Assessing and treating suicidal patients is a high-risk area of practice requiring psychoanalytic psychotherapists to be knowledgeable about risk and protective factors for suicide, and competent at assessing, formulating and treating this group of patients. The therapist must have a method of using research data and clinical judgment to understand the suicidal process, which often involves life span developmental vulnerabilities (diathesis) combined with more acute life stressors (stress). Interpersonal, cognitive, social, neurobiological, genetic, and psychodynamic factors may all contribute to suicidal states of mind. Integrating disparate sources of knowledge to develop a psychodynamic formulation is a core strength of psychoanalytic practice, which aims to understand the meaning of symptoms from unconscious, preconscious, and conscious aspects of the individual in a developmental and interpersonal context. Our study group has reviewed contemporary psychological theories of suicide and developed an integrative psychoanalytic tool for assessing and formulating the dynamics of the suicidal process at the level of the individual.