The Self in Crisis: Using Self-Trust to Enhance Therapeutic Practices for Patients with Chronic Suicidal Ideation

Abstract

In this thesis I set out to show that the bioethical literature concerning the treatment of chronic suicidal ideation occupies a serious omission: it does not discuss the critical function that self-trust serves in the recovery process. Self-trust is a core component of autonomy, and therefore plays a pivotal role in the shaping of one’s sense of self and his or her capacity to effectively engage in therapeutic interventions. I begin by discussing the relationship between agency and self-trust, and how this influences one’s ability to make decisions and self-advocate. Secondly, I evaluate how self-trust relates to aspects of the suicidal mind, including existential distress and negative urgency. Finally, I will offer recommendations as to how the explicit (re-) development of self-trust skills can significantly enhance the effectiveness and timeliness of contemporary dialectical treatment practices.