Suicide

Suicide (pronounced soo-uh-sahyd)

(1) The intentional taking of one's own life.

(2) By analogy, acts or behavior, which whether intentional or not, lead to the self-inflicted destruction of one's own interests or prospects.

(3) In automotive design, a slang term for rear doors hinged from the rear.

(4) In fast food advertising, a niche-market descriptor of high-calorie products deliberately or absurdly high in salt, sugar and fat.

(5) A trick in the game Diabolo where one of the sticks is released and allowed to rotate 360° round the diabolo until it is caught by the hand that released it.

(6) In Queensland (Australia) political history, as suicide squad, the collective name for the additional members of the Legislative Council (upper house) appointed in 1921 solely for the purpose of voting for its abolition.

(7) In sardonic military slang, as suicide mission, a description for an operation expected to suffer a very high casualty rate.

(8) A children's game of throwing a ball against a wall and at other players, who are eliminated by being struck.

(9) Pertaining to a suicide bombing, the companion terms being suicide belt & suicide vest.

(10) In electrical power, as "suicide cable (or cord, lead etc)", a power cord with male connections each end and used to inject power from a generator into a structing wiring system (highly dangerous if incorrectly used).

(11) In drug slang, the depressive period that typically occurs midweek (reputedly mostly on Tuesdays, following weekend drug use.

(12) In US slang, a beverage combining all available flavors at a soda fountain (known also as the "graveyard" or "swamp water".

(13) As "suicide runs" or "suicide sprints", a form of high-intensity sports training consisting of a series of sprints of increasing lengths, each followed immediately by a return to the start, with no pause between one and the next.

1651: From the New Latin  suīcīdium (killing of oneself), from suīcīda and thought probably of English origin, the construct being the Latin suī (genitive singular of reflexive pronunciation of se (one’s self)) from suus (one’s own) + cīdium (the suffix forms cīda & cide) from caedere (to kill).  The primitive European root was s(u)w-o (one's own) from the earlier s(w)e and new coining displaced the native Old English selfcwalu (literally “self-slaughter”).  Suicide is a noun & verb, suicidal is a noun & adjective, suicider is a noun; the noun plural is suicides.  Pedantic scholars of Latin have never approved of the word because, technically, the construct could as well be translated as the killing of a sow but, in medieval times, purity had long deserted Latin and never existed in English.  The modern meaning dates from 1728; the term in the earlier Anglo Latin was the vaguely euphemistic felo-de-se (one guilty concerning himself).  It may be an urban myth but there was a story that a 1920s editor of the New York Times had a rule that anyone who died in a Stutz Bearcat would be granted a NYT obituary unless the death was a suicide.

Terry Richardson's (b 1965) suicide-themed shoot with Lindsay Lohan, 2012. 

The Legislative Council was the upper house of the state parliament in Queensland, Australia and a bastion of what might now be called the upper 1% of white privilege.  The Australian Labor Party (ALP) had long regarded the non-elected Legislative Council (and upper houses in general) as undemocratic and reactionary so in 1915, after securing a majority in the Legislative Assembly (the lower house) which permitted the party to form government, they sought abolition.  The Legislative Council predictably rejected the bills passed by the government in 1915 & 1916 and a referendum conducted in 1917 decisively was lost; undeterred, in 1920, the government requested the governor appoint sufficient additional ALP members to the chamber to provide an abolitionist majority.  In this, the ALP followed the example of the Liberal Party in the UK which in 1911 prevailed upon the king to appoint as many new peers as might be needed for their legislation to pass unimpeded through an otherwise unsympathetic House of Lords.  Ultimately, the king agreed but so shocking did the lords find the idea of their chamber being flooded with "jumped-up grocers" that they relented in their opposition.  In Queensland however, the new members of the Legislative Council duly took their places and on 26 October 1921, the upper house voted in favor of abolition, the new appointees known forever as "the suicide squad".  Despite the success, the trend didn't spread and the Commonwealth parliament and those of the other five states remain bicameral although the two recent creations, established when limited self-government was granted to the Northern Territory and Australian Capital Territory (ACT), both had unicameral assemblies.

Suicide doors

1928 Mercedes-Benz Nürburg (W08) with four rear-hinged doors.

It wasn’t until the 1950s the practice of hinging doors from the front became (almost) standardized.  Prior to that, they’d opened from the front or rear, some vehicles featuring both.  The rear-hinged doors became known as suicide doors because they were genuinely dangerous (in the pre-seat belt era), the physics of them opening while the car was at speed had the effect of dragging the passenger into the airstream.  Additionally, it was said they were more likely to injure people if struck by passing vehicles while being opened although the consequences of being struck by a car sound severe whatever the circumstances.

