Postdischarge suicide: A psychodynamic understanding of subjective experience and its importance in suicide prevention.

Abstract:

:Recent discharge from a psychiatric inpatient facility is associated with a high risk of suicide. There are multiple factors that may contribute to this increase in risk. Psychodynamic considerations about the patient's subjective experience of suicidality, hospitalization, and discharge are often overlooked but are critical to understanding this phenomenon. Qualitative research has begun to provide empirical support for the importance of the psychological aspects of discharge, and the heightened state of vulnerability that patients experience during this time. Review of the literature and careful consideration of clinical experience is helpful in elucidating this experience in a way that can inform effective treatment. This article integrates a psychodynamic understanding of suicidality in the postdischarge period with a review of empirical research and formulates clinical recommendations for suicide prevention.

journal_name

Bull Menninger Clin

authors

Schechter M,Goldblatt MJ,Ronningstam E,Herbstman B,Maltsberger JT

doi

10.1521/bumc.2016.80.1.80

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

80-96

issue

1

eissn

0025-9284

issn

1943-2828

journal_volume

80

pub_type

杂志文章,评审
  • The role of the primary clinician in the multidisciplinary team.

    abstract::This article explores the role of the primary clinician as an integral member of the modern inpatient psychiatric treatment team, as it is practiced on the Professionals in Crisis program at The Menninger Clinic. The modern inpatient team consists of individuals from multiple disciplines and acts as an embodiment of t...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.67.1.5.23448

    authors: Haslam-Hopwood GT

    更新日期:2003-01-01 00:00:00

  • A psychoanalytically oriented combined treatment approach for severely disturbed borderline patients: the Athens project.

    abstract::A psychoanalytically oriented combined treatment is considered beneficial for severely disturbed borderline patients, especially during an acute crisis. The proposed treatment comprises hospitalization and specialized psychotherapeutic inpatient treatment, individual psychoanalytic psychotherapy, and psychiatric manag...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.68.4.337.56640

    authors: Vaslamatzis G,Coccossis M,Zervis C,Panagiotopoulou V,Chatziandreou M

    更新日期:2004-10-01 00:00:00

  • The relation between attachment, personality, internalizing, and externalizing dimensions in adolescents with borderline personality disorder.

    abstract::The relation between attachment and personality features is an important field to explore in adolescent borderline personality disorder (BPD), and previous research has shown that personality features may be conceptualized within latent internalizing and externalizing dimensions. This cross-sectional study used a stru...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.2016.80.3.213

    authors: Ramos V,Canta G,de Castro F,Leal I

    更新日期:2016-07-01 00:00:00

  • Conceptualizing and managing risk in pediatric OCD: Case examples.

    abstract::It is not uncommon for patients with obsessive-compulsive disorder (OCD) to present with symptoms that suggest possible risk. This can include apparent risk, which reflects the content of obsessional fears, and genuine risk arising as the unintended consequence of compulsive behaviors. In both situations, risk can cau...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc_2019_83_06

    authors: Lewis A,Stokes C,Heyman I,Turner C,Krebs G

    更新日期:2020-01-01 00:00:00

  • Clinical assessment of crying and crying inhibition based on attachment theory.

    abstract::Crying is attachment behavior triggered in infancy by separation and throughout life by loss. Adult crying, as reported and demonstrated in psychotherapy, reflects the quality of early attachment experiences as well as current adult bonds. Specific instances, as well as overall patterns, of crying and inhibited crying...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章,评审

    doi:

    authors: Nelson JK

    更新日期:2000-10-01 00:00:00

  • Psychoanalytic practice and the religious patient: a current perspective.

    abstract::Via a national survey and in-depth interviews, the author investigated training psychoanalysts' views on religion and spirituality and the impact of such views on their treatment practices. The training analysts surveyed described being appreciative of a patient's religious or spiritual worldview when it allowed for f...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.67.4.347.26984

    authors: Bartoli E

    更新日期:2003-10-01 00:00:00

  • Transference-countertransference repetitions of traumatic affects.

    abstract::Some patients defend against all affective experiencing, which limits their ability to process feelings verbally. When they establish such defenses to cope with early traumatic experiences, they may need to repeat the affective tone of these experiences within the transference. Using case material, the author explore ...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.2013.77.2.161

    authors: Gedo PM

    更新日期:2013-04-01 00:00:00

  • Suicidal patients' psychological attacks on the therapist.

    abstract::In therapy, suicidal borderline patients often use the therapist as a "selfobject," an object that regulates the patient's narcissistic equilibrium. To demonstrate this concept, the author presents the case history of a young woman who created a "selfobject transference" by means of attacks on the therapist similar to...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Milch WE

    更新日期:1990-07-01 00:00:00

  • The future of residency training in psychiatry.

