PSYCH 406 (Psychopathology) - Suicide as Related to Major Depressive Disorder

Abstract

This essay describes the symptoms and diagnostic criteria for major depressive disorder, with an emphasis on the symptoms of thoughts of death and suicidal ideation. It further reviews methods of treatment, and then finishes with a review of ways therapists can forge and strengthen therapeutic relationships with suicidal patients.

 

Introduction

To exist or not, as a human being, is up to us. Albert Camus (1979) contends suicide is the only genuinely profound philosophical question to answer. True, every individual has the choice to exit life, however the cost of that exit can be significant for those left behind. Not even counting the invaluable cost of loss of life, suicide attempts alone accounted for nearly $27B in health care costs in 2019 in the United States (Hughes, et al., 2023). Even despite the massive expense from the fallout of suicide attempts, the emotional toll and impacts heaped on loved ones and friends who remain behind in the wake of a successful or unsuccessful suicide will take countless hours of therapy and grieving and perhaps even significant pharmacological expense to remediate. From a psychological, to an emotional, to an economic perspective, any way to advance the understanding of the patient’s motivation for suicide and greater insight into how to prevent suicides would be a worthy endeavor not only for the individual, but also for the common good. To that end, this essay will explain the most common disorder which leads to suicide.

This essay will describe major depressive disorder, including all the criteria that must be met in order to diagnose an individual with major depressive disorder (Maddux & Winstead, 2016 and American Psychiatric Association, 2022). Along with those criteria, it will also outline the symptoms and warning signs of those seeking to end their life (National Institute of Mental Health, 2022). It will then review three major avenues of treatment for major depressive disorder, which include electroconvulsive, psychopharmacological and psychotherapeutic forms (Maddux & Winstead, 2016). Lastly, the essay will delve into the topic of clinicians establishing the clinician-patient therapeutic alliance to assist patients in opening up about the challenges they face with suicidal ideation (Foster, et al., 2021).

Description, Symptoms, Diagnostic Criteria

While the impacts of major depressive disorder (MDD) can be persistent and influence human productivity, symptoms can worsen and lead to the untimely death of the sufferer. Maddux and Winstead (2016) note that MDD will perhaps be the number one cause of premature death and human disability globally in the next one hundred years. In the United States alone, the suicide rate has increased over a third between 1999 and 2018 and with the recent COVID-19 pandemic, that trend has continued to rise (Moutier, 2021). Therefore, spotting MDD symptoms effectively and early is key to suicide prevention.

The symptoms of MDD described in the DSM-5-TR (American Psychiatric Association, 2022) begin with understanding what a major depressive episode is. Symptoms include nine key markers: 1) a depressed mood, which may include feelings of helplessness and hopelessness, 2) the loss of interests or pleasure in activities the person normally enjoys, 3) losing 5% or more of their weight in 30 days while not intending to diet, 4) poor sleeping habits stemming from insomnia or perhaps sleeping all day, 5) constant agitation in movement or a significant lack of movement, 6) general lack of energy, 7) self-loathing, exceptional feelings of guilt or worthlessness, 8) significant challenges in concentration, deliberation, thinking or even decision-making, and most importantly, 9) repetitive thoughts of dying, death or suicide. As for this ninth symptom, the patient does not need to demonstrate it every day for a two-week period; once is sufficient to qualify. The patient must exhibit five or more of the nine listed symptoms (two of which must be a depressed mood and loss of interests) for a period of at least 14 days, and these must cause a substantial impact on their social life, job or other important aspects of their life, and the attribution of these symptoms must not stem from some other condition such as drug use, or another disorder such as schizophrenia (American Psychiatric Association, 2022, p. 183, 185). Lastly, in order for MDD to qualify as the diagnosis, the patient must demonstrate having one or more major depressive episodes, without any type of mania or hypomania.

One other important aspect of the diagnosis is related to whether there is an identifiable cause of the patient experiencing the symptoms. Some people may have recently dealt with an impactful and emotional event in their life such as the loss of a baby, a bankruptcy or loss of job, living through an act of God such as having a home and all possessions burned down in a wildfire or even having contracted a serious medical illness such as terminal cancer (American Psychiatric Association, 2022, p. 183). While many people may exhibit major depressive episode symptoms stemming from one of these drastic life events, it does not mean the person qualifies for the diagnosis of MDD.

As noted in the ninth symptom of MDD, if a patient has repetitive thoughts of death or suicide just once in a two-week period, along with the other symptoms, then they may have MDD. It is also important to note external markers which may predict if a patient is suicidal. Maddux and Winstead (2016, p. 193) observe that a majority of suicidal people convey their intent to kill themselves. More specifically, the National Institute of Mental Health (2022) provides a list of warning signs which loved ones and other people around the patient can spot. The patient may verbally express ideas of suicide, feelings of guilt or sense of being a burden on other people. They may express feelings such as helplessness, hopelessness, being trapped, having no purpose, or being sad, anxious, angry or expressing unendurable pain be it physical or emotional. Lastly, the patient may communicate in non-verbal ways such as searching online for ways to die, pushing close ones away or retreating from normal social interactions, acting with recklessness (e.g. risky skiing, driving, cliff jumping), consuming more drugs or alcohol, and sleeping and eating less. Related to the warning sign of recklessness, Maddux and Winstead (2016) note that suicides may be underreported because the act of suicide may appear to be accidental. For example, 15% of automobile accidents with a fatality may actually have been suicide related.

Treatment Options

There are three major avenues of treatment for MDD: electroconvulsive, psychopharmacological and psychotherapeutic therapy. The essay will briefly describe mechanisms which address the first two methods and then more deeply address the third method through a discussion on cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT).

Electroconvulsive therapy (ECT) was discovered as a form of therapy in the 1930s (Maddux & Winstead, 2016, p. 205). The method for application is to deliver between 70 and 130 volts of electrical shock to the patient’s brain. The patient may endure nine or ten rounds of ECT over the course of several weeks. While ECT has proven to be somewhat effective, experts still do not know exactly why it works in some cases. One theory is that electrical shocks downregulate 5-HT (serotonin) receptors. Despite proving somewhat effective, patients’ memory functions degrade, and they have a more difficult time learning and recalling knowledge. Related to ECT is transcranial magnetic stimulation (TMS). TMS does not produce memory dysfunction and can be more precisely tuned. The only side effects reported are benign headaches and minor discomfort.

Pharmacological forms of therapy for major depressive disorder address dysfunction in serotonin regulation (Maddux & Winstead, 2016). Studies have shown that when individuals’ serotonin levels are depleted or if reuptake has been altered, then it begins to have a negative impact on mood, which may act as a catalyst for a depressive episode. Three medications have been used for quite some time to treat depression: monoamine oxidase inhibitors, tricyclic and tetracyclic antidepressants. More recent developments in antidepressant medications include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). All five medications work in some form or fashion to regulate serotonin levels. As for which one should be used with a patient, it is often a matter of finding the right medication and dosage with the least harmful side effects. One emerging medication to address depression is ketamine. Rather than targeting the regulation of serotonin, ketamine seems to aid in the regrowth of important synapses in the brain, improving brain neuroplasticity (Yale Medicine, 2021). Researchers are discovering that ketamine treatment coupled with CBT provides rapid and long-lasting positive change. Not only do ketamine and CBT together prove efficacious, but Maddux and Winstead (2016, p. 198) note that CBT coupled with other appropriate medication is more effective than either CBT or medication alone.

CBT and ACT are two well-known psychotherapeutic frameworks which help the patient to fundamentally change their underlying thinking to address negative perceptions of themselves and environment (Maddux & Winstead, 2016, p. 197-199). CBT encompasses multiple ways to help the patient alter the underlying thinking framework for how the patient processes events, as well as to couple their thinking to action. For example, people who suffer from MDD would be asked to recognize and write down their negative thoughts, along with the causes and effects which lead them to think this way. They would then be asked to assess and question those thoughts to ascertain if they truly match reality and rationality. Through this process, the patient begins to reconstruct their thinking narrative in a more positive and productive manner.

CBT is especially helpful in challenging and questioning hopelessness thinking in suicidal patients. In fact, studies have shown (Bryan, 2019) that versions of CBT for suicide prevention (CBT-SP) are so effective, that these specific forms of CBT have been recommended as standard care procedures for all suicidal patients. CBT-SP typically includes three successive phases. In the first phase, clinicians assess the risk of the patient and then collaboratively work with the patient to form a crisis and treatment plan. In the second phase, the therapist and patient work on revealing the dysfunctional thinking patterns and negative internal dialogues which lead to feelings and emotions related to helplessness, hopelessness, being trapped, and having no purpose. In the last phase, therapists and patients tie everything together by creating a plan to minimize relapse. Bryan (2019, p. 249) further observes the effectiveness of CBT-SP by stating that patients of CBT-SP were one-half to two-thirds less likely to attempt suicide when compared to treatment as usual.

