Dear Terry, Your recent letter dealt with the issue of self-awareness and the capacity to form “deliberate intent to put an end to one’s self.” You made the point that animals generally do not have the latter capacity. A number of points follow from this: first, we have the fact that suicide seems more or less unique to the human species and we have already covered that adequately. The next point is the issue of the relationship between self-awareness and the capacity to from suicidal intent. Originally the concept of suicide arose in the context of morality. We still tend to talk about “committing” suicide as if it were still a legal and, thereby, a moral offense. The moral basis to suicidology may have locked us into a witch-hunt with respect to suicidal intent. This is, of course, important in every day clinical practice, but I can’t help feeling that it has locked us into that mode of thinking. Of course, the evidence suggests that when it comes to prediction we are not very good hunters. You also make the point that thinking may be driven by feeling states, at least some of the time. This is very apparent in a patient with borderline personality who last week was on top of the world and this week hates himself to his very core and is certain there can be no absolution, so death must be the way to go. In a legal sense, it could be challenged whether he had capacity to form intent in either of the two weeks, although I would hate to see a society that became too paternalistic in this regard—especially clamping down on happiness! Nevertheless, it illustrates your point about thoughts often following feelings, rather than directing them. I wonder whether we need to re-visit types of suicide or suicidal intentions. I believe as a discipline we have tended to get stuck on hero-worshipping Durkheim far too much. He did a great job, but that was over a century ago and it is time we should be able to make most of his conclusions redundant. From what we have been talking about, we have, in effect, already come up with an irrational feelings based suicide type, e.g., a la borderline personality disorder. Similarly, we might delineate an abnormal cognitions type of suicide, e.g., one driven by delusional ideas. In addition, of course, there are the more rational sorts of suicide in which there is a reasonable balance of feelings and cognitions and the reasoning is not too remote from reality. Hence, following this reasoning we have three basic types of suicide—abnormal feelings driven suicide, abnormal cognitions driven suicide and rational feelings/cognitions driven suicide. Now I am talking about them as if they were discreet categories simply because my pigeon brain struggles to cope with the reality of dimensional approaches to psychopathology, although I have no doubt that they are more correct. Perhaps these dimensions might be approached as three corners of a triangle. The further a profile is from a corner, the more mixed is its underlying basis. Durkheim’s typology came from the moralistic era. The typology I am suggesting so far has nothing to do with what moral/immoral act is about to be committed, but is based on the nature of the psychological processes driving the behavior, which as we have already stated, originates in self-awareness which is virtually a precondition for self-destructiveness, at least in the suicide sense. You have referred to Freud’s analogy of the horse and it’s rider in which he compared a compromised ego to the rider on a runaway horse. Borderline personality disorder would presumably be a typical example of the runaway horse. Of course there has been research in recent decades that has emphasized the relevance to suicide of hopelessness (feelings + cognitions), impulsivity (largely feelings), cognitive inflexibility (largely cognitions), and other findings. However, the limited progress that has occurred in the understanding of what psychologically underlies suicide is concerning. At the time of writing this, the Gulf War fortunately seems to be settling down. I do hope those words do not require revision by the time this is published. You may