In Honor of National Poetry Month 2020
Let Me Awaken
Let Me Rise Up High
Beyond Dreams Bone-dry.
Let Me Fly.
©2020 Steven Barto
Let Me Awaken
Let Me Rise Up High
Beyond Dreams Bone-dry.
Let Me Fly.
©2020 Steven Barto
With the sun in my hand
Gonna throw the sun
Way across the land-
Cause I’m tired,
Tired as I can be.
Early nineteenth century missionaries were important participants in colonial expeditions. Given that many in twenty-first century Western culture decry the era, goals, and abuses of colonialism, we must ask: Did Christianity benefit from an un-Christian impulse (colonialism)? Discuss this by answering the following questions. Were Christian missionaries a positive exception to the abuses of colonialism? Does the fact that colonialism aided Christianity in its spread throughout the entire world bestow ultimate value on the colonial experiences, making colonialism worth it?
It is unfortunately true that abuses and ulterior motives lurk in nearly every corner of human endeavor. I think it is interesting to track and analyze historical, social, and theological developments. The “birth” of Christianity did not happen in a vacuum. Most people during the first century saw Christianity as a heretical sect of Judaism and not necessarily a “new” religion. When I consider the progressive thread of redemption throughout the entirety of Scripture, I am able to accept some of the negatives of Christianity developing alongside colonialism.
Were Christian missionaries a positive exception to the abuses of colonialism?
Colonialism is the total control or governing influence of one nation over people in another nation or territory. It is reasonable to expect abuses and negative consequences with such activity. Many Christians in academia and the church see globalization as a two-edged sword. Some of the more egregious actions often taken in the name of conquest or expansion include domination of indigenous peoples, the taking of land in the name of expansion, and forceful servitude (slavery). It would be nice if this had not occurred specific to evangelism during global expansion, but it was likely unavoidable. Consequently, it can be difficult to see the “good” impact Christianity had on new populations during the era in question.
Most mission societies were not responsible for the troublesome side effects of colonization. However, as Gonzalez notes, the relationship between colonialism and missions is complex and difficult to gauge. Tradesmen, explorers, and colonizers were often accompanied by missionaries. This interrelationship was both positive and negative. I think it is no coincidence that not all churches or colonizers supported missions. Several key companies objected to spreading the Gospel in conjunction with colonialism and industrialization as they feared it would cause disagreements and protests that could hinder economic growth. The aim of colonization was to exploit the economy of each region, which usually led to making the new colony economically dependent on the colonizers; not to share the gospel or plant new churches.
From a positive perspective, the missionary movement necessitated a spirit of cooperation that seemed to bring churches and denominations together in pursuit of the Great Commission. Gonzalez stated that missionary societies often pulled members from more than one denomination. I agree that this helped curb “competing” messages and rivalries among witnessing missionaries. This was possibly the spark that prompted a more ecumenical movement in Christianity. Missionaries stood up against the caste system in India. Protestantism helped liberate those people deemed “untouchable” and excluded from everyday society. Other missions helped rescue women from sexism and violence and spawned their education. Further, the rapid Westernization of Japan aided the work of Christian missionaries.
Although colonialism brought much abuse and controversy to new regions, does the spread of Christianity outweigh the negative?
Gonzalez tries to draw a line-in-the-sand between colonialism and missions. Missions over the centuries have reached regions not visited by white explorers, traders, or colonizers. Were these “missionary” activities better than those occurring in tandem with expansionism? Is “saving souls” worth it no matter what? Do the ends justify the means? Not an easy question to answer! Many individuals have been brought to Christ during colonization. Over the centuries, Christianity has been labeled elitist, manipulative, arrogant, destructive. Gonzalez describes the so-called “white man’s burden.” Simply stated, it means taking to the rest of the world the benefits of industrialization, capitalism, democracy, and Christianity. I cannot help but think about watching TV documentaries on countries devastated by war and extremism (such as Afghanistan, Syria, and Iraq), or underdeveloped nations showing conditions that no one should want to endure. It’s easy to ask (from my comfortable recliner in modern America) why anyone would enjoy living in such conditions? Actually, this underlying question (nay, concern) is one of the driving forces of many efforts over the centuries to industrialize or “modernize” underdeveloped nations.
Gonzalez said modernity has produced the dislocation of vast masses who became landless, suffering the destruction of cultural patterns that had sustained them for generations. Expansionism has been blamed for growing disparities in living conditions between rich and poor throughout the world (1). Indigenous populations frequently suffered a loss of culture as colonizers tried to impose their way of life on their new “subjects.” White colonizers often considered these native peoples to be savage and lacking in culture. No doubt they felt justified in attempting to bring stability to what they might have considered “barbaric” or primitive populations. This is unfortunately as much a “value judgment” as it is a desire to aid in improving the living conditions.
I think it is necessary to separate the sociocultural impact of colonization from the religious impact of missions. Certainly, most Christian missionaries who bring the gospel to remote parts of the globe have a singleness of purpose: to share the Good News of Jesus Christ in accordance with the command in Matthew 28:18-20. To achieve this, missionaries have translated and distributed the Bible in many languages. Countless indigenous peoples have learned to read through the work of missions. Treaties often included clauses that made allowances for the work of Christian missions. Following the Chinese Boxer Rebellion, the presence of tens of thousands of Protestant missionaries throughout the provinces (many in positions of authority in the church) helped quash further rebellion. Corrupt governments and rampant exploitations met staunch Christian opposition.
