Manila’s relations with Washington appeared to be in critical condition late Thursday after Philippine President Rodrigo Duterte told U.S. President Barack Obama to “go to hell.” It was Duterte’s strongest outburst yet over criticism of his deadly war on drugs.

Duterte said he may “break up” with the U.S., raising the specter of Washington losing the Southeast Asian ally to China.

White House spokesman Josh Earnest said the comments were “at odds” with the good state of ties between the U.S. and Philippine people.

Washington has so far shown patience with Duterte, refusing to take his verbal bait. A State Department spokesman on Tuesday suggested Duterte was having an uncomfortable time settling into office.

“He may in fact still be forming his policies,” State Department spokesman Mark Toner said. “He’s only been in office a few months.”

Duterte delivered his invective in a rambling speech in Manila that also touched on an apology for comparing the eradication of drug pushers and users, a campaign he calls virtuous, to the Holocaust.

He said criticism of the rising body count is unwelcome.

“Instead of helping us, the first to hit was the State Department. So you can go to hell. Mr Obama, you can go to hell,” he said. “EU, better choose purgatory. Hell is full already. Why should I be afraid of you?”

It was unclear what sent Duterte over the edge, but Philippine media reported that in the speech, delivered partly in English and partly in Tagalog, he spoke about being subjugated to the U.S.

“For the life of me, I’d rather kneel before the king of Brunei or Thailand but I will never before the Americans,” he said in the speech, according to the Philippine Daily Inquirer.

Duterte said he doubted Americans would sacrifice their lives for the Philippines. He cited war games that began Tuesday, involving around 1,400 U.S. Marines and sailors from Okinawa and several hundred Philippine troops. He said the drills benefit only the Americans because the weapons being used are incompatible with Philippine arms, the Inquirer reported.

“I really lost my faith in the Americans,” he added.

Some observers see Duterte’s actions as clumsy first steps toward forging equal ties with Washington, Moscow and Beijing.

“While it is quite difficult to get past the vulgarity and rather inarticulate statements of President Duterte, what seems to be emerging from his actions is that he wants to establish a more independent foreign policy,” said Carl Baker of the Center for Strategic and International Studies in Honolulu. “What is not clear at this point is what that policy will look like.”

Since taking office, Duterte has paired his focus on narcotics with talk of getting investment from China and weapons from Russia.

“One suspects that once he begins dealing with Beijing and Moscow, other issues beyond their willingness to turn a blind eye to his internal affairs are likely to create their own set of problems,” Baker said.

Analysts note, however, that Duterte’s Cabinet has spent time trying to downplay his negativity toward the U.S. This may reflect resistance within his administration over the pace and direction of his shift in policy.

Moreover, in other candid comments Duterte may have acknowledged his own over-reach. In Tuesday’s invective-laden speech, he also adopted a reflective mood.

“There are times when you talk too much and for too long,” he mused. “I never aspired to be a statesman, you know.”

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