Narrative inquiry was used to study three middle-aged persons who had undergone a suicidal crisis in response to a life-threatening illness. The research question was: “In the context of one’s ongoing life story, what is his or her psychological and emotional experience when undergoing a suicidal crisis while confronted with a life-threatening illness during middle age?”

Face-to-face interviews were done in a semi-structured format. Three main areas of focus framed the interviews: (a) the arc of the life-story as perceived prior to the imposition of the life-threatening illness, (b) responding to the fact of the life-threatening illness, and (c) the process of the suicidal crisis.

Thematic analysis was utilized to unpack and organize meaning. Findings were presented in two sections: (a) narrative and thematic descriptions oriented to each individual, and (b) the existential amplification of four shared, superordinate themes common to all three participants; followed by a discussion of the results within the context of the literature.

The elaboration of shared themes revealed a common story line whose highlights are: abandonment/betrayal, compensated by the “healing other,” followed by intensive negotiation around suicide, resulting in the emergence of increased authenticity.

The findings showed that intellectualization, transcendence, and complex resistance were used in conjunction with suicidal ideation as a means to exert mastery and control over the threat of death from the outside. Case study narrative material supported the theoretical claim that a suicidal crisis may indicate a desire for personal transformation; complex negotiations around suicide mediated by healing others resulted in increased authenticity.

Suicide prevention and an exploration of the suicide question were shown to be potentially complimentary endeavors. The process of a suicidal crisis was seen to have results similar to those experienced by individuals who have undergone complex rites of passage. The pronounced psychological and emotional desire to engage with death was shown in the approach to the death experience within the context of suicide itself.

The findings could be valuable in the following areas: suicidology, suicide prevention, coping with life-threatening illness, death studies, and psychotherapeutic applications for the depressed and suffering.