Therapeutic empathy with the suicidal wish: principles of therapy with suicidal individuals

Several principles of therapeutic work with suicidal individuals are described. These principles represent different aspects of therapeutic empathy with the suicidal wish. They are based on a theoretical model that presents suicide as an end result of unbearable mental pain. Mental pain is believed to emerge from reciprocal interactions between biochemical imbalances, life stress, personality factors, pain-producing inner patterns (e.g., self-hate, sense of being dispensable), and facilitators and inhibitors of self-destructive behavior. The therapeutic approach is characterized by an empathic experiential encounter with the death wish, the pain-producing inner patterns, self-destructive tendencies, and the exploration of the most dreadful and frightening inner experiences. An empathic attitude toward the wish to die, coupled by an uncompromised confrontation of self-destructiveness, can provide the hope of discovering a path of compromise with life's difficulties.