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Cited by 118Suicide and Self-Harm StudiesPsychosomatic Disorders and Their TreatmentsPsychoanalysis and Psychopathology Research

Dissociation, Physical Pain, and Suicide: A Hypothesis

Orbach, Israel·1994·Suicide and Life-Threatening Behavior
DOI 10.1111/j.1943-278x.1994.tb00664.x
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Abstract

The hypothesis of this paper states that at least some suicidal individuals are characterized by a disposition toward dissociation manifested in relative insensitivity to physical pain and indifference to their bodies. Three main topics are discussed: dissociation and suicide, psychological aspects of pain, and pain and suicide. Various theoretical and experimental studies suggest that certain stress conditions lead to the development of dissociative tendencies, and that once these tendencies are established, they become an integral part of suicidal behavior. Psychological variables that affect pain tolerance are presented and they include perception, motivation, emotions, and behavioral and cognitive strategies of pain control. These can increase tolerance of pain in suicidal individuals, making the suicidal act possible. The specific relationships of pain and suicide are then introduced through an examination of pain analgesia in the phenomenon of self‐harm. The integration of the material suggests that early and continuous stress lead to the simultaneous development of dissociative tendencies (including indifference to the body and pain) and heightened vulnerability to stress. These dispositions may facilitate suicidal behavior in the face of mounting intolerable stress, helplessness, and hopelessness. Preliminary empirical support for the present hypothesis is cited. This hypothesis shifts the focus of attention from the question of what causes suicide to what facilitates suicide, and in so doing suggests new directions for research and therapy.

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Authors
Orbach, I.
Affiliations
Bar-Ilan University (IL)
Corresponding author
Orbach, Israel
Venue
Suicide and Life-Threatening Behavior
Publisher
Wiley
Published
1994-03
Volume
24
Issue
1
Pages
68-79
ISSN
  • 0363-0234 (ISSN-L)
  • 1943-278X
DOI
10.1111/j.1943-278x.1994.tb00664.x
OpenAlex
W2115002595
Cited by
118
References
72
Citations by year
2026: 3 · 2025: 12 · 2024: 8 · 2023: 4 · 2022: 8 · 2021: 13 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 5 · 2016: 3 · 2015: 6 · 2014: 6 · 2013: 2 · 2012: 2
FWCI
3.57
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6148 d)
Locations
  • Suicide and Life-Threatening Behavior (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
dissociation, suicide, pain tolerance, pain perception, self-harm, stress, dissociative tendencies, helplessness, hopelessness
MeSH terms
Dissociative Disorders, Humans, Pain, Personality Development, Stress, Psychological, Suicide, Self-Injurious Behavior, Pain Threshold

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