The Ringel Service Award: The Man

Abstract

The Ringel Service Award of the International Association for Suicide Prevention (IASP) honors Erwin Ringel (1921–1994), the founder of the Association and arguably the most influential figure in 20th-century suicide prevention. Ringel was born in Temesvar, Rumania, and lived in Austria from 1926 on. He graduated with a degree in medicine from the University of Vienna in 1946 and then trained in psychiatry, individual psychology, and neurology. His early mentors included Professors Hans Hoff and Oskar Spiel. In 1948 he established a suicide prevention center in Vienna under the auspices of the Catholic Church charity Caritas. He was innovative in other ways as well, introducing a psychiatric clinic exclusively for women, as well as the first psychosomatic clinic in Vienna. He was Professor of Medical Psychology at the Institute for Medical Psychology of the Medical School of the University of Vienna from 1981 until his retirement in 1991. He remained active in retirement, and continued to produce celebrated sociopolitical works. Ringel was a persuasive man, and through his lobbying in 1970 the Austrian government recognized the need for formally supporting suicide prevention activities. For his work in this and other mental health and social initiatives he was awarded the prestigious Karl Renner Prize and the Cross of Honor for Science and Art (Ehrenkrenz fur Wissenschaft und Kunst) by the Austrian government. In 1960 Ringel established the IASP. He was not only the Founder and inaugural President of the IASP, but his ex-officio role of Founding President beginning in 1969 enabled him to have continuing active input into the administration of the organization for a further 20 years. It was during that period, and with the able assistance of his “fellow disciple” (Ringel, 1988) in suicide prevention, Gernot Sonneck, that the, at times, faltering Association survived and evolved into its present influential role in worldwide suicide prevention. His early suicide-prevention activities and his foresight in establishing the IASP are well described in his “Founder’s Perspective” (Ringel, 1988). A bibliography of his work until 1981 was published in Crisis (1981), and in all he contributed over 600 publications to the literature. The results of his early research were contained in the classic book, Der Selbstmord, Abschlus einer krankhaften Entwicklung [Suicide, Termination of a Psychological Development] (Ringel, 1953). In this he described what was to become an important term in suicidology, “the presuicidal syndrome.” This arose from his studies determining the emotional state of suicide attempters just prior to their suicidal act, and it describes the constriction of affect and intellect, inhibited aggression, and suicidal fantasies in those who are suicidal, and which are now well recognized in clinical practice. These features have been summarized in English by Sonneck (1986), and remain as valid now as when first articulated 50 years ago. The importance of “the presuicidal syndrome” is that it cuts across diagnostic boundaries, and “constitutes a common denominator of all psychiatric disorders that may result in suicide” (Lonnqvist, 1998), thereby allowing for a multimodal therapeutic approach. Another important work was his book Selbstschadigung durch Neurose [Neurotic Self-Destruction], (Ringel, 1973), which provides a broader overview of suicidal behavior. Ringel did not confine his work to examining psychological aspects of suicide prevention. He was an advocate for psychosomatic medicine, and he emphasized the importance of teaching it as part of medical training (Ringel, 1973). He also wrote on social, political, and religious matters. Indeed, Haenel and Battegay (1991) noted that his writings were at times provocative and tended to polarize readers, with some being “provoked to opposition, negating some of his theses.” This is not unexpected when the title of one of his books is considered: Religionsverlust durch religiose Erziehung [Loss of Religion Through Religious Education] (Ringel, 1985). Ringel was an astute social critic, and during the Nazi era his views were expressed without personal concern. He publicly called Hitler a psychopath in 1943; he wrote on antisemitism in his popular book Die osterreichische Seele [The Austrian Soul], (Ringel, 1984), and he was an oppo-