I would conclude that colonization was not specific to evangelism. Moreover, globalization was not always undertaken with pure motives. It seems the lion’s share of colonizers intended to benefit from expansion, industrialization, increased labor forces, additional sources of raw materials and minerals, agriculture, hunting and trapping, and eventual resale of real estate for profit. Of those colonizers, some intended to bring indigenous peoples out of their primitive state of existence. A smaller percentage, although their prime objective was economical, were practicing Christians who brought the gospel with them. I see no reason to pitch the baby out with the bathwater. At the least, many seeds of faith were planted. Of course, I believe most missionaries were primarily motivated by the Great Commission. Thankfully, all things tend to work for good for those who love the LORD and are called according to His purpose (Rom. 8:28). To this end, I believe the pros of colonialism outweigh the cons relative to spreading the gospel.
Response from Classmates
Thanks for sharing a great post. I deduced that you feel that it was “worth it” in the end. Although I must admit that I wrestled A LOT with my answer this week, I ended up concluding that the abuses of colonialism were not “worth it,” as I don’t think that God would place inherent worth/value on sin and evil. However, I do agree that He can bring good out of all things.
You and I have both shared painful experiences from our own past throughout the coursework. As I was writing this prompt, I couldn’t help but think about how it could relate to my life, or anyone who has experienced some form of abuse. I honestly felt as though the pain that I endured was “worth it” because it led me to Christ, and my salvation is the greatest gift I could receive in this life. I also realized that Christ’s abuses were deemed “worth it” for our salvation—His sufferings in the world and horrible death on the cross gave us a shot at eternity. This is where I struggled!
However, there was a difference with colonization—the individuals who were abused during colonization were not Jesus, but rather His sheep. That is where I decided that the abuses of some to lead to the salvation of others was not “worth it.” God does not delight in sin, and calls us to spread the Gospel, not evil. One of our classmates mentioned that they don’t think that Christians should ally themselves with the “lesser evil,” but rather should uphold to what is true according to the Word. Do you think it could be dangerous to justify a lesser evil in the name of a greater good?
My Response to Meredith
Thanks for your response to my initial discussion post. Let me begin by (re)stating the definition of colonialism: the total control or governing influence of one nation over people in another nation or territory. I do so in order to draw a definite line in the sand between colonizers and missionaries. I would further state that those colonizers who were Christians and yet chose to cajole, cheat, manipulate, dominate, or otherwise force themselves and their beliefs on indigenous people merely to profit from associated gains are to blame, and not Christianity itself. Further to this point, I am quoting from Tiffany’s initial discussion post:
It is important to separate out Christianity from Christians, as well as those falsely speaking under the claim of Christianity, in support of this assertion. It is not that Christianity was tarnished, but that the reputation of Christianity blemished. Christianity suffers in the way Christ suffered—in that Christianity is birthed in, sustained by, and brought to culmination in Christ. He is the identity of Christianity (italics in the original).
I would argue that one of the positives of colonization was missionaries often accompanied the colonizers, making it possible for missions to have the means and companionship to travel where they might otherwise be unable to get to. Admittedly, there were more explorers and tradesmen who were motivated by expansion, wealth, and increased territory than there were Christians solely dedicated to sharing the gospel. I can tell you’re on the fence regarding the “worth it” question. You are closer to saying yes than you think. You referenced Romans 8:28: God will always use whatever circumstance or individual He requires to bring about His will.
Grudem (1994) provides insight regarding God’s will as it relates to (i) His absolute moral will, and (ii) His providential will. God’s moral will is revealed in Scripture. We know His character, His affection, His desire for us. We know how He wishes us to behave. He has provided certain “moral commands.” God also has providential (or “secret”) will (1). God is able to permit us to do something that might displease Him in the short run but which brings about His intended results in the long run. This is the very essence of Romans 8:28.
Speaking of our pasts, as I struggled a year and a half ago to stop abusing pain medication and to “forgive” myself of my past and see it as an asset for helping others (rather than a liability), I met a gentleman from Brooklyn who had spent 17 years in active addiction living on the streets. He became a born-again Christian and quit abusing crack. He said, “God wants me to tell you something.” That got my attention for sure. He continued: “He wants you to know that everything you’ve been through from the moment of your birth to this moment right now meeting me was ordained by Him in order to assure you became the man He needs you to be to carry out your ministry.” Whoa!
The concept of God’s providential will also speaks to His eternal plan whereby He determined (before the foundation of the world) to bring about everything that happens, and to work it together for our and His good. Grudem believes this “decree” type of will is critical because it shows us God doesn’t “make things up as He goes.” Grudem says, “He knows the end from the beginning, and he will accomplish all his good purposes” (2).
