EP09 Topical Panel 11 – Suicidal Behavior – James Hillman, PhD; Cloe Madanes, Lic. Psychol.

EP09 Topical Panel 11 – Suicidal Behavior – James Hillman, Cloe Madanes

Educational Objective:  To compare and contrast clinical and philosophical perspectives of experts.

Outline:

Introduction and Context

• Speaker introduces Cloe Madanes and James Hillman.

• Thomas Szasz absent due to weather.

• Cloe begins by sharing real cases of suicidal clients.

Case 1: The Depressed Engineer

• 40-year-old man lost job, felt life had no meaning.

• Cloe challenges his belief that work defines self-worth.

• Suggests enjoying life—e.g., going to the zoo.

• Man calls next day, feeling hopeful and energized.

Case 2: The Epileptic Patient

• 26-year-old woman with uncontrollable seizures.

• Cloe involves her parents in therapy.

• Uses paradox: asks patient to have seizures on cue.

• Seizures become manageable; medication becomes effective.

Case 3: The Revengeful Daughter

• Woman’s symptoms began after her parents’ divorce.

• Therapy includes family; paradox: father pretends to be “dead.”

• Leads to financial support, marriage, and medication-free recovery.

James Hillman’s Reflections

• Praises Cloe’s creative, adaptive techniques.

• Emphasizes listening to implicit messages.

• Notes underlying motivations for suicidal behavior (e.g., revenge, risk).

• Encourages working hypotheses tailored to each client.

Suicide in Broader Contexts

• Teen and elderly suicide discussed.

• Cloe shares a story about inspiring a young man through Hemingway’s adventurous life.

• Speakers touch on meaninglessness and social pressure as suicide drivers.

Audience Questions

• On affluent teen suicide: pressure and lack of purpose are key issues.

• Fort Hood shooting discussed—debate whether it’s suicide.

• Elderly suicide: linked to isolation; meaning and connection are crucial.

Managing Risk in Therapy

• Questions about risk assessments and documentation.

• Speakers downplay reliability of risk scales.

• Emphasize understanding the client’s worldview and deeper drivers.

Case Consultations

• Cloe suggests viewing a client’s self-destruction as a protective gesture toward a parent.

• On rural suicide prevention (Alaska): Cloe recommends connecting with an experienced colleague.

• Addressing life insurance-motivated suicidality: explore alternative meanings and solutions.