A lethal code of honour

Aisha Gill is a criminology lecturer at the University
of Surrey, Roehampton, and management committee member at Newham
Asian Women’s Project in London, which supports women and children
experiencing domestic violence. Her teaching and research interests
include violent crime and gender inequality, youth crime, violence
against women and social justice.

Drawing on a study of 20 Asian women living in London,(1) this
article looks at three women’s stories to provide a qualitative
analysis of Asian female suicide attempters’ insight into the
dynamics of suicide attempts, and the implications for prevention
and intervention.

The three women attempted suicide primarily to take control of a
violent relationship and to escape an intolerable situation.
Further research – specifically into contributory socio-cultural
factors – is needed to establish why Asian women turn to suicide as
a way out.

These cases bring to light the many ways in which women become
isolated, trapped and depressed as a result of domestic violence.
Shame about violence, fear and a loss of sense of self all
contributed to the attempted suicides and thoughts of
suicide.

Although suicide rates around the world are about three times
higher for men than women, there is mounting evidence that in the
Indian subcontinent suicide is far more common among young women
than men. The same seems to be true of the diasporic communities in
the UK. (2),(3).

There are, however, few theories to explain why this is so.
Theorists such as sociologist Emile Durkheim propose that suicide
is related directly to the larger social context. In other words, a
society’s attitude towards suicide can and will affect suicidal
behaviour. A society that views suicide positively (encouraging or
approving of it as an honourable way to resolve problems, for
example) may foster a negative, destructive attitude within its
citizens.

In some Asian cultures, suicide may be viewed as a better
alternative to remaining alive if it protects the family from
shame, exposure or embarrassment.(4) Similarly, some religions may
allow for passive euthanasia or physician-assisted suicide,
depending on circumstances.

A society that simply ignores the incidence of suicide may
inadvertently undermine the value of life for some populations. On
the other hand, a society whose religious dogma or laws prohibit
suicide may be seen by its citizens as unsympathetic to the human
experience, or insensitive to the values of minority groups in a
multicultural and pluralistic society.

The attitude of any given society towards suicide can affect not
only the culture as a whole, but also the behaviour of individuals
within that culture.

Daljit* suffered physical and emotional abuse from her partner and
described the emotional abuse as more crippling than the physical
abuse. She felt lost as a result of violence, and this led her to a
point where she wanted to die. Remaining in an abusive relationship
was a way for her to die – something she could not do to herself.
Nevertheless, she eventually considered actively ending her
life.

“I think that there was a part of me that wanted to die but I was
too scared to do it myself,” she says. “When he hit me I realised
that I had lost a loving feeling inside. I felt I brought shame
upon myself and started to lose my confidence. He made me feel no
good, so I thought about killing myself and started to lose my grip
on reality. I would sit in the dark after he’d hit me and think
about it.”

For Shirin*, loss of self occurred as a result of the emotional
trauma of enduring almost daily violence from her husband. “It was
like living in a war zone. You just didn’t know when he was going
to throw a bomb at you. It got to the point where I could not
speak. I was too frightened. He turned the whole family against me
by saying I was going mad and had no respect for him.”

Shirin attempted suicide to deal with the crisis. “I needed to find
a way out. I was going crazy, isolated from everything. I didn’t
want to exist anymore. I wanted to die. It was taking control of my
body, which was being abused by others. It had got to a point where
I was nothing, I gave him everything and I was nothing.”

Shirin had hoped her marriage would improve but the violence ground
her down into a state of depression in which she felt helpless. The
suicide attempt offered her a solution. “I was trying to find a way
out,” she says.

For Priya*, all major decisions affecting her life were made by
those above her in the family’s hierarchy – older brothers, elders
and even her own sisters and mother.

“I tried to commit suicide when my father [sexually] abused me,”
she says. “He was an educated man, you know. We had a comfortable
life and all of us enjoyed a good education. But I guess that it
had a lot to do with image. It was the most important thing to my
father. Where was his honour image when he abused me? How could he
do that to me? Why? I didn’t know how to deal with it, so I just
buried it! There was no one I could talk to. In my heart, I just
felt so alone. I was ashamed.”

Paternal incest was incomprehensible to Priya’s mother, so Priya
could never disclose the abuse to her. Priya grew up in a “typical”
Asian family, with its concern for social image and the external
presentation of the self.(5) Priya’s mother either denied or
reconstructed her daughter’s activities to maintain her public
presentation of the “good daughter”.

Many researchers have documented the relationship between domestic
violence, its psychological effects and its tendency to inspire
thoughts of suicide.

