Joseph Richman

Patient dissatisfaction and attempted suicide.

This paper deals with the presence of suicidal behavior in a mental health clinic and psychiatric emergency room, and its relationships to what has been described in the literature as the “dependent-dissatisfied” personality. Procedures included a suicidal potential scale, projective figure drawings, and a brief interview about past and present suicidal behavior. The scale used significantly differentiated between high and low potentially suicidal groups. The high suicidal group showed a significantly greater dissatisfaction with treatment both past and present. The implications for both evaluation and therapy of suicidal patients are discussed.

The Role of Psychotherapy and Humor for Death Anxiety, Death Wishes, and Aging

This article is part of a series of humor on social attitudes (Richmen, 1977), humor by the elderly (Richman, 1989), assessment (Richman, 1996a), and psychotherapy (Richman, 1996b). The present study is based on the topics of humor related to death anxiety and wishes, and aging that emerged during psychotherapy with elderly patients. The healing qualities of laughter and humor have been observed since Biblical times to the present, however the applications of humor to professional psychotherapy is still in its infancy. The examples in this study spell out how humor in therapy can bring people together, and help them affirm life and laugh at anxiety, depression, and their problems in living.

Reporting Diagnostic Test Results to Patients and their Families

Summary Clinical psychologists have been concerned about the proper presentation of their test results to everyone but the patient. Nevertheless, they bear an obligation to inform the patient of the findings, which, after all, were contingent upon his cooperation and effort. A method of presenting such data is described, which can be applied to school, vocational, and psychiatric disturbances. and one case is presented in detail. The methods efficacy is largely a function of the skill and experience of the counselor, the motivation of the client, the presence of a positive working relationship, and a respect for the person being tested.

The Family Doctor and the Suicidal Family

Suicide is a broad social problem, the full scope of which extends beyond the medical profession. The physician is, nevertheless, one of the most important figures in the field of suicide prevention. Particularly because of the growth of community psychiatry and other changes in psychiatric practice, it is more urgent than ever that the physician be alert to the problem of suicide and other derivatives of emotional and interpersonal disturbances. The presence of a great potential for saving lives and preventing suicide entails an equally great responsibility. This responsibility has not been fully met by the medical profession and especially not by the medical educators. We therefore strongly recommend that the study of the theory and prevention of suicide be made an integral part of the medical school curriculum. In the light of the importance of the family in suicide we further recommend that family interviewing and counseling be incorporated into both medical school education and post-graduate training. Such a program would include not only a knowledge of how to interview and evaluate a family, but also how to recognize when a referral to a family therapy specialist is required.

Suicide and the Elderly

The reasons for suicide in the elderly are not as self-evident as they seem to some persons who attribute the event primarily or even solely to being old. For most of those so “afflicted,” old age is a very pleasing time, one of high morale and high life satisfaction.

Psychotherapy with Suicidal Older Adults.

Abstract A rationale for therapy with suicidal elderly patients, from assessment through psychotherapy, is presented. The process includes thorough and comprehensive attention to not only the suicidal individual, but also the situational and family components of the suicide crisis; crisis interuention; general principles of treatment; and applications of these principles to individual, group, and, family therapy. The intensity and complexity of the transference and countertransfirme reactions are emphasized.

Family Therapy with Elderly Suicidal Patients: Communication and Crisis Aspects

This article discusses the role of the family in the origins of a suicidal state, and its role in resolving the suicidal crisis, especially when family therapy is available. Death wishes, homicidal ideation, and suicide pact-and-suicide-murder ideation, are present far more frequently than is commonly realized. They all contain a constructive potential in the presence of a competent and experienced therapist. Success in therapy includes a knowledge of how to deal with the communication of suicidal impulses by the suicidal person, the familys communication of feeling burdened and fed up, and the venting of rage. Treatment is based upon the understanding that suicide is a process that is frequently handed down from one generation to the next, and includes several generations at one time. These considerations are illustrated by case examples, mostly from the experiences of the writer, demonstrating how destructive interactions can be transformed into life affirming ones.

Similarities and Differences Between Younger and Older Suicidal People

More younger people attempt and more older people commit suicide, but the bulk of research and treatment activities, presumably by younger professionals, is devoted to the younger suicidal population. In this paper, both younger and older suicidal patients were compared for age differences, age similarities, and the relationships between generations. Examples are presented of the precipitants and family determinants that were most frequently associated with suicidal behavior, with a discussion of their theoretical and clinical implications. The precipitants were based upon developmental tasks and crises which differ with age, while the family determinants were similar at all ages. Families also played a major role in the origin, outcome, and healing of a suicidal state. To a great extent, the steps leading to a self-destructive episode occurred outside of awareness. The examples illustrated both the typical and the unusual experiences that take place during the treatment of suicidal individuals, often involving the therapist in emotional, dramatic, and moving situations.