You quoted a classmate who declared that Christians should not align themselves with the “lesser evil” just because of a potential good outcome. For me, “aligning” with any evil would suggest being complicit. This is a question of personal motive. We must always remember that God works through human actions (even the horrific ones) in His providential oversight of creation. The individual making the wrong decision for the wrong reason is liable for his or her behavior, but God has absolute providence over the situation. I believe we must always remember that nothing about God, His creation, or us (as His image-bearers) is determined by chance or randomness; nor are they determined by impersonal fate or karma (determinism). God is sovereign over all.
(1) Justo L. Gonzalez, The Story of Christianity, Vol. II (New York: HarperOne, 2010), 418.
(2) Wayne Grudem, Systematic Theology (Grand Rapids: Zondervan, 1994), 332.
(3) Grudem, 333.
From the Monthly Blog of Dr. Nora Volkow, Exec. Dir.
NATIONAL INSTITUTE ON DRUG ABUSE
Original Date April 22, 2020
Untreated drug and alcohol use contribute to tens of thousands of deaths every year and impact the lives of many more. Healthcare already has effective tools including medications for opioid and alcohol use disorder that could prevent many of these deaths, but they are not being utilized widely enough, and many people who could benefit do not even seek them out. One important reason is the stigma that surrounds people with addiction.
Stigma is a problem with health conditions ranging from cancer and HIV to many mental illnesses. Some gains have been made in reducing stigma around certain conditions; public education and widespread use of effective medications has demystified depression, for instance, making it somewhat less taboo now than it was in past generations. But little progress has been made in removing the stigma around substance use disorders. People with addiction continue to be blamed for their disease. Even though medicine long ago reached a consensus that addiction is a complex brain disorder with behavioral components, the public and even many in healthcare and the justice system continue to view it as a result of moral weakness and flawed character.
Stigma on the part of healthcare providers who tacitly see a patient’s drug or alcohol problem as their own fault leads to substandard care or even to rejecting individuals seeking treatment. People showing signs of acute intoxication or withdrawal symptoms are sometimes expelled from emergency rooms by staff fearful of their behavior or assuming they are only seeking drugs. People with addiction internalize this stigma, feeling shame and refusing to seek treatment as a result.
In a Perspective published recently in The New England Journal of Medicine, Dr. Volkow tells the story about a man she met who was injecting heroin in his leg at a “shooting gallery”—a makeshift injection site—in San Juan, Puerto Rico, during a visit to that country several years ago. His leg was severely infected, and Dr. Volkow urged him to visit an emergency room—but he refused. He had been treated horribly on previous occasions, so preferred risking his life, or probable amputation, to the prospect of repeating his humiliation. This highlights a dimension of stigma that has been less remarked on in the literature and that is uniquely important for people with substance use disorders: Beyond just impeding the provision or seeking of care, stigma may actually enhance or reinstate drug use, playing a key part in the vicious cycle that drives addicted people to continue using drugs.
Previously on her montly blog Dr. Volkow highlighted research by Marco Venniro at NIDA’s Intramural Research Program, showing that rodents dependent on heroin or methamphetamine still choose social interaction over drug self-administration, given a choice; but when the social choice is punished, the animals revert to the drug. It is a profound finding, very likely applicable to humans, since we are highly social beings. Some of us respond to social as well as physical punishments by turning to substances to alleviate our pain. The humiliating rejection experienced by people who are stigmatized for their drug use acts as a powerful social punishment, driving them to continue and perhaps intensify their drug-taking.
The stigmatization of people with substance use disorders may be even more problematic in the current COVID-19 crisis. In addition to their greater risk through homelessness and drug use itself, the legitimate fear around contagion may mean that bystanders or even first responders will be reluctant to administer naloxone to people who have overdosed. And there is a danger that overtaxed hospitals will preferentially pass over those with obvious drug problems when making difficult decisions about where to direct lifesaving personnel and resources.
Alleviating stigma is not easy, in part because the rejection of people with addiction or mental illness arises from violations of social norms. Even people in healthcare, if they do not have training in caring for people with substance use disorders, may be at a loss as to how to interact with someone acting threateningly because of withdrawal or some drugs’ effects (e.g., PCP). It is crucial that people across healthcare, from staff in emergency departments to physicians, nurses, and physician assistants, be trained in caring compassionately and competently for people with substance use disorders. Treating patients with dignity and compassion is the first step.
There must be wider recognition that susceptibility to the brain changes in addiction are substantially influenced by factors outside an individual’s control, such as genetics or the environment in which one is born and raised, and that medical care is often necessary to facilitate recovery as well as avert the worst outcomes like overdose. When people with addiction are stigmatized and rejected, especially by those within healthcare, it only contributes to the vicious cycle that entrenches their disease.
The following website can help you find substance abuse or other mental health services in your area: www.samhsa.gov/find-treatment. If you are in an emergency situation, people at this toll-free, 24-hour hotline can help you get through this difficult time: 1(800) 273-TALK. Or click on: www.suicidepreventionlifeline.org.
You can also find help through Narcotics Anonymous at 844-335-2408.
Sitting there frozen in
old memories, recalling our favorite
lines from Proust.
Trembling as I close my eyes,
hearing the joys and sorrows
of twelfth grade one last time.