2021 Rolls-Royce Phantom VIII Tempus.

Still used in the 1960s by Lincoln, Ford and Rolls-Royce, they were phased out as post-Nader safety regulations began to be applied to automotive design and were thought extinct when the four door Ford Thunderbirds ceased production in 1971.  However, after being seen in a few design exercises over the decades, Rolls-Royce included them on the Phantom VII, introduced in 2003, the feature carried over to the Phantom VIII in 2017.  Like other manufacturers, Rolls-Royce has no fondness for the term suicide doors, preferring to call them coach doors; nomenclature from other marketing departments including flex doors and freestyle doors.  Engineers are less impressed by silly words, noting the correct term is rear-hinged and these days, mechanisms are included to ensure they can be opened only when the vehicle is at rest.  Encouraged by the reaction, Rolls-Royce brought back the rear-hinged door for their fixed (FHC) and drop-head (DHC) coupés although, despite the retro-touch, the factory seems now to call them simply coupés and convertibles.  

1971 Ford Thunderbird Landau.

In a nod to a shifting market, when the fifth generation Thunderbird was introduced in 1967, the four-door replaced the convertible which had been a staple of the line since 1955.  Probably the only car ever visually improved by a vinyl roof, the four-door was unique to the 1967-1971 generation, its replacement offered only as a coupé.  The decision effectively to reposition the model was taken to avoid a conflict with the new Mercury Cougar, the Thunderbird moving to the "personal coupé" segment which would become so popular.  So popular in fact that within a short time Ford would find space both for the Thunderbird and the Continental Mark III, changing tastes by the 1970s meaning the Cougar would also be positioned there along with a lower-priced Thunderbird derivative, the Elite.  Such was the demand for the personal coupé that one manufacturer successfully could support four models in the space, sometimes with over-lapping price-points depending on the options.  The four-door Thunderbirds are unique in being the only car ever built where the appearance was improved by the presence of a vinyl roof, the unusual semi-integration of the rear door with the C pillar necessitating something be done to try to conceal the ungainliness, the fake "landau irons" part of the illusion.

1966 Lincoln Continental convertible.

The combination of the suicide door, the four-door coachwork and perhaps even the association with the death of President Kennedy has long made the convertible a magnet for collectors but among American cars of the era, it is different in that although the drive-train is typical of the simple, robust engineering then used, it's packed also with what can be an intimidating array of electrical and hydraulic systems which require both expertise and equipment properly to maintain.  That need has kept a handful of specialists in business for decades, often rectifying the mistakes of others.  It was unique; after the even rarer Mercedes-Benz 300d Cabriolet D ceased production in 1962, Lincoln alone offered anything in the niche.  Introduced in 1961, the convertible was never a big seller, achieving not even four-thousand units in its best year and was discontinued after 1967, the two-door hardtop introduced the year before out-selling it by five to one.  The market had spoken; it would be the last convertible Lincoln ever produced.

Lincoln Continental concept, Los Angeles Motor Show, 2002.

Interest in the Lincoln Continental had been dwindling since the down-sizing of the early 1980s and the nameplate suffered a fourteen year hiatus between 2002-2016.  Unfortunately, the resuscitation used as its inspiration the concept car displayed at the 2015 New York International Auto Show rather than the one so admired at Los Angeles in 2002.  The LA concept might not have been original but was an elegant and balanced design, unlike what was offered in NYC fifteen years later: a dreary mash-up which looked something like a big Hyundai or a Chinese knock-off of a Maybach.  The public response was muted.

Lincoln Continental concept, New York Motor Show, 2015.

By 2019, it seemed clear the thing was on death-watch but Lincoln surprised the industry with a batch of eighty longer-wheelbase models with suicide doors to mark the eightieth anniversary of the Continental’s introduction in 1939.  Although there were cynics who suggested turning a US$72K car into one costing US$102K was likely aimed at the Chinese market where a higher price tag and more shiny stuff is thought synonymous with good taste, the anniversary models were sold only in the home market.

2019 Lincoln Continental Eightieth Anniversary Edition.

The retro gesture proved not enough.  After building a further one-hundred and fifty (non-commemorative) suicide door versions for 2020, it was announced production would end on 30 October 2020 and the Continental would not be replaced.  Not only was the announcement expected but so was the reaction; the market having long lost interest in the uninspiring twenty-first century Continentals, few expressed regret.  The name-plate however, one of the most storied in the Ford cupboard, will doubtless one day return.  What it will look like is unpredictable but few expect it will match the elegance of what was done in the 1960s.

Evelyn McHale: The most beautiful suicide.

The photograph remembered as “the most beautiful suicide” was taken by photography student Robert Wiles (1909-1991), some four minutes after the victim's death.  Evelyn Francis McHale (1923–1947) was a bookkeeper who threw herself to her death from the 86th-floor observation deck of New York's Empire State Building, landing on a Cadillac limousine attached to the General Assembly of the United Nations (UN) which was parked on 34th street, some 200 feet (60 m) west of Fifth Ave.  The police would later find he last note which read: “I don’t want anyone in or out of my family to see any part of me. Could you destroy my body by cremation?  I beg of you and my family – don’t have any service for me or remembrance for me.  My fiance asked me to marry him in June.  I don’t think I would make a good wife for anybody. He is much better off without me.  Tell my father, I have too many of my mother’s tendencies.”  It's reported her mother suffered from “an undiagnosed and untreated depression”.

Psychache

Psychache (pronounced sahyk-eyk)

Psychological pain, especially when it becomes unbearable, producing suicidal thoughts.

