IFS Therapy and Suicide: Exploring Joiner’s Interpersonal Theory with Compassionate Parts Work
Thomas Joiner’s interpersonal theory teaches that thoughts of suicide develop when two deep beliefs form: the sense that we do not belong and the fear that our existence burdens others. Action requires a third element, a body that has grown almost indifferent to pain or death.
Internal Family Systems therapy invites us to stay close to these sorrows, not as clinical symptoms but as living parts that carry stories. When we listen with the calm confidence of Self those same parts can step away from the ledge and back toward connection.
Think of a part, the lonely one. It remembers being left out in childhood or carries rejection from relationships, with the deep conviction that connection is for other people. On many evenings, the lonely one drifts to the background while a more hardened Protector steps in. This Protector scrolls through social media until dawn, numbing that quiets the ache for belonging without risking the rejection of asking anyone to care. Loneliness and social isolation reliably predict suicidal thoughts. When we meet the lonely one in session, we might ask what it longs for rather than what it lacks. We might help the scrolling Protector notice a tiny rise in heart rate that signals excitement about a group down the road offering free morning coffee group. Evidence for social prescribing programmes indicates that such gentle nudges toward the community reliably reduce loneliness and emergency health visits at the same time.
If belonging is one half of the equation the other is the burden story. Inside many clients lives a part engulfed in shame, convinced that every breath they take steals oxygen from someone more deserving. This part often wears the mask of perfectionism because flawless performance feels like the only ticket to self worth. During IFS work we invite the Shame Part to tell its origin story. Sometimes it remembers a hospital room where a caregiver sighed from exhaustion. Sometimes it recalls entrenched cultural narratives about being too much. When that memory is witnessed fully the part no longer needs to punish the body. The Protector that once drove relentless night shifts can experiment with boundaries and rest.
Acquired capability requires a body that no longer trembles on the edge, one that has overcome the instinct for self preservation when the world has become too much. Repeated non suicidal self injury quietly trained the nervous system to endure pain and reduced fear of death. In IFS language the pain-masking part sees suffering as a necessity. Tattoos, extreme workouts, or cutting are not rebellion; they are rehearsals for survival. When we greet the pain-masking part with genuine admiration for its grit we earn enough trust to try something new. Some parts seek the thrill of height or speed. Parts pushing high speed driving and cliff jumps, believing adrenaline will silence inner chaos, and it does for a moment. But when the moment is over high sensation seeking, implusivity combined with high distress tolerance is a recipe for increased acquired capability. Once again we do not shame these protectors. We redirect their courage toward coaching heavy weightlifting or organising weekend hiking groups where the challenge remains but death steps out of the equation.
Dissociation deserves its own spotlight. A Protector that lifts a client out of their body when memories slice too deep. Acute dissociation increases risk markers for suicidal behaviour precisely because the body and this life begins to feels unreal. Grounding with strategies such as tapping helps bring us back to land safely. Only when embodiment is solid can we ask to explore the memory that burdens our system.
All of these Protectors share one motive. They would rather risk the body than let the system drown in shame or emptiness. Suicide, therefore, is not failure; it is misunderstood internal loyalty. Saying this aloud transforms the tone of therapy.
The pain masker relaxes when it hears that its scars were read as devotion, not deviance. Dissocation drifts lower when someone finally thanks it for saving the client in childhood. Responsibility renders life meaningful. In parts language that means every Protector needs a purpose and role even once the crisis calms, a role that channels its talents toward building the future instead of rehearsing the end.
Change begins inside but must ripple outward. Self compassion practices like elongated exhale breathing restore warmth into our inner system, reducing loneliness and shame. Next come small social experiments. Exploring an IFS or DBT skills group offers real time belonging, whilst building our skills and capacity to access our Self energy. Join a community garden, not only does that garden feed burdened parts with purpose, connection and community. It reduces emergency presentations and crisis-driven GP visits with measurable gains in wellbeing after only a season of soil and sunlight
Movement helps too. A recent qualitative study of group yoga for adults with acquired brain injury found that participants spoke most often about the sense of belonging that came from breathing in unison rather than the physical gains. I have watched the dissociative part softens, finaly able to exhale during the final resting pose when they experience safe connection.
I have walked these roads with many people and the data reassures what practice already knows: connection saves lives yet it starts inside. Lonely parts, shameful parts, thrill seeking parts, numbing parts, each wants to belong. Our task as clinicians, friends, or family is to listen until we understand the loyalty beneath the danger. Only then can we invite those same fierce energies to build gardens, sing harmonies, coach courage, and keep breathing.
If this article lands in a moment of private despair may I speak directly to any Protector considering the final solution.
I know you act from devotion. I honour the miles you have carried this system alone.
Reach toward anyone safe, a clinician, a peer worker, a lifeline worker - 13 11 14
References
Alsubaie, L., Schmid, A., Stephens, J., & Weaver, J. (2025). Group yoga and exercise facilitated a sense of belonging for participants with acquired brain injury. Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/j.apmr.2025.04.010
Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., & Joiner, T. E. (2017). The interpersonal theory of suicide: A systematic review and meta-analysis. Psychological Bulletin, 143(12), 1313–1345. https://doi.org/10.1037/bul0000123
Gregory, P., Smith, C., Allison, C., Cassidy, S., & Baron-Cohen, S. (2022). Non-suicidal self-injury and its relation to suicide through acquired capability. Molecular Autism, 13, Article 45. https://doi.org/10.1186/s13229-022-00504-z
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352
Kline, A. C., Bloom, S. A., Park, S. J., & Hagan, C. R. (2021). Exploring dissociation as a facilitator of suicide risk: A scoping review. Journal of Affective Disorders, 303, 256–268. https://doi.org/10.1016/j.jad.2022.01.003
McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., & Linehan, M. M. (2018). Randomized trial of dialectical behavior therapy versus usual care for adolescents at high risk for suicide. JAMA Psychiatry, 75(8), 777–785. https://doi.org/10.1001/jamapsychiatry.2018.1109
National Academy for Social Prescribing. (2023). Measuring outcomes for social prescribing: Evidence briefing. https://www.socialprescribingacademy.org.uk/resources/measuring-outcomes
Schwartz, R. C., & Sweezy, M. (2021). Internal family systems therapy for complex trauma. Journal of Clinical Psychology, 77(9), 2030–2042. https://doi.org/10.1002/jclp.23082
Smith, R. A., Johnson, K. L., Wang, X., & Martinez, J. (2024). Association of substance use with suicide mortality: An updated systematic review and meta-analysis. The Lancet Public Health. https://doi.org/10.1016/S2468-2667(24)00055-9
Wright, R. A., Huston, A. C., Kelly, D. B., & Bichler, L. (2014). Emotional and physiological desensitization to real-life and movie violence. Journal of Youth and Adolescence, 43(2), 155–169. https://doi.org/10.1007/s10964-013-0013-0
