Friday, April 27, 2012

Lucid Analysis: Trials in Therapy – Disappointed

I’ve been exhausted all week. I’ve been having anxiety about going to bed even more than normal. As a result I haven’t gotten much sleep. Not surprising. When I’m over tired, my ability to control my emotional state goes right out the window. Sleep is necessary.

Yesterday I was cranky and felt like my brain was in a fog, but despite all that I held up at work and got an incredible amount accomplished. That was all I had in my I guess. As soon as I got to therapy Therapist noticed how tired I was.

I told her, again, about my sleep anxiety, and how I’ve always hated sleeping alone. My distaste for sleeping alone is nothing new. I don’t know if this anxiety about actually going to bed is more recent in the last couple years, or if it’s always been there but I haven’t noticed. I’ve always had sleeping problems. Classic insomnia all through middle school and high school. Periodically through college. And it reoccurs when I’m stressed. Usually my brain speeds up, I can’t stop thing, rethinking, overthinking, ruminating, my thoughts race and I can’t call myself down enough to fall asleep.

I did eventually figure out a trick to help myself get to sleep. Want to hear it? It’s the geekiest thing in the world. So I love comic books and cartoons. When I was younger I would write my own stories, especially Batman and X-Men. Before I’d go to sleep at night I’d start thinking about the story line or things that would happen in that Universe. It was engaging enough for my imagination that I wouldn’t think about all other stuff that normally overwhelmed me and relaxing enough that I could actually fall asleep. I still do this sometimes.

But falling asleep hasn’t been my problem so much, it’s been actually getting my ass into bed.  I sleep wonderfully when I’m sleeping with someone. Whether we’re romantically involved or not. Remember my best BPD friend #2? That was Riot. We would snuggle up and sleep together all the time. All the time. It was just comforting. For both of us. Therapist asks where Tech Boy’s been? I clearly have no problems when he’s with me. True, but we both work during the week. He gets up even earlier than I do. It wouldn’t really be conducive to getting much sleep = still not fixing the problem. Oh well. I sleep on the weekends.

Then we just started talking about our relationship. Where I see it going. How do we feel about each other. Blah blah blah. I couldn’t deal with it. I started to get really upset. Not even because anything is wrong, but I don’t have all the answers and I don’t want to start obsessing about whether or not he likes me enough or whatever. I actually don’t feel like I need to. I’m enjoying what we’re doing for the most part, even though I would like to see him more. But because our schedules have been so disjointed lately it’s just been difficult for me to hold onto my feelings. I can’t force myself to feel things. I have a lot of trust issues. A lot. As Therapist kept bringing up. But that’s not even it so much. I trust him as far as we go. I just, can’t hold onto how I feel if he’s not right there with me.
It’s funny though, what’s been not working for me and him in terms of that, has actually been helping my relationship with Roommate. When I don’t see Tech Boy I spend more time with Roommate. I feel like I’m internalizing her in a very real way. It’s fabulous. I just wish I could do that with Tech Boy. It makes me feel bad. 

She kept going on about how maybe he doesn’t talk about his feelings with me, because I don’t talk about mine with him. Or maybe he’s picking up on my hesitation and holding back. She says guys are actually very protective of their hearts and their feelings. It’s not like I’m not very affectionate and all those things. It felt like she was saying it’s my fault we’re not all in love. And I’m sitting there like, why can’t we just like what we’re doing? Why does it have to be everything right now? He’s awesome to me, we like each other, we like spending time together, why does it have to go faster than it’s already going? It was very frustrating for me. I was getting upset very easily. Maybe it was good that I was getting upset, because Therapist doesn’t see me lose control very often and it might be good that she does.

Anyway so back to the trust issues thing. She asked me if I feel like I can really be myself with him? Well, no. I can in a lot of ways, but there are lots of things I feel like I can’t tell him. Like what? Like, how about my eating disorders? I mask all those issues with talk of being healthy, which I am, but I’m also obsessive about my body. I hate it. I hate how I look. Hate other people looking at me. If I’m not comfortable with myself I can’t even bring myself to go out in public. It’s a problem. I don’t see what other people see. She said that is obvious because I’m beautiful and I clearly have dysmorphic issues. Which we know. She asked me if I believe people when they give me compliments. I believe that they mean what they say. But that’s not quite the same thing as me believing what they are saying.

