Psychodynamic Ideal Types of Elderly Suicidal Persons Based on Counter Transference

Suicidality among the elderly is a serious health and social problem. In contrast to the quantitative significance of suicidality in old age, utilisation of psychiatric and psychotherapeutic treatment by the suicidal elderly is low. Single case based knowledge of the intra‐psychic dynamics of the suicidal elderly exists but this has mostly been gained from long‐running psychotherapies, and not from people who remain silent about their suicidality, even during treatment. In a systematic qualitative study, in‐depth interviews were conducted with 30 people (60+), who judged themselves as suicidal but had not talked about it in treatment. Using the method of ‘forming types by understanding’, ideal types were developed by means of the suicidal elderly's transference offers on the background of their main biographic accounts and their suicidal symptoms. This typology presents the suicidal elderly's varied and multi‐reasoned dynamics of psychosocial retreat, which both encourage and maintain suicidality, also leading to the fact that these people keep silent about their suicidality in professional health care relationships, or they contribute to negative counter‐transference reactions, which make the start of a therapeutic relationship difficult.