What if they threaten to hurt themselves?
A crisis is escalating if a person with BPD begins to threaten to harm themselves. Sometimes self-harm signs may be less overt, such as scratching the skin, eating less, coloring or shaving off hair, or isolating from others. These actions represent the person’s inability to express their emotions verbally. Recognizing early signs can help prevent an emotional crisis from becoming more serious or requiring medical or psychiatric attention.
Be aware that you don’t put the idea into someone’s head by asking about self-harm or suicide. Instead, you invite the individual to talk about their emotions and allow yourself to gauge whether professional assistance is necessary. All threats of suicide should be taken seriously. Even if the behavior is attention-seeking, it can result in seriously harm or even death. However, that doesn’t mean you have to call 911 every time an individual speaks about hurting themselves. This sends the message that they have an enormous amount of power over all arguments. Instead, ask your family member what they would feel most comfortable doing when they threaten injury. They might want to speak with their therapist, call a hotline, or walk with you into an emergency room. Allowing them some amount of agency in of deescalating a crisis can help calm out of control emotions.