ACT can be viewed as an extension and evolution of CBT (Maddux & Winstead, 2016, p. 198-199). While ACT is similar to CBT, it differs from its aim. ACT does not focus on minimizing the negative symptoms of depression, but to empower the patient with greater flexibility in their thinking. ACT helps the patient understand their core values and then proceed in a consistent manner with those values. ACT prompts the patient to pause and reflect on what they deeply value in life, and then to engage with their emotions and thoughts, rather than questioning them. By engaging with their thoughts and emotions through a comparison with their core values, the patient is able to discern gaps between who they are and who they wish to be, and then take specific and meaningful action. For example, ACT has proven to be quite successful with veterans dealing with suicide (Walser, et al., 2015, p. 30). It has shown that when a patient experiences suicidal ideation, the therapist would work with the patient to explore the patient’s core values, either through dialogue or a values assessment test. As the patient is confronted with ideas of death, they can accept those thoughts and pivot toward ways to pursue and fulfill meaning in their life by focusing on something they value.

Article Summarization: Strengthening the Therapist-patient Alliance

In the context of suicidal ideation, it has been observed that most suicidal individuals do not explicitly disclose through self-reporting. Foster, et al. (2021) note that only 24% reveal their suicidal plans through disclosure. The driving causes of hesitating to divulge their thoughts of ending their life are fears of judgement, hospitalization, and losing independence. Therefore, if therapists, clinicians and others who are in a position to help the patient can establish trust and openness in communication, they may be able to garner the patient’s confidence and assist them in getting the needed medication and therapeutic treatment. Foster, et al. (2021) argue that three specific aspects on which clinicians can focus to improve the therapist-patient alliance are: 1) awareness and management of countertransference of negative emotions, 2) deploying communication techniques which are empathic and 3) leveraging the patient’s subjective experience as feedback.

Countertransference occurs when the therapist experiences conscious or unconscious projections or judgements of the patient, which in some cases may interfere with the therapeutic process (American Psychological Association, 2018). Foster, et al. (2021, p. 258) note that therapists can exude negative emotions to an individual intent on ending their life. Quickly assessing countertransference is crucial to strengthening the therapist-patient alliance. The Therapist Response Questionnaire-Suicide Form is an innovative tool to rapidly assess countertransference and enables the therapist to secure supervisory coaching and support to manage countertransference.

Empathy is how one person relates to another, including focusing on commonalities as well as differences, which enables shared insight between individuals (Foster, et al., 2021, p. 259). Clinicians and therapists must have a life-long commitment to developing and mastering empathy in their practice, especially when working with suicidal patients. Besides continuing education and hands-on training seminars to learn and practice empathy, there are also tools which assist therapists to hone their empathy skills. The Empathic Communication Coding System (ECCS) assists in identifying opportunities for the therapist to practice a range of empathic responses. The ECCS aids in identifying the patient’s statements as emotion, progress or challenge and then suggests a range of potential ways a therapist could use empathy. For example, a widow may mention how she constantly thinks of her deceased husband, to which a therapist could respond with, “Are you thinking about death?” or with the more empathic response of, “It seems that these thoughts you are having are difficult. Has suicide crossed your mind?” Therapists who master the art of empathy will improve the chances of the patient opening up and being more receptive to treatment rather than suicide.

Lastly, when therapists form a solid alliance with the patient, they can leverage that trust to gain insight from the patient feedback. Gathering feedback from a patient who has attempted suicide or had thoughts of suicide can prove rich in understanding the paths leading to death as well as paths leading to recovery (Foster, et al., 2021, p. 259). Collecting this feedback and sharing it broadly enables the wider community to benefit from this untapped resource. Tools such as the Consultation and Relational Empathy assessment and Working Alliance Inventory collect data from the patient’s perspective. These feedback mechanisms reinforce patient autonomy as well as shed light on the subjective experience of the patient.

In sum, there are innovative ways and tools to facilitate greater collaboration between the therapist and suicidal patient. First, the therapist must be aware of and manage countertransference of negative emotions. Second, they must constantly improve their communication techniques by focusing on improving empathy. Lastly, they can tap into the patient’s subjective experience to use as feedback in the therapeutic process.

Conclusion

In conclusion, with the increasing trend of suicides globally, and the severe impacts they have on society, this essay endeavored to illuminate the reader on the topic of major depressive disorder, with an emphasis on the symptom of suicidal ideation and the diagnostic criteria indicating a risk for suicide. The essay then examined three methods of treatment in the forms of electroconvulsive therapy, pharmacological and psychotherapeutic avenues. It specifically addressed CBT, CBT-SP and ACT in the context of suicidal patients. Finally, the essay discussed the importance of the clinician-patient therapeutic alliance, along with a set of tools to enable the fortification of that collaborative effort. 

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders, text revision (5th ed.). American Psychiatric Association.

American Psychological Association. (2018). APA Dictionary of Psychology. Dictionary.apa.org. https://dictionary.apa.org/countertransference

Bryan, C. J. (2019). Cognitive behavioral therapy for suicide prevention (CBT‐SP): Implications for meeting standard of care expectations with suicidal patients. Behavioral Sciences & the Law, 37(3), 247–258. https://doi.org/10.1002/bsl.2411

Camus, A. (1979). The Myth of Sisyphus, and Other Essays. (J. O’Brien, Trans.). Penguin Books Ltd. (Original work published 1955)

Foster, A., Alderman, M., Safin, D., Aponte, X., McCoy, K., Caughey, M., & Galynker, I. (2021). Teaching Suicide Risk Assessment: Spotlight on the Therapeutic Relationship. Academic Psychiatry, 45(3), 257-261. https://doi.org/10.1007/s40596-021-01421-2

Hughes, P. M., Phillips, D. C., McGrath, R. E., & Thomas, K. C. (2023). Examining Psychologist Prescriptive Authority as a Cost-Effective Strategy for Reducing Suicide Rates. Professional Psychology, Research and Practice, 54(4), 284–294. https://doi.org/10.1037/pro0000519

Maddux, J. E., & Winstead, B. A. (2016). Psychopathology : Foundations For A Contemporary Understanding (4th ed.). Routledge/Taylor & Francis Group.

Moutier, C. Y. (2021). Innovative and Timely Approaches to Suicide Prevention in Medical Education. Academic Psychiatry, 45(3), 252–256. https://doi.org/10.1007/s40596-021-01459-2

National Institute of Mental Health. (2022). Warning Signs of Suicide. Www.nimh.nih.gov. https://www.nimh.nih.gov/health/publications/warning-signs-of-suicide

Walser, R. D., Garvert, D. W., Karlin, B. E., Trockel, M., Ryu, D. M., & Taylor, C. B. (2015). Effectiveness of Acceptance and Commitment Therapy in treating depression and suicidal ideation in Veterans. Behaviour Research and Therapy, 74, 25–31. https://doi.org/10.1016/j.brat.2015.08.012

Yale Medicine. (2021, July 30). Ketamine & Depression: How it Works - Yale Medicine Explains. Www.youtube.com. https://www.youtube.com/watch?v=nW21-AYY_fs 

Quotes and Review of Myth of Sisyphus by Albert Camus

For my own reference, I'll simply be consolidating all the highlights I made from the book.  I may make some commentary as needed.

"There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy."

He notes that he has seen too many people die because they judged that life is not worth living.  The book is to help them dispel that idea.

"Beginning to think is beginning to be undermined."

"killing yourself amounts to confessing. It is confessing that life is too much for you or that you do not understand it"

"A world that can be explained even with bad reasons is a familiar world. But, on the other hand, in a universe suddenly divested of illusions and lights, man feels an alien, a stranger. His exile is without remedy since he is deprived of the memory of a lost home or the hope of a promised land. This divorce between man and this life, the actor and his setting, is properly the feeling of absurdity."

"it often happens that those who commit suicide were assured of the meaning of life."

"We get into the habit of living before acquiring the habit of thinking."

"Hope of another life one must 'deserve' or trickery of those who live not for life itself but for some great idea that will transcend it, refine it, give it a meaning, and betray it."

"It is always easy to be logical. It is almost impossible to be logical to the bitter end."

"The climate of absurdity is in the beginning. The end is the absurd universe and that attitude of mind which lights the world with its true colors to bring out the privileged and implacable visage which that attitude has discerned in it."

