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The suicidal survivor: Considerations for treatment in psychodynamic psychotherapy

Published online by Cambridge University Press:  13 August 2021

A. Maia Andrade De Souza
Affiliation:
Medicine, Centro Universitário Tiradentes, Maceió, Brazil
G. Lessa De Souza Maia*
Affiliation:
Medicine, Centro Universitário Tiradentes, Maceió, Brazil
L. Helena Freitas Machado
Affiliation:
Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
*
*Corresponding author.

Abstract

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Introduction

Suicide is a phenomenon that is increasing in prevalence. Exposure to suicide by a loved one can be experienced as a traumatic event, capable of precipitating or aggravating preexisting psychiatric conditions. As much as we are clinically aware of gravity situation experienced by suicide survivors, there is a marked lack of studies on psychotherapeutic interventions in this population group.

Objectives

The present work aims to review the literature on the psychodynamic treatment of suicide survivors, considering their theoretical and technical aspects.

Methods

Narrative review of psychiatric and psychoanalytic literature.

Results

The initial reaction described on becoming aware of the suicide of someone close to you is of disbelief, shock and helplessness. This is followed by ambivalent feelings of hate and guilt, shame and hopelessness. Sometimes, a chronic depressive state expressed by the survivor’s guilt can emerge. The mourning work will initially encounter resistance to face the loss of the object, through mechanisms such as denial, repression and psychotic fantasies. The lost suicide has a traumatic impact, modifying relational patterns and it is commonly associated with important isolation. The survivor will be able to transfer via fear the death of the therapist and even fantasize that he will also kill himself.

Conclusions

Psychodynamic psychotherapy with suicide survivors finds theoretical and practical foundations in the literature, mainly through discussions of reports clinical and theoretical reviews on the topic. Through transfer and therapeutic alliance, new patterns of object relation can be sketched, in a context of mourning so often complicated by shutdown pressures and loneliness.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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