Evidence map›Paper›PMID 42662257›Full record

ArticleClinical neuropsychiatry2026

Unconscious And Intersubjective Dynamics of Suicide. Over a Century of Psychoanalytic Perspectives.

Raffaele De Luca Picione, Elvira Martini, Chiara Fioretti, Vittorio Lenzo, Alessandro Musetti, Alessandro Germani

Abstract read
In one paragraph

Article in Clinical neuropsychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Raffaele De Luca PicioneFaculty of Law, Giustino Fortunato University, Benevento, Italy.ORCID https://orcid.org/0000-0002-5951-8336
Elvira MartiniFaculty of Law, Giustino Fortunato University, Benevento, Italy.ORCID https://orcid.org/0000-0002-1761-6405
Chiara FiorettiDepartment of Human, Philosophical and Educational Sciences/DISUFF, University of Salerno, Italy.ORCID https://orcid.org/0000-0002-1440-9398
Vittorio LenzoDepartment of Educational Sciences, University of Catania, Catania, Italy.ORCID https://orcid.org/0000-0001-8391-5123
Alessandro MusettiDepartment of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy.ORCID https://orcid.org/0000-0003-4125-0068
Alessandro GermaniFaculty of Law, Giustino Fortunato University, Benevento, Italy.ORCID https://orcid.org/0000-0002-7690-8934

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Suicide represents a complex clinical phenomenon that cannot be adequately understood through categorical diagnoses or risk-factor models alone. This narrative, historical, and critical review examines suicide through a psychoanalytic lens, integrating intrapsychic, intersubjective, and sociocultural dimensions. Drawing on major Freudian and post-Freudian traditions, this paper explores how unconscious dynamics, such as mental pain (psychache), guilt, shame, narcissistic injury, aggression, and fantasies of annihilation or rebirth, organize suicidal ideation and behavior in clinically meaningful ways. Rather than proposing a unitary explanatory model, this review advances an integrative clinical framework that conceptualizes suicide as the outcome of heterogeneous and dynamic psychic configurations, shaped by developmental trajectories, relational contexts, and failures in affect regulation and symbolization. By examining the profound connection between theory and clinical practice, this work advocates for a dimensional and idiographic approach capable of capturing the subjective meaning and the transformative or destructive function inherent in suicidal fantasies and behaviors. By mapping different psychoanalytic models onto specific clinical constellations, the paper highlights how suicidal behavior may serve distinct unconscious functions (e.g., self-punishment, revenge, spite, preservation of internal objects, escape from fragmentation). The implications for clinical assessment and intervention are discussed, emphasizing the importance of idiographic formulation, attention to unconscious meaning, and careful management of countertransference in suicidal crises. This perspective aims to complement contemporary suicidology by offering clinicians conceptual tools for understanding the subjective logic of suicidal behavior beyond risk prediction alone.

Indexed as

idiographic approachintersubjective processespsychachepsychoanalysissuicideunconscious dynamics

Identifiers

PMID42662257
PMCPMC13519276

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.