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Don Campbell and Rob Hale take us movingly and practically through the analyst's nightmare territory of patients who may, and sometimes do kill themselves. They explore the ways in which skilful therapeutic work can help to avoid such events. This concise volume should be on the shelf of all analysts and mental health practitioners, who at some time in their career will be faced with what the authors call “the pre-suicide state.” Their detailed exploration of the complex dynamics involved in the run-up to a suicide attempt offers understanding and hope with which to engage in situations where both are under attack. With its warmth, realism, and presentation of analytic ideas as extensions of ordinary thinking about ourselves—rather than as a separate belief system—it elegantly fulfils its intention to add to the resources of individuals and teams working with suicides. Its wide-ranging attention to the psychoanalytic and wider literature is a useful antidote to any tendency to an oversimplified understanding of suicide.
The book opens with each author outlining his own professional journey into this painful world. The focus on the feelings that these clinical encounters evoke in the analysts and fellow professionals is a constant resource throughout the book. The authors have worked in the field for over 40 years, both of them for many years at the Portman Clinic, a National Health Service forensic clinic caring for people who are sexually deviant or violent. This long encounter with people who use attacks on their own or others’ bodies is built on earlier experiences: Don Campbell at the Hampstead Clinic (now the Anna Freud Centre) and the Brent Centre for Adolescents, and Rob Hale at St Mary's Teaching Hospital and the Tavistock Clinic. Their immensely humane approach starts from the impact that threats of suicide and suicidal acts have on those around the suicidal person, and the book opens with the authors’ personal stories as to how they became involved in this