It is argued that suicidality is essentially a relational phenomenon; the presence or absence of certain key relationships paradoxically can be both suicide causing and suicide preventive. The relational aspects of suicide are especially poignant in clinical work with suicidal patients. However, when suicidality is involved, there are a number of issues that can interfere with effective clinical practice. Fortunately, a new paradigm has begun to emerge in contemporary clinical suicidology, which objectifies suicidality and emphasizes the phenomenology of suicidal states. Moreover, from an increasingly empirical perspective, this approach is creating new and better ways to effectively assess and treat suicidal conditions.