Please Note: The ideas contained in this FAQ are the opinions of the writer and are communicated without reference to supporting documentation in most cases. Other inspiration and influence for the writing came through consultation with other mental health professionals but the writer “Peter Quintano” is also fully qualified in DBT making him qualified to talk about the things discussed in this article.
I hesitate to write this article because of its depiction of the darker side of Borderline Personality Disorder (BPD) – becoming suicidal. The article highlights the painful types of thoughts, feelings, and experiences that can sometimes result in concluding that life isn’t worth living. It is by no means an easy subject to relate to, although if there is to be any real precision in understanding and healing BPD, then experiences of this nature need be articulated. A secondary purpose of the article is to offer deep validation to individuals suffering from BPD, as this form of support and healing is sometimes so rarely available in relationships and families.
My sincere hope is that anyone ever faced with the harrowing descent into death over life types of thinking will find the love and support that they need to begin healing. My firm belief is that even though the urge to die by suicide comes from a completely understandable set of circumstances, life is better than death because the knowledge gained and potential to experience joy make it worth the difficulty. Even when the suffering of BPD remains because change takes time, there is always hope for making things better and suicide is therefore arguably always the wrong answer. Learning how to live with BPD can dramatically reduce suffering and suicidal thinking can be corrected. I have no intention to glamorize suicide by writing this article and would never encourage following through with such an act.
Why do People With BPD Commit Suicide?
Perhaps the number one thing to understand about suicide and BPD is that it is associated with the urge to escape unbearable emotional pain, quite often occurring in connection with disturbed relationships (or a lack of relationships) with significant others. When important relationships become compromised, unhealthy, or non-existent, there can be feelings of rejection, feeling unwanted, feeling abandoned, feeling misunderstood, feeling alone, feeling ashamed and worthless, that can accumulate to the point of wanting to give up on life.
When relationships do not function in a way that emotions and related thoughts can be understood, processed and adjusted, the emotional pain can become repetitious, incessant, compounding and overwhelming. And because it is confirmed scientifically that those with BPD experience their emotions differently than others… with much more intensity and frequency… the experience for those with BPD becomes like a torture that is beyond exquisite, beyond words, beyond imagination and conception to the ignorant or insensitive outsider.
So what types of things are happening when emotional pain becomes so unbearable that suicidal thoughts come into play? Well for starters, there is typically a complete absence (or at least a sizeable void) of empathy in emotional experience. That is, there is little to no time taken to consider or witness the types of emotions that are being felt in moments of difficulty. People simply choose to “speak at” one another, only in logical or factual terms, and forego the effort required to exercise emotional sensitivity. Curiosity as to what self or other might be feeling does not factor into the conversational equation, as if the feeling had become a completely irrelevant or unknowable aspect of the human condition. When feelings do get expressed by a struggling person, and especially if there is a behavioural element to the expressed feeling, chances are high that the person and emotion will get dismissed, shunned, invalidated, mocked or ignored. In other more unfortunate circumstances, the consequence for expressed feeling may be a complete withdrawal of attention from significant others… perhaps the ultimate pain experience for a sensitive human being.
A most tragic pattern for a person with Borderline Personality Disorder is to react to (or vigilantly attempt to anticipate) emotional pain in ways that push much needed people away (friends, family, loved ones). When in severe emotional pain, an emotionally unskilled person with BPD may yell, swear, hit, walk or run away, self-harm, or otherwise ineffectively protest perceived hurts. When anticipating severe emotional pain, she may attempt to control situations in ways that others find annoying, micromanaging, hypocritical or inappropriate, and then become reactive when others complain or it seems she can’t control the situation to feel safe. This is the kind of behaviour that gets misunderstood, judged, and then eventually has people giving up on, condemning, or avoiding an otherwise high potential human being.
And despite the fact that a person with BPD wasn’t provided the necessary skills to manage the TIDAL WAVE emotions that are so often part of her life, she is judged asSuicide and Borderline Personality Disorder though she “should” have the skills or at least the willpower in place to manage herself because “she is an adult after all”. Then when it seems as though all is lost (people judging, people avoiding, people giving up, people rejecting, etc.) the suffering person gets pummeled yet again with another surge of tidal wave emotions (guilt, shame, regret, disappointment, abandonment) to the point of feeling ready to give up on herself and her life.
She doesn’t understand what’s going on and so blames herself for everything she “should have known”. She buys into all the “should know better” bologna being tossed around by people believing they understand psychology and behavior so well. When overwhelmed with so much emotional pain and being without emotional skill and support, and when it seems like there is no way out of the emotional hell, suicidal thinking starts to “make sense” as a last ditch avenue of relief.
The most important thing in the world for a person with Borderline Personality Disorder is to FEEL connected, loved, valued and secure in relationships, especially in relationships with significant others. A fundamentally difficult concept for some “non-BPD’s” to understand is that being told you are loved and feeling you are loved are not one and the same. The physical and chemical sense of FEELING loved trumps words like “I love you” at all times when you have BPD. Love words must be supported by behaviours that are meaningful to the person with BPD if they are to have any emotional value at all; otherwise, they are just empty words.
Feeling loved happens, for example, when a person with BPD observes behaviours that suggest she is worth listening to and being cared for (e.g., empathic listening from others). The polar opposite feelings… the ones that hurt the most (feeling unwanted, feeling rejected, feeling worthless and unlovable, feeling ignored or abandoned) can be experienced when a person with BPD observes behaviours that seem to suggest she is not worth listening to (e.g., being ignored, being partially listened to, or being invalidated). It can be extremely disappointing and frustrating to continually hear the words “I love you” but rarely experience the much needed love FEELING… and then on top of this to not even have the frustration and pain of the “empty words experience” validated by others.
The full throttle emotional hell of BPD that includes suicidal thinking usually only happens after a great many emotional hurts have accumulated when there is a persistent absence of emotional understanding and validation in significant relationships (family, spouses, important friendships), and when protest behaviours result in no improvements to situations and seemingly push significant others further and further away. When emotional hurts do not get resolved skillfully within the relationships they originated in, when it seems like life sustaining and life preserving connections are being lost, the pain experience and suicide risk for a person with BPD elevates.
It is often the lack of knowing and lack of understanding that leads to a risk of suicide in those with BPD. Ineffective responses to resolvable emotional suffering are where the tragedy begins. Thankfully it is possible to dramatically reduce these kinds of risks when there is a willingness to learn and take corrective actions that work to effectively offset and prevent intense emotional suffering, behavioural escalation, and desperation. When both the struggling individual and significant others take the time to learn and make the necessary adjustments to interaction styles on the emotional level, instances of suicidal thinking and behaviour tend to just go away.
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