An empirical study of seriously disturbed suicidal patients

Aspects of unconscious processes in a group of seriously disturbed psychiat ric patients are examined in an effort to predict near-lethal suicide attem pts and explore psychoanalytic formulations of suicide. The Rorschach Inkbl ot Test, the most widely used projective measure in suicide research (Bonga r 1991), was chosen for its potential to shed light on specific unconscious processes. Psychic states commonly associated with suicide were measured b y psychoanalytic Rorschach analog scales and then subjected to a progressio n of statistical analyses in order to predict future occurrence and lethali ty of suicide attempts. On the basis of a priori hypotheses, the authors de veloped a suicide index comprising four psychoanalytic Rorschach signs that predicted, with considerable accuracy which patients would later make near -lethal suicide attempts. The best predictors were unconscious processes in dicative of penetrating affective overstimulation, disturbance in the capac ity to maintain adequate ego boundaries, and depressive affective states ch aracterized by a morbid preoccupation with death and inner decay. These fin dings provide empirical support for several well-known formulations of the unconscious motivations for suicide.