Suicide: Understanding Ideation to Action Theories 

Ideation to Action Theories

The most prevalent current prevention theories which address suicide and ideation include the Interpersonal Theory, Integrated Motivational Volitional Theory, and 3 Step Theory, each of which we will discuss in brief.

The Interpersonal Theory or IPT centers around understanding the primary motivators of suicidal ideation. IPT posits that those experiencing suicidal ideation lack a sense of community and belongingness. Consequently, they feel isolated and unwanted in family and social circles. These feelings then lead to other feelings of being burdensome and unworthy of life

Untreated and combined, these feelings then overwhelm and evolve into internalized self-image distortion and self-hatred due to the belief that loving them or dealing with their mental health is an annoyance, responsible for keeping people from connecting or interacting with them. 

Finally, as the result of the perceived lack of a support system, hopelessness occurs as the individual reaches the point when they begin to exhibit tunnel vision of their belief that these circumstances and feelings will never change or resolve.

Once a person shifts to feeling hopeless, IPT posits that they reach the point of acquired capability.  Acquired capability refers to the development of fearlessness regarding death. This fearlessness is derived from the habituation of pain and suffering combined with a lack of appropriate coping skills. In other words, although a person may want to die, and may even express ideation of this feeling, they do not act on this desire unless they also have acquired the capacity to do so.

Integrated Motivational Volitional Theory or IMV. This model posits that there are three stages of suicidal ideation. 

The pre-motivational stage occurs when an individual experiences a negative life event, such as job loss, the ending of a relationship, or some other form of event perceived as trauma. Coupled with poor coping skills, this can develop into negative self-perception or negative perceptions about reality and globalized worldview.

These negative thoughts and global perceptions can then persist, shifting into deep depression stemming from internal feelings of failure, shame, defeat or humiliation, hopelessness, pain, and isolation.

As this develops into an internal struggle, negative perceptions of self-identity, value, social rank, and a lack of control and power, lead to feeling worthless and burdensome.

Next entrapment occurs, an IMV term describing a blockage or deficiency in the normal psychological motivation to escape feeling threatened or stressed (Siddaway, et al., 2015).

In the volitional stage or final phase of ideation, the culmination of these feelings overwhelms and escalates to the mental imagery of death and suicide planning, which combined with acquired capability (means to do so), develop into attempts. 

Lastly, with just three simple straightforward steps the 3-Step Model or 3ST (Klonsky & May, 2015), may be the easiest to retain of all 3 ideation theories

The model simplifies suicidal ideation to action by highlighting the main causes that lead to suicide attempts. 

1. In step one the person feels great pain combined with hopelessness. 

2. In step two, the person feels that their psychological distress and pain are greater than their sense of connectedness to others or with the living world.

3. Finally, in stage three the person has attained the means to carry out the act of suicide.

Remember, If you or a loved one is considering suicide, you are NOT alone. Please get help today! Help IS available and your life is worth it. 

Suicide & Crisis Prevention Lifeline: Call or text 988, 24 hours a day, 7 days a week. https://988lifeline.org/

Please tune in to our next blog post in the Understanding Suicide series to learn about prevention.