Why People Die by Suicide

by Thomas E. Joiner

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.

Genres: Psychology, Nonfiction, Mental Health, Mental Illness, Counselling, Science, Philosophy

276 pages, Paperback

First published January 15, 2005

About the author

Joiner, Thomas.
Joiner, Thomas E.
Joiner, Thomas E. Jr

Thomas Joiner is an American academic psychologist and leading expert on suicide. He is the Robert O. Lawton Professor of Psychology at Florida State University, where he operates his Laboratory for the Study of the Psychology and Neurobiology of Mood Disorders, Suicide, and Related Conditions. Joiner holds a Ph.D. from the University of Texas at Austin.

Reviews

[Claude · Rating 2 out of 5]

A suicide book. Yes it's a subject I claim to know a lot about, and this book is written by my often enemy: a psychologist. In my personal experience I am continually disappointed by the stupidity of both psychologists and psychiatrists, and this book is no exception.
There are some interesting anecdotes in this book, which I was not aware of before, which made the book worth reading. But Thomas Joiner's annoying habit of stating things like, "In my model" and "my interpretation", is extremely annoying and devoid of any real knowledge. These are not exact quotes as I am too lazy to offer anything verbatim.
So Thomas Joiner's father died of suicide - this means nothing! This doesn't guarantee that he has any kind of understanding of a suicidal person's mind. There are plenty of idiot aspiring psychologists at university, and qualified ones working in the field, who seem to think that their vicarious mental illness experiences qualify them as some kind of expert. Nothing could be further from the truth. How many idiot psych students have I met on campus who "want to help people", often because, "their mother has schizophrenia." Just because your intentions are admirable does not mean you have the necessary skills to help people. I have observed time and time again that psychologists have an inflated sense of what their professional work achieves. A psychologist's work is - and can only ever be - a metaphysical kind of help/worth/value. And I hate it when a psychologist (or even a psychiatrist) pretends that they have some kind of influence over a patient, that is grounded in scientific inquiry, when they are no more than an 'elaborate' councillor. I would prefer to speak to a switched on councillor than a psych any day. Qualifications for the most part mean nothing, in a field that is dominated by idiots. If you don't believe me, all you need to do is meet the students at any university studying psychology, and you will find out that on average they are significantly more air-headed than other faculties.
I go on a bit, yes I do. It's just that Thomas Joiner pisses me right off with his virtually worthless suicidal model. Just because his father died by suicide, does not qualify this comedian any more than someone else. And the fact that he is a Professor of Psychology doesn't mean much either - this could still mean that his IQ is relatively low. Don't be fooled in to thinking that academic qualifications equate to knowledge, and especially intelligence, all too often (sadly) they don't.
Those who know the most about suicide are the ones who have help the knife closest to their heart, and come within the nearest proximity to death by their own accord (and lived obviously), --- not those that have trivial pieces of paper from institutions that entry requirements are mediocre.
I should say something nice about the book. The model Thomas develops might be empirically true, and congratulations to him (a hint of sarcasm there), on pointing out the obvious. Anyone with half a brain and a minuscule understanding of suicide and mental illness, innately knows most of what he has said. But this is the world we live in, I suppose, we must spell things out for the stupid. Which is what people are taught when undergoing a psych degree. Sigh.

[Gerri Alexander · Rating 4 out of 5]

Last year my friend was diagnosed with a deadly form of ovarian cancer. She had lost her parents at 10 years old, which meant she had to quit school in 5th grade and became a maid. She eventually came to America, has a husband and several young children who depend on her.

At the same time we knew a young man who also had lost both parent by the time he was 17, but he was stong and healthy, had graduated from high school and had a house and car he'd inherited from his grandparents.

Which one is still alive today?

Thomas Joiner asked the question, why do some people kill themselves but not others? He looked at several studies of suicidal behavior to try to determine the risks. He found that people were most likely to kill themselves if they didn't feel connected to other and if they had knowledge of how to accomplish the act.

The human body is designed to work under a lot of stress. Killing yourself is actually pretty difficult and we have a natural fear of pain. Joiner found that suicidal people often "practice", by making little steps toward the act.

He also found that some people are at greater risk than others--doctors, military, police--because they are taught the skills as part of their job.

