The Suicidal Crisis

Abstract

One of the most difficult determinations a psychiatrist makes is whether the chronically suicidal patient is at risk for suicide in the immediate future. The Suicidal Narrative is the first book to help clinicians evaluate the risk of imminent suicidal behavior. The book describes a theoretical framework for a systematic and comprehensive assessment of short-term suicide risk and also describes practical ways of conducting risk assessment interviews in different settings. The book is based on the narrative crisis model of suicide, which posits that individuals with trait vulnerability for suicide attempt suicide after they develop the suicide crisis syndrome when they feel that their life narrative has no acceptable future. This book first reviews current models of suicidal behavior and introduces the narrative crisis model of suicide. Next, it provides a comprehensive description of trait vulnerabilities followed by a discussion of stressful life events that may increase short-term suicide risk. The book’s core introduces the key concepts of the narrative crisis model of suicide—the suicidal narrative and suicide crisis syndrome—and addresses the clinical value of clinicians’ emotional responses to suicidal patients. Finally, the book provides practical guidance for conducting short-term suicide risk assessment and introduces current approaches to suicide risk reduction. The Suicidal Narrative is designed as a textbook and reference guide. The book contains more than 50 clinical case vignettes, detailed examples of risk assessment interviews, as well as test cases for self-assessment.