Certifiable?

[NowYouSeeMe]

This was hard to confront in myself. I'm scared of the answer to this but feel like the feedback would help me to understand exactly what th f*** I am or am thinking. I've lost myself. ... Here it goes...

I'm freaking out at the prospect of therapy finishing and me not being ready for it. Had a tricky weekend. After my first session talking in detail about the trauma this week I guess I wasn't ok. I had thoughts of ending it all, started to think of how I could do this and I've become not fascinated by the idea of self harm but sort of compulsed to do it, so I used a knife to scratch myself (note scratch not cut). Then I wondered if I'm doing this to try and manipulate my therapist to not close my case yet. I don't actually know if therapy will end but I'm around session 7 on the nhs and it seems most people have between 12 and 16 through the depression service I'm under through iapt. On the other hand, I actually had some scary thoughts like "well I'll just make a vague plan so I can use it when I'm ready..." And I did get quite into the thoughts of what I'd need to do. My point and my question is....

Has anyone else hurt themselves to try and prolong therapy, if so, how did you stop and just basically, am I some kind of very screwed up horribly manipulative person or am I unwell? I'm so confused. I really aspire to be a good person but seriously who does stuff like this to manipulate another human being????

 

[lostforgottensoul]

am I some kind of very screwed up horribly manipulative person or am I unwell?

Neither, I think you're scared. Sort of like therapy craddled you and you wont have that. I know the feeling well as my insurence and my job has threatened to end my therapy.

Personally I stuffed and numbed as much as I could to be "ok" as much and as long as possible.

Question, what coping skills did you learn in therapy?

More of a reflection question. Those coping skills need to be activetly deployed before ending therapy.

Also talk to your therapist about this and advised that you have had thoughts of self injury to make it longer as you may indeed need longer and if so it should be longer, but also I think a lot of it is fear too.

Either way, your therapist needs to be aware as your saftey is first and foremost.

 

[Anarchy]

Hi NowYouSeeMe,
I don't claim to know how IAPT works
the bits I've gathered, is that you get triaged at the start and then assigned to the available T who's best able to handle you.

I gather that serious stuff can warrant a few additional sessions, and from another British member's experience, I think your T can perhaps wangle it.

but in every case, the NHS is innevitably a rationing device (like with free drinks in a bar - the demand for free care (which the NHS claims to be) is potentially almost infinite, but available resources, like stock behind the bar, are very definitely finite).

Most of us are in a bad financial state (I'm broke!) and our careers are generally badly damaged by the time we face up to our sh!t

that said - I started T again this year privately, and I clean toilets, wash and Iron bed linen and live on porridge (slight exaggeration but not by much) to fund it.

just on the self harm part, I got about 15 minutes extra by showing my upper arms to T just before the end of session (I'm a picker, not a cutter).

But stuff that's coming up now, I'm thinking that I'll probably be needing a year of more of T sessions, and I seriously doubt that you'll get that on the NHS - they're just stretched too thin.

hope you are able to sort something.

 

[Rumors]

I hope you can let go of the self judgement. It is irrelevant what anyone else says as long as you feel badly you need to listen to your gut. Things aren't well right now. It makes sense to not try and look at it under a microscope right now and just seek out help based on what you are feeling right now and the reason why you are scratching yourself with a knife. No judgment...just breathe and try and talk with someone soon.

 

[Sideways]

I agree completely with @lostforgottensoul. I think that the self-harm is likely to be your way of handling the fear and the prospect (however realistic) "I'm going to be alone in this soon." That's a pretty scary thought, and if no one has ever taught you how to express and handle emotions that huge in any other way, reaching for the knife kinda makes sense.

In my early days, I also used self-harm as a way of communicating with my T, because I didn't know how else to show how much pain I was in. And truth is, for quite a long while it worked. But in the long run, it wasn't worth it. It takes time to get on top of this stuff. When people used to break it down for me like this, I used to think that they were intellectualising stuff that I hadn't actually given that level of thought to: it just felt like what I needed to do, and in my head it really wasn't any more complex than that.

Having seen my sister use self-harm in a very manipulative way (like, if my parents took a weekend holiday, she'd get herself to the point where she was being stiched up in the ED, then call them and tell them they had to come home), honestly, even in her situation, saying it was "manipulation" is an unfair simplification. She was terrified, feeling incredibly alone, totally unable to cope...

T's call it "acting out", which fuels that "I must be manipulative" thought. But what they actually mean by that phrase is "acting out emotional pain". You're experiencing a lot more emotional turmoil than the average person ever has to deal with, and self-harm is a way of expressing that without having to actually feel the emotion itself.

It's a lot more complex than we often realise. So go easy on yourself. My guess is that when you were scratching yourself with the knife, you weren't actually sitting there assessing "how many and how deep do I need to get extra appointments?" Even if that thought was somewhere ij your head, it was almost certainly a far second to the need to just get the yuck out.

 

[expectingbetter]

our careers are generally badly damaged by the time we face up to our sh!t

It is so truth that it makes me feel sick.
God how much strength needs to just be able to try to get out of this vicious circle.

I think most of us see the therapy as one of rarely things we can do to help ourselves.

@NowYouSeeMe just be honest with your therapist, I hope you have confidence in him/her. You can explain with words how you feel and if (s)he is a good match for you (s)he would understand.
16 sessions is nowhere near to be able to heal any trauma.
If nhs can't provide you with more you will try to find the way to provide the help for yourself on your own. Thinking about self harming is not manipulative but just showing how much you are scared. Be honest and try to talk about it. Maybe you could find the solution together with your therapist. You are not alone, you have your T and you have us here.

 

[Sandstone]

After my first session talking in detail about the trauma this week I guess I wasn't ok. I had thoughts of ending it all,

I think the self harm has come up now in association with letting the trauma out, much more than the ending of your sessions. There are so many emotions associated with that, and SH can be a way to express them. It is really important that you tell your therapist about it. Don't let your harsh judgement of yourself convince you that you don't deserve help through every aspect of this.

 

[NowYouSeeMe]

Thanks for the replies/encouragement. Just about to go and see t

 

[expectingbetter]

Good luck :hug::hug:
Remember you are not alone! And your T is a person you can trust to .