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The Factor of Reality Among Suicidal Motivations

Uri Lowental, MD

Arch Gen Psychiatry. 1976;33(7):838-842.

Abstract
• A prevalent feature of many investigations of suicide is a degree of recoil from true empathic closeness to a suicidal person. The motives for this lie within the investigator's own dynamics—they are anxiety over one's own suicide proneness, together with guilt, shame, contempt, and the avoidance of medicolegal involvement. These motives are not altogether unrelated to the suicidal motives themselves, and they hamper the capacity of objective, neutral assessment.

With a recognition of these resistances, the seldomly mentioned realistic determinant of suicide becomes discernible, the act sometimes being a clever, courageous choice of death, and not, as usually diagnosed, a pathologically generated escape from life. All suicidal motives should be evaluated according to several concomitant ratings simultaneously, while emphasizing the realistic rating. A neutral, unbiased approach to suicide should reduce the dangerous false glory sometimes attributed to the act, thus contributing to the discrimination of sickness, therapy, and health.

Author Affiliations
From the Eitanim Psychiatric Hospital, and the mental health clinics of Ma'oz Zion and Kirjat Hajovel, Jerusalem, Israel.

Footnotes
Accepted for publication April 21, 1975.

Reprint requests to Eitanim Psychiatric Hospital, 99790 Jerusalem, Israel (Dr Lowental).

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