The Journal of San Diego History
Winter 1991, Volume 37, Number 1
Richard W. Crawford, Editor

Book Review

Self-Destruction in the Promised Land: A Psychocultural Biology of American Suicide.

By Howard I. Kushner. New Brunswick and London: Rutgers University Press, 1989. Notes. Bibliography. Figures, maps, tables. Index. 284 pages. $24.95.

Reviewed by James H. Cassidy, Historian, National Library of Medicine, Bethseda, Maryland; author of Democracy in Early America (1969), Medicine and American Growth, 1800-1860 (1986), and other works.

Howard Kushner disclaims any intention, in this book, to write a comprehensive social or cultural history of suicide in the United States. Some of his basic aims, in fact, are not even historical in nature. Nevertheless, his work is rich and challenging in its historical content and as such goes far to suggest what such a history might include.

Kushner, who is Professor of History at San Diego State University with a long-standing interest in the history of psychiatry and suicide, has immersed himself rather deeply in several of the sciences that are prominent in suicide research. In the present work he uses historical material and methods primarily to illustrate and help reconcile the different approaches to and findings about suicide that he has found in those disciplines. The author is particularly interested here in the explanations of the causation of suicide that have been advanced since the late nineteenth century by specialists in psychoanalysis, sociology, and neurology. He hypothesizes that the allegiances of such scientists to their emerging specialties and to their respective etiological explanations raised barriers between these disciplines which, in the twentieth century, have prevented the resolution of fundamental differences over the causes of suicide. His expressed objective then is to suggest how to break down these barriers, to demonstrate that the various disciplinary explanations should be seen as complimentary to each other rather than hostile or contradictory in nature.

To the non-scientist, there is much plausibility in Kushner’s thesis. However, any full assessment of its scientific validity will presumably have to be left to scientists or ultimately, perhaps, to the passage of time. Nevertheless, the historian will want to consider the extent and value of the uses of history in this work.

The first half of the book presents a selective review of American attitudes toward suicide from the seventeenth century to the present. Individual chapters deal respectively with the shift of suicide from a crime to a disease in Puritan society, with the “moral treatment” of suicide by nineteenth-century mental hospital physicians, and with the early rise of sociology, psychoanalysis, and neuropsychiatry.

The second half of the study is then given over to examining in detail the contradictions among competing explanations of suicide, with historical material from the various periods being brought in abundantly to help clarify these contradictions. Particularly interesting and convincing are Kushner’s case studies of Abraham Lincoln’s attempted suicide and Meriwether Lewis’s successful suicide; his analysis of suicides by gender and among migrants and immigrants since the 1850s; and his discussion of the mass suicides at Jonestown, Guyana, in 1978. Equally interesting but less persuasive is his argument that the shocking mortality of the settlers in Jamestown, Virginia, between 1607 and 1625 was also an instance of mass suicide. Another section, on the possible relationships of the “frontier myth” to suicide in American history, seems excessively speculative and based too extensively, for my taste, in the psychohistorical approach.

While Kushner is not exclusively concerned with Southern California, the West, or any other region, he effectively uses the suicide of a San Diego man in 1893 as a theme case to help highlight and develop the book’s hypotheses. Moreover, he has made good use of San Diego suicide statistics since the 1880s in his examination of the geographical distribution of the disease over time.

This work provides a sophisticated analysis of a complex subject. It is filled with careful reasoning and rewarding insights into the behavior of individuals in the American environment. Kushner displays an exceptional familiarity with and command of highly technical material. Equally importantly, he writes about this material competently and clearly, and with a welcome minimum of scientific jargon and stylistic quirks. His handling of controversial material is balanced and nonconfrontational.

Some historian readers may well be impatient with the scientific hypothesis and discussions that constitute the core of this book. Nevertheless, the illustrative historical material presented is solid, so gripping, so important, and much of it so little known, that the reader will be well repaid any effort made to absorb the entire work. It is hoped that Kushner’s book will be a stimulus to other studies, including ultimately, a full-scale social and cultural history of suicide in America’s past.