Ugh, so we’re having this catered gathering for my colleague that left. One of the supervisors is trying to arrange the food and wanted to know what I’d eat. He hands me a menu from a nice Italian place. The menu has plenty of things I could technically eat; zucchini sticks, eggplant parmesan, baked ziti, all sorts. None of which I want to touch. I don’t want to eat anything fried. I don’t want to eat a pile of carbs. I’m not going to be able to work out the way I normally do next week (Tattoo appointment tomorrow!). I can’t purge because of my medication (which I also can’t talk to him about). All I can do right now is count my calories and be very, very obsessive diligent. Do you really think this is a conversation I want to have with someone? They’ll think I’m nuts. Or sick. I’m not sure which is worse.   

And what’s worse is the supervisor and the guys I work with keep hounding me about it. I’ve told them repeatedly… REPEATEDLY… not to worry about me, I won’t eat that stuff, just get what they want and I’ll take care of myself. It took me two days to get him to stop, then today the other guys that weren’t around brought it up and were poking me about it again! Just stop people!

I don’t like being pressured like that. When I make up my mind about someone I mean it. I don’t like to be harangued. And again, I feel bad because I know he’s just trying to be polite, and I appreciate the effort but just stop. It makes me feel bad. Therapist says I’m not used to letting other people take care of me. I’m very Other-Directed. Very used to taking care of other people. Thinking about their need, what they want, before I even bother stopping to consider what I want or need. So when other people try and do things for me it makes me uncomfortable. This is true. Couple that with food and you have a maladaptive schema response + an eating disorder = a very chaotic mind. It’s upsetting. The whole while I have to grin and laugh it off so they don’t realize how much it all bothers me.

It’s exhausting.

Therapist brought up the idea of the Enneagram.

The Enneagram is a highly sophisticated system of nine personality profiles that are meant to help us know ourselves and others “as we/they are to themselves”. Each type profile serves as a customized road map for on-going personal growth consistent with categories of modern psychological typology.

She said I embody two different personality types. She went on about The Giver (which is one type) but never told me what the other was. We’ll see next week. She’s going to let me borrow some tapes on those types.

Tapes? Yeah, she said tapes. I don’t even know if they make tape players anymore. We’ll find out next week.

My problems are so little as of late. It’s nice to be so drama free, but it makes me feel really silly about complaining about stuff. Which makes me feel guilty for not appreciating everything that is going right. This whole having emotions things is really obnoxious sometimes.

Then she went on about how I’m such a good person and how all the good I have about me now far outweighs anything I would perceive as bad. And it’s just, I just can’t see it. I don’t understand. She says it all the time, but it was making me really upset that I couldn’t see what she wanted me to see. I always feel like I’m disappointing her when I’m honest about that. We’ve done so much work but I still can’t see what she wants me to see. I feel like I’m letting her down in some way. But I’m not going to tell her what she wants to hear just so she feels better. That’s not the point of therapy. Yet again, it was making me very upset. ::sigh::

Fortunately I got a lot of sleep last night and today I feel much better.

Thursday, April 26, 2012

Why Self-Harm?

In short? Because it helps. Now, now, before that is taken the wrong way, it is definitely a maladaptive form of coping. Maladaptive and destructive. However, it is important to acknowledge the fact that self-harm, while maladaptive, does help. What would be the point of it, if it didn’t help? I’ve discussed myreasons for doing it. Here are some other ways that it helps:

  • Expressing feelings you can’t put into words
  • Releasing the pain and tension you feel inside
  • Helping you feel in control
  • Distracting you from overwhelming emotions or difficult life circumstances
  • Relieving guilt and punishing yourself
  • Making you feel alive, or simply feel something, instead of feeling numb

People say things like:

  • It expresses emotional pain or feelings that I’m unable to put into words. It puts a punctuation mark on what I’m feeling on the inside!”
  • It’s a way to have control over my body because I can’t control anything else in my life.”
  • “I usually feel like I have a black hole in the pit of my stomach, at least if I feel pain it’s better than feeling nothing.”
  • I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain.”

