Suicide is helplessness hopelessness loneliness.

In The Suicidal Mind, Shneidman discerns psychache as the root of suicide — psychache as thwarted and distorted psychological needs that play out in the “drama of the mind.”[1] “Suicide never stems from happiness,” writes Shneidman. “It happens because of the stark absence of it.”

“Suicide is, by definition, a lonely, desperate, and unnecessary act.”

Psychache is the need for love, acceptance and belonging frustrated through rejection and alienation. The need for achievement, autonomy, and order, frustrated through fractured control, unpredictability, and instability. The need for protection, frustrated as defeat, humiliation, disgrace. The need for nurturance, frustrated as failed and hurtful relationships. The need for dominance and counteraction, frustrated into rage and hostility.

While a particular crisis may catalyze suicide, its very possibility follows from a “larger life pattern.” “All our activities at home, in school, on the street, on the job, during the day, after ours, and in our dreams and fantasies, are expressions of these needs that, to one degree or another, motivate our lives.”

Suicide is then constriction: the narrowing of life to an all or nothing proposition, in which to be or not to be is the only question.
Suicide is disconnection between thoughts and feelings (alexithymia): thoughts unregulated by feelings, feelings in free fall, without the organization of thought.

The split maintains the “illusion of control,” which is at once dizzying, disorientating, and nauseating: “therein lies madness.” “No one commits suicide out of joy,” writes Shneidman. “The enemy to life is pain.”

Aaron Beck et al. identifies hopelessness as the crucial link between depression and suicidal behavior. Hopelessness “is the catalytic agent,” write Beck, correlative to “impaired reason.” “The patient systematically misconstrues his experiences in a negative way and, without objective basis, anticipates a negative outcome to any attempts to attain his major objectives or goals.”[2]

Hopelessness, in turn, may be correlated to suicidal intent, which is the “relative weight of the patient’s wish to live and his wish to die, his psychological deterrents against yielding to suicidal wishes, and the degree to which he has transformed his suicidal wishes into a concrete plan or act oriented to death.”

These findings helped to produce the Beck Hopelessness Scale, “a psychometric means of measuring the intensity of … hopelessness.”[12] In contrast to psychodynamic analyses, the Hopelessness Scale relies on the patient’s thoughts and responses to twenty true/false questions:

True or False: I might as well give up because there’s nothing I can do to make things better for myself.

True or False: I happen to be particularly lucky and I expect to get more of the good things in life than the average person.

True or False: I never get what I want, so it’s foolish to want anything.

True or False: My past experiences have prepared me well for my future.

In “Aloneness and Borderline Psychopathology: The Possible Relevance of Childhood Development Issues,” Gerald Adler and Dan Buie focus on “intolerable aloneness” through “unmodulated separation or abandonment anxiety.”

“A child never acquires the ability to manage his emotional state,” they write. “The result is a “panic state,” out of control emotion, and a high incidence of suicide.”[3]

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[1] Edwin Shneidman, The Suicidal Mind (New York: Oxford University Press, 1996).
[2] Beck Aaron, et al., “Hopelessness and Suicidal Behavior,” JAMA 234, no. 11 (1975): 1146–1149..
[3] Gerald Adler and Dan Buie, “Aloneness and Borderline Psychopathology: The Possible Relevance of Childhood Development Issues,” in Essential Papers.