ABSTRACT
Psychotherapy is the treatment of choice for patients with chronic suicidality. This chapter reviews empirical studies on various forms of therapy, drawing on research findings rather than on clinical reports. It suggests that therapists should consider an intermittent course of treatment for chronically suicidal patients. Orlinsky et al. proposed a “generic model” of psychotherapy describing the common factors in all methods, from psychoanalysis to behavior therapy. However adaptations of psychoanalytic therapy for borderline personality disorder (BPD) have been subjected to randomized controlled trials. Dialectical behavior therapy (DBT) was developed specifically for chronically parasuicidal patients. DBT was most specifically designed to target the mood instability seen in BPD but also addresses impulsive behaviors, which are seen as attempts to cope with emotional dysregulation. DBT also places emphasis on how the therapist responds empathically to emotions. As with many forms of psychoanalysis, DBT emphasizes empathy because it provides validation for inner experiences.
