The Hurt Yourself Less Workbook: Before You Self Harm

Talk of self harm

Previously: Self Harm Timeline

How you feel BEFORE you self-harm

Thinking of your most recent experience of self-harm, answer any of these you feel comfortable with:

Describe what happened.

I was arguing with my partner and saying I didn’t feel like he cared about me. He told me this was wrong and that I need to stop saying those lies to myself. I began to panic because I felt like I couldn’t trust myself. I couldn’t understand how I could feel so confident about something but it be wrong and if it was wrong, why couldn’t I talk myself out of it?

What led you to do it?

A need to feel something that was real and too bring myself down from the strange feelings and thoughts I had going on inside.

What did you feel before?

Panic, desperation and out of control.

What else was important at the time? (Events, thoughts, memories, exhaustion, voices etc.)

I don’t think I was focused on anything but needing to come back down, I guess coming back to “reality”.

Was there anything else in the background? (This may be something current or an echo from the past)

I don’t think so. I was very focused on the moment and getting control back.

Did you spend a long time thinking about harming, or was it impulsive, or both?

More impulsive. I sat for a few seconds with the scissors and thought about if I wanted to do this since cutting lately hadn’t had the same calming effect it used to but I did it anyways.

Is that your usual way (if no, what was the difference)?

My self harm is usually a combination of thought and impulse. The more I think the less likely I am to do it or the less likely it will have the desired effect I want. This was just the first time in a long time that my self harm was impulsive and I can only assume it was because of my desperate need to regain control over my mind and body.

How do you feel now?

I feel that if I can keep getting that relief that I want to keep self harming. If I can’t then I want to continue with different coping techniques. I know that experience won’t always happen because I am in more control of myself than ever before which is good.

Sexuality Explained

Great video! Similar to what I learned in my first year sociology class

Bad Habits

I won’t do it again!

I have been biting my nails/chewing the skin around my nails for as long as I can remember. I have most likely caused the occassional infection that has turned my finger (usually the middle lol) green, painful and puss-filled. I also currently have  a “cut” on my thumb that was caused by skin biting that does hurt. I bite or chew mostly when I’m bored or when my hands have nothing to do. I seem to have this need to touch my face and have something in my mouth. I have never caused what I consider to be serious damage to my fingers but I’m sure others would disagree.

My sister sent me an article today that says nail biting and hair pulling could become forms of OCD. We are talking to the extent of having bald spots and causing fingers to bleed but since this is psychiatry I do not trust that they would just start classifying everyone who does either of these two behaviours (and others) as having OCD.

 

These ‘bad habits’ were originally impulsive control disorders known as trichotillomania (hair pulling) and dermatillomania (skin picking). Trichotillomania actually currently has it’s own category in the DSM IV.

I guess I’ll have to start being careful so I don’t end up with this diagnosis!

The article:
http://www.ctvnews.ca/health/certain-compulsive-bad-habits-to-be-re-classified-as-forms-of-ocd-1.994581#ixzz29HbfYj3F

Excuses and Reasons

I remember hearing from my Dad (I love my Daddy, he does everything for us and everyone else!) after I was diagnosed, “Kristen, don’t use depression as an excuse.” I would respond with, “It’s not an excuse, it’s the reason.” I understand what he was saying but even know I’m unsure how to separate an excuse and a reason when it comes to a mental illness.

A diagnosis can be a relieving thing to receive. I remember I was very excited to be able to tell people that I was sad all the time, cutting, binge drinking and being reckless because I was sick. Unfortunately it didn’t make things better for me.

Am I using depression as an excuse why I need an extra day to finish an assignment for school?

Am I using depression as an excuse when I don’t go to school for a few days because I can’t get out of bed?

Am I using depression as an excuse when I get angry with others and lash out negatively?

Or is depression the reason why these things happen too me?

This may have contributed into my current attitude of not letting my emotional states stop me. I don’t want to use them as an excuse as to why I can’t do anything. This does not mean that it always works out. Those same emotions that can be seen as an “excuse” are usually the reason why I can’t do something, why I need to do something differently or why I need help from others to complete the task.

