Family Dynamics and Drug Overdoses*

ABSTRACT: In a study of 40 patients who had taken an overdose, and with the relatives of 18 of these subjects, a pattern of family factors that appeared relevant to the choice of drugs was found. These family factors included: (a) a specific expectation that the person would use drugs; (b) an identification with another suicidal family member; (c) a high level of oral preoccupation and oral fixation; (d) trauma in the life history associated with food or orality; and (e) a direct participation of other family members in the suicidal act. The direct study of family interactions in evaluating suicidal potential is recommended for its unique diagnostic and therapeutic implications.     

4 Being Suicidal and Elderly in Changing Times: A Case History

Mr. Andrew A, at age 67, is a physically well and mentally active man who is involved in business failures and marital conflicts, which brought him dangerously close to precipitating his own demise. He is different from my other elderly suicidal patients, most of whom were ill, disabled, and in decline. They were grieving for many reasons, such as the loss of a spouse or — frequently — themselves as they had been. Andrew's story has hopeful implications for the changing nature of aging and suicide that extend beyond himself as an individual or my interventions as a therapist.     

Suicide and Infantile Fixations

ABSTRACT: Infantile fixations upon primary parental figures and relationships is one of several features central to the suicidal situation. The association of infantile fixations to suicidal behavior relates not only to their presence or degree but to their traumatic quality and to the occurrence of patterns of relationship with others who are similarly fixated. Other significant features of such infantile fixations are their rigid and repetitive character. Case illustrations highlight both the infantile fixation phenomenon and efforts to change by forming new or different attachments, and the conflict between the two. Lastly, implications for psychotherapy include the needs to reduce anxiety and self hatred associated with infantile ties; to provide a temporary regression as a first step towards transformation of fixation and mastery; and to accept, rather than to attack, the suicidal patient's infantile attachments and patterns.