Suicide and Forced Marriage

Abstract

The prevailing view that the vast majority of those who complete suicide have an underlying psychiatric disorder has been recently challenged by research on the contribution of "predicaments", in the absence of mental illness, to suicide. In this paper, we sought data to support the notion that forced marriage may lead to suicide without the presence of psychiatric disorder.
Historical records, newspapers, and the electronic media were searched for examples.
Two examples from ancient times and six from the last hundred years were located and described.
These cases suggest that forced marriage may lead to suicide and complements earlier findings that loss of fortune, health, liberty, and reputation may lead to suicide in the absence of mental disorder.

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Original Article
Suicide and Forced Marriage
Saxby Pridmore
1
, Garry Walter
2
1
Discipline of Psychiatry, University of Tasmania, Hobart, Tasmania,
Australia
2
Discipline of Psychiatry, University of Sydney, and Child and Adolescent
Mental Health Services, Northern Sydney Local Health District, Sydney,
NSW, Australia
Submitted: 3 Jun 2012
Accepted: 31 Jul 2012
Abstract
 Background:Theprevailingviewthatthevastmajorityofthosewhocompletesuicidehave
anunderlyingpsychiatricdisorderhasbeenrecentlychallengedbyresearchonthecontributionof
“predicaments”,intheabsenceofmentalillness,tosuicide.Inthispaper,wesoughtdatatosupport
thenotionthatforcedmarriagemayleadtosuicidewithoutthepresenceofpsychiatricdisorder.
 Method: Historical records, newspapers, and the electronic media were searched for
examples.
 Results: Twoexamplesfromancienttimesandsixfromthelasthundredyearswerelocated
anddescribed.
 Conclusion:Thesecasessuggestthatforcedmarriagemayleadtosuicideandcomplements
earlierndingsthatlossoffortune,health,liberty,andreputationmayleadtosuicideintheabsence
ofmentaldisorder.
Keywords: marriage, social condition suicide, prevention
Introduction
The conventional and dominant medical
wisdom is that all (1) or almost all (2) suicide is
the result of mental disorder.
Our group has developed the concept of
“predicament suicide” (3), according to which
suicide is viewed as a response to intolerable
circumstances. These predicaments are of two
main types; one is intractable or untreated
mental disorder, and the other entails social or
environmental stressors. Of course, individual
cases may manifest both types simultaneously.
Our contribution to the literature has been
to strengthen the argument that, at times, social/
environmental factors (in the absence of mental
disorder) may lead to suicide. To this end, we
have used accounts of suicide on the public
record (from mythology, history, and press). We
have described suicide by apparently mentally
healthy individuals who have suffered damage
to reputation (4), in particular, as a result of
having been revealed as pedophiles (5), people
in other forms of moral dilemma (6), people with
intractable illness (7), and people having lost life
savings (8). We have also examined suicide pacts,
in which the most common factor was the loss of
health of one or both members (9).
The circumstances in the above paragraph
are predominantly loss, and it appears that
these suicides are a means to escape the pain of
the loss. In the current paper, we are concerned
with suicide associated with forced marriage.
There is an important distinction to be made
between “arranged” and “forced” marriage.
In the former, the choice of whether to accept
the offer remains with the two central gures,
notwithstanding the uncertainty or “pressure”
that they may feel regarding the arrangement.
In contrast, in forced marriage, one or both
individuals are non-consenting and coercion is
used to ensure compliance.
In the forced marriage setting, suicide
may represent a means of avoiding potentially
distressing events, entrapment, control by others
or as a loss of a keenly anticipated, positive
future. The aim in this paper is to present
examples from the public record (from mythical
times to the current day) of suicide associated
with forced marriage in apparently mentally
healthy individuals as a means of increasing our
understanding of suicide.
Quantitative studies of the relationship
between forced marriage and suicide are not
yet available. However, in China, the most
common negative life events leading to suicide
have been identied as “those related to family
