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This is a detailed report of a thirty-four-year-old German woman who was hospitalized involuntarily after a suicide attempt. She had a long history of such attempts. During
psychotherapy she seemed devoid of feeling and single-minded in her desire to kill herself. She challenged the psychiatrist and other staff members to help her die or transfer her to a center for the fatally ill, thus negating their therapeutic function. The staff hated her and wished to be rid of her.
Both of her parents had been orphaned at an early age, and had attempted to compensate for emotional insecurity by actively joining in Nazi activities. They raised the patient in an atmosphere of similar psychological violence and control that left her no opportunity to develop a stable autonomous identity. Suicide was the most autonomous act of which she was capable. As the therapist came to understand that his helpless rage at the patient was a countertransference manifestation of the patient's own feelings in respect of her parents, the treatment team was able to take a neutral stance in regard to the patient's suicide attempts, which then abated.