Dr. Norman L. Farberow an American psychologist

Psychologist

Psychologist is a professional or academic title used by individuals who are either:* Clinical professionals who work with patients in a variety of therapeutic contexts .* Scientists conducting psychological research or teaching psychology in a college...

, is one of the founding fathers of modern suicidology

Suicidology

Suicidology is the scientific study of suicide, suicide prevention, and cultures who view suicide as a religious act . The word 'suicide' comes from the Latin words sui and cide or ciduim . There are many different fields and disciplines involved with suicidology, the two primary ones being...

. He was among the three founders in 1958 of the Los Angeles Suicide Prevention Center, which became a base of research into the causes and prevention of suicide.

Early life and education

He was born in 1918 in Pittsburgh, Pennsylvania.

After completing his tour of duty in World War II

World War II

World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

, Farberow enrolled in the University of California, Los Angeles

University of California, Los Angeles

The University of California, Los Angeles is a public research university located in the Westwood neighborhood of Los Angeles, California, USA. It was founded in 1919 as the "Southern Branch" of the University of California and is the second oldest of the ten campuses...

. UCLA’s doctoral program in psychology afforded Farberow an opportunity to study suicide againstcenturies of shifting attitudes. With few relevant references to draw upon for his 1949 dissertation, Farberow saw the potential for reawakening “interest in a long-neglected, taboo

Taboo

A taboo is a strong social prohibition relating to any area of human activity or social custom that is sacred and or forbidden based on moral judgment, religious beliefs and or scientific consensus. Breaking the taboo is usually considered objectionable or abhorrent by society...

-encrusted social and personal phenomenon.” Farberow earned his doctoral degree from UCLA in 1950 while working with veterans in the Veterans Administration

United States Department of Veterans Affairs

The United States Department of Veterans Affairs is a government-run military veteran benefit system with Cabinet-level status. It is the United States government’s second largest department, after the United States Department of Defense...

 Mental Hygiene Clinic. He helped found the suicide prevention center along with Robert E. Litman.

World War II

Farberow served as a World War II

World War II

World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

 Air Force

Air force

An air force, also known in some countries as an air army, is in the broadest sense, the national military organization that primarily conducts aerial warfare. More specifically, it is the branch of a nation's armed services that is responsible for aerial warfare as distinct from an army, navy or...

 Captain. The war years were a time in the United States of relatively low suicide

Suicide

Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...

 rates, a wartime phenomenon commonly observed when a nation’s armed forces and citizens unite under feelings of common purpose and mutual goals.

Career

In the decade after the war, suicide rates rose quickly as the sense of unity and shared purpose began to disappear. Wrenching social and personal readjustments were often needed, and these needs were further complicated by the emotional distress and mental health problems of returning veterans. Many expressed their deepening inner turmoil in unhealthy ways, through suicidal impulses and acts. Suicide’s continuing taboo, embedded in cultural and religious condemnations of shame

Shame

Shame is, variously, an affect, emotion, cognition, state, or condition. The roots of the word shame are thought to derive from an older word meaning to cover; as such, covering oneself, literally or figuratively, is a natural expression of shame....

, guilt

Guilt

Guilt is the state of being responsible for the commission of an offense. It is also a cognitive or an emotional experience that occurs when a person realizes or believes—accurately or not—that he or she has violated a moral standard, and bears significant responsibility for that...

, self-blame and cowardice, magnified an underlying sense of worthlessness and hopelessness.

Farberow saw the effects of these dynamics and how they compounded the misery of those who were suffering. His vision for solutions grew to include fundamental and humanitarian changes to the way in which communities treated the suicidal. Soon his time as a psychotherapist became eclipsed by his continuing research on suicide with Dr. Edwin Shneidman

Edwin Shneidman

Edwin S. Shneidman Edwin S. Shneidman Edwin S. Shneidman (born May 13, 1918, York, Pennsylvania,  – May 15, 2009, Los Angeles, California was a American suicidologist and thanatologist...

, a colleague equally passionate about changing the understanding and prevention of self-inflicted death.