None of these things are probably very surprising to those of us that have or do, utilize self-harming behaviors.

The simple fact of the matter is, that self-harm helps us get through. Whatever our reasons, it helps us. Alright, well if it’s so helpful, then why stop?

Because it’s not a permanent solution. It’s not a solution at all. It’s a band-aid on a bullet wound. The real wound is internal, emotional, and much, much deeper than our knives can go. Self-harm, at best, provides a very temporary relief, but it doesn’t actually fix the problem. It can actually create more problems for you as your life goes on. Many people don’t consider long term consequences when they’re so focused on just trying to get through the moment. I can’t tell you how many times I’ve had to survive minute by minute. Next year, hell, even next week, isn’t going to mean much if you can’t get through the next minute. So that moment is what you pour all your energy into. And it works. You survive long enough to feel some relief. A small weight being lifted as the rest of the world slows down around you. You made it through, but now what. Now you have this wound, eventually a scar, that you have to hide or explain, and carry with you often for the rest of your life. It can make a lot of interactions very uncomfortable.  

That relief you needed in the moment, eventually fades. And for many it’s replaced by something else; shame or guilt. How are you going to hide it? How are you going to explain it? What is my boyfriend going to say? What if my mother sees?  What will they think of me? They’ll know something is wrong. They’ll know I’m not ok. Not alright. Not perfect.

It becomes necessary to keep this secret from the people close to you. But how do you hide a secret that’s worn on your sleeve? I’d avoid people. Avoid going out. Avoid seeing friends. Avoid seeing family. It was very lonely. I had to skip doing things I’d want to do, make up excuses, so people wouldn’t see the things I’d done to myself. You can’t wear a bathing suit when you’re covered in cuts. Excuse after excuse. And it can be difficult to do the longer you have to keep it up.

Not to mention, the longer you practice self-harm, the more at risk you are for an accident. It’s easy to misjudge the pressure you put on a knife or a razor blade. I’ve done it. I have nerve damage on my lower calf from it. This was the night I went to the Psych ER. I’d cut up my left arm and hit my right leg. I went to deep on my leg and could see fat and tissue. And then ambulance arrived and I only had a chance to keep it closed with a fabric band-aid. I could care for it properly because I couldn’t let the Rescue kids or the cop know what I’d done.  How I managed to convince the Psych Doctors that I was fine and didn’t have a problem was next to miraculous because if they’d been even a tiny bit more vigilant and asked me to roll up both sleeves they would have quickly seen through the lie and my troubles with have tripled instantly. I never would have gotten out of there in the morning.  They would have held me there for treatment and evaluation. I remember sitting there, knowing I needed stitches in my leg, hoping that I wouldn’t bleed on the floor so I could just get home and deal with my wound that was open to potential infection without cleaning or a proper bandage.

You never know what might happen or what might prevent you from caring for your wounds the way you should. It also didn’t help that I had a habit of re-opening them and inhibiting their healing. I actually wanted more pronounced scarring though. I often got minor infections that could have easily become much larger problems.

And what happens when self-harm is no longer enough? It provides a temporary relief. But temporary is just that: it doesn’t last. But that doesn’t stop the craving for the feeling of release. The longer you have to deal with the darkness, the longer you are likely to remain in a depressed state. If you’re not already clinically depressed, not dealing with your issues, can make you so. Holding onto them, instead of healing them, only makes them worse. Until you start adding alcohol, or maybe drugs, into the mix. Drinking and cutting was not an uncommon practice for me. Can you imagine all the ways that could get worse? A lack of inhibition, a lack of judgment, a lack of control, with a blade pressed against your skin is a great way to make a mistake.  

Or maybe you begin to crave the sense of relief more often. Or you need that reminder to keep yourself on track more often to keep your control. So you begin to cut more. Until it’s one of the few ways you know to feel ok. It’s the only way you begin to feel ok. How can you quit the only thing that helps make your life bearable? Before you know it, the addiction has set in, and it becomes nearly impossible to quit on your own. You reach for your razors the way some people pick up a bottle.

