The Suicidal Person: A New Look at a Human Phenomenon

by Konrad Michel

Konrad Michel, a leading psychiatrist and acclaimed expert, draws on decades of experience to offer necessary new ways of understanding―and preventing―suicide. After one of his first patients died by suicide, Michel devoted himself to researching self-harm. Writing vividly and personally, he recounts more than forty years of working with and learning from suicidal patients.

Michel shows that suicide is not just a consequence of mental illness but an action related to a person’s life story. Drawing on hundreds of interviews with suicidal patients, he argues that suicide and suicide attempts occur when someone experiences extreme emotional pain that severely impairs the ability to think and act rationally. Based on this understanding, Michel and his colleagues developed a person-centered approach to treatment that overcomes the limitations of the traditional medical model. Through a brief therapy, patients find a personally meaningful narrative understanding of their suicidal thoughts and impulses. People at risk can learn to recognize their vulnerabilities in order to manage potentially life-threatening situations and keep themselves safe. Michel emphasizes the importance of medical professionals need to connect with patients as individuals to identify specific warning signs.

Both compassionate and rigorous, this book provides vital insight into suicide prevention and shows how changing attitudes will help save lives. It includes practical advice for people at risk, with special emphasis on young people, as well as for relatives and health professionals.

Genres: Nonfiction, Mental Health, Psychology

376 pages, Hardcover

Published September 12, 2023

About the author

Dr. Michel, M.D. is Professor emeritus of Psychiatry, affiliated with the University of Bern, Switzerland. He devoted a major part of his research and clinical activities to suicide and suicide prevention. As a trained psychotherapist, his main interest early in his career focused on the therapeutic relationship with suicidal patients. In an extraordinary collaboration with Ladislav Valach, Ph.D, he developed a model of suicide as a person’s action with a personal background story, as opposed to the traditional medical model which understands suicide as a consequence of mental disorders. Dr. Michel was the organizer of the “Aeschi Conferences”, a highly acclaimed international forum for new developments in the therapy of suicidal patients, which led to the volume titled “Building a Therapeutic Alliance with the Suicidal Patient”, edited by K. Michel and D.A. Jobes. The brief and highly effective therapy program ASSIP (Attempted Suicide Short Intervention Program) is today one of the most effective therapies for patients with a history of attempted suicide in use worldwide. With his new book “The Suicidal Person; A New Look at a Human Phenomenon” Dr. Michel takes his person-centered understanding of suicide further, by promoting a promising model which has the potential to overcome the prevalent medical model. The book includes practical advice for people at risk, as well as for relatives and health professionals.

Reviews

[Serena · Rating 4 out of 5]

I recieved an ARC of this book via NetGalley in exchange for an honest review.

I am honestly awestruck by this book. Absolutely speechless. I already have a background of studying suicide, but in the context of emergency work. There was a part of me that thought that you couldn't stop suicide before that point, or at least some cases, no matter how hard you tried. At the same time, being a psychologist, the death of a patient is a thought too scary to think sometimes. And I have a good relationship with death! But having the weight of it on you as a professional is entirely different.

There's this thing I've unfortunately noticed in mental health circles: people will gatekeep knowledge. There are too many awful people that do not want the best for other professional's patients, or the shared knowledge of the profession, but instead they strive for feeling superior because they know something you don't. I went to a psychoanalytical uni, so sometimes that meant that whatever secret they knew was absolute useless bullshit, on top of all that.

So I was EXTREMELY skeptic going into this book. The author talked about the conferences he started, which sounded very interesting, but I kept thinking "there's NO WAY he's going to tell us what was said on those conferences". And then he did. And he went on and on about the brain, a known mental-health-professional-author tactic to ramble and not get to the point, and said that his therapy model helped with the maladaptive processes he was describing, and I was like "yeah, sure, and you're not gonna tell us what the model is so we can't even fact check that". And then a chapter was a step by step guide on how to carry his therapy model. Like. What!!!!! People don't just do that!!!!!

