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Nice, T. (2020). Working in the Dark: Understanding the Pre-suicide State of Mind by Donald Campbell and Rob Hale. Published by Routledge, Abingdon, 2017; 120 pp, £22.99 paperback. Brit. J. Psychother., 36(1):153-156.

(2020). British Journal of Psychotherapy, 36(1):153-156

Working in the Dark: Understanding the Pre-suicide State of Mind by Donald Campbell and Rob Hale. Published by Routledge, Abingdon, 2017; 120 pp, £22.99 paperback

Review by:
Terence Nice

As indicated in the title of the book, Working in the Dark conveys the idea of clinical shadowlands where clinical clarity, simplicity and certainty are remote beacons in working with suicidal individuals. The authors have an imposing wealth of theoretical insights and rich clinical experiences that shape and form the core foundations of this book. They offer a rich blend of theoretical exploration and clinical observation that discusses 'the pre-suicide state of mind’. The idea of a pre-suicide state of mind raises several intriguing questions. What is a pre-suicide state of mind? How does it evolve? What are its core constituents and what is its relationship with suicidal ideation and the suicidal process? Campbell and Hale seek to explore these questions, crucially illuminating the clinical shadowlands and offering important tips and strategies in working with suicidal individuals.

The overarching aim of this book is to understand the pre-suicidal mind in the context of suicide attempts. Campbell and Hale describe the pre-suicidal mind as the patient's state of mind prior to attempting to end their life. Their descriptive understanding highlights the importance of the suicidal process and allows for interventions that reduce the risk of suicide. Working in the Dark is a book that is written for people, such as social workers, probation officers, nurses, psychologists, psychoanalysts and doctors who work with adolescents and adults 'who have threatened to stick a knife in their heart’ (p. 1). This assertion conjures up the bleak and highly destructive reality of individuals who wish to end their lives. Campbell and Hale's interest in the pre-suicide state of mind stems from their experiences of working with suicidal individuals and the pain, distress and dread that professionals feel when patients and clients are successful in concluding their suicide attempts.

The book is divided into 12 chapters examining themes such as suicide, mental illness, suicidal fantasies, the role of the father, adolescence, implications for professionals and self-mutilation. Each chapter runs effortlessly into the next chapter, but equally each chapter is self-contained and can be read as a stand-alone section.

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