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Suicidal thoughts and planning in the Book of Tobit – psychiatry in sacred texts

Published online by Cambridge University Press:  22 August 2022

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Abstract

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Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

The Book of Tobit is a short but charming Jewish novella found in the Apocrypha. It concerns the family life of Tobit and his relatives, who live in the Persian diaspora, and was written in Aramaic probably between 200 and 300 bce but comes to us through its Greek translation. Tobit is blinded when some pigeon droppings fall into his eyes and this causes his depression. Sarah is distressed because all seven times she gets married her bridegrooms die on their wedding night, leaving the marriages unconsummated, and this is all the work of the wicked Persian demon Asmodeus. As a consequence, both Tobit and Sarah suffer from depression and suicidal thoughts. The Book of Tobit is non-canonical in both the Jewish and Protestant religions, but is canonical for Catholics. Tobit 3: 1–11 and 16 is read in Catholic churches in the two-year cycle on the Wednesday of the ninth week of year one, and the following verses give a good description of their depression and suicidal thoughts.

Tobit's depression and suicidal thoughts:

1 Then with much grief and anguish of heart I wept, and with groaning began to pray […] 6 ‘So now deal with me as you will; command my spirit to be taken from me, so that I may be released from the face of the earth and become dust. For it is better for me to die than to live, because I have had to listen to undeserved insults, and great is the sorrow within me. Command, O Lord, that I be released from this distress; release me to go to the eternal home, and do not, O Lord, turn your face away from me. For it is better for me to die than to see so much distress in my life and to listen to insults.’

Sarah's suicidal thoughts:

10 On that day she was grieved in spirit and wept. When she had gone up to her father's upper room she intended to hang herself. But she thought it over and said ‘Never shall I reproach my father, saying to him “You had only one beloved daughter but she hanged herself because of her distress”. And I shall bring my father in his old age down in sorrow to Hades. It is better for me not to hang myself, but to pray to the Lord that I may die and not listen to these reproaches anymore.’ 11 At the same time, with hands outstretched towards the window, she prayed and said […] 12 ‘And now Lord, I turn my face to you and raise my eyes towards you. 13 Command that I be released from the Earth and not listen to such reproaches anymore. […] 15 […] But if it is not pleasing to you, O Lord, to take my life, hear me in my disgrace.’

These short extracts give us a clinically authentic description of suicidal thoughts at around 300 bce that resemble those spoken by patients today. Thus, suicidal thoughts tend to be repetitive and the prayers of both Tobit and Sarah, which ask God to take their lives, are repeated several times. An indication of the severity of suicidal thoughts is whether there is any indication of planning or method. Sarah reports her intention to hang herself in her father's upper room, which gives a clear description of intent, method and planning. Sarah does not do it, but what holds her back is the thought of the distress it will cause a close relative, in her case, her father. Today most patients with strong suicidal thoughts are also commonly restrained by thoughts of their relatives, often their children. The Book of Tobit has only six characters, five of whom have either depression or anxiety and depression; a more detailed account is given my book The Hidden Psychiatry of the Old Testament.

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