Children’s Minds in the Line of Fire Blog - COCAP

About Adolescent Suicide
by María del Carmen Míguez 

Writing about adolescent suicide is a delicate task, which requires us to consider the complexities of this stage of development and the inner world of youth. Before, during and after the Covid-19 pandemic, suicide (specifically in this age range), has been a source of concern. Long-term Covid-19 confinement meant a period of instability for adolescents, with consequences for their mental health. However, no studies have yet been published that would allow us to conclude that there has been an increase in adolescent suicides in these two years.(1).The word suicide is increasingly heard in informal exchanges, on social networks and in the news. What changes are we witnessing regarding the physical and mental integrity of adolescents?

In the 1980s, the French psychoanalyst Françoise Dolto already described suicide as a true pandemic .(2). Also, Al Alvarez in The Savage God. A Study of Suicide (1971) warned about the increase of the phenomenon. On the other hand, the 3rd regional report of the Organización Panamericana de la Salud (OPS), published in March 2021, indicates that: "Suicide is the third leading cause of death among young people aged 20-24 in the Americas"(3). The World Health Organization (WHO) reports that in 2019, suicide was the fourth leading cause of death among 15-19 year olds. But when the age range is extended to 29 years, the statistics increase and we find that: "Deaths of their own free will represent the second leading cause of death, after traffic accidents". (4).

There is no doubt that suicide in young people is a public health problem. A youth suicide is often preceded by several unsuccessful attempts. There is an underreporting in the statistics of those who do not succeed. Suicide attempts often go unreported because of the stigma and prejudice surrounding them. Many self-inflicted deaths are recorded as occurring from other causes. 

Beyond the statistics, the importance of adolescent suicide can be inferred from references in great literature. I would like to focus on two classics.

In Shakespeare's tragic romance Romeo and Juliet (1597) we find a version of this topic. There, passionate love, family rivalries, and Friar Laurence's equivocation come together in such a way that the young lovers commit suicide, although that was not their true intention. Romeo and Juliet take their own lives, although they did not want to die. But for contemporary young people, is love still the motive that leads them to death?

Adolescents present more frequently failed suicide attempts, which puts us on the track of their acting, passionate tendency and their particular relationships to others and to love. I think that in the style of Romeo and Juliet, young people today call upon death as a desperate measure. As a cry for help in the face of the experience of inner emptiness, or to escape in their fantasy from the limitations that reality imposes on them. They hope that someone will appear and save them (a good object), or that self-injury will magically put an end to an intolerable inner situation.

The suicidal gesture is an emotional response that runs the risk of not finding the right recipient. Acts without words define young people in this age of over-information. Young people often experience their sexual awakening in a mute way or without images that can signify it. Their body is changing and they do not know what to do with it, nor how to talk about it.  

How can we understand the meaning that young people are putting into their actions? The hegemony of social networks as a vehicle for interaction and communication has added a degree of difficulty in managing and understanding psychic dynamics. Changes in the primary family structure are not a minor element either.

The events surrounding the publication of Johann Wolfgang von Goethe's The Sorrows of Young Werther, in 1774, is another reference worth mentioning. What became known as "the Werther effect" was a phenomenon of the cult of suicide among a large part of the young people of the time, to the point that the novel had to be banned in some cities (5).

Imitation and idealization of figures with extreme, lawless or defiant behavior are also dangerous characteristics of the adolescent stage. And although it is not the characters of world literature that move the youth of the 21st century, there are "influencers'' and other persuasive factors that work as in Goethe's book in its time. As Thomas Mann said: “acting like a spark in a powder magazine, setting free a dangerous amount of pent-up force”. (6)

The "challenges" that are offered on social networks and that hook countless isolated adolescents, in need of testing themselves at the level of the flesh itself, sometimes produce self-injury and leave an identity mark, like that of someone who carries Goethe's book under his arm. Other times, they go beyond the limits of what is tolerable and lead to death.

Werther was a young man experiencing unrequited love - like many a young person today, who decides to end his life. But according to Adam Kirsch: “What kills Werther is not disappointed love but toxic self-centeredness, subjectivity run wild. (...) Werther is always really only involved with himself, his own ideas and emotions". (7) An adolescent issue - of yesterday and today - that is not aimed at death, but which can lead to it .

María del Carmen Míguez
Training analyst of the Sociedad Psicoanalítica de Caracas.
Scientific Secretary of the SPC. 2019-2023
IPA in the Community Awards in Education, 2019, for the project Asunto Precoz: Guía urgente para padres.
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1.- A partial study published in Ecuador did not report an increase in the number of adolescent suicides compared to pre-pandemic rates. http://www.scielo.org.pe/scielo.php?pid=S2308-05312021000400819&script=sci_arttext 
Also, Dr. Fernando Gomez reports in his article Adolescents in the Line of Fire: Pandemic and War, that among North American adolescents aged 12-17, the average weekly number of visits to the emergency department for suspected suicide attempts was 22.3% higher during the summer of 2020 and 39.1% higher during the winter of 2021 than during the corresponding periods of 2019. https://www.ipa.world/IPA/en/Committees_New/COCAP/ADOLESCENTS_IN_THE_LINE_OF_FIRE__PANDEMIC_AND_WAR.aspx 
2.- La Causa de los adolescentes. Seix Barral. España 1990
3.--https://www.paho.org/es
4.-https://www.who.int/es/news-room/fact-sheets/detail/suicide 
5.-  A. Alvarez. El Dios Salvaje. un estudio del suicidio. Norma, Bogotá, 1999
6.- Quoted in Design for Living: What's great about Goethe?  By Adam Kirsch. New Yorker January, 2016. https://www.newyorker.com/magazine/2016/02/01/design-for-living-books-adam-kirsch 
7.- Ibidem 

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