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“Suicidal pain includes the feeling that one has lost all capacity to effect emotional change. The agony is excruciating and looks as if it will never end. There is the feeling of having been beaten down for a very long time. There are feelings of agitation, emptiness, and incoherence. 'Snap out of it and get on with your life,' sounds like a demand to high jump ten feet.”

“In one sense the cause of suicide is simple: overwhelming pain. This overwhelming pain, however, is the aggregate of thousands of pains. Any hurt that we have ever suffered, if it remains consciously or unconsciously lodged within us, can contribute to suicide. This may range from being an incest victim 50 years ago, to losing a job 10 years ago, to having a car battery stolen yesterday. The pains come from everywhere: ill-health, family, peers, school, work, community, caregivers. For each suicide there was a finite point at which this aggregate became too much. Although "The straw that broke the back," is frequently an accurate metaphor, no one pain is ever the cause of suicide. Suicidal pain is decomposable into thousands of pains, and nearly all of these pains are decomposable into painful constituents. Sexual abuse, job loss, and personal theft each have numerous painful constituents. The search for the single cause is a fundamentally wrongheaded approach to the understanding and prevention of suicide. It is inaccurate to say simply that pain causes suicide, since a level of pain that is lethal for one person may not be lethal for someone with greater resources. Similarly, deficiency in resources cannot be regarded as the cause of suicide, since two people may have equal resources and unequal pain. Our resources may also come from everywhere; even such trivial distractions as going to a movie can contribute to coping with suicidal pain.”