Baby and Elderly Holding Hands
CPD Credits
3
Event Type
Live Online Event
Location
Zoom & Recording
Time (UK)
2:00 pm - 5:00 pm
Standard
£80.00
Trainee/NHS
£68
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Baby and Elderly Holding Hands
Friday, July 31, 2026

Assisted Death

A Psychoanalytic Perspective

With Dr Andrew Balfour, Dr Rachel Gibbons & Dr Zack Eleftheriadou (Chair)

Assisted death is often debated through legal, ethical and medical frameworks, yet its psychological dimensions are equally profound. From a psychoanalytic perspective, the question is not simply whether someone wishes to die, but what unconscious meanings, relational experiences and developmental anxieties become activated as life draws to a close.

As physical decline progresses, dependency, vulnerability and the loss of bodily autonomy can revive some of our earliest anxieties concerning helplessness, separation and annihilation. The prospect of death may evoke unconscious fears of fragmentation alongside a longing to preserve dignity, agency and continuity of self. Requests for assisted death therefore cannot be understood solely as a desire to end suffering; they must also be considered within the context of a person's internal world, relationships and life history.

Psychoanalytic thinking emphasises that dying is fundamentally relational. Patients continue to require emotional containment, recognition and the experience of being held in mind by others, when cure is no longer possible. Families, too, may begin mourning long before death occurs, negotiating complex feelings of love, guilt, hope, helplessness and ambivalence as they accompany someone towards the end of life.

Drawing upon both decades of clinical work, Andrew Balfour explores how assisted dying transforms the psychological experience of dying for patients and those closest to them. Rather than offering definitive answers, our speakers invite us to consider how psychoanalytic understanding can deepen contemporary conversations about autonomy, dependency, suffering and compassion, while illuminating the emotional realities that lie beneath one of society's most challenging ethical questions.

A recording is included and will be available two weeks after the event has taken place.

Programme

 14.00 Introductions

14.05 Rachel Gibbons
Assisting in dying or assisting in suicide? The role of mourning and countertransference in life and death decisions

Assisted Dying of Facilitating Suicide

In a society organised around suicide prevention, assisted-dying legislation poses a paradox: on what basis is a wish for death pathological in one context and reasonable in another? This talk argues that suicide and assisted dying are fundamentally different psychic configurations, distinguished by the work of mourning. Suicide is a pre-mourning state in which unbearable affect is evacuated through acting out; assisted dying may instead represent the culmination of mourning, in which mortality has been acknowledged, symbolised and shared. Yet these decisions are never purely rational. Through the countertransference, patients' despair and urgency can draw the physician into unconscious enactment, cast as rescuer, redeemer or executioner. Distinguishing assistance in dying from assistance in suicide depends on attending both to mourning and to the countertransference.

There will be time for discussion after the talk with Dr Andrew Balfour open to all participants and chaired by Dr Zack Eleftheriadou. 

15.20 Break

15.40 Andrew Balfour
What does psychoanalysis contribute to contemporary debates on assisted death?

In this thought-provoking lecture, Andrew Balfour explores the unconscious meanings of dying, dependency, autonomy and suffering, drawing on both his extensive clinical experience and focusing on a closely written account of an assisted death in order to highlight key issues in the debate. Moving beyond legal and ethical arguments, he considers how end-of-life decisions are shaped by internal worlds, early developmental anxieties and the need for emotional containment. This clinically rich session invites participants to reflect on the psychological experience of dying and how psychoanalytic thinking can deepen our understanding of patients, families and those who care for them.

There will be time for discussion with Dr Rachel Gibbons and participants chaired by Dr Zack Eleftheriadou.

17.00 End

Zack Eleftheriadou

Dr Zack Eleftheriadou is a Chartered Counselling Psychologist and Fellow of the British Psychological Society (HCPC reg). She has trained as a child and parent-infant psychotherapist (CPJA/UKCP) and as an adult psychoanalytic psychotherapist (CPJA/UKCP & Tavistock Society/BPC). Zack runs the consultancy service ‘Noema Psychology and Psychotherapy’, providing psychotherapy, supervision and teaching. She lectures in the following areas: developmental issues, trauma/complex trauma, migration/cross-cultural work and the ‘replacement child’ psychodynamics. She has published widely, including the text ‘Psychotherapy and Culture’. She is member of The Bowlby Centre and is a visiting external examiner for Doctoral projects across the UK. She feels passionate about early intervention and regularly presents on ‘the psychology of the baby’, for health professionals and psychotherapists. She has previously worked in several London NHS Hospitals and charities, such as Nafsiyat Intercultural Therapy Centre and Freedom from Torture. She is also currently an honourary psychotherapist of the Tavistock Complex Trauma Service.

Andrew Balfour

Andrew Balfour PhD is Chief Executive of Tavistock Relationships. He originally trained as a clinical psychologist at University College London and then as an adult psychoanalytic psychotherapist at the Tavistock & Portman NHS Trust, whilst in a staff post there. He subsequently trained as a couple psychotherapist at Tavistock Relationships, where for more than 10 years he was Clinical Director before becoming Chief Executive in 2016. He has many years’ experience of working psychotherapeutically with couples and conducting research, publishing numerous papers in the field and teaching widely both in Britain and abroad. He has co-edited two books How Couple Relationships Shape our World (edited by Andrew Balfour, Mary Morgan & Christopher Vincent, Routledge, 2012); Engaging Couples - New Directions in Therapeutic Work with Families (edited by Andrew Balfour, Christopher Clulow, & Kate Thompson, Routledge, 2019) and his latest book is Life and Death: Our Relationship with Ageing, Dementia and Other Fates of Time (Routledge, 2025).

Dr Rachel Gibbons

Dr Rachel Gibbonsis a leading voice on the emotional impact of suicide and homicide in clinical practice. She held 3 leadership roles at the RCPsych including chaired of the Working Group on the Effect of Suicide and Homicide, Patient Safety Group and Vice Chair of the Psychotherapy Faculty. A psychoanalyst, group analyst, consultant psychiatrist and organisational consultant she has written many well received open access papers, she received the RCPsych President’s Medal in 2024.

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