But feeling part of a group can protect them. For example marines might feel proud of being part of something and feel like others depended on them. Or a doctor might feel like his patients needed him.

The mother had many friends who she asked to pray for her, her family rallied around her providing transportation and care. The young man also had extended family who cared about him. He was supposed to be watching their animals while they were on vacation, but used their computer to get information on how to kill himself and used their car to drive where he could do it.

This was a great book to help understand why suicides happen, but by itself it won't do any good. It can inform people so they can possibly keep an eye on their loved ones, but unfortunately people may only be interested in reading it when it is really too late.

[Marti · Rating 3 out of 5]

Not a great book. More like "I have a theory. I am going to repeat it until you believe it." But I didn't believe it.

[Mihrdāt · Rating 4 out of 5]

زمانی که فاجعه‌ی دردناک خودکشی اتفاق می‌افتد، همراه حزن بی‌اندازه‌ی آن، ناباوری و بهتی میان نزدیکان می‌پیچد که چه شد؟! مسکوت ماندن جزئیات و دلایل رخداد این تراژدی تا همین امروز مسبب آن است که بارها جهت غلطی را -در جهت ستایش و تجلیل یا در جهت ساده‌انگاری و تقلیل آن-  برای قضاوت پیش بگیریم. اگر قرار است جان فردی که در لبه‌ی خطر قرار گرفته را نجات دهیم یا رنج بازماندگان این حادثه را التیام بخشیم نیاز است تا به خودکشی به چشم یک بیماری مرگبار که به قول ولتر «بر نیرومندترین غریزه‌ی حیاتی غلبه می‌کند» نگاه کرد، و از سازوکار و ملزومات مواجهه با آن آگاهی داشت.


توماس جوینرِ روانشناس که خودشْ خودکشی پدرش را از او گرفته از دیدگاه یک دانشمند اما در عین حال بسیار همدلانه در این کتاب خودکشی را موشکافی می‌کند.

او علاوه بر مروری بر نظریات انگشت‌شماری که در زمینه‌ی خودکشی پرداخته شده‌اند (چون دورکیم، مِنینگر، اشنایدمان، بومایستر و...) نظریه‌ی خودش را مطرح می‌کند که از دو بازوی اشتیاق به مرگ و توانایی انجام اعمال مرگ‌آور تشکیل شده. اشتیاق به مرگ -که عنصر دینامیک و پرتغییر نظریه‌ است- در نتیجه‌ی ادراک احساس باری بر دوش بودن و عدم تعلق اجتماعی شکل می‌گیرد و توانایی اجرای اعمال مرگبار هم با در معرض تجربه‌های دردناک و تحریک‌آمیز قرارگرفتن و عادت‌کردن به آنها می‌تواند شکل بگیرد که عنصر سخت و کم‌تغییری‌ست.
حجم زیادی از کتاب به تحلیل داده‌های کلان، بالینی و حتی داستان‌هایی از شاعران و خوانندگان پیرامون همین نظریه می‌پردازد و به این سوالِ معمولاً بی‌پاسخ‌مانده جواب می‌دهد که چرا با وجود عوامل خطر فراوانی که وجود دارند، میزان رخداد خودکشی پایین است.

کتاب همچنین به پژوهش‌های انجام‌شده برای روشن‌کردن نقش ژنتیک، نوروبیولوژی، خصایص شخصیتی و اختلالات روانی در پیدایش ریسک خودکشی می‌پردازد و در نهایت برای اقدامات لازم برای پیشگیری، مداخلات در شرایط بحران و درمان خودکشی توصیه‌های مفیدی برای خوانندگان متخصص دارد.


”متنفرم که او آخرین لحظاتش روی زمین را تنها پشت یک ون در پارکینگی گذراند.
متنفرم که هنگام مرگ او می‌بایست این نظر (اشتباه) را داشته باشد که از سوی عزیزانش و جهان به‌طور کلی رها شده.
متنفرم که من و مادرم و خواهرانم مجبور شدیم تحت بلاتکلیفی وحشتناک اتفاقی که برای پدرم افتاده بود قرار بگیریم؛ فقط برای کشف حقیقتی که بلاتکلیفی پیش آن آسان می‌نمود.
از تصور اینکه در آخرین لحظات هشیاری خود ممکن است خیلی دیر از تصمیم خود پشیمان شده باشد به خودم می‌لرزم.
و حسرت می‌خورم که خداحافظی نکرد.“

[Kasi Beorchia · Rating 4 out of 5]

I read this book as a requirement in preparation for providing gatekeeper trainings for suicide prevention. This book is absolutely ground-breaking in the suicide prevention world. Though it reads like a textbook or really long research paper often, there are so many valuable insights about the importance of social connection and competence/self-efficacy in preventing suicide.