And then all of those problems that I’ve mentioned previously, increase in probability.

The bottom line is: self-harm doesn’t actually help you with the issues that made you want to hurt yourself in the first place.

If that’s what you need to do, then do it. But recognize that all those problems aren’t going to go away if you do. The only way to truly stop that internal pain is to find help, face what is really going on internally, and confront the actual issues in a constructive way. Only then can you feel lasting relief, which is what we really need.

Be careful. Be safe. Be kind to yourself. The world often feels like an awful place filled with people that are out to make you miserable. Shouldn’t one person that wants to treat you well, be yourself?

Wednesday, April 25, 2012

Myths and Misconceptions of Self-Harm

Since we’re on the topic of Controversy and Self-Harm, let’s continue on in this vein. There are a lot of myths and misconceptions about self-harm. It’s important to dispel these myths and misconceptions because the longer they persist; the harder it becomes for people to come forward and heal from something so painful, and potentially fatal. Yeah, yeah, I know self-harm isn’t usually an attempt at suicide but that doesn’t mean accidents don’t happen. Especially when you consider you’re opening yourself up to infection and disease if wounds aren’t treated properly or dirty implements are used. I’ve done myself nerve damage that I didn’t intend because I accidentally went to deep. It’s possible to mess up. And when you're messing around with your body, your life isn’t something you want to slip up on.

Myths and Misconceptions

Self-harm is usually a failed suicide attempt.
This myth persists despite a wealth of studies showing that, although people who self-injure may be at a higher risk of suicide than others, they distinguish between acts of self-harm and attempted suicide. Many, if not most, self-injuring people who make a suicide attempt use means that are completely different to their preferred methods of self-inflicted violence.

Research into the underlying motivations for self-injury reveals important distinctions between those attempting suicide and those who self-injure in order to manage their stress and cope with overwhelming negative feelings. Most studies find that self-injury is often undertaken as a means of avoiding suicide.

I have had many reasons to self-harm in my life. Never, not once, was it an attempt at suicide. I have tried to kill myself, I have tried slitting my wrists (twice), mostly it was by alcohol and overdose though. The mentality I was in at those times was beyond self-harm. I was done. Self-harm actually became a way for me to hold onto my life. To reaffirm that I was alive, and to keep myself alive. While the actions may look scary, and similar, the intent is often the exact opposite of suicide. It’s life maintaining, not life ending.  

People who self-injure are crazy and should be locked up.
People who self-injure are no more psychotic than people who drown their sorrows in a bottle of liquor. For most who practice self-injury, it is used as a coping mechanism. However, it is a coping mechanism that is not understandable to many people and is not accepted by society.

People who self-harm are just trying to get attention.
You know what else is attention-seeking behavior? Wearing nice clothing, smiling at people, saying “hi”, going to the check-out counter at a store, and so on. We all seek attention all the time; wanting attention is not bad or sick. If someone is in so much distress and feels so ignored, or so incapable of expressing what is going on within them, that the only way they can think of to express that pain is by hurting their body, something is definitely wrong in their life and this isn’t the time to be making moral judgments about their behavior.

For some, self-injury is clearly an attention-seeking act. In this case, it is very important to honor the intent – if someone is injuring him/herself for attention then that person clearly needs it – this person is crying out for help. Just because they aren’t communicating in a way that is understandable to you, doesn’t mean they’re not communicating.

Sometimes bleeding on the outside is the only way we know to show how much is broken on the inside.

That said, most people who self-injure go to great lengths to hide their wounds and scars. Many consider their self-harm to be a deeply shameful secret and dread the consequences of discovery.  Although not overtly attention-seeking, hidden self-injury is still a symptom of underlying distress and it merits attention from others who are in a position to help.

For me, I always hid my wounds until they were completely healed. I wasn’t ashamed of them, but I didn’t want the attention either. I didn’t trust the people I had in my life and didn’t feel I had anyone I could turn to for help. No one understood, everyone judged. It was my way of coping on my own without risking putting myself into the hands of people I didn’t trust.

