Formulation and Treatment of Chronic Suicidality in Patients with Developmental Trauma
Although the psychodynamic literature has examined some of the links between developmental trauma and suicidal thinking and behavior, much of this scholarship focuses on the management of chronic suicidality in the treatment of patients with borderline personality disorder. In this paper, we examine the relationship between complex trauma and the broad spectrum of chronic self-destructive thoughts and behaviors commonly seen in clinical practice. We incorporate perspectives from psychodynamic theory with an emphasis on attachment theory in our understanding of the underlying mechanisms involved. We describe how we use this developmental understanding to address chronic suicidality in ongoing clinical treatment beyond management and safety planning, by providing psychoeducational, cognitive, behavioral and affect-focused strategies that serve to enhance the treatment alliance.
KeywordsTrauma Attachment Chronic suicidality
We gratefully acknowledge Sharon Jacobs MD and Jennifer Greenwold MD for thoughtful comments on this manuscript.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
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