    abstract::Psychiatric residency training faces an uncertain future related both to ongoing changes in the health care delivery system and to the current state of knowledge within psychiatry itself. The author discusses issues concerned with financing, models of training, clinical settings, generalist versus subspecialist traini...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Tasman A

    更新日期:1994-10-01 00:00:00

  • The manifestation and management of staff countertransference on a pediatric AIDS team.

    abstract::The authors discuss the countertransference reactions that arise in staff who work in a hospital outpatient clinic with children with HIV and AIDS. Countertransference feelings such as guilt, anger, and helplessness can be easily aroused when working with a young, impoverished, dying population. Factors that precipita...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Mayers AM,Svartberg M

    更新日期:1996-04-01 00:00:00

  • The SCID-D diagnostic interview and treatment planning in dissociative disorders.

    abstract::With the development of reliable diagnostic tools for the dissociative disorders, earlier implementation of appropriate therapy is now possible. The Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised (SCID-D) (Steinberg, 1994b), an extensively field-tested semistructured interview, can assist clin...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Steinberg M,Hall P

    更新日期:1997-01-01 00:00:00

  • Experience is a biochemical intervention: reconceptualizing the "biologically based mental illness".

    abstract::Empirical evidence challenges the discriminant validity of the "biologically based mental illness" (BBMI) construct. Data indicate that interventions such as psychotherapy, placebo, and medication yield similar changes in brain function when effective. Drug and brain imaging studies show that psychological and biochem...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.69.2.157.66506

    authors: Seidel JA

    更新日期:2005-04-01 00:00:00

  • Psychodynamic psychotherapy for social phobia: a treatment manual based on supportive-expressive therapy.

    abstract::Social phobia is a very frequent mental disorder characterized by an early onset, a chronic unremitting course, severe psychosocial impairments and high socioeconomic costs. To date, no manual for the psychodynamic treatment of social phobia exists. After a brief description of the disorder, a manual for a short-term ...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.2007.71.1.56

    authors: Leichsenring F,Beutel M,Leibing E

    更新日期:2007-01-01 00:00:00

  • Clinical supervision of therapists with difficult-to-treat patients.

    abstract::The author elaborates on her earlier findings and discussion on parallel processes in supervision and psychotherapy (Doehrman, 1976) by focusing on the supervision of more "troublesome" patients, in particular adolescents and those with borderline disorders. She also focuses more intensively on trouble spots in superv...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Adelson MJ

    更新日期:1995-01-01 00:00:00

  • Challenges in conceptualizing psychotic mood disorders.

    abstract::Psychotic mood disorders represent a complex group of syndromes in which depression and/or mania are accompanied by delusions, hallucinations, or both. The presence of psychotic features has a profound influence on the course and treatment response of mood disorders, and psychotic disorders in turn are influenced by c...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章,评审

    doi:

    authors: Dubovsky SL

    更新日期:1994-04-01 00:00:00

  • Unrequited love and the wish to kill. Diagnosis and treatment of borderline erotomania.

    abstract::The author hypothesizes that erotomania, or de Clérambault's syndrome, occurs in two forms: the clinically accepted delusional erotomania, in which patients believe that another person is in love with them; and borderline erotomania, in which no delusion is present, yet an extreme disorder of attachment is apparent in...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Meloy JR

    更新日期:1989-11-01 00:00:00

  • Gender and relational differences in sensitivity to internal and external cues at 12 months.

    abstract::Gender differences favoring women in relation to awareness of the subjective (internal) world are well demonstrated but their origins are poorly understood. We trained 173 12-month-olds to visually fixate a video image in response to an internal cue (opening own mouth), external cue (seeing a face open its mouth), or ...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1521/bumc.2011.75.1.64

    authors: Watson JS,Futo J,Fonagy P,Gergely G

    更新日期:2011-03-01 00:00:00

  • Music therapy in grief resolution.

    abstract::The multifaceted nature of grief and the enormous variation in individual clients' responses to losses make it necessary for therapists to have wide background knowledge and well-developed skills in counseling and/or psychotherapy. The author describes an innovative method of facilitating grief resolution using precom...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Bright R

    更新日期:1999-10-01 00:00:00

  • Psychotherapists who transgress sexual boundaries with patients.

    abstract::The causes of therapist-patient sex are complex and multidetermined. Efforts to understand why psychotherapists transgress sexual boundaries are hampered by the lure of reductionism and oversimplification. Most of those who examine this issue would prefer to categorize all such therapists as "bad" and "corrupt" as a w...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Gabbard GO

    更新日期:1994-01-01 00:00:00

  • Using commercially available films to teach about borderline personality disorder.

    abstract::Commercial films on videotape may be helpful in teaching medical students, residents, and other mental health trainees about various topics in psychiatry. Recommendations are made on the use of specific films, scenes, and characters to illustrate the DSM-IV diagnostic criteria for borderline personality disorder (BPD)...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Hyler SE,Schanzer B

