29 December 2008

Parasuicidality

This next topic is very non-politically-correct, but it needs to be discussed.

There is a behavior pattern called 'parasuicidality'.

It is a form of manipulation, very high-stakes. Usually, it is resorted to by people who have borderline personality disorder - or similarly severe emotional problems.

It is the use of suicide threats to blackmail people, emotionally, into doing what the parasuicidal individual wants them to do. The real objective is, of course, control. Suicide is threatened because the stakes are so high that it is seen as an essentially unanswerable form of blackmail - by the practitioner.

And yes, on some level the person making the threats knows exactly what they are doing.

This behavior can begin at an early age. I vividly remember a young man in my high school who would threaten to 'wrap his car around a tree' if any young woman he happened to fancy wouldn't sleep with him. This actually worked on several of his targets. [No, thank God, I wasn't one.]

Most laypeople don't understand that there is such a thing as parasuicidality, distinct from suicidality. We've been taught to take suicidality seriously, which is absolutely right and essential. But we haven't been taught to understand it, and in fact, it's such a fearful thing that it's extremely difficult to understand. Unfortunately, this lack of understanding makes us prime targets for manipulation by parasuicidality.

Please be aware, I am absolutely not saying that suicidality, in general, is manipulative. Far from it. Suicidality is dangerous, literally life-threatening, and must always be taken very seriously. What's more, parasuicidality itself is dangerous to its practitioners. Parasuicidal individuals do, sometimes, accidentally manage to take their own lives.

If you happen to know anyone who threatens suicide, especially if the person has done so more than once, try to remember what, historically, has triggered the threats.

If a threat of suicide is triggered by depression, life setbacks, or major losses, you are probably dealing with a genuinely suicidal individual. But if the threat seems to be triggered by frustration, by not getting one's way, and especially by not getting attention [or drama] when the person is trying to get attention [or create drama]... when the threat seems to be 'aimed' at someone specific, or when you have the sense that the person making the threat is 'upping the ante' in a game of some kind... it may very well be parasuicidality.

Generally the least constructive response one can make to any threat of suicide or any announcement of suicidal ideation is to panic.

If the person is genuinely suicidal, they need all the clear eyed support they can get, and they need to be steered to professional intervention as quickly as possible. This will get them the help they need, the medications they need, and hopefully break the ruminating - obsessing - suicidal ideation chain.

If the person is parasuicidal, they still need a clear eyed, unemotional, supportive response that - again - steers them to professional intervention. This will again get them the help they actually need, medication if they need it, and hopefully be a step towards clarifying and ultimately breaking their reliance on parasuicidal threats as a way of controlling others.

If you believe that you are experiencing parasuicidal manipulation, you can express - and act on - appropriate concern for the person's welfare, without allowing them to blackmail you. You don't have to let a parasuicidal person control you. You can counteract the threat in constructive ways instead.

Don't become enmeshed.
Don't believe that you are responsible for the person's emotional state
or that you alone can alleviate it by giving in to their demands.

[1] Remain as calm as you can.
[2] Advise the person to get to a therapist or emergency room.
[3] Monitor them, but maintain emotional separateness.
[4] If you think they are going to act out, call 911.
[5] Definitely call 911 to arrange transportation for them, if you think they may act out while you are transporting them. Don't take that risk. A parasuicidal person's judgement is poor, to say the least.

You will observe - and it is a very important observation - that these steps are exactly the same steps that you would take if the person were genuinely suicidal. And, in fact, you should react in exactly the same way, regardless of what you believe the underlying dynamic to be.

Stay calm,
advise professional intervention,
be prepared to call 911 and get the person to an ER if you must,
but maintain your emotional separateness.

Whatever you do, do NOT 'call their bluff' if you think someone is parasuicidal. DON'T EVEN MENTION parasuicidality. DON'T EVER MENTION parasuicidality.

Someone who is parasuicidal may well be sufficiently grandiose, or otherwise out of touch with reality, to make a genuine suicide attempt if they feel that they are being 'dared' to do it. They will almost certainly respond to ANY mention of parasuicidality as though you are daring them to prove that their intention is genuine. And they may very well succeed in the attempt.

Only a trained professional should ever raise this issue directly. This should be done only in the context of safe, supportive, closely attentive therapy. And it should only be done if, and when, that professional believes it is the right time to do so.


It's important to know that parasuicidality exists. It's important to know how to deal with it - internally by recognizing it, and externally by providing the same detached support to the person that you would otherwise.

But it's most important to know that the term should never, ever, be used as a 'club' or 'weapon' against anyone, no matter how much they have angered you, no matter how certain you are that this is what is happening.

The stakes are too high, and the losses may be permanent.

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