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Based on the account of a meeting with a young suicidal woman hospitalized in a pediatric unit, this paper attempts to put the issues of family secrets and adolescent suicidal crises into perspective. It analyzes the usual relationship the adolescent has with secrets and family secrets in particular. It discusses the meaning of the adolescent’s suicide attempt in light of the hypothesis of a family secret. Lastly, this paper examines what is playing out in the encounter between the suicidal adolescent and the psychiatrist during a hospitalization in the pediatric ward. This encounter is shaped by the transferential issues that arise in the therapeutic relationship. The medical confidentiality in which the encounter takes place between the psychiatrist and the adolescent may allow the family secret to be elaborated and integrated into the present.