Symbiosis, empathy, suicidal behavior, and the family.
This paper discusses the theoretical concept of symbiosis, as described by Mahler and her co-workers, and its clinical applications in suicidal situations. Symbiosis is defined as both a developmental phase characterized by a lack of differentiation between self and others and a relationship which is contingent upon the family and social network. A disturbed symbiosis is a major component in a suicide attempt. The destructive aspects of symbiosis are traced together with its relationship to empathy and the efforts to both restore and resolve a symbiotic conflict through suicidal behavior. In family therapy a repetition of older symbiotic relationships is frequently observed. These are repeated from one generation to the next in order to keep the old relationship alive. Finally, the practical implications of the concept of symbiosis for assessment and treatment are discussed.