The experience of the therapist when a patient commits suicide

Therapists who work with severely disturbed individuals will likely experience the suicide of a patient. The purpose of this study was to describe this experience using phenomenological methods of reduction. Eleven therapists participated in an audiotaped interview of between one to two hours in length. A reliability check of the themes which emerged in these interviews was conducted by two independent raters. Overall correlation between these raters and the interviewer was 78%.

Four major themes emerged in the analysis of these i. descriptions. First, the therapist exists in a zeitgeist of beliefs and expectations for his/her ability to be helpful to the patient prior to the suicide. They also develop expectations about the patient's willingness to be helped as conveyed in the nature of the therapeutic attachment. Because these cases often involve a wide variety of individuals, the therapist also develops expectations about the ability and willingness for these others to be helpful to the patient. These expectations comprise the first major theme entitled presuicide world. The next theme, entitled experience of disruption, describes the factors which impact upon the therapist as a result of the suicide. First, the therapist experiences a variety of powerful emotions upon hearing the news, including shock, denial, anger and sadness. These initial emotions may become intensified by: 1. the method used by the patient 2. the degree of expectations prior to the suicide which are challenged by the event and 3. the reactions of friends and collegues. This second theme describes in detail these factors and the variety of ways in which they can impact upon the therapist. The third theme which emerged describes the types of challenges which need to be resolved by the therapist as well as the methods utilized in this resolution. This theme is entitled the process of resolution. The final theme discusses the therapists' reactions to participation in the study. Many were quite surprised by the degree of emotion evoked during the interview. Implications for a successful resolution and future research endeavors are also presented.