Abstract
Chronic suicidality is a central feature of borderline personality disorder. While suicidal thoughts and attempts are highly prevalent in borderline patients, completion is relatively unpredictable. Self-cutting seems to function as a means of affective regulation. In borderline personality disorder, suicidality performs a set of psychological functions and can sometimes become “a way of life.” Strategies developed for acutely suicidal patients may not be effective in chronic suicidality. Since there is no evidence that hospitalization prevents completion, an ambulatory approach to the management of chronically suicidal patients may be most useful.