Cutting/self-harm

[Hope4Now]

Not much comes up on recent posts about self-harm, so here I am posting. My therapist asked me really directly today about self-harming, something that I find profoundly difficult to talk about because I am very ashamed of it. I understand a lot about myself, but not this part of me. He wants to talk about it. He says it is a desperate part, a last-ditch effort part that comes in when other manager parts just aren't up to the task of maintaining some sort of balance. He says it is a part that is welcome like all my other parts...that it is a protector part that needs compassionate attention.

I've managed it for almost a month now...recognizing it, and trying to find something, anything else to do but that, but I just did it again. For seemingly no reason. Perfectly decent evening with family. Well rested, etc. I'm writing here because I don't want to do it. I know it is a way of avoiding other pain from trauma, but sometimes I just can't seem to help it. And the compulsion to do it gets so bad sometimes that even when I use all my other strategies, I can't seem to stop myself from doing it.

It's as if I want to see my pain on the outside to make it real. See physical evidence of it because what's going on on the inside is invisible to everyone (sometimes even me). And yet, I don't want anyone else to see it because parts of me are very deeply ashamed that I am so weak that I can't manage to integrate emotional pain.

My therapist says that I am not the only one who does this. That it is not an uncommon symptom of PTSD. But why, why, why, can't I stop it even though I KNOW it is unhealthy. Even though I don't want to do it? I can distract and distract and distract, but it is always there.

Help? Advice?

 

[Chava]

I don't know what specifically your self-injury is and respect if you don't want to go into details. I've done more somatic-focused therapy and worked a lot on trying to identify what is going on in my body, not my mind, and what it needs. This might not be true for you, but when I survived an urge to injure myself recently, it was really helpful to notice it as a sort of "freeze" that was probably a fight response combined with need for protection or connection....like wanted to fight against something outside of myself but also be held really tight. My therapist explains "freeze" as these halted survival responses or responses glued together, and that my goal is to unglue or separate the impulse. Fight + wanting protection at the same time would make sense with my background. It was not okay to fight so it got turned back at myself. It's a really unsafe, impossible feeling. Anyway, I think I cut up a couple magazines and wrapped a scarf really tight around my torso (compression helps somehow) and gripped my arms tight. My urges revolve a lot around wanting to hurt my arms or legs. These are major fight-or-flight limbs of course. The energy is trapped, I want to release it but I also want to feel contained.

Can you notice any sort of fight quality behind your urges to cut? Any idea where the intense energy wants to go? I can relate to the tangible part, but the urges and act of self-injury feel really nervous-system activated for me. Distractions help, especially if you can't even connect to yourself well (that's a little part of it for me too...feeling very disconnected and numbed out...likely connected somewhat to a flood a numbing-chemicals under major feelings of stress, so distraction until it passes or safe outlets for the energy).

Finally, no, you're not alone. And good work trying to work through it.

 

[Hope4Now]

Hard to talk about it, even with my therapist. It's a part that makes me very scared and ashamed. What you say @Chava about your noticing is interesting and I need to think about that. Yes, it is some energy that needs release that isn't finding it elsewhere, even with all the other physical pain I deal with...it's like the somatic pain gone haywire. (I kind of know that my disabling somatic pain is "holding" the pain of the trauma). And yes, I need to be held tightly, which doesn't/can't happen or I haven't been able to make it happen. Fight + wanting protection make total sense with my background too. And yes, it's the arms and legs (and torso too).

I'm really struggling with this, and thank you for your response. I'm sorry you deal with this too. It is a horrible thing to deal with, especially when one is aware of how it is just dissociating from other things.

I'm just always afraid that it will go out of control, and that I will cut so so much that something bad will happen beyond the immediate release of the pain. Argh. I don't know. Anyway, thank you!

 

[joeylittle]

It's as if I want to see my pain on the outside to make it real. See physical evidence of it because what's going on on the inside is invisible to everyone (sometimes even me). And yet, I don't want anyone else to see it because parts of me are very deeply ashamed that I am so weak that I can't manage to integrate emotional pain.

This is why I struggle with it. It's some attempt to make my pain visible; but I hide my scars obsessively, and only recently felt OK going to therapy with my sleeves rolled up.

I think a big part of managing the urge, for me, is remembering that after it is done, I'll just have to hide it, like always. And it seems to be important enough to me that I don't repeat that cycle anymore. It's working so far, anyway, and has been for the last 10 months or so. Also - my technique for managing it is to take a really cold shower. So, even if I've decided I'm going to cut, I need to take a freezing cold shower first. I dread that so much, I rarely get to the cold shower actually happening.

It's good that you are afraid of it - because you can end up with something too deep, or in the wrong place, and going to the hospital isn't very fun. Have you tried any management techniques? Here's an old post of mine that has some listed: Self Harm - Help Me Understand You might need to experiment until you find a technique that works best for you.

 

[scout86]

What your T is saying about "manager parts" is kind of interesting. Mine talks about "parts" a lot too. One of the things he's mentioned is that some of these parts took on their jobs in the past, in an attempt to be helpful, but they are operating now on out dated information. He says it often doesn't work to just tell them to "quit". They are trying to help us and they want a job. He says sometimes you have to find them another job. (First you have to figure out what they think their job is!)

This is something I'm still thinking about and haven't had a lot of success with. In my case, he thinks there's a "part" that has decided "sleep" is a bad idea, for one example.

