The Suicide of a Survivor

Some Intimate Perceptions of Bettelheim’s Suicide…

by David James Fisher

There is but one truly serious philosophical problem, and that is suicide.
Albert Camus, 1942

In his final months of life, Bruno Bettelheim was a frail, ailing figure with a corpse-like appearance. He lived out his last years burdened by a variety of physical and psychological illnesses. Before arriving in Southern California, he had suffered from a mild stroke.

He complained of residues from the stroke, including frustration about physical activity, a pervasive feeling that his body was betraying him; he walked with a slight limp and needed a cane for assistance; he was no longer able to exercise by walking long distances. The stroke had also impaired his handwriting and his capacity to type, severely inhibiting the composition of his books and articles. Like many stroke victims, Bettelheim’s emotional state oscillated between depression and anguish.

My relationship with Bettelheim began with an epistolary exchange. I had published a review essay of his 1982 essay Freud and Man’s Soul.2 I took the risk of sending it to him in Northern California. Not surprised by the courteousness and intelligence of his reply, its immediacy was striking. The rapidity of his answer indicated that he cared deeply about intellectual dialogue. Perhaps it indicated his isolation and loneliness. He encouraged me to deepen my researches into Freud’s use of language. Writing as a senior scholar to a junior one, he generously offered me some further bibliographical citations. As a letter writer, Bettelheim was opinionated, charming, self-referential, and wasted no words. When I subsequently learned of his move to Southern California, I wrote again, asking if he wished to have a visitor. He telephoned me immediately and our friendship began. It lasted from April 1988 until January 1990.

Describing any friendship is an elusive matter and this friendship is particularly hard to decipher. We were two academically trained lay analysts separated by two generations and by widely different sensibilities, by divergent political and cultural orientations. I would almost always visit him at his home and subsequently at his apartment.

There was a pattern to our talks. In principle, I listened. I occasionally asked questions. I learned quickly not to contradict him or to get contentious. Bettelheim would reminisce, becoming flooded with memories and feelings, almost as if he were returning to earlier days. As a historian of psychoanalysis, I was fascinated by his experiences in Vienna in the period between the two world wars, intrigued by his direct and tragic knowledge of the Nazi concentration camps. Bettelheim would finish a story or an anecdote and then add pessimistically: „But that’s ancient history.“ This afterthought implied that no one would ever bother to take an interest or grasp his story’s historical or clinical relevance. I believe he liked me because I attended to his narratives, trying to understand his perspective and point of view.

Our relationship once moved from the private to the public sphere. I had arranged to have Bettelheim offered an honorary membership in the Los Angeles Psychoanalytic Society and Institute, an honor that was deeply significant to him, especially because of his former friendships with Otto Fenichel and Ernst Simmel, the two Central European founders of the Institute. On May 18, 1989, Bettelheim was formally inducted into the Institute and he read a paper before the Society called „How I Became a Psychoanalyst” that evening. As the formal discussant, I presented a condensed paper that summarized the seminal themes of his scholarship over his lifetime.4 Bettelheim commented ironically on my talk in the manner of Mark Twain, thanking me for „the beautiful eulogy of him.“

During these years, he suffered almost continuously from depression, sometimes mild, often severe. For at least some of the time, he took antidepressants prescribed by one of his doctors. With the recommendation of another psychoanalytically trained colleague and myself, Bettelheim entered a course of psychoanalytic psychotherapy for his depression; he stated sarcastically that he went back into therapy out of his „faith in psychoanalysis.“ He told me subsequently that he had benefited from this course of therapy, which may have lasted over one year.

Bettelheim’s central preoccupation in his last years was with suicide. He played with and discarded many possibilities for taking his life. He fantasized candidly about it and it was never absent from our conversations. He was ambivalent about it, to be sure. He postponed acting on it until early 1990 because he wanted to be alive for the birth of another grandchild to his daughter, Naomi, living in Silver Spring, Maryland. He also wished to witness the publication of his final book, Freud’s Vienna and Other Essays. It became evident to me that he had thoroughly considered and eliminated various methods of suicide; his main concern was to do it right. His intention was not to survive and not to be further incapacitated by a bungled attempt.

He often talked about taking an overdose of drugs, hoping for a quick and painless ending. He rejected this option because he feared that he might not absorb the pills, that he might vomit them up, or that he might suffer terrible side effects and be required to have his stomach pumped. He thought about jumping from the fifth floor of his Santa Monica apartment, but rejected the possibility because it was not a sure thing: he might endure as a cripple or invalid, exacerbating his current situation, becoming too immobilized to be able to take his life. For the first time in his life, he lamented that he was not medically trained because he could not use medical expertise about death, drugs, and the body.

