Jed Diamond, P.h.D, looks at suicide in men from both an individual and societal vantage point and gives ways to prevent it from happening.
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Recently I received a review copy of the book, Lonely at the Top: The High Cost of Men’s Success by Thomas Joiner, Ph.D. I was happy to offer a review. Dr. Joiner is one of the world’s leading experts on suicide and has published two previous books, Myths about Suicide (Harvard University Press 2010) and Why People Die by Suicide (Harvard University Press 2005).
Dr. Joiner and I share a professional interest in suicide prevention. Suicide is a major world-wide epidemic taking the lives of over 1,000,000 people a year, according to the World Health Organization. Estimates suggest that 10 to 20 times more individuals attempt suicide.
Self-harm now takes more lives than war, murder, and natural disasters combined.
Our personal lives have also been touched by suicide. My mid-life father tried to commit suicide when I was 5 years old. Although he lived, our lives were never the same. I grew up wondering what happened to my father and was terrified that the same thing would happen to me. My life-long interest in men’s health grew from my desire to help men, and the women and children who love them, to understand what causes men to give up on life and what we can do to keep them engaged.
Dr. Joiner’s father, also named Thomas, killed himself when Dr. Joiner was in his third year of graduate school. Although the senior Thomas was depressed, he didn’t seem like a suicide risk. As reported by Tony Dokoupil in a recent article, The Suicide Epidemic, “the 56-year old Joiner was gregarious, the kind of guy who was forever talking and laughing and bending people his way. He wasn’t a brittle person with bad genes and big problems. Thomas Joiner Sr. was a successful businessman, a former Marine, tough even by Southern standards.” As it turned out, these “manly” traits may have contributed to his demise.
Joiner remembers the day his father disappeared. “Dad had left an unmade bed in a spare room, and an empty spot where his van usually went. By nightfall he hadn’t been heard from, and the following morning my mother called me at school. The police had found the van. It was parked in an office lot about a mile from the house, the engine cold. Inside, in the back, the police found my father dead, covered in blood. He had been stabbed through the heart.”
The investigators found slash marks on his father’s wrists and a note on a yellow sticky pad by the driver’s seat. “Is this the answer?” it read, in his father’s shaky scrawl. They ruled it a suicide, death by “puncture wound,” an impossibly grisly way to go, which made it all the more difficult for Joiner to understand.
Suicide is a Primarily Male Problem
In his latest book, Lonely at the Top, Joiner asks, “which cause of death stands out as affecting men far more than women? Given their privileged financial and society status, perhaps it has something to do with the dark side of wealth and power such as the cardiac or stroke-related consequences of influential but stressful jobs, or a taste for expensive but unhealthy foods?”
“No,” he says, “It’s suicide.” Approximately 30,000 people commit suicide each year in the U.S. and 80% were men. Overall, males kill themselves at rates that are 4 times higher than females. But in certain age groups men are even more vulnerable. The suicide rate for those ages 20-24 is 5.4 times higher for males than for females of the same age.
In the older age groups suicide is even more a “male problem.” After retirement, the suicide rate skyrockets for men, but not for women. Between the ages of 65-74 the rate is 6.3 times higher for males. Between the ages of 75-84, the suicide rate is 7 times higher. And for those over 85, it is nearly 18 times higher for men than it is for women.
A New Understanding of Why People Die by Suicide
Joiner is 47 now, and a chaired professor at Florida State University, in Tallahassee. He’s made it his life’s work to understand why people kill themselves and what we can do to prevent them from taking their lives. He hopes to honor his father, by combating what killed him and by making his death a stepping stone to better treatment. “Because,” as he says, “no one should have to die alone in a mess in a hotel bathroom, in the back of a van, or on a park bench, thinking incorrectly that the world will be better off without them.”
Dr. Joiner has proposed a new theory of why people commit suicide which he believes is more accurate than previous formulations offered by writers like Edwin Schneidman, Ph.D. and Aaron Beck, MD. According to Schneidman’s model, the key motivator which drives people to suicide is psychological pain. In Beck’s understanding, the key motivator is the development of a pervasive sense of hopelessness. Dr. Joiner suggests that these are correct understandings but are also too vague to be useful for predictive purposes and not capable of offering a complete motivational picture.