This book is a PRICELESS tool for (mental) health practicioners. Not only does it provide extensive knowledge and evidence on the therapy model it presents, but it also is perfectly sourced, with a HUGE (and I mean 40% of the book) bibliography that left my firefox bookmarks overflowed. It recognizes its own limits, but doesn't shy away from proudly presenting what it can do. It takes inspiration from many different theories, I personally loved and will probably use on my practice the first narrative interview and the psychoeducation on the altered brain functions + psychological pain + dissociation.

AND on top of all that, the writing style is very inviting. Even when he's talking about neurons and neurotransmitters, a topic I love but which I am too stupid for, he managed to bring the concepts down to earth. This thing happens on the brain, and the result is this behavior, or this maladaptive thought path. That's also something that I've personally haven't seen much in mental health writings that talk about the biological aspect, they tend to leave it at the synapsis talk and not explain what that means. I also value and celebrate that the author was vulnerable enough to share his story on suicide research, from the conferences to his son's death. We are too afraid too often to come across as real people, and that leads to books and articles and conferences feeling like a robot who doesn't care about people wrote them. I'm so very glad that the author decided to share his story on this book.

[Lenaasty · Rating 4 out of 5]

"I lost our son Alex, aged twenty, to suicide in 2001. I couldn't help my own son. I hope this book will help others."

"With this book I hope to reach as many people as possible, including those who know about the topic from their own experience, those who have lost someone to suicide, those who are concerned about someone, those who simply want to learn more about a human phenomenon that is so difficult to understand [...]"

Although this book is mostly pertinent for medical professionals, I was very glad to have the opportunity to read it. I've learned and taken notes of several things that anyone can benefit from, either to help with their own thoughts or those of somebody close them.

I skipped the most medical parts, which represents a good chunk of the book but again this is supposed to help medical professionals and aspiring medical people to understand the topic better and be able to help patients as best they can. I liked how the author didn't discriminate anyone, all aspects of mental health and identity crisis, gender, age factors, media etc were talked about objectively. I was impressed to read about how they managed to change newspapers guidelines on how to cover suicide news so as to not romanticize it. It's so important today to be careful around media portrayal of mental illness, and the mention of 13 reasons why was very pertinent.

I really feel for the author who lost his own son to suicide ❤️‍🩹 writing this book and continuing his career to help people suffering from suicidal thoughts must have been incredibly tough.

I've highlighted several quotes that I found important to remember :

"Today I am convinced that the vast majority of people who die by suicide would regret their final act if they had an opportunity to reconsider."

""Real men" have difficulties accepting a psychiatric diagnosis. "Real men" do not seek help. They keep suicidal thoughts to themselves. "Real men" do not show weakness, nor do they need help. In medical consultations, men are often not recognized as being depressed because they avoid admitting mental problems but instead present with physical problems or turn to alcohol and aggressive behavior.
[...]
Professor Jules Angst [...] put it bluntly: "Women seek treatment, men drink and die by suicide." When I met Wolfgang Rutz at a conference, he said to me: "If you find out how we can get men to seek help you'll get the Nobel Prize!" Unfortunately, men don't seem to change and my Nobel Prize today remains as far away as ever."

"As long as we equate suicide with mental illness, a pathological condition that needs medical treatment, many people with suciifal tendencies will not turn to health professionals to seek help."

"The message is that connecting with a person who is acutely suicidal by, first, respecting their autonomy ("don't come near") and, second, starting any nonthreatening conversation will most likely get the person out of the suicidal mode."

""We could never listen as long as you did in this interview, without saying a word."" (this really shows how many therapists and medical people still need to learn how to LISTEN)

And most importantly, for regular people trying to help someone they love :

"You cannot be responsible for another person when it may be a matter of life and death."



[arc review, honest opinion]

[Max · Rating 5 out of 5]

One of the best books I have read via NetGalley so far. Very insightful book on suicide and the processes behind it. There's background information on how the brain handles this crisis, but also ways to help people that are considering ending their lives. Ofcourse a rough read, but very important. I've learned a lot from this book. Especially the power of actually listening to someone. It's well written and easy to read. I think it should definitely be read by mental health professionals, and interested individuals like me.

