Citation

Hendin H. Int. Rev. Psychiatry 1992; 4(2): 157-167.

Copyright

(Copyright © 1992, Informa - Taylor and Francis Group)

DOI

10.3109/09540269209066313

PMID

unavailable

Abstract

Knowledge of the psychodynamics of suicide helps to distinguish which patients with any given diagnosis are most at risk for suicide. Such knowledge is essential for the evaluation and treatment of the suicidal patient. The psychodynamic meanings of suicide for a patient derive from both affective and cognitive components. Rage, hopelessness, despair, and guilt are important affective states in which patients commit suicide. The meanings of suicide can be usefully organized around the conscious (cognitive) and unconscious meanings given to death by the suicidal patient: death as reunion, death as rebirth, death as retaliatory abandonment, death as revenge, and death as self-punishment or atonement. Topics for future research include: the role of anxiety in suicide; the capacity to bear hopelessness, rage and other unpleasant affects without regression; the use of particular defense mechanisms in distinguishing the risk for either suicide or violent behavior; and the relation of specific psychodynamic conflicts seen in suicide to particular psychiatric diagnoses. © 1992 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

Language: en

Keywords

human; cognition; violence; suicide; anxiety; review; risk; psychodynamics; coping behavior; guilt; rage; defense mechanism; punishment; affective neurosis