The Logic of the symptom: using a complex assessment procedure to reformulate the psychotherapeutic plan of a 9-Year-old suicidal child

Recent years, particularly following the COVID-19 pandemic, have seen a marked increase in suicidal behavior and thoughts among children, symptoms that can be alarming both for parents and psychotherapists. This study presents a single case of a 9-year-old boy who sought therapy after two suicide attempts, aiming to illustrate the benefits of a comprehensive psychodynamic assessment. This approach allowed to shift from an excessive focus on symptomatology toward a comprehensive understanding of the patient’s functioning. Utilizing the Psychodynamic Diagnostic Manual, second edition, and other empirically validated instruments to assess personality, overall mental functioning, and emotional and behavioral difficulties, this case will explore how such an assessment enabled the psychotherapist to transcend the “logic of the symptom,” provided a new perspective on the child, and allowed for the formulation of a more effective treatment plan. Furthermore, this case exemplifies how psychoanalysis can be integrated with empirical research, offering a vital approach, especially in the context of scarce treatment guidelines, as in the case of child suicidality.