In the presence of my father, a physician, I once witnessed Bettelheim asking specific questions about the efficacy of air embolus as a method of suicide, that is, injecting air into the vein with a syringe in order to kill oneself; he rejected this course because of the potential bleeding. He also asked this physician about the precise amount of Demerol needed for a lethal dose. The normal dosage of Demerol, a synthetic morphine, is approximately 50 mg; he was told that 100 to 200 mg might be sufficient. Demerol was risky because it too, might be vomited up. Bettelheim inquired of this doctor if he would be willing to prescribe the medicine. The physician declined.

Bettelheim was aware of the Hemlock Society, a euthanasia association designed to allow elderly and terminally sick individuals the right to die privately and in a dignified manner. To the best of my knowledge, he never made contact with members of the Hemlock Society. He and I also discussed his plans to travel to Holland, where he would receive a lethal injection and die peacefully under medical supervision. This procedure is apparently legal in Holland. His son Eric planned to accompany him on this last trip to Holland. Much to Bettelheim’s chagrin, the physician who agreed to administer this fatal dose himself died of a heart attack just weeks before he had scheduled his trip. Bettelheim was terribly disappointed. He urged me and others to help him find another Dutch physician who would agree to this procedure.

The New York Times reported that Bettelheim died of suicide on March 13, 1990. He suffocated himself by placing a plastic bag over his head. Subsequent reports indicated that he had ingested alcohol and pills prior to the asphyxiation. Medical experts disagree in evaluating this method of killing oneself. Some say it is relatively quick and painless; others insist that asphyxiation is a terribly violent and difficult way to die. Bettelheim never mentioned suicide by recourse to a plastic bag in our conversations. He evidently left a suicide note, the contents of which were not initially made public.

Psychologically, Bettelheim struck me as being in a continual state of dejection. He perked up and became animated in company, but he was not able to sustain an upbeat mood for long periods. He was depressed about having to limit his physical and mental activity, devastated about the diminution of his creativity. He played with the idea of writing another book, contemplating one centered on the psychoanalytic study of painting, thus combining two of his earliest interests. When I pressed him for a more specific theme, he was uncharacteristically vague. Bettelheim stated sadly that he lacked the energy and discipline to begin, let alone complete, such a project, which might require years of intellectual effort, years beyond his reach.

Besides acknowledging an inability to think and to focus, Bettelheim was pained by the incapacity to generate new ideas. This was a narcissistic wound to him. He had trouble getting out of bed. He was desperately lonely and isolated.

He was unable to overcome a loss of interest in the world; I noticed that even the Sunday newspaper delivered to his apartment was left unopened and unread. A former passionate concern with politics and social issues had drained away.9 Like other cultivated Viennese intellectuals of the inter-war years, Bettelheim was enthusiastic and knowledgeable about classical music, film, and the theater; he owned a wonderful record collection to which he stopped listening. He became increasingly reclusive, seldom going to a play or to the cinema. I once took him to an enthralling Beethoven chamber music
concert played by a first-rate ensemble at UCLA; he confessed that he found this music, once so inspirational and so vitalizing, hard to follow. His mind wandered and he became lost by the complexity of the performance.

At the end of his life, he took some solace in reading. He no longer wrote and he refused to dictate his thoughts to a secretary. He had few cohorts or age mates in Southern California. His teaching and supervisory activities became severely restricted as his health failed; he lacked the energy to speak publicly; the loss of his speaking platform and of his teaching deprived him of deeply meaningful professional activities, areas of high self-esteem and achievement. He steadily felt like a burden on others. To quote his own words, he was „decathecting“ from the world and from people, withdrawing his investment in relationships so as to better prepare himself for the end of life.

I cannot answer why he committed suicide or selected the method he used. I regard his suicide as an end to the torment, loneliness, and sense of futility about his present and future. Suicide was Bettelheim’s way of refusing to fall helpless, his refusal to submit to a meaningless, vegetative life. Taking his life allowed him to escape from the despair and emptiness that pervaded his everyday existence.

If his suicide was multi-determined, if it is not explainable by one theory or one cause, it is not useful to think of it as symptomatic of an illness or the expression of an immoral act. The devastating irony that a world-class expert on parenting had severed relations with a treasured child was not lost on him. I once asked Bettelheim if he was enraged at his abandonment by his daughter. He replied that he was not consciously angry at her.

