Around the world, more than a million people die by suicide each year. Yet many of us know very little about a tragedy that may strike our own loved ones—and much of what we think we know is wrong. This clear and powerful book dismantles myth after myth to bring compassionate and accurate understanding of a massive international killer.

Drawing on a fascinating array of clinical cases, media reports, literary works, and scientific studies, Thomas Joiner demolishes both moralistic and psychotherapeutic clichés. He shows that suicide is not easy, cowardly, vengeful, or selfish. It is not a manifestation of "suppressed rage" or a side effect of medication. Threats of suicide, far from being idle, are often followed by serious attempts. People who are prevented once from killing themselves will not necessarily try again.

The risk for suicide, Joiner argues, is partly genetic and is influenced by often agonizing mental disorders. Vulnerability to suicide may be anticipated and treated. Most important, suicide can be prevented.

An eminent expert whose own father's death by suicide changed his life, Joiner is relentless in his pursuit of the truth about suicide and deeply sympathetic to such tragic waste of life and the pain it causes those left behind.

In the wake of a suicide, the most troubling questions are invariably the most difficult to answer: How could we have known? What could we have done? And always, unremittingly: Why? Written by a clinical psychologist whose own life has been touched by suicide, this book offers the clearest account ever given of why some people choose to die.

Drawing on extensive clinical and epidemiological evidence, as well as personal experience, Thomas Joiner brings a comprehensive understanding to seemingly incomprehensible behavior. Among the many people who have considered, attempted, or died by suicide, he finds three factors that mark those most at risk of death: the feeling of being a burden on loved ones; the sense of isolation; and, chillingly, the learned ability to hurt oneself. Joiner tests his theory against diverse facts taken from clinical anecdotes, history, literature, popular culture, anthropology, epidemiology, genetics, and neurobiology--facts about suicide rates among men and women; white and African-American men; anorexics, athletes, prostitutes, and physicians; members of cults, sports fans, and citizens of nations in crisis.

The result is the most coherent and persuasive explanation ever given of why and how people overcome life's strongest instinct, self-preservation. Joiner's is a work that makes sense of the bewildering array of statistics and stories surrounding suicidal behavior; at the same time, it offers insight, guidance, and essential information to clinicians, scientists, and health practitioners, and to anyone whose life has been affected by suicide.