Lewin discusses the subtle, intense & complicated problems presented by chronically, suicidal patients with severe personality disorders. Therapists need to tolerate a great deal of uncertainty, to recognize both the interpersonal & intrapsychic complexities of suicidality, & to remember that suicidality is both a help & a hindrance to the patient. Two extensive commentaries by Hoge & King follow this article. Dr. Lewin’s response to these commentaries is also included.