Lifelines pp 115-136 | Cite as

Care, Containment, and Countertransference: Managing the Suicidal Patient in Medical Settings

  • Daniel Silverman


The psychiatric consultant had been paged “stat” to see an “acutely” suicidal patient whom the staff feared would jump out the window at any moment if they didn’t get help soon. Rushing breathlessly into the room, the consultant found the patient lying quietly in bed, staring off into space while a nurse paced anxiously at his side. The man, a 45-year-old former construction worker, told the consultant angrily that he wanted to throw himself from the window because of recent surgery; he feared never being able to do anything for himself again. The patient, who had suffered for years with severe peripheral vascular disease associated with diabetes, suddenly pulled back the bed coverings to display his bilateral above-the-knee amputations.


Suicide Attempt Suicidal Behavior Medical Personnel Medical Setting Physical Restraint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Murphy GE: The physician’s responsibility for suicide. I. An error of commission. Ann Inter Med 82:301–304, 1975Google Scholar
  2. 2.
    Pollack S: Suicide in a general hospital. In Shneidman E, Farberow NL (eds): Clues to Suicide, New York, McGraw-Hill Inc., 1957Google Scholar
  3. 3.
    Reich P, Kelly MJ: Suicide attempts by hospitalized medical and surgical patients. NEJM 294:298–301, 1976PubMedCrossRefGoogle Scholar
  4. 4.
    Farberow NL, Ganzler S, Cutter F, et al: An eight-year survey of hospital suicides. Life Threat Behav 1:184–201, 1971Google Scholar
  5. 5.
    Lipsitt DR: Medical and psychological characteristics of “crocks.” Int J Psych Med 1:15–25, 1970CrossRefGoogle Scholar
  6. 6.
    Nadelson T: Victim, victimizer: Interaction in the psychotherapy of borderline patients. Int J Psychoanal Psychother 5:115–129, 1976PubMedGoogle Scholar
  7. 7.
    Groves JE: Taking care of the hateful patient. NEJM 298:883–887, 1978PubMedCrossRefGoogle Scholar
  8. 8.
    Weissman MN: Epidemiology of suicide attempts. Arch Gen Psychiatry 30:737–746, 1974PubMedCrossRefGoogle Scholar
  9. 9.
    Weisman A, Worden JW: Risk-rescue rating in suicide assessment, in Beck A, Resnik H, Lettieri D (eds): The Prediction of Suicide, Maryland, Charles Press Publishing Co., 1974, pp. 193–214Google Scholar
  10. 10.
    Maltsberger JT, Buie DH: Countertransference hate in the treatment of suicidal patients. Arch Gen Psychiatry 30:625–633, 1974PubMedCrossRefGoogle Scholar
  11. 11.
    Gunderson JG, Singer MT: Defining borderline patients: An overview. Am J Psychiatry 132:1–10, 1975PubMedGoogle Scholar
  12. 12.
    Adler G: Hospital treatment of borderline patients. Am J Psychiatry 130:32–36, 1973PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1982

Authors and Affiliations

  • Daniel Silverman
    • 1
  1. 1.Harvard Medical SchoolUSA

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