Psychoanalytic notes on suicide.

The typology of and theories on suicidal behavior are reviewed to integrate various points of view in terms of the paranoid process. Freud's theory of internalized aggression, the relation of suicide impulses to depression, the operation of narcissistic components in the complex motivation of suicide are related to the concept of the victim-introject as central to the pathology of suicide. Suicidal patterns play out the dynamics inherent in the victim-introject and its correlative component the aggressor-introject. The victim-introject serves as the core internalization around which a false-self system is organized; the suicide represents the attempt to destroy the false-self as a means of realizing the dynamic purposes of the victim-introject. The concept of the victim-introject integrates previous psychoanalytic formulations of suicide and provides a template for the development of a therapeutic rationale. Implications for therapeutic response are considered, particularly in terms of the need to undermine the patient's attempts to maintain and reinforce his victimization.