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This work approaches the mind of the suicidal person from the perspective of a person on a dark journey that involves the suicide life story, stress and problems of living, dark ideas, dark emotions, dark physiology, hopelessness, and psychache. The work of the psychotherapist is to join the suicidal person on the dark journey, understand from the person's experience how suicide has come to make experiential sense, and finally affirm and validate the dark journey. In so doing, the psychotherapist builds a healing relationship that offers hope, relief, and skills to redirect the journey to one of light, hope, and possibilities. A multimodal, stage process model of suicide risk assessment and intervention is provided to guide the therapist. Case vignettes are used to illustrate the application of this model to therapeutic practice. Finally, the critical areas of risk management and self-care for the psychotherapist are covered to protect him or her from the emotional and legal challenges of this most difficult work.