I have experienced both ends of the spectrum. I have met people who think I’m all excuses and people who think I’m all reason. Oddly enough there is damage done when people believe our mental health issue is the reason you say, do and think everything.

This is when you begin to feel invalid.

I once had a “friend” explain to me that she knew I had a mental health issue so she was going to take that into consideration as to why I was mad at her. Ummmm thanks but NO! Why I was mad at her had NOTHING to do with a mental health issue but EVERYTHING to do with the fact that she had betrayed my trust!

To have everything about you blamed on a mental health issue leads you and everyone else to question who you are as a person.

Am I really angry?

Am I really sad?

Am I the one ruining my relationships?

You lose your agency. You lose you ability to react and be in a way that you want to be because there is always second guessing as to if it is you or if it is your illness.

There needs to be a middle. I’m not even sure how that middle would work but there needs to be a level of understanding that someone can have a mental health issue but still think, feel and behave for themselves.  There is a “dictation” so to speak of emotion and behaviour, something that feel out of our control, and that needs to be understood and coping methods need to be taught so we can feel more in control in our out of control moments.

I’m still figuring out how to do this. I am currently in a situation of where I need to be understanding but don’t want to be. It is difficult but not impossible.

 

Thought #7: Good vs. Evil

Thought: To make negative behaviours, even “evil” behaviours an illness is to  assume that humans are supposed to be good, if not genetically good. I don’t know how much truth is behind that and no one really does. It is compulsory kindness. 

Thought #4: A Divide Within A Divide

Thought: In my 3rd year of social work I took a required research course (which I’d never thought I’d need and now I do research lol). In groups we had to do a meta-analysis on a topic of our choice and present the findings to the class. My group and I chose restorative justice for youth. One day we were in the library organizing and all that and got onto the topic of mental health (I can’t remember why). I came out as having borderline personality disorder and the older man in my group laughed and said, “You don’t have BPD, I know people who have BPD and you aren’t one of them.” I was taken back and don’t remember how I responded but I know my face made a “wtf, how dare you, I can’t believe you just said that, is this actually happening” look. Who was this man to tell me what I was? He knew nothing about me but that of been where his “conclusion” came from. Without a DSM definition of what makes people experiencing BPD awesome you would assume that someone who was very nice, smiling, laughing and overall super cool would not have a mental health issue but this is NOT TRUE! Looking back his statement is perpetuating the “damning” stereotype, the belief that becoming well is no possible. As a person with BPD do I always need to angry, unstable and impulsive? NO! There is clearly “normal” and “abnormal” within “crazy”. It bothers me that because I don’t act a certain way or feel certain things people within my own community could pass judgement like that. He’s not a member of the mental health community to my knowledge but I have experienced and done it myself, decide if you are “crazy” enough to be let in. It’s horrible. We don’t know people’s experiences and the last thing we need to do is further negatively divide a divide within human variation. 

 P.S. This man was not aware of the years of therapy and the work I still currently do to keep all destructive emotions in check. I should have unleashed them then!

Neurodiversity Stigma

This idea is based off of my own personal experiences and strengthened by the speakers and people I met at PsychOUT 2011, “Anatomy of an Epidemic” by Robert Whitaker, “Talking Back to Psychiatry” by Linda J. Morrison, “Manufacturing Depression” by Gary Greenberg and countless websites such as www.mindfreedom.org.

I want to propose a new type of stigma that attacks all of us, not just those labelled with a mental disorder. If we want to give it a funky technical name MindFreedom would call it “neurodiversity”.

Neurodiversity is the radical idea that we’re SUPPOSED to be different! If your brain is “too different” then we will slap you with the label of mental illness, you are disordered.

I am unsure if I will outright deny that mental illness is real because I feel I have had an illness but also been a victim of simply being someone that society doesn’t want me to be. I will not easily, if ever, comply too the traditional standards of “yes I am ill, please fix me.” I will always maintain that there is more to our mental health system than we think and that the system will let on.

