The Myth of Sisyphus and Other Essays

It’s an odd book, but it’s often seen at the bottom of suicide prevention research articles: Albert Camus’ essay in book form, Myth of Sisyphus and Other Essays.  The myth is of a Greek hero who is subjected to rolling a boulder up a mountain, only to have it roll down from its own weight before reaching the top.  The relationship to suicide is opaque from the outside.  Inside, it’s about whether life has meaning – and therefore suicide interferes with that meaning.

Exit, Voice, and Loyalty

The book Exit, Voice, and Loyalty isn’t about suicide, but it has profound implications on understanding the way that people tolerate the intolerable.  It’s Hirschman’s work on the dynamics of corporations: it explains the option of leaving the organization, using your voice to make change, and the amount of loyalty to the organization that keeps you using your voice before exiting.

The model matches the kind of decisions that are made by those who are considering suicide.  While not every suicide involves a long period of contemplation, some do.  Exit is analogous to suicide.  Voice is the actions that the person takes toward resolving the pains and struggles in their lives that are driving them to consider suicide.  Loyalty is the force that keeps people trying to use their voice instead of exiting.

Death Is There as the Only Reality

A sentence caught my attention.  It made me wonder what it would be like if you only saw pain in your life.  What if you were so consumed by the sense of hopelessness and despair that it blotted out any joy and happiness?  As I read, and as I talk to people, I begin to sense this overwhelming sense of dread for the next day.  Others have called it cognitive constriction.  (See The Suicidal Mind.)

Of course, the reality of the matter may not be as bleak as it seems, but that doesn’t change the feelings of those who are captured by these thoughts.  (See Capture.)

The Best and the Worst

Just because one is reading a truly lousy novel doesn’t mean that all novels are bad.  We can’t discount the good in the world when we discover that not everything is good.  This is the binary thinking that creates struggle.  It’s not “either-or,” it’s “and.”  There is suffering and struggle but also soaring feelings of success and shared experiences.

Futile and Hopeless Labor

The story of Sisyphus is one of an eternal sentence to futile and hopeless labor.  Camus comments that the gods must have thought there was no worse fate than what they subjected Sisyphus to.  It is, of course, absurd to continue to try to accomplish something that you’ll never achieve.

There are ways that working at something can make you better.  After all, Anders Ericsson explains in Peak that purposeful practice can make anyone a master.  Edward Deci explains in Why We Do What We Do that we can be intrinsically motivated when we have autonomy (no one is telling us exactly how to do things), mastery (the belief we are becoming more capable), and purpose (what we’re doing has meaning in some small or large way).  These forces move us towards continuing the struggle with the hope that it will get better if we just persevere.  (See The Psychology of Hope for more on hope.)

The Other Side of the Stockdale Paradox

I first was exposed to the idea of the Stockdale Paradox in Jim Collin’s book, Good to Great.  He explains, “Retain absolute faith that you can and will prevail in the end, regardless of the difficulties, AND at the same time confront the most brutal facts of your current reality, whatever they might be.”  It’s the central dilemma for entrepreneurs.  Should they persist for the ultimate win – or fold early?  When it is time to give up on an idea or change it, and when should you “stick to your guns?”  There are stories of people who have been very successful after a moment of despair.  There are stories of those who have hung on as long as they could and still failed.

Ultimately, the problem with the Stockdale paradox is that it requires unknowable foresight into the future.  Instead, we’re constantly guessing at the right answer.  Prediction is difficult, as explained by Phil Tetlock (see Superforecasting), Nate Silver (see The Signal and the Noise), and Daniel Kahneman et al. (see Noise).  We’re never going to know the future with absolute certainty.

Those who are struggling against suicide are on the opposite side.  They’re not waiting for success and abundance.  They’re hoping for relief of the pain they feel is an inseparable part of living.  They’re in a constant battle between the parts of them that believe there is no hope and the parts of them that realize things are likely to get better – they just don’t know when.  Instead of looking for the next way to flourish (or thrive), they’re looking for the strength to make it through just one more day.

Sidebar: The Stockdale paradox is one of the most pervasive concepts I’ve encountered.  It shows up as a central conflict in so many fields and so many books.  (See books like Think Again, Rethinking Suicide, and Struggle Well for just a few examples of where this concept appears.)  It seems that knowing when to hold on and when to let go is one of the central struggles of life.

Crushing Truths

When Camus wrote Myth of Sisyphus, it was 1940.  It was the time before what I’d call the modern age of suicide prevention.  He was challenging the worth of life and therefore the legitimacy of suicide as a solution.  In the decades since his writings, we’ve failed to learn the essential lessons of suicide.

Much like the problem of stigmatization, demands, and ineffective approaches to the problem of drug abuse, suicide has gone down many bad paths.  We still live in an age where drug resistance programs that have been proven to cause harm are in use.  Most of the general public sees drug abuse as the problem instead of as a broader symptom of despair.  (See Deaths of Despair and the Future of Capitalism.)  Instead of finding out why people suffer and feel the need to use coping mechanisms that ultimately take control of them, we say that they’re weak or bad.  To be clear, addiction in any form is when a coping strategy starts to control the person.  This is true of narcotics, alcohol, shopping, sex, eating, or any other strategy that we use to cope with the slings and arrows of life.  For more on drug abuse and the myths, I’d encourage you to read The Globalization of Addiction, Chasing the Scream, and Dreamland.

As I write this in 2024, the US has released a new national strategy for suicide prevention that is substantially similar to the 2012 plan.  The crushing truth is that the national strategy in 2012 and all the suicide prevention work in the US was an utter failure.  I make this claim not subjectively but rather based on the data that the US rates of suicide increased about 13% between 2012 and 2022 (the last year for reliable data).  During the same time, the worldwide rates decreased by 21.1%.

The national strategy had one evaluation in 2017 that wasn’t focused on efficacy.  The question that it answered was how the plan had been rolled out.  Did all of the states and territories implement the strategy?  Not surprisingly, the plan wasn’t well implemented across the country.  However, the bigger problem isn’t the plan wasn’t implemented – it’s that the plan wasn’t implementable.  The 2012 plan had 4 strategic directions, 13 goals, and 60 objectives.  No one could implement the whole plan, because it wasn’t focused on the things that really make a difference.  Despite the research showing that the 2012 plan wasn’t well implemented, the 2024 plan retained those four strategic directions and expanded to 15 goals and 87 objectives.  This effectively ensures that if the implementation is studied for the 2024 plan, it will go down relative to the 2012 plan – which was a failure on the metric of implementation.

What’s worse is that the 2012 plan was never subjected to any efficacy evaluations.  We know that the overall outcome would have been negative, because the rate increased.  But no one did the work to figure out what was working and what wasn’t – thus, we ended up with a 2024 plan that couldn’t remove ineffective recommendations (objectives) nor focus on what was working.

Even the philanthropic sector struggled.  The American Foundation for Suicide Prevention (AFSP) quietly changed the name of their initiative Project 2025 to The Bold Goal.  The project was intended to span 10 years starting on October 27, 2015, with the goal to reduce suicides by 20%.  Clearly, their work wasn’t effective towards this goal.  Of course, they’ve got a year left to close the gap – but they’re in the hole by about 7%.  It’s not impossible to get a 27% reduction in one year but it would be unprecedented.

I share all this because Camus wrote, “But crushing truths perish from being acknowledged.”  Until we acknowledge that what we’re doing isn’t working, and we need to make a change, the entire field of suicide prevention will, in my opinion, be subjected to the fate in the Myth of Sisyphus.