Thank you so much to the author, publisher and NetGalley for an ARC to read & review. These are my honest opinions.

[Keri Karman · Rating 4 out of 5]

An important book about one of, if not the, most important topic in mental health care self-harm and suicide. Michel synthesizes important former works on this important topic, with new and informative takes on the available data that keeps the reader engaged. Suicide is an important topic to read about as a healthcare professional as it is important to learn about the myriad ways that someone can present as suicidal in order to treat the suffering patient to a greater extent.

The only negative of this book would be the verbosity. Michel seems to be repetitive at times, and this seems to distract the reader from the topic at hand.

I would recommend this book to all healthcare professionals, in order to help as many patients as possible. After all, like many scenarios in this book, the patient may present in crisis with other complaints that aren't evidently suicidal.

Thank you to NetGalley and Columbia University Press for this ARC!

[J Earl · Rating 4 out of 5]

The Suicidal Person by Konrad Michel is an intriguing look at both Michel's illustrious career and how, during that career, the ideas about suicide and those who consider it as an option have changed.

Other than a few courses years ago and several MOOCs more recently, I have no in-depth background in psychology, so I am coming to this as a layperson. I found it to be quite accessible though not a light read. If you have an interest, it won't be a problem, if you're mostly wanting a couple of quick "fix-it" ideas then you may be disappointed. Both because such fix-its don't exist and because Michel doesn't pretend to offer them.

What he does offer by way of showing his journey through the subject is a way to understand the personal nature of successfully reducing suicide rates in the population and suicidal thoughts in the individual. Because he went from a medical approach to a more personal narrative approach during his career, we are also able to understand why some previous approaches were not successful, on both a societal and an individual level.

There is information in here that can help the reader, whether you are someone who has considered suicide or you know someone who has/does. I know that, for me, reading this has helped me with better understanding some of my own thoughts even though they largely have always stopped short of being suicidal, though often being of the "I don't care whether I wake up, but I'm not gonna do something to ensure that" variety.

I would recommend this to both scholars and practitioners as well as laypeople with an interest, whether that interest is simply of the subject matter or because of some personal investment.

Reviewed from a copy made available by the publisher via NetGalley.

[Joana · Rating 4 out of 5]

The therapists must sometimes set aside their theory-based assumptions in order to understand the client’s subjective experience

Essencialmente, The Suicidal Person é um apelo a que o modelo médico no entendimento do suicídio caia em desuso, tanto pelo bem dos indivíduos que precisam de ajuda como para os profissionais de saúde. O livro mostra uma perspetiva humana do suicídio, despatologizando este fenómeno e tratando-o como uma ação que tem uma lógica interna para o indivíduo e que faz sentido no seu contexto e na sua biografia.

As ideias transmitidas por Konrad Michel vão de encontro às minhas leituras e perceções recentes em relação à psicologia - é mais importante despatologizar e entender o "paciente" como indivíduo, com as suas razões para ser como é, o seu contexto e a sua história de vida, que deve ser ouvida e levada em conta.

Em termos mais específicos, no âmbito do suicídio, a ideia central é a colaboração . É importante, como terapeuta, ouvir o indivíduo - "o especialista da sua própria história" - e entender como o fenómeno que, aparentemente isolado, levou à sua tentativa de suicídio, está muitas vezes associado a questões biográficas, planos de vida, fragmentação da identidade ou características da própria pessoa, relacionadas com experiências passadas sendo a situação "isolada" apenas um gatilho.

[Andrea Wenger · Rating 5 out of 5]

This fascinating, empathetic, and easy-to-read book explains how an exploration of life narratives can help patients and therapists identify the triggers for suicide. While most suicide attempts are correlated with mental illness and affective disorders, the author argues that the disorders don't cause suicide. Rather, through interviews, the author has identified that deep emotional pain can shut down rational thinking, leading patients to engage in self-harm to relieve the pain. A person-centered therapy approach helps patients gain self-awareness and recognize the danger signs.