    更新日期:1997-10-01 00:00:00

  • Self-comforting strategies used by adolescents.

    abstract::Two hundred sixty-four adolescents were surveyed in order to study the kinds and frequencies of self-comforting strategies they use. Fifty prompts with space to identify additional ones were provided. Significant differences were reported as determined by two-tailed t-tests. Gender was discriminating in both choice an...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.66.3.259.23369

    authors: Horton PC

    更新日期:2002-07-01 00:00:00

  • The threshold of the male Oedipus complex.

    abstract::The transition into the male Oedipus complex is complicated by the fact that there is no "change of object" as in female development. For the boy, the mother is both the object of preoedipal attachment to an omnipotent internal object and of oedipal desire for an external whole object. The psychological-interpersonal ...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Ogden TH

    更新日期:1989-09-01 00:00:00

  • Psychodynamic and cognitive mechanisms of change in adult therapy: a pilot study.

    abstract::To examine the effects of the patient-level mechanisms of change postulated by cognitive-behavioral theory and psychodynamic theory, thirty-three patients in eclectic therapy completed questionnaires at two time points. Decreases in automatic thoughts and immature defenses were each associated with lower symptoms, and...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.2005.69.3.206

    authors: Coleman D

    更新日期:2005-07-01 00:00:00

  • Interprofessional care improves health-related well-being and reduces medical costs for chronic pain patients.

    abstract::This study evaluated whether patients with somatic symptom disorder, expressing chronic pain that could not be attributed to a medical condition, would benefit from an 8-week inpatient residence at a psychiatric ward. In the 1-year follow-up after termination the authors examined the extent to which the integrated tre...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc_2019_83_01

    authors: Seitz T,Stastka K,Schiffinger M,Rui Turk B,Löffler-Stastka H

    更新日期:2019-04-01 00:00:00

  • New challenges to the faculty in the education of psychiatrists.

    abstract::Significant social and economic pressures on academic medicine to become more cost conscious and scientifically accountable have led to new tensions in psychiatric residency training. Failure to distinguish between changes in practice derived from scientific advances and those derived from other sources has major impl...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:

    authors: Kay J

    更新日期:1996-07-01 00:00:00

  • Obsessive-compulsive symptom profiles in individuals exposed to interpersonal versus noninterpersonal trauma.

    abstract::Obsessive-compulsive (OC) symptoms have been associated with trauma exposure. Although no studies have specified relations between type of trauma and OC symptom presentations, this information may inform personalized care for this complex population. Thus, this study used profile analysis via multidimensional scaling ...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc_2020_84_04

    authors: Ojserkis R,McKay D,Kim SK

    更新日期:2020-01-01 00:00:00

  • Emotion regulation: A treatment target for autism spectrum disorder.

    abstract::Individuals with autism spectrum disorder (ASD) tend to experience difficulties with emotion regulation (ER). Treatments designed to address ER difficulties in individuals with ASD are emerging. The authors review cognitive-behavioral therapy (CBT) and mindfulness-based treatments that have focused on ER difficulties ...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章,评审

    doi:10.1521/bumc.2019.83.3.205

    authors: Reyes NM,Pickard K,Reaven J

    更新日期:2019-07-01 00:00:00

  • Examining the effects of accommodation and caregiver burden on relationship satisfaction in caregivers of individuals with OCD.

    abstract::Obsessive-compulsive disorder (OCD) is a debilitating condition that does not always respond well to treatment. People with OCD often require a great deal of assistance from caregivers or family members, which is referred to as family accommodations. Caregivers may experience a great deal of stress, depression, and ot...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.2015.79.1.1

    authors: Lee E,Steinberg D,Phillips L,Hart J,Smith A,Wetterneck C

    更新日期:2015-01-01 00:00:00

  • Mentalizing in the psychotherapy of a disturbed adolescent girl.

    abstract::The author traces some of the literature related to such concepts as the development of the therapeutic alliance and collaboration in the inpatient and residential psychiatric treatment of disturbed adolescents. The more recently developed concept of "mentalization" is discussed, especially with its relevance to the p...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章

    doi:10.1521/bumc.67.2.150.23442

    authors: O'Malley F

    更新日期:2003-04-01 00:00:00

  • Integrating psychotherapy and pharmacotherapy.

    abstract::In recent years, the dichotomy between psychotherapy and pharmacotherapy vis-à-vis the treatment of mood disorders has begun to be resolved as the benefits of integrating the two modalities are increasingly recognized. This new understanding has expanded the scope of successful treatment, but it has also complicated t...

    journal_title:Bulletin of the Menninger Clinic

    pub_type: 杂志文章,评审

    doi:

    authors: Hyland JM

    更新日期:1991-04-01 00:00:00