There was a particularly powerful insight at the end of the book that has stuck with me:

"Theorists and scientists who work on suicide are often asked why they have chosen their field of study. Isn't the topic morbid and depressing? My answer is probably predictable by now--there is nothing depressing about working to prevent and relieve the kind of suffering that my dad, my family, and millions of others go through. This alone is enough of a reason to study suicide."

[ehk2 · Rating 2 out of 5]

notes: meaningless comments on Derrida and Lacan; superficial treatment of sociological and psychoanalytical explanations. so discouraging to read, after chp.1

[Rachel · Rating 1 out of 5]

I read this is 2017 but I was recently reminded of this stupid book, and I despise both the book and the author so much that I decided to lower the rating from 2 to 1 out of spite.

[arireadsthings · Rating 2 out of 5]

While I agree with several parts of this book, I also found that many of Joiner’s arguments were incredibly biased and based in assumption rather than fact. For example:

-Joiner uses the example of a specific transgender woman who he believes is more likely to die by suicide because she underwent many surgeries and thus became accustomed to pain (one of his arguments for why people die by suicide). However, he completely negates the other potential causes of increased suicidality in this case, including how challenging it must be to live in a body that does not align with one’s view of themselves or how being a gender non-conforming individual in today’s society might negatively impact mental wellness.
-The author suggests that people with tattoos and piercings are more apt to die by suicide because they are more accustomed to pain. However, he fails to acknowledge other potential causes for this association (i.e. maybe those with increased psychological pain seek out hobbies that cause physical pain to act as a distraction or punishment, in the same way self-harm serves a purpose? Or maybe suicidal individuals find more joy in decorating their bodies?)
-Joiner notes that times of war or high crisis decrease calls to crisis lines, which he assumes means people are less suicidal during this time. However, there could be a number of other reasons for this, including that they are experiencing other kinds of crises or access to mental health resources during these times may be limited. He uses a quote that says, during these high crisis situations, people are, “Forgetting one’s petty difficulties”. This approach is minimizing and harmful.
-The author says higher rates of suicide in rural communities may be due to rural areas being cultures of honor (tied into his perceived belongingness argument), but he fails to consider other causes like fewer access to mental health resources and greater stigma around mental illness.
-Joiner claims that he can’t call kamikaze pilots or martyr deaths suicides because they don’t meet his criteria for thwarted belongingness or perceived burdensomeness, but this feels like he is picking and choosing arguments to support his hypothesis (which is the general feel of the whole book, honestly). Maybe if something doesn’t fit the argument, then it should be taken as evidence that the theory is not all encompassing, instead of assuming that other standards are inaccurate due to a hypothesis that has yet to be accepted as standard.

These are just a few examples of arguments that I felt were not well thought out and manipulated evidence and statistics to meet his needs. Do I believe thwarted belongingness and perceived burdensomeness play into suicide rates? Absolutely. However, I struggle to support the approach this book took in arguing the case.

[Kat McMullen · Rating 4 out of 5]

This book helped me when I was left behind. This is not a book to give to someone to help them with their own struggles, but an academic analysis for someone grappling with a devastating loss and trying to understand "why" in an intellectual way. There are no easy answers, but reading this book helped me to grieve and feel less guilt-ridden about someone else's permanent choice.

[Dan · Rating 5 out of 5]

This is a good read for anyone trying to understand suicide. Joiner takes a very personal approach as his father committed suicide. He revisits that throughout the book. He also reflects on his experience as a clinician and researcher. He presents what he thinks is a more compelling model for the causes of suicide, or at least what contributes to someone completing a suicide. From Harvard press, “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 also addresses the key areas of intervention and treatment, but it seems these are best left to the mental health professionals.

Suicide is a full-fledged epidemic in the U.S. military and increasingly looks like a national epidemic.

