PSYCHOLOGICAL ASPECTS OF
THE SUICIDAL PROCESS
J. Mark G. Williams and Leslie R. Pollock
Our aim in this chapter is to illustrate with some examples from our own and others' research what a psychological model can do to help our understanding of suicide and self-harm. In particular, we need to address the question of whether psychology can add anything to social or biological models. On the social side, there is overwhelming evidence that people who harm or kill themselves have experienced a large number of social stresses in their recent or remote past. Life events and difficulties—such as abuse, bullying, poverty, and social isolation—are undeniably linked to the increased risk of suicidal behaviour (e.g. see Van Egmond et al, 1993 and chapters 3 and 5 in Williams, 1997 for a review). When such evidence of external stresses exists, why search for psychological variables to explain suicidal behaviour? However, the fact that there are many more people with severe social problems who do not commit or attempt suicide encourages clinicians and researchers to look for psychological factors that may mediate the relationship between stressful events and suicidal responses.
On the other hand, of course, biological explanations for suicidal behaviour (see Chapters 3 and 4) appear to present a different sort of challenge for psychosocial models. Biological and genetic research is making good progress in determining who is vulnerable for the sort of violent and impulsive behaviour that characterizes much suicidal behaviour (Kety, 1990). Biological research has focused on examining the