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.

Drawing on extensive clinical and epidemiological evidence, as well as personal experience, Thomas Joiner provides the most coherent and persuasive explanation ever given of why and how people overcome life's strongest instinct, self-preservation. He tests his theory against diverse 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.

Drawing on extensive clinical and epidemiological evidence, as well as personal experience, Thomas Joiner provides the most coherent and persuasive explanation ever given of why and how people overcome life's strongest instinct, self-preservation.

Around the world, more than a million people die by suicide each year. Yet many of us know very little about a tragedy that may strike our own loved onesÑand much of what we think we know is wrong. This clear and powerful book dismantles myth after myth to bring compassionate and accurate understanding of a massive international killer. Drawing on a fascinating array of clinical cases, media reports, literary works, and scientific studies, Thomas Joiner demolishes both moralistic and psychotherapeutic clichŽs. He shows that suicide is not easy, cowardly, vengeful, or selfish. It is not a manifestation of "suppressed rage" or a side effect of medication. Threats of suicide, far from being idle, are often followed by serious attempts. People who are prevented once from killing themselves will not necessarily try again. The risk for suicide, Joiner argues, is partly genetic and is influenced by often agonizing mental disorders. Vulnerability to suicide may be anticipated and treated. Most important, suicide can be prevented. An eminent expert whose own father's death by suicide changed his life, Joiner is relentless in his pursuit of the truth about suicide and deeply sympathetic to such tragic waste of life and the pain it causes those left behind.

AS FEATURED ON BBC RADIO 4 Winner of the 2021 BPS Popular Science Book Award 'Read this incredible book. I wept and I learnt' - Prof Tanya Byron 'This book comes from the heart' - Roman Kemp 'Compassionate, personal and thought-provoking' - Prof Steve Peters When you are faced with the unthinkable, this is the book you can turn to. Suicide is baffling and devastating in equal measures, and it can affect any one of us: one person dies by suicide every 40 seconds. Yet despite the scale of the devastation, for family members and friends, suicide is still poorly understood. Drawing on decades of work in the field of suicide prevention and research, and having been bereaved by suicide twice, Professor O'Connor is here to help. This book will untangle the complex reasons behind suicide and dispel any unhelpful myths. For those trying to help someone vulnerable, it will provide indispensable advice on communication, stressing the importance of listening to fears and anxieties without judgment. And for those who are struggling to get through the tragedy of suicide, it will help you find strength in the darkest of places.

With recent studies using genetic, epigenetic, and other molecular and neurochemical approaches, a new era has begun in understanding pathophysiology of suicide. Emerging evidence suggests that neurobiological factors are not only critical in providing potential risk factors but also provide a promising approach to develop more effective treatment and prevention strategies. The Neurobiological Basis of Suicide discusses the most recent findings in suicide neurobiology. Psychological, psychosocial, and cultural factors are important in determining the risk factors for suicide; however, they offer weak prediction and can be of little clinical use. Interestingly, cognitive characteristics are different among depressed suicidal and depressed nonsuicidal subjects, and could be involved in the development of suicidal behavior. The characterization of the neurobiological basis of suicide is in delineating the risk factors associated with suicide. The Neurobiological Basis of Suicide focuses on how and why these neurobiological factors are crucial in the pathogenic mechanisms of suicidal behavior and how these findings can be transformed into potential therapeutic applications.

The past 25 years have seen a major paradigm shift in the field of violence prevention, from the assumption that violence is inevitable to the recognition that violence is preventable. Part of this shift has occurred in thinking about why violence occurs, and where intervention points might lie. In exploring the occurrence of violence, researchers have recognized the tendency for violent acts to cluster, to spread from place to place, and to mutate from one type to another. Furthermore, violent acts are often preceded or followed by other violent acts. In the field of public health, such a process has also been seen in the infectious disease model, in which an agent or vector initiates a specific biological pathway leading to symptoms of disease and infectivity. The agent transmits from individual to individual, and levels of the disease in the population above the baseline constitute an epidemic. Although violence does not have a readily observable biological agent as an initiator, it can follow similar epidemiological pathways. On April 30-May 1, 2012, the Institute of Medicine (IOM) Forum on Global Violence Prevention convened a workshop to explore the contagious nature of violence. Part of the Forum's mandate is to engage in multisectoral, multidirectional dialogue that explores crosscutting, evidence-based approaches to violence prevention, and the Forum has convened four workshops to this point exploring various elements of violence prevention. The workshops are designed to examine such approaches from multiple perspectives and at multiple levels of society. In particular, the workshop on the contagion of violence focused on exploring the epidemiology of the contagion, describing possible processes and mechanisms by which violence is transmitted, examining how contextual factors mitigate or exacerbate the issue. Contagion of Violence: Workshop Summary covers the major topics that arose during the 2-day workshop. It is organized by important elements of the infectious disease model so as to present the contagion of violence in a larger context and in a more compelling and comprehensive way.