I admit, I was skeptical about this book at first. But once I began reading, it all made sense. How the brain's executive functions shut down, and the emotional brain takes over. How it's like being in an altered state, and if you can get the executive functions back online, the suicidal impulse dissipates. Treating the suicidal impulse not as a symptom of disease but rather as a manifestation of a particular brain state could revolutionize the field and save lives.

Thanks, NetGalley, for the ARC I received. This is my honest and voluntary review.

[Belle · Rating 5 out of 5]

"I lost our son Alex, aged twenty, to suicide in 2001.
I couldn’t help my own son.
I hope this book will help others."- Dr Konrad

Gut wrenching. And unexpected 💔

~

Intellectual. Honest. Inspiring. Hopeful.

A thoroughly studied assessment from a highly respectable doctor with 50 years experience. Dr Konrad's voice is humble, pleasant and grounded.

It was courageous to speak of his son.

The Dr. House cameo had me chuckling, and genuinely surprised by Dr. Konrad's spot of humour.





I am certain Dr. Konrad's dedicated and passionate work has helped countless people and will continue to do so for years to come.

"Hamlet says: “There is nothing either good or bad, but thinking makes it so.” Shakespeare, 1602.

Amazing." ~ Dr. Konrad

💙👊 Seek help. You are worth it.


*E-arc received via Netgalley in exchange for an honest review.

[Amanda · Rating 3 out of 5]

Overall, this book was an interesting read, but oftentimes it felt repetitive to the point of frustration.

I enjoyed the concept Dr. Michel stresses in the book, which considers suicide as an "individual, subjective, and transient" crisis, sometimes happening in the absence of typical risk factors.

The one bit of constructive feedback I have is that the book seems to suffer, at times, from a lack of clear audience. In some sections, it seems written for the already science-savvy reader, even a mental health professional. At other times, it seems too repetitive to be written for a professional. It also feels self-aggrandizing in some areas and like an academic name-drop, specifically when detailing the Aeschi conferences. By the final chapter, the book seems exceedingly repetitive about the narrative interview concept and the therapeutic relationship.

That said, the book would be well-suited for individuals with an interest in mental health and suicide prevention. Thank you to NetGalley and the publisher for an ARC.

[Jenny · Rating 4 out of 5]

Takeaways:
- seeing suicide as action—the only feasible solution (in the moment) to deep psychic pain—rather than the endpoint of a certain pathology
- using narrative methodologies (reminded me a lot of the My Life, My Story model, where the first-person account and the collaborative retelling can be very therapeutic) to build alliance and more personalized safety plans

Appreciated his clear writing and summaries at the end of every chapter, as well as his openness to new ideas and feedback. It reads somewhat like an academic memoir which I think makes sense because this is essentially the story of his entire career, which is deeply entangled with his personal life and mission. There are moments of both humility and pride which feel sincere rather than promotional/affected.

[Robert Bogue]

Understanding the suicidal person is at the heart of prevention. If you don’t understand them, how can you help them? The Suicidal Person: A New Look at a Human Phenomenon examines the suicidal person while retaining their humanity. Instead of simplifying them to a mental disorder or relying on a formulaic, linear set of cause and effect for suicide, it examines what in our humanity makes us susceptible to suicide.

Read more

[Brilyn · Rating 3 out of 5]

A NetGalley review:

I have been trying to get more into psychology reading and I saw this book on NetGalley and decided to request it. I think this book was quite interesting because I am interested in how the brain works and the reaction it has to thoughts. However, to someone not interested in a medical or psychological field, this book would be boring. I lost focus multiple times while reading but I also learned a lot.

[Rachael · Rating 4 out of 5]

That’s to NetGalley and the publisher for the e-arc. A thorough and fascinating look at suicide prevention.

[Ксения Чистопольская · Rating 5 out of 5]

a great book for practitioners to work with suicidal people. a personal memoir and, at the same time, very well-structured and comprehensive read