Understanding the psychodynamics of the pathway to suicide

Figures & data

Table 1. Definitions of terms used throughout the paper.

Term	Definition
Emotions	Originates as a cluster of sensations in the body that represent different emotional states. They are manifested unconsciously.
Feelings	Thoughts generated through symbolisation from the somatic emotional states in the body. They are manifested primarily consciously.
Symbolise	A symbol is an indirect form of representation that allows an individual to think about people, objects, events that are not concretely available. These symbols are available for utilisation intrapsychically to represent ideas, conflicts or wishes.
Containment	A relational term. Distress is projected and the container digests these projections and makes some sense of them reducing anxiety and generating meaning.
Split in the ego	A division in the sense of self, where two parts of the self, function side by side without influencing each other, one taking reality into account and the other disavowing reality. Each side not communicating with the other.
Ego	One of three parts of Freuds ‘structural model’ of the psyche that mediates between the ‘id’ and the ‘superego’. The ego engages with reality and it is where self-identity is located. The id is entirely unconscious and holds the basic instinctual urges, such as aggression and sexuality.
Superego	The superego functions as a conscience, repressing what it considers to be morally unacceptable.
Ambivalence	In ambivalence there are two contrary wishes at the same time. In someone who is suicidal it is the wish to live and the wish to die. In a primary ambivalent state these wishes are held by two different parts of the individual due to the split in the ego.
Projection	An unconscious defence to expel unacceptable aspects of the self into the outside world and then experiencing them as belonging to someone or something else.

Figure 1. The Pathway to Suicide as described by Hale and Campbell (Ref working in the Dark).