1993: The construct was psyche- + ache.  Psychache was coined by US clinical psychologist Dr Edwin Shneidman (1918-2009) and first appeared in his book Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior (1993).  The prefix psych- was an alternative form of psycho-.  Psycho was from the Ancient Greek ψῡχο- (psūkho-), a combining form of ψυχή (psukhḗ) (soul).  Wit was used with words relating to the soul, the mind, or to psychology.  Ache was from the Middle English verb aken & noun ache (noun), from the Old English verb acan (from the Proto-West Germanic akan, from the Proto-Germanic akaną (to ache)) and the noun æċe (from the Proto-West Germanic aki, from the Proto-Germanic akiz), both from the primitive Indo-European heg- (sin, crime).  It was cognate with the Saterland Frisian eeke & ääke (to ache, fester), the Low German aken, achen & äken (to hurt, ache), the German Low German Eek (inflammation), the North Frisian akelig & æklig (terrible, miserable, sharp, intense), the West Frisian aaklik (nasty, horrible, dismal, dreary) and the Dutch akelig (nasty, horrible).  Historically the verb was spelled ake, and the noun ache but the spellings became aligned after Dr Johnson (Samuel Johnson (1709-1784)) published A Dictionary of the English Language (1755), the lexicographer mistakenly assuming it was from the Ancient Greek ἄχος (ákhos) (pain) due to the similarity in form and meaning of the two words.  As a noun, ache meant “a continuous, dull pain (as opposed to a sharp, sudden, or episodic pain) while the verb was used to mean (1) to have or suffer a continuous, dull pain, (2) to feel great sympathy or pity and (3) to yearn or long for someone or something.  Pyscheache is a noun

Psychache is a theoretical construct used by clinical suicidologists and differs from psychomachia (conflict of the soul).  Psychomachia was from the Late Latin psӯchomachia, the title of a poem of a thousand-odd lines (circa 400) by Roman Christian poet Prudentius (Aurelius Prudentius Clemens; 348-circa 412), the construct being the Ancient Greek Greek psukhē (spirit) + makhē (battle).  The fifth century poem Psychomachia (translated usually as “Battle of Spirits” or “Soul War”) explored a theme familiar in Christianity: the eternal battle between virtue & vice (onto which can be mapped “right & wrong”, “good & evil” etc) and culminated in the forces of Christendom vanquishing pagan idolatry to the cheers of a thousand Christian martyrs.  An elegant telling of an allegory familiar in early Christian literature and art, Prudentius made clear the battle was one which happened in the soul of all people and thus one which all needed to wage, the outcome determined by whether the good or evil in them proved stronger.  The poem’s characters include Faith, Hope, Industry, Sobriety, Chastity, Humility & Patience among the good and Pride, Wrath, Paganism, Avarice, Discord, Lust & Indulgence in the ranks of the evil but scholars of literature caution that although the personifications all are women, in Latin, words for abstract concepts use the feminine grammatical gender and there’s nothing to suggest the poet intended us to read this as a tale of bolshie women slugging it out.  Of interest too is the appearance of the number seven, so familiar in the literature and art of Antiquity and the Medieval period as well as the Biblical texts but although Prudentius has seven virtues defeat seven vices, the characters don’t exactly align with either the canonical seven deadly sins, nor the three theological and four cardinal virtues.  In modern use, the linguistic similarity between psychache and psychomachia has made the latter attractive to those seduced by the (not always Germanic) tradition of the “romance of suicide”.

A pioneer in the field of suicidology, Dr Shneidman’s publication record was indicative of his specialization.

Dr Edwin Shneidman (1918-2009) was a clinical psychologist who practiced as a thanatologist (a practitioner in the field of thanatology (the scientific study of death and the practices associated with it, including the study of the needs of the terminally ill and their families); the construct of thanatology being thanato- (from the Ancient Greek θάνατος (thánatos) (death)) +‎ -logy.  The suffix -ology was formed from -o- (as an interconsonantal vowel) +‎ -logy.  The origin in English of the -logy suffix lies with loanwords from the Ancient Greek, usually via Latin and French, where the suffix (-λογία) is an integral part of the word loaned (eg astrology from astrologia) since the sixteenth century.  French picked up -logie from the Latin -logia, from the Ancient Greek -λογία (-logía).  Within Greek, the suffix is an -ία (-ía) abstract from λόγος (lógos) (account, explanation, narrative), and that a verbal noun from λέγω (légō) (I say, speak, converse, tell a story).  In English the suffix became extraordinarily productive, used notably to form names of sciences or disciplines of study, analogous to the names traditionally borrowed from the Latin (eg astrology from astrologia; geology from geologia) and by the late eighteenth century, the practice (despite the disapproval of the pedants) extended to terms with no connection to Greek or Latin such as those building on French or German bases (eg insectology (1766) after the French insectologie; terminology (1801) after the German Terminologie).  Within a few decades of the intrusion of modern languages, combinations emerged using English terms (eg undergroundology (1820); hatology (1837)).  In this evolution, the development may be though similar to the latter-day proliferation of “-isms” (fascism; feminism et al).

