Born near Vienna to a grain merchant, Adler’s experiences with rickets and a near fatal case of pneumonia as a child made him interested in a medical career. He received his M.D. from the University of Vienna in 1895 and practiced general medicine until about 1900, when he turned to psychiatry and neurology. As a physician, Adler demonstrated a holistic approach to the patient, taking seriously into account the contexts of social and human factors. In 1902, he began a close association with Sigmund Freud, which eventually disintegrated because of irreconcilable differences between their theories. Adler rejected Freud’s idea that neurosis stemmed from childhood sexual conflicts; instead, for Adler, sexuality filled a figurative position in the attempt to overcome feelings of inadequacy, that universal infantile “inferiority feeling” (or “inferiority complex,” as it came to be known), responses to which form the basis of character.
In a Study of Organ Inferiority and Its Psychical Compensation (1907) and The Neurotic Constitution (1912), Adler repudiated drive psychology and developed a system that came to be known as “Individual Psychology.” This theory posits that man’s opinion of himself and his surroundings affects all of his psychological operations; man’s principal motive is an inherent effort for perfection while his liability is the inferiority complex. For Adler, psychotherapy was a tool to help the patient become more self-determined, socially useful, reasonable, mature, and self-transcendent; this is accomplished by bringing the patient’s attention to the failures of his attempts to cope with feelings of inferiority. In 1921, Adler was the first to establish child-guidance clinics in Vienna where he could implement his belief that social values were transmitted in the early education of children, though these clinics were closed by the Austrian government in 1934 because of Adler’s Jewish heritage. He lectured and taught widely on social and scientific issues: from 1927 to 1937, he taught in the United States at Columbia University and the Long Island College School of Medicine. He died while on a lecture tour in Scotland.
Adler’s essay “Suicide” (1937) is an example of the increasingly scientific, non-moralizing treatment of suicide that arose with the development of psychiatry and psychology around and after the turn of the century. Adler recognized the situational factors that contribute to suicide, such as cultural beliefs and financial distress; in addition, certain predisposing factors are apparent in certain characteristics of children, such as oversensitivity. Adler also argued that the typical suicide suffers from a limited “social interest”—the importance of social interest was the doctrine Adler had attempted to spread in the 1930s in the face of European nationalist totalitarianism—and has a selfish motive to hurt others by his act; the suicide “hurts others by dreaming himself into injuries or by administering them to himself.” This damaging pattern is not seen as morally blameworthy, however, but as the occasion for therapy directed toward expanding the patient’s social interests.
Alfred Adler, “Suicide,” from Superiority and Social Interest: A Collection of Later Writings, eds. Heinz L. Ansbacher and Rowena R. Ansbacher (Evanston, IL: Northwestern University Press, 1964), pp. 248-252.
The frequent fact of suicide is surrounded by mystery for the average observer. When he is not personally touched by the suicide of someone near to him, he usually resorts to a superficial explanation which occasionally makes the suicide comprehensible, but usually leaves it incomprehensible. The members of the suicide’s intimate and wider circles also usually find the occurrence strange and inexplicable. This does not seem very significant, since, in general, an understanding of human nature and thinking directed toward prophylaxis cannot be taken for granted.
Attempts at explanation often begin with the frequency of suicide among mentally disordered individuals, especially depressed persons, to all of whom suicide appears as a way out of their distress even if by their words they seem to reject it. Thus the approximately normal person is inclined to regard suicide as an entirely pathological phenomenon.
Even so, there are certain situations from which the normal person regards suicide as the only way out. These are situations which are too distressing and unalterable, such as torment without any prospect for relief, inhumanly cruel attacks, fear of discovery of disgraceful or criminal actions, suffering of incurable and extremely painful diseases, etc. Surprisingly enough, the number of suicides actually committed for such reasons is not great.
Among the so-called causes for suicide, disregarding the cases of the psychologically ill, loss of money and unpayable debts take the first place. This gives us much to think about. Disappointed and unhappy love follow in frequency. Further frequent causes are permanent employment, for which the individual may or may not be responsible, and justified or unjustified reproaches.
Another cause is suicide epidemics which, puzzling as this may be, do occasionally happen. Harakiri, although on the decline, still exists among the Japanese. Among women and girls, suicide or attempted suicide takes place relatively frequently at the time of menstruation. Lastly, suicides increase strikingly after the age of fifty. All these facts ought to be explicable through Individual Psychology.
It is not surprising that qualified and unqualified circles often endeavor to work for the reduction of suicides. So far as we can see, such attempts have not succeeded in reducing the suicide rate. This is because individuals who turn to associations for the prevention of suicide would only be those who still regard the future with a certain amount of hope. In our time, the number of suicides is unchanged, possibly even increasing.
The Interpersonal Factor
The frequency of suicide is a serious accusation against the none-too-great social interest of mankind. In view of this, a comprehensive exploration of this puzzling phenomenon is urgently needed.
