Psychotherapists' experiences of patient suicide.
Item
-
Title
-
Psychotherapists' experiences of patient suicide.
-
Identifier
-
AAI3063875
-
identifier
-
3063875
-
Creator
-
Rubenstein, Hilary Jane.
-
Contributor
-
Adviser: Larry Gould
-
Date
-
2002
-
Language
-
English
-
Publisher
-
City University of New York.
-
Subject
-
Psychology, Clinical
-
Abstract
-
50% of psychiatrists and 35% of other mental health professionals experience the suicide of a patient during the course of their career (Chemtob, 1988). Yet, few case studies of patient suicide have appeared in the literature. This study uses the recollections of ten therapists to study treatments of patients who committed suicide.;A pattern emerged from the treatments studied. Therapists felt an immediate positive connection with the patient early in the treatment. The hypothesis derived from this study suggests that idealization and omnipotence dominated the transference and countertransference in these treatments, leading the patient and therapist to feel excitedly hopeful in the early phases of treatment. Although patients improved to some degree in most treatments, the therapists felt hopeless in the later phases of the treatment and doubted that the patient could benefit from further analytic exploration. Yet, they could not imagine terminating the treatment because the patient was seen as too impaired. Most therapists handled this dilemma by turning towards a solely supportive approach with the patient. They sought to help the patient avoid intolerable states of mind in general, and intolerable negative transference states in particular. Although a positive rapport was maintained with the patient, it will be argued that avoidance of intolerable states of mind is an interminable, impossible pursuit that breeds disillusionment and hopelessness in both therapist and patient and undermines the task of psychoanalytic work. In the treatments studied, none of the patients shared their suicidal intentions with the therapist prior to the suicide. Both therapist and patient had lost faith in the analytic process as potentially helpful. It will be suggested that hope could only be renewed through the analysis of hopelessness.;This study does not provide definitive explanations the patients' suicides, nor does it suggest that another intervention could have prevented the patient's suicide. Detailed clinical material is presented to illustrate the themes of idealization, omnipotence, hope/hopelessness, intolerable experience, and the physical and emotional availability of the therapist. Three contemporary perspectives on analytic involvement (Freudian, relational and Kleinian) are presented to provide a theoretical framework to discuss the findings of this study.
-
Type
-
dissertation
-
Source
-
PQT Legacy CUNY.xlsx
-
degree
-
Ph.D.