"It happens that the stage sets collapse. Rising, streetcar, four hours in the office or the factory, meal, streetcar, four hours of work, meal, sleep, and Monday Tuesday Wednesday Thursday Friday and Saturday according to the same rhythm—this path is easily followed most of the time. But one day the “why” arises and everything begins in that weariness tinged with amazement. “Begins”—this is important. Weariness comes at the end of the acts of a mechanical life, but at the same time it inaugurates the impulse of consciousness. It awakens consciousness and provokes what follows. What follows is the gradual return into the chain or it is the definitive awakening. At the end of the awakening comes, in time, the consequence: suicide or recovery. In itself weariness has something sickening about it. Here, I must conclude that it is good. For everything begins with consciousness and nothing is worth anything except through it."

"At the heart of all beauty lies something inhuman, and these hills, the softness of the sky, the outline of these trees at this very minute lose the illusory meaning with which we had clothed them, henceforth more remote than a lost paradise."

"Just as there are days when under the familial face of a woman, we see as a stranger her we had loved months or years ago, perhaps we shall come even to desire what suddenly leaves us so alone."

"This discomfort in the face of man’s own inhumanity, this incalculable tumble before the image of what we are, this “nausea,” as a writer of today calls it, is also the absurd."

"The mind’s first step is to distinguish what is true from what is false."

"Understanding the world for a man is reducing it to the human, stamping it with his seal."

"If man realized that the universe like him can love and suffer, he would be reconciled."

"That nostalgia for unity, that appetite for the absolute illustrates the essential impulse of the human drama."

"It is essential to consider as a constant point of reference in this essay the regular hiatus between what we fancy we know and what we really know, practical assent and simulated ignorance which allows us to live with ideas which, if we truly put them to the test, ought to upset our whole life."

This is a very important point Camus makes and one which is not made explicit in day-to-day conversations.  It is a point not explicitly made, but strongly implied when talking philosophy.  What we know is very little.  Much of the rest is conjecture.  Just the other evening, I was talking with my sister about the period of time in history between John Wycliff (d. 1384) and the Münster rebellion (~1535).  In that 150 year period alone there was horrible violence all because of a few philosophical ideas on God and church.  Millions (perhaps billions?) have died for ideas which can be categorized as "simulated ignorance."

Camus goes on to say, "So long as the mind keeps silent in the motionless world of its hopes, everything is reflected and arranged in the unity of its nostalgia. But with its first move this world cracks and tumbles: an infinite number of shimmering fragments is offered to the understanding. We must despair of ever reconstructing the familiar, calm surface which would give us peace of heart."

I think that the yearning - the nostalgia - for certainty is what people cling to and over which they start wars and bloodshed.  In searching for the familiar, simulated ignorance which they think gives them a 'calm surface' and 'peace of heart' they find uncertainty ... when they have that realization, it disrupts their world and in some cases, violence ensues and for some, suicide.

"If the only significant history of human thought were to be written, it would have to be the history of its successive regrets and its impotences."

"Of whom and of what indeed can I say: “I know that!” This heart within me I can feel, and I judge that it exists. This world I can touch, and I likewise judge that it exists. There ends all my knowledge, and the rest is construction. For if I try to seize this self of which I feel sure, if I try to define and to summarize it, it is nothing but water slipping through my fingers."

"This very heart which is mine will forever remain indefinable to me. Between the certainty I have of my existence and the content I try to give to that assurance, the gap will never be filled."

"Socrates’ ”Know thyself” has as much value as the “Be virtuous” of our confessionals. They reveal a nostalgia at the same time as an ignorance. They are sterile exercises on great subjects. They are legitimate only in precisely so far as they are approximate."

"You explain this world to me with an image. I realize then that you have been reduced to poetry: I shall never know. Have I the time to become indignant? You have already changed theories. So that science that was to teach me everything ends up in a hypothesis, that lucidity founders in metaphor, that uncertainty is resolved in a work of art. What need had I of so many efforts?"

a good definition of the absurd: "A stranger to myself and to the world, armed solely with a thought that negates itself as soon as it asserts, what is this condition in which I can have peace only by refusing to know and to live, in which the appetite for conquest bumps into walls that defy its assaults? To will is to stir up paradoxes. Everything is ordered in such a way as to bring into being that poisoned peace produced by thoughtlessness, lack of heart, or fatal renunciations."

"despite so many pretentious centuries and over the heads of so many eloquent and persuasive men, I know that is false. On this plane, at least, there is no happiness if I cannot know. That universal reason,

practical or ethical, that determinism, those categories that explain everything are enough to make a decent man laugh. They have nothing to do with the mind. They negate its profound truth, which is to be enchained. In this unintelligible and limited universe, man’s fate henceforth assumes its meaning."

"what is absurd is the confrontation of this irrational and the wild longing for clarity whose call echoes in the human heart."

"On the plane of history, such a constancy of two attitudes illustrates the essential passion of man torn between his urge toward unity and the clear vision he may have of the walls enclosing him."

"Chestov, for his part, throughout a wonderfully monotonous work, constantly straining toward the same truths, tirelessly demonstrates that the tightest system, the most universal rationalism always stumbles eventually on the irrational of human thought."

"Of all perhaps the most engaging, Kierkegaard, for a part of his existence at least, does more than discover the absurd, he lives it. The man who writes: “The surest of stubborn silences is not to hold one’s tongue but to talk” makes sure in the beginning that no truth is absolute or can render satisfactory an existence that is impossible in itself."

"Thinking is learning all over again to see, to be attentive, to focus consciousness; it is turning every idea and every image, in the manner of Proust, into a privileged moment."

"I want everything to be explained to me or nothing."

"The world itself, whose single meaning I do not understand, is but a vast irrational. If one could only say just once: “This is clear,” all would be saved. But these men vie with one another in proclaiming that nothing is clear, all is chaos, that all man has is his lucidity and his definite knowledge of the walls surrounding him. All these experiences agree and confirm one another. The mind, when it reaches its limits, must make a judgment and choose its conclusions."

"Absurd is not in man (if such a metaphor could have a meaning) nor in the world, but in their presence together. For the moment it is the only bond uniting them. If wish to limit myself to facts, I know what man wants, I know what the world offers him, and now I can say that I also know what links them."

"A man who has become conscious of the absurd is forever bound to it."

"'the unthinkable unity of the general and the particular.' Thus the absurd becomes god (in the broadest meaning of this word) and that inability to understand becomes the existence that illuminates everything. Nothing logically prepares this reasoning. I can call it a leap."

"'The only true solution,' [Chestov] said, 'is precisely where human judgment sees no solution. Otherwise, what need would we have of God? We turn toward God only to obtain the impossible. As for the possible, men suffice.'"

"Chestov discovers the fundamental absurdity of all existence, he does not say: “This is the absurd,” but rather: “This is God: we must rely on him even if he does not correspond to any of our rational categories.” So that confusion may not be possible, the Russian philosopher even hints that this God is perhaps full of hatred and hateful, incomprehensible and contradictory; but the more hideous is his face, the more he asserts his power. His greatness is his incoherence. His proof is his inhumanity. One must spring into him and by this leap free oneself from rational illusions. Thus, for Chestov acceptance of the absurd is contemporaneous with the absurd itself."

"the absurd is the contrary of hope."

"The moment the notion transforms itself into eternity’s springboard, it ceases to be linked to human lucidity."

"This leap is an escape."

"The intoxication of the irrational and the vocation of rapture turn a lucid mind away from the absurd. To Chestov reason is useless but there is something beyond reason. To an absurd mind reason is useless and there is nothing beyond reason. This leap can at least enlighten us a little more as to the true

nature of the absurd."

"The absurd man, on the other hand, does not undertake such a leveling process. He recognizes the struggle, does not absolutely scorn reason, and admits the irrational. Thus he again embraces in a single glance all the data of experience and he is little inclined to leap before knowing. He knows simply that in that alert awareness there is no further place for hope."

"Kierkegaard likewise takes the leap. His childhood having been so frightened by Christianity, he ultimately returns to its harshest aspect ...  Christianity is the scandal and what Kierkegaard calls for quite plainly is the third sacrifice required by Ignatius Loyola, the one in which God most rejoices: “The sacrifice of the intellect.” ... “In his failure,” says Kierkegaard, “the believer finds his triumph.”

"through a strained subterfuge, he gives the irrational the appearance and God the attributes of the absurd: unjust, incoherent, and incomprehensible."

"I want to know whether I can live with what I know and with that alone"

"The absurd, which is the metaphysical state of the conscious man, does not lead to God. Perhaps this notion will become clearer if I risk this shocking statement: the absurd is sin without God."