 

[Chava]

Does it help to know if there is somewhere you can go or someone you can call if you are in an emergency? I like that @joeylittle mentioned scars. I hide the scars or have convenient lies. But I'm not okay with the thought of more scars. The urge is deeper than this desire, but that's enough to sort of halt me so I can try to redirect that energy. I think the "halting" ideas are really important, the reasons you want to stop or not have more scars, but I know they can't in themselves always lower the intensity...so having halting ideas, distraction ideas, and keep searching for release ideas and/or safety ideas. For me it's sort of process like this...recognizing, knowing I don't want to do it, and finding an alternative...but it's been really hard sometimes because the intensity doesn't seem to let up fast enough. But I'll say, it does pass.

I can't say for sure, but arms and legs seem fight-or-flight connected (arms a little more fight, legs a little more flight), and torso or chest feels a little more about protection. For me, at least. It might not be helpful to try to figure out what it's really about on your own, but it helps me to just notice the energy as a general response that my body needs to release.

I have to sit in my garage sometimes. I'm out here right now because it's where I smoke. It's disgusting, not seemingly cozy at all, but there are no windows...I probably feel very contained and protected.

 

[Jane.l]

I was reading an interesting bit on SI the other day - one of the reasons we do it is to regain emotional regulation - when feelings are too uncomfortable causing ourselves pain and concentrating on the act of doing that is a way of zoning out - dissociating from the memory or the unbearable feeling it's bringing up .

Communication - often as sufferers we find it hard to explain our pain - even to ourselves - this is a way of saying 'I am hurting really badly' without words.

You do also receive a hit of endorphins when you cut too which may explain why it feels like a release - it is a rewarding behaviour in someways and that's why it can be hard to break - especially when you get into the guilt/shame cycle .

I am finding it useful at the moment to vividly imagine cutting when I get the urge - so instead of trying to avoid thinking about it I imagine getting the cutting implement - cutting and I imagine the pain in as much detail as possible as vividly as possible, the way it looks and feels at the moment it's helping me not to do it - would be interested to know if anyone else has tried that and if it helps? May only work for a while but it's helping me break the cycle.

 

[honeypie058]

I have many reasons myself for giving in to the urges. Basically from the overwhelming anxiety and thinking the pain is better from the outside then inside. Its hard to talk it over with my therapist as well. What helps me get through it is the 15 minute strategy. I tell myself that I can go without harming for 15 minutes. Then I go another 15 minutes. It helps me to distract from the urges. I hope this might be helpful for you.

 

[Hope4Now]

Here's an old post of mine that has some listed: Self Harm - Help Me Understand

Thanks for this link @joeylittle.

He says it often doesn't work to just tell them to "quit". They are trying to help us and they want a job. He says sometimes you have to find them another job. (First you have to figure out what they think their job is!)

Your therapy sounds like my therapy. I've learned too that it doesn't work to tell parts like that to just "quit." If it did, I wouldn't smoke or drink or hurt myself say mean things to myself, or do any other myriad of things that make me hate myself even more. And when I do manage to make them quit for a bit, they just come back even more riled up. I have so many damned parts to find different jobs for that I feel like an overworked headhunter/consultant!

For me it's sort of process like this...recognizing, knowing I don't want to do it, and finding an alternative...but it's been really hard sometimes because the intensity doesn't seem to let up fast enough

Yes, this is my process too. It's when the intensity doesn't let up fast enough that the problems happen. What you said about the fight/freeze stuff was true about last night. Something happened that shouldn't have flipped me out, but did, and I didn't know how to respond and ended up in the intensity vortex. It's when the internal chaos of parts clash with/get mixed up with external expectations and I feel trapped. I never know when it will happen, and when it does it comes on hard and fast and I feel helpless to stop it. Hah! Sounds like a repeat of my whole childhood to me as I write this. Maybe I will be able to talk about it with my therapist after all.

Thanks everybody for your support and words of wisdom.

 

[Friday]

For me... Physical pain trumps emotional pain... And physical pain also floods my bloodstream with endorphins/pain killers, adrenaline, etc. So not only does it mitigate emotional pain, but it also provides a helluva chemical reset when I'm in a hard and dark place. Whoomph.

So, for me, it's no different than taking meds. Same effect in the short term. Meds are better long term, because they don't have the side effect of causing me physical injury.

It's not my first choice on a massive reset, though. My first choice is sex. Second choice is physical damage.

I've found I reeeeeally shouldn't ignore either impulse. Because they'll come on waaaay earlier/sooner/faster than massive depression & suicidal ideation. Not that I should go pick up some cut guy at the park, or run till my feet are bleeding, and my knees are swollen like balloons... But that I should be aware that if I'm craving sex or running myself to shreds? I'm on thin ice, heading downhill fast, about to be in a very bad way.

 

[passerine]

I was just going to write a post about self-harm when I saw this. I can definitely relate to wanting to see your internal pain on the outside, to make it real. I also cut and burn myself as a way to manage overwhelming feelings, particularly fear, and as a way to get back into my body when I'm dissociated. While I know there are better ways to ground, and I have worked very hard at developing healthier coping skills, there are still times that self-harm feels like the only solution.

My therapist and I just came up with an agreement the other day, which is that I will contact him and leave a message BEFORE I self-harm and then wait until I hear back. This is going to be VERY challenging for me, but it gives me some motivation to practice non self destructive coping skills, like holding a frozen orange, wrapping up in my weighted blanket, going for a walk or bike ride, doing some gentle yoga, using my pastels and paints on big sheets of paper, or molding clay. These are some activities that have distracted me from the urge and given me the sensory input / grounding that I am needing when the urge is very strong.

There have been times when I have cut or burned myself during a dissociative state and later not remembered doing it, which is always scary. I don't know if anybody else experiences this, but the relentless grounding has helped decrease the frequency of these episodes.