I have not read any other books on this topic, but I am certain you could do worse than Joiner.

[Tori · Rating 2 out of 5]

9 - I am halfway through this book, and not sure if I will finish it. I have read a lot on this subject, and this book is really slow reading for me. A lot of it is pretty technical. The author talks about prior theories about why people commit suicide and then his own theory. I was interested in reading it as I was going through the "why's". I think this book might be better for psychologists than for S.O.S.

[Calvin Caulee · Rating 2 out of 5]

I cannot give this book the minimum 3 stars.

This book is an example of the dangers of being a reductionist when it comes to complex phenomenon. The use of limited research and bias from the get go. It's a disjointed attempt to explain suicide on a global level using just three factors.

[Madilynn · Rating 4 out of 5]

I read this book for my internship with the suicide hotline, and I think it was a really meaningful novel to read. I think anyone who wants to understand more about why people die by suicide would benefit from this book.

[Mary Chase Mize · Rating 5 out of 5]

Transformative and life changing - as a counselor and fellow human being.

[kate j]

probably could have been an article, not a book — important theories all the same.

[Jenn Amanda (she / her) · Rating 4 out of 5]

4.5⭐

I enjoyed this a lot and my biggest issue is that Joiner was detailed in how some died even though he acknowledged that media outlets doing so could be harmful to those contemplating suicide.

[Gabby Applebaum · Rating 4 out of 5]

Disclaimer: had to read this for class. However fabulous book!! Really enjoyed it and learned a lot!

[Corin · Rating 5 out of 5]

I am only about 1/3 into this book. It is an empathetic discussion of suicide, from the point of view of a family member (Joiners's father killed himself).

Joiner begins the book by discussing his experience as a survivor. He makes a profound comment that it is not necessary to understand suicide in order to be compassionate about it. Likewise, trying to prioritize understanding suicide can interfere with one's compassion. Maybe it is true, in other words, that there is an accurate psychoanalytic response to a suicidal person, but at the same time the person really just needs compassion and willingness to listen. Not to understand the urge or event itself, necessarily, but the understanding to put listening first. (This reminds me of Victor Frankl's argument that a suicidal person may be pathological, but philosophically correct, and it is important that the clinical response not invalidate the philosophical decision because the person has shown pathological reason).

The argument then moves to how the suicidal person develops a tolerance for pain and an understanding of how the body responds to the threat of death. He points out that there is a biological instinct to live, and how in acting destructively the person is "practicing" suicide. Thus repeated suicide attempts are like research. A person makes gestures to alleviate extraordinary pain, but also because it is because part of the pain of suicide is that we are ambivalent to the very end--there is some part of us that wants to live, even at the point of very serious suicide attempts. So the way of "practicing" suicide is to see what it is like to override this most automatic of reflexes, to protect against self-harm.

I am trying to read the book for practice and policy implications. I think that there are many ways that suicide can be reduced, and it would probably not include involuntary treatment.

There is another book that has recently come out by Arthur Kleinman and others, called Reducing Suicide, which I would like to read after this one.

[Davie · Rating 4 out of 5]

I was inspired to read this after learning that more active duty soldiers are dying by suicide than in combat. @)$*)#*!?!!?

Joiner is a researcher in the field, so he is as much an expert as there is -- although of course standard experimental designs aren't possible (pesky ethics and all that). And sadly, he has personal expertise. His father committed suicide. His research is particularly relevant to military suicides, more below.

He starts with an entertaining survey of the ideas about why people commit suicide through the ages. Many were contributed by philosopher / psychoanalyst types, who were more inspired by Grand Ideas than data. Against this background, the novelty of his ideas is striking.

What Joiner is after is a way to distinguish the subset of very depressed/distressed people who are likely to go on to attempt/succeed at suicide from the larger group who have almost identical symptomology on many dimensions. The Joiner theory of suicide is that two psychological factors are particularly key in predicting whether someone will attempt suicide: (1) perceived burdensomeness/self-efficacy and (2) perceived connectedness + one life experience factor: (3) tolerance for physical pain -- presumably very high in military personnel. Leahy's review on amazon does a good job of explaining these concepts. http://www.amazon.com/Why-People-Suic.... The book describes para-experimental data that supports these ideas with varying persuasiveness. One idea I found particularly disturbing was that many people who are eventually "successful" have a history of partial efforts/attempts that are a kind of tragic practice/rehearsal -- in contrast to the idea that early unsuccessful attempts are nonserious cries for help.

