Suicide is a form of acting in coupled with acting out (like a temper tantrum), internalized and externalized aggression. It is preceded by switching to another self-state (secondary psychopathy in borderlines and borderline organization in narcissism).

BPD and NPD are prone to switching owing to splitting and self-splitting defenses (previous self-state all bad while new self-state all good), lack of core identity (identity disturbance), and no constellated or integrated self/ego (emptiness or empty schizoid core). They are in constant flux.

When confronted with promise or threat, real, imaginary, anticipated, or recalled.

Responsive to real or anticipated environmental cues (e.g. stress, anxieties, substance abuse, holidays, important events, life crises or traumas, new people, crowds, mortification, medication, even sensa – see Proust).

Preceded by emotional dysregulation (emotional switching – Houben).

Switching: consensual, forced, triggered.

Signs of switching (prodromal phase):

Rigid body posture or pseudo-fainting
Calm before the storm: atypical kindness, reasonableness, submissiveness, conflict aversion
Changes in body self-image
Dramatic change in identity (behaviors, preferences, values, beliefs, emotionality, cognitive style)
Talkativity (hyper-verbalizing), hyperreflexivity (pseudo-psychosis) and hyperactivity followed by a period of subdued, slow motion, hesitant reactivity
Impulsivity
Dissociation

LITERATURE
Houben M, Bohus M, Santangelo PS, Ebner-Priemer U, Trull TJ, Kuppens P. The specificity of emotional switching in borderline personality disorder in comparison to other clinical groups. Personal Disord. 2016 Apr;7(2):198-204. doi: 10.1037/per0000172. Epub 2016 Feb 15. PMID: 26882282; PMCID: PMC4816671.
 
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