During the 1950s, the men worked together at the Veterans Administration (VA) in Los Angeles and sought answers for another jump in suicide rates—the sudden doubling of suicides among the VA’s neuropsychiatric hospital patients. At the same time, a survey they had conducted of L.A.-area hospitals, clinics, and emergency rooms revealed that no provisions existed for the follow-up care of suicide attempters. Farberow and Shneidman shared their findings with the National Institute of Mental Health

National Institute of Mental Health

The National Institute of Mental Health is one of 27 institutes and centers that make up the National Institutes of Health...

 and the VA and proposed the creation of two agencies: a community-based Referral Center for treating the psychological problems of the suicidal, and a Central Research Unit for assessing and investigating suicide among veterans within the VA.

A suicide prevention center

In 1958, Farberow and Shneidman launched the nation’s first center of its kind, the Los Angeles Suicide Prevention

Suicide prevention

Suicide prevention is an umbrella term for the collective efforts of local citizen organizations, mental health practitioners and related professionals to reduce the incidence of suicide....

 Center (LASPC) with the psychiatrist

Psychiatrist

A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

 Robert E. Litman, M.D., as its director. Farberow described Litman as, “a free spirit cloaked in psychoanalytic trappings, always intellectually adventuresome and inquisitive.” Together, the three men developed a scientific, methodologically sound, and professionally conceived organization where a social and professional vacuum had once existed. Farberow described this as a time of “attraction and excitement in the feeling that we were into a relatively unexplored area of vital community concern.” The objective of the agency—to provide a center for the follow-up care of suicidal patients discharged after treatment in the Los Angeles County Hospital—changed in the first year as calls came in from people in crisis. Capitalizing on the opportunity to intervene and avert a suicide attempt broadened the Center’s objective to include crisis intervention and 24-hour accessibility of professionals or rigorously trained non-professionals. These efforts led to the development of the L.A. Scale for Assessment of Suicidal Potential and the crisis hotline

Crisis hotline

A crisis hotline is a phone number people can call to get immediate emergency telephone counseling, usually by trained volunteers. Such hotlines have existed in most major cities of the United States at least since the mid-1970s. Initially set up to help those contemplating suicide, many have...

.

As the LASPC’s reputation as an informed referral center grew, collaboration with the coroner

Coroner

A coroner is a government official who* Investigates human deaths* Determines cause of death* Issues death certificates* Maintains death records* Responds to deaths in mass disasters* Identifies unknown dead* Other functions depending on local laws...

’s office, mental health professionals, police, probation, schools, and other organizations created the awareness needed to demystify suicide’s taboo and give hope to those who were suffering. Through writing, teaching, training, and publishing, LASPC directors disseminated their principles for the organization and functioning of a suicide prevention and crisis intervention community agency. Their principles are still in use today and serve as models in community agencies around the world. The LASPC is now part of a comprehensive mental health facility based in Culver City, California

Culver City, California

Culver City is a city in western Los Angeles County, California. As of the 2010 census, the city had a population of 38,883, up from 38,816 at the 2000 census. It is mostly surrounded by the city of Los Angeles, but also shares a border with unincorporated areas of Los Angeles County. Culver...

, known as Didi Hirsch Mental Health Services.

CRU for SUD

The name of the “Central Research Unit for the Study of Unpredicted Death” shows that Farberow and Shneidman at first had to hide the nature of their work. During the 1950s and just after the introduction of psychotropic drugs, the Veterans Administration became concerned with a sudden doubling of the suicide rate of its neuropsychiatric hospital patients. The new psychotropics markedly improved symptoms, allowing patients to be released much sooner than usual. But more patients killed themselves either while on leave or shortly after they returned to the hospital. Farberow determined the new psychotropics were “too successful,” controlling disturbed behavior so well that other treatments, such as psychotherapy

Psychotherapy

Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

, were disregarded. In Farberow’s words, “Our research led mental health professionals to accept the fact that the miracle drugs could only do a part of the job and that the psychotropics would have to be integrated into a more comprehensive approach.”

The Unit's analysis of hundreds of veterans’ suicide cases allowed Farberow and Shneidman to determine suicidal factors in specific psychiatric syndromes, such as schizophrenia

Schizophrenia

Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

, depression, anxiety

Anxiety

Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

 and dysthymia, as well as suicidal factors in patients suffering from physical health problems, such as cancer

Cancer

Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

, cardiorespiratory illnesses, and others.