"god is maintained only through the negation of human reason. But, like suicides, gods change with men. There are many ways of leaping, the essential being to leap. Those redeeming negations, those ultimate contradictions which negate the obstacle that has not yet been leaped over."

another key quote which defines absurdism: "In fact, our aim is to shed light upon the step taken by the mind when, starting from a philosophy of the world’s lack of meaning, it ends up by finding a meaning and depth in it." ... "Thinking is learning all over again how to see ... the act of attention"

"Reason and the irrational lead to the same preaching. In truth the way matters but little; the will to arrive suffices. The abstract philosopher and the religious philosopher start out from the same disorder and support each other in the same anxiety. ... It is constantly oscillating between extreme rationalization of reality which tends to break up that thought into standard reasons and its extreme irrationalization which tends to deify it."

"Just as reason was able to soothe the melancholy of Plotinus, it provides modern anguish the means of calming itself in the familiar setting of the eternal. The absurd mind has less luck. For it the world is neither so rational nor so irrational. It is unreasonable and only that. ...  The absurd is lucid reason noting its limit."

"Sin is not so much knowing (if it were, everybody would be innocent) as wanting to know. Indeed, it

is the only sin of which the absurd man can feel that it constitutes both his guilt and his innocence."

"It is that divorce between the mind that desires and the world that disappoints, my nostalgia for unity,

this fragmented universe and the contradiction that binds them together."

"Is one going to die, escape by the leap, rebuild a mansion of ideas and forms to one’s own scale? Is

one, on the contrary, going to take up the heart-rending and marvelous wager of the absurd?"

"At a certain point on his path the absurd man is tempted. History is not lacking in either religions or prophets, even without gods. He is asked to leap. All he can reply is that he doesn’t fully understand,

that it is not obvious."

"It was previously a question of finding out whether or not life had to have a meaning to be lived. It now becomes clear, on the contrary, that it will be lived all the better if it has no meaning. Living an experience, a particular fate, is accepting it fully."

"The theme of permanent revolution is thus carried into individual experience. Living is keeping the absurd alive. Keeping it alive is, above all, contemplating it."

"One of the only coherent philosophical positions is thus revolt. It is a constant confrontation between man and his own obscurity. It is an insistence upon an impossible transparency. It challenges the world

anew every second. Just as danger provided man the unique opportunity of seizing awareness, so metaphysical revolt extends awareness to the whole of experience. It is that constant presence

of man in his own eyes. It is not aspiration, for it is devoid of hope. That revolt is the certainly of a crushing fate, without the resignation that ought to accompany it."

"Suicide, like the leap, is acceptance at its extreme. Everything is over and man returns to his essential history. His future, his unique and dreadful future—he sees and rushes toward it. In its way, suicide settles the absurd. It engulfs the absurd in the same death. But I know that in order to keep alive, the absurd cannot be settled. It escapes suicide to the extent that it is simultaneously awareness and rejection of death. ... That revolt gives life its value."

"Consciousness and revolt, these rejections are the contrary of renunciation. Everything that is indomitable and passionate in a human heart quickens them, on the contrary, with its own life. It is essential to die unreconciled and not of one’s own free will. Suicide is a repudiation. The absurd man can only drain everything to the bitter end, and deplete himself. The absurd is his extreme tension, which he maintains constantly by solitary effort, for he knows that in that consciousness and in that day-to-day revolt he gives proof of his only truth, which is defiance. This is a first consequence."

"either we are not free and God the all-powerful is responsible for evil. Or we are free and responsible but God is not all powerful."

"The only conception of freedom I can have is that of the prisoner or the individual in the midst of the State. The only one I know is freedom of thought and action. Now if the absurd cancels all my chances of eternal freedom, it restores and magnifies, on the other hand, my freedom of action. That privation of hope and future means an increase in man’s availability."

"Thinking of the future, establishing aims for oneself, having preferences—all this presupposes a belief in freedom, even if one occasionally ascertains that one doesn’t feel it. But at that moment I am well aware that that higher liberty, that freedom to be, which alone can serve as basis for a truth, does not exist. Death is there as the only reality."

"The absurd enlightens me on this point: there is no future. Henceforth this is the reason for my inner freedom."

"The absurd man thus catches sight of a burning and frigid, transparent and limited universe in which nothing is possible but everything is given, and beyond which all is collapse and nothingness. He can then decide to accept such a universe and draw from it his strength, his refusal to hope, and the unyielding evidence of a life without consolation."

"But what does life mean in such a universe? Nothing else for the moment but indifference to the future and a desire to use up everything that is given. Belief in the meaning of life always implies a scale of values, a choice, our preferences. Belief in the absurd, according to our definitions, teaches the contrary. ... Knowing whether or not one can live without appeal is all that interests me."

"belief in the absurd is tantamount to substituting the quantity of experiences for the quality. If I convince myself that this life has no other aspect than that of the absurd, if I feel that its whole equilibrium depends on that perpetual opposition between my conscious revolt and the darkness in which it struggles, if I admit that my freedom has no meaning except in relation to its limited fate, then I must say that what counts is not the best living but the most living. It is not up to me to wonder if this is vulgar or revolting, elegant or deplorable. Once and for all, value judgments are discarded here in favor of factual judgments."

"The most living ... quantity and variety of experiences ... there must also be taken into consideration the individual’s spontaneous contribution, the “given” element in him ... on the one hand the absurd teaches that all experiences are unimportant, and on the other it urges toward the greatest quantity of experiences. How, then, can one fail to do as so many of those men I was speaking of earlier—choose the form of life that brings us the most possible of that human matter ... Being aware of one’s life, one’s revolt, one’s freedom, and to the maximum, is living, and to the maximum ... The absurd and the extra life it involves therefore do not defend on man’s will, but on its contrary, which is death. Weighing words carefully, it is altogether a question of luck. ... The present and the succession of presents before a constantly conscious soul is the ideal of the absurd man."

"Thus I draw from the absurd three consequences, which are my revolt, my freedom, and my passion.  By the mere activity of consciousness I transform into a rule of life what was an invitation to death—and I refuse suicide."

"For the spectator, if he is conscious, that leap is still absurd. ... the point is to live."

"What, in fact, is the absurd man? He who, without negating it, does nothing for the eternal. Not that nostalgia is foreign to him. But he prefers his courage and his reasoning. The first teaches him to live without appeal and to get along with what he has; the second informs him of his limits. Assured of his

temporally limited freedom, of his revolt devoid of future, and of his mortal consciousness, he lives out his adventure within the span of his lifetime. That is his field, that is his action, which he shields from any judgment but his own. A greater life cannot mean for him another life."

"There is but one moral code that the absurd man can accept, the one that is not separated from God: the one that is dictated. ... “Everything is permitted,” exclaims Ivan Karamazov. That, too, smacks of the absurd. But on condition that it not be taken in the vulgar sense."

He then paints a picture of various absurd characters who embody the philosophy.

Don Juanism

"There is no noble love but that which recognizes itself to be both short-lived and exceptional."

Drama (the actor)

"The everyday man does not enjoy tarrying. Everything, on the contrary, hurries him onward. But at the same time nothing interests him more than himself, especially his potentialities. Whence his interest

in the theater, in the show, where so many fates are offered him, where he can accept the poetry without feeling the sorrow."

"Choosing between heaven and a ridiculous fidelity, preferring oneself to eternity or losing oneself in God is the age-old tragedy in which each must play his part."

Conquest (the conqueror)

"Conscious that I cannot stand aloof from my time, I have decided to be an integral part of it. This is why I esteem the individual only because he strikes me as ridiculous and humiliated. Knowing that there are no victorious causes, I have a liking for lost causes: they require an uncontaminated soul, equal to its defeat as to its temporary victories."

"deprived of the eternal, I want to ally myself with time."

"Conquerors know that action is in itself useless ... I have chosen this absurd and ineffectual effort. This is why I am on the side of the struggle."

"Victory would be desirable. But there is but one victory, and it is eternal. That is the one I shall

never have."

"Conquerors sometimes talk of vanquishing and overcoming. But it is always ‘overcoming oneself’ that they mean."

in sum of the characters ... "Let me repeat that these images do not propose moral codes and involve no judgments: they are sketches. They merely represent a style of life. The lover, the actor, or the adventurer plays the absurd. But equally well, if he wishes, the chaste man, the civil servant, or the president of the Republic."

"Being deprived of hope is not despairing. ... They are not striving to be better; they are attempting to be consistent."

"The imagination can add many others, inseparable from time and exile, who likewise know how to live in harmony with a universe without future and without weakness. This absurd, godless world is, then, peopled with men who think clearly and have ceased to hope. And I have not yet spoken of the most absurd character, who is the creator."

Absurd Creation

"War cannot be negated. One must live it or die of it."  This quote reminds me of Heraclitus, war is the father of all.

"Creation is the great mime."

"Even men without a gospel have their Mount of Olives. And one must not fall asleep on theirs either. For the absurd man it is not a matter of explaining and solving, but of experiencing and describing. Everything begins with lucid indifference."

