How to Respond to Threats of Self-Harm
How to respond when a loved one uses threats for compliance.
Posted October 19, 2025 | Reviewed by Kaja Perina
Some individuals use threats of suicide or self-harm to manipulate others. This is common with individuals who suffer from symptoms of borderline personality disorder (BPD). People whose children, parents, partners or friends threaten them in this way often report that they feel they must give in to whatever is demanded. When they do give in, they reward the person making threats and encourage them to do it more.
People who are planning to hurt or kill themselves don’t negotiate or manipulate. Sometimes, people feel the urge to hurt themselves and they tell others to give them a chance to stop them. Where this occurs, there is no demand made and therefore it is not a manipulation. If someone comes to you in this way, you should encourage them to seek professional help immediately.
Individuals who make threats in order to get you to do something you don’t want to do, or to stop you from doing something you do want to do, are not looking to hurt themselves. They are using the threat as a weapon to bully you. They expect that you will give in. This doesn’t mean that they won’t hurt themselves if they don’t get what they what. For this reason, you must take the threat seriously. Giving in will almost guarantee that the threat will be reiterated the next time the person does not get what they want.
In the following example, Jerry is about to leave for work and his domestic partner, Alex begins the following dialogue.
Alex: I feel shaky today. It is not a good day for me to be alone.
Jerry: What is your plan?
Alex: I guess I will just stay here alone.
Jerry: Don’t you have work today?
Alex: I called in sick. I need you to stay with me today.
Jerry: I can’t. I am on my way to work.
Alex: Can’t you call in sick?
Jerry: I have some very important meetings today.
Alex: More important than me?
Jerry: Of course, not but people are coming from out of town and I have to be there.
Alex: If you leave me now I will hurt myself.
Jerry: Are you serious?
Jerry: Get dressed and we will get you some help.
Alex: I don’t need any help. I just need you to stay home with me.
Jerry: Thinking about hurting yourself is a serious symptom of mental distress.
Alex: Forget it. Just go to work.
Jerry: I will be by your side while you seek help.
Alex: Why won’t you just stay home with me?
Jerry: Because you are not well. I will be by your side if you seek wellness. I can’t be by your side if you refuse to help yourself
If Alex still does not accept help, emergency services (e.g. 911) should be accessed expediently. Alex will not be happy with Jerry’s position in the moment, but as Alex gets well, they will be able to see that Jerry is acting responsibly with love.
Alex makes it seem that the compassionate response would be for Jerry to just call in sick and stay home. It certainly would be easier for Jerry than to have to compel Alex to get help. But staying home under these circumstances sends the message that it is alright to be so afraid of being alone that self-harm is a healthy option, and that threatening self-harm is a healthy way of getting what you want. These are unhealthy messages and encourage further unhealthy behavior while depriving Alex the opportunity to find healthier coping mechanisms. This is not compassionate.
If Jerry is able to consistently compel Alex towards professional help, when he was threatened, Alex will quickly learn that threats will not get what they want, it will get a mental health referral. Alex will eventually stop using threats for the purpose of manipulation and might get some effective treatment.
This could result in Alex increasing their tolerance for being alone and also improve relationship skills. Ultimately, both and Alex and Jerry will benefit as the relationship becomes healthier. Clearly, this is the compassionate response to threats of self-harm, even though the reaction of the person making the threat might not acknowledge this in the moment.
Having someone you care about threaten to hurt or kill themselves is a terrifying experience. This is compounded when they attach whether or not they will self-harm to your compliance with their demand. This makes you feel like you are responsible for protecting them. You may feel like you have no choice but to give into their demands. If you give into them under these circumstances, you might prevent them from imminent self-harm, but you increase the chance that they will use threat again in the future.
Using threats of self-harm to manipulate others is a symptom of mental illness. Professional help is generally required to successfully address this pattern of behavior. Compassionate help for a friend or loved one with symptom must focus getting them to utilize professional help.
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Daniel S. Lobel, Ph.D. , is a clinical psychologist in private practice in Katonah, NY, as well as an Assistant Clinical Professor at Mount Sinai School of Medicine in the Department of Psychiatry.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.