Autopsy of a Suicidal Mind

by Edwin S. Shneidman

Autopsy of a Suicidal Mind is a uniquely intensive psychological analysis of a suicidal mind. In this poignant scientific study, Edwin S. Shneidman, a founder of the field of suicidology, assembles an extraordinary cast of eight renowned experts to analyze the suicidal materials, including a ten-page suicide note, given to him by a distraught mother looking for insights into her son's tragic death. The psychological autopsy centers on the interviews conducted by Shneidman with Arthur's mother, father, brother, sister, best friend, ex-wife, girlfriend, psychotherapist, and attending physician.

To gain some understanding of this man's intense psychological pain and to examine what may have been done to save his tortured life, Shneidman approached the top suicide experts in the country to analyze the note and Morton Silverman, Robert E. Litman, Jerome Motto, Norman L. Farberow, John T. Maltsberger, Ronald Maris, David Rudd, and Avery D. Weisman. Each of the eight experts offers a unique perspective on Arthur's tragic fate, and the sum of their conclusions constitutes an extraordinary psychological autopsy.

This book is the first of its kind and a remarkable contribution to the study of suicide. Mental health professionals, students of human nature, and persons whose lives have been touched by this merciless topic will be mesmerized and enlightened by this unique volume. An epistemological tour de force , it will speak to anyone who is concerned with human self-destruction.

Genres: Psychology, Nonfiction, Mental Health, Mental Illness, Science, Psychiatry

208 pages, Hardcover

First published February 26, 2004

About the author

Dr. Edwin S. Shneidman (born c. 1918) is a noted American suicidologist/thanatologist. He with co-workers from the Los Angeles Suicide Prevention Center provided a major stimulus to research into suicide and its prevention. He was the founder of the American Association of Suicidology and of the principal United States journal for suicide studies, Suicide and Life Threatening Behavior. He is Professor of Thanatology Emeritus at the University of California and lives in Los Angeles.

Reviews

[Amirreza Mahmoudzadeh-Sagheb · Rating 4 out of 5]

"Autopsy of a Suicidal Mind" by Edwin S. Shneidman

First read: April 2022, 3 stars.
Second read: April 2024, 4 stars.

In spite of his vast amount of experience, Shneidman failed to understand Arthur's firsthand experience completely. This is obvious from his letter to Arthur's mother in the last chapter:

"The early Freudians (around 1910) saw suicide primarily as hostility toward the parents: It appeared to them that in assuaging his own desperate need to stop the unbearable psychological pain, the suicidal person, coincidentally at least, broke his mother’s heart. We see that Arthur, for all his wit, cannot escape inflicting collateral damage on his family. Part of our discomfort in this case has to do with our puzzlement over how he could be so thoughtless. The answer, I believe, lies in the constriction, the concentration, the tunneling of vision, the pathological narrowing and focus on the Self that is a usual part of the suicidal state."

Here, Shneidman doesn't consider that if committing suicide is shifting the pain to the relatives, then staying alive is bearing the pain only to make the relatives satisfied. If suicide is being selfish, as he seems to think, then asking a relative to stay alive can be selfish in the same way.

"As a psychotherapist I have an ingrained responsibility to be empathic, to resonate to Arthur’s private psychological pain, and to reaffirm his right to end his suffering. But at the same time, in this same role, I am aware of his towering narcissism, his view that his suffering is somehow unique, that he is special among men—a kind of malignant grandiosity that asserts that no one has ever had it as bad as he has. This almost delusional greatness-of-my-pain seems to be present in many suicidal people."

Blaming Arthur for being narrow-minded and breaking her mother's heart?! Well, it seems to me that Shneidman did this partly because of his own biases as a father. Blaming Arthur for not being strong enough to endure "what has happened to many"?! To call Arthur's pain "one of the many" and "not unique"?! Having a shared pain and sorrow with many other people doesn't necessarily reduce the amount of suffering, especially if your distress tolerance limits are different from them. I think Shneidman let himself to blame Arthur only after his death. Else, if he showed such an unempathetic look towards Arthur, he might have run away from the office.

In my opinion, relatives' overemphasis on biologic essence of Arthur's depression comes from their denial of the possibility that they could somehow help him psychologically but they didn't. Calling him "biologically cursed" is somehow closing the issue before completely analyzing it. However, I don't deny the effectiveness of ECT and other biological methods in his case. I disagree with seeing all the roots of his depression in his biology because there were at least some triggers which exacerbated his depression. For example, being bullied by his brother was an example of "Social defeat stress" which exists in animal studies and is related with different negative psychiatric, cardiovascular, and other types of consequences.

