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Terrible_Life

Specialist
Jul 3, 2025
356
1. Psychache: The Central Concept

· Definition: Psychache is intense, unbearable psychological pain. It's not just depression, sadness, or anxiety in a clinical sense; it's a feeling of immense mental agony, hopelessness, and helplessness.
· The Core Proposition: Shneidman famously stated, "Suicide is caused by psychache." He argued that when this pain is perceived as endless and intolerable, and when an individual can see no other way to escape it, suicide emerges as a solution. He wrote, "The enemy to life is pain, self-perceived psychache. The key clinical question is: 'Where do you hurt?' and the key operative question is: 'How can we reduce your pain?'"

2. The Ten Commonalities of Suicide

Shneidman identified ten common characteristics he observed in most suicides. These are not causes in themselves, but rather the typical "symptoms" or "profile" of a suicidal state of mind.

1. The Common Purpose: To seek a solution. Suicide is seen as the only way out of an unbearable problem or emotional state.
2. The Common Goal: To cease consciousness. The goal is to end the unbearable pain, not necessarily life itself. The shutdown of awareness is the desired result.
3. The Common Stimulus: Unbearable Psychological Pain (Psychache).
4. The Common Stressor: Frustrated Psychological Needs. Shneidman drew on Henry Murray's work on personality, identifying needs like achievement, affiliation, autonomy, and shame avoidance. When these core needs are chronically frustrated, psychache results.
5. The Common Emotion: Hopelessness-Helplessness. A profound feeling that things will never get better and that no one can help.
6. The Common Cognitive State: Ambivalence. Most suicidal people have conflicting feelings—part of them wants to live, and part of them wants the pain to stop. This is a critical window for intervention.
7. The Common Perceptual State: Constriction (Tunnel Vision). The person's thinking becomes dichotomous (either/or) and rigid. They can only see two options: a magical solution or death. They lose the ability to see alternative paths, past coping mechanisms, or the impact on others.
8. The Common Action: Egression. The desire to escape, to flee, to "get out."
9. The Common Interpersonal Act: Communication of Intention. Shneidman emphasized that most people who die by suicide communicate their intent, either directly or indirectly, beforehand (e.g., "You'd be better off without me," giving away possessions).
10. The Common Pattern: Consistency of Lifelong Coping Styles. People often deal with crisis in ways that are consistent with their lifelong patterns. Someone who has always responded to stress by "running away" may, in an extreme situation, see suicide as the ultimate form of escape.

3. Cubic Model of Suicide

Shneidman also developed a model to visualize the risk of suicide, based on three dimensions:

1. Pain (Psychache): The intensity of the unbearable psychological pain.
2. Pressure (Inner "Can't Stand It Anymore" Feeling): The internal urgency and demand for relief.
3. Perturbation (Agitation/Discomfort): The level of emotional turmoil and restlessness.

According to this model, the risk of suicide is highest when all three of these factors are high simultaneously.
 
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niki wonoto

Experienced
Oct 10, 2019
206
thank you so much for sharing this

- from Indonesia -
 
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Terrible_Life

Specialist
Jul 3, 2025
356
thank you so much for sharing this

- from Indonesia -
You're welcome:)

I find this theory helpful to understand suicide better, especially the part about the so called psychache

What's your opinion about the theory?
 
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Forever Sleep

Earned it we have...
May 4, 2022
13,574
I agree with some points he made. I imagine his scenario could be textbook for some people but, I doubt all. I do agree with the observation that people do show signs often though.

For me though, I wouldn't say I'm in horrendous psychological pain all the time. I wouldn't say my thinking is utterly rigid and fixated on suicide as being my only option. I don't like how intense and beyond reasoning this type of description makes us all seem. I'm sure some do feel like that of course.

For me though- I've certainly had worse periods in my life- both mentally, emotionally and physically. Where there would have been far more reason to go ahead and kill myself. I'm actually less desperate emotionally and circumstantially than I was.

The reality for me is- I can keep going as I am. I've had ideation for 35 years. Logically speaking- if I survived that long, I can survive a little longer. I imagine it could well become more difficult as I get older though. And who knows? Maybe I will just keep going till my bitter, natural end.

But, for many of us- I think there are still multiple paths. Suicide may be the path we want to take the most but- we may feel compelled to stay here- so as not to devastate loved ones or dependents for example. In which case- we are perhaps more inclined to look for paths that make it easier to live- which could look like recovery to others.

How unrealistic is the whole: magical sollution vs. suicide though? I feel like he portrays it as something unreasonable or, crazy. But- let's say a person wants something desperately. A certain career, a romantic partner, to transition, to be free of an illness- whatever is a central need for them.

Perhaps that wish is so great that not achieving it is massively harming them. But really- how likely is it they will get what they want- to the point of being satisfied sufficiently anyway? What if they have tried everything they can think of for years on end? Is it really such 'rigid' thinking for them at that point to conclude that: Only a miracle will 'save' them at this point? And, to go on will only mean they are stuck in the same miserable state. Why can't their choice to suicide be a rational one- born through the experience of multiple failures and disappointments? Rather than an act of psychotic desperation because a person is so all or nothing about life?

I feel that my choice- should I take it- will be less dramatic than all that. I know I could still work my arse off to achieve the things I wanted. But, having achieved some of them, my opinion was- they weren't worth the effort! Will my unachieved goals in life be worthy of my effort? Experience tells me they won't! Experience tells me that they will only bring a whole new set of problems into my life.

I think life is far more complex than how he tends to portray it. I think our perspectives on life are complex as a result. So- rather than suicide being always this desperate, last resort act because we are deranged in our thought process- can it really not be a reasoned out conclusion that all we have tried so far has failed to meet our standards? That the rewards may not seem worth the effort anyway?

