Psychotherapists as suicide survivors.

This paper examines the effects of a patient's suicide on the treating psychotherapist. Psychotherapists were found to react to a suicide with feelings of disbelief, guilt, and shock. This was followed by grief, shame, despair, anger, and a loss of self confidence. The psychotherapists interviewed were permanently affected in two ways. First, the experience remained vividly in their minds. Second, they tended to no longer minimize suicidal behavior, attempts, and gestures. The experience allowed the psychotherapist to confront his grandiose rescue fantasies and to question his sense of security. A support group for the surviving psychotherapists is recommended that would allow them the opportunity to talk about the death. Training programs that would encourage the explicit exploration of suicidal issues, including the patient's responsibility for suicidal behavior, should be established. It is believed that managing the feelings about a patient's suicide needs to become an active process.