The psychological autopsy

The L.A. County Coroner’s request for psychological information to help determine equivocal cases of suicide led Farberow and Shneidman to create the psychological autopsy as a procedure for evaluating the critical factor of intention. With Farberow and his colleagues based in a city known for its Hollywood luminaries, the coroner often called on the men to use the psychological autopsy in determining whether suicide was the cause of death for such celebrities as Marilyn Monroe

Marilyn Monroe

Marilyn Monroe was an American actress, singer, model and showgirl who became a major sex symbol, starring in a number of commercially successful motion pictures during the 1950s....

, Robert Walker

Robert Walker

-Creative arts:*Robert Walker , American actor*Robert Walker , English portrait painter*Rob Walker , Australian poet*Robert Joseph Walker , Australian Aboriginal poet*Robert W...

, and Marie (The Body) McDonald. The procedure gained international application as Farberow enlisted other international researchers in the study of personality differences in modes of death in Finland

Finland

Finland , officially the Republic of Finland, is a Nordic country situated in the Fennoscandian region of Northern Europe. It is bordered by Sweden in the west, Norway in the north and Russia in the east, while Estonia lies to its south across the Gulf of Finland.Around 5.4 million people reside...

 with comparisons of suicides in Los Angeles

Los Ángeles

Los Ángeles is the capital of the province of Biobío, in the commune of the same name, in Region VIII , in the center-south of Chile. It is located between the Laja and Biobío rivers. The population is 123,445 inhabitants...

, Vienna

Vienna

Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...

, and Stockholm

Stockholm

Stockholm is the capital and the largest city of Sweden and constitutes the most populated urban area in Scandinavia. Stockholm is the most populous city in Sweden, with a population of 851,155 in the municipality , 1.37 million in the urban area , and around 2.1 million in the metropolitan area...

, among others.

Indirect self-destructive behavior

As part of his activity in the Central Research Unit for the Study of Unpredicted Death (CRU for SUD) in the Veterans Administration, Farberow identified and characterized his observations of indirect self-destructive behavior, or ISDB, and described a broad range of behaviors ranging from “slight to extreme, from mild smoking to noncompliant medical neglect, from risk-taking, excitement-seeking, depression-averting, denial-mediated aspects of substance abuse addiction to dare-devil flaunting of fate in chasm jumping on a motorcycle.” Farberow considered this body of work integral to understanding the continuum of self-destructive behavior, which he carefully researched and documented in what he called his labor of love, a book entitled The Many Faces of Suicide.

Suicide's depiction in the arts

“The history of suicide, with its fascinating vagaries, to my view, is seen much more clearly and comprehensively when viewed through its reflection in the paintings of the master artists of their times,” wrote Farberow. While on sabbatical in Europe

Europe

Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

 and on other trips, Farberow frequently visited museums to see paintings, illustrations, and sculpture

Sculpture

Sculpture is three-dimensional artwork created by shaping or combining hard materials—typically stone such as marble—or metal, glass, or wood. Softer materials can also be used, such as clay, textiles, plastics, polymers and softer metals...

 that depicted suicide; he became interested in studying the visual arts to chronicle history’s shifting attitudes. Combining slides and posters, he arranged a collection of works that spanned the millennia. He found a neutral attitude in Biblical suicides, followed by later ambivalence, and then the cry for help indicative of modern times. Farberow’s poster collection is held by the American Association of Suicidology, a research-based organization established by Shneidman in 1968.

For suicidal persons

Of the many calls received by LASPC volunteers on the 24-hour crisis hotline

Crisis hotline

A crisis hotline is a phone number people can call to get immediate emergency telephone counseling, usually by trained volunteers. Such hotlines have existed in most major cities of the United States at least since the mid-1970s. Initially set up to help those contemplating suicide, many have...

, Farberow noted that approximately one-third were acutely suicidal. In Farberow’s words, “The chronically suicidal people who made up the other two thirds needed more, mostly continuing evidence of caring, interest, and concern.” For Farberow, assisting this population was one of the more gratifying clinical activities to come out of his work at the Center. Several models of group therapy were developed in the effort to meet different needs. At its height, the group therapy program at LASPC included two long-term insight-oriented groups, a post-crisis oriented time-limited group, a drop-in group, a creative expression group using nonverbal expressive procedures, a socialization group focusing on interaction and relationships, and four drug rehabilitation groups meeting once a week. Farberow wrote about the program, hoping to stimulate other centers, but it never achieved the widespread use as a clinical tool for treatment he had envisioned.

