Abstract
PSYCHOTHERAPY IS A LIFE-ENHANCING PURSUIT. The treatment and management of
suicidality are considered the most vexing dilemmas a therapist will face in their entire
clinical career. Those providing care to suicidal clients are vividly aware of the awesome
responsibility, intense dedication and exquisite sensitivity required for this work. Not
surprisingly, the overwhelming fear generated by suicidality, stems from the
unpredictability that coincides with a ‘death threat’ hanging over the therapeutic
relationship. Indeed, the subject of suicide cuts deep into the heart of this encounter.
Suicidality is commonly conceived in benign terms, as part of depressive state, a cry for
help, or as a means to manipulate others. It matters how we conceptualise suicide, and in
this study, a psychoanalytic illumination of the process of suicide is deemed critical to
understand the impact of suicidal acts.
Despite extensive research examining the effects of traumatic experiences on
therapists who work with sexual abuse or domestic violence, there is limited empirical
literature on the impact on those practitioners working exclusively with suicidal
populations. In Ireland, it is estimated that 500 citizens die by suicide each year, while
approximately 11,000 ‘Accidents & Emergency’ admissions are the consequence of
suicide attempts. The establishment of the Irish National Task Force on Suicide in 1995
generated a proliferation of therapeutic preventative programs.
Therefore, this research seeks to explore and examine the effects of suicide
prevention on seven accredited and experienced Irish psychotherapists. The process of
interpretative phenomenological analysis (IPA) was applied to the narratives of these
mental health professionals, and three salient superordinate themes emerged from the
data: 1) Overworking; 2) “All Changed, Changed Utterly”/Identity Disruption; 3) “A
Terrible Beauty is Born”/A Spiritual Practice. Most striking across all seven transcripts
was the mix of the corrosive nature of suicidality on the self of the therapist, combined
with unparalleled opportunities for personal growth and spiritual reformulation. Author keywords: Suicide, impact, clinician, suicidality, trauma, burnout, contagion, disruption