The Pain of Suicide: It’s Not About Wanting to Die, It’s About Wanting the Pain to Stop

The Pain of Suicide

Video: Learning More About Suicide

10 Commonalities of Suicide

Below are 10 commonalities of suicide, identified by suicide expert, Edwin Shneidman, author of The Suicidal Mind.

1. The common purpose of suicide is to seek a solution: A suicidal person is seeking a solution to a problem that is “generating intense suffering” from within.
2. The common goal of suicide is cessation of consciousness: The anguished mind of a suicidal person interprets the end of consciousness as the only way to end the suffering.
3. The common stimulus of suicide is psychological pain: Shneidman calls it “psychache” by which he means “intolerable emotion, unbearable pain, unacceptable anguish.”
4. The common stressor in suicide is frustrated psychological needs: A suicidal person feels pushed toward self-destruction by psychological needs that are not being met (for example, the need for achievement, for nurturance, or for understanding).
5. The common emotion in suicide is hopelessness-helplessness: A suicidal person feels despondent, utterly unsalvageable.
6. The common cognitive state of suicide is ambivalence: Suicidal people, Shneidman says, “wish to die and they simultaneously wish to be rescued.”
7. The common perceptual state in suicide is constriction: The mind of a suicidal person is constricted in its ability to perceive options, and, in fact, mistakenly sees only two choices—either continue suffering or die.
8. The common action in suicide is escape: Shneidman calls it “the ultimate egression (another word for escape) besides which running away from home, quitting a job, deserting an army, or leaving a spouse…pale in comparison.”
9. The common interpersonal act in suicide is communication of intention: “Many individuals intent on committing suicide…emit clues of intention, signals of distress, whimpers of helplessness, or pleas for intervention.”
10. The common pattern in suicide is consistent with life-long styles of coping: A person’s past tendency for black-and-white thinking, escapism, control, capitulation and the like could serve as a clue to how he or she might deal with a present crisis.

“The Suicidal Mind” by Edwin Shneidman

The suicide of a child of any age presents unique circumstances that can intensify and prolong the mourning process for parents, family members and friends. Suicide is believed to be a reaction to overwhelming feelings of loneliness, worthlessness, helplessness, hopelessness and depression. Suicide is the third leading cause of death in the United States among 10-14 year olds and 15-24 year olds, and the second leading cause among 25-34 year olds.

2017 The Compassionate Friends, USA

Video: Learning More About Suicide

Understanding the Suicidal Mind

” Psychache” torments individuals who often do not want to die; they just cannot escape.

Understanding the Suicidal Mind, Sally Spencer-Thomas, PsyD

Experts who study suicide coined the term “psychache” to describe the excruciating psychological pain that suicidal people experience, which often blocks the ability to see other potential solutions to problems. “Psychache” torments individuals who often do not want to die; they just cannot escape. Even though a pervasive sense of hopelessness stifles the ability for many to seek help, most suicidal people are very ambivalent about taking their lives. Another common metaphor people use to describe suicidal pain is feeling trapped in a completely darkened room with no way out.

Understanding the Suicidal Mind, Sally Spencer-Thomas, PsyD

In his book Why People Die by Suicide, Dr. Thomas Joiner explains that those who [die by suicide] not only have a desire to die, they have also learned to overcome the instinct for self-preservation. This theory goes beyond previous theories of suicide that were adequate in describing psychological risk factors but did little to explain why some people with those risk factors died by suicide and others did not. 

Understanding the Suicidal Mind, Sally Spencer-Thomas, PsyD

A Model of Suicide Risk

A Model of Suicide Risk
A Model of Suicide Risk, Why People Die by Suicide, Thomas Joiner

…wanting death is composed of two psychological experiences. The first is a perception of being a burden to others (perceived “burdensomeness”). [And] when people are in this state, they feel that their death is worth more to the people who love them than their life is. The word “perceived” is emphasized because frequently these thoughts are significantly distorted by depression or other mental disorders. While conventional wisdom might believe that the suicidal person is selfish, Joiner has found the opposite to be true.