Among inner, endogenous causes, Individual Psychology considers only the style of life which is established out of heredity and environmental influences by the individual’s own creative power with his incomplete, humanly limited insight. In addition, one must determine the external, exogenous cause which reveals the inadequate preparation of the individual in question for the urgent situation before him. When the self-consistent life style thus clashes with the external situation, the extent to which the individual stands the test of living with other in society becomes apparent.
Observations of Individual Psychology have shown that every step of an individual is directed toward the successful solution of a presently imminent task in accordance with the total conception of his self-consistency. What the individual considers success is always a matter of his subjective opinion. Our experience has also shown that all tasks which the individual may have to meet require, without exception, adequate social interest for their correct solution. Each individual is so joined to society that he can make no movement, think no thought, and express no feeling without testifying to the degree of his connectedness with society, to hi social interest. From this is follows that suicide is a solution only for one who in the face of an urgent problem has arrived at the end of his limited social interest.
This coming to the end of their limited social interest shows itself in all failures, be they active or passive, in their greater development of the inferiority complex. That the suicide departs from the line of social interest is quite obvious. All forms of working together, of living together, and of fellowship are lacking. Further, it must certainly be admitted that this departure occurs in an active way. The activity has a particular curve, however, in that it runs apart from social life and against it, and that it harms the individual himself, not without giving pain and sorrow to others.
The suicide generally gives little or no (conscious) thought to the shock which he causes others. But this difficulty in the way of a further understanding can be resolved. Could it not be that he would have to eliminate others from his thoughts before he could commit suicide? In some cases his social interest might well be great enough for that. Moreover one finds quite frequently, by contrast, that in his last letter or words the suicide hints as asking forgiveness for the sorrow he has afflicted. The movement and the direction of the suicide cannot avoid the fact of sorrow to another. And perhaps there are many on the brink of suicide who, through greater social interest, are deterred from afflicting this sorrow to another.
The “other” is probably never lacking. Usually it is the one who suffers most by the suicide.
Individual Psychology continuously seeks to understand the unity and self-consistency of the individual. We are prepared for failures and try to prevent them, always in the conviction that the origin of a misconception of life and its organization can be traced back into early childhood. Therefore we must try to find the type of child which can be regarded as the potential suicide type. Studies of the past life and the childhood of suicides and of those who have attempted it always bring to light those traits which we have found in similar forms in all those failures who combine lesser social interest with a relatively large degree of activity. Suicidal persons have always been problem children, spoiled at least by one side of the family, very complacent, and oversensitive. Very often they showed hurt feelings to an unusual degree. In case of a loss or defeat, they were always poor losers. While they seldom made a direct attack against others, they always showed a life style which attempted to influence others through increased complaining, sadness, and suffering. A tendency to collapse under psychological pain when confronted with difficult life situations often stood out, in addition to increase ambition, vanity, and consciousness of their value for others. Fantasies of sickness or death, in which the pain of others reaches its highest degree, went parallel with this firm belief in their high values for others, a belief which they usually acquired from the pampering situations of their childhood. I have found similar traits in the early history of cases of depression, whose type borders on that of the suicide, and also of alcoholics and drug addicts.
Among the early childhood expressions of the suicide one also finds the deepest grieving over often negligible matters, strong wishes to become sick or to die when a humiliation is experienced, tantrums with willful self-injury, and an attitude towards others as if it were their duty to fulfill his every wish. Occasionally inclinations toward self-accusation come to the fore which elicit the sympathy of others, deeds of exaggerated foolhardiness which are performed to frighten others, and at times stubborn hunger strikes which intimidate the parents. Sometimes one finds ruses in the nature of a direct or indirect attack against others, acts of aggression followed by suicide, or only fantasies, wishes, and dreams which aim at a direct attach while suicide follows later.
Examples of suicide in the family have an attraction for those of similar tendency, as do the example of friends and well-known persons and special places associated with suicide.
Reduced to the simplest form, the life style of the potential suicide is characterized by the fact that he hurts others by dreaming himself into injuries or by administering them to himself. One will seldom go wrong in determining against whom the attack is aimed when one has found who is actually affected most by it. We find in the suicide the type who thinks too much of himself, too little of others, and who is unable sufficiently to play, function, live, and die with others. Rather, with an exaggerated consciousness of his own worth, he expects with great tension results which are always favorable for him.
The idea of suicide, like all other mistaken solutions of course always breaks out in the face of an urgent confronting exogenous problem for which the individual in question has an insufficient social interest. His greater or lesser activity then determines the direction and development of the symptoms. The symptoms can be done away with through an understanding of the context.
The psychiatrist will do well to keep his diagnosis of a potential suicide to himself, but to take all precautions. He must not tell it to others, but must see to it that something is done for the patient to enable him to find a better, more independent, socially oriented attitude toward life.