Trauma and hopelessness, two key factors in suicidal behavior
More than 700,000 people die by suicide worldwide each year, according to the World Health Organization. In Spain, 4,097 people died by suicide in 2022, the highest figure since records began. This represents a 2.35% increase compared to 2021 ( Suicide Observatory in Spain 2021 , Spanish Foundation for Suicide Prevention).
Suicidal behavior is a complex and multifactorial phenomenon involving the interaction of multiple distal and proximal factors. Distal factors include genetic factors and adverse childhood events. Proximal factors include current stressful situations or present mental health symptoms. This may partially explain why some people, but not all, exhibit suicidal behavior in certain situations.
Hopelessness in suicidal behavior
Hopelessness is a key and widely studied factor in suicidal behavior and can appear in the presence of adversity (current) and trauma (life history).
In order to explain hopelessness, it is necessary to describe hope as a concept:
- Dynamic.
- Multidimensional.
- Of empowerment.
- Focused on life.
- Related to external aid.
- Related to care.
- Future-oriented.
- Highly individualized.
Hope is an effective tool for managing suicidal behavior.
Despair , on the other hand, is an experience within the human condition, described as a lack of hope or the desire for hope, despair, or feeling hopeless. Hope and hopelessness are continuum concepts, ranging from hope to absolute and extreme despair. It is a concept:
- Multidimensional.
- Dynamic.
- It entails disempowerment.
- Threat to quality and longevity of life.
- Related to the absence of affection.
- Oriented towards the past.
- Highly customized.
Long-term hopelessness poses a threat to people's quality of life, both physically and psychologically, and is a key factor in explanatory theories about suicide.
Hopelessness is a construct that encompasses the following aspects:
- Motivational: it involves a lack of response initiation and a lack of expectation towards the future.
- Cognitive: difficulties in assessing one's ability to control and respond. There is an inability to think about or imagine a tolerable future. It impairs the ability to concentrate, search for solutions, and carry out problem-solving.
- Emotional: sadness.
Within the phenomenology of suicidal behavior, there are several components, such as cognitive rigidity, which restricts how we perceive reality and our reaction to the environment. This rigidity makes it difficult to evaluate alternatives, and reality is perceived as intolerable, leading to a feeling of hopelessness . The person feels stuck in the past and is unable to see the future, focusing on their failures and doubts.
Long-term hopelessness poses a threat to people's quality of life, both physically, psychologically, and spiritually. It is a key factor in explanatory theories about suicide.
Beck's theory
It focuses on hopelessness as a prevailing factor in all suicidal behavior. The person has a maladaptive and negative perception of reality and is unable to formulate a positive view that leads to hope.
The theory of hopelessness
He explains that the interaction between negative coping styles and negative events generates a feeling of hopelessness.
Interpersonal theory
It posits that death by suicide is conditioned by two factors: the desire for suicide and the capacity to attempt suicide. The desire for suicide is the result of:
- Experiencing a lack of belonging.
- Feeling like a burden to family, friends, or society.
- Despair about the future.
It explains that the feeling of not belonging and of being a burden generates a desire to die that can put a person at risk of suicidal ideation. This construct can vary over time due to interpersonal and intrapersonal changes. The lack of belonging, coupled with the feeling of being a burden and the presence of hopelessness about the future, causes a passive desire for death to become active. This theory positions hopelessness as the key factor between ideation and intent.
The lack of belonging plus the feeling of being a burden, along with the presence of hopelessness about the future, causes the passive desire for death to become active.
The 3-step theory
It explains that suicidal ideation results from a combination of pain (primarily psychological) and hopelessness. Connectivity is the key protective factor that prevents acting on the impulse. The three steps described in this theory are:
- Development of suicidal ideation : This theory considers that the first step in the development of suicidal ideation is pain (physical or psychological), the presence of which diminishes the desire to live. Pain alone is not sufficient to produce suicidal ideation; hopelessness is necessary for suicidal behavior to develop. The person experiences a sense of hopelessness and believes that their pain will not improve.
- Moderate to severe suicidal ideation : a lack of connection with others is the second step toward a potential suicide attempt. Connection can be through a project, a role, an interest, or work that provides a sense of purpose or meaning in life. The presence of a feeling of connection helps to alleviate feelings of pain and hopelessness.
- Progression from suicidal ideation to suicide attempt : the capacity for suicide is acquired through habituation to pain, fear, and death. A history of exposure to adverse life events (traumatic situations) generates ineffective coping mechanisms and leads to suicidal tendencies.
The patterns of behavior or coping mechanisms associated with hopelessness do not arise spontaneously. They are usually a response from the past that perpetuates itself in a person's present and future.
Keys to preventing suicidal behavior
The relationship between past traumas, hopelessness, and suicidal behavior
The literature repeatedly argues that hope is oriented toward the future and hopelessness toward the past. People who exhibit suicidal behavior often have past experiences related to feelings of hopelessness. Individuals with traumatic experiences have a higher risk of suicidal behavior. (Sadeck, J., 2019; Van Orden KA, 2010; Klonsky D., 2015; Liu RT, 2025; Pompili M., 2021)
In this context, we must introduce the concept of attachment , which provides a framework for understanding our relationships with others and our emotional well-being . In this sense, the baby develops a view of themselves, others, and the world based on their initial experiences with their attachment figures. Emotional regulation develops through interaction with the primary caregiver.
