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What to do when feeling manipulated by suicide threats

This article originally appeared in my Stop Walking on Eggshells blog on Psychology Today.

When someone in your life has borderline personality disorder, things can get out of sorts very quickly. Apparently, it's the same thing if you write a blog about borderline personality disorder.

In my second post in this blog, I was going to give you an overview of the disorder. But someone posted this comment to my very first post:

...I am so unhappy in this relationship...[but] ...he kept threatening to kill himself if I leave. I want to break up and tell him to go get help. If he gets better, I will reconsider the relationship. Is this just prolonging things again? Should I just break it off and tell him I hope he gets help?

So...let's talk about suicide threats sooner instead of later.

One out of every 10 people with BPD dies by their own hand. More, of course, make an attempt. The presence of other conditions like major depression, substance abuse, and eating disorders seems to magnify the likelihood of actual suicide.

If the person in your life with BPD or BPD traits (BP for short) in your life really wants to die, you need assistance beyond what I can provide in this blog. Please seek immediate professional help. You may also wish to call a local crisis line or hospital emergency department and ask for guidance. Then, keep the phone numbers of these people and places right by the phone.

Take threats seriously. Tell your family member you will call for help. Then, do it.

What do you do, though, in situations like those above, when the suicide threats appear to be an attempt to scare you or make you do something you don't want to do? When this happens, your sympathy and concern may begin to dissolve into anger and resentment. People on the receiving end of these threats feel extremely guilty, confused, and worried.

In their 1996 book Choosing to Live, Thomas Ellis and Cory Newman write:

The sense of collaboration and togetherness you once had with the suicidal person diminishes, while the uncomfortable power struggle increases. Comments like, "If you really cared whether I lived or died you would come back to me," and "You make me want to die" have something in common: they make someone else's decision whether to live or die conditional on your response. This is unfair to both parties.

Sometimes your family member will try to make you believe that you are responsible for their misery, and that you will be to blame if he kills himself. Remind yourself that you are not threatening the other person with homicide-the other person is threatening suicide. You're dealing with someone who needs immediate professional attention much more than he needs your capitulation.

What Not To Do

Newman and Ellis suggest avoiding the following actions with someone threatening suicide:

Don't fight. Don't get into an argument with your BP about whether he or she is serious about wanting to die-even if you're angry and feel like venting. He may attempt suicide simply to prove you wrong.

Don't confront your family member and accuse her of manipulating you. Again, this may turn into a power struggle. If she is asking you to do something that is against your better judgment, follow your instincts. However, if the two of you are in a session with a mental health professional, it can be helpful to talk about how this behavior is making you feel.

Don't give in to threats. Be extremely cautious about relenting just to prove that you really care. You and your partner will not be happy in a relationship in which one of you stays because of emotional blackmail. In the long term, your loved one won't be happy in a relationship with someone who doesn't want to be with them. They need to get better before they're ready for a healthy relationship.

Remember, contrary to what your angry, distraught family member may be telling you, you don't have to prove anything. Say Newman and Ellis, "When you give in to the threats, you will still be angry, the other person will still be at risk for self-harm at any time, and the underlying issues will not have been addressed. Plus, it is likely that the same scenario will repeat itself again and again."

Seek help for yourself. If you have a history of complying with demands because you believed that suicide was imminent, get professional help for one or the both of you before the next crisis occurs.

What To Do

Suicide threats that feel manipulative are the ultimate in no-win situations. Whether you comply with the other person's wishes or not, the risks are unacceptable.

So, Newman and Ellis say, the best thing to do is to simply refuse to be put in this position, despite your family member's attempts to make you feel responsible for her life and death. Just say no, following the guidelines that follow.

Express your support and concern for your family member while firmly maintaining your personal limits. You can do both, even if your BP thinks otherwise. You can accomplish this with mirroring responses that put the choice of life or death back where it belongs-with him-while stating as strongly as possible that you care about him and you want him to choose life and seek help.

Newman and Ellis give these sample responses, which I have paraphrased:

In response to, "I'll kill myself if you leave me":

I'm not breaking up with you to be cruel. I'm very, very sorry that this hurts you. I want what's best for you in the future, but I just can't be part of it. And even if I were to stay with you, that wouldn't solve our problems.

For one thing, your life's worth should be based on much more than just being in a relationship with me. Secondly, I know that you know deep inside that our relationship shouldn't be based on me staying because I'm afraid of you dying and you staying because you think you can't live without me. That's not healthy. I care about you. And because I care about you, I want you to live. And I want you to find your own happiness, and your own life's worth, without me.

In response to, "If you really cared whether I lived or died, you would come home every weekend":

The fact that I love you and am concerned about you is already beyond doubt. I feel like I have proven my love time and time again, and I suspect that even if I did come home every weekend, that wouldn't be enough for you. I want to see you, and I do plan on coming up once a month or so.

The fact is that I can't visit every weekend because I have my own family now and my own life to attend to. Perhaps the answer is that you need more things to do on your own, or more friends you can get together with on Saturday and Sunday. You used to talk about a lady you played cards with from your church; have you seen her lately?

These statements should be accompanied by statements that show that you are taking the threats of suicide very seriously. Show warmth and concern in your voice and actions. For example, you might say, "We have to get you to the hospital. This is a matter of life and death." Show that a serious threat warrants a serious response.

In this way, you give appropriate attention to your family member's cry for help while making it clear that you aren't qualified to give the professional help that is necessary in such extreme situations.

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