Psychotherapy of a Suicidal,Terminal Cancer Patient

Abstract

Psychotherapy of a terminal cancel patient who had attempted suicide is described. The suicidal attempt occurred when she was unable to ventilate her sad feelings to either her doctors or family. Immediately after the suicidal attempt, psychotherapy while on the medical floor opened a channel of communication between the patient and the psychiatrist, resulting in a trusting relationship. Second phase, outpatient therapy, was characterized by the patient's insistence to find psychologic meanings of her illness, in addition to dealing with feelings of jealousy regarding healthy acquaintances and mourning over her health and youth. By identifying the cancer as an introjected bad mother, she began to see it as an alien object, thus gaining a sense of psychological control. The final phase was characterized by increasing signs of metastases and increasing efforts on her part to “psychologize” the illness, without neglecting medical treatment. There were few signs of “acceptance” of death in this patient who was once suicidal. Some terminal cancer patients can use exploratory psychotherapy to make remaining life more gratifying. This presupposes a close collaboration between the psychiatrist, oncologist, and the patient's family.