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Konrad Michel, a leading psychiatrist and acclaimed expert, draws on decades of experience to offer necessary new ways of understanding—and preventing—suicide. After one of his first patients died by suicide, Michel devoted himself to researching self-harm. Writing vividly and personally, he recounts more than forty years of working with and learning from suicidal patients.Michel shows that suicide is not just a consequence of mental illness but an action related to a person's life story. Drawing on hundreds of interviews with suicidal patients, he argues that suicide and suicide attempts occur when someone experiences extreme emotional pain that severely impairs the ability to think and act rationally. Based on this understanding, Michel and his colleagues developed a person-centered approach to treatment that overcomes the limitations of the traditional medical model. Through a brief therapy, patients find a personally meaningful narrative understanding of their suicidal thoughts and impulses. People at risk can learn to recognize their vulnerabilities in order to manage potentially life-threatening situations and keep themselves safe. Michel emphasizes the importance of communication: medical professionals need to connect with patients as individuals to identify specific warning signs.Both compassionate and rigorous, this book provides vital insight into suicide prevention and shows how changing attitudes will help save lives. It includes practical advice for people at risk, with special emphasis on young people, as well as for relatives and health professionals

Background: In the course of their lives individuals may encounter the phenomenon of suicide in various ways, for example, directly through suicidal behavior in the family or among peers; or indirectly through hearsay, the media, literature, etc. Aims: The study investigates such memory traces (engrams) in patients with and without a suicide attempt. Methods: Ten patients from a psychiatric crisis unit who had attempted suicide and ten patients without a history of suicidal behavior were interviewed with a narrative/semistructured interviewing technique. Interviews were video-recorded and fully transcribed. Stepwise reduction of the content was used to develop categories of recurrent memories and models of suicidal behavior. Results: Suicide attempters reported more memories of direct exposure to suicidal behavior (e.g., witnessing a suicidal act) than did patients who had no history of attempted suicide. They also reported more own suicidal crises, but associated them more often with interpersonal problems than with depression. They considered suicide more often as normal behavior than nonattempters. The total number of suicide-related memories and their origins was remarkably similar in both groups. Conclusions: The results suggest that direct exposure to suicidal behavior may leave engrams (memory traces) that increase an individual's susceptibility to suicidal behavior.

Summary: A literature search was conducted to collect randomized controlled studies evaluating the outcome of psychological and psychosocial interventions after attempted suicide and deliberate self-harm. Twenty-five studies meeting the inclusion criteria were identified. The studies are grouped according to the psychological approach chosen for the intervention. They are discussed with regard to both the various therapeutic strategies and models used, and the repetition of self-harming behavior as the main outcome.

This study was conducted to support the publication of guidelines for media reporting on suicide. First, quantitative and qualitative aspects of suicide reporting in Swiss print media were surveyed over a time span of 8 months. The results were presented at a national press conference, and written guidelines for suicide reporting were sent out to all newspaper editors. The results of the survey and the guidelines were discussed in a personal meeting with the Editor-in-Chief of the main tabloid. After the publication of the guidelines a second, identical survey was conducted. The main variables regarding frequency, form, and content of the newspaper reports before and after the press conference were compared. The number of articles, on the one hand, increased over the 3 years between the first and second survey, but the quality of reporting clearly improved on the other. The personal contact with the editor of the tabloid was probably the most effective means of intervention.

Suizidversuch ist der wichtigste Risikofaktor für anschließenden Suizid oder weitere Suizidversuche. Es ist von großer klinischer Bedeutung, Patient/innen nach Suizidversuch die Möglichkeit zu guten Gesprächen und einer guten Beziehung bieten zu können, denn die Zufriedenheit der Patient/innen nach dem Initialkontakt spielt eine entscheidende Rolle in der Bereitschaft zu weiteren therapeutischen Kontakten und daher auch für die Suizidprophylaxe. Was sind gute Gespräche mit Patient/innen nach Suizidversuch? Wodurch zeichnen sich von den Patient/innen positiv erlebte Gespräche aus, und wie lässt sich dies auf der Basis empirischen Materials explorieren? Das Ziel der hier vorgestellten Untersuchung von vier Einzelfällen ist die Eruierung von interviewer/innenspezifischen Interaktionscharakteristiken, die mit einer besonders guten oder einer auffällig schlechten Beurteilung des Gesprächs durch die Patient/innen einhergehen. Konversations- und interaktionsanalytische Methoden bieten einen besonders wertvoller Zugang, weil sie es ermöglichen zu verfolgen, wie die Gesprächspartner/innen die Interaktion Zug um Zug entwickeln, wie sie einander ihre Relevanzen verdeutlichen und zur Darstellung bringen und wie kommunikative Züge fruchtbar gemacht oder liegen gelassen werden. Im vorliegenden Artikel werden die Ergebnisse einer solchen Untersuchung von vier Erstgesprächen mit Patientinnen nach Suizidversuch vorgestellt. Aus einem Gesamtbestand von 40 videografierten Erstgesprächen, die am Inselspital Bern aufgenommen wurden, wurden zwei der von den Patient/innen am besten und zwei der am schlechtesten bewerteten Gespräche ausgewählt, transkribiert und untersucht. Dabei wurde gefunden, dass die Interviewer/innen der beiden besonders gut bewerteten Begegnungen durchgehend aufmerksam-empathisch und das Gespräch strukturierend präsent waren. Sie gewährten ihrem Gegenüber genügend Raum zur eigenständigen Entfaltung und Entwicklung der Geschichte ihres Suizidversuchs, deren Produktion sie strukturierend und klärend unterstützten. In den beiden auffällig schlecht bewerteten Begegnungen dagegen wurde die Interaktion einseitig von einer der beiden Gesprächsparteien dominiert. Es entfaltete sich ein Interaktionsmuster, in welchem dem Gegenüber die eigene Relevanzsetzung aufgedrängt wurde.