Suicidality as an expression of ‘Psychic retreats’: Some clinical and theoretical aspects

Abstract

The paper aims to show that the theory of ‘Psychic Retreats’ can offer a clinically helpful framework for understanding manifest and latent suicidal tendencies. A psychic retreat is often clung to when the contact with reality (internal or external) becomes too frightening or would confront the patient with unbearable psychic pain. In such a situation a retreat may serve as a temporary refuge; but in its chronic form it leads to an impasse which can obstruct any possibility of psychic development and often reflects a pathological organization of the personality. Originally aimed at binding and neutralizing destructive impulses, the retreat may then become itself an expression of chronic and tormenting destructiveness. Using clinical material the paper illustrates how suicidal fantasies can create an impasse which serves to control the analyst by making use of perverse mechanisms and specific forms of projective identification. On the other hand, a psychic retreat may also serve as a masquerade to cover up suicidal tendencies. In the first form the underlying cruelty is displayed more openly while in the second it is disguised by romanticization and idealization. Both forms of a psychic retreat confront the therapist with considerable technical difficulties and make it necessary to carefully register and interpret the subtle enactments of very pathological object relations within the transference relationship.

Acknowledgement

I would like to thank Dr John Steiner, London, for his ideas and comments.

Notes

^1. An earlier, unpublished version of this paper was given at the international congress on Suicidality – Psychoanalysis, University of Hamburg, Germany, in 2001.

^2. This case was communicated to me by a colleague, whom I want to thank for his permission to quote the material.