The Treacherous Path: Developmental Psychopathology and the Evolution of Risk for Suicide

As suicide rates continue to rise in the United States, efforts to study the factors that might create vulnerability to suicidal thoughts and behaviors have similarly increased. Challenges associated with arriving at an empirical understanding of the role that environmental, relational, intrapsychic, and other sources of risk play in determining an individual’s vulnerability to acting on suicidal impulses has led to limited efforts to articulate a comprehensive model of suicide that takes psychoanalytically informed developmental principles into account. Whereas the few longitudinal studies of suicidal individuals that do exist have primarily focused on history of psychiatric symptoms, the timing of traumatic events, and the stability of other specific risk factors known to relate to suicide, research is lacking that addresses the relative influence of relational disturbances and subjective experiences of pain and alienation in suicidal individuals, which often begin in childhood and adolescence and are known to play a role in determining how an individual contends with experiences of adversity over the course of a lifetime. This paper provides an overview of literature relevant to the understanding of how psychoanalytic constructs such as attachment style, object relations, and defenses are related to suicidal behavior, and illustrates the need for ongoing research on suicidal behaviors approached from within a psychoanalytic perspective.