The therapist's assumption that the suicidal patient has an underlying narcissistic conflict, usually not conscious, brings unexpected clarity to the immediate reasons for the self-destructive urge and leads to a successful therapeutic approach. Disappointment in a partner often figures centrally in the precipitating circumstances. In the author's experience with suicidal patients, a timelimited treatment with emphasis on what is experienced as an acute situational difficulty is indicated, rather than long term therapy.