Where the Mind Suffers: Understanding Psychic Pain and Suicidal Crisis

Speaker: Katie C. Lewis, PhD

Psychic pain – often described as unbearable, overwhelming emotional suffering – has been increasingly recognized as a core contributor to suicide risk, yet its clinical contours and empirical significance have only recently begun to be clarified. This talk will review the concept of psychic pain within the broader landscape of suicidology, psychoanalysis, and clinical science and highlight emerging findings that illuminate its structure, correlates, and role in the unfolding of suicidal crises. Across both clinical and nonclinical populations, recent work has demonstrated that psychic pain is not a diffuse or monolithic experience but reflects distinct dimensions of affective overwhelm and perceived loss of emotional control. These facets of psychic pain show robust links with well-established suicide-related vulnerabilities, including trauma exposure, greater severity of psychopathology, diminished psychological resilience, and pathological personality traits. Together, these associations underscore psychic pain as a meaningful marker of heightened vulnerability rather than a nonspecific emotional state. In this presentation, the presenter will review findings from recent studies which show that psychic pain is not only associated with chronic risk but also exerts a powerful moment-to-moment influence on both affective and interpersonal experiences. Taken together, these converging findings position psychic pain as a dynamic, clinically actionable construct that may help identify both who is at risk and when risk is likely to emerge. Implications for assessment and intervention will be discussed, with attention to how recognizing and targeting psychic pain may support more precise and timely suicide prevention efforts.