Half in Love with Death: Managing the Chronically Suicidal Patient

Cover
Half Title
Title Page
Copyright Page
Dedication
Table of Contents
Preface
	The Problem of Chronic Suicidality
	Rationale for a Second Edition
Introduction
	Challenging Conventional Wisdoms
	The Four Major Points of This Book
		The Inner World of the Chronically Suicidal Patient
		What Kinds of Patients Are Chronically Suicidal?
		How Not to Manage Chronic Suicidality
		Managing Chronic Suicidality in Therapy
	How I Became Interested in Chronic Suicidality
	The Plan of This Book
	Acknowledgments
Chapter 1: Suicidality and Suicide
	What Is Suicidality?
	Suicidal Ideation
	Suicide Attempts
	Suicidal Intent and Suicidal Plans
	Implications of a Lack of Predictability
	Why Self-Harm Is Not Suicidal Behavior
	Profiles of Suicidality
	Conclusions
Chapter 2: Epidemiological and Social Perspectives
	The Demographics of Suicide and Suicidality
	Social Factors in Suicidality
Chapter 3: Myths of Suicide Prevention
	Predicting and Preventing Suicide
	Population-Based Interventions
		Restricting Access to Means
		Education of Gatekeepers
		Suicide Hot Lines, Close Follow-up, and Media Coverage
	The Importance of an Evidence Base for Prevention
	Hospitalization and the Illusion of Safety
	Accepting Calculated Risks
Chapter 4: The Inner World of the Chronically Suicidal Patient
	Psychic Pain and Chronic Suicidality
		Case Example
		Case Example
	Emptiness and Chronic Suicidality
		Case Example
	Hopelessness and Chronic Suicidality
		Case Example
	The Need for Control and Chronic Suicidality
		Case Example
	The Interpersonal Context of Chronic Suicidality
		Case Example
	Empathy and the Inner World
Chapter 5: Suicidality, Development, and the Life Course
	The Developmental Origins of Suicidal Behavior
	Suicidality and Adolescence
Chapter 6: Chronic Suicidality and Personality Disorders
	How Personality Disorder Can Account for Chronic Suicidality
	Chronic Suicidality and Depression
	The Origins of Personality
	Measuring Personality Traits
	Personality Dimensions and PDs
	PDs and the Decline of Psychotherapy in Psychiatry
	Personality and Suicidality
	BPD and Chronic Suicidality
	Childhood Experiences in BPD
	BPD in Adolescence
	Suicidality and the Long-Term Outcome of BPD
Chapter 7: Psychotherapy Research and Chronic Suicidality
	General Principles of Psychotherapy
	Dialectical Behavioral Therapy for BPD
	Other Psychotherapies for BPD
		Mentalization-Based Treatment (MBT)
		Transference-Focused Psychotherapy (TFP)
		Schema Therapy
		Systems Training for Emotional Predictability and Problem-Solving (STEPPS)
		GPM
		Intermittent Therapy
		TAU
		Overview
Chapter 8: Pharmacotherapy and Chronic Suicidality
	Pharmacotherapy and Contemporary Psychiatry
	Psychopharmacology and Suicide Prevention
	The Pharmacological Mismanagement of Chronic Suicidality
	Research on Pharmacology in BPD
		Antipsychotics
		Antidepressants
		Mood Stabilizers
		Anxiolytics
		Other Agents
	Overview
Chapter 9: Tolerating Chronic Suicidality
	Why Tolerating Suicidality is Necessary
	Reflection vs. Action
		Clinical Example
	The Vicious Cycle of Repeated Hospitalization
		Clinical Example
	Chronic Suicidality and Regression
	Responding Empathically to Suicidality
	How to Avoid Hospitalization
		Clinical Example
	Protecting Therapists
	Hope and Recovery
Chapter 10: Managing Chronic Suicidality
	Alliance-Building and Its Fragility
	Suicidal Crises and Impulsivity
	Telephone Contact: Pros and Cons
		Clinical Example
	Boundary Maintenance and Suicidality
	Emotion Regulation: Tolerating, Decentering, and Reappraising
		Case Example
	Managing Impulsivity: Slowing Down and Thinking Things Over
		Case Example
	Getting A Life
		Case Example
	Working with the Families of Chronically Suicidal Patients
		Clinical Example
	How Long Does Therapy Need to Be?
	Thinking Differently about Chronically Suicidal Patients
Chapter 11: Suicidality and Litigation
	Suicide as a Normative Risk of Practice
	Under What Conditions Are Therapists Sued after A Suicide?
	Making Litigation Less Likely
	Families and Litigation
		Case Example
	Summary
Chapter 12: Guidelines for Therapists
	Research Directions
	Final Comments
References
Index