The psychodynamics of hope in suicidal despair

For suicidal individuals, crushing hopelessness correlates more strongly than depression with suicidal intent. Ambivalence is recognized as a principal aspect of suicidality – wanting to die and wanting to be rescued at the same time. Hope is the mental state in which the desire of a positive outcome in one’s life is directed toward the future, and supports a positive resolution to psychic pain, thereby playing an important role in suicide prevention by delaying self-destructive action. This paper explores the psychodynamics of hope in suicidal distress, as it functions to support the suicidal patient’s sense of connection over abandonment and rescue over the wish to die. Three pathways that instill and support hope in suicidal patients are examined through the use of clinical examples.