"The philosopher, even if he is Kant, is a creator."

"Today when thought has ceased to lay claim to the universal, when its best history would be that of its repentances, we know that the system, when it is worth while, cannot be separated from its author. The Ethics itself, in one of its aspects, is but a long and reasoned personal confession." This is his way of saying one must embody their philosophy.

"I want to know whether, accepting a life without appeal, one can also agree to work and create without appeal and what is the way leading to these liberties. I want to liberate my universe of its phantoms and

to people it solely with flesh-and-blood truths whose presence I cannot deny. I can perform absurd work, choose the creative attitude rather than another. But an absurd attitude, if it is to remain so, must remain aware of its gratuitousness. So it is with the work of art. If the commandments of the absurd are not respected, if the work does not illustrate divorce and revolt, if it sacrifices to illusions and arouses hope, it ceases to be gratuitous."

"What holds for creation, looked upon as one of the possible attitudes for the man conscious of the absurd, holds for all the styles of life open to him. The conqueror or the actor, the creator or Don Juan may forget that their exercise in living could not do without awareness of its mad character."

"There is so much stubborn hope in the human heart. The most destitute men often end up by accepting illusion. That approval prompted by the need for peace inwardly parallels the existential consent."

Kirilov

"What distinguishes modern sensibility from classical sensibility is that the latter thrives on moral problems and the former on metaphysical problems. In Dostoevsky’s novels the question is propounded with such intensity that it can only invite extreme solutions. Existence is illusory or it is eternal."

"Convinced that human existence is an utter absurdity for anyone without faith in immortality, the

desperate man comes to the following conclusions:

“Since in reply to my questions about happiness, I am told, through the intermediary of my consciousness, that I cannot be happy except in harmony with the great all, which I cannot conceive and shall never be in a position to conceive, it is evident...”

“Since, finally, in this connection, I assume both the role of the plaintiff and that of the defendant, of the accused and of the judge, and since I consider this comedy perpetrated by nature altogether stupid, and since I even deem it humiliating for me to deign to play it ...”

“In my indisputable capacity of plaintiff and defendant, of judge and accused, I condemn that nature which, with such impudent nerve, brought me into being in order to suffer—I condemn it to be annihilated with me.”

"There remains a little humor in that position. This suicide kills himself because, on the metaphysical plane, he is vexed. In a certain sense he is taking his revenge. This is his way of proving that he “will not be had."

"“I shall kill myself in order to assert my insubordination, my new and dreadful liberty.” It is no longer a question of revenge, but of revolt. Kirilov is consequently an absurd character—yet with this essential reservation: he kills himself. ... he wants to kill himself to become god. ...  “If God does not exist, I am god,"

"Kirilov in fact fancies for a moment that Jesus at his death did not find himself in Paradise. He found out then that his torture had been useless. “The laws of nature,” says the engineer, “made Christ live in the midst of falsehood and die for a falsehood.”" ... He is the complete man, being the one who realized the most absurd condition. He is not the God-man but the man-god. And, like him, each of us can be crucified and victimized—and is to a certain degree."

"If God exists, all depends on him and we can do nothing against his will. If he does not exist, everything depends on us."

"Kirilov must kill himself out of love for humanity ... it is not despair that urges him to death, but love of his neighbor."

"Kirilov’s pistol rang out somewhere in Russia, but the world continued to cherish its blind hopes."

"Consequently, it is not an absurd novelist addressing us, but an existential novelist. Here, too, the leap is touching and gives its nobility to the art that inspires it. It is a stirring acquiescence, riddled with doubts, uncertain and ardent. Speaking of The Brothers Karamazov, Dostoevsky wrote: “The chief question that will be pursued throughout this book is the very one from which I have suffered consciously or unconsciously all life long: the existence of God."

"It is not an absurd work that is involved here, but a work that propounds the absurd problem."

"what contradicts the absurd in that work is not its Christian character, but rather its announcing a future life. It is possible to be Christian and absurd."

"The surprising reply of the creator to his characters, of Dostoevsky to Kirilov, can indeed be summed up thus: existence is illusory and it is eternal."

Ephemeral Creation

"To work and create “for nothing,” to sculpture in clay, to know that one’s creation has no future, to see one’s work destroyed in a day while being aware that fundamentally this has no more importance than building for centuries—this is the difficult wisdom that absurd thought sanctions."

"At the moment of death, the succession of his works is but a collection of failures. But if those failures all have the same resonance, the creator has managed to repeat the image of his own condition, to make the air echo with the sterile secret he possesses."

"human will had no other purpose than to maintain awareness. But that could not do without discipline. Of all the schools of patience and lucidity, creation is the most effective. It is also the staggering evidence of man’s sole dignity: the dogged revolt against his condition, perseverance in an effort considered sterile. It calls for a daily effort, self-mastery, a precise estimate of the limits of truth, measure, and strength. It constitutes an ascesis. All that “for nothing,” in order to repeat and mark time."

"Thus, I ask of absurd creation what I required from thought— revolt, freedom, and diversity. Later on it will manifest its utter futility. In that daily effort in which intelligence and passion mingle and delight each other, the absurd man discovers a discipline that will make up the greatest of his strengths."

"The final effort for these related minds, creator or conqueror, is to manage to free themselves also from their undertakings: succeed in granting that the very work, whether it be conquest, love, or creation, may well not be; consummate thus the utter futility of any individual life."

The Myth of Sisyphus

"The gods had condemned Sisyphus to ceaselessly rolling a rock to the top of a mountain, whence the stone would fall back of its own weight. They had thought with some reason that there is no more dreadful punishment than futile and hopeless labor."

"You have already grasped that Sisyphus is the absurd hero. He is, as much through his passions as through his torture. His scorn of the gods, his hatred of death, and his passion for life won him that unspeakable penalty in which the whole being is exerted toward accomplishing nothing."

"Then Sisyphus watches the stone rush down in a few moments toward that lower world whence he

will have to push it up again toward the summit. He goes back down to the plain. It is during that return, that pause, that Sisyphus interests me."

"If this myth is tragic, that is because its hero is conscious."

"The lucidity that was to constitute his torture at the same time crowns his victory. There is no fate that cannot be surmounted by scorn."

"Happiness and the absurd are two sons of the same earth."

"the absurd man, when he contemplates his torment, silences all the idols."

"The absurd man says yes and his effort will henceforth be unceasing."

"I leave Sisyphus at the foot of the mountain! One always finds one’s burden again. But Sisyphus teaches the higher fidelity that negates the gods and raises rocks. He too concludes that all is well. This universe henceforth without a master seems to him neither sterile nor futile. Each atom of that stone, each mineral flake of that night-filled mountain, in itself forms a world. The struggle itself toward the heights is enough to fill a man’s heart. One must imagine Sisyphus happy."

Letters from a Stoic 98 - On the Fickleness of Fortune

On the Fickleness of Fortune

For a Stoic, the summum bonum is a flourishing life or eudaimonia.  "eu" means 'good' or 'well' and "daimon" is 'soul' or 'spirit' (see this link).  According to Stoic physics, each human has a bit of divinity within him and for the human to fully flourish, he must live in accordance with God or Nature.

Pierre Hadot cites Chrysippus in The Inner Citadel,

The definition of the happy life, according to Chrysippus, is that in which everything is done "in accordance with the harmony between the daimon within each one of us and the will of the governor of the universe" (p. 123).

The translation of this can also be found at The Project Gutenberg EBook of The Lives and Opinions of Eminent Philosophers, by Diogenes Laërtius - see Book VII, Zeno), in which it reads,

Again, this very thing is the virtue of the happy man and the perfect happiness of life when everything is done according to a harmony with the genius of each individual with reference to the will of the universal governor and manager of all things.

This is the basis for the Stoic phrase, 'live according to Nature' or 'live in agreement with Nature.'

Furthermore, the Stoic philosophy maintains that achieving eudaimonia is something which is 'up to us.'  We are not dependent on externals in order to achieve this.  Hence Seneca writes in this letter,

joy which springs wholly from oneself is leal and sound; it increases and attends us to the last; while all other things which provoke the admiration of the crowd are but temporary Goods.

This well-spring of joy or eudaimonia can be found regardless of goods or ills (externals) in our life.  In fact, the externals or indifferents are the material for our use, in order to demonstrate arete which demonstration leads to eudaimonia.

For men make a mistake, my dear Lucilius, if they hold that anything good, or evil either, is bestowed upon us by Fortune; it is simply the raw material of Goods and Ills that she gives to us – the sources of things which, in our keeping, will develop into good or ill. For the soul is more powerful than any sort of Fortune; by its own agency it guides its affairs in either direction, and of its own power it can produce a happy life, or a wretched one (emphasis added).