After all, this book is a good example of psychological autopsy by providing narratives from different relatives, friends, psychotherapist and psychiatrist of the patient. Also, there are some chapters in which some professionals who were colleagues of Shneidman discussed the case. As Shneidman said, the book brought a Rashomon-type look at the case of Arthur. By reading it after 2 years, the value of it became more bolded in my eyes.

[Alexandra Dav]

Dnf pg. 111

A fost interesantă o bună parte, însă apoi au început să se repete aceleași idei și interesul meu a dispărut. 😅

[Mehwish · Rating 5 out of 5]

'Suicide notes often seem like parodies of the postcards sent home from the Grand Canyon, the catacombs of the pyramids–essentially pro forma, not at all reflecting the grandeur of the scene being described or the depth of the human condition that one might expect to be engendered by the situation.' - Shneidman

The autopsy of Arthur’s suicide was instigated by Edwin S. Shneidman. He contacted the best in the field of suicidology and asked them to comment on the case. In that manner, the book is extremely valuable in piecing the puzzle together. With all due respect, you can come so close to understanding why someone killed themselves but the inner workings of the mind at the time of taking the decision can never be fully understood.

The ultimate questions that were put forward to all the experts and Arthur’s immediate family, friends and therapists:

1) Why?
2) Could he have been saved?

The answers to “why” had a theme running through them. A troubled childhood, a failure to find satisfaction and happiness in life, a failure to associate and a whole range of biological causes

The answer to the second question was divided into two camps of “Yes” and “No”. Some believed he could have been saved whereas others believed that intervention could have only prolonged his life for a certain period.

The Pitfalls

My immediate reaction to reading the interview of Arthur's psychiatrist was, “Oh my God!”

He mentions that as soon as he met with Arthur he knew that Arthur was going to kill himself AND he maintained this tone throughout the interview. I am not an expert, but the first judgment that we pass about someone can stick for a long time unless you actively go seek evidence against it. If someone who is in the role of “helping others” had such a steadfast conviction from day one that the person could not be helped then that person cannot be helped.

The other part of the interview with the psychiatrist that rung alarm bells for me was the manner in which the prescription was refilled. Arthur would call a “telephone number and answer approximately 15 questions about his mood state and fifteen questions about his functioning state…That then gets faxed, and I would okay the refill, based on how he was doing.”

The Suicide Note

The last part included Arthur’s suicide note. An extremely painful experience to read a note that is the last written record of the person. It has so much yet it does not have anything. It talked about the suffering and pain but no matter how much you try to understand it, you cannot. You were not there.

I have written many suicide notes in my time and after reading this book, I went through those. Retrospectively, what I found was that those notes were nothing close to what I had felt. They were kind of putting up a “front” to give the people who would have been left behind with some sort of closure. I looked at those notes and thought if I had completed it what would my suicidal autopsy look like and then it started playing like a movie in my mind. All those childhood experiences, failures, DSM diagnoses etc. but no one would have gotten close to exactly what or why. No one ever does.

A highly recommended book.

[Chloe · Rating 3 out of 5]

It's interesting to compare how various people in Arthur's life describe his struggles. There are so many conflicting things being said about Arthur, because it's of course all but impossible to try to summarize an actual human being and the way they see the world. It's a bit repetitive, because a lot of the interviewees cover similar topics, although it's interesting finding bits where they disagree with each other (how did Arthur view his mother, or his romantic relationships, etc). Otherwise it's not a very long case study to read through. I will say that I wish the book was structured differently - the suicide note ultimately left by Arthur should have been at the front of the book and not the back, and I wish the interviews were clumped together and not broken up by all the professional opinions.

[Platon Cristina · Rating 5 out of 5]

5/5

Mereu am zis că atunci când trăiești vreo experiență pe propria piele e ca și cum ți-ar cădea un filtru și ar trece direct spre tine, mai intens, mai dureros, mai altfel.

Cartea asta a pus în cuvinte ceea ce eu n-am îndrăznit să întreb, să lămuresc. Răspunsurile la întrebările mele nerostite m-au scos la tablă și m-au arătat cu degetul.

Mă gândesc la familia lui Arthur, cel care a făcut cartea să existe, și la „biografia” involuntară pe care aceasta o reprezintă și atât de necesară oamenilor pe care i-a lăsat în urmă cu regrete și dor. O amintire răscolitoare, dar alinătoare într-un fel. Oricine o poate deschide, citi și transporta în anii când Arthur trăia.

