I want to die! The suicidal patient.

“How do I overcome my patient’s urge to die?”

We don’t overcome her urge to die. We accept it. We make room for it. We explore it.

As therapists, we can make the mistake of trying to “fix” the patient. We try to drug away her suicidal thoughts. We argue with her, try to convince her not to kill herself, offer all the reasons she should live. Then the conflict is between you and her: you want her to live and she wants to die. Meanwhile, no one listens to her.

The urge to die is double-sided. On the one hand, wanting to die is almost always how we turn rage toward others upon ourselves. In fact, the suicidal urge can be an opportunity to help the patient feel her rage where it really belongs.


At the same time, the urge to die affirms her life: “I don’t want to live this way. I don’t want to pretend I feel something I don’t feel. I don’t want to keep putting up this façade. This life of the false self is not worth living.”


We can agree. A life of lying to oneself, of being a false self, is not worth living.


Underneath her wish to kill the false self that traps her, is the urge to come out of prison. Underneath her wish to die is a wish to be reborn. Suicidal thoughts keep saying to her, “This is not enough! You shouldn’t have to live this way.” Her despair is not wrong. She should despair. Living with a façade is hopeless. Lying to herself is hopeless. She does not need to give up hope on herself, but she does need to give up hope on hopeless strategies: defenses.


She is right. Something does need to die. Not her. But her way of dying, the defenses that are killing her.









4 responses to “I want to die! The suicidal patient.”

  1. Philip Kjær Avatar
    Philip Kjær

    Hi Jon

    Have you any videopost, transcripts of treatment or longer recordings on treatment of suicidal patients? I am working at a secure Youth Institution and I tend to get stock in intervention with these patients.

    Hope you can help og guide to some litterature or something else


    Philip Kjær Core-training student DK.

    1. Jon Frederickson Avatar
      Jon Frederickson

      I don’t have any videotapes available on the website for this kind of work. However, in my new book, The Lies We Tell Ourselves, I have several examples and transcripts involving work with suicidal and dying patients. I hope you enjoy the book!

    2. istdpadmin Avatar

      No, I don’t have any videos for release on suicidal patients.

  2. Philip Kjær Avatar
    Philip Kjær

    It has been ordered!!

    Thank you

    Merry Christmas and may the new year bring you happiness.


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