What internal factors cause a person to end his or her life, and what are the familial and societal factors which seem to make a destructive contribution? The answers to both questions are at the heart of this volume, which will be invaluable for practitioners when assessing risk and designing treatment for depressed and suicidal patients. The author argues that the key to understanding suicidal behaviour comes from a knowledge of the destructive thought processes of those at risk, and an awareness of their origins in early family interactions. Firestone sees negative events in our lives as being less harmful than what we tell ourselves about them, which can result in a downward spiral of negative internal conversations. With detailed case histories providing depth of emotional reality to the theory, the book is built around the sound theoretical framework and psychotherapeutic method developed by Firestone and his colleagues. This framework offers a unique perspective not only on suicide, but also on other self-destructive, potentially life-threatening behaviours and lifestyles.