The Aeschi Working Group

MEETING THE SUICIDAL PERSON

The therapeutic approach to the suicidal patient

Third Aeschi Working Group Conference Explores New and Better Therapies for the Suicidal Person

By Melinda Moore
KBHC Interim Executive Director

Nestled in the Swiss Alps, high above Lake Thun and the resort town of Spiez, rests the village of Aeschi (pronounced "Eshi"), the most unlikely spot for a biennial meeting of an international group of clinicians and researchers, representing an array of therapeutic models, and their mainly clinical audience, all seeking consensus among their disparate approaches, but more importantly, a better way to treat their suicidal patients.

Emanating from a 1999 meeting to discuss the findings of a Swiss suicide study, the current Aeschi Working Group members came together and discovered their mutual dissatisfaction with the current state of suicide treatment and research discourse. The group has been convening a conference in March, inviting a limited number of participants, meeting every two years since.

"We agreed that new models of understanding suicide are badly needed. We agreed that patient-oriented models are needed, as opposed to a physician-oriented approach based on a traditional illness model" says Konrad Michel, M.D. "Aeschi is very much about developing better concepts of suicidal behavior and applying them in clinical practice. Aeschi is not about advocating one specific form of treatment but about finding the essential ingredients for an effective treatment of suicidality."

This year's conference agenda included an impressive range of speakers, including radical behaviorist Marsha Linehan on the therapeutic relationship in Dialectical Behavioral Therapy (DBT) and Jeremy Holmes on Attachment Theory. Psychoanalyst John (Terry) Maltsberger's gloss and response to Edwin Shneidman's theory of "psychache" provided a thought-provoking foil to the neurobiological discussions of suicidal states by psychiatrists Michael Bostwick and Konrad Michel, Lisa Firestone's Voice Theory presentation, and Richard Young's Narrative and Action Theory lecture. David Jobes provided a realpolitik perspective to the treatment of suicidal patients, presenting impressive research on the Collaborative Assessment and Management of Suicidality (CAMS) Protocol, an approach aimed at squaring the realities of managed care and outpatient treatment with the assessment and enjoining of the suicidal patient in their own treatment plan. In word and deed, Jobes attests to the "Aeschi spirit - which speaks to the interest and desire to think outside the box. How we reconcile these perspectives is sort of the dialectic or the tension that we'll try to evolve."

Melinda Moore
Interim Executive Director
Kristin Brooks Hope Center
Program Manager, National Hopeline Network/1-800-SUICIDE (784-2433)
201 North 23rd Street
Purcellville, Virginia
www.hopeline.com

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