For the bereaved

Though survivors after a suicide experience the same feelings of loss and grief that are found after any death, they are subject to additional complications because of the taboo aspects of the death and the commonly experienced intense feelings of shame and guilt. As a result they are often excluded from the comfort and support traditionally offered by family, friends and community at the time of a death. This survivor population required a new approach to group therapy: these were not patients seeking to explore conflicts and problems with a therapist trained in traditional models.

These were people who needed a place to address the stigma

Social stigma

Social stigma is the severe disapproval of or discontent with a person on the grounds of characteristics that distinguish them from other members of a society.Almost all stigma is based on a person differing from social or cultural norms...

 of suicide and to talk without guilt or embarrassment. The LASPC introduced this new model in the 1980s and identified two major aspects:

• Meetings would be led by a mental health professional and a survivor facilitator, and
• Meetings would be limited to eight weeks with monthly follow-ups for those that wish it.

They determined the meetings would focus on caring, sharing, support, and interactive discussion—not conflict identification and resolution, aspects typically addressed in traditional group therapy.

The model for the Survivors After Suicide program quickly grew in the U.S. and Canada

Canada

Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

. Change came more slowly in Europe, where the cultural and religious taboos around suicide were more deeply entrenched. The establishment of the international Farberow Award in the IASP (see below) has helped this therapeutic model gain universal acceptance.

International collaboration

Farberow distinguishes Vienna Psychiatrist Erwin Ringel

Erwin Ringel

Erwin Ringel was an Austrian psychiatrist and neurologist who dedicated his life to suicide prevention and who, in 1960, defined the presuicidal syndrome....

 as a crucial pioneer in the development of suicide prevention in the world. Ringel convened the first European meeting focused on suicide prevention in 1960 in Vienna. The following year, Ringel visited the LASPC and invited Farberow to share his vision. In its infancy, the concept of a new global organization underwent “a classic clash of American vs. European ideas of how an Association was structured.” Farberow wrote, “My approach reflected my experience in U.S. psychology governance while his approach reflected his experience in an autocratic university and European associations.” The commitment to argue through and resolve these issues resulted in a global organization that constitutes an important part of Farberow’s professional legacy, the International Association for Suicide Prevention

International Association for Suicide Prevention

-Introduction:The International Association for Suicide Prevention is the global go-to suicide prevention organization. Founded by Erwin Ringel and Norman Farberow in 1960, IASP, which is in an official relationship with the World Health Organization, is dedicated to preventing suicidal behaviour...

 (IASP). Today, the IASP consists of a consortium of National Associations, mental health agencies, clinicians, researchers, and survivors of suicide from more than fifty countries.

Overview

Farberow rates as the most significant impacts work to be the lessening of the taboos related to suicide, so that the cry for help could be both more readily voiced and more easily heard. While preparing items for inclusion in the bibliography of his first book, The Cry for Help, Farberow noted an average of thirty-five suicide-related journal items per year over a sixty-year period, from 1897 through 1957. With the opening of the LASPC and the continual documentation of its progress, the long-neglected status of suicide as a significant public, physical, and mental health problem began to change. When Farberow collected citations for a second bibliography nine years later, the number had surged to roughly one hundred per year. The awareness created by Farberow, Shneidman, and Litman stimulated a growth in publications on all aspects of suicide.

The conundrum of suicide maintained its challenge. Farberow examined the shifting nature of risk within a variety of subgroups, including police officers, gay men, the obese, schizophrenics and other psychiatric patients. youth, adolescents, the aged, and the chronically and terminally ill. He evaluated and developed scales for assessing suicide risk in various levels of public schools and universities; offered recommendations to doctors, nurses, and hospitals; assisted in addressing the problems of the coroner and the bereaved; provided expert witness testimony for numerous trials; and consulted with both professional and Hollywood filmmakers. His work broadened to include crisis intervention with the publication of guidelines for human service and child health care workers in large-scale natural disasters.

Throughout his career, Farberow was prolific in publishing his observations, research findings, and clinical insights. He wrote 16 books, 50 chapters, 93 articles, three monographs, four manuals, three brochures, 13 book reviews, six forewords, three Veterans Administration Medical Bulletins, and one module. His books and articles have been translated into Japanese

Japanese language

is a language spoken by over 130 million people in Japan and in Japanese emigrant communities. It is a member of the Japonic language family, which has a number of proposed relationships with other languages, none of which has gained wide acceptance among historical linguists .Japanese is an...

