This book is intended for anyone with either an interest in suicide or suicidal behaviour. It is not aimed solely at the professional psychotherapist but at a broad range of professionals who encounter suicidal people in their work. It is also intended for those of us who have been touched by suicide personally.The book approaches suicide from the point of view of the suicidal state of mind and is intended to help us understand more about this condition. In its essence suicide is examined as a largely unconscious aggressive act having its roots in a perceived or real experience of thwarted childhood needs. The wounds of the suicidal person are often long held and deep. The suicidal person is pursued by haunting losses and the suicidal act comes from deep disturbance created by this and from the idea of death as an acting out of some form of suicidal fantasy. The quasi delusional and split quality of the act is examined – namely that suicide is both an act for and against the self. Consequently a strong case is made for the contribution of psychotherapy to the project of suicide prevention since it is in this carefully managed arena the suicidal fantasy can be examined and the settling of these scores can be worked through, rather than acted out by suicide. The hope is that the book will increase understanding, challenge concepts of mental illness and suicidality but most importantly address the understandable fear we all have about suicide and its power to render us impotent. In turn it is hoped this will empower readers, who might otherwise be fearful of suicide, to intervene, support and work with those who are suicidal.