Death and the College Student: A Collection of Brief Essays on Death and Suicide by Harvard Youth (1973) by Dr Edwin Shneidman.  Dr Shneidman wrote many papers about the prevalence of suicide among college-age males, a cross-cultural phenomenon.

Dr Shneidman was one of the seminal figures in the discipline of suicidology, in 1968 founding the AAS (American Association of Suicidology) and the principal US journal for suicide studies: Suicide and Life-Threatening Behavior.  The abbreviation AAS is in this context used mostly within the discipline because (1) it is a specialized field and (2) there are literally dozens of uses of “AAS”.  In Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior (1993) he defined psychache as “intense psychological pain—encompassing hurt, anguish, and mental torment”, identifying it as the primary motivation behind suicide, his theory being that when psychological pain becomes unbearable, individuals may perceive suicide as their only escape from torment.

Although since Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior appeared in 1993 there have been four editions of American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), “psychache” has never appeared in the DSM.  That may seem an anomaly given much in the DSM revolves around psychological disturbances but the reason is technical.  What the DSM does is list and codify diagnosable mental disorders (depression, schizophrenia. bipolar disorder et al), classifying symptoms and behaviors into standardized categories for diagnosis and treatment planning.  By contrast, psychache is not a clinical diagnosis; it is a theoretical construct in suicidology which is used to explain the subjective experience of psychological pain that can lead to patients taking their own lives.  It thus describes an emotional state rather than a psychiatric disorder.

Lindsay Lohan and her lawyer in court, Los Angeles, December, 2011.

Despite that, mental health clinicians do actively use the principles of psychache, notably in suicide risk assessment and prevention and models have been developed including a number of “psychache scales”, self-reporting tools used to generate a metric measuring the intensity of psychological pain (categorized with headings such as shame, guilt, despair et al).  The approaches do in detail differ but most follow Dr Shneidman’s terminology in that the critical threshold is the point at which the patient’s pain becomes unbearable or inescapable and the objective is either to increase tolerance for distress or reframe troublesome thoughts.  Ultimately, the purpose of tools is to improve suicide risk assessments and reduce suicide rates.

DSM-5 (2013).

Interestingly, Suicidal Behavior Disorder (SBD) was introduced in Section III of the DSM-5 (2013) under “Conditions for Further Study”.  Then, SBD chiefly was characterized by a self-initiated sequence of behaviors believed at the time of initiation to cause one’s own death and occurring in the last 24 months.  That of course sounds exact but the diagnostic criteria in the DSM are written like that and the purpose of inclusion in the fifth edition was to create a framework so systematically, empirical studies related to SBD could be reviewed so primary research themes and promising directions for future research could be identified.  Duly, over the following decade that framework was explored but the conclusion was reached there seemed to be little utility in the clinical utility of SBD as a device for predicting future suicide and that more research was needed to understand measurement of the diagnosis and its distinctiveness from related disorders and other self-harming behaviors.  The phase “more research is required” must be one of the most frequently heard among researchers.

In the usually manner in which the APA allowed the DSM to evolve, what the DSM-5s tentative inclusion of SBD did was attempt to capture suicidality as a diagnosis rather than a clinical feature requiring attention.  SBD was characterized by a suicide attempt within the last 24 months (Criterion A) and that was defined as “a self-initiated sequence of behaviors by an individual who, at the time of initiation, expected that the set of actions would lead to his or her own death”.  That sounds uncontroversial but what was significant was the act could meet the criteria for non-suicidal self-injury (ie self-injury with the intention to relieve negative feelings or cognitive state in order to achieve a positive mood state (Criterion B) and cannot be applied to suicidal ideation or preparatory acts (Criterion C).  Were the attempt to have occurred during a state of delirium or confusion or solely for political or religious objectives, then SBD is ruled out (Criteria D & E).  SBD (current) is given when the suicide attempt occurred within the last 12 months, and SBD (in early remission), when it has been 12-24 months since the last attempt.  It must be remembered that while a patient’s behavior(s) may overlap across a number of the DSM’s diagnosises, the AMA’s committees have, for didactic purposes, always preferred to “silo” the categories.

DSM-5-TR (2022).

When in 2022 the “text revision” of the DSM-5 (DSM-5-TR) was released, SBD was removed as a condition for further study in Section III and moved to “Other Conditions That May Be a Focus of Clinical Attention” in Section II. The conditions listed in this section are intended to draw to attention of clinicians to the presence and breadth of additional issues routinely encountered in clinical practice and provide a procedure for their systematic documentation.  According to the APA’s editorial committee, the rationale for the exclusion of SBD from the DSM-5-TR was based on concerns the proposed disorder did not meet the criteria for a mental disorder but instead constituted a behavior with diverse causes and while that distinction may escape most of us, within the internal logic of the history of the DSM, that’s wholly consistent.  At this time, despite many lobbying for the adoption of a diagnostic entity for suicidal behavior, the APA’s committees seem still more inclined to conceptualize suicidality as a symptom rather than a disorder and despite discussion in the field of suicidology about whether suicide and related concepts like psychache should be treated as stand-alone mental health issues, that’s a leap which will have to wait, at least until a DSM-6 is published.

