Birtchnell J
Am J Psychother. 1983 Jan;37(1):24-36. doi: 10.1176/appi.psychotherapy.1983.37.1.24.
The management of the suicidal patient is complicated by (1) the emotions expressed and the demands made by the patient, (2) the therapist's own responses, and (3) the influence of significant others. The therapist may be required to make himself available and to become personally involved to a greater extent than is usual. The suicidal patient has a tendency to involve himself in symbiotic relationships from which it is difficult for either partner to become detached without generating anxiety in the other. The degree to which the therapist indulges the patient in his dependency needs or encourages him to act responsibly is a matter of fine clinical judgment. The unwillingness of the suicidal individual to entrust himself to others causes him to become ambivalent towards both the therapist and life itself. The hostile, even murderous attitude of family members may require his temporary removal from them and necessitate their involvement in his treatment.
（1）患者表达的情绪和提出的要求；（2）治疗师自身的反应；（3）重要他人的影响。治疗师可能需要比平时更随时待命并亲自深入参与。自杀患者倾向于陷入共生关系，在这种关系中，任何一方若不引起另一方的焦虑就很难脱离。治疗师在多大程度上迁就患者的依赖需求或鼓励他负起责任，这需要精细的临床判断。自杀个体不愿信任他人，这使他对治疗师和生活本身都产生矛盾心理。家庭成员的敌意甚至 murderous 态度可能需要让他暂时与他们分开，并使他们参与到他的治疗中来。 （注：原文中“murderous”直译为“ murderous”，结合语境推测可能是“ murderous”，但这个词在这里比较罕见，可根据实际情况进一步确认准确含义）