Joiner proposes that there are three key motivational aspects which contribute to suicide. These are: 1) a sense of not belonging, of being alone, 2) a sense of not contributing, of being a burden 3) a capability for suicide, not being afraid to die. All three of these motivations or preconditions must be in place before someone will attempt suicide.
Although women, too, can take their own lives when they suffer at the intersection of “feeling alone, feeling a burden, and not being afraid to die,” this is clearly a more male phenomenon. Throughout our lives males take more risks and invite injury more often. We are taught that “winning isn’t everything, it’s the only thing” and “no pain, no gain.”
We often invest so much of our lives in our work, when we lose our jobs or retire we feel worthless, unable to contribute. It’s a short step to feeling we are a burden on those we love. We also put less effort into developing and maintaining friendships so we can come to feel more and more alone.
Preventing Suicide In Men
I’ve found that Joiner’s model, what he calls the Interpersonal Theory of Suicide, can be very helpful in understanding suicide risk in men. The three overlapping circles help alert us to the kinds of questions we might ask ourselves if we want to prevent suicide. Joiner and his colleagues have developed a questionnaire that addresses these issues. Here are a few of the items they assess:
Thwarted Belonginess:
These days, I feel disconnected from other people.
These days, I rarely interact with people who care about me.
These days, I don’t feel I belong.
These days, I often feel like an outsider in social gatherings.
Perceived Burdensomeness:
These days the people in my life would be better off if I were gone.
These days the people in my life would be happier without me.
These days I think I have failed the people in my life.
These days I feel like a burden on the people in my life.
Capacity for Suicide:
Things that scare most people do not scare me.
The sight of my own blood does not bother me.
I can tolerate a lot more pain than most people.
I am not at all afraid to die.
♦◊♦
Like most people, I’ve had thoughts of suicide at numerous times in my life, but the one time I felt at high risk of actually killing myself was when all three sectors overlapped. I was lucky that my wife was smart enough to remove the guy from the house until I saw a therapist and got into treatment for my depression and my suicide risk subsided.
Some people believe that if a person is going to kill themselves, there’s nothing one can do. If you try to stop them, they’ll just bide their time and do it later. However, we now know that suicidal intention is transient. If we can get support to get through those times when we feel disconnected, a burden to others, and having the means and mind-set to actually kill ourselves, we can begin to develop the social supports to turn things around.
I suspect the difference between James Joiner’s dad and my dad wasn’t their level of “thwarted belongingness” or “perceived burdensomeness” but my father’s lower capacity for suicide. Disrupt one of the risk circles and we buy ourselves more time to heal. Making a connection can be as simple as a smile. I read the report of a man who left a note as he walked across the Golden Gate Bridge. It said, “If one person smiles at me, I won’t kill myself.” The note was found after he had plunged to his death. We can all reach out, in our own way, and touch someone who may feel disconnected, disrespected, and useless.
We can also let in the love when we are feeling down. I remind myself, and my clients, to take heed of the lines from the Eagles song Desperado. “You better let somebody love you, you better let somebody love you, you better let somebody love you…before it’s too late.”
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If you’re dealing with feelings of hopelessness or thoughts of suicide, help is available. 800-273-TALK (8255) is on-call 24/7 if you need to talk, or reach out to a friend or health professional in your life.
photo: jamesackerley / flickr
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I am a married man. I lost my father a couple few years ago in a freak accident. Just recently i realized that my depression caused by the loss of my father has ruined my marriage of 4 years. i started trying to work through that and revisit those feelings and change back to the optimistic fun loving guy i used to be, my wife drops a bomb on me saying she doesnt want to be with me. And yesterday she tells me she is in love with someone else. I am nearing my final breaking point and dont know… Read more »
If you don’t know about the Crisis Text Line (CrisisTextLine.org) there is help waiting 24/7 simply by texting. You can learn about how it came to be by the founder, Nancy Lublin, here, https://www.ted.com/talks/nancy_lublin_texting_that_saves_lives
So many heart-felt comments of grief, despair, and hope. It reminds of the value of sharing our pain with others. When my father faced the possibility of ending his life when I was five he felt burdened and thought people would be better off without him. There have been times in my own life where the emotional pain in my life was overpowering and I just wanted relief. Often, it was a small thing that saved me–a smile, a kind word, a recognition that I’m worth something, and I’m not alone. I hope and pray that all those who read… Read more »
thank you Jed. I needed to read,see,hear something, and just acknowledge my emotional pain. Just to admit to myself it was overwhelming me, it allowed for it to wash thru a bit. I’m not dead today, not by my hand or grief. I will go and do my best…one more day at a time until I liberate my spirit from this ailment.
