Half in Love with Death

This week’s review considers the experiences of chronically suicidal patients and recommends evidence-based treatment.

Posted on September 9, 2024 in Reviews of the Month

Half in Love with Death: Managing the Chronically Suicidal Patient 2nd ed

Paris, Joel. Routledge, 2024
196p bibl index, 9781032335117 $160.00, 9781032335063 $39.95, 9781000909371 $39.95

Half in love with death book cover.

Paris (emer., psychiatry, McGill Univ., Canada) explores the treatment of chronically suicidal patients and challenges current interventions. Clinicians often view suicide as difficult to treat and thus face dilemmas regarding the hospitalization, safety, and treatment of chronically suicidal patients, considering clinical and legal risks. Examining epidemiological and social perspectives and myths surrounding suicide prevention, Paris illuminates the inner worlds of the chronically suicidal. Although psychiatric medications may treat comorbidities, they provide no demonstrated benefit for preventing suicide; psychotherapy, however, is useful. The book includes a thought-provoking discussion of suicide over the life course. With scant research available, clinicians struggle with how to manage acute and chronically suicidal patients. They hope hospitalization will provide safety, yet it offers no guarantees and may exacerbate chronicity. Therapy with patients who experience chronic suicidality needs to focus on life goals, limit setting, and treating underlying borderline personality disorders (BPD). Paris urges readers to think differently about chronicity and recommends dialectical behavior therapy for BPD—although it is not usually covered by insurance—and stepped care. He reports that shorter treatment periods of 12 weeks are more effective than ongoing therapy over years. This is an essential reference for clinicians who may treat suicidal patients.

Summing Up: Essential. General readers through faculty; professionals.
Reviewer: S. M. Valente, independent scholar
Subject: Social & Behavioral Sciences – Psychology
Choice Issue: May 2024

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