Suicide is sadistic. And masochistic. Sometimes both.

In “Attempted Suicide in Adolescence: The Suicide Sequence,” Jack Novick turns to “sadomasochistic pathology with the delusion of omnipotence as a core fantasy.” Novick establishes that this pathology often manifests itself in “the tendancy to make the therapist responsible for whether the patient lives or dies.”

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Novick, “Attempted Suicide in Adolescence: The Suicide Sequence,” in Essential Papers, 524-48. See also, Hendin, “Psychotherapy and Suicide”; Birtchnell, “Psychotherapeutic Considerations in the Management of Suicidal Patients.”