Managing Suicidal Behavior

SUICIDE is the most extreme behavior physicians confront. When a patient commits suicide, it may be a result of our failure to intervene effectively. It may make us angry, for the act itself is an extremely hostile communication, but it also invokes a sense of guilt at our inability to prevent an unnecessary death.

Modern suicidologists classify suicide as either interpersonal or intrapersonal. Interpersonal suicide victims make frequent threats and attempts to kill themselves. They possess emotional lability, ill-defined suicide plans, and a fairly clear idea of how their crisis might be resolved. Intrapersonal suicide victims are less open in showing their suicidal drives and are withdrawn rather than emotional. They show clearly formulated plans but have no solutions other than suicide to end their crisis. Both types may result from the loss of a valued person, an intangible, or their self-esteem. The intrapersonal victim is less accessible and more