"Why don't you just stop self injuring?"

RussellSue

MyPTSD Pro
I know that when I did self-injure, I did not go to the hospital 99% of the time. It was a coping mechanism and not a suicide attempt. And given that you have a job, maybe you want to choose your own vacation dates. You certainly are within your rights to do that.

But when other people hear about self-harm, they do tend to think it is the same as a suicide attempt and see it as an immediate emergency, even therapists. And too often, it is. No one wants to be the person who failed another human being by ignoring the signs that suicide was imminent. Your therapist certainly sounds persistent but if he is new, this may look like a huge emergency and less like a maladaptive coping strategy. It sounds like he probably has a fair amount of anxiety over it or he would have left you alone.

I am sorry that your therapist triggered you and proceeded to ruin your evening. Hopefully he will back off and you can focus on things other than why you have the difficulties that you do. You obviously have a lot going for you with a job and a moderator position here. It's not all about what is "wrong" with you. I agree that his wording was insensitive but that is not a reflection on you as it is on him.

Please be safe. I do hope you can swap ought coping mechanisms soon but we all have maladaptive coping stategies of different types and feeling ashamed and pushed is certainly not going to help that happen since it just adds to the stress you were already having.

I hope you have a better day.
 

Justmehere

Moderator
We spoke at 9pm last night. I told him no more emails no more texts in writing, and he continued so I blocked him. Omg. He blew up my email this morning. He’s blocked from my phone but I fear he texted it too.

I called him this morning at the scheduled time AT 7AM and this time, I was asking the questions. “What is it going to take for you to listen to no?” “What do I need to do so you stop texting and emailing me?”

He kept telling me how he knows I said no but it’s for my benefit. “If I can’t text or email you, how will I reach you?”

"Phone. Postal mail. By GROWING UP and acting like an ADULT." I continued on, “How do you think running over no stop helps traumatized women?” “Do you have a supervisor?” “Why are YOU behaving this way?” Blew up my phone with 20 phone calls before 7am. While we were on the phone, he emailed a termination EMAIL also demanding I email back. No Hipaa compliance. He wants to stay in touch on email and text to find me a new therapist.

I told him he is free to search for a new therapist taking new patients and treats PTSD and ADHD and takes my insurance, and if/when I am interested in that information I will contact him and he can provide it by the means I specify as acceptable. But there will be no further contact until then. Of any type.
He asked, “But how am I going to reach you?”
You won’t. I am done. I said stop.”

He kept going. I told him, "Go ahead, one more email one more text and I drop everything and get a restraining order. Wanna do that? Want to explain to a judge why you kept at it after I said NO?!"
"Ok. I will stop."
"I don't believe you. I will be printing and preparing the restraining order request now to have it ready for the moment you email or text me again."

I don't even care if my response is rational. I already know it's not. I just can't do this. It's so beyond my limits. I think from now on, I'm going to try to ask A LOT OF questions of any therapist I see.
 

piratelady

MyPTSD Pro
When I read page one of this thread, I was reminded of a time recently when my therapist tried to help me with making some improvements to my life. He went about it all wrong. I got upset, but eventually we talked about it rationally and he learned from that.

Then I read the next two pages of this thread... wow. I am speechless regarding how a therapist can act like this. I wonder, can you report him somewhere? He’s made so many errors, it seems appropriate...
 

Sideways

Sponsor
why are you being this way?
Million dollar question. Incredibly complex. And incredibly simple.

Oftentimes for me? The honest answer is, "Because I'm afraid." Which is not easy to say out loud to a stranger.

It's incredibly hard when we're really unwell - we have to convince a T that we hire that we are safe from ourselves . We have to convince them not just by our words, but by our behaviour - every tiny nuance.

Here? They can lock me up if they're not convinced I won't harm myself. And saying "I'm safe", when I'm really unwell? Is rarely enough. It's all the things we're communicating non-verbally that gets them concerned. And new therapy relationships they almost always err on the side of caution. Which is the situation where you get harassed by them, cops and ambos at your door, endless calls to guarantee this or that and "check ins" to the point where an involuntary admission would almost be less invasive!

