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Suicide is not the result of a single, immediate life crisis, according to Hendin, but of a long lasting pathology with origins in
the early psychic history whose events are determined by sociological as well as psychological phenomena. For example, for the young, black ghetto male, violence and existence blend into one; the culture's rejection is felt in the family that individually brutalizes its young. The uncontrollable rage created by the black experience can be checked by suicide. Thus, although Hendin accepts Freud's thesis that suicide is the ultimate expression of depression caused by the turning inward of anger, he feels that Freud failed to recognize the cultural elements in suicide.
Hendin profiles suicides by sociological group: elderly white male, young urban blacks, teenagers, etc. He discusses the links between suicide and violence, homosexuality and alcoholism, using statistics, pertinent studies, case illustrations, clinical observation and psychoanalytic theory. He refers to Freud's linking of murder and suicide and argues that his thinking has been distorted by those who conclude that they are opposite types of adjustment. Behavioral scientists have made a similar error in supposing that societies deal with aggression by either homicide or suicide. Recent statistics show that in some countries both rates are either high or low; in America, both are high. People who kill others have a much higher suicide rate than the general population.
Hendin favors psychotherapy, supplemented by medication to control severe depression, as the treatment of choice for the suicidal patient. However, he warns against psychoanalysis: “Seriously suicidal patients are either too depressed, too withdrawn or too fragile to tolerate the anxiety that is generated in the psychoanalytic process.” He has in mind the confrontation and interpretations of classical analysis, which attack the depressive defense instead of resolving it gradually.
The blend of information, theory a