The Comprehensive Narrative-Crisis Model of Suicide

Abstract

The narrative crisis model of suicide posits that individuals attempt suicide when they experience a distinct emotional state termed the suicide crisis syndrome. This chapter describes the model, which has three components: trait vulnerability, suicidal narrative, and the suicidal crisis syndrome. Trait vulnerability includes all static risk factors, which are relatively stable over time and distal to acute suicidal behavior. Suicidal narrative describes a suicidal person’s perception of his or her life story in which the past has led to an intolerable present and a future that is unimaginable. The suicidal crisis syndrome (SCS) is a distinct emotional state characterized by entrapment, affective dysregulation, and loss of cognitive control. The result is the suicidal act, brought on by an emotional urge to end the intolerable mental pain of SCS. Imminent suicide risk is primarily determined by SCS intensity, to which both trait vulnerability and the suicidal narrative also contribute independently.