This is probably THE book to read about the topic if you want a survey of what is known from a research perspective, especially since there are many many more "my personal account" books than books like this. This book contains a bit of that, but much much more.

[Rachael · Rating 4 out of 5]

I read this book at a watershed in my relationship with my personal history. Joiner's theories, after years of research, meta analysis, and lived experience (his father died by suicide), prove to be both simple enough to understand, logical enough to make sense, and almost heartening to those of us who live in the wake of suicide. Suicide, so often seen as selfish or inexplicable, has long been stigmatized more than almost any other cause of death which results in both a failure to help suicidal people properly and also a failure to help all the victims of a suicide: the family, the friends. What Joiner proposes is that there are three major factors in suicide: belongingness (or lack thereof), burdensomness, and tolerance to pain/self injury, and that people who commit suicide do not feel as though they belong (not that they actually don't have connections, but that they do not feel connected - much like body dysmorphic disorder or other mental illnesses, this lack of belongingness might not be obvious to others), that they are a burden to those around them, and who have inured themselves to pain and/or the idea of violence and self-injury.
This is a fairly scientific book, as Joiner pulls from both his own research and other studies done in order to support his theory, much more so than his later Myths About Suicide. This academic tone was not at all a detraction for me, but it did make his frequent references to Kurt Cobain a little jarring. I can understand wanting examples, and Cobain is arguably the most famous modern suicide, but I felt these inclusion were unnecessary. Still, this is an obviously minor drawback in an overall solid and approachable text. While Joiner doesn't deserve all the credit for the measure of peace I have found, I will give him credit for helping me re-frame some of my old conceptions.

[Mark · Rating 3 out of 5]

This is the best -that is, most persuasive- book I've found on the subject. The author's thesis, buttressed by a great deal of research, has the benefit of simplicity: people kill themselves when they feel they don't belong to another person; feel they are not effective in their own lives; and have habituated themselves to the thought of death by "practicing" suicide -that is, by harming themselves or repeatedly putting themselves in harm's way or by attempting, in ever more rigorous fashion, suicide itself.

Having lost a brother to suicide, I can say that the theory perfectly fits with what I know of his death and the circumstances leading up to it.

The author -whose father killed himself- is also very good on the pain, guilt and bewilderment that survivors feel; and he's especially good on the further pain inflicted on survivors by people who, through lack of compassion or fear or moral idiocy or misplaced tact or bewilderment of their own, fail to offer a kind word when it's most needed.

[Jeniffer A · Rating 5 out of 5]

Ever since I heard about Dr. Thomas Joiner's research background, I knew I wanted to read more of his work. Suicide has touched my life personally, and reading through this book gave me a glimpse into my friends' and my own life. He articulates many logical points but brings them together in a manner that makes suicide comprehensible.

[Eliana · Rating 3 out of 5]

Not the best book on suicide I have read (I prefer Kay Redfield Jameson's) but he does propose a theory that is used in clinical practice. Its a quick read and pretty interesting.

[Alicia Zuto · Rating 5 out of 5]

