This blog is written as part of the BSA Medical Sociology event MedSoc Month, which has invited attendees to think creatively both about the topics we research and about how we communicate and engage others with that research. When we saw the call for paper, as suicide and self-harm researchers we (Hazel Marzetti a post doc at the University of Edinburgh, Veronica Heney a PhD student at the University of Exeter and Amy Chandler a senior lecturer at the University of Edinburgh) were excited at the opportunity to work together and find connections between our qualitative, sociological work on suicide and self-harm, as these opportunities are few and far between within this primarily quantitative, psychologised area of research.
We felt excited about the opportunity to think collectively, to think across and between our different individual projects, to find both commonalities and differences. We also hoped to demonstrate and explore the benefits we see in taking qualitative, sociological approaches to the topics of self-harm and suicide, highlighting the insights, nuances, and productive criticality which such approaches can bring. We are hopeful that in doing so we might invite others with interests in medical sociology into the area of self-harm and suicide, into our considerations around embodiment and emotions, and our exploration of how a sociological perspective might make a valuable intervention in typical ‘psychocentric’ approaches to the topic. We wanted to invite others to join us in such an intervention. To do so we have written three short blogs introducing our projects and the papers we will give at the conference, which we hope might prompt both ideas and responses.
Confronting queer death: complexity and meaning making in LGBT+ youths’ suicidal distress
Hazel Marzetti – firstname.lastname@example.org
In the spirit of the creativity that this year’s MedSoc Festival aims to foster and as an antidote to the compulsory pathologisation of suicidal feelings (Marsh, 2013), this post is structured around a poem by Andrea Gibson (pronouns: they/them) entitled The Nutritionist. Engaging with this poem is designed to be an explicitly emotional experience and acts as a rebellion against the dominant agenda in suicide research that seeks to identify and quantify suicidal ‘thoughts’ and ‘behaviours’ and explain them through associations with individualistic ‘risk factors’ such as suicidal people’s ‘perceptions’ about the state of the world in which they live (Hjelmeland and Knizek, 2016, 2020). Sharing it, I hope, will provide a lens through which we can reflect, connect, and expand our empathy as listeners, readers and researchers in preparation for my MedSoc talk, which will share findings from my doctoral research on LGBT+ young people’s suicidal thoughts and attempts in Scotland.
It has been argued that queer death, and particularly queer death through suicide, has become an all too unremarkable part of the narratives on queer youths and queer futures (Cover, 2012; Bryan and Mayock, 2017). Within these narratives queer suicide is constructed as an endpoint to queerphobic stigma and shame (Cover, 2012; McDermott and Roen, 2016; Bryan and Mayock, 2017), relating suicidal distress solely to individuals’ sexual orientation or trans identity, ignoring the possibility that suicidal distress can additionally be impacted by the many other facets of an individual’s identity.
However, this is not simply a product of the cisgender, heterosexual on-looker’s imagination, but can also be recognised and re-produced within queer narratives. In the Nutritionist we see a connection through queerness, loneliness and ultimately suicide drawn between the author and Tyler Clementi whose suicide in 2010 can then be read as an echo of the suicidal thoughts, feelings, attempts and deaths of the queer people we are, we know and we love. This connection travels through the journey of the poem and these shared feelings and experiences come full circle to disrupt loneliness; it is ultimately through this connection that Gibson finds ways to stay alive. It is exactly these kinds of complexities of feelings and meaning making related to LGBT+ youths’ suicidal distress that my talk seeks to explore.
Being on the edge: Suicide as slow death
Suicide – and self-harm – are often described as being difficult to talk about, with self-harm sometimes referred to as a way of expressing feelings or thoughts without using words. In collaboration with colleagues Zoi Simopoulou, and Sarah Wright, I’ve been exploring different ways of researching self-harm and suicide that do not privilege words or talk, and which make space for more embodied, creative ways of expressing or exploring meaning. Zoi and I initially developed a project around self-harm and art-workshops (Chandler and Simopoulou, 2021 ), and in 2019, Sarah and I tried out something similar, but focusing on suicide specifically.
We held a number of ‘arts-based discussion groups’ with four groups of people: two groups were made up of people who used a community-based mental health centre located in a semi-rural area of Scotland; and two groups of people who attended organisations that catered for and supported black and minority ethnic and/or migrants in Scotland. The groups all met between one and four times to talk about meanings of suicide in general, and for the various communities they were each a part of. In each case, participants had the option of also using a range of art materials to explore or express ideas. In practice, the use of art varied widely, though that is a story for another day!
In the presentation that I’ll give as part of our BSA MedSoc panel, I’m going to share some of the conversations that Sarah and I had with participants in the discussion groups. I will be focusing on a few moments in the groups, where the metaphor of ‘being on the edge’ was introduced by participants to illustrate stories about how someone might come to feel or ‘be’ suicidal. I will be reading these stories through Lauren Berlant’s (2011, and Puar 2012) concept of ‘slow death’ to think through suicide as an embodiment of structurally and culturally produced ‘feeling’ and ‘being’. Drawing on qualitative and – sometimes – arts-based material to think through meanings of suicide allows us to face and consider the complex ways in which suicide may be experienced; and how individual experience (perhaps agency, mastery, will) can be situated in and shaped by unequal social structures, and inter-related cultural meanings.
