Book excerpt: Suicide presents a real and often tragic puzzle for the family and friends of someone who has committed or attempted suicide. 'Why did they do it?' 'How could they do this?' 'Why did they not see there was help available?' For therapists and clinicians who want to help those who are vulnerable and their families, there are also puzzles that often seem unsolvable. What is it that causes someone to end his or her own life, or to harm themselves: is it down to a person's temperament, the biology of their genes, or to social conditions? What provides the best clue to a suicidal person's thoughts and behaviour? Each type of explanation, seen in isolation, has its drawbacks, so we need to see how they may fit together to give a more complete picture. Cry of Pain examines the evidence from a social, psychological and biological perspective to see if there are common features that might shed light on suicide. Informative and sympathetically written, it is essential reading for therapists and mental health professionals as well as those struggling with suicidal feelings, their families and friends.