Assessing and Engaging Suicidal Teenagers in Psychoanalytic Psychotherapy: A Case Consultation

Abstract

Assessing and engaging suicidal adolescents in psychoanalytic psychotherapy is filled with complexity and stress, but offers a potential for lasting suicide prevention. This study provides a detailed account of the initial psychotherapy sessions with a suicidal teenager, drawing extensively on the comprehensive notes taken by the therapist. Four discussants were invited to provide their perspectives as to how they would assess the main factors in the case and from this to provide a brief commentary for their own perspectives. This study concludes with a discussion of the differences and commonalities between the various contributions.

Keywords:

• adolescent
• psychoanalytic psychotherapy
• suicide
• therapeutic relationship

Notes

¹The case discussed formed part of a research project, ‘Object relations and suicide in adolescence’, funded by the Tavistock Institute of Medical Psychology. Ethical approval was given by the Tavistock and Portman NHS Trust Research Ethics Committee. All names and some other details have been changed to preserve anonymity and confidentiality.

²The self psychology approach in North America (Kohut, 1977) has recently made links with Kleinian thinking (Maltsberger, 2004). In Germany, the approach in this case relies on the “first scene”, perhaps the most important post war contribution to psychoanalysis from Germany (Argelander, 1970; Klüwer, 2001; Lorenzer, 1973).