Why People Die by Suicide / Edition 1

by Thomas Joiner

Overview

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 neurobiology—facts 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.

Product Details

ISBN-13:	9780674025493
Publisher:	Harvard University Press
Publication date:	09/30/2007
Pages:	288
Sales rank:	494,549
Product dimensions:	5.50(w) x 8.25(h) x 0.75(d)

About the Author

Thomas Joiner is Distinguished Research Professor and Bright-Burton Professor of Psychology at Florida State University.

Table of Contents

Acknowledgments

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

Epilogue

What People are Saying About This

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.

Carla Fine

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

Pauline Boss

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

Editorial Reviews

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

It is the synergy and tension between Joiner's dual identity as suicide survivor and academic that imbues this book with both its power and a certain logical grandiosity...Joiner is to be commended for a powerful effort to integrate science and personal tragedy. In an easily digestible style, he reviews the breadth of modern suicide scholarship—biological, psychological, and social, and presents his integration clearly and forcefully.

Boston Globe - J. Michael Bostwick

The Florida State University psych professor, who grew up here and endured the suicide of his father not far from their Atlanta home, asserts that suicide is not simply an act but a process. Joiner describes how a person works up to suicide by overcoming the fear of death and the instinct for self-preservation. In accessible, somber prose, he also explains the conditions under which a person becomes suicidal.

Atlanta Journal-Constitution - Lawrence Wright

Mr. Joiner's book is a useful guide to suicidal behavior...Mr. Joiner draws on many scientific fields—genetics, neuroscience, psychiatry, evolutionary psychology—all of which, he thinks, have something to offer the study of suicide. The major lesson of his book is the necessity of keeping the ability to commit suicide from coinciding with the desire for death...His book is a practical study, full of up-to-the-minute research.

Wall Street Journal - Thomas Meaney

Many researchers and clinicians have tried to explain why people commit suicide. The majority of studies that have been conducted to date have examined correlates and risk factors for suicidal behavior. However, many of these risk factors are found throughout the general population, and the vast majority of people do not engage in suicidal behavior. Dr. Joiner's theory is one of the first that integrates many of these risk factors into an explanatory model. His model makes sense both intuitively and empirically. What makes Dr. Joiner's theory particularly credible is the research that he and his students have done to support his model. Additionally, he is able to use his theory to explain such diverse behaviors as the suicide attacks on 9/11 and Kurt Cobain's suicide. What makes this book particularly interesting is that it begins with a prologue detailing Dr. Joiner's personal account of loss by suicide...This book is a must-read for clinicians and researchers who are involved with suicidal patients. Dr. Joiner's model highlights the acute risk factors for serious suicidal behavior thus providing tangible targets for assessment and treatment. Additionally this volume is an excellent resource for family members who have lost a loved one to suicide...Based upon the book's combination of sound scientific research with thoughtful personal reflections and examples it is given a strong recommendation.

Cognitive Behavioral Therapy Book Reviews - Elizabeth L. Jeglic

[Joiner's] theory is the most comprehensive yet put forth to explain why some people end their lives. Joiner offers a dizzying array of studies to shore up his argument, and some of the evidence he offers is quite novel for the lay reader.

Newsday - Philip Connors

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

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

Taking one's own life goes against one of our strongest urges—the instinct of self-preservation. The deterioration of this instinct, says Thomas Joiner, should be regarded as a symptom of disease...His theory, outlined in Why People Die by Suicide is that it happens when severely depressed people acquire fearlessness. How do people become fearless? Through practice and learning, he says. This explains the bouts of self-harm or failed suicide attempts that are not cries for help so much as rehearsals for a deadly finale.

The Times - Anjana Ahuja

The change in the way I now look at my dad's death comes because of [this] compelling book.

The Times - Steve Martin

Many researchers and clinicians have tried to explain why people commit suicide. The majority of studies that have been conducted to date have examined correlates and risk factors for suicidal behavior. However, many of these risk factors are found throughout the general population, and the vast majority of people do not engage in suicidal behavior. Dr. Joiner's theory is one of the first that integrates many of these risk factors into an explanatory model. His model makes sense both intuitively and empirically. What makes Dr. Joiner's theory particularly credible is the research that he and his students have done to support his model. Additionally, he is able to use his theory to explain such diverse behaviors as the suicide attacks on 9/11 and Kurt Cobain's suicide. What makes this book particularly interesting is that it begins with a prologue detailing Dr. Joiner's personal account of loss by suicide...This book is a must-read for clinicians and researchers who are involved with suicidal patients. Dr. Joiner's model highlights the acute risk factors for serious suicidal behavior thus providing tangible targets for assessment and treatment. Additionally this volume is an excellent resource for family members who have lost a loved one to suicide...Based upon the book's combination of sound scientific research with thoughtful personal reflections and examples it is given a strong recommendation.
— Elizabeth L. Jeglic

