Monday, September 17, 2012

New book review - Working with suicidal individuals

The first sentence is nice and it gets better as it goes on. Feels good to have peers (I have no idea who he is) who obviously know what they are talking about, give praise like this.

Article citation: William Harper, (2012) "Working with Suicidal Individuals: A Guide to Providing, Understanding, Assessment and Support", Social Care and Neurod
isability, Vol. 3 Iss: 2, pp. -

Article Type: Resource reviews From: Social Care and Neurodisability, Volume 3, Issue 2
Tony White,Jessica Kingsley Publishers,London,2010,£19.99,272 pp.,ISBN: 978 1 84905 115 6

Psychologist Tony White delivers a commanding exposition in his guide to providing understanding, assessment and support in working with suicidal individuals. At the outset, Tony describes his first hand experience of the associated “affective” state by sharing that he twice attempted suicide as an adolescent. This was clearly a profound personal experience and one that has enabled a unique “inside” view of the area of suicide and comes across particularly strong in the area of teenage suicide in this book.

The book is divided into three parts. Understanding suicide; assessing suicide risk and supporting the suicidal individual. Building his model around Eric Berne’s transactional analysis and supplementing this with attachment theory, he provides a robust framework with which to explore the varied and complex existential reasons why someone may seek suicide as a solution and to understand their motivations. This is an accessible model that will indeed be useful for frontline clinicians and practitioners who will be able to conceptualise in more depth, the potential presenting influences that may be in the consulting room such as the nature of human communication, transactions, the driving force of historical figures and their relationship to the unconscious.

The “mind” here is conceptualised as a series of “tapes” that are laid down at key areas of development throughout the life course. This is particularly helpful when considering the assessment of the suicidal individual and offers clear paths to tailor intervention strategies accordingly. Moreover, the integration of both quantitative and qualitative measures of risk, points the reader to a more comprehensive and individualistic assessment. Chapter 14 on the no-suicide contract should prove particularly powerful for frontline clinicians engaged in this emotionally charged task. There is clear guidance about theoretical framework behind this intervention and when and who it works well for. The no-suicide contract “iceberg” is a useful short-hand conceptualisation for understanding the complexities of contracting with vulnerable individuals. Case studies are woven throughout the text and capably demonstrate the theory and the practice of this approach.

In the therapy section a ”gestalt” like or whole form approach is sought to define principles of perception through the use of a two-chair technique to permit regression, in order to achieve the same emotional and physiological states of arousal as occurred when the first set of state-dependent learning was achieved. The extra chair here, representing the critical parent ego state and the potential to rework this and integrate into the adult self.

Transactional analysis can have its limitations. Purist object relation theorists may argue that from the standpoint of the ego, suicide is, first of all, an expression of the fact that the terrible tension the pressure of the superego induces has become unbearable. To have a desire to live evidently means to feel a certain self-esteem, to feel supported by the protective forces of the super ego. When this feeling vanishes, the original annihilation of the deserted hungry baby reappears.

Tony White’s dynamic psychology has the task of reconstructing, from certain given manifestations, the constellation of forces that produced the manifestations. The client work demonstrates significant effort to enable a more direct expression of its dynamic foundations and will be essential reading for frontline practitioners and clinicians working with people at risk of suicide and harm in the neurodisability field.

William Harper Team Manager, Islington Assertive Outreach Team


  1. I think it is great that you have positive and professional reviews. I know a lot of work and passion has gone into what you are doing and reading things like this just validates it. Very happy for you.