How to and how not to: Informatie over Zorgvuldige Levensbeëindiging (Information about the Careful Ending of Life, 2008) by Stichting Wetenschappelijk Onderzoek naar Zorgvuldige Zelfdoding (The Foundation for Scientific Research into Careful Suicide) (left) and How Not to Kill Yourself: A Phenomenology of Suicide (2023) by Clancy Martin (right).

Informatie over Zorgvuldige Levensbeëindiging (Information about the Careful Ending of Life, 2008) was published by a group of Dutch physicians & and researchers; it contained detailed advice on methods of suicide available to the general public, the Foundation for Scientific Research into Careful Suicide arging “a requirement exists within society for responsible information about an independent and dignified ending of life.”  It could be ordered only from the foundation’s website and had the advantage that whatever might be one’s opinion on the matter, it was at least written by physicians and scientists and thus more reliable than some of the “suicide guides” which are sometimes found on-line.  At the time research by the foundation had found that despite legislation in the Netherlands which permit doctors (acting within specific legal limits) to assist patient commit suicide, there were apparently several thousand cases each year of what it termed “autoeuthanasia” in which no medical staff directly were involved.  Most of these cases involved elderly or chronically ill patients who refused food and fluids and it was estimated these deaths happened at about twice the rate of those carried out under the euthanasia laws.  Since then the Dutch laws have been extended to included those who have no serious physical disease or are suffering great pain; there are people who simply no longer wish to live, something like the tragic figure in Blue Öyster Cult’s (Don't Fear) The Reaper (1976) © Donald Roeser (b 1947):

Came the last night of sadness
And it was clear she couldn't go on
Then the door was open and the wind appeared
The candles blew then disappeared
The curtains flew then he appeared
Saying don't be afraid

There is a diverse literature on various aspects of suicide (tips and techniques, theological & philosophical interpretations, cross-cultural attitudes, history of its treatment in church & secular law etc) and some are quite personal, written variously by those who later would kill themselves or those who contemplated or attempted to take their own lives.  In How Not to Kill Yourself: A Phenomenology of Suicide (2023) by Canadian philosopher Clancy Martin (b 1967), it was revealed the most recent of his ten suicide attempts was “…in his basement with a dog leash, the consequences of which he concealed from his wife, family, co-workers, and students, slipping back into his daily life with a hoarse voice, a raw neck and series of vague explanations.”

BKA (the Bundeskriminalamt, the Federal Criminal Police Office of the FRG (Federal Republic of Germany (the old West Germany)) mug shots of the Red Army Faction's Ulrike Meinhof (left) and Gudrun Ensslin (right).

The song (Don't Fear) The Reaper also made mention of William Shakespeare's (1564–1616) Romeo and Juliet (1597) and in taking her own life (using her dead lover’s dagger) because she doesn’t want to go on living without him, Juliette joined the pantheon of figures who have made the tragedy of suicide seem, to some, romantic.  Politically too, suicide can grant the sort of status dying of old age doesn’t confer, the deaths of left-wing terrorists Ulrike Meinhof (1934–1976) and Gudrun Ensslin (1940–1977) of the West German Red Army Faction (the RAF and better known as the “Baader-Meinhof gang”) both recorded as “suicide in custody” although the circumstances were murky.  In an indication of the way moral relativities aligned during the high Cold War, the French intellectuals Jean-Paul Sartre (1905–1980) and Simone de Beauvoir (1908–1986) compared their deaths to the worst crimes of the Nazis but sympathy for violence committed for an “approved” cause was not the exclusive preserve of the left.  In July, 1964, in his speech accepting the Republican nomination for that year’s US presidential election, proto-MAGA Barry Goldwater (1909–1998) concluded by saying: “I would remind you that extremism in the defense of liberty is no vice!  And let me remind you also that moderation in the pursuit of justice is no virtue!”  The audience response to that was rapturous although a few months later the country mostly didn’t share the enthusiasm, Lyndon Johnson (LBJ, 1908–1973; US president 1963-1969) winning the presidency in one of the greatest landslides in US electoral history.  Given the choice between crooked old Lyndon and crazy old Barry, Americans preferred the crook.

Nor was it just politicians and intellectuals who could resist the appeal of politics being taken to its logical “other means” conclusion, the Canadian singer-songwriter Leonard Cohen (1934-2016) during the last years of the Cold War writing First We Take Manhattan (1986), the lyrics of which were open to interpretation but clarified in 1988 by the author who explained: “I think it means exactly what it says.  It is a terrorist song.  I think it's a response to terrorism.  There's something about terrorism that I've always admired.  The fact that there are no alibis or no compromises.  That position is always very attractive.”   Even in 1988 it was a controversial comment because by then not many outside of undergraduate anarchist societies were still romanticizing terrorists but in fairness to the singer the coda isn’t as often published: “I don't like it when it's manifested on the physical plane – I don't really enjoy the terrorist activities – but Psychic Terrorism.”

First We Take Manhattan (1986) by Leonard Cohen

They sentenced me to twenty years of boredom

For tryin' to change the system from within

I'm coming now, I'm coming to reward them

First we take Manhattan, then we take Berlin

 

I'm guided by a signal in the heavens

I'm guided by this birthmark on my skin

I'm guided by the beauty of our weapons

First we take Manhattan, then we take Berlin

 

I'd really like to live beside you, baby

I love your body and your spirit and your clothes

But you see that line there moving through the station?