Cognitive Behavioral Therapy Book Reviews

The Florida State University psych professor, who grew up here and endured the suicide of his father not far from their Atlanta home, asserts that suicide is not simply an act but a process. Joiner describes how a person works up to suicide by overcoming the fear of death and the instinct for self-preservation. In accessible, somber prose, he also explains the conditions under which a person becomes suicidal.
— Lawrence Wright

Atlanta Journal-Constitution

It is the synergy and tension between Joiner's dual identity as suicide survivor and academic that imbues this book with both its power and a certain logical grandiosity...Joiner is to be commended for a powerful effort to integrate science and personal tragedy. In an easily digestible style, he reviews the breadth of modern suicide scholarship—biological, psychological, and social, and presents his integration clearly and forcefully.
— J. Michael Bostwick

Boston Globe

Mr. Joiner's book is a useful guide to suicidal behavior...Mr. Joiner draws on many scientific fields—genetics, neuroscience, psychiatry, evolutionary psychology—all of which, he thinks, have something to offer the study of suicide. The major lesson of his book is the necessity of keeping the ability to commit suicide from coinciding with the desire for death...His book is a practical study, full of up-to-the-minute research.
— Thomas Meaney

Wall Street Journal

[Joiner's] theory is the most comprehensive yet put forth to explain why some people end their lives. Joiner offers a dizzying array of studies to shore up his argument, and some of the evidence he offers is quite novel for the lay reader.
— Philip Connors

Newsday

The change in the way I now look at my dad's death comes because of [this] compelling book.
— Steve Martin

The Times

The change in the way I now look at my dad's death comes because of [this] compelling book.
— Steve Martin

The Times

Guggenheim Award winner Joiner (psychology, Florida State Univ.) provides a fascinating contribution to psychological literature that is certain to join the ranks of mile Durkheim's Suicide and Karl Menninger's Man Against Himself. Not only has Joiner established professional prominence in suicidology, but he also has a profound personal relationship with the subject: his own father died by suicide. Drawing on the pain of this experience as well as on clinical and epidemiological evidence, Joiner has managed to conduct significant research into why some people die by suicide, while others survive their attempts at self-annihilation. His persuasive thesis is that practice, mental and physical, is what separates the completers from the attempters. In particular, those who have become desensitized to physical pain are most likely to orchestrate their own deaths successfully. Joiner also identifies perceived burdensomeness, little sense of belonging, genetics, neurobiology, and mental disorders as contributors to suicidality and completion. Akin to Kay Redfield Jamison's superb Night Falls Fast: Understanding Suicide, this book is strongly recommended for all university and public library collections.-Lynne F. Maxwell, Villanova Univ. Sch. of Law Lib., PA Copyright 2005 Reed Business Information.

Library Journal

Reviewer: Steve C. Lee, MD (Rush University Medical Center)
Description: This ambitious presentation of Thomas Joiner's theory on suicide contains ample citations of the current literature as well as personal insights.
Purpose: The author's aim is to provide a unifying theory explaining why certain people die by suicide. He highlights the pressing need for a deeper understanding of suicide by referring to known epidemiological data and also by sharing the personal toll of losing his father to suicide.
Audience: This book will appeal to both mental health professionals and lay persons who have a personal interest in the topic of suicide. It is clear that the book is a product of the author's passionate life work. His expertise is evident through his own studies in addition to his knowledge of the available body of literature.
Features: The introduction draws one into the aftermath of the suicide of the author's father. It proceeds to survey the current state of knowledge regarding suicide. He then synthesizes a theory whereby completed suicide is the product of an interaction between perceived burdensomeness, failed sense of belonging, and the acquired ability to enact lethal self-injury. This theory is subjected to testing by examples in the real world. His theory is a psychological one and he does a commendable job summarizing what is known genetically and biologically from the psychiatric literature. He also presents practical implications for further research and screening and treatment options.
Assessment: Thomas Joiner has produced an impressive book that can engage professional and lay person alike. Intellectual prowess merges with an impeccable writing style unlike anything I've seen in the mental health literature. It is worthy of nonfiction bestseller status. But more importantly, it may provide windows of opportunity to prevent suicides by enlightening one's intuitive sense of the motivation and experience of suicidal people.

Doody's Review Service