ABSTRACT
Emotional reactions of therapists who experienced the death by suicide of one or more of their patients were investigated. Data were collected by a questionnaire containing both objective and open-ended items from 27 men and 36 women, psychiatrists and psychologists, working in psychiatric hospitals in Slovenia. The most frequently reported reactions by the therapists were of increased caution in the treatment of their patients and an increase in conferring with colleagues, partners, and supervisors. About two thirds reported experiencing strong guilt feelings along with other commonly reported survivor feelings of grief, depression, and loss. Gender differences were apparent (women more often felt shame and guilt, sought consolation, or doubted their professional knowledge). No significant differences appeared between disciplines and years of work experience. Agreement was general that support was important both professionally and personally. Suggestions are offered to help the therapist work through the trauma of a patient's suicide.
Subject(s)
Bereavement , Professional-Patient Relations , Psychiatry , Psychology , Suicide , Adult , Female , Humans , Male , Middle Aged , Sex Factors , SloveniaABSTRACT
This study examines the psychosocial problems of spouses bereaved as a consequence of unnatural causes of death (suicide and traffic fatality) in two countries, Slovenia (n = 53) and The Netherlands (n = 32). Structured interviews consisted of standardized measures for depression, substance use, social reactions, and acceptance and attribution of the loss. Although marked differences in sociodemographic background exist, bereaved subjects from both countries show more similarities than differences. Depressed symptomatology is slightly higher in the Slovene bereaved, but symptom patterns are almost identical. Core indicators of clinical depression, as well as reported substance use, are equally low in both countries, and gender and mode of death do not differ significantly. Social acceptance is more problematic in suicide bereaved, particularly in Slovenia. Methodological considerations of cross-cultural bereavement studies are discussed.
Subject(s)
Accidents, Traffic , Bereavement , Depressive Disorder/psychology , Suicide/statistics & numerical data , Adult , Aged , Cross-Cultural Comparison , Depressive Disorder/diagnosis , Female , Humans , Life Change Events , Male , Middle Aged , Netherlands/epidemiology , Psychiatric Status Rating Scales , Slovenia/epidemiologyABSTRACT
This article describes some characteristics, advantages, and disadvantages of crisis intervention in patients with borderline personality disorder. The theoretical issues are illustrated by a case study of a patient with the disorder. Therapeutic proceedings are analyzed, with special focus on the treatment plan, goal-setting, and termination of therapy. The positive effects of the treatment and the patient's unexpected loss of compliance are discussed. Some suggestions are made about dealing with such patients in the light of mistakes made by the crisis therapist, which produced feelings of inadequacy and incompetence in her, stemming from unresolved transference-countertransference problems.
Subject(s)
Borderline Personality Disorder/psychology , Crisis Intervention , Adult , Borderline Personality Disorder/therapy , Combined Modality Therapy , Countertransference , Humans , Internal-External Control , Male , Psychotherapy/methods , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Transference, PsychologyABSTRACT
This article analyzes anger as a phase in the process of bereavement after suicide. Anger is generally very difficult for the survivors to recognize, accept, and express. At the beginning of the survivors' group meetings, anger is repressed and denied. After the group has become more structured and more cohesive, the aggression is first expressed indirectly (through dreams) and directed at different objects (the environment, the survivor him- or herself). In the final group sessions, when the members support each other emotionally, both the group atmosphere and the therapist help them to recognize their anger and to vent their aggression toward their relative who committed suicide. If the survivors do not go through this phase, the bereavement process should not be considered completed.
Subject(s)
Aggression/psychology , Anger , Bereavement , Suicide/psychology , Adaptation, Psychological , Defense Mechanisms , Guilt , HumansABSTRACT
To all patients hospitalized in 1986 in the Crisis Intervention Unit in Ljubljana, Yugoslavia, an inventory was sent. In this way, we tried to find out how the patients experience the treatment and stay on the Unit, what is most helpful in solving their problems and what are, in their opinion, the direct gains of hospitalization. On the basis of the results, we determined what should be changed or improved to make the treatment in our Unit more effective.
