The descent into suicide

Suicidal breakdown requires attention both to attack upon the self (ego) as aggressive forces are unleashed against it by the superego, but also to the phases of self‐breakup (ego regression) that follow. Less attention has been directed to ego‐regression in suicide than to superego‐directed assault on the ego in the psychoanalytic literature; this paper directs attention to the phenomena of ego failure and disarticulation of the self‐representation. Clinical study of suicidal patients shows four aspects of suicidal collapse as ego loosens: affective flooding, desperate maneuvering to counter the resulting mental emergency, loss of control as the self begins to disintegrate, and grandiose magical scheming for mental survival as the self‐representation splits up and body jettison becomes plausible. These phenomena are discussed theoretically in terms of failed affect regulation, ego helplessness, narcissistic surrender, breakdown of the representational world, and loss of reality testing.