Norman Louis Farberow (February 12, 1918 – September 10, 2015) was an American psychologist, and one of the founding fathers of modern suicidology. 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, Farberow enrolled in the University of California, Los Angeles. While enrolled in UCLA's doctoral program in psychology Farberow studied suicide. With few relevant references to draw upon for his 1949 dissertation, Farberow saw the potential for reawakening “interest in a long-neglected, taboo-encrusted social and personal phenomenon.”Farberow, N. L. My Legacy in Suicide: Professional and Personal. Unpublished manuscript. Farberow earned his doctoral degree from UCLA in 1950 while working with veterans in the Veterans Administration 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 Air Force Captain.Kosky et al. (1998). , Suicide Prevention: The Global Context, SpringerLink. The war years were a time in the United States of relatively low suicide rates, a wartime phenomenon commonly observed when a nation's armed forces and citizens unite under feelings of common purpose and mutual goals.Shneidman, E. S., Farberow, N. L., & Leonard, C. S. (1961) Some facts about suicide. Public Health Service Publication No. 852. Washington, D. C.: Superintendent of Documents, U. S. Government Printing Office.
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,Farberow, N. L. (Ed.) (1963). Taboo Topics. New York: Atherton Press. embedded in cultural and religious condemnations of shame, guilt, self-blame and cowardice, magnified an underlying sense of worthlessness and hopelessness.
Farberow saw the effects of these dynamics and focused on solutions including 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 his colleague, Dr. Edwin Shneidman.
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.Shneidman, E. S. & Farberow, N. L. (1956). Clues to suicide. Public Health Reports, 71, 109-111. 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 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.
The scientific investigation of suicide A suicide prevention center In 1958, Farberow and Shneidman launched the nation's first center of its kind, the Los Angeles Suicide Prevention Center (LASPC)Litman, R. E., Shneidman, E. S., & Farberow, N. L. (1961). A suicide prevention center. American Journal of Psychiatry, 117, 1084-1087. with the psychiatrist 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 professional 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 interventionFarberow, N. L., Heilig, S. M., and Litman, R. E. (1968). Techniques in Crisis Intervention: A Training Manual. Los Angeles: Suicide Prevention Center, Inc. and 24-hour accessibility of professionals or rigorously trained non-professionals.Heilig, S. M., Farberow, N. L., and Litman, R. E. (1968). "The role of nonprofessional volunteers in a suicide prevention center", Community Mental Health Journal, 414. These efforts led to the development of the L.A. Scale for Assessment of Suicidal PotentialLitman, R. E., & Farberow, N. L. (1961). Emergency evaluation of self-destructive potentiality. In N. L. Farberow and E. S. Shneidman (Eds.), The Cry for Help. New York: McGraw-Hill Book Company.Litman, R. E., Farberow, N. L., Wold, C. I., & Brown, T. R. (1974). "Prediction models of suicidal behaviors", In Aaron Beck, H. L. P. Resnik and Dan J. Lettieri (Eds.), Prediction of Suicide. Bowie, Md.: Charles Press Publishers, Inc., Ch. X, 141-159. and the crisis hotline.Litman, R. E., Farberow, N. L., Shneidman, E. S., Heilig, S. M., and Kramer, J. (1965). "Suicide prevention telephone service", Journal of the American Medical Association, 192:1, 21-25.
As the LASPC's reputation as an informed referral center grew,Shneidman, E. S. & Farberow, N. L. (1965). "The Los Angeles Suicide Prevention Center: A demonstration of feasibilities", American Public Health Journal, January, 25:1, 21-26. collaboration with the coroner’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,Farberow, N. L. (1969). "Training in suicide prevention for professionals and community agents", American Journal of Psychiatry, 125:12, 1702-1705. 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, 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.Shneidman, E. S. & Farberow, N. L. (Eds.) (1957). Clues to Suicide. New York: McGraw-Hill Book Company; (Japanese Translation) Tokyo: Seishin Shobo Company, 1968. 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.Shneidman, E. S. & Farberow, N. L. (1956). "Clues to suicide", Public Health Reports, 71, 109-111. 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, were disregarded.Farberow, N. L. (1981). "Suicide prevention in the hospital", Hospital and Community Psychiatry, 32(2):99-104. 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, depression, anxiety and dysthymia,Farberow, N. L. & Heilig, S. M. (1990). "The suicide prevention center: concepts and clinical functions", in Howard J. Parad and Libby Parad, Crisis Intervention. Baltimore: Charles Publishing Company. as well as suicidal factors in patients with physical health problems, such as cancer,Farberow, N. L., Shneidman, E. S., & Leonard, C. S. (1963). "Suicide among general medical and surgical hospital patients with malignant neoplasms", Washington, D. C.: Veterans Administration Medical Bulletin, 9. cardiorespiratory illnesses,Farberow, N. L., McKelligott, J. W., Cohen, S., & Darbonne, A. R. (1966). "Suicide among patients with cardiorespiratory illnesses", Journal of the American Medical Association, 195:422-428. and others.
Other cultural influences 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 autopsyLitman, R. E., Curphey, T. J., Shneidman, E. S., Farberow, N. L., & Tabachnick, N. D. (1963). Investigations of equivocal suicides. Journal of the American Medical Association, 184, 924, 929. as a procedure for evaluating the critical factor of intention.Cutter, F., Jorgensen, M., Farberow, N. L., Ganzler, S., & Sapin, D. P. (1968). Ratings of intention in suicidal behavior. Veterans Administration Newsletter for Research in Psychology, May, 10:2, 36-37. 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, Robert Walker, and Marie McDonald. The procedure gained international application as Farberow enlisted other international researchers in the study of personality differences in modes of death in FinlandFarberow, N. L. (1977). "Research in suicide 1971-1973: A review", In Kalle Achté and Jouko Jonnqvist (Eds.), Suicide research in Finland 1974-1977. Psychiatria Fennica Supplementum 1976, 23-47. Helsinki: Psychiatria Fennica. with comparisons of suicides in Los Angeles, Vienna,Farberow, N. L., & Simon, M. D. (1969). Suicides in Los Angeles and Vienna: An intercultural study of two cities. Public Health Reports, 84:5, 389-403. and Stockholm, among others.Farberow, N. L. (Ed.) (1975). Suicide in Different Cultures. Baltimore, Md.: University Park Press, 286 p.
Indirect self-destructive behavior