APA Citation
Maltsberger, J., & Buie, D. (1980). The Devices of Suicide: Revenge, Riddance, and Rebirth. *International Review of Psycho-Analysis*, 7, 61-72.
Summary
Psychoanalysts Maltsberger and Buie explore the psychological functions suicide attempts can serve: revenge (making others suffer), riddance (escape from unbearable internal experience), and rebirth (magical fantasy of starting over). They analyze how suicidal states develop from intolerable self-hatred and object loss, and how understanding these functions helps clinicians respond to suicidal patients.
Why This Matters for Survivors
Survivors of narcissistic abuse often experience suicidal thoughts as the relationship destroys their sense of self-worth. Understanding suicide as potentially serving different psychological functions—escape, revenge, rebirth—helps survivors and clinicians address the underlying needs driving suicidal thinking. For some, the narcissist's abuse creates intolerable self-hatred that suicide appears to resolve.
What This Research Establishes
Suicide serves psychological functions. Beyond the act itself, suicidal thinking can serve different purposes: revenge (making others suffer), riddance (escape from unbearable internal experience), or rebirth (fantasy of starting over).
Understanding functions guides treatment. Knowing what suicide represents for a particular person helps clinicians address the underlying needs rather than just the surface behavior.
Self-hatred drives suicidal states. Intolerable self-contempt—often internalized from external abuse—can make continued existence unbearable. Suicide appears to offer escape from the hated self.
Object loss contributes to suicidality. Loss of sustaining relationships, including loss of idealized relationships that provided self-worth, can precipitate suicidal states.
Why This Matters for Survivors
Understanding suicidal thinking. If narcissistic abuse has led to suicidal thoughts, understanding what function these thoughts serve can help address them. Are you seeking escape from self-hatred the narcissist created? Revenge? A new beginning?
The connection to abuse. Narcissistic abuse often creates the self-hatred that drives suicidal thinking. You internalized the narcissist’s contempt; now it feels impossible to live with yourself. This is effect of abuse, not your inherent worthlessness.
Seeking help. Understanding suicidal states doesn’t replace getting help. If you’re experiencing suicidal thoughts, reach out—to crisis services, therapists, trusted others. These states are treatable.
Recovery includes this. Recovery from narcissistic abuse includes recovery from the self-destruction the abuse caused. The self-hatred driving suicidality can be addressed; the hated self can be reclaimed.
Clinical Implications
Assess function of suicidality. When working with suicidal patients, explore what purpose suicidal thinking serves. This guides intervention.
Address underlying self-hatred. Suicidal states often involve intolerable self-contempt. Work to understand and address this self-hatred rather than just managing the suicidality.
Consider relationship to abuse. In patients who experienced narcissistic abuse, suicidality may represent internalized abuse. Connect suicidal states to their interpersonal origins.
Different functions, different approaches. Riddance suggests addressing unbearable internal states; revenge suggests working with anger and relationship issues; rebirth suggests addressing identity and hope for change.
How This Research Is Used in the Book
Maltsberger and Buie’s framework appears in chapters on the most severe effects of narcissistic abuse:
“If narcissistic abuse has led you to suicidal thoughts, Maltsberger and Buie’s work helps understand what these thoughts represent. Are you seeking escape from the self-hatred the narcissist installed? Revenge—wanting them to finally see what they did? Fantasy of rebirth as different person? Understanding the function helps address the need. But this understanding doesn’t replace getting help. Reach out—to crisis services, to therapists, to trusted others. The self-hatred driving suicidality can be addressed. The hated self was created by abuse; it can be reclaimed. Recovery includes recovery from this.”
Historical Context
Published in 1980, this paper provided psychoanalytic framework for understanding suicide that complemented developing cognitive and behavioral approaches. The insight that suicide serves psychological functions—not just representing despair but attempting to accomplish something—has influenced clinical work with suicidal patients.
Further Reading
- Joiner, T. (2005). Why People Die by Suicide. Harvard University Press.
- Shneidman, E.S. (1996). The Suicidal Mind. Oxford University Press.
- Maltsberger, J.T. (1986). Suicide Risk: The Formulation of Clinical Judgment. NYU Press.
- Linehan, M.M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
About the Author
John T. Maltsberger, MD (1933-2010) was a leading expert on suicide and its treatment, teaching at Harvard Medical School. His psychoanalytic approach to understanding suicidal states has been influential in clinical training.
Dan H. Buie, MD collaborated with Maltsberger on psychoanalytic understanding of suicide and its treatment.
Historical Context
Published in 1980, this paper provided psychoanalytic understanding of suicide at a time when the field was developing more sophisticated approaches to suicidal patients. The framework of understanding the functions suicide serves has influenced clinical work with suicidal individuals.
Frequently Asked Questions
Maltsberger and Buie identify three: revenge (making others suffer, punishing them), riddance (escape from unbearable internal experience), and rebirth (magical fantasy of starting over as different). Different functions suggest different interventions.
Narcissistic abuse often creates intolerable self-hatred—the victim internalizes the narcissist's contempt. Suicide may appear to offer escape from this unbearable internal state. The connection is through the self-destruction narcissistic abuse causes.
Riddance refers to suicide as escape from intolerable internal experience—self-hatred, emptiness, or despair that feels impossible to live with. The person isn't primarily seeking death but escape from unbearable life.
Some suicidal thinking involves making others suffer—'they'll be sorry.' This may particularly apply in abusive relationships where the victim's death would punish the abuser or make others see the truth.
Some suicidal thinking involves magical fantasy of starting over—death as portal to new existence rather than end. This may reflect unbearable current identity and wish for different self.
Understanding what function suicidality serves guides intervention. Riddance suggests addressing unbearable internal states; revenge suggests working with anger; rebirth suggests addressing identity and possibility of change in life.
Seek immediate help—contact a crisis line, therapist, or emergency services. Suicidal thoughts often emerge from treatable states. Understanding the function doesn't replace getting help; it helps helpers understand what you're experiencing.
Yes. The self-hatred and despair that drive suicidality can be addressed in treatment. Recovery from narcissistic abuse includes recovery from the self-destruction the abuse caused, including suicidal states.