All changed, changed utterly : a terrible beauty is born. An exploration on the effects of suicidality on the experienced clinician

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Moore, Heather
Issue Date
MA in Psychotherapy
Dublin Business School
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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