I’m drowning in emotions; they tear at me,
pulling me beyond my fail safe
and I cringe, frightened.
Eyes wide shut, I misunderstand
the mirage, gazing at a chimara
of your face and I let out a sigh.
I catch glimpses of you across the meadow.
The sun dances through your hair;
your feet float above the grass
and you vanish behind our
favorite willow tree where my lips
first touched yours.
That summer of our wildness
was incomparable, a cruel yardstick
against which I’ve measured every
summertide of my later days,
struggling with the emptiness and
hollowness of everything not you.
If only I could un-lose you, hold you
securely, tightly, intensely,
Just for a moment, just for a season.
I reason with God—please let me keep
my first love.
Things were simple
back when I knew you.
Uncomplicated and sure. I smile
and reach for you—it’s second nature.
All this remembering has me
by the heart.
My present life is haunted—
I feel the warmth of you
on my sheets.
I catch faint remains of your sweet perfume,
and reach for something I can’t have.
Something I maybe never had.
©2020 Steven Barto
In the opening chapter of the reading for this section, Justo L. Gonzalez (2010) makes this statement: “…from the perspective of the history of Christianity, the most important event of the nineteenth century was the founding of a truly universal church in which peoples of all races and nations had a part” (302). After completing your reading, answer the following questions:
Gonzalez describes changes in the economic power of nation-states in Europe and throughout the Western hemisphere during the second half of the eighteenth century. In addition, there were great political and social upheavals during the nineteenth and twentieth centuries “…that would have a serious impact on Christianity as a whole” (1). This period also featured tremedous geographical expansion of Christianity. I agree with Gonzalez that the most important event of the nineteenth century was the founding of a truly universal church—one available to all races and nations. His qualifying comment is important: “On the other hand, however, it is necessary to point out that this took place within the context of colonialism and economic imperialism” (2). As colonialism, neocolonialism, and the Industrial Revolution took hold, personal and cultural diversity put doctrine and hierarchy at risk in the Christian church.
While Christianity must always involve a personal choice and commitment, simply doing missions will not assure universal adherence to accepted Christian doctrine. There are four marks of the Church, signifying it is (i) one; (ii) holy; (iii) “catholic” and (iv) apostolic. Each mark is critical for establishing and maintaining “consistent” Christianity. Without preservation of a single, holy, universal, and apostolic church, geographic expansion would surely have had a more devastating and lasting impact on the gospel than it did. As it is, there were periods of amazing proliferation of Christianity as a natural companion to colonialization, but there were also periods of painful, heretical, and villainous actions. Let’s look at the key “marks” of the church.
One means there is one body (the Christian church) with Christ as its head. Grudem says, “The church is the community of all true believers for all time” (3). Christ holds all authority over the church. Paul wrote, “[A]nd he has put all things under his feet and has made him the head over all things for the church, which is his body, the fullness of him who fills all in all” (Eph. 1:22-23, NRSV). Ephesians 2:19-20 says we’re fellow citizens with the saints and members of the household of God, built upon the foundation of the apostles and prophets, with Christ Jesus being the cornerstone. In this regard, the “church” is much more than the visible local church. As the Body of Christ, it must remain one regardless of dispensation or geographic disbursal.
Holy means the church and its believers must be “set apart” and sanctified. Moreover, the church is holy because it is Jesus Christ, who teaches holiness. Grudem says, “The purity of the church is its degree of freedom from wrong doctrine and conduct, and its degree of conformity to God’s revealed will for the church” (4). The holy church must be separate from the world, but its unity requires freedom from divisions among the community of believers (the true Christians) as well. Its “holiness” is grounded in the need for proper doctrine, conscience, and considerations. This feature also helps identify “false” churches—which by definition are not a part of the Body of Christ. It’s through caution and humility that we preserve proper doctrine.
“Catholic” means it is universal. The Greek word for “catholic” (katholikos) means “throughout the whole” or “general.” The term “catholic” first showed up during the patristic era denoting universal. For example, “Wherever Jesus Christ is, there is the catholic church (Ign. Smyrn. 8:2)” (5). Harrison says when the term began appearing in the Apostle’s Creed (and earlier in the Nicene Creed), “one holy catholic and apostolic church” expressed a sense of universality; accenting the church’s unity despite its geographic dispersion. The term “catholic” can also apply to the New Testament epistles, indicating they were intended for the entire church and not just those to whom they were addressed. This is a critical point, given the fact that the Scriptures are alive and timeless. Further, Harrison indicates that in the face of numerous heresies during the Apostolic Era, the term “catholic” was equivalent to orthodox. Of course, during the Reformation “catholic” was used to delineate between the emerging Protestant church and the Roman Catholic Church.
Apostolic means the church was founded by Jesus Christ. Jesus said, “All authority in heaven and on earth has been given to me” (Matt. 28:18). Jesus then delegated that authority to the church: “Go therefore and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, teaching them to observe all that I have commanded you; and lo, I am with you always, to the close of the age” (28:19-20). Apostolic propriety has established key matters such as baptism, the Eucharist, authorship of the canonical Gospels, and acceptable key doctrines. The apostles founded churches and appointed their successors. This provided the means by which emphasis was on the context of the central gospel message. The apostolic feature of the church allowed for establishing its marks, purity, power, hierarchy of governance, grace, and unity.
