The author argues that a constructive therapeutic relationship with the suicidal patient should be based on a joint understanding of the patient’s suicidality. He argues that suicide & attempted suicide are actions & not illnesses, and suggests that patients typically relate their act of self-harm to long-term goals in their lives that are seriously threatened. He concludes that only by joining the patient in his or her narrative will the clinician be able to help the patient re-establish life-oriented goals. (24 refs)