Sugahorse, I am utterly horrified and really distressed that any T would ever say this. There is so much wrong with this that I don't know where to start.

It makes much more sense to help you before things have got this bad. Not only would it be easier/more straightforward for her to help before things have escalated, but it would also avoid reinforcing dangerous behaviours in you- if you have to line up tablets to have your distress taken seriously, then that's what you'll inevitably do.

I really hope this rant hasn't increased your own distress at her response. I really wanted to validate your distress at this situation. It's not ok that she said this.

If you are struggling a lot with sui ideation, could you consider DBT? I do DBT for chronic sui ideation rather than for a diagnosis of bpd. The contingencies for contact with your therapist in DBT are completely the opposite of what your therapist is using. In DBT you contact your therapist as early as you can in the chain of behaviour, way before you get close to carrying out the behaviour. The therapist reinforces this by being available and helping you effectively. Once you've engaged in the behaviour, you're actually not allowed to contact your therapist for 24 hours, because how can they help you when you've already done it? For most people the experience of being cut off from their T is so aversive that it pushes them to make contact before the behaviour next time. This explanation is over-simplified, but I suppose I'm trying to say that Ts are supposed to do everything they can to help us move away from using behaviours to communicate, but this is exactly what your T is instructing you to do.

Do think seriously about whether you need something different. This is not a game, or just a nuiscance, as she seems to think, it's a question of your life. Each time you 'line up the tablets' there is a risk you will take them. Please make sure you get what you need to help you save your life; it may be that you can't get it from this therapist.