Out of Sight, Still in Mind: Intersession Processes and Suicidal Ideation in Psychodynamic Treatment

Presenter: Mareike Ernst, PhD

This presentation introduces the concept of intersession processes—patients’ thoughts, feelings, fantasies, and internalized experiences of therapy and therapist between sessions—and examines their relevance from a contemporary psychodynamic perspective. Drawing on psychodynamic theory and empirical research, the talk discusses how intersession processes may illuminate clinically meaningful fluctuations in suicidal ideation, including both protective and risk-related dynamics in outpatient treatment. Particular attention is given to recent findings showing how both between-person and within-person variation in intersession experience can deepen our understanding of suicidal processes beyond symptom severity alone. It further considers how the study of intersession life may open new avenues for clinically sensitive routine monitoring, smartphone-based assessment, and personalized interventions, while also inviting a critical discussion of the conceptual and methodological limitations of integrating intersession-focused assessment into care.