relations, love affairs, and marital issues” (10).
In India, death from burns (which could be
murder or suicide) are frequently associated
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Malays J Med Sci. Mar-May 2013; 20(2): 47-51
with “dowry and family quarrels and marital
disharmony” (11). In Turkey, the suicide rate
of is higher in young women (15–24 year olds)
than young men, and the causative factors for
young women include forced marriage, young
marriage age and low literacy (12). Although our
focus is on forced marriages, we acknowledge
that, depending on circumstances, any marriage
– forced or otherwise – can be stressful for the
individuals and the couple, culminating in a
range of adverse psychiatric outcomes.
Methods
An extensive search was made of historical
texts, newspapers, and the electronic media.
Factiva (media), PsycInfo, Medline, general
internet, and manual searches were conducted.
These tools were used to identify both ancient
texts and cases from the last 100 years.
Results
Eight cases (two from ancient texts and
six from the last hundred years) were located
and are presented. Many reports, including one
from Yakin Erturk, Special Rapporteur of the
United Nations Commission on Human Rights
(13), make clear that forced marriage not
infrequently leads to suicide, but do not provide
individual examples.
Daphne
In Greek mythology, Daphne was a minor
nature deity and Apollo (son of Zeus) was a major
Olympian deity. In The Metamorphoses, Ovid
(14) reports that Cupid shot both with arrows.
The one which hit Daphne (a sworn virgin) didn’t
have the expected outcome, but the one which
hit Apollo had a profound effect. He chased her
across the countryside. When she was about to be
caught, she called to the Gods, “cover with green
earth/This body I wear too well” (page 19), and
was immediately transformed into a (laurel) tree.
Thus, Daphne chose to cease living as a human
rather than marry or participate in physical
intimacy.
Aino
Aino is a beautiful young woman in the
Finnish national epic poem, “The Kalevala” (15),
which records events from ancient times up until
about 900 CE. She was promised by her brother to
an old man, Vainamoinen, with magical powers.
Rather than marry Vainamoinen, Aino drowned
herself in a river.
Aino has been celebrated in paintings and
an opera by Finnish artists. Aino was the most
popular name for girls in Finland in 2006 and
2007.
Miss Chao (died, 1919)
Chao Wu-chieh of Changsha, China, was
engaged to marry Wu Feng-lin of Kantzuyuan,
China. The marriage had been arranged. The
couple had met on a couple of ceremonial
occasions. Miss Chao disliked her husband-to-
be, but her parents insisted that the marriage go
ahead. When she was raised up in the bridal chair,
to be carried shoulder-high to her husband-to-
be’s home, she drew a dagger and cut her throat,
killing herself.
We know about her death because Mao
Tse-tung (16) wrote on the events several times.
Interestingly, he stated, “A person's suicide
is entirely determined by circumstances”. He
railed against the culture of the time and the lack
of individual rights, and recommended social
change.
Gul Rukh (died, 1976)
In the vast majority of cases of forced
marriage leading to suicide, the bride is decades
younger than her husband. In this Afghani case,
the reverse was the situation (17).
The Gul and Malang families were related.
When Rukh was 1 year old, a boy was born into
the Malang family. When he was 1 month old,
the families arranged their marriage and an
engagement was celebrated according to local
custom. However, the boy died at 2. When Rukh
was 5 years old, another son was born to the
Malang family, and she was again promised in
marriage. When the husband-to-be was 17, he was
killed by accident, during wedding preparations.
Rukh was then promised to the youngest Malang
family son, Khan (aged 5 years).
Kahn was teased at school for being engaged
to an “old woman”, and he protested that he did
not want to marry Rukh. Nevertheless, they were
married when Rukh was 37 and Khan was 20
years. He rejected her and the following year she
died by self-immolation.
Fariba (died 2007)
Fariba was 18 years of age and lived in the
Kapisa province of Afghanistan. She had been
pleased to become engaged to Mujahid, aged 22,
3 years earlier. However, Mujahid had gone
to work in Iran, and when he returned he was
addicted to drugs. In these circumstances, Fariba
was adamant that she did not want to marry him

