And not for nothing, but it's been a very long time since I have acted on that behavior. Some would consider me healed from that aspect of my disorder and no longer consider me to have self-mutilating behavior though I once did. Even though Criteria #5 has been crossed off my list I still have BPD.
Tuesday, April 24, 2012
Self-Harm or No Self-Harm: Is Borderline the Problem?
Since I was mentioning my self-harm last week I thought I’d mention another controversy that I’ve been contemplating.
Controversy: Anyone who self-harms probably has Borderline Personality Disorder. And. All people with Borderline Personality Disorder self-harm.
Cutting. Burning. Hitting. Banging. Pulling. Scratching. Self- harm is a way to release emotional pain. It’s a way to gain a sense of control over your life. It’s a way to punish. It’s a way to remind yourself that you’re living. It’s a way to keep yourself going. Yes, it can be a cry for attention. It can also be an aesthetic art (scarification). Any of these, and more, can be your reason and you might not have BPD.
With the exception of the Scarification as an aesthetic option, using self-harm as a means of coping with something probably does indicate some turmoil in the mental health arena. From what I’m told, it’s not a “normal” way of coping. And sometimes yes, it’s not so much about coping, as a cry for attention made obvious for everyone to see.
Then there are those of us that use self-harm for very meaningful reasons when it feels necessary for us. By meaningful I don't mean it is necessarily healthy, or that the behavior should be approved of, but to us there is a very valid reason for it at the time. I’ve personally known people who self-harm that were diagnosed Bipolar, Major Depressive, General Anxiety Disorder, PTSD, DID, Anti-Social PD, Obsessive-Compulsive, and many that had no diagnosis at all. There are still more personality disorders and mental health disorders that could lead to self-mutliating behavior as well.
If you were to see me on a warm summer day sans jacket, and knew what self-harm was, you would take one look at me and know that I’ve dealt with it at some time in my life (You’d be amazed at how many people don’t know about it). However, you probably wouldn’t assume I had BPD simply by talking to me or hanging out with me casually.
And many others that you might assume were Borderline by how they behave have never self-harmed at all. At least not in the way that is meant by the diagnostic criteria. There are 9 diagnostic criteria to qualify for Borderline Personality Disorder. Self-harm and self-mutilating behaviors is only 1, one, of those criteria. That still leaves many combinations, and a lot of options open for qualification without cause for physical self-harm. Drugs and alcohol can be argued as self-harming behavior, but those fall into their own category under the diagnostic criteria.
Remember Borderline Friend #2 that I mentioned in the past? She’s never self-harmed in her life. Oddly she used to envy my scars. On multiple occasions she would run her fingers over a particular grouping, tell me they were pretty, and ask me to do that for her. Honestly, I was a little angry and appalled. But not for the reasons you may think. I remember the pain and the reasons that caused me to create those particular scars and she wanted them because they were pretty? Yes and No. She wanted them as a symbolic connection between the two of us, but that wasn’t going to fly with me either. Self-harm, for me, is a personal experience and I found it insulting that she would ask that of me. It was almost like asking me to suffer for her so she could pose that she had that experience. I guess it’s an odd thing to get possessive over. She never had it in her to do it herself though.
I’m happy that she didn’t. In her own way she had ways of coping that didn’t leave a permanent mark etched in her flesh. They were potentially just as destructive and dangerous at times, which qualified her for impulsivity problems and substance abuse, but not self-harm.
As a funny aside, I was telling Therapist about my tattoo. She wanted to make sure that I wasn’t doing it for masochistic reasons, that I didn’t enjoy the pain of it or anything. First off, I never enjoyed the pain when I was cutting. That would rather defeat the purpose. Secondly, I told her with an air of exaggeration, “Please, and besides, if I was going to do something masochistic I’d do it myself.” Of course I was joking and I laughed at my jest, but she didn’t see the humor. Note to self, don’t joke about destructive behavior with Therapist. I reassured her that I hadn’t done anything like that in a long time. I joke around and laugh at my BPD behavior a lot. It helps me put it into a perspective where the world isn’t ending at every turn. It’s not that I don’t take it seriously, but in fact, everything isn’t as serious as it often feels, and it helps me remember that.
So there you have it, everyone who self-injures isn’t Borderline, and everyone that is Borderline does not always self-injure. While it may be a symptom of Borderline Personality Disorder, that does not rule out the possibility that it can occur with other people as well.