Why Might Men Be More at Risk of Suicide After a Relationship Breakdown? Sociological Insights

Abstract

Relationship breakdown constitutes a major risk factor for suicide ideation and completion. Although no definitive conclusion can be reached about a gender differential in susceptibility to this factor, several studies have identified that there is an elevated risk factor in men following divorce and separation. This article presents an overview of sociological explanations that may be employed to understand this phenomenon. There is discussion of the changing nature of intimacy, men’s loss of honor, marriage as a more positive experience for men than for women, control in relationships, the increasing importance of the care of children for men, and men’s social networks. The article concludes with possible implications for policy and practice.

Introduction

Suicide is a major public health issue. In the United States, for example, 38,364 people took their own lives in 2010, which means 105 suicides every day (McIntosh & Drapeau, 2012). Men are disproportionately at risk of suicide in almost every country in the world that reports suicide rates (Stack, 2000a). In the United States, in 2010, the ratio of men to women dying by suicide was almost four to one (McIntosh, 2012). The gendered character of suicidality is more complex, however, than this headline suggests. Women are more likely than men to have suicidal thoughts and to attempt suicide. These complex patterns have been labeled the “gender paradox” of suicide by Canetto and Sakinofsky (1998). The reasons for attempted and complete suicide are not necessarily the same (De Jong, Overholser, & Stockmeier, 2010), reflecting in part the different gender profiles of the two groups.

Suicide is a complex phenomenon, with multifarious causes. These include mental illness, but social circumstances and life events are of central importance (Cavanagh, Carson, Sharpe, & Lawrie, 2003). There is evidence to suggest that one life event strongly associated with suicidal ideation, attempts, and completion is the experience of divorce and separation. Individual-level studies have reported a higher suicide rate in divorced people (Cutright & Fernquist, 2005; Stack, 2000b), and ecological studies have reported higher rates of suicide in countries or regions with higher divorce rates (Andrés, 2005; Fernquist, 2003). Research on separation and suicidality is less common, but there is some evidence that separated people may be at even greater risk of suicide than divorced people (Ide, Wyder, Kõlves, & De Leo, 2010), and Stack and Scourfield (2013) identified a greater suicide risk for more recent divorce than for more distal divorce.

Although relationship breakdown is an established risk factor for suicide, it appears that men and women may not be equally susceptible to this risk (Corcoran & Nagar, 2010; Ide et al., 2010; Kovess-Masfety et al., 2011; Petrovic, Kocic, Nikic, Nikolic, & Dragan, 2009). In one of a limited number of studies that considered the interaction of gender and relationship breakdown, Kposowa (2003) noted that divorced men were more than eight times more likely to die by suicide than divorced women (relative risk = 8.36, 95% confidence interval = 4.24-16.38). A review by the authors on this issue in Western countries (Evans, Scourfield and Moore, 2014) identified 19 individual-level articles that included a separate analysis by gender. Of these, 12 articles reported a greater risk of suicide in men following relationship breakdown, 2 indicated a greater risk in women, and 5 reported no clear gender differential for men and women. However, meta-analysis was not conducted due to the heterogeneity of studies and thus no definitive conclusion could be reached about gender differential. On balance, the evidence indicates that men may be at greater risk of suicide in the aftermath of relationship. Yet despite acknowledgement that suicidal behaviors occur within the context of “a dynamic interaction between the process of separation, and individual and social factors” (Ide et al., 2010, p. 1709), there remains a dearth of empirically substantiated reasons as to why men might be at a higher risk. This article offers a narrative review of sociological explanations that may help understand the potentially gendered nature of this phenomenon in order to support both policy and practice.

The term relationship breakdown is used in the article, recognizing that while there is a propensity for studies to favor formal marital status (i.e., married, never married, divorced), a broader category may be more useful. A relationship crisis may plausibly lead to a suicidal act, even in a formally intact couple. The social significance of marriage has considerably changed in recent decades, with many couples cohabiting outside of formal marriage and many more publicly acknowledged same-sex partnerships. Consequently, a broader conception of relationship breakdown should include a wide range of circumstances, beyond formal legal dissolution, which may act as a trigger to suicide.

There is a broad body of sociological theory that can potentially help illuminate the source of gender differentials in suicide risk following the breakdown of intimate relationships. This includes articles on suicidal masculinities and also more general research and theory on gendered identities and gendered practices. It is important to move beyond a simple sex group binary of comparing men with women and instead to consider a diverse range of masculinities (Canetto & Cleary, 2012; Scourfield, 2005). Qualitative research can illuminate the diversity between men, and such studies are referred to in the sections that follow. The proposition that there is a singular construct of masculinity universally embodied by all men is not credible. However, some dominant gendered social practices are highly relevant to understanding the gendered character of suicide, and there is still some worth in sociological generalization about typical differences. In the following subsections, conceptual themes have been identified that hold some promise for theorizing gender differentials in suicide risk when relationships fail.