I told you, I told you, told you, I was one of those

 

Ah you loved me as a loser, but now you're worried that I just might win

You know the way to stop me, but you don't have the discipline

How many nights I prayed for this, to let my work begin

First we take Manhattan, then we take Berlin

 

I don't like your fashion business, mister

And I don't like these drugs that keep you thin

I don't like what happened to my sister

First we take Manhattan, then we take Berlin

 

I'd really like to live beside you, baby

I love your body and your spirit and your clothes

But you see that line there moving through the station?

I told you, I told you, told you, I was one of those

First We Take Manhattan performed by Jennifer Warnes (b 1947), from the Album Famous Blue Raincoat (1986). 

Whatever they achieved in life, it was their suicides which lent a lingering allure to German-American ecofeminist activist Petra Kelly (1947–1992) & the doomed poet American poet Sylvia Path (1932-1963) and the lure goes back for millennia, the Roman Poet Ovid (Publius Ovidius Naso; 43 BC–17 AD) in his Metamorphoses telling an ancient Babylonian tale in which Pyramus, in dark despair, killed herself after finding her young love lifeless.  Over the centuries it’s been a recurrent trope but the most novel take was the symbolic, mystical death in Richard Wagner's (1813–1883) Tristan und Isolde (1865).  Mortally wounded in a duel before the final act, Tristan longs to see Isolde one last time but just as she arrives at his side, he dies in her arms.  Overwhelmed by love and grief, Isolde sings the famous Liebestod (Love-Death) and dies, the transcendent aria interpreted as the swansong which carries her to join Tristan in mystical union in the afterlife.  This, lawyers would call a “constructive suicide”.

Austrian soprano Helga Dernesch (b 1939) in 1972 performing the Liebestod aria from Wagner’s Tristan und Isolde with the Berlin Philharmonic under Herbert von Karajan (1908–1989).

While she didn’t possess the sheer power of the greatest of the Scandinavian sopranos who in the mid-twentieth century defined the role, Dernesch brought passion and intensity to her roles and while, on that night in 1972, the lushness of what Karajan summoned from the strings was perhaps a little much, her Liebestod was spine-tingling and by then, Karajan had been forgiven for everything.  Intriguingly, although Tristan und Isolde is regarded as one of the great monuments to love, in 1854 Wagner had written to the Hungarian composer Franz Liszt (1811–1886) telling him:

“As I have never in life felt the real bliss of love, I must erect a monument to the most beautiful of all my dreams, in which, from beginning to end, that love shall be thoroughly satiated.  I have in my head ‘Tristan and Isolde’, the simplest but most full-blooded musical concepion; with the ‘black flag’ which floats at the end of it I shall cover myself to die.”

It’s not known whether Listz reflected on this apparent compositional self-medication for psychache after in 1870 learning from his morning newspaper his daughter Cosima (1837-1930) was to be married to Wagner (then 24 years her senior) but because she’d been for some seven years conducting an adulterous affair with the German the news may not have been unexpected.  He was aware Cosmia’s daughter (Isolde Beidler (1865–1919)) had been fathered not by her then husband (the German conductor Hans von Bülow (1830–1894)) but by Wagner and her second marriage proved happier than the first so there was that.

Cutter

Cutter (pronounced kuht-er)

(1) A person employed to cut something, applied especially to one who cuts fabric for garments.

(2) A machine, tool, knife or other device for cutting.

(3) In nautical use, a single-mast sailing vessel, very similar to a sloop but having its mast set somewhat farther astern, about two-fifths of the way aft measured on the water line.

(4) In nautical use, a ship's boat having double-banked oars and one or two lugsails.

(5) In nautical use, a lightly armed government vessel used to prevent smuggling and enforce the customs regulations (known also as a revenue cutter).

(6) In psychiatry & psychology, a patient who repeatedly inflicts self-injury by cutting their flesh, a behavior traditionally associated with negative emotions.

(7) A person employed as a film editor, the titled derived from when physical film stock was physically cut with blades and re-joined.

(8) A small, light sleigh, usually single-seated and pulled by one horse.

(9) In construction, a brick suitable for cutting and rubbing, traditionally yellow and used for face-work (also called a rubber and now mostly obsolete but still use in restoration work).

(10) In industrial meat production (in the US government’s grading of beef), a lower-quality grade between utility and canner, used mostly in processed products such as hot dog sausages.

(11) In industrial meat production, a pig weighing between 68-82 kg (150-181 lb), from which fillets and larger joints are cut.

(12) In industrial meat production, an animal yielding inferior meat, with little or no external fat and marbling.

(13) In baseball, a variation of the fastball pitch.

(14) In cricket, as "leg cutter", a ball bowled by a fast bowler using finger spin to move the ball from leg to off (when delivered to a right-handed batsman); unrelated to the cut shot ("leg cut" & "off cut") except in the adjectival sense whereby a batsman might be described as “an expert cutter”, “an inept cutter” etc.  The "off cutter" is a delivery which moves in the other direction. 