As our conversations turned ineluctably to suicide, I experienced a variety of powerful feelings, often conflicting ones. First and foremost was a sense of sadness that Bettelheim was determined to end his life, that this willful and focused man was not to be deterred. The attitude I adopted was acceptable and comfortable to both of us: the analytic stance. I listened, tried to understand, and attempted to remain empathically attuned to him. I did not give advice, nor offer unsolicited suggestions. I would offer a tentative interpretation, usually in the hope of letting him run with it, seeing if it offered any possibilities of clarification. Our meetings seldom lasted more than two hours. I left them psychologically exhausted. They always stimulated me to reflect on and ponder the meanings of his utterances.

Bettelheim was neither my analyst, my supervisor, my teacher, nor my mentor. This freed both of us to talk and to engage in frankly open exchanges and debates. Transferential issues were present. My relationship to Bettelheim was complicated by its convergence with the terminal phase and ultimately the termination of my training analysis with Rudolf Ekstein. Actually, my conversations with Bettelheim continued for almost one year after my analysis ended. Termination is always a loss and an ending, symbolically a death. Though we rarely touched directly upon themes in my own analysis, my friendship with Bettelheim helped to ease the pain of my separation from Ekstein; I now see it as part of my mourning process.

Though younger than Bettelheim, Ekstein was a mature lay analyst, also trained in Vienna, who was Bettelheim’s closest friend in Los Angeles. I knew that Bettelheim was telling me deeply troubling and personal things that he did not discuss with my analyst. This gave me privileged access to his inner world, but it also gave rise in me to a double burden: of feelings of guilt on the one hand, and feelings of triumph over my former analyst for knowing things that he did not know on the other. Let me add that Bettelheim realized perfectly well that I was in analysis with Ekstein and that he never said or did anything disrespectful or counter therapeutic regarding my analytic experience.

My friendship with Bettelheim then immersed me in the existential dilemmas and psychological problematic of old age. It provided me with a window into and an articulate voice about what happens to a sensitive individual who runs out of options, whose viable choices are eliminated, and who experiences the decline of generativity. My reactions to these conversations with Bettelheim were alternatively enlightening, sobering, and painful. It made me aware of my own limitations; I knew that I could not rescue Bettelheim, that I could not derail him from his choice to end his life.

Bettelheim, I should add, always treated me non-condescendingly. He offered to refer analytic patients to me. And he always spoke honestly about his desires to end his life. Perhaps the strangest and most surprising aspects of our extended discussions of suicide was the intimacy that emerged between us.

Despite being privy to these intense revelations with Bettelheim, I must add that I still felt an enormous sense of shock, loss, and personal disbelief when I learned of his suicide. I was not surprised, but I was devastated nonetheless. I felt deprived by his absence. Abandonment is easy to grasp intellectually, but disruptive emotionally. I am convinced, though it is beyond the scope of this paper, that the assault on Bettelheim’s clinical and intellectual reputation since his suicide stems, at least in part, from the rage and outrage triggered by feelings of abandonment − both on the part of his detractors and defenders, myself included.

Bettelheim committed suicide on the exact day − March 13th − of the Nazi takeover of Austria, fifty-two years after those events. Psychoanalysts understand the powerful symbolic effects of anniversaries, particularly their ability to recapitulate disintegrating feelings of loss and grief. It is not accidental that Bettelheim chose the day when the Nazis marched into Vienna. His life was drastically altered by those events and by his incarceration in German concentration camps. Part of his depressive character stemmed at least partially from the prolonged traumatic experience of fascism and the memories, fantasies, and feelings generated by the concentration camps, the ensemble of which were not and could not be worked through. Bettelheim’s guilt about surviving, perhaps his guilt and shame about his own behavior in surviving, was never repaired. Perhaps these wounds are irreparable, the victims become doomed to endure extraordinary misery and horrific memories as long as they live. Suicide then becomes a rational way out of this psychological and existential impasse, putting a stop to the consciousness of repetitive trauma and endless suffering.

Survivor guilt in Bettelheim’s case went with a lifelong preoccupation with suicide and the Freudian concept of the death drive, as well as with the psychodynamic defenses against hatred, dependency, and the loss of hope, including his own. As a concentration camp survivor, Bettelheim had to contend with the painful reminiscences of those who were tortured and died, but who could not be helped or rescued, including relatives and comrades. He was also tormented by the ways in which Holocaust survivors unconsciously identified with some of the worst features of their torturers, including the assumption of an authoritarian and dogmatic character style. One of the most persistently terrifying aspects of surviving the camps was the degree to which the fascist personality became imprinted on the personality of the survivor.