I am utterly superfluous. I have no relationship and have no children. I am 36 close to 37 and I am just utterly pointless. I have no career worth speaking of- I have a medium job at a government office in the UK. If I died they might appoint someone like a woman to replace me which would help end some of the sexism in the world. I have no point and if I died no one would really miss me- my friends are married and in families, my parent’s generation is dying, I can spend entire weeks without seeing… Read more »
I’m so sorry for that comment. I am so sorry.
well you need to let it out, dont let it build up ..talk out as much as u can, even if its just writing to yourself,,get that stuff out. one day, suicide will be removed from your ideas and options, and you will live without torment.
i hear you my friend from across the pond. i urge you to go share a simple smile, and eye contact with a homeless person..you will see you have so much love and support to offer. i love ya buddy, hold yer head up mate!
Henry…I pray that you are ok. You are not a burden. At all. People like you make me realize there are others who feel the same way. Rejected and hopeless. But you are not alone. At all. I pray you get help.
I really just don’t see the point. Work, pay bills, rinse wash repeat! Save up a little money just so something can break and I have to start all over again. The world is a toilet of corruption and stupidity! I don’t feel sorry for myself, I feel badly for my 7 year old daughter, but I’m sick and tired of the corrupt tyranny of family courts taking all my money away for so called child support, all they’ve done is supported my alcoholic ex with a steady supply of booze and cigarettes! I just don’t feel like wasting any… Read more »
you have many valid points.. but the only difference is that everything you do is not in vain. There is a scripture that says that what we reap, we will sow. Fortunately for you, everything you do now that is good and with good intentions will in the end have great benefits. You will see it with your own eyes and my word to you is not to give up. Your life has purpose and a destiny and Your daughter is 7 now but will one day she be your age.. and I wouldn’t want to miss all those years… Read more »
I’m waiting for my lease to be up. Trying to make it smooth and un-noticeable as possible. I know where, when and how. Set up bank accounts to be transferred, letters written -instructions, etc.
35 yo weirdo.
Its not time for that. i know you want peace, but you are needed. there is a whole list of people waiting to meet you..for laughter, and New dreams to be born, cause they need it as much, maybe even more. not today my friend.
goodbye
what about hello? Andy, can you see that even i feel sad that we never met, before you even said good bye…I’m hoping you said goodbye to suicide,and hello to the possibilities you never thought could happen..give you a chance.
I’ve seriously considered suicide ever since my father took his life three years ago. A thought that had never crossed my mind till he had done it. I’m torn somewhere in between. My father suicide sent me into a downward spiral that has left me hopeless. I have two children and a wife that loves me. I understand that feeling of letting them down. Thinking they would be better off without me. I also never felt that way till my father did what he did. I can’t imangine doing that to my two boys and putting them in the situation… Read more »
I guess my point was, I understand how hard and painful life can be. But think about the consequences of your actions and even then I understand how hard it is.
There is a saying I heard which makes so much sense – suicide is a permanent solution to a temporary problem. And I have always heard it is a selfish act, to cause your loves ones so much pain. If you can, talk to someone and get help, you are not alone! 🙂
You should feel blessed to have a wife and a family. You should feel blessed knowing you’re loved. Seems like you’ve got so much to live for. I’m 42. Never been married. No kids. Never had a girlfriend in my life. Never been kissed. I’m a decent looking guy with a good sense of humor, but I have no confidence in myself. I’m a wimp. I suck at being a man although I try very hard to be one. I have a hard time understanding why a man who has a wife and kids feels like he has nothing. You’ve… Read more »
I’m going to kill myself today, I just had to tell someone
Don’t tim.
Take a moment to plan a trip away, some time from everything that is making you feel like this. I’m sitting in a bar right now, watching people walking by. Smiles, laughs might seem hard to come bye, yet there is a while world out there. Before making a big decision. Head out, travel. What is there to lose if things are so bad where you are? It’s worth a go at least. Life is shit at times, but in my experience people might surprise you if you take the plunge. Everyone hear know how you feel. Give it one… Read more »
Don’t tell the people you love what where your at give them a chance to help. I wish my dad had.
