In the wake of a suicide, the most troubling questions are invariably the most difficult to answer: How could we have known? What could we have done? And always, unremittingly: Why? Written by a clinical psychologist whose own life has been touched by suicide, this book offers the clearest account ever given of why some people choose to die.
Drawing on extensive clinical and epidemiological evidence, as well as personal experience, Thomas Joiner brings a comprehensive understanding to seemingly incomprehensible behavior. Among the many people who have considered, attempted, or died by suicide, he finds three factors that mark those most at risk of death: the feeling of being a burden on loved ones; the sense of isolation; and, chillingly, the learned ability to hurt oneself. Joiner tests his theory against diverse facts taken from clinical anecdotes, history, literature, popular culture, anthropology, epidemiology, genetics, and neurobiologyfacts about suicide rates among men and women; white and African-American men; anorexics, athletes, prostitutes, and physicians; members of cults, sports fans, and citizens of nations in crisis.
The result is the most coherent and persuasive explanation ever given of why and how people overcome life's strongest instinct, self-preservation. Joiner's is a work that makes sense of the bewildering array of statistics and stories surrounding suicidal behavior; at the same time, it offers insight, guidance, and essential information to clinicians, scientists, and health practitioners, and to anyone whose life has been affected by suicide.
Thomas Joiner is Distinguished Research Professor and Bright-Burton Professor of Psychology at Florida State University.
Table of Contents
Prologue: Losing My Dad
1. What We Know and Don't Know About Suicide
2. The Acquired Ability to Enact Lethal Self-Injury
3. The Desire for Death
4. What Do We Mean By Suicide and How Is It Distributed in People?
5. Genetics and Neurobiology of Suicidal Behavior, and the Roles of Impulsivity, Childhood Adversity, and Mental Disorders
6. Risk Assessment, Crisis Intervention, Treatment, and Prevention
7. Summary and Conclusion
What People are Saying About This
As a survivor, I find this book to be illuminating, informative, and, most of all, healing. Joiner searches for the "why" of suicide as both a scientist and a survivor himself, and his research and insights help us to make sense of the pain and confusion that led our loved ones to end their lives. Carla Fine, author of No Time To Say Goodbye: Surviving The Suicide Of A Loved One
In a book both personal and scientific, Thomas Joiner gives us the deepest understanding of suicide that has yet been written. He reminds us that to go on living we need to feel that we belong to someone and that we are effective. But he adds a surprising third factor--we must not break down our fear of death. Joiner offers wise guidance not only to professionals, but to those who must live on after this kind of death in the family. Pauline Boss, author of Ambiguous Loss
Aaron T. Beck
Joiner provides an elegant description of what leads people to commit suicide and what professionals, families, and friends can do to prevent the crisis that this tragedy creates for everyone involved. Aaron T. Beck, M.D., University Professor of Psychiatry, University of Pennsylvania