The incidence of suicide among preadolescent children is surprisingly high. This article discusses the development of children's conception of death and of their own mortality. Case material is presented to explore how child and therapist work through suicidal tendencies in self psychologically oriented psychotherapy. Three cases are discussed. Two of them involve children of 5 and 6 years of age who were brought for therapy because they wanted, and in 1 case had tried, to kill themselves. Parallel material is presented from the case of an adult during whose therapy a childhood suicidal attempt was uncovered.

This article presents ideas on the early development of children's sense of temporality and death and on how suicidal children make use of the therapist in an effort to work through heart wrenching issues of life and death. Emphasis is placed on the use of mutual enactment as the dramatic representation of profound issues, which otherwise resist verbal expression.