Shifting shame: experiencing self-harm in fiction
McDermott and Roen criticise the approach to self-harm taken by “quantifying methods” which flatten the “relational and meaning-making aspects” of people’s lives (9). In my PhD I attempt to counter this both by using qualitative interview data, and by placing self-harm specifically within its cultural context, through exploring its representation in fiction.
One participant in the study, Siobhan, talked about watching depictions of self-harm on TV and said that “If I’m with someone, it’s usually, I feel kind of ashamed. […] When I was with my boyfriend and if there was ever self-harm in a film or something that we were watching. It was always really shameful, even though like I might have done whatever the person was doing” whereas “if it’s me on my own, it just loses my interest” and she felt able to skip over or just dismiss the depiction.
To me this comment is not only interesting, but also helpfully destabilises certain assumptions. For instance, we might take for granted that a fictional text, like a film or a TV program, would have a consistent effect on an individual viewer. Yet for Siobhan it seems the impact depends on who is watching with her. Interpretation is not only personal but contextual. Similarly we might assume that self-harm is inherently shameful or that any shame associated with self-harm is felt consistently (Heney, 2021). But here we see that this is far from the case. Thus both self-harm and shame function socially, they take on different meanings or intensities in public and in private.
Self-harm, fiction, shame: all of these things can change and shift, they can be deeply personal and yet always relational, they can be individual but also social, they can be intense yet indeterminate. In my talk at MedSoc I’ll be thinking about how an attention to both interpretation and shame, as experiences which traverse the relation between the personal and the public (Mitchell, 2019) might offer new or valuable ways of negotiating the complexities of self-harm. In particular it allows for further exploration of self-harm’s own complex association with the dichotomy between public and private (Scourfield et al, 2011) and of fiction’s complex role in both intensifying shame and constructing experiences through which shame might be refused.
Over to you!
We see this BSA panel as uniting us around some common threads that run between our work – for instance the way that all three abstracts prompt consideration of self-harm and suicide not as individual acts but as contextual (if not straightforwardly context-determined), relational, and located within structural forces and inequalities. They all try to reframe or unsettle some of the ‘inevitability’ which often surrounds discussions of self-harm and suicide, whether that is the inevitability of the act itself or the inevitability of the shame and silence which surrounds it. All three abstracts start to explore the particular contribution that qualitative and sociological methods can make to complicating, questioning, and reconsidering the meanings associated with self-harm and suicide.
But now, over to you! Whilst we hope these short posts have given a flavour of our research, we would love to hear your thoughts on these blogs to broaden this collective thinking beyond just the three of us. We want to hear what you thought of the blogs, how you connected to them and how they made you feel, and of course which questions you still have after reading them. So please leave comments on the blog and we will get back to you on them, and if you’re attending our BSA MedSoc panel discussion on the 2nd September, we look forward to discussing them further with you then!
Confronting queer death: complexity and meaning making in LGBT+ youths’ suicidal distress – Hazel Marzetti
Bryan, A. and Mayock, P. (2017) ‘Supporting LGBT Lives? Complicating the suicide consensus in LGBT mental health research’, Sexualities, 20(1–2), pp. 65–85.
Cover, R. (2012) Queer Youth Suicide, Culture and Identity: Unliveable Lives?, Queer Youth Suicide, Culture and Identity: Unliveable Lives? Surrey, England’ Burlington, USA: Ashgate Publishing.
Gibson, A (2019) ‘The Nutrionist’ [online video] Available at: https://www.youtube.com/watch?v=8kIffc8Phfs
Hjelmeland, H. and Knizek, B. (2020) ‘The emperor’s new clothes? A critical look at the interpersonal theory of suicide’, Death Studies, 44(3), pp. 168–178.
Hjelmeland, H. and Knizek, B. L. (2016) ‘Time to Change Direction in Suicide Research’, in O’Connor, R. C. and Pirkis, J. (eds) The International Handbook of Suicide Prevention. 2nd edn. West Sussex: John Wiley & Sons, Ltd, pp. 696–709.
Marsh, I. (2013) ‘The uses of history in the unmaking of modern suicide’, Journal of Social History, 46(3), pp. 744–756.
McDermott, E. and Roen, K. (2016) Queer Youth, Suicide and Self-Harm Troubled Subjects, Troubling Norms. London: Palgrave Macmillan.
Being on the edge: Suicide as slow death – Amy Chandler
Berlant, L. (2011). Cruel Optimism. Durham: Duke University Press.
Chandler A, Simopoulou Z. The Violence of the Cut: Gendering Self-Harm. International Journal of Environmental Research and Public Health. 2021; 18(9):4650. https://doi.org/10.3390/ijerph18094650
Puar, J.K. (2012). Coda: The Cost of Getting Better: Suicide, Sensation, Switchpoints. GLQ: A Journal of Lesbian and Gay Studies, 18, 149-158.
Shifting shame: experiencing self-harm in fiction – Veronica Heney
Heney, V. 2021, Shame and Self-harm: Association and Avoidance, https://shameandmedicine.org/shame-and-self-harm-association-and-avoidance/
Mitchell, M.K., 2019. Writing Shame: Gender, Contemporary Literature and Negative Affect. Edinburgh University Press.
McDermott, E. and Roen, K., 2016. Queer youth, suicide and self-harm: troubled subjects, troubling norms. Springer.
Scourfield J, Roen K, McDermott E. (2011) The non-display of authentic distress: public-private dualism in young people’s discursive construction of self-harm. Sociol Health Illn. 33(5):777-91