Hoff writes:”The association between violence from one’s spouse,
low self-esteem, and suicidal tendencies is very strong, especially
when compared to the women’s pre-battering life phase.”(6)

Bhugra suggests that suicide attempts are usually non-habitual and
carried out at the height of a crisis.(7)

In the present study, Daljit, Priya and Shirin attempted to take
their lives as an escape from domestic violence, usually in the
form of emotional, physical or sexual abuse. When family and
friends discovered the attempts, the women encountered hostility in
some cases, and further violence after recovery.

Vulnerability to suicidal behaviour increases with social
isolation, alienation, cultural incompatibility and lack of a
supportive community, as well as family pressure to conform to old
or “traditional” cultural values.

Further sources of conflict may derive from the incongruity between
the cultural belief that the family should provide support and
intimacy, and the reality of the Asian family’s status within
society, where they are often oppressed as well as being racially
segregated and the subjects of discrimination.

Diekstra and Garnefski argue that the significance of the Asian
family unit in the development of suicidal behaviour needs greater
emphasis.(8) They found that the primary causes of attempted
suicide were family-based:conflict with spouses, parents and
parents-in-law.

Interpersonal disputes (particularly over marriage and lifestyles),
the pressures of economic competition and the loss of self-esteem
associated with failure, and the anxiety attached to nonconformist
behaviour have all been cited as causes of self-harm among young
people.(9),(10),(11).

These pressures are intensified in young Asian women, who have to
cope with rigidly defined roles imposed by the community.
Submission and deference to males and elders, arranged and forced
marriages, the financial pressures imposed by dowries and the
marital and family conflicts that ensue have all also been cited as
contributory factors to self-harm in young Asian women. Self-harm
in this context, therefore, serves as a form of problem-solving in
the face of threatening social forces and expectations.

Key recommendations have been advanced for immediate action by all
agencies involved with the prevention of suicide among young Asian
women.

• Promote awareness that suicide and self-harm in ethnic minority
  communities is a major, but largely preventable, public health
  problem.
• Develop and implement strategies to reduce the stigma
  associated with mental illness, substance abuse and suicidal
  behaviour, and promote opportunities for seeking help.
• Institute training for all health, mental health, substance
  abuse and human service professionals (including teachers, social
  workers and health professionals) for suicide risk assessment and
  recognition, treatment, management and aftercare
  interventions.
• Develop and implement safe, effective programmes in educational
  settings for young people that address adolescent distress, provide
  crisis intervention and incorporate peer support.

It is important that agencies, particularly social services,
provide appropriate conditions in which young Asian women can
report their suicidal vulnerabilities in a safe and confidential
space without fear of being misunderstood.

This, however, requires significant investment in suicide
prevention measures across the health care services to deliver
comprehensive and socially appropriate care packages targeting risk
behaviour and social exclusion.

*Names have been changed

Abstract

This piece provides a qualitative analysis of Asian female
suicide attempters, an insight into the dynamics of suicide
attempts and the implications for prevention and intervention.
Asian women who have failed one or more suicide attempts have
participated in this study, sharing their stories and
motivations.

References

(1) A Gill, Challenging Silence: A Study of Domestic Violence
Against South Asian Women Living in East London, PhD thesis,
University of Essex, 2002

(2) J Merrill and J Owens, “Ethnic differences in
self-poisoning: A comparison of Asian and white groups,” British
Journal of Psychiatry, Vol 148, 708-712, 1986

(3) D Bhugra and M Desai, “Attempted suicide in south Asian
women”, Advances in Psychiatric Treatment, Vol 8, 418-423, 2002

(4) A Gill, “Voicing the silent fear: South Asian women and
domestic violence”, Howard Journal of Criminal Justice
(forthcoming), 2004

(5) E Goffman, The Presentation of Self in Everyday Life,
Doubleday, 1959

(6) A Hoff, “Human abuse and nursing’s responses”, in P Holden
(ed), Anthropology and Nursing, Routledge 1990

(7) D Bhugra, “Attempted suicide in west London”, Psychological
Medicine, 29 (5), 1131-1139, 1999

(8) R Diekstra and N Garnefski, “On the nature, magnitude and
causality of suicidal behaviours: An international perspective,
suicide and life-threatening behaviour”, Vol 25(1), 36-57, 1995

(9) J Merrill and J Owens, as above

(10) Bhugra, 1999, as above

(11) S Raleigh “Suicide patterns and trends in people of Indian
subcontinent and Caribbean origin in England and Wales”, Ethnicity
and Health, Vol 1(1), 55-63, 1996.

Contact the Author

E-mail a.gill@roehampton.ac.uk