Dan may have not played the entire call and I’m personally biased, so it’s possible that I’m misinterpreting the details.
Dan has a truly terrible response to his final caller in episode 610. A woman asks about her boyfriend: he can fly off the handle at himself for days because of simple mistakes. While she describes him as genuinely kind to others, he also has significant self-hatred: thinking that he is a worthless person and being uncomfortable when he is happy because he doesn’t believe he deserves it. Dan’s verdict is the boyfriend is a manipulative asshole who just needs to grow the fuck up.
It’s far more likely that this man suffers from severe mental illness and desperately needs treatment. For one, it sounds like the behavior precedes the relationship, that he’s tortured himself while single as well. The caller never mentions him getting angry at her or that his explosions have anything to do with her behavior (or reality in general). He doesn’t blow up when she goes out with friends, when she picks up the wrong food, when she’s not paying attention to him. Rather, he’s triggered by his own silly mistakes. While his behavior clearly affects her, it hardly seems like his motivation is to manipulate her. After all, what behavior is he trying to change?
And I’ve been that guy. I can get extremely angry with myself for completely irrational reasons. When it gets really bad, I torment myself with the conviction that all I’ve ever done is hurt people, up to and including a friend that I helped avoid deportation. On some level, I even know the thoughts are disconnected from reality, but my mind only doubles down, insisting any evidence that I’ve helped people is a lie. These days, I mostly hide that behavior, going to my bedroom and convulsing until my body is exhausted, but in the past, I have sought comfort from partners. Not because I wanted to control their behavior, but because I was in psychological and physical pain. It certainly wasn’t fun for them and many eventually broke up with me, but that’s because I wasn’t in good working order, not because I was a total asshole.
Even his kind behavior may be a sign that he is ill: if he’s such a terrible person, he must go above and beyond in helping others to make up for his sins. In past relationships, I even used my love of my partner as a distraction from my depressive thoughts. While this did have negative effects on the relationships, it also meant my partner was always on my mind and I would pick up things they liked, plan activities, etc. Not because I wanted to gaslight them, but because I really did love them and wanted to do nice things for them.
Perhaps counter-intuitively, unlike Dan, I think the caller should definitely break up with her boyfriend. He needs serious treatment and needs to choose it for himself, not to save the relationship. At the moment, he is resistant to both therapy and medication. If anything, losing the relationship may be the motivation for him to start doing something.
If she does stay with him and he does go into treatment for himself, she will have to accept it will be a long process and that there will be times where she will have to take the role of caretaker. It could be something as simple as dealing with dinner because his self-torture has exhausted him or even just sitting with him. Which may sound easy, but watching someone you love experience pain and not being able to help really, really sucks. As with any serious illness, the symptoms persist even as the underlying disease is treated. In a sense, it is not very different than dating someone with a serious disability, perhaps someone who finds it physically difficult to feed themselves. They are not manipulating their partner into being a caretaker at times: they have a physical limitation.
That said, it would be a big commitment at six months and she has no responsibility to make it. Her life will be a lot easier if she doesn’t date him. Even in the best case scenario, it will take a while for him to get a handle on his illness and things begin to get easier. Most likely, it won’t be a straight line as well: he could get worse before he starts getting better and there will be relapses. Some relapses could be worse too; he may need inpatient treatment at some point. A person who is deeply convinced that they are worthless, has trouble being happy, can’t control self-anger, and might be expecting suicide has a lot of healing to do.
Describing the boyfriend as someone who just needs to grow up contributes to the stigma around mental illness. Dan might as well be saying that a person with asthma should just learn to run a marathon. In both cases there are real and serious health issues. I’d bet dollars to donuts that if it were “easy” for the boyfriend to stop hating and torturing himself he would have done it years ago. By downplaying the boyfriend’s symptoms to basic insecurity and low self-estimate, doubting that those emotions are real, and suggesting the boyfriend is just playing a game to get attention, Dan displays a profound lack of compassion and his bias that severe emotional outbursts are always a sign of control and abuse rather than a sign that the person is ill, hurting, and damaged.