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Fear of Feelings! Treating Male Suicide & Depression
Male Suicide & Depression continuing education counselor CEUs

Section 16
Man Against Himself: Purposive Accidents

CEU Question 16 | CEU Answer Booklet | Table of Contents | Depression
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs


Evidence as to the motives and devices of focal self-destruction accrues from the study of certain "accidents" which upon analysis prove to have been unconsciously purposive. The paradox of a purposive Sad man Fear of Feelings Treating social work continuing educationaccident is more difficult for the scientific-minded person to accept than for the layman who in everyday speech frequently refers sardonically to an act as done "accidentally on purpose."

Indeed, it is probably upon the basis of an intuitive recognition of this paradox that superstitious fears have arisen with respect to certain "accidents," e.g., spilling salt, breaking mirrors, losing wedding rings, etc. These have become conventionalized and hence no longer capable of specific interpretation although they are sometimes taken seriously. The philosopher Zeno is said to have fallen down and broken his thumb at the age of ninety-eight, and to have been so impressed by the significance of this "accident" that he committed suicide (from which we might guess the unconscious meaning of the accidental fall and injury).

We must exclude from this category any conscious deception, i.e., pretended accidents. But quite aside from this there exists the phenomenon of apparent (i.e., consciously) absent intention in acts which gratify deeper hidden purposes. I recall that I was once seated at a formal dinner by a woman for whom I had some dislike, which, however, I resolved to blanket completely so as not to spoil the conviviality of the party. I believe I succeeded quite well until an unfortunate piece of clever clumsiness on my part resulted in upsetting a glass of water over her gown into her lap. My dismay was the greater because I knew that she knew that "accidents [to quote from a recent insurance advertisement] don't happen; they are caused."

In many of these accidents the damage is inflicted not upon someone else but upon one's own self. The body then suffers damage as a result of circumstances which appear to he entirely fortuitous but which in certain illuminating instances can be shown to fulfill so specifically the unconscious tendencies of the victim that we are compelled to believe either that they represent the capitalization of some opportunity for self-destruction by the death instinct or else were in some obscure way brought about for this very purpose.

Such cases have been reported frequently. In one of his earliest case histories, Freud cites an example of this. Herr K., a former lover of the patient, Dora, and latterly the object of her accusations and hostilities, came one day face to face with her on a street where there was much traffic. Confronted with her who had caused him so much pain, mortification, and disappointment, "as though in bewilderment and in his abstraction, he . . . allowed himself to be knocked down by a car." Freud comments in this paper of thirty years ago that this is "an interesting contribution to the problem of indirect attempt at suicide."

The significant and differential thing about purposive accidents is that the ego refuses to accept the responsibility for the self-destruction. In some instances, it can be seen how determined the ego is to make this evasion. This is sometimes ascribed by insurance companies and their attorneys to the wish to obtain double indemnity for the beneficiaries, but there must be more than this philanthropic motive back of it, even when it is conscious, and here I repeat that it is only unconscious purpose that I now have in mind.

If one thinks of his occasional hazardous blunders in street navigation, he is apt to ascribe them (if not to carelessness) to impulsiveness, absorption in other lines of thought, distraction, etc. But, after all, if one permits himself to so far relinquish interest in his own personal safety in favor of contemplating the stock market or the purchase of a new dress, one is certainly betraying self-destructive indifference to reality. And, as for impulsiveness, a volume could be written about the disasterous consequences of this symptom. it has ruined many a business, many a marriage, and many a life. The tragedy of Romeo and Juliet is, of course, a dramatic exposition of the way impulsiveness combines with hate to produce self-destruction. Romeo's impulsiveness lost him his sweetheart just before he met Juliet in the same mood. His subsequent impulsiveness first resulted in the death of his best friend (he started to intervene in the duel and did so in such a way as to allow his friend to be stabbed) and then, in the avenging of this death, his own exile. Finally, had he not been so impulsive in jumping to conclusions after he observed Juliet in the tomb and so precipitous in resolving upon suicide, neither his suicide nor Juliet's would have been necessary.

Someone might ask if such impulsiveness, granted that it be a symptom of imperfect psychological organization, is for that reason alone necessarily self-destructive in its purpose. We can only answer this by saying that experience shows that it is frequently self-destructive in its consequences; as to its origins, we have no right to speak with too much generality or definiteness. However, in numerous individual subjects the consequences of their impulsiveness has brought them into such serious straits that they sought psychiatric treatment. We do know that the impulsiveness arises from an ill-controlled, partially disguised aggressiveness. This is almost transparently so in certain individuals who rush at their tasks or opportunities as if to sweep everything before them and, as they themselves sometimes put it, "to tear into it," only in the end to abandon the task prematurely or to make a botch of it in some way. They often appear to have the best of intentions but friends come to regard these as inconsequential bluffings. In love relationships viewed both from the psychological and the physical standpoint such prematurity is often extremely disappointing to both parties and its unconscious aggressive intent often suspected.