My gosh, I meant to say tell the people you love. Give them a chance to throw you a life line.
Tim Coxon , are you still with us
I have been thinking if suicide since the age of 17 and it’s come to my mind every other day but I thought it was wrong but now I’m 30 and I still feel the same and after surviving so many years hoping thing will get better nothing have changed. Now I regret why I’ve done this before and it getting worsen. And my family don’t have any clue about it they r searching girl for my marriage.
I my sister and my daughters have all had more than one friend commit suicide over the years. We will never understand their sadness their hopelessness. Our lives have never been perfect. Cheating partners suckey jobs financial problems. But we live for the few shining moments that come along once in a while. I change jobs and keep looking for more goals to reach. Change where you live try new things really search your soul to figure out what you need to be happy. or fulfilled. I really wish all of you here hope. There are people in the world… Read more »
I almost did the other night. I’m now speaking with a therapist again. It helps sometimes.
I have had depression since I was young. Not the same suicidal every day as you mention, but pretty serious stuff.
I hope you make the right decision for yourself. And I hope if it is to continue to live, that you find relief in the form of medication, talk therapy, or some other way that takes the pain away.
<3
I think there are social factors that heavily contribute to suicides among men. I have also noticed that a lot of psychiatrists/psychologists rely heavily on anti-depressants to the point that they just give someone an anti-depressant and expect it to work. Sometimes people who are depressed over a temporary event are given anti-depressants even if it will take a month or longer for the anti-depressant to work. One social factor is that many men cannot find a woman and commit suicide because they don’t want to be alone for the rest of their lives. For example, men who are shorter… Read more »
I have had thoughts of suicide. My divorce is defiantly the catalyst. I was a decent man Great provider. I busted my ass for 25yrs working a very hard job I received a pension. Then my wife asked for a divorce. the Court system took 23% of my pension and gave it to her and held me to a earning capacity of 33 K on top of the pension I already had basically ordering me to go back to work. based on that 33k I have to pay her child support and the best part is I have 50/50 custody… Read more »
Larry, take a moment. This is harsh and unfair.life has dealt you a tough hand. But think. Have you saved any money, even a little. Could you save some over the next year with a goal in mind. Plan something, an escape. India, Thailand anywhere. A few months of free space which you can afford. You will be there, alive, with a future ahead and there’s nothing anyone can do about it. The alternative is what anyone who comes on this post has considered. Get away, disconnect from all the things making you sad. Who knows how you might feel… Read more »
I won’t go alone! I will take as many of these crooked Judges and Lawyers I can! It will be a blaze of glory.
I am contemplating suicide and it has nothing to do with the things mentioned. I have anxiety brought on by a chronic illness and I feel trapped in my thoughts. I hate that I’m depressed, but don’t see another way out. I am very loved and very appreciated and belong to many close knit groups. It’s just a physical pain I feel in my heart and emotions.
Male suicide is indeed a bad thing. But then men are probably killing themselves at much fewer rates than the rates at which they are killing women and other men. The problem is an incredible rage and anger that is uncontrolled in many people and I doubt much of the reasons stated above. Think about it, people were much less privelaged in the past and had to fend for alot of their food and not get some at a takeaway. Yet I doubt they resorted to killing themselves or killing others as much as people do today. I believe media(hollywood… Read more »
Are you for real??? That has to be the most inappropriate and ignorant comment i have ever seen “ever”!!!! This is like a suicide lifeline, some peoples last fucking hope FFS!! Did you even read any of the comment? The next guy right after you casually says ” i feel like jumping in front of the train, is that normal?” I don’t know what bothers me more, reading that comment right after yours or the fact that just a week ago i was punching my own face in trying to build up the courage to jump in front of the… Read more »
^^ It’s evil people like this that cause the most suffering in the world.
An account named “hope” wow, the irony.
This basically boils down to.
I hate men and it’s their privilege to kill themselves.
I think people like this are why there are so many suicides. They murder others with their words. Much easier than a gun and much more deadly.
I feel like jumping in front of the train is that normal?
