How would you handle someone who has a suicide plan?

Song lyrics from A perfect Circle, "If you choose to pull the trigger, should your drama prove sincere, do it somewhere far away from here" Don't make a mess in the house!

Personally, I would build a bomb and go out in a pink mist in the wilderness. Two birds, one stone. Remains gone to the wind and my own fish pond crater as a memorial. OK, not likely to happen but what a way to go out. I suppose I shall check out according to the will of my Creator.

 

The best example is Borderline Personality Disorder, which, in short, manifests as an inability to regulate emotions.

Much in the same way that the concept of language/communication or empathy/sympathy must be learned by a certain stage in neurodevelopement or they can never be learned, so must the concept of emotional regulation. In cases where children with highly emotional natures are repeatedly and/or prolongedly traumatized and prevented from expressing the resulting emotions (typically by being abused and then forced into suppressing the emotions instead) the ability to regulate emotions can permanantly be halted, resulting in Borderline Personality Dissorder (or Complex Post Traumatic Stress Disorder, which is similar and may actually turn out to be the same). While a few psychologists claim success in teaching people to manage this dissorder, the psychological community consenses that it is not curable and most psychologists will not even take patients with this diagnosis. It would be like trying to teach empathy to a sociopath- it cant be done.

This inability to regulate emotions leads to an altered perception of reality. To understand- think back to the last time you had a misunderstanding. Some time when you thought something was bad, you reacted emotionally, and then found out or realized it wasn't as bad as you thought and you felt better about it. You felt better because you regulated your emotions -and your response- to mesh with your new understanding of reality. A person with BPD can't do that. They can't adjust their emotions to new information. They can logically understand that the situation has changed for the better, but they cant make themselves feel like its better, leaving them in a panic state for no reason. Emotions will eventually subside on their own, obviously- even people with BPD will eventually get over something, but often they will react so irrationally in the meantime that by the time they're over the initial crisis, they've created new ones. And since this disorder only presents in people who are already predisposed to abnormally high emotional experience, this is generally a long period of time during which the BPD sufferer is responding to normal situations in a panic state, which means they're lashing out at those around them. This causes them great guilt after the panic finally subsides. Guilt is one of our most powerfully negative emotions. Most of us learn our greatest lessons as a result of trying to avoid future guilt. The BPD sufferer, having no control over their frequent 'fight/flight' responses being triggered, cannot avoid the resultant guilt because they cannot learn the one thing that would prevent it- emotional regulation. So they manufacture emotional validation instead by altering their perception (or more accurately their memory) of events. They will remember an event being as bad as it made them feel so they can avoid being guilty about having overreacted to it. This makes BPD a largely untreatable and reality-altering dissorder.

Even worse, they will eventually try to manufacture the reality that they're experiencing. For example, if the BPD sufferer believes a spouse is cheating and then finds out thats not the case, they will still feel like they are being cheated on and will be unable to avoid treating their spouse like a cheater. To avoid the guilt of treating their spouse so unfairly, they will push their spouse away in the hopes that their spouse will cheat so they can validate the irrational response and illeviate their guilt.

 

I would either be the best or the worst person to help them... I don't do medium if I can help it.

Actually scratch that.. step 1. make sure I'm nowhere near them

 

Wisely put. There are times when the best of intentions can turn out to be the worst if put into practice. I'd offer what succour I could, but because I firmly believe that self-determination is the ultimate human right, in no way would I persist or otherwise interfere.

 

An equally profound dilemma would be if a loved one asked an individual for assistance, or even make it possible in the case of someone with no motor function, to end it for them? Bloody hell, what then??

 

Right. PDs. Your use of the term 'emotional disorder' was .. different

Meantime, it's important to point out that PDs (like Borderline) are unequivocally NOT the result of 'repression of emotion' in childhood. Entire cultures/ethnic groups practice 'repression of emotions' as a matter of course, and have the same (or more often, lower) rates of BPD. PDs are a result of inconsistent and/or poor parenting, almost always involving a parent with their own un-managed PD.

But they can be treated. When the Personality Disordered person is voluntarily placed in situation in which they're required to regulate their emotions, and are answerable for any failure to do so, they will eventually do it. Of course, since the majority of PDs will preserve their 'freedom' to indulge the habit, stable relationships (which depend upon mutual answerability) are usually forfeited .. so in practice this doesn't happen too often. But the important thing to note is that it CAN. The compulsion to keep acting out is no different to any other impulsive behaviour. It's a kind of juvenile selfishness and laziness, to use the most bald lay terms. The early dysfunctional environment into which all such people are born, is itself a product of juvenile and selfish/lazy parenting. So that is what is learned. Almost all Personality Disorders are a form of juvenile self-centredness. When we're never asked to grow out of same, nor shown what NOT being self-centred looks like, we have no clue. We remain toddlers for life.

 

Yes, that is the view of most clinical psychologists.

The book I read was by a psychologist who had a higher than normal success rate in teaching BPD sufferers to manage their condition, and disagreed with some of the more traditional approaches.

I believe it was this one: Loving Someone with Borderline Personality Disorder: How to Keep Out-of-Control Emotions from Destroying Your Relationship by Shari Y. Manning Phd ...though it was a while ago and Im not 100% on that.

 

All alternatives should be explored, IMO. Even when they come from Psychologists