Published online by Cambridge University Press: 04 December 2009
The psychodynamic perspective seeks to understand the meaning of suicidal behavior in terms of feelings, motives, and their conflicts, in the context of past and present interpersonal relationships. For example, in looking at the immediate experiential antecedents of suicidal action, we may ask, what are the intolerable affects from which suicide is a perceived means of escape? What kinds of internal or external events serve to trigger suicidal feelings and behavior and what is their significance in the broader context of the suicidal youngster's life? The psychodynamic approach is also a developmental one that attempts to understand the origins of the vulnerability to suicide and depression in the related developmental vicissitudes of the capacity for self-care and comfort, the ability to develop, sustain and make use of protective affiliations; and the regulation of self-esteem (King and Apter, 1996). Finally, the psychodynamic perspective seeks clues as to how the challenges of a given developmental epoch, such as adolescence, may confer a particular vulnerability to suicidal behavior. The psychodynamic approach to suicide is thus intended not to supplant but to complement the biological, sociological, and nosological approaches to suicide.
The earliest psychoanalytic attempts to understand suicide came early in the twentieth century against the background of a perceived epidemic of youth suicide in Germany and Austria (Neubauer, 1992). Much as in our own day, lay writers sought to blame the schools and the decline of family and social values, while medical writers looked for hormonal defects or “hereditary taints.”