ABSTRACT
This chapter describes a group of patients that test to an enormous limit the therapist's capacity to retain his thinking abilities intact. Identifying a suicidal patient is not as easy as lay people might imagine it to be. A further, very subtle complication involves the complex range of thoughts, words and behaviours that can be included under the heading of "suicidal". Ordinary medical jargon will refer to a patient having "attempted suicide" or made a "suicidal gesture". It is important to note the link made in psychoanalytic literature between suicide and violence. Thinking of the ordinary person who attempts or commits suicide, discovering how isolated they were from family, friends, neighbours, any people in fact, tends to be a very common post-facto finding. But when suicidal thoughts or behaviour appear in a patient under therapy, it may be difficult for the therapist to recognize, let alone to deal with, that patient's isolation.