In conclusion, it is my opinion that missions should not take precedence over the establishment of a universal church with a uniform set of core doctrines. Failure to grant preeminence to the marks of the church and its core doctrines would cause replication that would eventually lead to false churches.
You mentioned that you “do not believe missions should take precedence over the establishment of a universal church with a uniform set of core doctrines.” Yes, I do agree we need core beliefs, but at the same time I feel there is urgency in sharing the Gospel with the unreached and that it should not be sacrificed. I could see a combination of missions and the formation of a universal church being the most important, but it’s hard to really specify which one has a great significance on Christianity. Do you think missions, or the formation of mission societies was a significant event during the nineteenth century, even if not the most significant?
Thanks for your feedback to my initial discussion post. We are closer in agreement than it might sound. The Great Commission is critical. It applies to the entire church. We are all responsible for bringing the gospel with us wherever we go; whatever our vocation. Rather than say a “universal” church is somehow more important than missions probably fails to accurately express what I meant. These two aspects of the church are “nearly” equal in importance. I give more importance to first establishing a church that displays all the marks: one, holy, universal (“catholic”) and apostolic. A sort-of prerequisite to missions. Like taking a course on “fundamental Christian principles” first, and then moving on to an advanced course on deeper issues of doctrine. I addressed this issue to an extent in Church History I (Session 5) when answering the prompt about benefits of the Reformation versus the evangelical benefits of colonial expansion: i.e., which of these two has contributed the most to the course of Christianity?
At that time, I said the Reformation yielded more positive results than colonization (“expansion” or “globalization”). I took that position for the same reason I bring to this week’s discussion. The church is commanded to go forth into every nation, spreading the Good News—teaching and baptizing, making disciples of men for further proliferation of the gospel. Colonialism includes explorers, travelers, merchants, and missionaries (who bring their religion with them). But “good” Evangelism (one of Christianity’s most sacred and clearly established responsibilities) must be well-grounded in an accepted and uniform set of principles. Granted, Christianity has fractured into numerous denominations, which is why I believe it is paramount that the church had to first settle on a centralized or universal set of doctrines prior to setting out to share the gospel.
Consider the deeper intellectual revolution Gonzalez (2010, 304) speaks about. The philosophy of thinking (epistemology) was drastically impacted by the Renaissance. One side-effect of the Industrial Revolution was a focus almost exclusively on empirical evidence as the best means for gaining knowledge. Nationalism took hold and led to changes in government models and the social order. In the face of all these changes, the church remained present, cutting across “national boundaries, class distinctions, and political allegiances” (6). Gonzalez said that for the first time in history a “truly universal church had been born” (7).
Gonzalez also noted, “[F]rom the perspective of the twenty-first century it would appear that the most important event in the history of Christianity in the nineteenth and twentieth century was that [Christianity] moved beyond its traditional [geographical?] confines within Western civilization and became a truly universal faith” (8) (italics mine). Given the fact that secularism, pluralism, and moral relativism was impacting philosophy and theology, Christendom fell on leaner times, thereby setting up the post-Christian society we see today. It is critical that Christianity have a uniform set of core beliefs and a sense of universality before there can be any accurate and efficacious proliferation of the message.
The universality of the Christian church is extremely important. Arguably, this has not created “flawless” adherence to uniform doctrine throughout the world, but “universal faith” has created a solid foundation from which to preach, teach, disciple, and baptize people that holds true to the nuts-and-bolts of Jesus’ instructions to the church just prior to His ascension.
(1) Justo L. Gonzalez, The Story of Christianity, Vol. II (New York: HarperOne, 2010), 301-02.
(2) Gonzalez, 302.
(3) Wayne Grudem, Systematic Theology (Grand Rapids: Zondervan, 1994), 853.
(4) Grudem, 873.
(5) E.F. Harrison, “Catholic,” in the Evangelical Dictionary of Theology, 3rd ed., edited by D.J. Treier and W.A. Elwell (Grand Rapids: Baker Academic, 2017), 163.
(6) Justo L. Gonzalez, The Story of Christianity, Vol. II (New York: HarperCollins, 2010), 312.
(7) Gonzalez, 314.
(8) Gonzalez, 316.
Written by Steven Barto, B.S., Psy.
IT WAS FOUR IN the afternoon. I was driving along the river in my home town. It was the fourth decade of my struggle with active addiction. Overwhelmed with thoughts of utter failure, rabid hypocrisy and complete hopelessness, I started ruminating about the idea of suicide. Why not? It made sense. I was in bondage to drugs and had grown tired of living a life so out of touch with my Christian upbringing. Seems I could not stop lying, cheating, stealing. Doing whatever it took to keep getting high. Duplicity was the word that most described my existence. I’d grown weary of living on the down-low. I was defeated, exhausted and tired of failing.