To turn from these clinical observations and theories to the matter of traffic accidents which have justifiably concerned all of those interested in public welfare in recent years, we now have statistical verification for the theory that certain individuals are more likely to have accidents than the average person. In a study of the street car motormen made in Cleveland, Ohio, by the Policy Holders Service Bureau of the Metropolitan Life Insurance Company, it was found that thirty per cent of the motormen on a certain division of the railway had forty-four per cent of all of the accidents. The National Safety Council has discovered this same propensity for accidents among automobile drivers. The people with four accidents were about fourteen times as numerous as they should have been on the basis of the theory that bad luck might be only pure chance, while people with seven accidents each during the time of the study were nine thousand times commoner than the laws of chance would require. Furthermore, those persons who had numerous accidents showed a pronounced tendency to repeat the same type of accident. "Chance plays but a small part in accidents" concludes this study by J. S. Baker, engineer of the public safety division of the National Safety Council.

Automobile accidents often occur under circumstances which are suspiciously indicative of at least unconscious intent. We sometimes say of a man who drives his car recklessly that "he must want to kill himself." Sometimes in the course of psychoanalytic treatment the evidence for a particular instance of this becomes convincingly great.

Patients frequently confess to conscious fantasies of "accidentally" driving their cars off cliffs or into trees in such a way as to make their death appear to have been accidental. Such as episode occurs, for example, in Michael Arlen's play, The Green Hat, One can only conjecture how frequently fatal accidents are brought about through some more or less conscious suicidal intention.

That they are sometimes determined by unconscious suicidal impulses is suggested, for example, in a press clipping. . . . The National Safety Council computes the economic cost of accidental deaths, injuries, and motor vehicle damage to be approximately three and a half billion dollars a year. It would surprise many people to know that more men die daily in accidents than from any single disease except heart disease, and that accidents rank third among the causes of deaths to all persons in the United States. From the ages of three to twenty accidents kill more persons than any disease, and from the time he is three years old until he is forty a man is more likely to die of an accident than in any other way.

Every five minutes someone is killed in the United States in an accident and while one is being killed in an accident a hundred others are being injured. It is somewhat startling to think that while you have been reading these pages several people have been killed and several hundred others injured in our country alone.

Such statistics can only call our attention to the seriousness of the problem. Numerous plans are underway for reducing accident hazards in industry, traffic, agricultural life, and in the home. But all of these plans and the work of most of the agencies interested in the problem, it seems to me, fail to take into sufficient consideration the self-destructive element lurking unseen behind many "accidents."

In conclusion, it may be said that while some of the most dramatic illustrations of purposive accidents and of habitual victimization by "fate" are to be found in news journals, accurate and definite understanding of them awaits more detailed data. From pyschiatrically studied cases of this type, however, it is possible to make certain of the existence of the same motives familiar to us in other forms of self-destruction whether extreme (suicide) or partial (self-mutilations, compulsive submission to surgery, malingering). These motives include the elements of aggression, punition, and propitiation, with death as the occasional but exceptional outcome. The latter observation leads us to suspect that the principle of sacrifice is operative here so that in a sense the individual submits himself to the possibility or certainty of accidents in which he has at least a chance of escape rather than face a destruction which he fears even though it may threaten only in his conscience and imagination. In this way a partial neutralization of the destructive impulses is achieved. Meanwhile, practical interest in the very important problem of accidental death and injury is increasing, but thus far without benefit of research into this fundamental aspect of the matter. The telephone is an important element in any counseling treatment plan. Its use allows for an infinite extension and expansion of the counselor's availability and skills. Careful use of the phone is a time-saver for both the client and the counselor. In this chapter we will discuss the use of the telephone as part of emergency and crisis intervention, and as an element in ongoing treatment.
- Shneidman, Edwin S., Comprehending Suicide: Landmarks in 20th~Century Suicidology, American Psychological Association: Washington DC, 2001.

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Personal Reflection Exercise #2
The preceding section contained information about purposive accidents. Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 16
On the basis of the theory of bad luck, people with 4 accidents were 14 times higher to have an accident then the normal population. However, people with 7 accidents were how much more likely to have an accident beyond the laws of chance would explain? Record the letter of the correct answer the CEU Answer Booklet.

 
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