Assessing Risk with Joiner’s Interpersonal Theory of Suicide
Thomas Joiner, author of ‘Why People Die By Suicide’, is well-known for his Interpersonal Psychological Theory of Suicide. This model has been a great tool at assessing risk for those considering suicide. The theory behind Joiner’s model is that those who kill themselves must not only have a desire to do so, but they also must have learned to overcome the inherent instinct for self-preservation. To be a true risk for suicide there must be a perception of being a burden and a social disconnection from others. When these two factors exist, there is a high risk of suicide.
Two States of Disconnection Must Be Present to Be a Suicide Risk
Without having both states of disconnection present, according to Joiner’s Interpersonal Theory of Suicide, the person is not a risk. There must be a perceived feeling of being a burden, though not necessarily accurate. How the world sees the individual isn’t what matters in this scenario, but how the person views themselves. When these views are skewed, the first condition can be achieved. A common feeling is that they are worth more dead than alive, along with a lost sense of purpose.
The second condition that needs to be present, according to this theory, is a loss of a social connection. When relationships with others are cut, we suffer from social isolation. This can have a direct impact on your mental health. Under Joiner’s theory, for a person to commit suicide both of these states must be present at the same time. The instinct to preserve human life is too strong for suicide with only one of these conditions present.
While having an occurrence of these two states simultaneously does increase the risk of suicide, there is one additional consideration with Joiner’s Interpersonal Theory of Suicide. The third element is the ability to acquire a means for self-injury. Under this theory, the body is not designed to cooperate with its own demise. Instinctual preservation may kick in. The theory is that when faced with death, our fight or flight instinct will come into play. When there is an acquired ability to do fatal harm to oneself, this is a very high-risk situation.
How the Interpersonal Theory of Suicide Can Assess Risk
Realizing that these two conditions need to be present can help to assess the risk of suicide in an individual. A trained therapist can quickly assess the situation and their patient’s risk using Joiner’s model. This can also be a tool in therapy, as the goal is to eliminate any conditions that can make the patient vulnerable to suicidal attempts. Through therapy, the patient can learn how they matter to others and be provided with family support that will help to get them out of the danger zone for suicide as outlined in Joiner’s model.
Knowing when someone is most at risk is a big step to reducing the number of suicides. While not all feelings are transparent enough to identify this, a trained therapist can work to assess the risk and take actions to prevent self-harm.