I turned into an area boat launch and stopped about fifty yards from the edge of the water. I closed my eyes and took my foot off the brake. I’d barely touched the accelerator when I heard an audible voice. It filled the cabin of my car: Don’t. I jammed the brake pedal to the floor and gripped the steering wheel in a panic. I must be losing my mind! There was no one else in the car. The radio was off. Yet, somehow, I heard a voice that seemed to fill the interior of my car. I could feel the voice, insistent but not loud. No sense of anger or disappointment. It was simply an audible, gentle, compassionate insistence.
It’s been said that suicide is a permanent solution to a temporary problem. Perhaps if some in-between state existed—some alternative to death—many suicidal people would take it. One question every surviving family member has asked without exception, that they ache to have answered more than any other, is simple: Why? Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note is left behind, it still never makes sense. Yes, they felt enough despair to want to take their own life, but Why did they feel that way? Alex Lickerman, MD said, “People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy, but a valid one nevertheless” (1).
A friend of mine took his own life in 1996. We met a few years earlier as co-workers at a Philadelphia law firm. We were both on staff as litigation paralegals. He had recently started a new career trading stocks. Apparently, he was under investigation by the SEC for insider trading. His wife kicked him out and filed for divorce. He moved in with his parents and had become quite depressed and withdrawn. He stayed home from work on a Tuesday. After his parents left the house, he took his father’s .357 handgun and drove to his wife’s place. When she answered his knock, he shot himself on the stoop in front of her. I always knew him to be outgoing, hilarious, and always up for a good time. His death made no sense to me.
Unfortunately, suicide without warning is common. Patrick J. Skerrett quoted Dr. Michael Miller, a psychiatrist at Harvard Medical School, in a recent article on suicide: “Many people who commit suicide do so without letting on they are thinking about it or planning it” (2). Currently, suicide is the tenth overall cause of death in the United States. In 2018 there were 48,334 suicide deaths in America. Had I not heard God’s voice that afternoon in 2018, the total would have been 48,335. There were an estimated 1.4 million suicide attempts in the U.S. in 2018. The rate of suicide is highest in middle-age white men in particular. It was the second leading cause of death among individuals between the ages of 10 and 34. On average, there are 132 suicides per day. In 2018, firearms accounted for 50.57% of all suicide deaths in America (3).
America’s suicide rate has increased for 13 years in a row.—The Economist
According to the National Vital Statistics Report, suicide was the second leading cause of death for age groups 10 to 24, or 19.2% of deaths, and 25 to 44, or 10.9%. This report presents final 2017 data on leading causes of death in the United States by age, sex, race, and Hispanic origin. These data accompany the release of final national mortality statistics for 2017 (4). In 2017, the 10 leading causes of death were, in rank order: heart disease; malignant neoplasms; accidents (unintentional injuries); chronic lower respiratory diseases; cerebrovascular diseases; Alzheimer disease; diabetes mellitus; influenza and pneumonia; nephritis, nephrotic syndrome and nephrosis; and intentional self-harm (suicide).
Various social media platforms offer an unprecedented volume, velocity, and variety of social data to researchers. Among these, the most consistently studied is Twitter, a microblogging platform in which participants broadcast 140-character posts directly to one another or to the Twitter community simultaneously. Twitter’s sociological and psychological relevance for researchers and treatment providers is elevated due to ease of accessibility to data, the fact that most data collection activities can be undertaken at no cost to the researcher, and the ease of data management. For example, because Twitter limits individual posts to 140 characters, the information is more easily stored and reviewed than longer Facebook posts.
Facebook Suicide Prevention webpage can be found at www.facebook.com/help/594991777257121/ [use the search term “suicide” or “suicide prevention”].
As with a variety of social media platforms, Twitter has been a boon to suicide researchers, who can observe the behavior of individuals in a non-invasive manner, collecting “live” (time-sensitive) information that might not otherwise be shared because of the stigma of mental illness and suicide. One researcher was able to analyze 125 users who publicly announced they had attempted suicide. Analysis of these individuals’ posting history revealed distinct signals in previous posts that could have been used to predict their upcoming attempts and initiate an intervention (5). This is a relatively large sample that otherwise might have been overlooked.
Strong correlations have been discovered between suicidal expressions on Twitter and state-specified age-adjusted suicide rates. It is believed that posting suicide-related content on social media specifically identifies at-risk individuals. In fact, unique posting patterns have been posthumously discovered for Twitter members who died by suicide when compared to those who died of other causes (6). Such results demonstrate the value of verbal content people post on social media sites—providing unique insight into suicidal behavior.
Twitter’s Best Practices in Dealing With Self-Harm and Suicide at https://support.twitter.com [use the search term “suicide,” “self-harm,” or “suicide prevention”].
Psychologists and sociologists have begun to analyze social media data—correlating the content of social media posts regarding the topic of suicide with eventual suicides or attempts. Analysis has proven most useful in this regard. It must be determined whether suicidal behavior can be correlated to online comments among peers beyond one degree of social separation. Also, it must be determined whether that correlation persists after excluding innocuous commentary regarding mood and attitude. In other words, if mood is held to a constant in the analysis, will the observed association in suicide-related behavior still be higher than chance? Recent research has determined that comments on social media relative to suicidal expressions can be studied and correlated up to three degrees of separation between peers, but no further.
