The Interpersonal Theory of Suicide

Let's talk about some really dark sh*t

This is your invitation to turn around because things are about to get heavy. I consider this post a successor to another heavy post, except this one is not so cute and creative as it is largely a non-fiction discussion.

The motivation for this post is roughly as follows:

• I am in the middle of writing a different piece that is lighter and more exploratory; however, I’ve hit a major block largely because;

• For the past fortnight, I’ve been sliding into a deeper and deeper depression bordering on passive suicidal ideation such that;

• Through a combination of doom-scrolling and watching random YouTube videos on despair, I came across a fascinating paper that I want to discuss.

I will note, somewhat positively, that on the severe depression scale: last year at this time I was at an 11 out of 10, and this year I’m at about 7-and-a-third. Also, my doctor recently prescribed me an über-dose of Vitamin D which should theoretically stably improve my mood.

In other words, this post is my feeble and wretched attempt at coping with ridiculous emotional pain. Let’s go!

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The paper that I want to discuss is on the Interpersonal Theory of Suicide by Dr. Thomas Joiner. I would encourage you to read the whole paper because it’s quite interesting and informative. But, even if you don’t, I will distill the parts that shook me up.

The paper introduces two constructs that independently contribute to suicidal ideation, or the desire to kill oneself. These two factors are:

1. Thwarted Belongingness – “I am alone.”

2. Perceived Burdensomeness – “I am worthless.”

I translated this in my mind to the equation:

Suicidal Ideation = (Thwarted Belongingness + Perceived Burdensomeness)

The paper then also introduces a third construct: “capacity for suicide”. We’ll talk about this in more detail later, but there are a couple of things of import to note right away:

• This third factor is what converts suicidal ideation into suicide attempts.

• This third factor is an emergent variable. That means it appears in a causal chain after the first two factors are present. For this reason, and a few others, it is called the acquired capability for suicide.

• This acquired capability is composed of two sub-factors that appear in a causal sequence: (1) lowered fear of death, and then (2) increased pain tolerance.

Because acquired capability only appears after suicidal desire already exists, it kind of serves as a dual checkpoint on the route toward lethality. I translated this in my mind to the equation:

Acquired Capability = Lowered Fear × Pain Tolerance

Putting these two equations together:

Suicidal Attempt Likelihood = Ideation × Capability
= (Belongingness + Burdensomeness) × Fear × Pain

This equation may not be the most accurate way to model the causal chain from Ideation / Desire → Intent → Attempt, but loosely tracks it and simplifies the mathematics involved. For convenience, we can use a five-point scale for each factor, giving a total possible value of 250.¹

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The original paper cites that women score higher than men in “perceived burdensomeness” and “thwarted belonging”. On the other hand, men score higher than women in “acquired capability”. Thus, a hypothetical woman could look like this:

Suicide Likelihood = (3.6 + 4.5) × 1.8 × 2.9 ≈ 42

whereas a hypothetical man would look more like the reverse:

Suicide Likelihood = (1.8 + 2.9) × 3.6 × 4.5 ≈ 76

People who are already familiar with suicide research know that women tend to be more depressed, but men tend to kill themselves more. This paper’s well-grounded model confirms why. Women who are depressed want to commit suicide, but because they are so bad at it, they fail and continue to wallow in misery. Men, on the other hand, don’t necessarily ever want to kill themselves that badly, but because they’re so stoic and well-trained, they succeed with minimal effort.

That’s right. Neither sex achieves their true desire. Everyone suffers. Welcome to the heart-breaking reality of mammalian sexual dimorphism. I have to say that from my standpoint, the emotion of not-even-wanting-to-die-that-much-but-could-definitely-pull-it-off resonates.

But, wait, there’s more! This paper dives deeper to reveal an even more horrifying implication regarding the male talent for “acquired capability”.

Thus, while the capability for suicide is conceptualized as a capability that is gained over time, we also propose that through genetic and/or temperamental predispositions to fearlessness, impulsivity, or greater physical pain tolerance, some individuals are more susceptible to acquiring the capability for suicide given exposure to painful and provocative events, or even more likely to seek such events out.

For the past several thousand years of civilization, in an attempt to develop strong war-like capacities, societies have turned “facing down fear of death” and “withstanding severe pain” into high (possibly the highest!) masculine ideals to strive toward. Additionally, many cultures construct explicit moralities that encourage boys to indulge their impulsivity, albeit in pro-social ways, e.g., entrepreneurial risk-taking. This means men are trained to become as effective at suicide as they possibly can.

My judgment at this point is that men have done an incredibly good job of f*cking themselves over.

Do you feel bleak enough yet? Let’s trek onward!

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Now is the part of the show where I share my own experience in terms of this model. My “perceived burdensomeness” is quite low. In fact, it’s never really been an issue, even from the time feeling significantly suicidal at 15 years old. A lot of people find me to be extremely competent, handsome, and well-socialized to the point they can’t tell when I’m sliding past checkpoint H2.

My “thwarted belongingness”, on the other hand, is through the roof. Using the scale from above, I don’t think it’s ever been lower than 4 for more than a couple of months at a time over the entire past decade. Partially because so few who are close to me – y’know the ones who you’d expect to care the most – seem to recognize what’s going on under the surface.

Interestingly, what has protected me the most from sharing my fate with a plethora of other depressed dudes is the fact that I was raised as a Tamilian Brahmin. The intense spiritual focus on non-violence from my cultural lineage, endemic specifically to the caste I was born into, meant that I was discouraged from contact or combat sports past the age of nine. Furthermore, I was never taught how to use a gun or any other weaponry. This disabled me from developing the requisite “acquired capacity” factor that many of my Caucasian brethren possess.

Despite this, there are plenty of other ways in which my resistance to the H3 and H4 checkpoints has been systematically lowered. Specifically, the meditative practices that I’ve spent time honing (e.g., Vipassana) are designed precisely to cultivate peace with the notion of physical death, sliding me right past H3. Growing up in a family that valued public achievement meant teaching myself to tolerate the pain of sacrificing short-term pleasure for long-term goals to an unhealthy degree. I also played competitive sports for many years which involved building the endurance and/or discipline key to moving beyond H4.

Lastly, for better or for worse, as an American adult, I now practice Ju Jitsu and train with a Glock 48 that I own.² So, uh, …

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…

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… someone better give me a solution to my chronic hopelessness soon.

1. These are not the actual scales for each factor. The true scoring methods provided by clinical questionnaires are provided in the paper.

2. Are you worried about me yet? I’ve just admitted my risk for lethality went way up due to my increasing familiarity and comfort with aggressive behavior and activities.