Câte istorii a multor suflete de pretutindeni nu au fost puse în pagini și niciodată nu vor fi, dar care ar aduce un pic de liniște familiei.

«Чтобы суицид превратился из табу в хорошо понятую тему, мы должны выяснить почему разговоры о нем вызывают столь негативную реакцию.»

«Просто натяни улыбку и сделай вид, что все хорошо.»

[stephanie · Rating 4 out of 5]

how do you really understand why someone committed suicide? this book outlines the process of the "suicidal autopsy" which is a psychological endeavor, not a medical one.

it usually starts with the suicide note (though i think less than 10% of completed suicides leave notes) and then goes through any hospital paperwork, etc, and interviews the family and friends. it's like trying to work backwards to understand the outcome, which is very familiar to me with my history background, so maybe that's why i was drawn to it so much.

my only problem with the book was that it's extremely short and only has one case study - i think if you are going to purport trying to do these autopsies on everyone, you need to have more evidence. then again, he admits the autopsies are more for the family of the victim than anything else, so.

it will be interesting to see if they take more hold in the community.

[Elisse · Rating 4 out of 5]

Trying to learn more about some of the issues that confront young people in a program I started working in this year, I chose this book to look at suicide. Taking the suicide of one young man as its focus, the family and doctors are interviewed and several experts on suicide comment on the case. It reminded me of all the different "experts" who have looked at my son through their own lens. What struck me most is that one of the experts felt that the young man was on the autistic spectrum (probably Asperger's Syndrome) with Sensory Integration Disorder and this could explain much of his difficulty both as a young child and in school. The family never commented on this, and I wonder, if this one doctor is correct, if it could have helped them understand this man, and perhaps have helped him understand himself better.

[Matthew Moffitt · Rating 5 out of 5]

As a doctoral candidate in clinical psychology, you get trained in understanding the risk and protective factors of someone considering suicide. However, it is rare that students and professors alike dig deeper and uncover the stones of those risk and protective factors. Edwin Shneidman is the godfather of suicidology, founding the Los Angeles Suicide Prevention Center. In this work he and several clinical experts, including David Rudd and Avery Weisman other pioneers in the field, examine a case study of Arther, a young adult caucasian male, both doctor and lawyer, who ends up completing suicide. Shneidman proceeds to interview members of the family, his friends, his psychotherapist, and psychiatrist in order better help the family understand what happened. Shneidman poses the deadliest question to each and every one of them: could his death have been prevented?

Dispersed between these engaging interviews are case conceptualizations provided by experts in their respective theoretical orientations or training (e.g., sociology, Cognitive-behavioral therapy, psychoanalysis, and biological bases). Some have argued in their reviews that no one disagrees with Shneidman. That may be true. However, there are several different viewpoints provided by these experts that often conflict and compliment one another. A few are cynical. Some are hopeful. Others are stuck in between.

This was a fantastic book, and as a professional in the clinical psychology field, I found the work invaluable. I recommend this to social workers, psychologists, sociologists, physicians, counselors, and anyone interested in understanding how an individual reaches a point where he or she considers that it would be best to die rather than live.

[Mohsen · Rating 5 out of 5]

Suicide and depression are not alien to me. Although I have never committed it, or better say, never had the courage in me to stop the flow of life within my body, i deeply thought about it at times. To see that your future is as dark as your past, that no light shines through your soul and your days, makes suicide the last resort, for hope! Freud once said, the person who is committing suicide is the most hopeful of us all. A hope for something better or even just stopping the pain. A pain which this author coined the term: psychache. Reading the book is difficult at times, when you're reading through pages which the family members of the protagonist are talking about him, it moves you beyond what you're capable of comprehending it. The way he talked about his daily suffering is just not easy to bear. Although it saddened me but nonetheless i loved the book

[Emma · Rating 5 out of 5]

an informative, emotional, and overall riveting investigation into the mind and motives of a suicidal individual, utilizing interviews with the family, analysis from various figures of authority in the field of suicidology, and the suicide's own note in an effort to make sense of such tragedies, and to ask the central question: could the suicide have been prevented.

i was in love with this book from start to finish. there is a lot about arthur's struggles with anhedonic feelings throughout the book--a struggle that i found relatable to some of my own past and present feelings (the anhedonia). this, along the top-tier quality of the study itself, has made this a book which i find not only informative, but deeply cathartic in some respects.

[Robert Bogue]

Decades after Shneidman started doing psychological autopsies at the request of the medical examiner, a mother who lost her son implored him to use his technique not to help decide whether the death was a suicide or not. Arthur left a long suicide note, so there was no doubt that it was suicide. However, she was a mom who wanted more insights about the death of her son than she could glean from the note on her own. Autopsy of a Suicidal Mind is the report of the psychological autopsy of Arthur and an opportunity to see the process of discovery that one might follow to do a psychological autopsy.