(15) In dental classification, a foretooth; an incisor.

(16) In UK prison slang, a ten-pence (10p) piece, so named because it is the coin most often sharpened by prison inmates to use as a weapon.

(17) In medical slang, a surgeon (also modified to reflect specialties, neurosurgeons being “head cutters”, thoracic surgeons “chest cutter” etc).

(18) In the slang of criminology, an offender who habitually uses balded weapons to inflict injuries (also known as “slashers”).

(19) In film & television production, a flag, plate or similar instrument for blocking light.

(20) An officer in the exchequer who notes by cutting on the tallies the sums paid (obsolete).

(21) In slang, a disreputable ruffian (obsolete).

(22) As Cutter Expansive Classification (CEC), a library classification system, now obsolete although the core structure remains the basis for the system used by the US Library of Congress.

1375–1425: From the Middle English kittere & cuttere, the construct being cut(t) + -er.  Cut was from the Middle English cutten, kitten, kytten & ketten (to cut) (the Scots form was kut & kit), of North Germanic origin, from the Old Norse kytja & kutta, from the Proto-Germanic kutjaną & kuttaną (to cut), of uncertain origin, though there may be links with the Proto-Germanic kwetwą (meat, flesh) (related to the Old Norse kvett (meat)).  It was akin to the Middle Swedish kotta (to cut or carve with a knife) (the Swedish dialectal forms were kåta & kuta (to cut or chip with a knife)), the Swedish kuta & kytti (a knife), the Norwegian Bokmål kutte (to cut), the Norwegian Nynorsk kutte (to cut), the Icelandic kuta (to cut with a knife), the Old Norse kuti (small knife) and the Norwegian kyttel, kytel & kjutul (pointed slip of wood used to strip bark).  It displaced the native Middle English snithen (from the Old English snīþan) although the German schneiden survives still in some dialects as snithe or snead.  The –er suffix was from the Middle English –er & -ere, from the Old English -ere, from the Proto-Germanic -ārijaz, thought most likely to have been borrowed from the Latin –ārius where, as a suffix, it was used to form adjectives from nouns or numerals.  In English, the –er suffix, when added to a verb, created an agent noun: the person or thing that doing the action indicated by the root verb.   The use in English was reinforced by the synonymous but unrelated Old French –or & -eor (the Anglo-Norman variant -our), from the Latin -ātor & -tor, from the primitive Indo-European -tōr.  When appended to a noun, it created the noun denoting an occupation or describing the person whose occupation is the noun.

A glove cutter at his bench at Omega srl Gloves (the Omega Glove Factory), Rione Sanità district, Naples, Italy.  In American Pastoral (1997), Philip Roth (1933–2018) wrote that no one was able to make gloves as well as “some small factory in Rione Sanità in Naples.”  In the 1980s, most glove production moved from Europe to the Far East and it's believed there are now fewer than a hundred master-certified glove cutters left in the world, the title formalized in seventeenth century France and conferred only after years of mentorship.

Night Suspect, a British Coast Guard Cutter in Pursuit (1958), oil on canvas by Montague Dawson (1890-1973). 

As a surname derived from occupation, Cutter emerged in the late twelfth century, based on the agent noun cutter (“one who cuts something” or “one who shapes or forms by cutting") from the verb cut From the 1630s it came to be used to describe an "instrument or tool for cutting", the use spreading as specialized tools and machines were developed.  In nautical use, beginning in 1792, it was applied to a range of small, single-mast vessels, a borrowing from the earlier use for a “double-banked boat belonging to a ship of war”, noted since 1745 and the rationale is unrecorded but it may have been either because of the similar lines of the hull or the more romantic idea of “cutting through” (moving quickly) the water.

Cake cutter: Lindsay Lohan cutting her chocolate birthday cake.

The original ships were the “revenue cutters", lightly-armed government vessels commissioned for the prevention of smuggling and the enforcement of the customs regulations.  The use was therefore for some time restricted to vessels cutter-rigged, but the name has survived to transcend the original specification, almost all revenue ships now powered while the handful of sailed-ships are schooner-rigged.  Modifiers are used to describe various specialized tools used for cutting including biscuit cutter, cigar cutter, bolt cutter, box-cutter, gem cutter, glass cutter, leaf-cutter et al.  The original box cutters, dating from 1871, were those employees with the task of “cutting boxes” while the installed box cutters were pieces of large industrial plant, first noted in 1890; the familiar modern box cutter (hand-held bladed tool for cutting cardboard) first sold in 1944.  A cookie cutter is literally a device used to cut shapes from a sheet of pastry dough but is also used figuratively to describe to things which are un-original or un-imaginative.  Cutter is a noun & adjective; the noun plural is cutters.

Cutters: Non-Suicidal Self-Injury (NSSI)

Fresh cuts.