Original Article | Suicide and forced marriage
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49
(18). As pressure to marry increased, and she
could not persuade her parents otherwise, she
completed suicide by shooting.
Adyru Begum (died, 2010)
Adyru Begum was 12 years of age, a grade 5
student living in Rangpur, Bangladesh. Against
her will, her father arranged her marriage to an
adult man (Enamul Haque). After the marriage
ceremony, and during the wedding feast, Aduri
completed suicide by taking poison (19).
Mitu Molla and Soud Sheikh (died, 2012)
Mitu Molla (16 years) and Soud Sheikh
(17 years) lived in neighboring villages in
Gopalganj district, Bangladesh. After their affair
became public, Molla’s mother took her to a town
200k from her village and married her against
her will, to a man twice her age. At this point,
Sheikh was at high school in the capital Dhaka.
Two months later, when Molla went home
to visit her parents, Sheikh left Dhaka and
met her in her village. On Valentine’s Day, they
tied their hands together and jumped to their
deaths from a mobile phone tower. Sheikh had
earlier telephoned his brother to say that they
planned to die on Valentine’s Day “to stay together
forever” (20).
Amina Filali (died, 2012)
Amina was 15 years of age when she was
raped, in Morocco, by a man 10 years her senior.
The matter went to court and the judge ordered or
recommended (depending on reporting source)
that the couple marry. By this mechanism, her
honor would be restored and her rapist could
avoid a lengthy jail sentence. In Morocco, the age
of consent to marry is 18 years, but this can be
varied in special circumstances (21).
Amina married her rapist and lived at his
family home. Her mother (Zohra) reports that he
beat her severely, and shortly afterwards, Amina
completed suicide by ingesting rat poison.
Discussion
Our aim was to seek information as to whether
forced marriage might lead to suicide. At least one
epidemiological study (12) and anecdotal report
(13) support the notion of a causal relationship.
We found two stories from ancient times (one
Greek and one Finnish) and six stories from the
past hundred years in which death was preferred
to an unacceptable marriage–substantiating
the above-mentioned material. Whether these
ancient people (Daphne and Aino) ever existed, or
behaved as described, is not critical - the point is
that myths and legends advise us about the range
of possible human responses and, in many cases,
the responses that are recommended.
The details of the six stories from the
last hundred years are limited, as might be
expected, emanating as they do from isolated,
disadvantaged regions. The story of Miss Chao
was recounted a number of times by Mao Tse-
tung, and could perhaps have been distorted for
political purposes, but subsequent scholars (22)
have conrmed the events. The story of Amina
Filali (who died in 2012), whose marriage to her
rapist was ordered/recommended by a court, has
received international attention, and the facts are
probably substantially correct.
We have sought to extend understanding
of suicide. The “one-size-ts-all” notion that all
or almost all suicide is attributable to mental
disorder is unhelpful, and has recently been
called into question by other researchers (23).
Adherence to the belief places responsibility for
suicide with psychiatry. It puts clinicians in peril
during Coroners’ Court hearings, and denies the
possibly of non-psychiatric interventions which
may have benecial outcomes. Notwithstanding
these issues, psychiatrists and other mental
health professionals retain a role in identifying,
understanding and ameliorating psychosocial
risk factors that might play a part in suicide in
those without mental illness.
In our earlier work, we have acknowledged
that environmental/social events such as loss of
fortune, health and reputation may not only lead
to psychiatric illness, such as depression, anxiety,
and adjustment disorder, but we have also
suggested that those events may lead to suicide
in the absence of mental disorder. Here, without
discounting situations where forced marriage may
lead to suicide and simultaneously be associated
with psychiatric disorder, we are proposing that
forced marriage may, alone, lead to suicide. The
use of qualitative methodology, whose value
in psychiatric research is being increasingly
recognized (24), facilitated our understanding of
the potential motivations to suicide in the cases
described. The motivation may be to escape the
attention of a disliked individual, the loss of an
ideal future, a feeling of entrapment or similar
unacceptable circumstances. The Gul Rukh case
is somewhat atypical in that the association of
forced marriage and suicide appeared to relate
to rejection, shame and narcissistic humiliation;
in this case, too, however, there was an apparent
lack of mental disorder.

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Malays J Med Sci. Mar-May 2013; 20(2): 47-51
Acknowledgement
We thank Dr Nerissa Soh for her assistance.
Conict of interest
Nil.
Funds
Nil.
Authors’ Contributions
Conception and design, analysis and interpretation
of the data, drafting of the article, critical revision
of the article for the important intellectual
content, nal approval of the article, provision of
study materials or patient, statistical expertise,
obtaining of funding, administrative, technical
or logistic support and collection and assembly of
data: SP, GW
Correspondence
Professor Garry Walter
MBBS (UNSW), BMedSc (UNSW), PhD (USyd),
FRANZCP, Cert Child Psych (RANZCP)
Coral Tree Family Service
PO Box 142, North Ryde
NSW, 1670, Australia
Tel: +612-9887 5830
Fax: +612-9887 2941
Email: gwalter@mail.usyd.edu.au
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