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In Los Angeles County in 1968, there were a total of 1,171 recorded suicides, 40% of whom were women. Of these, 244 were age 20 to 49. All diagnostic categories were represented. The ingestion of barbituates was the common method in the group of women, with gunshot wound being second. The reverse was true for men, gunshot wound being the most frequent method. This difference may reflect the increased need of women to see themselves as beautiful and feminine, even in death, with males seeing themselves as dying in a more manly, active way.
But, regardless of the method, one must surely ask, “Why?” Why do people kill themselves? Experience has confirmed Freud's statement that suicide is multiple-determined. According to Freud, the general features of the condition, at least in Western civilization, which make each individual somewhat vulnerable to suicide, are as follows: 1) The death instinct with its clinical derivatives, 2) The splitting of the ego in which the human, in infancy, is unable to master its own instincts and must conform to the parents or perish, and 3) The group institutions, family and civilization, which require guilty compliance from every member (Litman 1974) and Freud 1953, 1930, 1925).
However, the first of these, the death instinct, seems unnecessary in the explanation of the suicide attempts to be described. Additional predisposing conditions, variably present, may include: (Menninger 1938, 1933): 1) A poorly organized ego structure which becomes further disorganized under relatively low conditions of stress, 2) A tendency to be fixated at pre-Oedipal positions with disturbing distortions in the resolution of the Oedipal relationship, 3) Strong tendencies toward sadism and masochism, 4) An insufficiently reciprocal relationship with love objects in which, because of the parents' narcissistic expectation and disappointment,