- Providing assistance or support for someone in need involves doing what needs to be done from the point of view of the patient or client
- Services that are not available when needed can have devastating, perhaps even catastrophic consequences for the person seeking assistance
- Recommending that a client or a patient seek assistance or treatment from someone who in the end renders no productive assistance can be deflating and at times even destructive
- All parties must relevantly and appropriately invest in the relationship of trust
- If no productive advice or assistance is forthcoming, the patient or client can be discouraged from being so forthcoming in the future. That can have a detrimental effect on their motivation to seek advice or assistance in the future.
False Claims of Suicidal Ideation
Helpers are discouraged from rendering assistance where there are false claims of suicidal ideation.
In the case to which I will refer in this post, I had significant doubts as to the credibility of the narcissistic person in question (“the Narcissist”) on some matters I considered relevant to their circumstances. In my view, full disclosure was not one of their strengths.
The Narcissist had formed a view about something. I did not share their view.
On the day in question I received several text messages from the Narcissist using their work mobile telephone. The last message was the one which concerned me the most. I did not reply to it and I have had no further contact with the Narcissist since receiving that message.
The subject message contained suicidal ideation. Relevantly it read: "I feel like killing myself today."
Later that day the Narcissist was visible elsewhere and was seemingly in good spirits. In subsequent appearances the Narcissist continued to seem in good spirits, in fact they seemed to be revelling in the new circumstances they had created for themself.
The reference in the subject text message to suicidal ideation was something that concerned and upset me. It was not the first time the Narcissist had raised suicidal ideation as a topic. It had been raised on at least one (1) prior occasion by them and there were at least two (2) hysterical telephone calls, which were a complete overreaction to the situation which presented itself at the relevant times. I was aware that there were significant developments in the life of the Narcissist at the time which placed them under much more pressure than would ordinarily be the case.
I was in the company of another adult when I received the message and we had a discussion about it shortly afterwards. I did not consider that the Narcissist was doing anything more than trying to manipulate me, bully me and guilt me into behaving in a way consistent with their wishes.
I found it disturbing that the Narcissist had easy access to many qualified medical practitioners, including psychiatrists, psychologists and general practitioners, yet chose to communicate their difficulties in the way they did. Eight (8) months earlier the Narcissist was able to access a psychiatrist from their work to engage in a public activity with them for a purpose which suited their agenda. Apparently the Narcissist did not consult any of their work colleagues, nor did they consult any of their friends or family about their situation on the day they sent the manipulative, false suicidal ideation claim message to me. In respect of that message, the Narcissist knew or would be expected to know:
- The policy of their employer about suicide threat risk; and
- The consequences of an expression of suicidal ideation.
The Narcissist communicated the message to me on their work mobile telephone, in my view thereby compromising not only themself, but also their employer.
Once the message was received by me it enlivened several issues:
- The mental stability of the Narcissist
- What impact did the new circumstances in which the Narcissist found themself have upon them?
- I had noticed a marked change in the behaviour of the Narcissist in relatively recent times
- The level of dishonesty of the Narcissist had increased measurably
- The extent, if any, that the message I received might be indicative of the Narcissist experiencing genuine mental health issues
- There is a theory that someone who makes manipulative suicide threats is someone who needs immediate professional attention
- To what extent am I obliged to raise my concerns with the Narcissist?
I was also annoyed that the Narcissist would resort to sending me a text message indicating suicidal ideation on their part in their campaign to manipulate and control what I say and do in relation to them. The selfish attention-seeking of the Narcissist is bereft of integrity.
In their article “Suicide Risk Assessment: Where Are We Now? - A definitive way to identify patients who will suicide remains elusive”, Christopher J Ryan 1 2 and Matthew M Large 3 4 said the following:
- "Suicidal ideation, for example, is not useful as an indicator of the likelihood of future suicide, but it is an invaluable sign of a person’s inner despair."
- “We cannot prevent tragedy by trying to identify those few souls who will be consumed by it. We must instead gather a comprehensive picture of each individual patient, and use this to tailor optimal management for the patients and families needing our care.”
Some observations from a friend about making a false claim of suicidal ideation are instructive:
- It is manipulation at it's worst.
- Anyone who has ever been touched by suicide would be mortified that someone would use those words to make another person feel bad.
- Someone making such a false statement has no respect for people that are truly suffering.
Making a false claim of suicidal ideation is a far from ideal way to communicate one’s inner despair. Using it as a manipulation tool to achieve an ulterior purpose is appalling behaviour and a form of emotional blackmail and emotional abuse. It detracts from and devalues people who make a genuine cry for help. Further it can discourage people from responding and rendering assistance to those who really are suicidal.
Nothing positive is achieved by making a false claim of suicidal ideation.
1 (MB BS, MHL, FRANZCP, Senior Clinical Lecturer)↩
2 Discipline of Psychiatry and the Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW.↩
3 (BSc(Med), MB BS, FRANZCP, Senior Clinical Lecturer)↩
4 School of Psychiatry, University of New South Wales, Sydney, NSW.↩