Werther's Syndrome: Copycat Self-Immolation in Israel with a Call

IMAJ • VOL 14 • JuLy 2012 FOCUS Werther’s Syndrome: Copycat Self-Immolation in Israel with a Call for Responsible Media Response Benjamin Greenberg MD1 and Rael D. Strous MD1,2 1Department of Psychiatry, Beer Yaakov Mental Health Center, Beer Yaakov, Israel 2Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel throughout the Arab world and became person... fighting to the end... a soldier self-immolation, suicide, copycat KEY WORDS: known as the “Arab Spring.” who fell in battle, in contrast to the weak behavior, Werther’s syndrome Bouazizi’s act received massive media ones, who deteriorate to poverty” [7]. IMAJ 2012; 14: 467-469 coverage worldwide. He was hailed by Media coverage of suicide acts has Arab commentators as a “hero” and been found to be significantly related a “martyr,” and his act was reported to an increase in the rates of copycat extensively in the western media as suicide. This phenomenon is known elf-immolation is the act of setting well. TIME magazine named Bouazizi as the “Werther effect” [8], alternately S oneself on fire, in the majority of “Person of the Year” for 2011, describing referred to as “Werther’s syndrome.” cases with the intention of committing him as a “martyr who brought the Arab The phenomenon was first elucidated by suicide, while expressing a social or world down to its knees” [4]. David Phillips in 1974 [9] and refers to political protest. The incidence varies Most recently in Israel, Moshe the trend noted throughout Europe in among different cultures, religions and Silman, a 57 year old social activist the 18th century and considered to be social-political climates. In developed with financial and health problems, set a consequence of Goethe’s novella The countries it is considered a rare form himself alight on 14 July 2012 during Sorrows of the Young Werther (1774). In of suicide (comprising 0.06–1% of all a protest rally in Tel Aviv against gov- Goethe’s book, the main protagonist, suicide cases), whereas in developing ernment social policy. His act received Werther, experiences a failed romance countries it occurs more frequently wide media coverage. Photographs of with Charlotte, a woman who was (up to 40% of all suicide cases) [1]. The Silman setting himself on fire were already engaged to marry another man. first reported self-immolation was car- published extensively and his desperate Once Werther recognized that he had ried out by a Chinese monk in the 4th act appeared on the front page of every no chance of winning her over, he put century and became a common form daily newspaper. A journalist from a an end to his life. The book became very of protest by Buddhist monks until leading newspaper wrote: “He made influential and, apart from inspiring a the 20th century [2]. As a common act the sensible decision from his point of fashion of yellow pants, blue jackets and of protest or as a symbol of religious view. It was the only option… while the open-necked shirts, led to several hun- devotion in Buddhism and Hinduism, flames engulfed his body; while he was dred copycat suicides among young men. self-immolation has become especially in agonizing pain… he didn’t cry out, While relatively little is known about the common in India, with a reported aver- he was smiling…” [5]. Another lead- psychological processes and individual age of 1500 self-immolations a year in ing journalist wrote of Silman’s choice: vulnerabilities that lead some to engage 2000 and 2001 [3]. “Moshe Silman didn’t have any other in suicidal behavior after exposure to The most famous case of self-immola- option, in the choice between being media presentations of suicides, at least tion in recent years was that of Mohamed a dead man walking or truly dead, he one assessment of emotional and cogni- Bouazizi, a 26 year old Tunisian street chose the option that would salvage tive reactions resulting from exposure vendor who set fire to himself in some remains of his dignity… by doing has indicated that emotional reactivity December 2010 in the city of Sidi Bouzid, nothing, the authorities are responsible and higher dissociation tendencies may Tunisia, in protest against persecution by for every burned piece of skin, every lac- be significant risk factors of the phe- the authorities. His act of self-immolation eration of his aching soul which brought nomenon [10]. It was also suggested by leading to his subsequent death, defined him to the furnace of hell” [6]. Another Phillips [11] that many commit suicide by most as an act of suicide, set off riots quote from a local prominent newspaper in this copycat fashion following the around Tunisia which effectively brought and journalist (Gideon Levy of Haaretz) realization that subsequent media cover- about a civilian uprising that spread presented Silman as being a “strong age of a celebrity suicide indicated that 467 FOCUS IMAJ • VOL 14 • JuLy 2012 instead of being censured, the individual Suicide by self-immolation seems to potential for copycat suicides in such sit- committing suicide is in many ways be especially prone to igniting copycat uations, the Centers for Disease Control lauded and granted respect, status and suicides. The act is usually perceived as in the U.S. has suggested that the media admiration that many did not enjoy an act of heroism, aimed at a common refrain from offering simplistic explana- in life. Thus, with the media-induced target, and generally occurs during tions for suicide and from reporting sui- removal of the social stigma associated times of crisis and hostility towards cide in a repetitive or disproportionate with suicide, a distinct level of disin- authorities. During the 6 months after manner. In addition, they recommend hibition emerges, culminating in the Bouazizi’s act, at least 107 Tunisians that the media desist from portraying increased incidence of copycat suicides. self-immolated. In the days following suicide as a means of accomplishing Interestingly, the phenomenon even Silman’s self-immolation a number of certain goals or from glorifying persons extends to accessing information about copycat attempts (at least 10 reported in who commit suicide and focusing on any one particular case. For example, in the media) to self-immolate took place their positive qualities [21]. Subsequently, Austria it has been shown that there is in Israel, including many threats, a few many countries have devised their own a strong correlation between suicide by actual attempts which were thwarted specific codes for the reporting of sui- firearm following a celebrity suicide and at the last minute by bystanders, and cides, ranging from extreme measures, distribution of the newspaper describing at least one successful self-immolation such as in Norway where media reports the intimate details of the case [12]. The resulting in severe burns, a comatose of suicide are prohibited, to more moder- Werther effect lies in distinct contrast to state and subsequent death. ate recommendations. In Turkey, visual the “Papageno effect,” where the media The response to Silman’s act stands images of suicidal acts are not published may exert a protective effect against sui- in stark contrast to a previous similar [22]. To our knowledge, no such guide- cide [13,14]. This latter effect is based on act of protest in Israel. It turns out lines exist in Israel. Papageno, a central character in Mozart’s Moshe Silman was not the first to There is one additional clinical opera The Magic Flute who becomes sui- self-immolate in the country. A 54 observation that should be considered. cidal due to fear of losing his much loved year old woman, Yelena Bosinova, In people who self-immolate, death Papagena. As a result of the influence of from the Gaza settlement K’dumim occurs at least a few days after the act. three boys who convince him that there set herself on fire in 2005 during the The majority of copycat cases seem to are other ways of coping with such loss he ‘Disengagement’ and uprooting of the occur after the death of the individual, is able to desist from the suicidal act [13]. Jewish presence in the Gaza Strip as an and only to a lesser extent after the act The copycat suicides, also known as act of political protest and died shortly of burning. For example, Bouazizi self- suicide contagion, tend to be similar to after [18]. Her act received only mini- immolated on 17 December 2010 and the original act in the mode of suicide mal press coverage, with no pictures died on 4th January 2011. Based on news and demographics of the index case. One published. No known copycat immola- reports, the first self-immolation after example is the town Bridgend in Wales tions followed her act. Her immolation Bouazizi took place on 13 January and where, since 2007, dozens of teenagers remains in distinction to Silman’s – a many more followed after that index aged 13–17 committed suicide, most of widely publicized act in the media with event. Similarly, the majority of copycat them by hanging. Several other poten- a number of subsequent copycat cases. self-immolation threats or attempts in tial cases of Werther’s syndrome have In an attempt to curb the media’s Israel took place after Silman’s death. been suggested and noted by many in influence in encouraging copycat sui- This could be of value when trying to recent years, prompted by the suspected cides, the World Health Organization understand the cause for copycat cases, suicide of a celebrity, for example, the published guidelines aimed at creating and could also be relevant if one tried to American rock singer Kurt Cobain (of “responsible reporting.” The WHO predict the most sensitive periods from Nirvana fame) who shot himself in 1994 Media Guidelines include recommen- the media coverage point of view.

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