Suicide as a distorted goal-directed process: Wanting to die, killing, and being killed.

It has been suggested that suicidal persons engage in distorted thinking. We propose that suicide can be understood as a distorted goal-directed action. The purpose of this qualitative study was to identify the specific distortions in the goal-directed processes of suicide as indicated in suicide narratives of 40 persons after a suicide attempt. The findings indicate action distortions such as the disconnect between the wish to die, the action of killing oneself, and the experience of being killed. Furthermore, we found a lack of long-term nonsuicidal pursuits, missing or incomplete action monitoring, and control and regulation processes. The implications for suicide prevention are discussed, and the procedure of self-confrontation interview is suggested as a helpful intervention.