I am proposing the idea that mental illness can be a form of social control. “If you can’t be who we want you to be then we will call you sick.”

Yeah...cause being the same is fun....

We accept different genders, races, religions, beliefs, sexual orientations and so on but mental differences are not making the cut. I like to think of everything about us as being on a spectrum. We are not all in the middle of this spectrum. Some are far on either “extreme” ends of spectrum and others are scattered in the middle.

We have been learning that too much emotion is a bad thing, that being the person who is sadder or angrier is to be the undesirable person. These emotions and behaviours can interfere with your life, I know, and that is when it becomes a problem but would it be a problem if we cared so much about everyone being a certain way? If we allow people to feel and support them in feeling then maybe recovering from those feelings would be easier?

Example: while I was a teenager I found it very hard to not be sad when everyone around me was telling me my feelings were illegitimate. There was no support so there was no moving forward. This is why I ALWAYS legitimize a person’s feelings because whatever they are feeling is real to them and that needs to be understood and respected in order for you to help solve the problem that brought on those feelings.

Support rules!

Should this be an illness though? “Manufacturing Depression” by Gary Greenberg looks at how psychiatry and the pharmaceutical industry have turned normal reactions to upsetting situations into the illness depression. He does not deny that depression as an illness can and does exist but to the extent at which it is being diagnosed he is very suspicious and we all should be.

Example: I was diagnosed with depression only based on my symptoms. My psychiatrist never asked why these symptoms appeared. If he had he would have found out that I initially became deeply depressed because I was excluded and made fun of by my friends and peers for many years. This would make anyone depressed but is it an illness? I personally do not think so. I feel my reaction to my situation was legitimate. Medication cannot take away the fact that people I knew made fun of me. (More on medication in later blogs)

Just like in the media we need to be critical of our mental health system. I realized I needed to quickly develop this critical thinking when I received my diagnosis for Borderline Personality Disorder. I could see myself in the symptoms but I could justify all of them and did not see most of them as being a bad thing. (A commentary on borderline personality disorder to come soon) It seemed like no matter what I said or what I did I was going to get a label. All I really want is to be myself.

Look through the DSM and you will find bits of yourself in many of the disorders. Although not legitimate diagnosing tools (if those exist) online quizzes will also give you different results. According to these quizzes I have borderline personality, major depression, narcissistic personality, various degrees of bipolar and dependant personality.

ADD and ADHD in children is a good example of what I feel is relatively normal child behaviour turned into an illness. If you can find me a child that can sit still, pay attention and keep quiet, please give them a medal but I can tell you those children do not exist. It pains me to see the kids I work with labelled as ADD when they’re made to sit and do math when all they want to do is get outside and run! We need to be careful with ADD and ADHD.

They are children after all

Some of our reactions are learned responses. Men receive the more “violent” diagnoses because men are taught in our society that violence in men is ok (until it’s an illness). Women receive the more submissive diagnoses because women are taught to be submissive (until it’s an illness). (More on gender and mental illness later)

Example: I learned how to be angry when I knew I had all right to be angry at a traumatic situation but no one was letting me be angry. This resulted in now my usual responses being in anger in order to protect myself and get my point across.

We all need help when overcoming tough situations and it’s up to you to choose what will work best for you. I have experienced the intenseness of what could have been an illness but I have also experienced what I feel is an attack on my being. We are supposed to be different. We should love being different. Being able to feel should be a beautiful part of being human and with support people in your life it can be. Do not feel shame in being sad, angry or any of the other “negative” emotions. Be excited that you can feel those things because there are people out there who exhaust themselves trying to always be happy and I think those are the people with the problems.

Neurodiversity, we should be who we are meant to be and with support it is easier to be that person and develop that person. Fitting into rigid categories is madness itself. This will be controversial but we need to be critical about everything around us and I see no reason why mental health should escape our critique.