At a fairly recent local Stoic meetup, we were talking about how Marcus Aurelius viewed wealth.  I forget which passage it was, but the idea conveyed by Marcus was that riches and wealth are indifferents.  One of the attendees wondered if what Marcus was writing about wealth was simply propaganda - basically telling people wealth didn't matter (so why should you pursue it).  I replied that, first, it could not really be propaganda because Meditations was meant for himself and not for others' consumption; and second, that the Stoic view of wealth is simply that of material for good use.  The goal is not to pursue wealth, but the goal is to demonstrate wisdom - wise use - of wealth.  The same can be said of poverty.  Seneca confirms this view when he notes that wealth or poverty are simply 'raw material' for a person to use in order to demonstrate what is uniquely 'up to them.'

Seneca further elaborates,

upright and honest man corrects the wrongs of Fortune, and softens hardship and bitterness because he knows how to endure them; he likewise accepts prosperity with appreciation and moderation, and stands up against trouble with steadiness and courage.

One of the Stoic exercises, which both help him prepare for and endure fortunate and unfortunate events is premeditatio malorum.  I've often wondered if the 'malorum' should be dropped from this phrase.  A Stoic who is comprehensive in his premeditation practice would consider all types of events - ones preferred and dispreferred.  Seneca writes of this practice,

If you are thus poised, nothing will affect you and a man will be thus poised if he reflects on the possible ups and downs in human affairs before he feels their force. ... Be sure to foresee whatever can be foreseen by planning. Observe and avoid, long before it happens, anything that is likely to do you harm. To effect this your best assistance will be a spirit of confidence and a mind strongly resolved to endure all things.

And perhaps most of all, the premeditation we should always consider is the loss of life.

men are so wayward, and so forgetful of their goal and of the point toward which every day jostles them, that they are surprised at losing anything, although some day they are bound to lose everything. ...  We must lose our lives as surely as we lose our property, and this, if we understand the truth, is itself a consolation. Lose it with equanimity; for you must lose your life also.

Other scenarios we ought to reflect on are fire, crucifixion, poison and exile.

The last part of the letter has an interesting tid-bit.  We know that Stoics don't shy away from suicide.  If one's death or suicide is a noble act, then he ought to carry it out.  But when should one carry on living versus dying?

In continuing to live, he deals generously. Some other person might have put an end to these sufferings; but our friend considers it no less base to flee from death than to flee towards death ... if he can no longer be of service to anyone [then he should consider dying].

The man suffering from pain must make the wise choice.

he trust himself in the face of both; he does not suffer with resignation because he hopes for death, nor does he die gladly because he is tired of suffering. Pain he endures, death he awaits.

Letters from a Stoic 77 - On Taking One's Own Life

On Taking One's Own Life

****

This post deals with and discusses suicide.

If you are in a good spot mentally speaking, then feel free read this post with all the candidness that philosophy has to offer.

But if you have suicidal thoughts or are considering suicide, please ask for professional help.  Below are phone numbers for immediate help, if you are based in the United States of America.

Crisis Text Line: Text HOME to 741741

National Suicide Prevention Lifeline: 1-800-273-8255

Trans Lifeline: 1-877-565-8860 (for the transgender community)

TrevorLifeline: 1-866-488-7386 (for LGBTQ youth)

Veterans Crisis Line: 1-800-273-8255, Press 1

If you are not based in the USA, please search on the internet for sources of help in your country, before reading this post.

****

To be a bit clearer, Seneca's 77th letter really deals with euthanasia rather than suicide in general.

The object of the letter is Tullius Marcellinus, but before he begins discussing him, Seneca observes the hustle and bustle of people in the excitement of the ship which has just docked.  

While everybody was bustling about and hurrying to the water-front, I felt great pleasure in my laziness, because, although I was soon to receive letters from my friends, I was in no hurry to know how my affairs were progressing abroad, or what news the letters were bringing; for some time now I have had no losses, nor gains either. Even if I were not an old man, I could not have helped feeling pleasure at this; but as it is, my pleasure was far greater. For, however small my possessions might be, I should still have left over more travelling-money than journey to travel, especially since this journey upon which we have set out is one which need not be followed to the end.

Seneca is pleased with himself because he has not been caught up in the excitement of the incoming ship and pivots this reflection into the fact that he thinks, metaphorically, he still has ample time left in his journey of life.  He makes the point very much clearer when he states that the length or end of the journey matters not so much as the manner in which you leave it.

An expedition will be incomplete if one stops half-way, or anywhere on this side of one's destination; but life is not incomplete if it is honourable. At whatever point you leave off living, provided you leave off nobly, your life is a whole.

In other words, a man of 20 years can live just as nobly as a man of 90 years.  The length does not matter so much.  What does matter is the fashion of leaving.  Therefore, a boy of 20 years old, who jumps on a grenade is much more honorable than the couch potato who dies of a heart attack at age 50.  Equally honorable is the man who labors for 40 years teaching ungrateful middle school students, in order to provide for his family, and dies on the day he retires, while it would be dishonorable of a man of 20 years who drinks to excess and dies in a drug overdose.

The object of the letter is one

Tullius Marcellinus ... [who] fell ill of a disease which was by no means hopeless; but it was protracted and troublesome, and it demanded much attention; hence he began to think about dying.

He called his friends together to give him advice.  One of his friends was a Stoic.

[the] Stoic friend, a rare man, and, ... a man of courage and vigour, admonished him best of all. ... [He said]: "Do not torment yourself, my dear Marcellinus, as if the question which you are weighing were a matter of importance. It is not an important matter to live; all your slaves live, and so do all animals; but it is important to die honourably, sensibly, bravely. Reflect how long you have been doing the same thing: food, sleep, lust, – this is one's daily round. The desire to die may be felt, not only by the sensible man or the brave or unhappy man, but even by the man who is merely surfeited."

Marcellinus' slaves were reluctant to help him in his death.  So the Stoic friend advised him

to distribute gifts to those who had attended him throughout his whole life, when that life was finished, just as, when a banquet is finished, the remaining portion is divided among the attendants who stand about the table. ... so he distributed little sums among his sorrowing slaves, and comforted them besides.

He fasted, then made a steam tent, as it were, and sat in a hot bath and had hot water poured over him until he passed out and then passed away.

Death becomes us all.  If you are someone who desperately wishes to cling so tightly to life, recall Seneca's words:

Would you not think him an utter fool who wept because he was not alive a thousand years ago? And is he not just as much of a fool who weeps because he will not be alive a thousand years from now? It is all the same; you will not be, and you were not. Neither of these periods of time belongs to you.

You are a blip in an unfathomable ocean of time and space.  Do not cling to something so insignificant.

Do not pray for something that is impossible, namely to escape death.

Give over thinking that your prayers can bend Divine decrees from their predestined end.  These decrees are unalterable and fixed; they are governed by a mighty and everlasting compulsion.

Returning to the concept of an honorable death, Seneca recounts the story of the Spartan boy who was taken captive.

The story of the Spartan lad has been preserved: taken captive while still a stripling, he kept crying in his Doric dialect, "I will not be a slave!" and he made good his word; for the very first time he was ordered to perform a menial and degrading service, – and the command was to fetch a chamber-pot, – he dashed out his brains against the wall.

Do not forget that we are all free from the bonds of life.  Do not fear death.

Unhappy fellow, you are a slave to men, you are a slave to your business, you are a slave to life. For life, if courage to die be lacking, is slavery.

And while you live, ponder deeply on what is up to you - on what your purpose is.  Do not let your purpose be so lowly as an animal.  Do not be a robot who works all day, to earn money, to spend it on things and food, to process said food, to deposit it in a hole, to be flushed and then to repeat the whole process again.  You are not a food processor.  You are a rational being.  Find meaning; live purposely; carpe diem.

It makes no difference whether a hundred or a thousand measures pass through your bladder; you are nothing but a wine-strainer.  You are a connoisseur in the flavour of the oyster and of the mullet; your luxury has not left you anything untasted for the years that are to come; and yet these are the things from which you are torn away unwillingly.

And if you are the type of person who is duty bound and must keep on living to fulfill your duties, recall that dying is a duty too and that to live excellently (your duty) also means choosing to die excellently (also your duty).

"I wish to live, for I am engaged in many honourable pursuits. I am loth to leave life's duties, which I am fulfilling with loyalty and zeal." Surely you are aware that dying is also one of life's duties?

His letter ends,

It is with life as it is with a play, – it matters not how long the action is spun out, but how good the acting is. It makes no difference at what point you stop. Stop whenever you choose; only see to it that the closing period is well turned.

Letters from a Stoic 70 - On the Proper Time to Slip the Cable

On the Proper Time to Slip the Cable

This post deals with and discusses suicide.