Cutters are the best known example of self-harmers, the diagnosis of which is described in the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) as non-suicidal self-injury (NSSI).  NSSI is defined as the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned; it includes behaviors such as cutting, burning, biting and scratching skin.  Behaviorally, it’s highly clustered with instances especially prevalent during adolescence and the majority of cases being female although there is some evidence the instances among males may be under-reported.  It’s a behavior which has long interested and perplexed the profession because as something which involves deliberate and intentional injury to body tissue in the absence of suicidal intent (1) it runs counter to the fundamental human instinct to avoid injury and (2) as defined the injuries are never sufficiently serious to risk death, a well-understood reason for self-harm.  Historically, such behaviors tended to be viewed as self-mutilation and were thought a form of attenuated suicide but in recent decades more attention has been devoted to the syndrome, beginning in the 1980s at a time when self-harm was regarded as a symptom of borderline personality disorder (BPD) (personality disorders first appeared in the DSM-III (1980), distinguished by suicidal behavior, gestures, threats or acts of self-mutilation.

US Coast Guard (USCG) Legend Class National Security Cutter.

Clinicians however advanced the argument the condition should be thought a separate syndrome (deliberate self-harm syndrome (DSHS)), based on case studies which identified (1) a patient’s inability to resist the impulse to injure themselves, (2) a raised sense of tension prior to the act and (3) an experience of release or at least partial relief after the act.  That a small number of patients were noted as repeatedly self-harming was noted and it was suggested that a diagnosis called repetitive self-mutilation syndrome (RSMS) should be added to the DSM.  Important points associated with RSMS were (1) an absence of conscious suicidal intent, (2) the patient’s perpetually negative affective/cognitive which was (temporarily) relieved only after an act of self-harm and (3) a preoccupation with and repetitiveness of the behavior.  Accordingly, NSSI Disorder was added to the DSM-5 (2013) and noted as a condition in need of further study.

KEIBA Side Cutters.

Although interest in the cutters spiked in the 1990s, papers had been published as early as the 1930s and the literature suggests something of a consensus among clinicians it should be regarded a matter of self-mutilation, such acts a form of attenuated suicide.  Accordingly, all non-fatal and deliberate forms of self-injury tended to be viewed as suicide attempts, regardless of whether there was any expressed suicidal intent and it wasn’t until the 1960s that any volume of doubt emerged.  That was significant, not only because self-injury was coming to be understood as something distinct from attempted suicide but that it implied the instance of attempted suicide was significantly overstated, something of interest to many.  This led to the coining of the novel word “parasuicide”, perhaps an indication the profession still preferred to think cutting a sub-set rather than anything distinct.

Cutters' scars, fresh & fading.

For clinicians, NSSI can at the margins be a difficult diagnosis.  To fit the diagnostic criteria in the DSM-5, NSSI must be intentional and deliberate but acts sometimes occurs during dissociative episodes so a judgment needs to be made determining whether an act can be held to be intentional if the patient is detached from reality.  As a definitional matter. there’s also the issue that if the motivation is to “feel something” some degree of intentionality seems at least implied but these examples do illustrate why NSSI among those suffering an episode of dissociation need even more carefully to be assessed before a diagnosis is decided.  There’s also a threshold criterion for the injury suffered, wounds needing to be “moderately intense” to qualify, thus the exclusion of such as lip-biting, scab & skin picking, hair pulling and nail-biting, even if these injuries might demand clinical care in another context (and may well be relevant in assessment measures).  Some extent of a “destruction of body tissue” is thus required and the current DSM-5 definition specifies bleeding or bruising.  However, it’s noted in cases studies that while minor and highly normative behaviors such as lip-biting, skin picking and hair pulling are excluded: (1) When severe they may be indicative of another specific condition such as trichotillomania (hair-pulling disorder) or excoriation (skin-picking disorder) rather than NSSI and (2) repeated and obsessional instances of behavior that might otherwise be considered mild and normative might appropriately be diagnosed as NSSI.

Case Fatality Rates by Suicide Method (8 indicative US states, 1989-1997)

Although the instances of death resulting from cutting are low, it’s clear many patients engage in NSSI behaviors while experiencing thoughts of suicide and while the evidence suggests many report being resigned to death as a consequence of cutting, actual suicidal thoughts and hopes for death are markedly higher in those exhibiting suicidal behaviors.  Intriguingly, it seems some may engage in NSSI as a way to avoid acting on thoughts of suicide; NSSI for these patients serving to regulate and reduce suicidal thoughts and intentions.  So it’s clear that in both thought and behavior, there’s some overlap between NSSI and suicidal thoughts meaning that even if a cutter’s injuries are (medically) minor, the condition should not be thought trivial although, for practical purposes, NSSI and suicidal behaviors need still to be categorized separately.  Cutting is also special in that it is so overt, unlike other forms of self-harm such as alcohol & drug abuse, risky behavior or neglecting to follow a prescribed treatment for a chronic condition.  There does however seem to be a pronounced co-morbidity between NSSI and eating disorders, the obvious link being a patient’s relationship with their body, NSSI being in some sense a compensatory behavior and form of self-punishment.  Data is clearly accumulating but the APA’s editorial committee seem not yet ready to make major structural changes: in the DSM-5-TR (Text Revision, 2022) although codes were included both suicidal behavior and NSSI, Suicidal Behavior Disorder (SBD) and NSSI Disorder remained in the section “Conditions for Further Study”.