Sorry it's so incredibly stressful. I hope you can find a moment of inner peace, somehow.
 

scout86

MyPTSD Pro
I will delay response a because I’m internally talking myself down that the question isn’t a test... only to have the therapist get frustrated (especially in intakes) that “I need you to answer the question.”
Sounds like there are an awful lot of people out there calling themselves "therapists" who maybe aren't very good at it. If my T asks something I'm reluctant to answer, he'll wait a beat, then change the subject. The subject always comes around again, but probably another day. Seems like there's an art to all this and these people don't sound like artists. On the other hand, my T has said some things that scared me, or confused me, or upset me too. Most of the time, he was surprised to learn that. But, one of the most valuable parts of the the whole deal has been learning that it's possible to work through that stuff. The challenge, I guess, is to find someone to work with where you actually CAN work through stuff, and then finding the way to give yourself and the relationship the time it takes to do it. What I've come to see is that, sometimes, neither of us gets it "right" to begin with, but it turns out that isn't the end of the world, and it doesn't have to be the end of the relationship.

About the original question, "Why don't you just....?" My T doesn't like questions that start with the word "Why". He finally said I could ask HIM questions like that, if I absolutely had to, but I'm not "allowed" to ask myself those questions. He says they aren't good questions. Not accurate enough. Too likely to invoke unhelpful feelings. He DOES, though, some up with questions like "Have you ever thought about what would happen if you stopped doing.... ?" Questions kind of like "Why don't you just...?", but a little more on point and a lot less likely to come off as victim blaming. I'm learning to like those questions because, fairly often, I HADN'T thought about what ever he asked and thinking about it turns out to be useful. Questions about the purpose of the self harm, and the possible alternatives to it, and reasons to chose one or the other, seem pretty legit. But maybe a little shocking right off like that. Which would make me wonder if "shock" was the intent and, if it was, what was the intended purpose.
 

grit

MyPTSD Pro
It feels like my protective side would have said to him/her: Why dont you shut your mouth? or screen your thoughts? It is almost as if he or she is assuming you never thought about this novel idea!!! Pure power trip and invalidation. There are so many other ways to gauge risk below any behaviour but to be this blunt for something so obvious is not therapy. It is bar brawl! provocation!
 

kkd

New Here
@Justmehere - your reply #26 - I was cheering for you for standing up for yourself. I hope you are doing ok-er today and that if you give another T a shot they are experienced in the areas you are looking to emphasize.

Green/new or not this guy and the "I'm steamrolling past your boundaries for your own good" approach would be inappropriate for any kind of therapy, but it's "holy crap" level inappropriate for trauma IMO.

Good on you for pushing back, and I hope when you are up to it you do let his boss or clinical supervisor (or your insurance even) know that he spoke way out of line & that his he leapt to assumptions and escalated (the cops thing) after his badgering was the reason you had to put your foot down and get some breathing room. That's some questionable judgment right there. Your insurer should care if they are paying a damaging nincompoop. And his group should definitely care that he's a liability. Running patients off due to his weird controlling bs or neediness is bad for the practice, and escalating like that when he (should) know it may be adding stress to an already stressed out situation sounds professionally irresponsible (if not maybe malpractice).

If he's licensed or registered, his licensing entity should also be interested in this.

This guy sounds like he'd be pretty bad at therapy in person, but telehealth is extra irresponsible for him since wow does it ever open the door for something like this (stir things up, then person is on their own). Even IF we're generous and assume he meant "what function does SH serve for you?" he should have asked it THAT WAY. Words & framing matter, and it does not take special psych training to realize that, good grief!

Do you know anyone whose recommendation you'd trust/bother with that has a therapist or counselor they'd recommend?

As for responding to his stupidly-put question: I think I'd have gone with "I'm working on it but still looking for strategies/replacements" if I was being up front, or "Why is a lot less useful & it's pretty much in control right now. I am looking for help with [what you want to focus on]. Can you help with that or shall I keep looking?" if I wasn't interested in total honesty (and this dude doesn't warrant it!).

The only piece of your response that would maybe look funny is mentioning the restraining order, but honestly he didn't quit pestering you and you have the timestamped texts, etc to prove it so it really isn't that weird given how incredibly far out of line this was from the moment after he asked that.
 