What
Sometimes I feel like jumping in front of the train
The common thread in all of this is the way women treat men. They are horrible. They complain about how we objectify them at the top of their lungs all the while assigning us little to no value. Women can throw us away and get a hundred penis’s to take our place, so why do they care? Unless we have money. It shows in the way they treat us. They cheat at a rate four times greater than men, they lie, and lie, and lie, and unless we want to be alone we just have to put up with it.… Read more »
My brother in law, an alcoholic, hung himself yesterday because my little sister asked for a divorce, after 3 years of family counseling and 2 failed – month long rehab stents. I am angry and mad and so angry. My 4 year old nephew’s father chose to NEVER see his sweet face or hear his sweet voice again. I am trying to find answers for my soulbroken sister and this just struck a hard nerve. She had recently looked into this tender thing and it made her sick…most of the men were married. She didn’t cheat, she thought about it,… Read more »
Its a pain thing. What if he was in pain you couldn’t imagine? Sadness and despair that didn’t change regardless of his circumstances; I guess I’m asking you not to judge him too harshly.
What were the reasons she wanted a divorce? Im sure it was some bullshit like she changed.
Add Toxic Psychiatric “Medicines” as well. “When someone commits suicide or homicide don’t ask what “mental illness” they had but what psyche “meds” they were on.”
Until we have a system that teaches young boys values, such as, you have to be a feminist or your marriage will end, we will continue have a high suicide rate. These boys will grow being disenfranchised fathers.
The first two reasons for suicide seem accurate. You failed to ask the questions about why men don’t belong and why they have no purpose.
Society and the family law stem has made it so. Countless men are disenfranchised from their children and end up losing hope and finding purpose. Having limited access, limits real family memories and any bonding. Fathers become nothing more that debt slaves with the purpose of paying child support for children that later learn to hate them.
Men act like another child so the women is forced to get on without him. Women feel suicidal every morning but they have to get up and carry on for the kids. When a mother pays does the leg and has the hassle of chasing the dad so she can feed his kids, yeah her face changes and the contact game that most men didn’t want until they were told oh don’t bother then, becomes her fault. Getting past depression is a full on fight every day. Don’t blame women, the same woman that has been asking you the wrong… Read more »
I have been considering ending my life for a number of weeks. Some days I actually feel OK and then the hopelessness takes over again. My wife has left me and I am homeless. I hurt her and let her down and I am so sorry for that. I am much older than she is and she has moved a man that is closer to her age into our home. I really see no good reason to live any longer as I can never return to be with her and live the life that I loved so dearly. I am… Read more »
Please don’t <3
You know when life gets cruel with you its time to punch it in the face and do something about it, not give up ! You may not have that same life again, alot of us can’t but think about when you’ll be dead maybe death is not gonna be worth it, who knows death is far more worse than life. So try to live a little we all have to go one day, sooner or later !
Hope you’re still with us.
I always think of killing myself. Nobody cares. I can’t be helped.
It can be helped if you want to… It takes a little bit of trust (trust in the person who is writing this comment to you). I’ve been through a lot. I’ve caused unnecessary suffering to the people I love the most. To me there is no worse thing than hurting my father. When I couldn’t control my emotions I know I’ve caused him a great deal of pain. At some point, I realized that whatever I tried, or whatever power I thought I had to make things better wouldn’t be enough. It followed that I started feeling that my… Read more »
I’m going through divorce now…I’m living with friends and can only see my kids three times a week for 2hrs. I’m thinking I’ll end it this Christmas. The pain is a little too much to bare.
Avoid alcohol.
Please don’t <3
Dude you have kids. I know what you are thinking of I was there myself. Not in your situation, but I have felt alone too. Most of us feel that way I felt it at a young age do to moving to a different country and facing racism, stereotype, ect. I didn’t grow up with a bunch of friends because I didn’t speak English at all but throughout my teen years I learned a lot about myself. I have always felt inferior to white people because of the place where I was born they got treated better and basically were… Read more »
MGTOW my friend. The system is broken.
Please, you sound like you love your children. You need to carefully consider the effect that will have on them. Some children interpret that as the ultimate rejection. Some children think that they weren’t lovable enough for you to stay. Then there are those who will grow up to see your way out as a solution to their problems also.
You can’t do anything to help them understand once you are gone.
I think we live in a country that ignores the mentally ill. I have been struggling with mental illness most of my adult life, and up until about a year and a half ago, was managing to hold down a job and do something with my life. I have sinse fallen physically ill, and now have a new component to my misery. I think about suicide often as way to end my physical and mental pain. It seems very attractive compared to the life I lead now.