What a truly caring man ( author) who has been able to use his heart-wrenching personal loss associated with his father's suicide to help others In bereavement/suicide prevention.
I saw this at one of those little free library book houses . I kept putting it down thinking, no I won't be interested. Then Id pick it back up and say to self, well I love psychology so maybe I will.
I will admit that he did reiterate too much but I can't take points off for that because of the extensive research did in care of this matter.;)
Plus I was playing with some poetry a month ago and framing both sides of the coin with suicide. I was pretending to be compassionate in my writing and wrote from the perspective that I could understand how somebody must be in such dramatic pain to be able to take their life. Then, arguing with that side, I wrote from the perspective of a writer that was countering against my original poem. I like to exercise my brain this way. I was framing the victim as selfish. I wrote in the demeanor that I felt sorry for the family/loved ones who were really the victims and the one who committed suicide was in turn the suspect or whatever you want to call it. They were left with questions and pain while the one who committed suicide checked out. Leaving a big mess for others to clean up without a warning that disrupted their universe. . Because of that word play I wrote on subject, I chose to bring this book home. Even in the first two chapters I felt like I learned so much. I feel like it made me very aware. I felt bad for even jumping to conclusions before I had all the facts. This book is an informative essay style that couples with self-help and understanding. I hope that it's been therapeutic for Thomas Joiner who is the author and that it says no matter how much time passes he still feels that fresh pain. not even as intense as it was in the beginning for his father but intense for the fact that right at this moment he knows how many families are going through what he went through.
I respect the fact that Mr Joyner was very open to other research and encouraged it instead of got competitive. Somebody that's so close to the tragedy can sometimes act like a know-it-all. A lot of the times they have a right to but his humble demeanor was one that made for such a more pleasant read and opening of my mind.
As I read his personal accounts and the research and statistics I couldn't help but hope that in writing this book he was able to feel better about everything. Clear his mind and that it had a therapeutic effect for him. It sounded like he was very eager to share with us the questions that family and loved ones are left to answer, the mental aspect but equally as important to share the memory of his father when he was full of life and a paradox of strength. Also share with us his reflection and things that he noticed after the fact that weren't as noticeable before the tragedy.
One of the facts that took me by surprise but now makes sense is that people who do commit suicide work their way up to it. Also that some of us are guilty of thinking it takes a weak person to give up on everything and just take your life but it shows and backs up why the people that actually follow through with suicide are ones that are tougher and stronger. It's a contradiction when you first think that way but when you read why and all the other careful work that went into this book ,you really start to see things under a new light. Or maybe you want but either way at least you will have had the opportunity to learn about a subject before actively judging it. When I say this I'm pretty much just calling it out because I was very biased and judgmental about it. This book taught me a very important lesson and it goes beyond even just the subject. I despise people that judge but I am guilty of it. I don't want to be that person. Anyway this book was a very deep subject and I would recommend reading it if you want to learn more about the subject or if this has touched your life in some way. If you went through this or you or somebody you love has depression which makes you have suicidal thoughts. It's a shame that the suicide rate is rising. As a blessing that we have people although that are working on this and hopefully we can prevent as many as possible by not pointing fingers or making some of that feels horrible feel even worse

[Rena Sherwood · Rating 4 out of 5]

When my neighbor died from an overdose in 2018, his father came to clear his dead son's house out. Meeting me, he suddenly blurted, "IT WAS AN ACCIDENT!"

The stigma against suicide is that strong, still, despite books like this, which came out in 2005.

In one sense, I thought it was obvious why people kill themselves -- an extreme desire to stop living. I was going from my own experience. I've had more suicide attempts than I've had hot baths. The problem with completing a suicide is that it's so damn PAINFUL.

But how do people get over the pain? And, what was it that made me want to want not to live anymore? It couldn't just be depression, since most people with depression don't commit suicide.

Suicide rates have risen in America and the world since this was published. Access to mental health care has plummeted. It looks like, in the near future, there will be no mental health care for those of us not filthy rich. We have to educate and treat ourselves.

This is a very accessible book on suicide. It's not bogged down in jargon. The author begins the book with his father's suicide, and circles back to it at the end.

It's at times a touching and troublesome read. For example, after a man jumped to his death, a suicide note was found at his home. It read, "If just one person smiles at me on the way to the bridge, I won't jump."

There are a lot of stories like that in this book.

The book focuses on suicide in America. Joiner further focuses the book on suicides not caused by terminal, untreatable illnesses, although he does mention them. He notes that Native Americans, people over 50 are most prone to suicide, but that there have been sharp increases in younger people committing suicide.

People who feel that they are a burden to their families or communities are most prone to suicide, as well as people who have been habituated to pain. Suicides are not spontaneous decisions. (I can vouch for that.) It takes careful planning.

He doesn't talk much about poverty, but does mention that people of all incomes kill themselves. Kurt Cobain and Spalding Gray are discussed a few times. He even did a study of the poetry of poets who killed themselves (now THAT'S dedication). There were some identifiable changes in word choice, particularly not using group pronouns like "we."

He then looked at the word usage in two characters in William Faulkner's As I Lay Dying, since one guy killed himself, and the word usage matched that of the suicidal poets.

