It is perhaps the scientific ‘law’ in suicidology that suicidal individuals are experiencing psychological pain or suffering and that suicide may be, at least in part, an attempt to escape from this suffering. Suicide occurs when the psychological pain or psychache is deemed by the person to be unbearable. Shneidman proposed that the key questions to ask a suicidal person are ‘Where do you hurt?’ and ‘How may I help you?’ If the function of suicide is to put a stop to an unbearable flow of painful consciousness, then it follows that the clinician's main task is to mollify that pain. Shneidman also pointed out that the main source of psychological pain is frustrated or thwarted psychological needs. These psychological needs include the needs for achievement, affiliation, autonomy, counteraction, exhibition, nurturance, order and understanding.

Although the concept of psychache is used in discussions of suicidal behavior, there have not been many attempts to devise quantitative measures of the variable for research. Also, for suicidal psychiatric patients, amelioration of symptoms is not sufficient to reduce pain associated with certain events, probably because of the lack of proper management. In addition, efforts should be made to reduce the psychache currently experienced and to restructure the cognitions of the patients about the traumata that they have experienced in the past. Asking of the suicidal person about psychache and suicidality may be useful in establishing rapport with the patient and in assessment, beyond psychometric scores.