Drs. Gutheil and Schetky Reply

THOMAS G. GUTHEIL, M.D., and DIANE SCHETKY, M.D.Authors Info & Affiliations

Publication: American Journal of Psychiatry

https://doi.org/10.1176/ajp.156.11.1843-a

To the Editor: We greatly appreciate—and find ourselves largely in agreement with—the dynamic insights of our French colleagues, Dr. Chabrol et al. We, too, have observed the splitting phenomenon, wherein suicide is an attempt to destroy the bad parts of the self rather than simply to die.

We were attempting to counsel therapists to avoid power struggles (e.g., by acknowledging realistic limits on the ability to prevent suicide) more than to convey an attitude of helplessness that, as the letter notes, may promote another of the patient’s attempts to control the therapist (or other persons or fate itself) through a projective identification mechanism. We did imply that the patient’s feeling of helplessness may lead him or her to resort to this defense.

Finally, we are grateful for the letter writers’ obviously close and thoughtful reading of our article.

Information & Authors

Information

Published In

American Journal of Psychiatry

Volume 156 • Number 11 • November 1999

Pages: 1843-a - 1843

History

Published online: 1 November 1999

Published in print: November 1999

Authors

Affiliations

THOMAS G. GUTHEIL, M.D.

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DIANE SCHETKY, M.D.

Boston, Mass.

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Drs. Gutheil and Schetky Reply