Secure attachment involves the internalization of behaviors that lead to calming emotional regulation. The individual has the resources to tolerate hopelessness because they are able to accept their limitations; they will have the capacity to tolerate reality and accept that suffering is inevitable.
People who exhibit suicidal behavior often have past experiences related to feelings of hopelessness. Those with traumatic experiences are at higher risk for suicidal behavior.
Studies have linked insecure attachment to a higher risk of suicidal behavior (Miniati M., 2017; Turton H., 2022). Adverse experiences during the attachment development stage are considered to generate insecure attachment patterns that, in adulthood, manifest as pessimism, difficulty developing a stable identity, loneliness, difficulties with emotional regulation, low self-esteem, hopelessness, and suicidal risk. Thus, children who experience traumatic situations perpetrated by an attachment figure may develop a sense of betrayal that leads to greater emotional dysregulation . It is believed that this emotional dysregulation could be the key factor explaining the increased risk of suicide.
Socio-emotional development in adolescence
People are at risk of developing coping strategies that hinder their ability to deal with loss, rejection, and disappointment. Life will bring moments of adversity that can trigger suicidal crises , during which the person will be unable to develop coping strategies and will experience a sense of loneliness similar to that felt in earlier stages of attachment development.
Relational trauma
Childhood adversity, such as child abuse, is one of the risk factors most closely linked to suicidal behavior. Some studies indicate that 30% of individuals who exhibit suicidal behavior have a history of trauma (child maltreatment, sexual abuse, emotional abuse, neglect, etc.). In the specific case of child abuse, this figure reaches up to 43%, according to some studies, which also indicate that childhood abuse generates a cognitive pattern of vulnerability to depression and hopelessness . (Panagioti M., 2009; Berardelli I., 2022; Spokas M., 2009)
In cases of adverse childhood experiences, children try to understand the cause of the mistreatment in order to prevent it in the future. The sequence is as follows:
- Initially, he makes an external and unstable attribution for the origin of this adverse situation.
- If the situation becomes chronic, these initial attributions are not confirmed, and the likelihood increases that the child will make an internalized attribution, which may become permanently established. They believe there is something about them that makes them prone to being the target of repeated abuse.
- A sense of hopelessness develops regarding the ability to cope with adversity and the future. This carries an increased risk of depression.
- The perpetuation of traumatic events reinforces these attributions.
30% of people who exhibit suicidal behavior have a traumatic history, such as child abuse, sexual abuse, emotional abuse, neglect, etc.
Traumatic situations perpetrated by loved ones have the greatest impact and predispose individuals to feelings of insecurity and a higher risk of suicidal behavior. This situation compromises a person's ability to cope with future painful situations. The individual tends to develop a sense of guilt that is closely linked to aggression and hostility, primarily directed toward themselves.
Single trauma and post-traumatic stress disorder (PTSD)
Trauma and post-traumatic stress disorder pose a greater risk of suicidal behavior.
Trauma is not caused by the situation itself, but by the emotional response, often associated with a feeling of hopelessness at being unable to escape. In a stressful situation, panic, fight-or-flight responses, terror, etc., are activated, all aimed at enabling the person to escape. But when this is not possible, it generates pain, despair, and hopelessness due to the feeling of being trapped. This situation can go from tolerable to intolerable. Along these lines, there is the Cry of Pain Theory, which explains that suicidal behavior is triggered by the feeling of being trapped and that this feeling leads to hopelessness stemming from the inability to escape. This theory posits that nightmares present in post-traumatic stress disorder could trigger feelings of defeat, entrapment, and hopelessness.
There are also studies that demonstrate that hopelessness is closely related to a higher risk of suicide in people with post-traumatic stress disorder (Panagioti M., 2009; Berardelli, I., 2022; Spokas, M. 2009). The person experiences a sense of defeat or humiliation, or a feeling of being trapped, and this may be related to a higher risk of depression and suicide. The feeling of being trapped is different from hopelessness, and this feeling can originate from internal sources (pain, thoughts, feelings) or external sources (related to the motivation to escape and the perception that escape routes are blocked).
In conclusion, hopelessness is part of the emotional landscape of everyday life and also of adversity. The vast majority of people experience adversity and hopelessness at some point in their lives, often simultaneously. Traumatic situations can develop a pattern of behavior characterized by a predominant sense of hopelessness through various mechanisms. These patterns can become ingrained in people's lives, and in times of crisis and adversity, they can lead to a higher risk of suicide.
This risk can be reduced if we enhance coping resources such as (Sadeck, J, 2019):
- Mapping: the ability to gather information to plan and explore alternatives.
- Minimize : the ability to reduce the importance of the negative effects of traumatic experiences.
- Replace: the ability to cope with negative events by taking alternative actions.
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