Bettelheim often told me that the experience of being a concentration camp inmate was beyond communication or transmission through teaching. For the survivors, their unimaginable fate included the internalization of something analogous to a metallic foreign object. They were doomed to live out their days, as the historian Saul Friedlander expressed it, as if they contained „shards of steel“ that would never heal.13 Despite Bettelheim’s commitment to non-sentimentalized memory and to political and personal resistance to the concentration camps, he never fully recuperated from this personal history. His suicide, once again, documents how fragmenting that experience was, testifying to its shattering effects even after half a century.

Concentration camp victims become dejected because they lose everything they care for in their previous lives. They become paralyzed with despair and emptiness. They rage against their fate. They become emotionally numb, affectively dead. They begin to live non-lives. Their consciousness becomes dominated by depressive feelings and the unrelenting sense of irrevocable loss. For Bettelheim, old age and the prospects of life in a nursing home did not promise a significant chance, a possibility of renewal of life. What he dreaded was becoming a „Muslim,“ an unfortunate concentration camp term designating a living corpse, a totally helpless and dependent human being.14 Persevering as an anonymous, discarded, and decrepit body confined to an old age home was simply a reenactment of his years of incarceration, of becoming passive and pathetic. With hope destroyed, with his autonomy jeopardized, with physical illness and incapacitation a sure prediction for the future, Bettelheim opted for suicide.

When I once asked him if he was concerned about how his audience might perceive his suicide in the future, that it might be impossible to discuss his work without an inevitable reference to his suicide, he replied that he was unconcerned about posterity. He put it bluntly: “I do not give a damn.” He was defiantly indifferent about his death tarnishing his historical reputation.

From the first moment of his transport to the Fascist concentration camps in 1938, Bettelheim became acutely aware of the mentally deteriorating aspects of this experience to the inmate. Time does not heal some wounds. Self-knowledge is sometimes not enough. Concentration camp survivors suffer from horrific reminiscences. Although weary and groggy, after receiving from the Gestapo both a bayonet wound and a severe injury to his head, he reported wondering „all the time that man can endure so much without committing suicide or going insane.“15 His life history and work became an introspective reflection on this act of enduring.

Toward the conclusion of The Informed Heart (1960), Bettelheim narrated the tragic story of a female concentration camp prisoner who risked death by assassinating an SS guard. The prisoner had formerly been a dancer. Lined up naked before entering the gas chamber, she was commanded to dance for the SS guard. Reversing her sense of humiliation, refusing her state of bondage, she commenced to dance and managed to seize the SS’s gun and to shoot him. She was immediately assassinated.

Bettelheim describes this story of suicide as both a stirring and exemplary act of resistance. It demonstrated the momentary transformation of extreme brutalization and dehumanization into an active restoration of her former self. For a moment, she reassumed a self of dignity, self-respect, and a capacity for sentient and meaningful behavior. She recovered her personality and responded to a grotesque situation with an appropriate degree of revolt and the reassertion of her individuality, even if it led to her death:

“Exercising the last freedom that not even the concentration camp could take away − to decide how one wishes to think and feel about the conditions of one’s life − this dancer threw off her real prison. This she could do because she was willing to risk her life to achieve autonomy once more. If we do that, then if we cannot live, at least we die as men.”

Bettelheim’s suicide can also be understood as the determination to assert his individual autonomy. Unwilling to endure a slow, meaningless death in an old age home, unable to maintain his identity as a human being in a bureaucratic system that regarded him as a thing to be administered to, that treated him without care or compassion, taking his own life became his refusal of the internal prison, the prison house of his personal and historical memory. Suicide became his last dance, his final affirmation of himself as a man.

