When Marsha Linehan, PhD, developed Dialectical Behavior Therapy (DBT) in the 1980s, she originally intended it to be used for treating patients who were at a high risk of suicide, with multiple suicide attempts and self-injuries. She obtained research grants because Seattle (where she was living and working) had one of the highest rates of suicide attempts of any city in the US. Soon into her research, she realized that most of her suicidal patients met criteria for BPD.
Some families with loved ones with symptoms of BPD hear about suicidal thoughts or fact suicide threats regularly. Some families don't hear about any suicide ideation, but lived through an attempt that came about as a total surprise to everyone. Such families can experience everything from panic to resentment to exhaustion with regard to this issue.
The science says there is no relationship between the presence and intensity of suicide ideation and suicide attempts among adolescents. Among adults there is some relationship between the intensity of suicide ideation and suicide attempts. However, there is no reliable predictor of who will attempt suicide. There are a lot of myths out there about this subject.
It is recommended that family members ask openly about suicidal thoughts. One might inquire about past attempts if it was never spoken about and/or just ask a loved one if they ever think about it. It is appropriate and useful to inquire in a way that is calm, nonjudgmental, and curious.
In the 12-week SWOE DBT workshop we cover the basics of talking about suicide. This is a complex subject and may be useful to do some research about the subject to have more confidence and understanding. Some useful resources about suicide ideation and information on how to respond and prevent suicide of a family member are listed below:
“Risk factors and warning signs”
From the CAMS (The Collaborative Assessment and Management of Suicidality) website
“Helping someone who is struggling with suicide thoughts”
From Samaritans website
"When Suicidal Thoughts Do Not Go Away"
Speaking of Suicide, website by Dr. Stacey Freedenthal
Also, a new book is forthcoming and I expect it to be very useful. The author survived her youth in spite of suicidal thoughts and went on to become a leader in the field of suicide prevention. Loving Someone with Suicidal Thoughts: What Family, Friends, and Partners Can Say and Do by Dr. Stacey Freedenthal, to be released in January 2023