ABSTRACT
Many authors have noted the association between suicide and aggression. Since Freud's (1917) formulation of suicide as anger turned back upon the self, many authors have taken up the aspect of suicide as internalized anger. Later authors have also taken up the role of suicide as an experience of hostility from signi®cant others. In this chapter I review some of the literature about aggression and hostility. I suggest that suicide takes place in the context of unbearable hostility towards the self, which is experienced both interpersonally and intrapsychically. Therapeutic interventions should therefore focus on helping the patient to recognize internal aggression and violent rages that end up being aimed at the self. At the same time, efforts should also concentrate on developing a non-hostile external sustaining environment. Psychotherapy that recognizes the patient's emotional experience enables growth of internal sustaining resources. However, that might not be enough. Suicide prevention might necessitate changing the external environment as well.