The Changing Nature of Intimacy

Some social theorists have claimed that the “pure relationship” is increasingly idealized in late modernity (Giddens, 1992), with an expectation that committed sexual partners will also be emotionally intimate, trustworthy, and engage in authentic interpersonal communication. Love, according to Beck and Beck-Gernsheim (1995, p.179) is the “new secular religion.” Changing expectations of intimacy will affect both men and women, but according to Whitehead (2002), the notion of love conflicts with the normative expectation of men as self-sufficient subjects. Hence, the idea of the pure relationship “does not work, either as theory or practice, unless men change” (p. 160). Whitehead further argues the quest for the elusive ideal of the “pure relationship” will only lead to disappointment and “serve to increase, rather than resolve, existential angst” (p. 161). So intimate relationships can be challenging for men and further to this, gendered expectations of men can affect their ability to cope emotionally when relationships fail. It may be that when expectations of intimacy are increased but relationships fail, men are more likely to have a self-destructive reaction, as opposed to communicating distress and seeking support. Although in reality males and females differ very little in terms of the experience of emotion, dominant discourses of masculinity suggest that the admission of distress, loss, and grief can signal weakness and be seen as an expression of feminine qualities (Cleary, 2012; O’Connor, Sheehy, & O’Connor, 2000; Oliffe, Ogrodniczuk, Bottorff, Johnson, & Hoyak, 2012).

Men’s Inflexible Roles and Loss of Honor

Traditional constructs of masculinity may be understood as detrimental to men’s mental health (Courtenay, 2011) due to the perceived inflexibility of men’s social roles compared with those of women, who are more adaptive due to the multitude of roles they must perform over the life course (Stack, 2000a). If role inflexibility is connected to emotional distress, a mediating factor may be loss of honor, leading to shame. According to Bourdieu (2001), honor is “a system of demands which remains, in many cases, inaccessible” (p. 50). It requires public affirmation and validation “before other men” (Bourdieu, 2001, p. 52). Scourfield (2005) has applied the idea of honor to men’s suicide, in circumstances where there is an overt and publicly acknowledged gap between the culturally authorized ideal of “hegemonic masculinity” (Connell, 1995) and the grim reality of life for men in crisis, so that a life without masculine honor is not seen as a life worth living. The “connecting contexts” of men’s relationships provide a space to represent their masculinity and prove their endorsement with the hegemonic form, by being a good partner, a family man, and a father (Oliffe et al., 2012). Where relationships break down and this enactment of the idealized masculinity is compromised, a sense of shame may ensue. However, this is not to suggest that women do not also experience separation-shame prior to suicide, as noted by Kõlves, Ide, and De Leo (2010).

Marriage as a More Positive Experience for Men Than Women

Men are often thought to derive more benefit from marriage than women, with the experience of being married entailing more distress for wives than for husbands (Trovato, 1991). As Trovato (1991) notes, wives tend to report more psychiatric distress than husbands, and unmarried females tend to have lower levels of distress or psychiatric disorders than unmarried males. Various explanations have been offered to explain the protective role of marriage for men, including the reduction of risk behaviors that are tied to masculinity and which precipitate suicide, notably alcohol and substance misuse (Payne, Swami, & Stanistreet, 2008). Equally, men receive important stability and support within marriage, which may be particularly important in light of the evidence that men have fewer alternative close relationships (Kposowa, 2003; Moller-Leimkuhler, 2003; Payne et al., 2008). Moreover, the embodiment of traditional caregiver roles means that women often look after the men in their lives (Oliffe et al., 2012). McMahon (1999) has described how the relatively recent model of new men who share domestic responsibilities equally with women is an ideal rather than a day-to-day reality. Most men still expect to be taken care of within intimate relationships, and when this care is withdrawn, psychological distress may ensue.

The assumption that men gain more from marriage is, however, challenged by some more recent research. Both Stack and Eshleman (1998) and Williams (2003) have reported no difference in levels of happiness and well-being according to marital status and marital quality. Williams argues that the assumption of marriage as more satisfying and protective for men is based on research evidence from the 1970s and which predates changes in gender and family roles ushered in by second wave feminism.

Furthermore, the plausibility of a causal connection between marriage and well-being for either sex may need to be tempered by the problem of matrimonial selection. This thesis supposes that people with psychiatric problems or suicidality are less likely to get married and stay married, so it should not be assumed that relationship breakdown causes suicidal distress (Smith, Mercy, & Conn, 1988). While the possibility of matrimonial selection suggests a need for further research on the interaction of mental health and marital status, there is arguably enough evidence to suggest that higher mortality in divorced or separated individuals is independent of initial morbidity and that the risk posed by selection should not be overstated (Burgoa, Regidor, Rodriguez, & Gutierrez-Fisac, 1998).