Self-inflicted violence is just an attempt to manipulate others.
Some people use self-inflicted injuries as an attempt to cause others to behave in certain ways, it’s true. Most don’t, though. If you feel as though someone is trying to manipulate you with SI, it may be more important to focus on what it is they want and how you can communicate about it while maintaining appropriate boundaries. Look for the deeper issues and work on those.

People that self-harm to manipulate others, are probably doing so because they’re being so ignored, so misunderstood, that they can’t think of a more constructive way to get your attention, or everything else they’ve tried previously has failed and this is the next resort. Self-Harm is a behavior. It’s the manifestation of a deeper problem. When someone is self-harming they have deeper issues that need to be addressed, need help getting better, but in order to get better, first, they need to get your attention. That’s not justifying the behavior, it’s just an attempt to explain that sometimes people don’t listen, don’t see the signs or ignore less extreme forms of communication. On the flip side, some people don’t know how to communicate their problems effectively.

If the wounds aren’t “bad enough,” self-harm isn’t serious.
The severity of the self-inflicted wounds has very little to do with the level of emotional distress present. Different people have different methods of SI and different pain tolerances. The only way to figure out how much distress someone is in is to ask. Never assume; check it out with the person.

I admit I can be occasionally guilty of this. I’ve had such bad injuries that I occasionally feel like people are just being silly whining about paper-cut like injuries. However, if the motivation to hurt yourself exists, and you act on it, no matter how severe the wound on the outside, the emotional wound is probably very severe.

Only teenagers self-injure.
While it is true that the majority of those who self-injure do so during their adolescent years, people of all ages practice self-injury. Cases of self-injury have been documented in children aged seven years or younger and a number of adults engage in self-injury, too.

I was 12 when I started to self-harm. I’ve only been free of from the behavior for 17 months. I was 29 the last time I injured myself on purpose.

Only females self-injure.
Studies show that 30%-40% of people who self-injure are male.

Only people with Borderline Personality Disorder self-harm.
Self-harm is a criterion for diagnosing BPD, but there are 8 other equally important criteria. Not everyone with BPD self-harms, and not all people who self-harm have BPD (regardless of practitioners who automatically diagnose anyone who self-injures with BPD).

It is truly important to remember that self-harm is not unique to the borderline personality disorder (BPD) community. It’s also important not to use the terms “borderline” and “cutter” interchangeably.

Borderlines don’t all self-harm. Those who self-harm are not all borderlines. And just as importantly, many people who self-harm aren’t “cutters” at all.

People who self-injure only do so by cutting.
Although a common method of self-injury is cutting, there are many methods of self-injury. Studies also show that individuals who report repeat self-injury often report using multiple methods. Examples of other methods include:
• Burning themselves
• Poisoning or overdosing
• Scratching themselves
• Carving words or symbols on their skin
• Breaking their bones
• Hitting or punching themselves
• Piercing their skin with sharp objects
• Head banging
• Pulling out their hair
• Interfering with wound healing
• Pinching themselves
• Biting themselves

Let’s see. For me I do favor cutting. Though, burning, overdosing, scratching, carving, piercing, pinching, and interfering with wound healing are all things that I’ve done.

People that Self-harm can just stop if they want to.
Self-harm can become addictive and habit forming. So like all addictive behavior, there’s more to it than “just stopping”. Telling somebody to “just stop it” will not work and could possibly alienate them further. They need help and understanding to recover, and learn other strategies for coping with emotional pain and stressful situations. I would even argue that Self-harm isn’t the real problem; the problem is what is causing the self-harm in the first place.

It’s hard to explain and I don’t want to romanticize this, but there’s something visceral that comes from holding an implement, and seeing how much your body can take. Seeing, actually seeing, that you are alive and that blood runs in your veins. It made me feel strong. Reminded me that I could take more. Felt like a literal release of the pressure that was building up beneath my skin. Maybe it was adrenaline. But afterwards I always felt more calm. Less in pain. When you walk through every minute in emotional agony, those few minutes of emotional neutrality, relaxation, are almost as good as drug induced high. To simply not feel the consuming emotional pain for a few moments can definitely be addicting.