If you are in a good spot mentally speaking, then feel free read this post with all the candidness that philosophy has to offer.

But if you have suicidal thoughts or are considering suicide, please ask for professional help.  Below are phone numbers for immediate help, if you are based in the United States of America.

Crisis Text Line: Text HOME to 741741

National Suicide Prevention Lifeline: 1-800-273-8255

Trans Lifeline: 1-877-565-8860 (for the transgender community)

TrevorLifeline: 1-866-488-7386 (for LGBTQ youth)

Veterans Crisis Line: 1-800-273-8255, Press 1

If you are not based in the USA, please search on the internet for sources of help in your country, before reading this post.

****

I've contemplated taking my life.  In 2014, I was perhaps at the closest point to seriously taking it.  But as I considered the impact on my children and wife, I decided I needed help and therefore, I sought a therapist who helped me see a clearer path.  Things and life were not as dark as I was making them out to be in my mind.  I didn't have any problems that were worth dying to avoid.

Around that same time, perhaps in 2013 or 2014, I began to drink coffee and found it to be a wonderful antidote to contemplating suicide so often.  Later, I learned of a quote that has been attributed to Albert Camus which goes: "Should I kill myself, or have a cup of coffee?"  My new found love of coffee coupled with that quote resonated with me.  It's an absurd way to reframe life's challenges and problems to the point that if I ever went to that dark place, I could ask myself that question and almost all the time, I would prefer to simply go have a cup of coffee.  It became my internal rallying cry in the years 2015-2017.

I continued to see a therapist trained in cognitive behavioral therapy for about 4 months in 2014, after which I learned of the connection between CBT and Stoicism and the rest is history.  I hardly ever contemplate suicide these days, but I do contemplate my own death.  For the Stoics, death (suicide) was always open.  Seneca gets into it a bit here in the 70th letter from a Stoic.

Just a bit more commentary about suicide before delving into the letter.  I was listening to a Victor Davis Hanson podcast last week and he discussed this ancient concept of luxury and decadence (link to podcast, go to minute 45:01) and it got me thinking about how we, in this modern era and particularly in the west, have become decadent.  And, I think several years back, I was prone to consider that life was bad, when in actuality, it really wasn't that bad!  In a sense, I had become decadent.  Temporally speaking, our society has had it quite easy - air conditioning, cars, indoor plumbing, heated water at the turn of the tap, massive amounts of data and information in our pocket at all times and ample time to sit in leisure and comfort.  Just today, the jobs report for the United States came out, and one news story noted:

However, that drop in the jobless rate also came alongside an unexpected drop in the labor force participation rate to 61.6% from the 61.7% in May, suggesting a smaller share of Americans out of work returned to the labor force to look for or take new jobs.

This indicates that anxiety to work and provide for families and people is less urgent.  Stated differently, people don't feel the need to work, perhaps because of unemployment benefits and the greater application of Universal Basic Income (UBI).

Again - what is my point?  To show that to live and survive is not that difficult compared to many people living in 3rd world countries today as well as compared to people who lived decades and centuries ago.  For me personally, it shows my excuses and complaints were and are small and I really didn't and don't have such a great grievance to justify contemplating taking my life.  This theme will emerge a bit in Seneca's letter.

He begins the letter by comparing life with a voyage.  Some reach the destination slowly; others quickly.

if a man has reached this harbour in his early years, he has no more right to complain than a sailor who has made a quick voyage. For some sailors, as you know, are tricked and held back by sluggish winds, and grow weary and sick of the slow-moving calm; while others are carried quickly home by steady gales.  You may consider that the same thing happens to us: life has carried some men with the greatest rapidity to the harbour, the harbour they were bound to reach even if they tarried on the way, while others it has fretted and harassed.

He then gets into the quality of life, which is what wisdom seeks.  It's not so much about quantity or length.

mere living is not a good, but living well. Accordingly, the wise man will live as long as he ought, not as long as he can.  He will mark in what place, with whom, and how he is to conduct his existence, and what he is about to do. He always reflects concerning the quality, and not the quantity, of his life. As soon as there are many events in his life that give him trouble and disturb his peace of mind, he sets himself free.

If you lead a rational life, you will contemplate this idea: that a life worth living, is also worth living well.  And once you've determined it's worth living, then your task is to live it well and even to end it well.  I've heard a similar sentiment about one's career.  Several people and managers at work say that as long as their job is interesting, they show up to work.  They realize that some days are just horrible, long and disastrous.  But they know that not all days are like that.  They also think about where they ought to draw the line of continuing to show up at work or to resign or retire.  One manager said that as long as he has 3 good days, he can accept a couple of bad days a week.  But as soon as it becomes 3 and then 4 bad days, he'll know when to call it quits.  It seems that Seneca is saying something similar with regard to living.

Seneca even offers an example of living ill (the opposite of living well).

This person was thrown into a cage by his tyrant, and fed there like some wild animal. And when a certain man advised him to end his life by fasting, he replied: "A man may hope for anything while he has life."  This may be true; but life is not to be purchased at any price. No matter how great or how well-assured certain rewards may be I shall not strive to attain them at the price of a shameful confession of weakness.

In other words, just because you can live doesn't not mean you ought to.  Living well is the goal of a philosopher and a good human.

Socrates continued to live well (rather than take his own life) and to prove a point (teach) his friends and the Athenians.

Socrates might have ended his life by fasting; he might have died by starvation rather than by poison. But instead of this he spent thirty days in prison awaiting death, not with the idea "everything may happen," or "so long an interval has room for many a hope" but in order that he might show himself submissive to the laws and make the last moments of Socrates an edification to his friends.

In living and in choosing death, we should do both rationally.

Do not be mindless about living or dying.  But have a purpose.  Seneca writes:

Every man ought to make his life acceptable to others besides himself, but his death to himself alone. The best form of death is the one we like.  Men are foolish who reflect thus: "One person will say that my conduct was not brave enough; another, that I was too headstrong; a third, that a particular kind of death would have betokened more spirit." What you should really reflect is: "I have under consideration a purpose with which the talk of men has no concern!"

A rational being will seek and know his purpose, though it is not an easy task.  A wise person, therefore, will not simply default into the thinking of: "I'll let Nature decide when I die."  Rather, the wise person will know why he lives and when he should die.  If he complains about living, then perhaps he does not know his reason for living.  But Nature has given every one of us the choice to die or keep on living.  Seneca echoes the idea often written by Marcus Aurelius.

This is the one reason why we cannot complain of life: it keeps no one against his will. Humanity is well situated, because no man is unhappy except by his own fault. Live, if you so desire; if not, you may return to the place whence you came.

If you desire to hold on to life as long as possible, then pivot your thinking that your body is similar to a home: you can't live there forever.

Live in it as if you were about to leave it. Keep thinking of the fact that some day you will be deprived of this tenure; then you will be more brave against the necessity of departing.

While fortune may not test us on other matters and therefore we must practice them on our own (poverty, hardships, etc), there is one thing we must prepare for yet can't practice: our death.  Therefore, we ought to contemplate death often.

Seneca next goes into various examples of people who were put in horrible circumstances, and were prevented from killing themselves at every turn.  Yet, they sill managed!  Seneca cites these examples to prove that the door to leave life is, indeed, open to all.  He cites gladiators who shoved a wood stick tipped with a sponge down their throats, and who broke their necks with the spokes of a cart wheel while it was moving and one who used a spear to kill himself, by shoving it down his throat.  Again, the point of which is to prove that death is open to us all and that "the foulest death is preferable to the fairest slavery."

And, if death is open to the lowest of people (gladiators), then why should it not be available to rational people as well.

If such a spirit is possessed by abandoned and dangerous men, shall it not be possessed also by those who have trained themselves to meet such contingencies by long meditation, and by reason, the mistress of all things? It is reason which teaches us that fate has various ways of approach, but the same end, and that it makes no difference at what point the inevitable event begins.  Reason, too, advises us to die, if we may, according to our taste; if this cannot be, she advises us to die according to our ability, and to seize upon whatever means shall offer itself for doing violence to ourselves.

 In sum, the takeaways are:

- seek help if you are suicidal

- stay alive to find your purpose

- live with a purpose

- live rationally

- contemplate death - it is all our fates

- as far as you can, rationally choose your death

Letters from a Stoic 58 - On Being

On Being

This is a longish letter from Seneca, but he eventually makes some excellent points.  He starts off by talking about how language and words have changed and evolved over time before getting into Plato's thoughts about ideas and forms and what exists or not.  It can be a bit opaque to read, if you don't have some background of what Plato is talking about.  I've done some reading on this and reading through the first half of Seneca's letter was a bit of a struggle.  If you need a brief summary of Plato's theory of forms, see this link.

