[Psychotherapy of acute suicidality. "The anti-suicide promise" as a method of preventing suicide].

A trustful therapeutic relationship is considered to be the most important suicide-preventing measure. Furthermore, it has frequently been recommended to have the severely suicidal patient promise not to commit suicide within a certain period of time. Using three clinical examples the unreliability of this suicide-preventing method is demonstrated. When the patient can give such a promise responsibly, it probably is no longer necessary. Also, the patient's giving such a promise can negatively influence the development of the therapeutic relationship. A reciprocal contract should be preferred: the patient contacts the therapist whenever he feels to loose control over his suicidal potential whereas the therapist offers his availability to the patient.