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Half in Love With Death: Managing the Chronically Suicidal Patient Paperback – 17 Jul 2007


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“The management of suicide remains the almost evidence-free zone left in routine clinical practice. What so many people do when confronted by a suicidal patient is to throw evidence out of the window because of fear the patient will follow. Joel Paris reminds us, and we defi nitely need reminding, that most people who harm themselves do not eventually commit suicide, that self-mutilation is not suicidal behaviour, that ‘admission to hospital’ and a host of other quick fi xes are not the answers to problems that take time and care to control and resolve.”

—Peter Tyrer, FRCPsych, FRCP, FMedSci                                                            Professor of Community Psychiatry, Imperial College, London

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Amazon.com: 2 reviews
4 of 6 people found the following review helpful
Poor Title, But Some Good Ideas 11 July 2012
By EmmaH - Published on Amazon.com
Format: Paperback
First, the title. I realize the title comes from a famous poem, but it gives a misleading idea of what suicidality feels like, which is torturous. Second, the subtitle about "managing" suicidal patients is offensive and implies that therapy is a one-sided operation. I realize this book is intended for clinicians, but I would much prefer "working with" or something along those lines to stress what he himself describes as a collaborative endeavor. The reason I harp on his language is that there is already an abundance of misunderstanding and stigma about clients with bpd and frequent suicidal feelings. As an expert in the field, Paris ought to be aware of this and take extreme care not to reinforce or go alone with those misguided and hurtful ideas.
This is overall a bold challenge to popular responses to and treatment of people with "bpd." He suggests working on the reasons for the suicidality rather than responding with fear by repeatedly hospitalizing patients. I think while scary for most professionals, this is the correct approach, as hospitalization nowadays does not offer any therapy except medication, which is not the main treatment for this issue. Here again, I wish Paris had taken more care to emphasize that the 'regression' that often occurs is not the fault of the patient, but rather derives from the infantilizing experience of psych units. No more can patients earn privileges when they meet goals and make progress on the unit. It is truly frightening not to have a measure to predict (and therefore prevent) suicide in these patients, but I agree that that is the case. Validating people's suffering and desire for relief while working on improving quality of life may be our best plan to help.
I recommend this book to professionals and some patients. Mostly, Paris avoids the pejorative language that riddles other professional writings on the topic. It is unfortuante to need to mention that as a positive. Patients with bpd are in extreme pain and all too often have to defend themselves against hurtful attitudes and stigma along with fighting their most difficult internal battles. Sometimes it becomes unclear which is a bigger burden.
Another book I recommend on bpd, thogh not specifically about suicidallity, is Alex Chapman's The Borderline Personality Disorder Survival Guide.
Terrific book 28 Mar. 2014
By Susan Stefan - Published on Amazon.com
Format: Paperback Verified Purchase
This is one of the best books I have ever read about providing genuine help to people who are chronically suicidal. Many mental health professionals avoid these patients because of fear of liability, or move too quickly to involuntarily commit their patients because of the anxiety created by someone who is chronically suicidal. This book exhibits an understanding of these patients, and authentically helpful framework to treat them. I highly recommend it to anyone who is treating, related to, friends with or representing someone who is chronically suicidal.
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