Notes

Bettelheim, Freud’s Vienna and Other Essays (New York, 1990).
Bettelheim, The Informed Heart: Autonomy in a Mass Age (New York, 1960), pp. 151-156, 245.
Bettelheim, “Individual and Mass Behavior in Extreme Situations,” in Bettelheim, Surviving and Other Essays (New York, 1979), pp. 61; originally published in 1943 in The Journal of Abnormal Social Psychology, Vol. 38, pp. 417-452.
Bettelheim, The Informed Heart: Autonomy in a Mass Age (New York, 1960), p. 259.
Goleman, D. (1990a): “Bruno Bettelheim Dies at 86. Psychoanalyst of Vast Import,” New York Times, March 14, 1990.
Goleman, D. (1990b): “Bettelheim’s Suicide Tied to Many Troubles,” New York Times, March 15, 1990.
Fisher, “Homage to Bettelheim,” in Fisher, Cultural Theory And Psychoanalytic Tradition, pp. 177-181.
Fisher, “Psychoanalytic Cultural Criticism and the Soul,” in Fisher, Cultural Theory and Psychoanalytic Tradition, pp. 139-157.
Fisher, “Concerning Bruno Bettelheim,” Society, Vol. 28, No. 5, 1991, pp. 6-9; David James Fisher and Rudolf Ekstein, “An Open Letter to Newsweek, “ Los Angeles Psychoanalytic Bulletin, 1991, pp. 50-51.
Fisher, “A Final Conversation with Bruno Bettelheim,” in Fisher Cultural Theory and Psychoanalytic Tradition, pp. 159-175.
Fisher, “Homage to Bettelheim,” in Fisher, Cultural Theory and Psychoanalytic Tradition (New Brunswick, 1991), pp. 177-181.
Fisher, “Review of Bettelheim’s Freud and Man’s Soul,” Los Angeles Psychoanalytic Bulletin, Vol. 1, No. 4, 1983, pp. 20-26.
Kirschenbaum, L. M. (1989): Report of Dr. Bruno Bettelheim’s Presentation ‘How I Became A Psychoanalyst,’” Los Angeles Psychoanalytic Bulletin, Summer, 1989, pp. 3-8; Bettelheim’s talk became chapter two of his Freud’s Vienna and Other Essays (New York, 1990). pp. 24-38.
Fisher, D. J. (1991): “Bruno Bettelheim’s Achievement,” Free Associations, No., 22, 1991, pp. 191-201.
Fisher, D. J. (1991): “A Final Conversation with Bruno Bettelheim,” in Fisher, Cultural Theory and Psychoanalytic Tradition (New Brunswick, 1991), pp. 159- 175.
Fisher, D. J. (2003): Psychoanalytische Kulturkritik und die Seele des Menschen. Essays über Bruno Bettelheim unter Mitarbeit von Roland Kaufhold et. al., Gießen (Psychosozial-Verlag). http://www.psychosozial-verlag.de/psychosozial/details.php?p_id=281
Friedländer, S. (1979): When Memory Comes (New York, 1979), translated by Helen R. Lane, p. 110. 154 Bettelheim: Living and Dying.
Kaufhold, R. (Hg.) (1994): Annäherung an Bruno Bettelheim, Grünewald, Mainz.
Kaufhold, R. (ed.) (1998): Ernst Federn – Versuche zur Psychologie des Terrors. Material zum Leben und Werk von Ernst Federn. Gießen (Psychosozial-Verlag).
Kaufhold, R. (2001): Bettelheim, Ekstein, Federn: Impulse für die psychoanalytisch-pädagogische Bewegung, Psychosozial-Verlag, Gießen.
Kaufhold, R. et. al. (2003) : Einleitung. In : Fisher (2003), S. 24-69.
Kaufhold, R. (ed.) (2003a): “So können sie nicht leben” – Bruno Bettelheim (1903 – 1990). Zeitschrift für Politische Psychologie 1-3/2003.
Reich, K. (1994): Bettelheims Psychologie der Extremsituation. In: Kauf¬hold (Hg.) (1994), S.134–155.

David James Fisher ist Kulturhistoriker und praktizierender Psychoanalytiker in Los Angeles. Er ist Professor für klinische Psychiatrie an der UCLA School of Medicine, Senior Faculty Member des Psychoanalytischen Instituts in Los Angeles sowie Trainer und Supervisor am Institute of Contemporary Psychoanalysis.

Diese Studie wurde auf englisch publiziert in: David James Fisher: Bettelheim: Living and Dying, Contemporary Psychoanalytic Studies 8, Editions Rodopi B.V., Amsterdam – New York 2008, S. 145-154. Nachdruck mit freundlicher Genehmigung von David James Fisher, Los Angeles.
Die deutschsprachige Version dieser Studie ist erschienen in: David James Fisher (2003): Psychoanalytische Kulturkritik und die Seele des Menschen. Essays über Bruno Bettelheim – unter Mitarbeit von Roland Kaufhold et. al., Gießen (Psychosozial-Verlag), S. 159-172.

Die Studie wurde von Roland Kaufhold für diese haGalil-Veröffentlichung durchgesehen und leicht gekürzt. Wir danken dem Psychosozial Verlag und seinem Inhaber Prof. Dr. Hans-Jürgen Wirth für die freundliche Abdruckgenehmigung.