Treating the suicidal patient. Basic principles

Successful psychotherapy with suicidal patients requires an emotionally full, active engagement from the therapist with his patient. Emphasis is on the real relationship, not the transference, and the therapist must be available to the patient as a sturdy, reliable object with whom to identify. The therapist's attitude must be loving, not neutral; the alliance is built upon the therapist's devotion to the patient's growth and the development of the attributes necessary for successful autonomous adult functioning. Patients require emotional containment and support, assistance in modulating painful affect, validation, education, help with reality testing, and kindly limit setting. Countertransference reactions must be expected and kept in check, so that the therapist does not get in the patient's way as he tries to build up the faulty mental structures that got him into trouble in the first place.