology and psychiatry to sociological, particularly Durkheimian, explanations, by acknowledging the importance of psychological/psychiatric explanations of suicide. The integration of the ‘different scales’ is indeed challenging but neither empirically unattainable nor theoretically impossible. I am less pessimistic than Baudelot and Establet appear to be about the possibility of achieving a genuinely inter-disciplinary approach to researching and understanding suicide. If this book contributes to the realisation of this dream it will have served a very useful purpose indeed.