Self-injury is untreatable.
Although self-injury can be difficult to control or stop, most people who practice it are able to stop at some point. There is, however, no “magic bullet” in the treatment of self-injury, as the behavior is most often a symptom of any of a variety of other underlying issues. Cognitive Behavioral therapies, Dialectical Behavior Therapy, and Group or Family therapy are those therapies most commonly used to treat self-injury. Anti-depressants or other psychiatric medications are also used to treat underlying depression or anxiety. Some who self-injure also successfully stop on their own, without ever seeking formal help. Because it is most often used as a coping mechanism, however, the practice of self-injury typically does not stop until the individual who uses it has other methods to cope and is fully ready to stop self-injuring – Although SI can be difficult to control or stop, most people who practice are able to stop.

Finding other methods to cope is important. More constructive methods. It may also be about finding a reason not to self-harm. I did stop after I started therapy, but that wasn’t why I stopped. I stopped because I didn’t want to have to explain the injuries. I didn’t other people to worry. I didn’t want to turn other people off or see the disappointment or concern in their eyes. I did it for the people around me, not because I felt it was something I needed to stop. Whatever your reason, find one, on that means enough that you learn something more constructive, because ultimately, the only thing self-harm does is leave a trail of scars behind for your to remember your way back to an unpleasant place.

Anyone who self-injures is part of the “Gothic” or “Emo” subgroup.
Ok, while I may be considered Gothic, if you call me Emo I’ll punch you in the face. This is not only stereotyping self-injurers, but it’s stereotyping two subcultures as well. Aye.

Self-injury excludes no one. People who self-injure come from all types of groups, ethnicities, and economic backgrounds. People who self-injure may be male or female, rich or poor, gay, straight, bisexual or questioning, be very well or less well educated, and live in any part of the world. They may be “jocks,” “skaters,” “preps,” or “nerds.” Some people who self-injure manage to function effectively in demanding jobs; they can be teachers, therapists, medical professionals, lawyers, professors, or engineers. It is impossible to classify someone as a person who self-injures (or not) based on what they look like, the type of music they listen to, or who their friends are.

People who self-injure enjoy the pain or they can’t feel it.
Self-injury most often hurts. Sometimes feeling the pain is the whole point – a person may self-injure to reconnect with his or her body or just to feel something. There is no evidence that individuals who self-injure feel pain any differently than people who do not self-injure.

It never really hurt me that much. My pain tolerance appears to be much better than most though. It was the experience that I needed. That being said, there was definitely an element of pain, which was kind of the point. I sought out that pain, but I didn’t enjoy the pain. I didn’t derive pleasure from it. I found relief in it. It was a transfer of pain from one high concentration source, to one of less concentration which seemed to make it more manageable.

This is also why Therapist had me a little confused when she was checking to make sure that I wasn’t getting tattooed because I enjoyed the pain. First of all, I don’t (enjoy the pain - also, it just doesn't hurt that much, or at all). But secondly, I would self-harm because I needed to cope, myself, because I didn’t have anyone else I could turn to for help. Having someone else inflict pain doesn’t make sense when it’s something I do for myself.  

All people who self-injure have been abused.
Some people who self-injure have been abused but certainly not all. Reasons for self-injuring are varied and unique to the individual.

Someone who self-injures is a danger to others.
Self-injury is generally a private activity and many who practice it are accustomed to turning their anger and frustration inward rather than outward.

I’m pretty sure self-injury was about hurting myself. It was exactly that, relieving the problems I had turned inward. You don’t unblock the kitchen sink by poking a hole in the garage.

Can you think of any other myths or misconceptions about self-harm, self-injury, self-mutilation that I may have missed?

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.

False and false.

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.

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.

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.

