Splitting and the psychodynamics of adolescent and young adult suicide attempts.

The authors point to a link between the contradictory meanings and functions of adolescent and young adult suicide attempts and splitting mechanisms that may explain the normal coexistence of opposite tendencies. They argue that suicide attempts of young people reveal a deadlock in development, in which individuation and the need for dependence are equally intolerable because of the arousal of anxiety linked to persecution or abandonment. The sexualisation of the body and of intimate relationships engenders a risk of psychic decompensation, which is temporarily set aside through the reinforcement of splitting and denial; the suicide attempt, however, is precipitated by conditions that provoke a traumatic return of that which has been split-off and denied. Suicide attempts thus represent an act of compromise, the object of which is to avoid psychic disorganisation through the re-establishment of a precarious equilibrium between antithetical tendencies that splitting can simultaneously address. In particular, suicide may represent an attempt at individuation and flight from incest while at that same time satisfying fusion needs and the realisation of oedipal fantasies. Clinical examples are presented to illustrate the manifestation and the function of splitting in young people's suicide attempts.