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Daniel

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A new book by FSU psychology professor Dr. Thomas Joiner entitled Why People Die of Suicide states that three of the most significant markers of suicide risk are:

- "the feeling of being a burden on loved ones"
- "the sense of isolation"
- "the learned ability to hurt oneself"?

Regarding the last point, the book states:? "People cannot develop the ability to lethally injure themselves quickly; the experiences that are required take time and repetition. By contrast, people can quickly develop views that they do not belong or that they are particularly ineffective...Repeated risk assessment is thus necessary..."?

A 29-page PDF excerpt of the book:
http://www.hup.harvard.edu/pdf/JOIWHY_excerpt.pdf

more info from the publisher:
http://www.hup.harvard.edu/catalog/JOIWHY.html
 

Daniel

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Revisiting Impulsivity in Suicide

...Although the causes of suicide are complex, they are not mysterious, and in fact are becoming better understood thanks to decades of scientific research. One comprehensive theory of suicide is Joiner’s (2005) interpersonal-psychological theory. Importantly, at least 20 empirical studies on this theory have been conducted, and all were supportive (Van Orden, et al., 2008). According to this theory three proximal, jointly necessary, and sufficient causes must be present before a person will die by suicide; these are: 1) feelings of perceived burdensomeness, 2) a sense of thwarted belongingness, and 3) an acquired capability to lethally self-harm. Perceived burdensomeness occurs when a person believes his/her death is worth more than his/her life to others. In essence, a person experiencing burdensomeness feels that others would be better off if s/he were dead. Thwarted belongingness results when one of the basic human needs, to be connected to others (Baumeister & Leary, 1995), is not met. Both perceived burdensomeness and thwarted belongingness are theorized to contribute to the desire for suicide (c.f., suicidal ideation), and elevated levels of both perceived burdensomeness and thwarted belongingness have been found to significantly predict suicidal desire (Van Orden, Witte, Gordon, Bender, & Joiner, 2008).
 

suewatters1

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I have the sense of isolation the feeling of not belonging not fitting in this world. I feel I don't have this sense of purpose for why I should be here. The only thing it would matter to my family if I were gone but not to me.

Sue
 

Daniel

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Yeah, which is why the researcher mentions in his book therapies like CBT for dealing with those maladaptive schemas (such as negative self-stereotypes).

Similarly, from a book by a different author:
Cognitive Behavior Therapy for Suicide
 

Jazzey

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I think that what I'd like to pull from that is mostly just knowing where it's coming from. So, understanding that stress reinforces certain patterns of thinking. It doesn't mean that we can't pull out of them. But maybe with an understanding of those patterns, we can use other coping mechanisms to pull out of the thinking patterns.

I hope I didn't butcher the meaning here.


Actually...just realized that this is what you were saying, Daniel. Sorry.
 

Daniel

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Also, regarding CBT:

"What are you telling yourself to make yourself suicidal? You largely constructed your depression. It wasn't given to you. Therefore, you can deconstruct it. What do you think you're telling yourself to make yourself this way?" We'd get the client to admit things like, "I don't like my life," and then we'd say, "Yeah, but that wouldn't induce you to commit suicide. What else are you telling yourself?" And that's when clients say things like, "It shouldn't be the way it is. It's terrible that I failed. I'm no good." That's when we hear the shoulds, the oughts and the musts, and then we convince the client to abandon these irrational demands. Our slogan is, "I will not should on myself today."

~ Albert Ellis

http://forum.psychlinks.ca/suicide/22682-the-inner-voice-that-drives-suicide.html
 
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There are a lot of times when the word should can be replaced with could (and other words),. I find using could takes away a certain power from a sentence. (Like the power to induce guilty feelings ect),, could leaves room for choice and options. Sometimes should is like an order... the only thing you can do or supposed to do. It does have its place but is used too often imho.
 

amastie

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I'm not suicidal though that sometimes feels more attractive to me. I'm tired. Living with unresolved mental illness has done that. More important to me is my spiritual belief which means that every experience is important, my reason for being, so I won't suicide. Neither would I ever advocae it because I *do* believe in the value of all our experence, although I can understand why some people contemplate it. I'm not in their shoes. I would only hope that those people have access to all possible supports before they get that far.

- amastie
 
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I think lost of hope is the main reason people leave as one just does not see any escape from the sadness and yes one does get to the point where one feels it would be better for all if they left

That is why it is so important that people do not take away any hope from the people that are suffering
One just needs to know there will be a door opened for them to help them get support they need to heal.
When one feels so isolated so ignored not cared for not important enough then they will feel they only have one option
 

Daniel

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Yes, of course, hopelessness is a big issue. But while hopelessness is necessary for a person to be at a high risk of suicide, a person can feel very hopeless without being suicidal. So the point of Joiner's book is that other things are necessary, including becoming increasingly less fearful of suicide itself.

So, for example, I remember when I was a depressed young adult, on a couple of occasions both my psychologist and psychiatrist would remind me that I could end up as a vegetable if I attempted suicide again. I don't know how much that helped in the long term, but it seemed to help in the short term. And such "scare tactics" are used to some degree by Marsha Linehan when appropriate, namely informing the client that attempting suicide is never a sure thing.

---------- Post added at 12:55 PM ---------- Previous post was at 11:43 AM ----------

But to your point, the book says that lethality -- the learned ability to hurt oneself, such as from previous suicide attempts -- is built up over time and there is relatively little that can be done about after the fact. So the emphasis on treatment is with the first two factors, which can vary on a day-to-day basis and are amenable with CBT.

---------- Post added at 02:28 PM ---------- Previous post was at 12:55 PM ----------

So, anyway, I would agree that hopelessness can be a precursor to all three factors mentioned by Joiner.

---------- Post added at 03:26 PM ---------- Previous post was at 02:28 PM ----------

And the book makes it clear that hopelessness is required for the first two factors, which can be referred to as hopelessness about belongingness and burdensomeness.

BTW, concerning treatment, my favorite point in the book is that emotional dysregulation (a focus of DBT) can also be a precursor for all three factors.
 
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