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Minerva Psichiatrica 2001 December;42(4):305-14

language: Italian

Psychodynamic aspects of suicide and therapeutic remarks on patients with suicidal tendencies

Morelli G., Cellucci A.


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The paper examines the complex dynamics that lead to suicide and proposes a treatment for patients with suicidal tendencies. The paper therefore looks at: a) Data and epidemiological remarks enabling us to formulate hypotheses on the characteristics of the potential suicide. b) Some reflections on the ''rational suicide'' and an attempt to confute the idea that it is possible to prefer death to life in the absence of mental disturbance. c) A classification of suicide from a psychodynamic viewpoint in which the theories of Freud, Musatti, Rado, M. Klein, Blatt, Meissner, Hendin, Fenichel, Conforto, Marcenaro and Bowlby are taken into consideration. d) A comparison with systemic/relational hypotheses according to which the act of suicide originates from the continuous interaction between all members of the system. e) The risk factors and prevention of suicide according to the hypotheses of Ringel (pre-suicidal syndrome), Beck (lack of hope and impossibility to help) and Tatarelli who subdivides prevention into primary, secondary and tertiary.
f) The treatment of the patient with suicide tendencies in whom the importance of the therapeutic relationship which must allow the broadest possible communication is emphasised. The essential therapeutic function is to be taken on board by the patient, not the immediate solution of the self-destructive problem, namely the proposed place where the patient's ideas can be accepted and where a process of re-scaling of his view of his situation experienced as irresolvable can be begun.

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