Control in Relationships

Mixed-methods research by Shiner, Scourfield, Fincham, and Langer (2009; see also Fincham, Langer, Scourfield, & Shiner, 2011) observed that evidence of actual or attempted control of partners was present in many suicides in men that were triggered by relationship breakdown (the majority in their small sample could be put into the category of domestic abuse). There were reactions of sexual jealousy when ex-partners started new relationships and acts ostensibly meant to punish ex-partners, with some examples of vituperative suicide notes. It is important to note that some self-destructive acts are at least partly motivated by the expected effect on others. These cases need to be put in the context of what is known about domestic abuse and the high prevalence of men’s controlling behaviors in intimate relationships (Garcia-Moreno, Jansen, Ellsberg, Heise, & Watts, 2006). Homicide-suicides, which are rare but culturally powerful events (Joiner, 2014), often feature extreme jealousy and the desire to control.

The Increasing Importance of the Care of Children

Dominant discourses of fathering are shifting, and the importance of men’s hands-on involvement in the care of children is increasingly emphasized, even though older discourses of men as providers have not faded (Lupton & Barclay, 1997; Shirani, Henwood, & Coltart, 2012). Divorce can have a particular impact on men, as they are more often the partner to lose their home, children, and family (Payne et al., 2008). Shiner et al. (2009) reported separation from children being cited as a factor in a number of coroners’ suicide inquests, and men’s separation from children seemed to be the primary causal factor in some cases. Moreover, disputes over the care of children postseparation can result in anger at court systems perceived to favor the interests of women (Kposowa, 2003). Kõlves et al. (2010) have noted that the legal negotiations associated with separation can be stressful experiences. They reported that men who perceived legal negotiations and property/financial issues as stressful were more likely to have serious suicidal ideation, while this same risk was not observed in separated women. The cultural context here includes the high-profile campaigns by fathers’ rights organizations about the perceived injustice of the family courts. Suicide cases have been cited within these campaigns, contributing to the idea that postdivorce contact and residence conflicts could be reasonable grounds for suicidal reaction.

Men’s Social Networks

The nature of men’s wider social relationships is an important consideration when an intimate relationship breaks down. Joiner (2011) has presented extensive evidence to suggest the loneliness of men. Even where men have a number of social contacts, the quality of these relationships might be such that these men are still lonely. Joiner notes that many men do not recognize this loneliness, preoccupied as they are with work, but in difficult times, for example, when a marriage fails, they might be suddenly stuck by their lack of meaningful social support. Even where social support may exist, the nature of these relationships may not protect against suicide. As noted earlier, there may be a propensity to conceal distress, as men’s policing of each other’s masculinity can lead to a fear of disclosing emotional vulnerability (Cleary, 2012; O’Brien, Hunt, & Hart, 2005). Conversely, women may not experience such a sense of loneliness following the dissolution of a relationship as they are more likely to have developed supportive networks and meaningful friendships (Kposowa, 2000). Equally, the construction of emotionality as a feminine trait may permit the expression of emotional distress within such relationships.

Conclusion

This brief narrative review article has discussed possible sociological explanations as to why men may be at greater risk of suicide than women in the aftermath of relationship breakdown. Some psychosocial issues were highlighted that could potentially inform the development of interventions to prevent suicide in the context of relationship breakdown. The issues of particular relevance to prevention would seem to be men’s role inflexibility, the increasing importance of the care of children, men’s desire for control in relationships, and men’s social networks.

One clear implication of the evidence that relationship breakdown is associated with heightened suicide risk is that when working with men and women already identified as at risk of suicide, practitioners need to be alert to the possibility that relationship breakdown can be a trigger to suicidal acts (Ide et al., 2010). There are also possible implications for a more population-based public health approach. One idea would be the promotion and greater free provision of services, which mitigate the most damaging aspects of relationship breakdown, such as relationship counseling and mediation. There are relationships that could be maintained with some help from a counselor or mediator. There are others that inevitably will come to an end, but that ending could be eased with a third-party mediator to help negotiate the process. This can be especially helpful when there are disputes over the care of children.

Social and educational program that encourage critical reflection on gender role socialization (see Featherstone, Rivett, & Scourfield, 2007) also have potential. There is a particular opportunity to develop these for young people, in schools, colleges, and youth clubs. An emphasis on encouraging boys and men to disclose distress to friends and family is one aspect that could help protect against suicidality. Another, more specific to men and to relationship breakdown, is an emphasis in interventions on questioning the need for control in intimate relationships.

Further research is also needed on this issue. It is important to move beyond the formal legal categories of married/separated/divorced. It is also especially important to explore the psychosocial circumstances that precede suicides. This will inevitably require qualitative, quantitative, and mixed-methods studies.