INDIVIDUATION-ATTACHMENT AND SUICIDE TRAJECTORY - A DEVELOPMENTAL GUIDE FOR THE CLINICIAN

This article applies a two-axis model of human development to the prob lem of suicide trajectory. The two-axis approach represents a fundamen tal shift in the way Eriksonian stages are viewed. Typical interpretat ions of Erikson suggest healthy development is achieved by resolving e ach stage crisis horizontally in favor of the syntonic as opposed to t he dystonic ego quality. A two-axis view proposes that an organism beg ins each stage at the negative or dystonic position in reaction to the stage-initiating life event and must move ahead vertically to achieve the positive syntonic quality and the attaining of a stage-specific s yntonic equilibrium. We are suggesting that successful development inv olves not the avoidance of the negative or dystonic ego qualities at e ach stage but the very plunging into each of them as the natural seque la of the preceding life event. Successful development involves workin g through a stage vertically to attain the respective stage-specific p ositive or syntonic ego position, followed by forward regression to th e next advanced stage. The logic of this developmental axis is simply that the loosening of one's defenses (i.e., greater permeability of wa lls) should occur in conjunction with the strengthening of one's ego ( i.e., greater definition of boundaries). Incongruent resolution of the individuation-attachment dilemma results in ''enmeshment'' (attachmen t to the external world without individuation), or in ''disengagement' ' (remaining detached even after becoming sufficiently individuated). Extreme distress can result from the attempt to simultaneously apply e nmeshed and disengaged styles to cope with the overwhelming challenges of the new life stage, creating a potentially suicidal level of stres s.