Self, ego and suicide

Working with patients who end their lives through suicide is one of the greatest challenges and fears a clinician might face. This paper explores the experience of working with such patients in the course of psychiatric care and Jungian analysis. Jungian theory is used to explore a conceptual understanding of the dilemmas faced. Such theory points to an intractable conflict between Self and ego giving rise to unbearable distress, partly through difficulties arising in achieving individuation. The paper proposes that our difficulties in dealing with a patient's suicide might reflect a manifestation of relentless hope and, perhaps contentiously, these patients made a more considered decision in their final acts than prevailing clinical opinion suggests.