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Dissociation, Physical Pain, and Suicide: A Hypothesis
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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“Michel (65) highlights the importance of a dissociative state of mind in the immediate run-up to a suicidal act (cf. 66).”
From Ambivalence model of suicidality [ABS-model]: an orientation model for the treatment of suicidal individuals (2024) · cites this paper as [66]
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The Body Investment Scale: Construction and validation of a body experience scale.
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Self-citationAn fMRI study on mental pain and suicidal behavior
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Thresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents.
Orbach, I., Mikulincer, M., King, R. A., Cohen, D. J., & Stein, D. J. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.65.4.646 · Cited by 153
Self-citationThresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents
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Self-citation
Metadata
- 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
- 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
- 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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