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April 15, 1974. SUICIDAL BEHAVIOR DURING PHASES OF DEVELOPMENT. Henry Schneer, M.D.
The concept of specifying suicidal behavior in phases of development does not necessitate a suicidal drive or death instinct but rather the recognition that aggression as a drive is ever-present and has constructive as well as destructive force. What determines aggressive energy to be exercised in any developmental phase? Kernberg has developed the concept of eliminating self and object images built up under the influence of aggressively determined object relations by 'splitting mechanisms'. Dr. Schneer believes that when the attempt to eliminate by splitting of damaging aggressive self and object images fails, fusion of damaging aggressive self and object images of the narcissistic primary object choice becomes manifest as suicidal behavior. Thus suicidal behavior can be studied with a genetic, developmental view of the vicissitudes of a triadic constellation of aggression, narcissistic object choice, and splitting versus regressive fusion.
When separation-loss is experienced traumatically rather than as an opportunity for maturation, de-differentiation occurs. Persistent damaging, aggressive self and object images prevail and splitting serves the defensive purpose of impeding regressive fusion of aggressive self-images with images of the narcissistic object choice. In itself, splitting is a regressive ego state which functions defensively.
A complex of factors, which operate during phases of development, are active in causing suicidal behavior: in coping with conflict and adaptation a narcissistic organization is stimulated by traumatic separation-loss, narcissistic object choice, and splitting versus fusion.
Clinical examples of suicidal behavior during phases of development from infancy to old age were presented.