My only thought was, "Somebody killed himself in As I Lay Dying? How'd I miss that?"

But seriously, this is a very readable book about a topic most people prefer to ignore. There are also suggestions on how to talk to suicidal people, and a recommendation that most antidepressants are too strong for children, which was unusual for an American to write at that time.

[Joseph · Rating 5 out of 5]

An sincere "thank you" to Thomas Joiner for writing this work. This book is a valuable piece to anyone looking to study or understand the concept of suicide, a very misunderstood and not-so-talked-about subject. It's unfortunate to mention, but suicide appears to be a growing trend since the publishing of this book in 2005.

Due to recent experience with suicide I decided to pick this up. In summarizing his model, the three reasons one commits suicide are: a perceived feeling of burdensome among loved ones, a sense of isolation, and the learned ability to lethally self-injure oneself. However, the answers are much more complicated than that. In addition, his visual models and explanations of the models do much justice to those looking for answers. My hypothesis walking into this was that suicide is not completed because any one particular reason. As he demonstrates, its a concoction a few different feelings and experiences. As the reader, one watches as he breaks each piece of his model down in a very detailed and elaborate manner. He examines all sides of the argument and even goes so far as to define suicide in its variable interpretations. While I wouldn't say I'm well-versed in the field of psychology or psychiatry, I can see that he is very much open to any counterarguments within the subject.

Other reviews describe this work as "repetitive." I'd have to disagree; rather that this work is intricate. It's a complex subject. I was very hesitant to read this book and read it out in public as people might ask me, "Are you okay?" To which the answer is "Yes, I'm only looking for some understanding of the subject."

He even provides other arguments that have been thrown out to review and left to the reader for interpretation. For example, maybe suicide is part of Darwin's evolution. He cites and searches for answers in the work of known sociologists like Emile Durkheim. He's very much open to potentially being wrong, like any great thinker.

Upon review of my state for suicide statistics with information from the CDC, in 2017 the rate was 21.4 per 100,000. Further review of the numbers detail about 663. That's 663 far too many.

I'm unsure that we can ever really 100% understand why suicide happens. We cannot revive those who successfully committed to the act and ask. But this work really helps to understand suicide as a whole. It's a hard read. It's an extremely heavy subject. It's written in the style of a scientific journal. But all in all, its a necessary read for those who have experienced suicide as well as those looking to understand it.

[Patrick · Rating 3 out of 5]

This book had been on my to-read list for a while. I love psychology and I've been through a brief suicidal phase in high school. It wasn't until one of my best friends was diagnosed with depression and battled daily suicide thoughts that I knew I had to read this book.

Why People Die By Suicide is an informative look at a problem that kills about a million people each year. I'm sure that most people have at least flirted with the thought of suicide at one point in their lifetime. However, most people don't have the courage to follow through with it either because they fear the physical harm or because they realize that life is actually worth living. But what about those who don't make it?

The subject is deeply personal for the author Thomas Joiner as his dad took his own life during the Joiner's youth. Ever since then, he's struggled with finding the answer.

Most of the book is founded on the theory that people commit suicides for two main reasons: 1) a thwarted sense of belongingness and 2) perceived burdensomeness. I can safely say that both these points are incredibly relatable. Joiner explains these two concepts over 20-30 pages and circles back to them constantly.

Joiner also talks about how many people lower their aversion to self-harm by taking gradual steps. For example, someone who makes non-lethal cuts on their arms will eventually get used to grander acts of self-harm. Other things such as surgeries and tattoos help build up this type of tolerance.

The author also briefly touches on other factors such as personality and genetics, but doesn't spend too much time on those subjects.

It's clear that Joiner took the time and effort to make Why People Die By Suicide as explanatory as possible. He cites dozens of studies and research papers to back up his claims. Joiner also mentions other famous psychologists, including two people I admire: Charles Duhigg and Roy Baumeister.

However, the book simply isn't that interesting. Now, I wouldn't expect a book on suicide to be anywhere near the same level of something like a graphic novel, but I never knew that the subject could feel so dense. Joiner seems to go on at length at times and dwells quite a bit on the same subjects. It also doesn't really seem to offer much of a solution. As another reviewer said, it seems to be more geared towards psychologists rather than those with depressed and suicidal people in their lives.