Monday, April 23, 2012

Lucid Analysis – Trials in Therapy: Gender Queer Relationships and Otherwise

I know I said I’d post Saturday, but well, I didn’t. So you get it Monday instead.
Therapist started off the session with my Homework from the previous week, which was to think about what it would mean to me if I didn’t have female companionship for the rest of my life because I chose a male partner in a monogamous relationship. Or something along those lines. Honestly I didn’t do this homework. I thought about doing it a lot, but I quickly got side tracked and my thoughts were filled with other things. I have a little bit of that absent minded mad scientist in me. ::shrug::
I actually spent a good deal of time trying to explain to her how I feel towards women in relationships. How do you explain the attraction you feel to someone who has never experienced that kind of draw before? She kept getting caught up in these thoughts of female intimacy in friendship and thinking that would be a ‘good enough’ substitute. Women often feel very close to one another in a way that is different than male friendships. More intimate, more relatable. Yes, that’s true. That’s how I feel about Roommate. But it’s not the same thing as having a reciprocal intimacy on a romantic level.
Roommate is one of the most beautiful people I know. She’s gorgeous. She’s intelligent. She’s warm and caring. She’s steady and trustworthy. And a wonderful, wonderful friend. But we’ve never had a romantic chemistry. There just isn’t that intimate spark. For all intents and purposes, she’s straight, and while I can appreciate the beauty that is her person, without an aspect of reciprocity there’s just something missing for me to be attracted to her as more than a friend. It’s different than, say, how I’ve felt about the women I’ve dated in my past who shared that intuitive attraction. That mutual appreciation on that additional level.
Women feel different. At least the ones I’ve dated, the kind of chemistry and connection is different. I’m a little more myself. I don’t have to worry about male egos. I can be romantic and girly. I can hold doors, and buy her flowers, and wrap my arms around her without feeling like my role is wrong. Not that I can’t buy a guy flowers, or make a construction paper card, but the gesture isn’t usually as appreciated in the same way. There are just ways that don’t fit into the dynamic properly.
Two side thoughts: 1. I wonder if it would be different with a bisexual guy. 2. While I appreciate Roommate highly and she’s one of the most important people in my life, I don’t think I idealize her in an unhealthy way. I don’t need her in a way that is more than what she already is to me. I’m becoming comfortable with the idea that just because I can’t provide EVERYTHING she would want in a relationship (often I feel like if I can’t be everything, friendship, sexual, companion, etc, it won’t be enough to bind someone to me), that doesn’t mean I’m not important to her, and she won’t want to just up and walk out of my life…. More on this later.
I’ve had so many problems with men not respecting my independence that I tend to overcompensate the tough girl act. Even though if I’m honest, I like that guys can be so much bigger than me, wrap around me, and I can feel protected and safe. Which is not a feeling I tend to have with women. I’m the protector in those relationships. With men I know that I can protect myself, but in my more healthy male relationships, there’s at least the aspect of knowing they probably could/would defend me should I need it.
Both kinds of relationships obviously have their pros and cons for me, but with women there’s more of an intuitive understanding and I don’t feel the need to overcompensate, or suppress parts of myself because it doesn’t fit the dynamic properly. Having a genderqueer relationships throws out expectations of how I’m supposed to act in a relationship, not that it stops me, but there’s less pressure, and less of a concern to even have to think about these things.
Idk, I still don’t think I’ve accurately described why I feel different  in homo vs. hetero relationships. It’s just a feeling. An intuitive comfort. ::sigh::
For now though, I’m going to try not to worry about it. I still have a difficult time grasping that someone would want to “put up with me” for a long term relationships. For as much as I want a lifelong partner, I can’t actually envision it happening.  It’s all so uncertain and I’m just going to have to wait and see. Hate that.
I was pretty anxious on Thursday as well. I talked to Therapist about my anxiety about going to bed. About going to bed alone. How I stall  and stall, and even after I’m in bed I stay awake as long as I can to put off closing my eyes and being in the dark alone. It’s always been this way with me. Always, since I was very young. I hate sleeping alone. It’s a very rare day when I actually want to sleep by myself.
