In the United States, half a million people present to hospital admitting staff each year; threatening, but not accomplishing, suicide. Over ? of all psychiatric emergency room visits each year are for chronically acute behaviors often labeled "parasuicidal," leading to a continuous loop of complaints and ineffective interventions. This book offers an effective way out. In clear and understandable language, it introduces an innovative theory that radically departs from current ideas about such behaviors. With numerous vignettes, it provides clinicians, in diverse professional roles, a cluster of effective therapeutic and organizational interventions that often counter today"s business-as-usual means of responding to individuals who repeatedly threaten suicide and self-harm.