Beginning around verse 25 of the letter, Seneca writes,

"Very well," say you, "what good shall I get from all this fine reasoning?" None, if you wish me to answer your question. Nevertheless, just as an engraver rests his eyes when they have long been under a strain and are weary, and calls them from their work, and "feasts" them, as the saying is; so we at times should slacken our minds and refresh them with some sort of entertainment. But let even your entertainment be work.

In sum, Seneca went through all this as a diversion to 'slacken [his] mind' for entertainment!  After this verse, is when the letter gets better, in my opinion.

He explains why he did the analysis of the essence of things.

I try to extract and render useful some element from every field of thought, no matter how far removed it may be from philosophy. Now what could be less likely to reform character than the subjects which we have been discussing? And how can I be made a better man by the "ideas" of Plato? What can I draw from them that will put a check on my appetites? Perhaps the very thought, that all these things which minister to our senses, which arouse and excite us, are by Plato denied a place among the things that really exist.  Such things are therefore imaginary, and though they for the moment present a certain external appearance, yet they are in no case permanent or substantial; none the less, we crave them as if they were always to exist, or as if we were always to possess them (emphasis added).

What Seneca gets out of that analysis is that the very things which we think are real and exist, in fact are imaginary.  Therefore, while a Stoic may not agree or adhere to the Platonic ideas of Forms, we nonetheless can see a similarity in how we view indifferents and things that cause us to desire and crave.  Seneca applies the discipline of assent in seeing things as they really are:

We are weak, watery beings standing in the midst of unrealities; therefore let us turn our minds to the things that are everlasting. Let us look up to the ideal outlines of all things

I understand this to mean that we Stoics recognize that there is a sole good and on it we should rest our desires - namely ageless and timeless ideas such as moral virtue.  Seneca doesn't quite come out and explicitly state this in the letter, but he tends to focus more on the "defects of the body" and our impulses and "pleasures" and how we should "acquire the ability to control and check those pleasures" which ail the rest of humankind.  He advocates that we should mimic Socrates who practiced "frugal living, by setting a limit upon all that rouses the appetites, and by painstaking attention to himself."

Next he gets into his opinions about old age and when one should consider enduring old age or ending his life.

The question, therefore, on which we have to record our judgment is, whether one should shrink from extreme old age and should hasten the end artificially, instead of waiting for it to come.

It all depends on the circumstances and Seneca wants to do the right thing for the right reasons.  He writes his thoughts on the matter of extreme old age and what he thinks is the wise course of action.

I shall not abandon old age, if old age preserves me intact for myself, and intact as regards the better part of myself; but if old age begins to shatter my mind, and to pull its various faculties to pieces, if it leaves me, not life, but only the breath of life, I shall rush out of a house that is crumbling and tottering.

Here he makes it clear - as long as I have my wits about me, I'll endure living.  But if I lose my wits, I'm outta here!

I shall not avoid illness by seeking death, as long as the illness is curable and does not impede my soul.  I shall not lay violent hands upon myself just because I am in pain; for death under such circumstances is defeat.

I won't let myself off easy by killing myself to avoid the pain from a curable ailment.

But if I find out that the pain must always be endured, I shall depart, not because of the pain but because it will be a hindrance to me as regards all my reasons for living. He who dies just because he is in pain is a weakling, a coward; but he who lives merely to brave out this pain, is a fool (emphasis added).

But if he is going to endure pain that will never leave, he finds justification for ending his life.  If the pain hinders him for his reason to live, then he will depart.  We won't be a fool to bravely live out in pain.  He looks to his reason to live and if the pain prevents that, then he will go.

In sum, he will endure extreme old age, as long as he has his cognitive abilities and the pain does not prevent him from accomplishing his own reason or reasons to live (i.e. perhaps living to talk with loved ones, or writing letters to friends or something else).

Epictetus Discourses 4.7 - On freedom from fear

it's about the game, not about owning more dice

Of freedom from fear

My journey into Stoicism began over a decade ago.  After graduating high school, and after living in a foreign country for two years serving a church mission and after graduating from college and getting married and starting a family and working full time, I began to feel like something wasn't right.  I suffered from bouts of depression - especially on the weekends.  Between 2007 and 2014, the bouts got worse and worse, until my reasoning got to the point where I thought ending my life was more bearable than continuing to live.  Those were dark days.  It was like looking over a vast chasm that was pitch black and contemplating jumping into it.  There was real fear in my soul.

Instead of jumping, I reached out for help.  First to my wife, then to some others and eventually to a trusted therapist.  My therapist was able to help me correct some faulty internal thinking using Cognitive Behavioral Therapy.  After I learned what CBT is, I then learned that it had strong similarities with Stoicism.  From there, I learned of Donald Robertson, Ryan Holiday, then Marcus Aurelius, Seneca and Epictetus.  The dark days, as I call them, have never returned and I doubt they ever will.  I can return to that vast, dark chasm and look down, but now I experience no fear whatsoever.  This is the freedom Stoicism offers.

Epictetus talks of a similar situation - that of staring at death in the form of a tyrant.

if someone who has no particular desire either to die or to live, but is happy to accept whatever is granted, comes into the presence of the tyrant, what is to prevent him from approaching him without fear? - 'Nothing.' - If someone feels the same, then, about his property, and his children, as that man feels about his body, and in short, he has been brought into such a state by some madness or despair that he doesn't care whether he has them or not, but as children playing with bits of pottery (dice) compete with one another in the game without caring about the bits of pottery, so he too has come to set no value on material things, but merely takes pleasure in the game and its moves, what tyrant could still inspire him with fear, or what guards, or what swords of theirs? (v 4-5, p. 254)

If someone who is mad (crazy) or someone who is in despair can achieve this state of mind, then surely "reason and demonstration [can] teach people that God has made all that is in the universe, and the universe itself as a whole, to be free from hindrance, and self-sufficient, and has made all the parts of it to serve the needs of the whole?" (v. 6, p. 254)  When that person has come to an understanding of this logic, there is nothing that can prevent them "from living with a light heart and easy mind, calmly awaiting whatever may happen, and putting up with what has already happened." (v. 12, p. 255).  That is the true Stoic mental state.

There is an old movie, based on an old book, which has an interesting scene in it.  It is from A River Runs Through It and it is about how the young Maclean is learning how to write well.  His father makes him write the same paper over and over again until it has been written well.  Once he accomplishes it, his father tells him to throw it away!  If you are like me, you might gasp a bit about all that work, only to be crumpled and tossed into the trash.  But, the ends have been achieved!  The young Norman Maclean learned what his father wanted him to learn.  The goal was not to write a perfect paper to be framed and published.  The goal was to have gone through the learning.  You can see this scene here: https://www.youtube.com/watch?v=gA-sEfXOaEQ

Similarly, we must approach life and even our life itself.  The goal is not to hold onto wealth, health, possessions, fame, wife, children.  The goal is to go through the experience and to exercise what is truly yours: your use of judgement, impressions and virtues.

If the universe or God wishes you to be poor, then "bring it on" and demonstrate the part of "a good actor to play the part."  If the universe or fate wishes you to "hold office," then "bring it on."  If you should no longer hold office?  Bring it on.  If you should suffer hardships; bring it on.  To go into exile; bring it on.  You must learn to embrace this attitude: "Wherever I go, all will be well with me ... not because of the place [in time or space] but because of my judgements." (see v. 13-14, p. 255)

Your judgements are: you hold wealth, possessions, fame, health, relationships as externals and indifferents.  These things are the clay of life and inherently have no value.  The value is in what you do with the clay - what your unique judgement and virtue demonstrates.  "Let others be afraid [of losing or gaining] such things!  For my part I've enquired into them, and no one holds any power over me.  I've been set free by God, I know his commands, no one has the power any longer to enslave me, I have the right emancipator, I have the right judges." (v. 16-17, p. 256)

As for the tyrant, "I have no fear" of him or the way he can treat me.  "Why should I admire him any longer, why should I be in awe of him, why should I be afraid of his guards?  Why should I rejoice if he speaks kindly to me and offers me a welcome, and why should I tell others how he spoke to me?  Is he Socrates, by any chance, or Diogenes, that his praise should provide proof of what I am?" (v. 28-29, p. 257)

Don't be like those people whose concern is for living in "marble halls" or having hundred of people working for them ("slaves") or who are concerned about wearing "eye-catching clothes" or having many possessions, listening to the latest music, seeing the newest movies or getting the newest tech (see v. 37, p. 258).  As long as they "devote [their] concern to external things, [they'll] own more of those than anyone else" but their "ruling part" of them will be "filthy and neglected." (v. 41, p. 259)

But rather, be like a child, whose goal is to play the dice game.  They want to roll the dice and enjoy the game.  They value the game more than owning the dice!