Associations between experiences of disrupted attachments and suicidal thoughts and behaviours: An interpretative phenomenological analysis

Rationale: Suicide is a major public health concern and its aetiology is complex. Evidence suggests that experiences of early disrupted attachment relationships with parents and family members are associated with later experiences of suicidal thoughts and behaviours (STB). However, no study has investigated this relationship from an inductive, interpretative and idiographic perspective. Objective: This paper explores the role of interpersonal relationships in STB among nine individuals who have attempted suicide. Method: Semi-structured face-to-face interviews were analysed using an interpretative phenomenological analysis approach. Results and conclusion: Two inter-related master themes were identified: 1) 'challenging relationships as catalysts for STB'; and 2) 'positive relationships as buffers against STB'. Findings indicate that experiences of early disrupted parent-child attachments may contribute to vulnerability for STB by shaping participants' perceptions of intimate others and themselves (internal working models). These working models, along with other environmental factors and life events, may increase the risk of STB through perceptions of defeat, entrapment, perceived burdensomeness and thwarted belongingness. Results also suggest that being exposed to respectful, caring, unconditionally accepting, reciprocal, trusting, and non-judgemental intimate adult relationships increase resilience and is associated with recovery from past STB and a reduction of current suicide risk. The theoretical and clinical implications are discussed.