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Keen, E. (1973-74). Suicide and Self-Deception. Psychoanal. Rev., 60(4):575-585.

(1973-74). Psychoanalytic Review, 60(4):575-585

Suicide and Self-Deception

Ernest Keen, Ph.D.

Introduction

The possibility of suicide makes existentialists of us all. In suicide, existence is at stake, and the character of human existence is that suicide is always a possibility—for ourselves, our friends, and our patients.

To see suicide as a human possibility is to see it very differently from the way our culture would have us see it: as a disease, a crime, at best an unfortunate accident. To see suicide as a possibility instead of such an eventuality is to orient ourselves toward ourselves, our friends, and our patients in a particular way. It is to see man as possibility instead of eventuality.

To see man as possibility is common among the treatment professions, such as when we speak of the responsibility patients must take in their own getting well. When the issue is a life decision a patient must make, we are likely to see him as possibility; but when the issue is a death decision a patient may make, that is, suicide, our courage fails us and the patient becomes for us less than a man. He becomes a disease, a management problem, a professional embarrassment. Our thinking about suicide, then, is often plagued by an inconsistency born of our unwillingness to resist cultural precriptions and to face death and suicide as characteristic and essential possibilities of being human at all.

If we take seriously that man is possibility and that suicide is an ever-present possibility, then it is absolutely necessary for the treatment professions to face squarely the issue of when to intervene to prevent a suicide and when not to. Is there a way to consistently

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