, Finnish

Finnish language

Finnish is the language spoken by the majority of the population in Finland Primarily for use by restaurant menus and by ethnic Finns outside Finland. It is one of the two official languages of Finland and an official minority language in Sweden. In Sweden, both standard Finnish and Meänkieli, a...

, German

German language

German is a West Germanic language, related to and classified alongside English and Dutch. With an estimated 90 – 98 million native speakers, German is one of the world's major languages and is the most widely-spoken first language in the European Union....

, Swedish

Swedish language

Swedish is a North Germanic language, spoken by approximately 10 million people, predominantly in Sweden and parts of Finland, especially along its coast and on the Åland islands. It is largely mutually intelligible with Norwegian and Danish...

, French

French language

French is a Romance language spoken as a first language in France, the Romandy region in Switzerland, Wallonia and Brussels in Belgium, Monaco, the regions of Quebec and Acadia in Canada, and by various communities elsewhere. Second-language speakers of French are distributed throughout many parts...

, Spanish

Spanish language

Spanish , also known as Castilian , is a Romance language in the Ibero-Romance group that evolved from several languages and dialects in central-northern Iberia around the 9th century and gradually spread with the expansion of the Kingdom of Castile into central and southern Iberia during the...

, and Korean

Korean language

Korean is the official language of the country Korea, in both South and North. It is also one of the two official languages in the Yanbian Korean Autonomous Prefecture in People's Republic of China. There are about 78 million Korean speakers worldwide. In the 15th century, a national writing...

. He edited, contributed to, and consulted with many periodicals over the years and remains active with six.

Marriage and family

Farberow married Pearl (1925–2008), a teacher and counselor. They had two sons.

Legacy

• The IASP established the Farberow Award, to recognize his treatment model for survivors of suicide by loved ones.

Farberow’s ingenuity has been influential internationally: in the doctrines of mental health clinics and educational institutions, and in virtually any community that relies on established protocol to address the problem of suicide. Farberow’s penetrating insights, sincere vision, and lifelong perseverance helped turn this once heavily taboo-laden topic into a legitimate health concern, making resources available to people interested in suicide research, treatment, and prevention worldwide.

Selected works

• Farberow, N. L., & Shneidman, E. S. (Eds.) (1961). The Cry for Help. New York: McGraw-Hill Book Company; (Japanese Translation) Tokyo: Charles E. Tuttle Company, 1968; (Spanish Translation) Mexico City: La Presna Medica Mexicana, 1969.

• Shneidman, E. S., & Farberow, N. L. (Eds.) (1957). Clues to Suicide. New York: McGraw-Hill Book Company; (Japanese Translation) Tokyo: Seishin Shobo Company, 1968.

• Farberow, N. L. (Ed.) (1980). The Many Faces of Suicide. New York: McGraw-Hill Book Company.

• Evans, G., & Farberow, N. L. (1988). Encyclopedia of Suicide. New York: Facts on File Publishing Co.

• Farberow, N. L. (Ed.) (1975). Suicide in Different Cultures. Baltimore, MD: University Park Press, 286 p.

• Reynolds, D. K., & Farberow, N. L. (1976). Suicide, Inside and Out. Los Angeles and Berkeley: University of California Press, 226 p.

• Reynolds, D. K., & Farberow, N. L. (1977). Endangered Hope: Experience in Psychiatric Aftercare Facilities. Los Angeles and Berkeley: University of California Press, 184 p.

• Reynolds, D. K., & Farberow, N. L. (1981). Family Shadow. Los Angeles and Berkeley: University of California Press, 177 p.

• Farberow, N. L., & Gordon, N. (1981). Manual for Child Health Workers in Major Disasters. Washington, D.C.: U.S. Government Printing Office, DHHS Publication No. (ADM) 81-1070.

• Maida, K., Gordon, N., & Farberow, N. L. (1989). The Crisis of Competence. Transitional Stress and the Displaced Worker. New York: Brunner-Mazell.

• Shneidman, E. S., Farberow, N. L., & Litman, R. E. (1994). The Psychology of Suicide (2nd ed.). Northvale, NJ: Jason Aronson, Inc.