I suppose all pro-life philosophy is based upon life being something worth participating in but- surely there are legitimate reasons it may well not be for some of us. And, shouldn't we be the ones with the right to decide that?
 
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whywere

Illuminated
Jun 26, 2020
3,656
Thank you so much for sharing and the educational aspect.

You are a VERY thoughtful and wonderful person, as to think of others to share.

Walter
 
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Terrible_Life

Specialist
Jul 3, 2025
356
Thank you so much for sharing and the educational aspect.

You are a VERY thoughtful and wonderful person, as to think of others to share.

Walter
You're welcome, I hope it might help:)
I always find these theories about suicide fascinating. Of course never will a theory be 100% correct for everyone but some of these aspects in these theories suit me.
I think in the end every suicide will be some sort of "the persons own mystery " because the other people will never have the possibility to see which thoughts he had, how exactly he saw the things therefore the main driving forces will die with that person. Even if someone writes a book and lets it there so his loved ones might understand him they'll never fully 100% from his perspective be able to understand it.

I hope this makes sense, sorry for my english it isn't my mother language.
 
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Whale_bones

Whale_bones

A gift to summon the spring
Feb 11, 2020
523
I'm sure this could be true for some people, but I disagree that it's true for most suicidal people. My decision isn't made out of black-and-white, rigid or magical thinking; quite the opposite. It's a carefully considered, well-thought out decision that takes into account my permanently low quality of life. Magical thinking would be believing my reality is different than it actually is, believing that "things will get better" when I have decades of evidence to the contrary.

I have found that the field of psychiatry often assumes these things; that suicide is just "running away" from your problems, you don't have enough coping skills, and you're having tunnel vision or black-and-white thinking.

But these assumptions are made without actually learning about the person's life, and come from the viewpoint of suicide being an irrational thing caused by a flaw within the person's thinking, rather than a logical, carefully considered reaction to their life circumstances. So, I definitely don't think this model should be assumed to be true for all or most suicidal people.
 
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Crescendo

Crescendo

Member
Aug 9, 2025
32
Psychache is intense, unbearable psychological pain. It's not just depression, sadness, or anxiety in a clinical sense; it's a feeling of immense mental agony, hopelessness, and helplessness.
Shneidman famously stated, "Suicide is caused by psychache." He argued that when this pain is perceived as endless and intolerable, and when an individual can see no other way to escape it, suicide emerges as a solution.
Well, ask yourself - have all the suicides you've witnessed necessarily involved a display of "immense mental agony, hopelessness, and helplessness" to the extent that you can best interpret each individual's psychological state prior to following through with the act? I've personally seen quite a few videos of people committing suicide. Some were visibly distraught in the moments leading up, while others appeared rather calm and collected. Of course, an outwardly composed demeanor doesn't prove that someone isn't suffering internally - but the reverse is also true: we shouldn't assume that extreme inner torment is always present, even when there is no clear indication of it.

I absolutely believe it's coherent to hold that the decision to expedite death can sometimes stem from a considered philosophical stance rather than from overwhelming, pathological "psychache." Consider philosophers such as Philip Mainländer and David Hume, among others, whose writings treat the question of suicide in explicitly rational and reflective terms. To insist that Shneidman's psychache thesis covers all cases is, necessarily, to place those teachings and any similar positions outside the realm of consideration.

I understand that many people who become suicidal are indeed in profound mental anguish, and acknowledging that suffering matters - for which the concept of psychache provides validation and a framework of understanding for. However, there is a very real danger for right-to-die advocacy in turning this into a universal claim that any decision to end one's life must be the product of unbearable, mind-clouding pain ("psychache").

Once you grant credence to that premise, you enable opponents of the right-to-die to use it as an anchor point for their argument: if all suicide is caused by "immense mental agony, hopelessness, and helplessness," then the person is, by definition, not in a position to make a rational, autonomous choice - and thus every suicidal decision can be dismissed as irrational. Even if psychache explains many suicides, it doesn't follow that it explains all of them, nor that suicidal intent is automatically incompatible with a sound and reflective mind.
 
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UserFromNowhere

UserFromNowhere

Student
May 4, 2025
100
It's important to recognize that Shneidman was foundational in modern suicide research, much as Freud was instructive in the field of psychology in general or Einstein in the field of physics. However, not everything he said was correct. For example, he was of the belief that most deaths have some aspect of suicide in them, whether that's someone accepting their end or inadvertently hastening it. It does not appear particularly accurate to say that every dead person was, in fact, suicidal. Additionally, some of Shneidman's contemporaries even believed that suicide could be a rational decision for a patient who was suffering. Modern researchers have more accurate models of suicide, even recognizing that their model cannot adequately explain every aspect of suicide due to the complex, nuanced nature of the topic. I wouldn't take Shneidman's model of psychache as wholly correct, even if it's something I can resonate with in some regards.
 
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Terrible_Life

Specialist
Jul 3, 2025
356
When I first read about this suicide theory I was impressed about Shneidman's word "psychache" . I mean he simplified it and made it so easy to understand. In the end don't most of us here do have psychache? Don't we have unbearable mental pain which led to us to this point where we came here and started researching a way how to kill ourself?
I understand there might be people who do not need these so called "basic psychological needs" like for example belonging to society, having a functioning social life, a partner, a job etc. but I think there are lots of suicides happening because of the non existence of these things.
Some people commit suicide because their partner left then, someone else because of financial struggle, someone else because his job was his personality his whole life then he got fired and feels a not belonging, then there are older people who loose their wife/husband with whom they were married for 50+ years and they ctb.
I think with the psychache theory he really had a good point.
 
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