Sues

Confident
I am just floored by the horrible behavior of this "therapist" who is not behaving like a therapist. I agree that you should definitely report him... and put a review online that outlines how horrible and actually abusive they were to you. It would possibly help prevent others from going through the same thing you did. I am so proud of you for standing up for yourself! From what you've said, I'm just going to say it and put it out here that, yes, he was abusive and traumatizing towards you. I've been in therapy for over 2 years, and I had one therapist that was horrible and poorly trained. The other therpists that I've seen are actually trained and know how to speak to me without triggering, accusing, or harassing me. - All of which it sounds like this therapist has done to you. There are so many wonderful therapists out there. Please do not give up on therapy. Please try to find someone else. Therapy has helped me so much. I'm really just getting started on the trauma stuff, but having a good therapist has made such a huge difference.
 

Starfire

Confident
Is there a sane way to respond to a therapist saying this? I told him I would like to stop. I'm trying. I thought therapy could help.
"Well, I think you need to realize there are other options."
"Realized."

Maybe I am not ready for therapy again.

He's a therapist and he doesn't know the answer to that question? Needs more schooling!
 

joeylittle

Administrator
Hey JMH - just wanted to give you a reminder of this thing you said up-thread:
There is this horrible state I am in, and I don't know how much is ADHD and how much is PTSD. I forgot the ADHD meds today. That probably would have prevented the whole thing.
You've written this other places, too - that the ADHD meds have a huge positive impact for you. I think you've written that you're not always consistent with them - side effects, maybe? (I can't recall) - but maybe a good thing coming out of what sounds like a shitshow of a situation is just, things are better with the ADHD meds, and it's worth it to up your commitment to them.

Cool story, bro: I can go through a number of weeks, having my sleep get off and then not being able to fit the full dose of one of my meds into my day (it's a 2x a day, and needs to be separated by x amount of time, and can't be taken too late in the evening....etc.....) - I always think it's not that big of a deal, because it won't be every day, just maybe two or three a week. But then, a month later, my mood has really sunk, irritability is sky-high, ideation increases....and I remember that I haven't been maintaining a consistent med regimen. /end anecdote.

With the self-harm...I know I become a broken record about this, but the thing that really got it out of my life was replacing it with various forms of what kinda boils down to cold-water therapy...the cold showers, that also caused a certain amount of aversion to the self-harm, and they were a fairly extreme solution. But even now, splashing very cold water on my face, or covering my face with a very cold wet washcloth, or filling a bowl with water and ice and shoving my face into it...there are medical/scientific reasons why it works, and I think that's been part of why it was helpful for me. The replacement behaviors usually recommended (holding ice cubes, rubber bands, etc) always just felt (to me) like self-harm-lite. Not effective.

I also want to say - I empathize very much with the insistent believe that the behavior is a necessary - even essential - coping mechanism, and that to not do it makes things worse, not better. I just really, really get it. There are maladaptive behaviors I engage in that I still feel that way about. It never worked for me to tell myself I was 'choosing' a different action, or 'supporting myself' by not self-harming. Instead, I basically needed to not think about anything at all - just do the cold water.
 

Justmehere

Moderator
You make some super solid points. I need to get on top of the meds, no doubt.

The ADHD meds is a funny thing. Doctors have always posed them as optional, like a “vitamin.” It’s only been recently that I’ve connected it to emotional regulation abilities... and gotten my doctor on board with steady dosing for two weeks... then reassess...

The addiction history in my family and the side effects (feeling sleepy, flat, not eating...) and some other unknown hesitation plus outright forgetting (which the meds help with) somehow makes it weird to be consistent.

I have low dose naltrexone to stop any dissociative spaces and my doc is on me for making sure that if I have those spikes, that I’m taking that med. As I write this, the one other thing naltrexone helps with at a higher dose... self injury. It weirdly helps alcohol addiction, bulimia, and self injury. They think it knocks out the addictive endorphin rush of self injury. I forgot that! I can ask her for the higher dose. That would help! It’s cheaper too. Maybe the lower dose will help...

