Suicidal thoughts and behaviors often stem from profound emotional pain, unresolved trauma, and chronic feelings of disconnection. While evidence-based approaches such as Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) and Dialectical Behavior Therapy (DBT) are highly effective in reducing suicide risk, they may not fully address the attachment wounds at the root of persistent suicidality.

Attachment is more than a developmental theory—it is a roadmap for healing relational trauma. In clinical work, particularly with clients who have experienced neglect, inconsistency, or relational harm, attachment-based interventions offer a powerful path toward emotional safety, resilience, and long-term well-being.

Suicide risk assessment tools like SAFE-T and the Columbia-Suicide Severity Rating Scale (C-SSRS) are widely used in clinical practice—but are they enough? While these checklists help clinicians triage immediate danger, they often miss a critical dimension of suicidality: the underlying attachment wounds that drive chronic despair.

Suicide risk assessments are a critical part of mental health care, but the tools we often rely on—standardized checklists, acute risk factors, and crisis protocols—can sometimes miss the deeper psychological terrain that drives suicidality.

When assessing suicide risk, clinicians often rely on standard measures: prior attempts, access to means, and current suicidal ideation. These factors are undeniably important. However, to fully understand and address the complexity of suicidality, we must dig deeper.

Suicidality is more than a mental health symptom—it is often a relational wound rooted in disrupted attachment. Clients who experience chronic suicidal ideation frequently carry deep histories of inconsistent caregiving, early trauma, or relational neglect.

Human beings are wired for connection. From our earliest moments, we are neurologically and emotionally programmed to seek safety, identity, and belonging in our relationships.

Attachment isn't just about emotional closeness—it's a core survival mechanism. Understanding this from infancy, our nervous system is wired to seek connection, attunement, and safety from others

Attachment is more than just a bond—it is a biological system hardwired for survival. From infancy, humans are neurologically wired to seek connection, comfort, and co-regulation from others.

Part 2: How Attachment Trauma Intersects with Suicide Risk

In Part 1 of this series, we examined the high-risk groups most impacted by suicide, including older adults, LGBTQ+ individuals, Indigenous populations, veterans, and those living with psychiatric disorders.

Part 1: Suicide Risk Among Vulnerable Populations

Suicide, a pressing public health crisis, permeates every community. However, the level of risk is not uniform across all communities

When we think about suicide risk, we often focus on mental illness, acute stressors, or chemical imbalances. While these are essential considerations, there's another powerful and often overlooked contributor: attachment trauma.

Suicide is often framed as a personal crisis—linked to mental illness, trauma, or overwhelming stress. While these are critical factors, attachment science offers an equally important but often overlooked perspective: suicide risk is deeply relational.

Borderline Personality Disorder (BPD) is one of the most emotionally intense and misunderstood mental health conditions. Characterized by overwhelming emotions, unstable relationships, and deep fears of abandonment, BPD can be incredibly difficult for individuals and those who love them.

When we think of depression, we often picture it as a biochemical imbalance—a condition treated with medication or therapy targeting brain chemistry. However, growing research in the field of attachment psychology reveals a deeper, often hidden contributor: our earliest relational experiences.

Setting boundaries isn't just a communication skill—it's a relational experience shaped by early attachment patterns and nervous system responses. For many people with insecure or disorganized attachment styles, boundaries can feel threatening, confusing, or emotionally unsafe.

Setting boundaries isn't just about asserting personal preferences—it can stir deep emotional responses rooted in early attachment experiences. For many individuals, especially those with insecure or disorganized attachment styles, the process of boundary-setting can unconsciously activate fears of abandonment, guilt, or emotional rejection.

When early attachment wounds go unhealed, they often resurface later in life as chronic emotional struggles, unstable relationships, and mental health conditions like depression or Borderline Personality Disorder (BPD). But the good news is this: healing is possible.

Disorganized or insecure attachment is one of the strongest predictors of BPD. This is due to early relational trauma that disrupts the formation of a stable sense of self and emotional regulation

While attachment theory has long been associated with childhood development, its relevance doesn't end there.  Attachment insecurity often persists into adulthood, shaping how individuals experience and navigate mental health challenges