Naturally Therapist asked me about Tech Boy. He doesn’t stay over during the week. Even though we work together, he comes into work even earlier and let’s face it, we probably wouldn’t be getting to sleep at a reasonable hour if he did. But also, for the last few weeks our schedules have not been aligning well at all. One weekend he went out of state with some friends, the next  I went on vacation to see my family/friends back home, the I got tattooed (which still lead to an intimate evening but there was a little more caution involved because, ouch), then he was out of state this weekend, I’ll be getting tattooed again next weekend though I’ll be seeing him for sure… it’s just all kinds of not waking up with him and it’s getting to me. Therapist noticed how I get much more anxious when there are breaks in my routines. For a long while there Tech Boy was staying over, or I was at his place, every weekend. That hasn’t been the case quite as regularly as of late and it’s been throwing me off. He always makes sure to compensate by seeing me during the week, or at least doing stuff Sunday night, but it’s just not the same as being able to fall asleep with him and wake up wrapped up in each other. Therapist would like me to mention it to him, and see if we can’t get back into our more regular style of seeing each other on the weekends. I don’t to have a formal talk about it or anything, I’d just come off sounding crazy. Hi, my anxiety wants our relationship to be on a schedule so get back on track buddy. No. That just sounds awful. But mentioning that I miss doing certain things, and would like to spend more ::cough:: alone time together should be reasonable. Right?
As Therapist put it, it seems like I have either an oasis or a desert with his affection. He can be incredibly thoughtful and considerate like the Saturday when I had my  tattoo done and he brought me snacks and left early to make dinner so I would have food by the time I was done, but then other times I don’t see him at all because he spends the weekend with friends out of state. It’s hard on me and I don’t know what’s ok and what’s not ok for me to ask for. Therapist reminds me that I have a tendency to accept and tolerate too much, even if it bothers me, until it becomes too overwhelming and then I snap. She wants me to try and do things differently. Hence mentioning that I’d like to see him more regularly on weekends again. I totally get the need for guy time and hanging out with friends and would never ask him to give that up, but I’d like a little more time for us as well.
Therapist asked something about whether or not we were in love. I told her I didn’t think so. She asked me if he loved me. I don’t know. I know he likes me. He obviously likes spending time with me and seeing me, but I don’t know if that translates to more. I’m honestly not worried about it though. I like seeing him. I like spending time with him. And for once, I don’t really feel a need to overthink that. I’m having an odd, but not awful, time with my lack of object constancy. This is part of why I can’t say whether my feelings or more or not. Unless I’m in his direct presence I have a hard time holding on to feelings. Especially when our time together has been so sporadic. However, when we can’t hang out, Roommate, her boyfriend, and I have been going out and doing things together so I haven’t been lonely, I’ve been having fun, and I haven’t been as stressed out socially. So while I have a hard time  holding onto how important I might be in his life, I don’t feel as empty because that time is being spent with people that are just as important to me and whose relationships I have faith will be steady and solid for me.
If Roommate and I were from the 20's.
Which is a special revelation for me because Roommate will actually be moving and we won’t always be living together. But we’ll have more on this update a little bit later.
At the end of our session, as is usual, Therapist told me that I’m a joy to work with. That she loves talking to me because I’m very bright and intelligent and I have such an interesting perspective on things. She tells me that I’m wonderful and that I truly am a good person with loving warm qualities. That I’m a good friend to the people in my life and I deserve to be happy.
This always makes me a little uncomfortable. I have two simultaneous but separate experiences when she does this. One, I’m uncomfortable because, while I believe she is telling me the truth as she sees it, I do not believe this of myself. I can only think of the things that I have done wrong, how I haven’t been a good friend, how I have made mistakes and that clearly makes me not the wonderful deserving person she things I am. And then I have the cognitive aspect that wonders if this is simply part of the psychological limited reparenting that often accompanies BPD therapy. Is she giving me praise and approval for the person that I am because I didn’t get that growing up and she is trying to provide that for me now?
That doesn’t mean I don’t deserve it. I can appreciate that it may be a psychological technique but at the same time it can also be the truth. She does acknowledge that I’ve made mistakes in the past, but she also reminds me that I try to correct these actions. Or if I can’t, make different, better, decisions going into the future. I am making more appropriate choices as I go into the future and doing this in a progressively more responsible and emotionally balanced way. And that is something that I deserve credit for.
Therapy is a lot of work sometimes. A lot of work, but  in the end, very worth it.

P.S. I’m not okay with this new Blogger style change. I have to relearn where everything is and it feels too empty and open. I don’t like it =( It’s hard for me to adjust to stuff like this.

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