Suicide and Forced Marriage

Abstract

Background:

The prevailing view that the vast majority of those who complete suicide have an underlying psychiatric disorder has been recently challenged by research on the contribution of “predicaments”, in the absence of mental illness, to suicide. In this paper, we sought data to support the notion that forced marriage may lead to suicide without the presence of psychiatric disorder.

Methods:

Historical records, newspapers, and the electronic media were searched for examples.

Results:

Two examples from ancient times and six from the last hundred years were located and described.

Conclusion:

These cases suggest that forced marriage may lead to suicide and complements earlier findings that loss of fortune, health, liberty, and reputation may lead to suicide in the absence of mental disorder.

Introduction

The conventional and dominant medical wisdom is that all (1) or almost all (2) suicide is the result of mental disorder.

Our group has developed the concept of “predicament suicide” (3), according to which suicide is viewed as a response to intolerable circumstances. These predicaments are of two main types; one is intractable or untreated mental disorder, and the other entails social or environmental stressors. Of course, individual cases may manifest both types simultaneously.

Our contribution to the literature has been to strengthen the argument that, at times, social/environmental factors (in the absence of mental disorder) may lead to suicide. To this end, we have used accounts of suicide on the public record (from mythology, history, and press). We have described suicide by apparently mentally healthy individuals who have suffered damage to reputation (4), in particular, as a result of having been revealed as pedophiles (5), people in other forms of moral dilemma (6), people with intractable illness (7), and people having lost life savings (8). We have also examined suicide pacts, in which the most common factor was the loss of health of one or both members (9).

The circumstances in the above paragraph are predominantly loss, and it appears that these suicides are a means to escape the pain of the loss. In the current paper, we are concerned with suicide associated with forced marriage. There is an important distinction to be made between “arranged” and “forced” marriage. In the former, the choice of whether to accept the offer remains with the two central figures, not withstanding the uncertainty or “pressure” that they may feel regarding the arrangement. In contrast, in forced marriage, one or both individuals are non-consenting and coercion is used to ensure compliance.

In the forced marriage setting, suicide may represent a means of avoiding potentially distressing events, entrapment, control by others or as a loss of a keenly anticipated, positive future. The aim in this paper is to present examples from the public record (from mythical times to the current day) of suicide associated with forced marriage in apparently mentally healthy individuals as a means of increasing our understanding of suicide.

Quantitative studies of the relationship between forced marriage and suicide are not yet available. However, in China, the most common negative life events leading to suicide have been identified as “those related to family relations, love affairs, and marital issues” (10). In India, death from burns (which could be murder or suicide) are frequently associated with “dowry and family quarrels and marital disharmony” (11). In Turkey, the suicide rate of is higher in young women (15–24 year olds) than young men, and the causative factors for young women include forced marriage, young marriage age and low literacy (12). Although our focus is on forced marriages, we acknowledge that, depending on circumstances, any marriage – forced or otherwise – can be stressful for the individuals and the couple, culminating in a range of adverse psychiatric outcomes.

Methods

An extensive search was made of historical texts, newspapers, and the electronic media. Factiva (media), PsycInfo, Medline, general internet, and manual searches were conducted. These tools were used to identify both ancient texts and cases from the last 100 years.

Results

Eight cases (two from ancient texts and six from the last hundred years) were located and are presented. Many reports, including one from Yakin Erturk, Special Rapporteur of the United Nations Commission on Human Rights (13), make clear that forced marriage not infrequently leads to suicide, but do not provide individual examples.

Daphne

In Greek mythology, Daphne was a minor nature deity and Apollo (son of Zeus) was a major Olympian deity. In The Metamorphoses, Ovid (14) reports that Cupid shot both with arrows. The one which hit Daphne (a sworn virgin) didn’t have the expected outcome, but the one which hit Apollo had a profound effect. He chased her across the countryside. When she was about to be caught, she called to the Gods, “cover with green earth/This body I wear too well” (page 19), and was immediately transformed into a (laurel) tree. Thus, Daphne chose to cease living as a human rather than marry or participate in physical intimacy.

Aino

Aino is a beautiful young woman in the Finnish national epic poem, “The Kalevala” (15), which records events from ancient times up until about 900 CE. She was promised by her brother to an old man, Vainamoinen, with magical powers. Rather than marry Vainamoinen, Aino drowned herself in a river.

Aino has been celebrated in paintings and an opera by Finnish artists. Aino was the most popular name for girls in Finland in 2006 and 2007.

Miss Chao (died, 1919)

Chao Wu-chieh of Changsha, China, was engaged to marry Wu Feng-lin of Kantzuyuan, China. The marriage had been arranged. The couple had met on a couple of ceremonial occasions. Miss Chao disliked her husband-tobe, but her parents insisted that the marriage go ahead. When she was raised up in the bridal chair, to be carried shoulder-high to her husband-tobe’s home, she drew a dagger and cut her throat, killing herself.

We know about her death because Mao Tse-tung (16) wrote on the events several times. Interestingly, he stated, “A person’s suicide is entirely determined by circumstances”. He railed against the culture of the time and the lack of individual rights, and recommended social change.

