Explain why it would be a mistake to describe self-harm in borderline personality disorder as simply 'attention-seeking' or manipulative.

Self-harm here is often, though not always, better understood as a way of expressing or managing overwhelming emotion, rather than as a bid for attention — and framing it that way doesn't make it any less serious or any less deserving of a careful, compassionate safety assessment. More broadly, behaviours in borderline personality disorder that can look manipulative from the outside are often better understood as desperate, poorly regulated attempts to manage an intense fear of abandonment. Dismissing these behaviours as manipulation risks both misjudging clinical risk and damaging the therapeutic relationship with someone whose distress is genuine.