ADHD is weirder to manage? It is how my brain is 100 percent of the time. PTSD has spikes, so there is a baseline to aim for... and I know when I’m away from baseline. But ADHD’s constant nature makes it hard for me to realize it causes suffering that I don’t need to endure. I know this seems silly. Something like that. I think I keep writing about it because it’s so new to understand. I can’t seem to find a therapist who will even humor me on it. They hear I have a trauma history and ADHD gets ignored. I finally spoke to an ADHD specialist this week, with zero openings, but she confirmed my experience is common for adult women with trauma histories but proved tested ADHD. I told her it feels like therapy is almost like trauma-porn at this point. Like oooh let’s go dive into the trauma for the 500th time and completely ignore this giant other issue. She laugh and emphasized with me that yeah, that happens. I recently told my mother of the diagnosis I and she said it makes perfect sense. PTSD too... but not that alone.

I need to figure out the ADHD better. This therapist and I argued over it often. He kept wanting to do EMDR for it. Every one of the 5 sessions we had was my enduring a 15 minute sales pitch for EMDR for ADHD. It’s not a treatment for ADHD. That’s not a thing.

I hate self injury. I want to stop. Beyond words. I absolutely do not need it in my life and I’m deeply ashamed I do it. I have sat on the floor on my hands, my body shaking, for up to four hours in one spot, to force myself to stop.

And failed.

Sometimes I can’t figure out how to make myself to stop —-> that’s what made his questions so painful. I want to stop, and I don’t yet have the way to fully stop. It’s not something I plan to do. It’s not like I’m thinking out a plan to self injure. I haaaate it. I have been suicidal over the reality that I will do all I can and I’m still failing to stop the self injury habit. To have someone get so in my face and keep saying “why do you do this?”
The reasons I give of why I do it? It’s not like I think, “oh I’m crying and this will make the tears stop.” It also does not actually affect my emotions uh a good way. It has no “positive” effect anymore. Its all bad. It’s a horrible habitual behavior. The questions seriously stirred up really ugly stuff in my head and I had to stop before I went to bad places. I had to stop me. That’s what I had in my tool belt to stop - changing the subject. I explained all of this to him and he acted like it was the most bizarre thing anyone could say. I told the ADHD specialist, and she said it makes perfect sense. She said it’s like fidgeting when off meds. People can tell me to stop. I would have to sit on my hands and do nothing else but focus on not doing that to get myself to stop. it’s not a simple choice. It’s a driven habitual behavior. Or something like that. I can find the tools anywhere around me to self injure. I am too creative.

As for this therapist I told him no email, no text, and he kept emailing and texting so much I had to block him and when I finally spoke to him he shamed me for the boundary. I calmly told him text or email me again, and I’ll call the police. I am done. Stop. He emailed again. I called police. They asked he stop. They told me he promised he would. I can’t do therapy with a therapist who texts and emails between sessions about therapy session content. Already know this. It’s not a thing I can do and stay stable in my life right now - and my own respect of those limits is helping. It wasn’t going to ever work. Dude has no boundaries.

Since cutting contact with this therapist, there has been ***zero*** self injury despite many stressors and a few triggers. I’m proud of that.

Did I take ADHD meds today? No. Should I have? Yes. I see my primary care doc in two days who prescribes them. I asked if we could talk through my hesitations and she said “of course!” She’s a brilliantly supportive doctor.

I think a good solid chunk of time on consistent ADHD meds and naltrexone might get the habitual part of self injury to stop for enough time it stops being so habitual and more of something I have to think through to do.

My doctor has no idea I self injure except two times I needed medical help afterwards this summer... I can’t yet have that conversation with her. So much nope. Just can’t. But she knows the emotional part really well. There is never a why question. Just a “what do we do about it now...” She’s seen me triggered and says yes, it’s PTSD and something else and somehow, it never happens on ADHD meds. I’ll get triggered, but manage fine on the outside.

The ADHD specialist gave me a list of names but none with openings.., (damn pandemic.) I’m not sure therapy is what I need. It could help but the process it dragging me back to bad places. I have no therapist but a path forward at least with meds. I’m going to make it a top priority to be in the right level of meds every day for the next two months. 60 days is a doable goal.
 

Skywatcher

MyPTSD Pro
Self harm is the only way for me to stop the anxiety cold in its tracks when it’s really bad and I tried everything else... but afterwards the guilt sets in. So far, my therapist’s response is to encourage me to give compassion to my self harm. It helps.

Your T’s response concerns me that the workers on tele-therapy may not be legit. Sorry you had to go through that.
 
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