On chronic suicidality

Abstract

Chronically suicidal patients with serious personality disorders present their therapists with clinical problems that are subtle, intense and complicated. Therapists need to tolerate a great deal of uncertainty, to recognize both the interpersonal and the intrapsychic complexities of the functions and meanings of suicidality, and, above all, to keep in view the fact that the suicidality is both a hindrance and a help to the patient. Suicidality, in fact, may be central to a patient's search for a degree of dignity and autonomy as well as connectedness worth staying alive to enjoy.