The Psychoanalytic Study of Suicide, Part I: An Integration of Contemporary Theory and Research

Psychodynamic psychotherapy has an important role in suicide prevention. The psychoanalytic study of suicide has taught us a great deal about the human experience and the process of suicidality. There is also much to be learned from other fields of study and from empirical research that can be integrated into psychoanalytic therapies. Central to the psychoanalytic approach to suicide has been understanding the patient's internal subjective experience of unbearable emotional or psychic pain and the urgent need for relief. Emotional pain can include intense affects such as shame, humiliation, self-hate, and rage. Factors that can increase vulnerability to suicidal states include problems with early attunement, dissociation and deficits in bodily love and protection, conscious and unconscious fantasy, and certain character traits and dynamics. Empirical research has confirmed many basic psychoanalytic concepts about suicide, including escape from unbearable pain as the primary driver of suicidal behavior, the role of dissociation in increasing risk of bodily attack, and the importance of unconscious processes. Further research into implicit processes and their role in the suicidal process holds potential to improve suicide risk assessment and to enhance psychotherapy by bringing otherwise inaccessible material into the treatment.

Automated summary

Psychodynamic psychotherapy plays a crucial role in suicide prevention and has provided valuable insights into the human experience and the process of suicidality through psychoanalytic research. Understanding the unbearable emotional or psychic pain experienced by patients and their urgent need for relief is central to the psychoanalytic approach. Factors such as early attunement problems, dissociation, deficits in bodily love and protection, unconscious fantasy, certain character traits, and dynamics contribute to the vulnerability to suicidal states. Empirical research has validated many essential psychoanalytic concepts about suicide, including the escape from unbearable pain as the main driver of suicidal behavior, the role of dissociation in increasing the risk of self-harm, and the significance of unconscious processes. Further research into implicit processes holds potential to enhance suicide risk assessment and optimize psychotherapy outcomes.