Parasuicide, is particularly prevalent among individuals meeting criteria for borderline personality disorder (Clarkin, Widiger, Frances. Hurt, & Gil-more, 1983). To date almost all published treatments for these individuals have been psychoanalytic (Adler, 1985; Kernberg, 1984; Masterson, 1976). Behavior therapy methods are also useful. Over the past several years, we have developed and evaluated a comprehensive, behavioral treatment Dialectical Behavior Therapy (DBT) for chronically parasuicidal individuals. DBT is based on a biosocial theory that views parasuicide as problem-solving behavior emitted to cope with or ameliorate psychic distress brought on by negative environmental events, self-generated dysfunctional behaviors, and individual temperamental characteristics. Three factors keep parasuicide high in the individual's hierarchy of problem-solving responses: (1) low distress tolerance, (2) inadequate functional coping resources, and (3) parasuicidogenic expectancies. Low distress tolerance provides a powerful motivation for the individual to do something about the problem. Poor coping responses include deficiencies in emotion regulation, interpersonal problem solving, and self-management skills. Parasuicidogenic expectancies include beliefs about the value and probability of consequences of suicidal behavior. Parasuicidal behavior occurs when the individual believes that an intolerable, inescapable life problem exists and that parasuicide is the only or the best possible solution; that is, the parasuicidal act is regarded as a potentially effective problem-solving behavior. A further review of the general theory underpinning DBT and the empirical support for these propositions is beyond the scope of this paper. The interested reader is referred to a number of works by Linehan et al. (Linehan, 1981, 1987; Linehan, Chiles, Egan, Devine, and Laffaw, 1986; Linehan, Chiles, Camper, Strosahl. and Shearin, 1987).