[Jadewik · Rating 5 out of 5]

This book is wonderful for people trying to understand suicide. I have a sister with borderline personality disorder (BPD), and recently a BIL who died by suicide via VSED, and it has had a significant impact on my family. When I heard about this book, I was looking for ways to understand and cope with my sister's suicidal behaviour and attempts. It was mentioned in a Dr. Phil episode that dealt with The Bridge, a documentary about people who have died by suicide at the Golden Gate Bridge. (The documentary is also good.)

Joiner's book really dissects the topic from both a scientific, psychological perspective and a personal perspective, as his own father died by suicide. He expounds on the faux-pas topic with a summary of intensive research and his own observations as a professional. He discusses his theories on what causes someone to desire death, who is at risk, how to recognize suicidal behavior in loved ones, how to understand people who may be suffering from suicidal thoughts, and gives suggestions for how to help loved ones who are suffering from suicidal thoughts and how to cope with the loss of a loved one who has died by suicide.

If you want to learn more on the topic of suicide, I highly recommend this book. As far as I know, this is the only book that covers suicide so unflinchingly and comfortably. Read this book. You won't regret it.

The prologue is a personal experience, and the first chapter moves slow, but give it time. It is worth the time spent reading. It takes a while to slog through, as it references over 240 references on suicide and really delves into details of the author's own theory on the subject of suicide. I dog-eared my copy and wrote notes all over the inside based on my experiences. I reference those pages often.

Thank you, Thomas Joiner.

[Maria Morozova · Rating 4 out of 5]

This is a great research on the topic of suicide.

Serious attempts or death by suicide occur when a person is experiencing the following things:
1. Perceived burnonsomeness (old people who feel that they are a burden on their families; 'the world is better off without me')
2. Failed belongingness (low social connection, immigration, losing social circle throughout your life; "If at least one person smiles at me while I am going to the Golden Gate bridge, I won't jump" - the failed need for human connection)
3. The acquired ability to enact self-injury (people who have been through a lot of physical pain in the lives: due to injuries, eating disorders, tattoos, piercings etc. ) - when a person beats down the instinct to live; years of substance abuse, engagement in dangerous activities, violance exposure.

Self-cutting is an example of emotional disregulation (instead of talking to a friend when feeling bad, a person enacts self-injury).

Two mental disorders, borderline personality and anorexia nervosa, are among the most lethal of all psychiatric disorders.

Suicide is sometimes romanticised in pop culture. Song lyrics, newspaper articles depicting suicide as an enigmatic noble act. There are suicide prevention organisations that control how suicide is portrayed in the media.

A quote explaining anorexia:
I can try to control myself (and others) through controlling my body. My body is my only practical handle on the world, a rheostat (that I can turn up and down) - gain or lose the same 15 pounds - I can control my life by controlling my body. And if life gets too painful - I can turn it down completely.

This isn't a particularly enjoyable read. Nonetheless, it's crucial to be aware of such things so that we know how and when to intervene when someone we know is showing alarming behavioral patterns.

[Abdul Alhazred · Rating 2 out of 5]

20 years old at this point and out of date with current research, though I doubt that it was on the pulse of the research at the time, as the author's biases steer him towards conclusions that have some support but are vastly overstated. Central to his theory is that pain is a stepping stone toward the ability to commit suicide, but this isn't always in terms of explicit self-harm but also just having experienced pain (for example a very tortured case is made for that of Reimer's botched gender reassignment and attempt at realignment leading to suicide based on painful surgeries, it should be obvious there's a sea of confounding issues there), and even tattoos - in being painful - is some type of self harm (more than 20 year old social stereotypes about who gets tattoos and why might be the cause of that whopper). Having gotten absolutely stuck on this idea he reformulates even risk seeking behavior like skydiving to a progressive desensitization to death, because of "habituation to injury".

The central idea that (many) suicides are a progressive escalation, and that means, motive and opportunity conspire to make certain cases more or less lethal and likely has wide support. The overlap between risk seeking, drug use and suicides also seems present in the wide data but in formulating a definite causality this book really falls on its face.

Joiner's own work on "thwarted belongingness and perceived burdensomeness" (The Interpersonal Theory of Suicide link to paper) seems much more fruitful in searching for suicide prevention methodology.