N.A. Christakis and J.H. Fowler (7) noted that correlation held between suicidal remarks and suicidal actions even when accounting for the distribution of mood among participants in the social media network. They used the bootstrapping method (employing computer-intensive analysis of variability within their data samples) to study real-time posting activity on Twitter. Their samples were comprised of two non-consecutive 28-day periods. Mechanical Turk (MTurk; Amazon, 2016) raters have compiled suicide-relatedness ratings for each of the 10,222 most common words in contemporary English for use in evaluating social media posts for occurrence of “suicidal conversation.” These words are correlated with a preexisting list of “sad” words (as they relate to the sad/happy continuum) used to infer the general mood of social media users. Collection and analysis was conducted via double-blind method for accuracy and to allow for detecting statistical variation and spurious correlation.
Some variants of “sad/happy” word expressions that may or may not be associated with suicidal ideation include “I’m so sad! I’m gonna kill myself!” “I’m the worst! LOL!” “My final day on earth…” “Just got in a fight…” “It’s a sad day.” “I love my life!” Analysis included placing “sad,” “happy,” and “suicidal” words into columns on a graph and quantifying the number of uses of such words or phrases. Also, degrees of separation (direct friend versus once, twice, thrice removed) were determined at one through six degrees: friend, friend of friend, friend of friend of friend, and so on. The Sad Column, Happy Column and statistically relevant variables were each plotted along the graph comparing “mood” and “suicide-relatedness” comments. Amazingly, this study may be the first of its kind, and involved collection and analysis of over 64 million post from over 17 million unique social media users in two nonconsecutive 28-day periods. Analysis of this real-time data helped predict (by an algorithm) the information collected, which typically has infinite possibilities of correlative meaning.
You might ask, But why is this important? What does it mean? How can it be utilized? Suppose a counselor is concerned with the suicide risk of students in a high school where a fellow student recently took her own life. To get the best data in the shortest amount of time, the counselor would do the following:
Although the above process will provide an initial “hint” of an assortativity-informed treatment approach, additional research would be necessary before beginning any efficacious intervention. Researchers warn that no offline behavior was included in their study, and therefore was not available for comparison.
Suicide is a major public health problem and a leading cause of death in the United States. Everyone who chooses to attempt suicide has an underlying reason for wanting to do so. Suicide does not discriminate—people of all genders, ages, religious faiths, and ethnic groups can be at risk. Most people at risk will not follow through. Still, assessing the risk for suicidal behavior is complicated. Researchers tell us that people who attempt suicide may do so in reaction to a particular event, thought, or emotion. These individuals make decisions differently than those who do not attempt suicide. Such factors for increased risk are depression, anxiety, personality disorders, psychosis, severe bullying, rape or trauma, and substance abuse.
Suicidal acts may be connected to recent events or current conditions in a person’s life. Although such factors may not be the primary motivation for the suicide, they can precipitate it as underlying or co-morbid triggers. A major underlying cause of suicide has been combat stress and other related PTSD issues. People in this at-risk category do not necessarily have to experience the horrors of a war zone. Other types of immediate stress include natural disasters, terrorism at home, or catastrophic loss from such events as a structure fire or a serious motor vehicle accident.
People suffering from chronic pain, severe disability, or a major illness may attempt suicide, believing their suffering is too great or that their death is inevitable. Victims of an abusive or repressive environment from which they have little or no hope of escape sometimes commit suicide. Situations that fit this category may include torture, confinement, sexual assault, or persistent physical abuse. Also, occupational stress has been indicated in some suicides due to extreme tension, anxiety, disillusion or “burnout,” and job-related financial pressures.
In addition to the above precipitating factors, many suicide attempts are preceded by a severe change in mood that do not correlate to an underlying psychiatric diagnosis. Mood changes most likely to lead to suicide often include extreme sadness, unresolved anxiety, frustration, anger, or shame. Unfortunately, the number of teens and young adults who take their own lives has increased due to bullying at school or on social media sites. Nearly 1 in 5 students (21%) report being bullied during the school year, impacting over 5 million youth annually. See National Center for Education Statistics [NCES], 2018.
There has been a spike in cyberbullying over the last couple of years. This is willful and repeated bullying behavior that takes place using electronic technology, including texting, comments during gaming, Internet sites, social media, emails, blogs, cell phones, and so on. Unlike traditional bullying it can happen anywhere at all hours of the day. Approximately 34% of students report experiencing cyberbullying during their lifetime. See Hinduja & Patchin, 2015. Students who experienced bullying are nearly 2 times more likely to attempt suicide. See Hinduja & Patchin, 2018.
Worldwide, more than 1 million people die by suicide every year. Self-harm deaths have been on the rise in nearly every state in America. In the U.S., suicide deaths (47,173) were almost equivalent to the number of deaths from opioid overdoses (47,600) in 2017. It is essential that suicide prevention practices be implemented and expanded wherever possible (8). Opioid Use Disorder (OUD) has a distinctly strong relationship with suicide as compared with other substance use disorders (9). Pain causes alterations in brain circuitry in the brain’s reward center (involving the ventral tegmental area, nucleus accumbens, and the amygdala), resulting in vulnerability to suicide and a higher risk of opioid addiction. This is supported by epidemiological data that have shown chronic-pain diagnoses are linked to suicide. These associations are only partially explained by co-occurring mental health conditions, which tend to further complicate morbidity.
