Psychoanalytically informed treatment can be beneficial to most people. For example, it can provide relief from the troubling symptoms of anxiety, depression and other life-disrupting concerns. You might, for instance, be plagued by private rituals, compulsions and repetitive thoughts of which no one else is aware. Alternatively, you might be living a constricted life of isolation and loneliness, or feel incapable of getting close to others. In some cases, as a result of destructive patterns of behaviour, you may have experienced repeated failures, particularly in key areas such as work and love.

As an alternative to more simplistic, short term interventions, psychoanalytically-oriented therapy can be a particularly beneficial treatment option for individuals managing high stress-related worries or concerns, typical of those confronting busy professionals in their work or lives generally. Despite relative satisfaction and success in their lives, individuals fitting this category may nonetheless be suffering disruptive symptoms that restrict choices and other opportunities for pleasure. Hence, certain people may choose to seek out this treatment approach because other interventions have not resolved their problems or, at best, only temporarily so.

In working with a psychologist who is also an internationally accredited psychoanalyst, patients can be confident that they are being treated by a uniquely trained mental health practitioner. Psychologists with this extra level of expertise have not only completed the rigours of their own professional training (i.e. an extensive graduate program in clinical psychology), but also at least 4 years of additional training in psychoanalytic theory and clinical practice. In particular, psychologist-psychoanalysts, trained under the auspices of the Toronto Psychoanalytic Society and Institute have received the most rigorous training available. This particular training leads to membership in both the Canadian Psychoanalytic Association and International Psychoanalytic Association (the world wide umbrella organization for the training of psychoanalysts). In summary, people undergoing psychoanalysis or psychoanalytically-oriented therapy can feel confident that practitioners with affiliation to the International Association meet the highest training standards available for this particular treatment.

Robin Williams’ recent suicide prompted an enormous reaction from the general public, evoking a variety of opinions and perspectives. Locally, Carly Weeks, (Globe and Mail, August 15th, 2014) rightfully asserts that there are no easy answers to understanding suicide and that we are often left at a loss as to try and understand why someone would take their own life. She cites Dr Martin Heisel, a researcher at the University of Western Ontario who emphasizes the fact that, “…there are variety of factors” that go into a individual’s death by suicide, and rarely just one consideration.

Weeks states that the vast majority of those who die by suicide have some form of mental health difficulty, with depression being the most frequently occurring syndrome. As David Gratzer (also The Globe and Mail,  August 15) points out, many people carry with them on a daily basis, the burden of depression, anxiety, addiction or other some the debilitating affliction. Michael Redhill’s poignant commentary on depression particularly caught my eye (The Globe and Mail, August 16) and is a particularly personal account from the perspective of an “artistic mind”.

Instead of avoiding talking about depression and suicide, Heisel, (from Week’s article), rightly stresses the importance of speaking about depression openly, that  helping a person express how she or he feels is critical. As a psychoanalyst listening to people talk about suicide I feel that it is vital to listen with an attitude of equanimity, non-judgement, seriousness and patience. I think that the capacity to listen to a patient verbalize suicidal feelings or ideas can actually strengthen the boundary between thought and action. In my mind it is important to give the individual (implicit) permission to express the powerful emotions that are threatening from within. In particular, I have found that this can help improve a person’s capacity to understand his or her inner and outer realities.

In circumstances where matters are thought to be getting more out of hand, often as a result of the patient becoming too depressed to communicate or indeed making practical plans for committing suicide, it is important that the individual be actively protected. However,  I always feel that such behavioural limit setting should be combined, as much as possible, with a continual emphasis on understanding and on attempting to uncover the potential meanings of impulses and actions. Otherwise, I feel that a patient can get  the impression that I’m only interested in his/her behaviour and not the subjective distress that underlies it. At times we, as psychoanalysts dealing with suicidal patients,  should realize that there are situations when one to one psychotherapy is simply not enough to contain the psychosocial distress involved. Hence, I might deploy adjunct measures including, amongst other things, the enlistment of family members’ help.