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Re: suicidality exhaustion... linkadge

Posted by Dinah on September 14, 2010, at 8:20:54

In reply to Re: suicidality exhaustion..., posted by linkadge on September 14, 2010, at 6:54:46

I can understand and appreciate your feelings of frustration. Especially if you have been frightened repeatedly by suicidal behaviors.

But in my experience, it's difficult to determine another person's feelings or motivations from their actions or your feelings about their actions. For example, it's possible to feel manipulated even when the other person is not trying to manipulate you. Or it's possible that behaviors can look the same on the outside but have different feelings and motivations behind them.

While some people might consciously use threats of suicide as a way of seeking help, I don't think it can be generalized that all people who exhibit suicidal or parasuicidal behaviors are attempting to do so.

In some disorders, mood lability is an issue. A person might genuinely feel despair and have suicidal impulses that are difficult to resist. At the moment the person is experiencing the feelings, they feel absolutely real and are absolutely real. I would hope that over time a good therapist could help a client learn to recognize the warning signs, realize the impulses and obsessions as something that will pass, and learn skills to delay acting and hold on without suicidal gestures. It would be nice if medications could help control the lability. I *still* get those feelings and urges sometimes, and it's very difficult to hold onto the knowledge that I've felt that way before, and it will pass. I think a large part of my therapy was learning to think "I'm having suicidal thoughts and impulses" instead of "I want to kill myself." Externalizing it a bit. I'm not sure it's even a good thing to be quite so certain as I am. It's probably wiser to seek help. Well, I suppose I do tell my therapist...

Other people might indeed feel suicidal when they feel really really bad and want to be helped. However, that still doesn't make their behavior deliberate or conscious. DBT is a therapy that helps make those things conscious through a combination of validation of the client's feelings, while bringing awareness to their actions. But I'm pretty sure I read in the books on DBT that it isn't helpful to insist that the client is behaving manipulatively when they may not have any awareness of their motivations. I know I wouldn't be inclined to change if others insisted that I was feeling things and doing things that were not true to my experience. I'd likely feel resistant and defensive. On the other hand, if a therapist could bring me to see that my behaviors were not in my best interests in a *nonjudgmental* way, I might grow to an understanding of how my actions might be having a negative impact on my life and my relationships, what might be motivating my behaviors, and healthier ways to get help.

I'm sure there are other possibilities I haven't even considered for repeated suicidal behaviors. Just trying to recall some of my long ago readings on DBT. My apologies to Marsha Linehan for any errors in my recollections.

If you have an interest in the subject, I really recommend her book. DBT was developed for patients with suicidal and parasuicidal behaviors, though it has since been used for many other disorders. She's done a good deal of research on the topic.

"Cognitive-Behavioral Treatment of Borderline Personality Disorder"




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