Patients who are at risk need to be assessed, monitored, and seen often. Their grief needs to be acknowledged, whether or not the object of grief was known to them.
More recently, there has again been much discussion about the potentially contagious effect of celebrity suicide. According to one article, the suicide of film stars is especially dangerous because there are many facets of the person’s real life that are widely known because of extensive media coverage and that consequently serve as springboards for identification.7 In addition, people identify with various aspects of the characters a film star has portrayed. Marilyn Monroe is a case in point. The obsession with her suicide continues to this day, almost 60 years after her death.
The sources of copycat suicides go beyond identification. By using new technology to analyze the emotional tone after celebrity suicide tweets, recent studies conclude that the unexpectedness of the suicide contributes to the likeliness of it being imitated.8,9 A surprising, unexpected suicide seems to shake people out of their habitual routine into serious reconsideration of their reasons for living and, at times, into impulsive action.
Are there lessons here for clinicians? I think there are. In the wake of a celebrity suicide, it is wisest to express neither shock nor surprise to one’s patients. Patients who are at risk need to be assessed, monitored, and seen often. Their grief needs to be acknowledged. They also need assurances that you understand, are available, and that there are ways, admittedly difficult, by which one can overcome adverse circumstances and survive anguish. Persuading someone that viable alternatives to suicide exist has been called the Papageno effect in honor of the character Papageno in Mozart’s opera The Magic Flute. In the plot, Papageno decides to hang himself because he is convinced that he has forever lost his one true love, Papagena. Three child spirits prevent his death, however, by showing him how he can summon her back.
My own experience suggests that overzealous intervention is not a good idea and that it is best to check with elders in the field who are more experienced before leaping into unknown therapeutic territory. Sensitive topics such as thoughts of suicide need private one-on-one discussion, not group therapy. Membership in a group transforms a person and the results of such transformations can be difficult to foresee.
Originally posted on 9/10/19 and has since been updated.
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2. Wheeler L. Toward a theory of behavioral contagion. Psychol Rev. 1966;73:179-192.
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