A Transactional Analysis Perspective on Suicide Risk Assessment

Abstract

The author discusses some of the difficulties in making suicide risk assessments. He focuses on Goulding and Goulding’s (1978) theory of injunctions, particularly their notion of a Don’t Exist injunction. He argues that this injunction in the mind of an individual can consciously or unconsciously lead to suicidality. Therefore, diagnosing the presence of a Don’t Exist injunction is useful in the assessment of suicide risk. A client illustration is included as an example of how to diagnose this injunction.

States of Self as Agents of Self-Killing: An Egogram-based Suicide Note Analysis Study in Russia

“…Undoubtedly, understanding a suicide attempt as an act of interpersonal communication or as a transaction in TA terms may have important clinical implications. Quite a few TA authors theorised that it was the Don't Be/Don't Exist injunction that laid the basis for suicidality (Holloway 1973;Drye, Goulding & Goulding, 1973;Steiner, 1974;Schustov & Lester, 1999;White, 2017). According to White (2011), the Don't Exist decision gives rise to a group of 7 suicidal decisions, 2 of which are manipulative ("If you don't change, I will kill myself"; "I will almost die (over and over) to get you to love me"); and the remaining 4 contain some kind of a communicative message to others ("I will show you even if it kills me"; "I will get you to kill me"; "I will kill myself by accident"; "I will kill myself to hurt you").…”