Day 543

In 2009 Thomas Joiner proposed the Interpersonal-Psychological (I-P) theory of suicidal behaviour.

Author of over 385 peer reviewed journals, Thomas Joiner has worked extensively in the field of psychology, neurobiology and suicidal behaviour.
As per the I-P theory, an individual will not die by suicide unless s/he has both, the desire and the ability to do so.
Who desires suicide?
There are 2 specific psychological states in their minds simultaneously:

  1. Perceived burdensomeness
  2. Low belongingness/social alienation.

Perceived burdensomeness:

“My death will be worth more than my life to family, friends, society, etc.” – a view that often represents a potentially fatal misperception. Studies have shown that this is a robust predictor of suicide attempt status and of current suicidal ideation, even controlling for powerful suicide-related covariates like hopelessness.

Low belongingness:

Not feeling like an integral part of a family, circle of friends, or other valued group.  As with the research base on perceived burdensomeness, there is abundant evidence that this factor is implicated in suicidal behaviour. A study by Joiner in 2008 showed that college students’ suicidal ideation peaked in the summer semester when the campus is less active. This accounted, in part, for the association between semester and suicidality.

How does one overcome the powerful instinct for self-preservation?

By developing a fearlessness of pain, which is acquired through a process of repeatedly experiencing painful events such as previous self-injury, repeated accidental injuries, numerous physical fights and occupations like physician and front-line soldier in which exposure to pain and injury, either directly or vicariously, is common.

The Interpersonal-Psychological theory is a promising one with growing evidence base. It suggests that clinicians be cognizant of their patients’ levels of belongingness, burdensomeness, and acquired capability (especially previous suicide attempts), as this knowledge may aid clinicians in the task of suicide risk assessment and of targeting ttreatments.

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