Meanings of adolescent overdose

Overdose, as a subcategory of self-harm, is under-represented in the psychoanalytic literature in terms of attempts to understand what may underpin it. Given the current prevalence of medication overdose (as distinct from addiction-based overdoses) among self-harming adolescents, it seems important to try to understand this from a psychoanalytic perspective. In this chapter, the author attempts to make sense of how overdose can be used by certain patients as a means of unconsciously communicating their difficulties. It is suggested that overdose might be understood in the following ways: as a physical enactment of the way in which the patient’s mind is overwhelmed by thoughts, feelings, and experiences that cannot be digested or processed; as a disguised wish beneath overt self-destructiveness to take in a ‘good feed’; as an enactment of past and present force-feeding, both literally and figuratively, by parents or carers; and as an enactment of an internalised death wish from an object that has projected something poisonous.