Tolerance to THC can build quickly in cannabis users. Teens who seek help for cannabis-use problems often report withdrawal symptoms such as anxiety, insomnia, appetite disturbance and depression (Budney & Hughes, 2006). These symptoms are of sufficient severity to impair everyday functioning (Allsop et al., 2012) and they are markedly attenuated by doses of an oral cannabis extract (Sativex) that contains THC (Allsop et al., 2014). Bagge and Borges (2015) conducted a case-crossover study of 363 persons who had recently attempted suicide and were treated in a trauma hospital for a suicide attempt within the previous 24 hours in Mississippi. The researchers compared rates of cannabis use in the 24-hour period leading up to the individual’s suicide (case period) to individuals who used cannabis during the same time period but did not commit suicide (control period). They found that 10.2% of those who attempted suicide had used cannabis within 24 hours of their suicide.
Cannabis was involved in an estimated 6.5% of drug-related suicide attempts, and in 46% of attempts the person had also used alcohol. In the 23% of drug-related suicide attempts with toxicology reports, 16.8% tested positive for cannabis, although this cannabis use could have occurred days or even up to one week earlier. In general, 9.5% of all toxicology reports for deaths by suicide (Borges, Bagge & Orozco, 2016) show the presence of cannabis. There is preliminary evidence of higher detection of cannabis among suicide decedents that do not involve overdose (CDC, 2006) and higher detection among male suicide decedents using non-overdose methods than among females (Darke, Duflou & Torok, 2009; Shields et al., 2006).
The Centers for Disease Control and Prevention (CDC) released data on the ten leading causes of death in the United States recently. Tragically, suicide—too often a consequence of untreated mental illness and substance use disorders, and as such a preventable condition—remains on that list as the 10th leading cause of death for adults and the second-leading cause of death in our youth. Suicide rates increased from 29,199 deaths in 1996 to 47,173 deaths in 2017. Click here for more information.
What are the contributing factors to a state of mind that ends in a person taking his or her life? What can be done to intervene? How can we turn the numbers around? The increased number of suicides year after year say something about the conditions under which people live and die, and about our society at large. Our teens and young adults are deciding in record numbers that killing themselves is the best solution to what is usually a temporary situation. Citizens at the lower end of the socioeconomic scale are significantly more vulnerable due to negative views about life and an increased amount of psychological and social difficulties. Many of these conditions are not diagnosed in time or go untreated. Many are turning to substance abuse to cope, which often increases the risk of self-harm behavior. This speaks to an environment that can promote depression, anxiety, and elevation in substance use disorder. Some sociologists have referred to these suicides as “deaths of despair.”
There are a number of interventions we can apply to these dire circumstances:
If you are struggling with thoughts of suicide, please reach out to someone before the fog of desperation clouds your mind. If you have a friend or loved one who has expressed an intent to take their own life, do not dismiss it as a cry for attention—instead, it is a cry for help. If you are interested in becoming a volunteer or mental health professional and want to be a part of the solution for this national epidemic, please talk to a teacher, professor, mental health professional, pastor, or mentor to find out how to get started.
NATIONAL SUICIDE PREVENTION HOTLINE
(1) Alex Lickerman, M.D. (April 29, 2010). “The Six Reasons People Attempt Suicide.” Psychology Today. https://www.psychologytoday.com/us/blog/happiness-in-world/201004/the-six-reasons-people-attempt-suicide
(2) Patrick J. Skerrett (Sept. 24, 2012). “Suicide Often Not Preceded by Warnings.” Harvard Health Publishing.
(3) “Suicide Statistics.” American Foundation for Suicide Prevention. https://afsp.org/about-suicide/suicide-statistics/
(4) Melonie Heron, Ph.D., (June 24, 2018). “Deaths: Leading Causes for 2017.” National Vital Statistics Reports, Vol. 68, No. 6. https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_06-508.pdf
(5) Wood, A., Shiffman, J., Leary, R., and Coppersmith, G. (2016). “Language Signals Preceding Suicide Attempts.” CHI 2016 Computing and Mental Health, San Jose, CA.
(6) Bryan, C.J., Butner, J.E., Sinclair, S., et al. (2018). “Predictors of Emerging Suicide Death Among Military Personnel on Social Media Networks.” Suicide and Life-Threatening Behavior, 48, 413-430. http://dx.doi.org/10.1111/sltb.12370
(7) Christakis, N.A., and Fowler, J.H. (2013). “Social Contagion Theory: Examining Dynamic Social Networks and Human Behavior.” Statistics in Medicine, 32, 556-577. http://dx.doi.org/10.1002/sim.5408
(9) Bohnert KM, Ilgen MA, Louzon S, McCarthy JF, Katz IR. Substance use disorders and the risk of suicide mortality among men and women in the U.S. Veterans Health Administration. Addiction 2017; 112:1193–1201.
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