Understanding the Suicidal Mind, Sally Spencer-Thomas, PsyD

Those who desire [to die by] suicide often believe that they have become such a burden on others, everyone will be better off if they are not around. In other words, in the mind of the suicidal person, they are practicing ultimate selflessness. When we combine this emotionally painful experience of being a burden with isolation, suicidal despair often results.

Understanding the Suicidal Mind, Sally Spencer-Thomas, PsyD

Video: Understanding the Suicidal Mind

Thus, the second common factor in the desire to die is a social disconnection to something larger than oneself (thwarted belongingness). As humans, we are hardwired to be in a relationship with others. For some people, this means just a couple of very intense relationships; for others, it means vast social networks.

When people lose key relationships with partners, children, colleagues, and friends through death, divorce, separation, moves, layoffs, or conflict, they can experience profound distress that can lead to a desire to die. Marked social withdrawal is not temperamental shyness. Rather, it’s a marked change: the person used to be engaged with friends and family, and now they withdraw into a bedroom or into their own head, and what you see is what Dr. Joiner calls “an inward gaze of bemused resignation and resolution.”

Understanding the Suicidal Mind, Sally Spencer-Thomas, PsyD

Suicide attempts by the young have quadrupled over six years, and that is likely an undercount.

Along with suicides, since 2011, there’s been nearly a 400 percent increase nationally in suicide attempts by self-poisoning among young people. “Suicide attempts by the young have quadrupled over six years, and that is likely an undercount,” said Henry A. Spiller, director of the Central Ohio Poison Center, who called the trend “devastating.” “These are just the ones that show up in the E.R.”

Jane E. Brody, December 2019, The New York Times, “The Crisis in Youth Suicide”

Nationally, suicide has emerged as the second leading cause of death for children ages 10-19 old.

Nationally, suicide has emerged as the second leading cause of death for children ages 10-19 years old.

*Nearly 1 in 6 teens has seriously contemplated suicide in the past year.

*Suicide affects people of all backgrounds. 

*Early identification of risk factors can aid behavioral health specialists in prevention strategies for youth at risk of suicide.

*Suicide is complex and tragic yet often preventable if communities are provided with the right tools.

Nationwide Children’s Hospital, Center for Suicide and Research

Acquired Capacity for Suicide

3 Contributing Factors for Acquired Capacity for Suicide

In his book Why People Die by Suicide, Thomas Joiner outlines three factors that contribute to an individual’s acquired capacity for suicide:

1. You are born with it. Some people just come into the world with a temperament for risk-taking. They do not seem to be afraid of anything. Natural risk-takers in our society include law enforcement personnel and military, skydivers, adventure explorers, race car drivers, and emergency room doctors. These folks are not at risk for suicide unless they have the first half of the diagram, “desire for suicide.” Should that desire ever develop, however, they have less distance to cross to self-harm because the fear of death or pain is not as great as in other people.
2. You learn it. Other people may not be born with this innate sense of courage, but they learn it over time by living through painful and provocative experiences. By being exposed to violence and life-and-death situations, people become more accustomed and less afraid. For some people, this means a history of physical or sexual abuse. For others, it is chronic injuries or illnesses that require adapting to high levels of pain. For still others, it may be repeated suicidal thoughts or attempts.
3. You have access to and familiarity with lethal means. For example, you might have at hand firearms, lethal medications, and access to high places. The more comfortable a person is with the lethal means of suicide, the more likely he or she will choose that method should he or she find themselves wanting to die by suicide.

Further Reading: Thomas Joiner, Why People Die by Suicide (Cambridge, Massachusetts: Harvard University Press, 2006).

Suicide is not despair. Dictionaries define despair as the complete lack or absence of hope. But that’s not what happens in most suicides. What does happen?

The person who is taking his or her own life is not intending that act as an insult or affront to God or to life (for that would be an act of strength and suicide is generally the antithesis of that). What happens in most suicides is the polar opposite. The suicide is the result of a mammoth defeat.

When Someone is Too Bruised to Be Touched: On Suicide, Despair, and Addiction, Fr. Ron Rolheiser