Gul Rukh (died, 1976)

In the vast majority of cases of forced marriage leading to suicide, the bride is decades younger than her husband. In this Afghani case, the reverse was the situation (17).

The Gul and Malang families were related. When Rukh was 1 year old, a boy was born into the Malang family. When he was 1 month old, the families arranged their marriage and an engagement was celebrated according to local custom. However, the boy died at 2. When Rukh was 5 years old, another son was born to the Malang family, and she was again promised in marriage. When the husband-to-be was 17, he was killed by accident, during wedding preparations. Rukh was then promised to the youngest Malang family son, Khan (aged 5 years).

Kahn was teased at school for being engaged to an “old woman”, and he protested that he did not want to marry Rukh. Nevertheless, they were married when Rukh was 37 and Khan was 20 years. He rejected her and the following year she died by self-immolation.

Fariba (died 2007)

Fariba was 18 years of age and lived in the Kapisa province of Afghanistan. She had been pleased to become engaged to Mujahid, aged 22, 3 years earlier. However, Mujahid had gone to work in Iran, and when he returned he was addicted to drugs. In these circumstances, Fariba was adamant that she did not want to marry him (18). As pressure to marry increased, and she could not persuade her parents otherwise, she completed suicide by shooting.

Adyru Begum (died, 2010)

Adyru Begum was 12 years of age, a grade 5 student living in Rangpur, Bangladesh. Against her will, her father arranged her marriage to an adult man (Enamul Haque). After the marriage ceremony, and during the wedding feast, Aduri completed suicide by taking poison (19).

Mitu Molla and Soud Sheikh (died, 2012)

Mitu Molla (16 years) and Soud Sheikh (17 years) lived in neighboring villages in Gopalganj district, Bangladesh. After their affair became public, Molla’s mother took her to a town 200k from her village and married her against her will, to a man twice her age. At this point, Sheikh was at high school in the capital Dhaka.

Two months later, when Molla went home to visit her parents, Sheikh left Dhaka and met her in her village. On Valentine’s Day, they tied their hands together and jumped to their deaths from a mobile phone tower. Sheikh had earlier telephoned his brother to say that they planned to die on Valentine’s Day “to stay together forever” (20).

Amina Filali (died, 2012)

Amina was 15 years of age when she was raped, in Morocco, by a man 10 years her senior. The matter went to court and the judge ordered or recommended (depending on reporting source) that the couple marry. By this mechanism, her honor would be restored and her rapist could avoid a lengthy jail sentence. In Morocco, the age of consent to marry is 18 years, but this can be varied in special circumstances (21).

Amina married her rapist and lived at his family home. Her mother (Zohra) reports that he beat her severely, and shortly afterwards, Amina completed suicide by ingesting rat poison.

Discussion

Our aim was to seek information as to whether forced marriage might lead to suicid e. At least one epidemiological study (12) and anecdotal report (13) support the notion of a causal relationship.

We found two stories from ancient times (one Greek and one Finnish) and six stories from the past hundred years in which death was preferred to an unacceptable marriage–substantiating the above-mentioned material. Whether these ancient people (Daphne and Aino) ever existed, or behaved as described, is not critical - the point is that myths and legends advise us about the range of possible human responses and, in many cases, the responses that are recommended.

The details of the six stories from the last hundred years are limited, as might be expected, emanating as they do from isolated, disadvantaged regions. The story of Miss Chao was recounted a number of times by Mao Tse-tung, and could perhaps have been distorted for political purposes, but subsequent scholars (22) have confirmed the events. The story of Amina Filali (who died in 2012), whose marriage to her rapist was ordered/recommended by a court, has received international attention, and the facts are probably substantially correct.

We have sought to extend understanding of suicide. The “one-size-fits-all” notion that all or almost all suicide is attributable to mental disorder is unhelpful, and has recently been called into question by other researchers (23). Adherence to the belief places responsibility for suicide with psychiatry. It puts clinicians in peril during Coroners’ Court hearings, and denies the possibly of non-psychiatric interventions which may have beneficial outcomes. Notwithstanding these issues, psychiatrists and other mental health professionals retain a role in identifying, understanding and ameliorating psychosocial risk factors that might play a part in suicide in those without mental illness.

In our earlier work, we have acknowledged that environmental/social events such as loss of fortune, health and reputation may not only lead to psychiatric illness, such as depression, anxiety, and adjustment disorder, but we have also suggested that those events may lead to suicide in the absence of mental disorder. Here, without discounting situations where forced marriage may lead to suicide and simultaneously be associated with psychiatric disorder, we are proposing that forced marriage may, alone, lead to suicide. The use of qualitative methodology, whose value in psychiatric research is being increasingly recognized (24), facilitated our understanding of the potential motivations to suicide in the cases described. The motivation may be to escape the attention of a disliked individual, the loss of an ideal future, a feeling of entrapment or similar unacceptable circumstances. The Gul Rukh case is somewhat atypical in that the association of forced marriage and suicide appeared to relate to rejection, shame and narcissistic humiliation; in this case, too, however, there was an apparent lack of mental disorder.