Read more

[Rita · Rating 4 out of 5]

Случай, описанный в книге, это крайность. Когда у тебя депрессия на химическом уровне с детства, и ты начинаешь задумываться о самоубийстве в 7 лет, такой исход не удивителен. Такое ощущение, что автор хотел показать, что как бы плохо все ни было, при помощи специалистов можно протянуть довольно долго. Как бы то ни было, книга понравилась

[Cindy Hammonds · Rating 5 out of 5]

Timeliness is a factor

I began reading this book just weeks after my grandson died by suicide. As a therapist and scientist, I plan to use the information shared in this book to conduct an autopsy on my grandson's suicidal mind.

[Nasim · Rating 4 out of 5]

شاید با توجه به کتاب‌ها و مطالب جدید در خصوص خودکشی، یکم کتاب قدیمی‌ای به نظر بیاد، خصوصا اگه از قبل در این زمینه مطالعه داشته باشید، اما در کل به نظرم سیری که نویسنده در مواجهه با چندتا مراجع توصیف می‌کنه، جالب و خوندنیه.

[Glenda Love · Rating 5 out of 5]

Important read

I have clients whose loved ones took their own lives. Helping them reach understanding and peace is esstial to healing. This book helped me help them.

[Jade · Rating 4 out of 5]

I thought that this was a wonderful book. It was the first psychological autopsy I have read. It was repetitive, but since I read through it in about two hours, it was not to the point that it made me sick of the book.

The subject of the "autopsy", "Arthur", was a tortured soul. Several respected suicidologists discuss Arthur's life and possible reasons for suicide, dissecting interviews with those close to him and his unusual, lengthy suicide note.

The only issue I took with this book was that Shneidman's postulation that perhaps he would have saved Arthur and how he might have accomplished this was probably very difficult for Arthur's family members to read. I am not sure what the benefit of stating how Arthur could have been helped better is, considering that he is, sadly, gone forever. I think this may have gone over better if Shneidman would have put the situation and possibilities in the context of helping future suicide victims. That's just my two cents. It is definitely worth a read, though. Shneidman has his faults, but he is a fascinating man and a great writer.

[The Angry Lawn Gnome · Rating 3 out of 5]

Interesting topic, but I've got a Noah's Ark of issues with this one. First, the experts brought in to do the "autopsy" make an interesting example of groupthink. If any of them seriously disagreed with Shneidman on any major point at any time, I missed it. Quite frankly, they seemed as much acolytes kowtowing to their master as psychiatrists/psychologists/sociologists performing an unbiased analysis of why Arthur did what he did when he did it. Second, Arthur's suicide note is placed at the end of the text, but is referred to constantly throughout it, by interviewees, the experts and Shneidman himself. Shneidman made some comment about it being a distraction, hence moving it to the end of the book. But all this really accomplished was to confuse someone who did not in fact read the thing when critiquing the interviews and various "autopsies." Third, the way we hop from interview to analysis and back again gets rather confusing. Meh, I could continue but I think I've had my say. Good, but could have been better. Or at least more coherent.

[quick · Rating 5 out of 5]

i started this book more than a month ago, and i’m about halfway through. i could 100% finish this in less than a week but i don’t want the damn thing to end. i’m not exaggerating when i say this is my favourite book.
it’s so interesting to read the interviews of arthur’s loved ones, especially his parents. and if you look at the consultations from schneidman’s colleagues along with it,,,there’s just so much info and analysis, you have to keep reading.
i fucked up and skipped to the end of the book to read arthur’s suicide note (one hell of a note), but dr. scheidman put it at the back of the book for a reason. don’t skip to the back like i did.

[Suzanne Quinn · Rating 3 out of 5]

Interesting and insightful look into the thoughts and feelings of someone chronically depressed and suicidal. Author interviews various people associated with a man who committed suicide - also includes his suicide note...very interesting, but deifnitely not a light read for someone who's not so interested in this topic!!

[Deb · Rating 4 out of 5]

Riveting. I'm doing some research for a piece I'm writing, and this was a brilliant combination of personal story with cogent expert analysis that read like a piece of fiction.

[aloveiz · Rating 3 out of 5]

Psychological autopsy organizations are interesting, more interesting than this book which is very process based. Still, worth reading if you like this kind of thing.

[Tori · Rating 5 out of 5]

Reread 7/22/13



Read 4/1/07

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