Tag: urges

Therapy

Self harm or self care?

suninthespring

(Please note: This is about self harm and suicidal urges, self-destructive thoughts, and specific ways I try to harm myself (including with food).)

I’ve been struggling recently with basic self care. Anything that I know is good for me or that will help me is hard for me to do.

I used to self harm myself in one specific way. I told my DBT therapist over the summer about it, and I’ve been tracking it on my diary card and using skills like distraction, “riding the wave,” etc. to not engage in the behavior. And, I’ve been successful! I haven’t done that behavior in over three months. Yay!

But… the urges to hurt myself or kill myself haven’t gone away. I have the urges as much as I did when I was still using the behavior. Sometimes I’m successful in using distraction or some sort of positive coping mechanism to manage and resist the urge. However, if the urge is very strong, or I’ve been feeling it constantly for several hours and nothing seems to be helping, or I’m too hopeless to believe skills will work… then I bargain with myself.

I say, “Okay, fine, I won’t kill myself. But, as a compromise, I won’t eat dinner. I know that eating dinner is something that will help me and make me feel better, and that is exactly why I won’t do it.”

I’ll say to my emotion mind, “I know you have the urge to hurt yourself. You can’t do that because it’ll mean you have to stop trauma work. But you still feel intense shame and anger at yourself and want to harm yourself. So, here’s something. I know you feel tired and want to go to sleep. How about you just don’t go to sleep?” And then I stay up until 2 am and don’t get enough sleep and feel more angry and guilty the next day and even more tired.

I’m still harming myself, just in less obvious ways. Not eating enough. Not sleeping enough. Not brushing my teeth. Avoiding friends because I know they’ll make me feel better. Avoiding using skills because I know they’ll make me feel better. Not submitting applications because I’m mad at myself and don’t think I deserve it. Eating chocolate late at night because I know it’ll keep me awake, and I want to prevent myself from taking care of myself and sleeping.

It’s almost easier to self harm in these ways because it’s a smaller decision to make. It often doesn’t require action, just intentional inaction.

Writing this out is helping me realize that self harm is still an issue for me, even if it doesn’t leave visible scars. I’m losing weight, even if it’s not noticeable. I’m hungry all the time. I sometimes have an erratic sleep schedule. My teeth hurt often. My eyesight is getting worse because I refuse to look up from my phone or computer when I start to get a headache. I feel as though I need to feel the pain of the headache because I deserve it.

So, it’s not good. There are negative consequences to doing these things. My “cured” self harm has really just been transformed into different behaviors because I was replacing the behavior, not acting opposite to it.

To be fair to myself, I do sometimes just distract and not do anything harmful. I sometimes reach out to friends or my therapist. I sometimes eat meals because I know it’ll make me feel better. There are just some times that I don’t…

I think the solution is opposite action. Instead of acting on the urge to harm myself, I want to acknowledge that it’s an urge, use the self talk that my therapist and I came up with, and act opposite to the urge.

The self talk is along the lines of,

  • “This is emotion mind talking. It’s strong, but it’s emotion mind.
  • Using skills has helped in the past.
  • Sometimes skills take a while to work.
  • Skills “working” is relative.
  • Distress tolerance is supposed to help get you through the moment, not make you feel better. If you feel better, that’s an added bonus.
  • When you are feeling better, you like feeling better.
  • In the times that you’re not feeling like this, you would want to take care of yourself and help yourself feel better.”

Opposite action to the urge to hurt myself and to the emotions of shame and guilt is to be kind to myself. Some options are: putting lotion on my skin instead of hurting my skin, eating food, hanging out with friends, wearing pretty clothes, watching or reading something funny, etc.

Opposite action to self harm is self care. It’s hard to do because it’s the very thing that the self harm urges are telling me not to do. That’s where the self talk comes in. I have to believe it’ll work and have enough perspective to remember that there’s more than this moment and that self care or skills have helped in the past.

If I’m not thinking clearly enough to do the above, then distraction, calling my therapist, or other skills (if I’m willing to use them) are helpful.

In conclusion… self harm is still a problem for me, and I, Wise Mind Me, want to use the techniques listed above to take care of myself as opposite action to the emotions and urges I sometimes feel. I do deserve to feel better.

Therapy

Wanting to be my friends’ therapist

suninthespring

Recently I’ve been struggling with an urge to act like a therapist towards my friends who are emotionally unwell. I am not a therapist.

And I am certainly not their therapist. But, I can relate to many of the issues they struggle with. I know (some of) the issues well and know ways that I have overcome them or ways that other friends have overcome them. I am also a friend. I enjoy spending time with, appreciate, care about, and want the best for my friends. So I want to help them, and feel like I am able to help them, but…

A therapy relationship is different from a friendship. People aren’t always ready to be pushed or analyzed—they’re just saying random things, and even if the things they say are concerning, people just want to go about their day and not be bothered, corrected, or dragged into painful memories. I wouldn’t want to push that on someone, and I don’t want to act like I’m superior to anyone.

I also don’t want to constantly push advice on people, even if I think it could really help them and it comes from a place of good intent. I very rarely say, “you should…” because I know from personal experience and from hearing many people’s experiences that “should”s can be annoying and unhelpful and make people feel worse. But I do say things like, “When I’m feeling x, I find that y really helps me z” and “What if you did x?” I don’t think saying these things is harmful if I don’t say them that frequently (I think they’re probably helpful and appreciated), but if I’m saying them a lot, I wonder if it starts to get annoying.

Now that I’m thinking about it, I guess one of the main ways I interfere is to try to change my friends’ negative beliefs. I have one friend that consistently says things about how she’s lazy, she has no friends, she’s a bad influence on other people, people don’t want her around, she’s failing, etc. I feel really sad when I hear her say these things because I firmly believe they’re not true and that that’s just her depression talking. It makes me really sad that she truly sees herself this way.  I sometimes try to argue back and say that I disagree, and we can agree to disagree, or I try to remind her that I am her friend, x is her friend, and she was really worried about that last test but ended up doing well so maybe this one won’t be as bad as she expects, and Halloween is coming up so that’s something to look forward to, etc. I don’t know if I’m actually being helpful though. I suppose I could ask… asking would be a good thing to do but would require courage and finding the right time and wording it correctly.

I just want to fix all my friends’ problems.

Another part of my problem is that I’m not entirely sure how to have a close friendship without it being a therapeutic relationship. My relationship with my therapist that I’ve had for a few years was my first real place I shared a lot of things I had kept inside me for years. I feel like when I make close friendships now, they’re modeled on that relationship – I ask questions and listen similarly to how my therapist would. (Not the same way, though; I’m my own person) And the people I feel closest to are the people I talk about my mental health with.

Most of my closest friends also have mental health issues.

I’m not really sure where I’m going with writing this. I’m also not sure what to do about this in general. I’m not even sure if it’s a problem or not.

I guess the part that’s a problem for me is that I feel more distant from my friends when I’m acting more therapist-y because I feel like I’m less “on their level,” even though I am.

I also want to be friends in a way that doesn’t have to do with mental health. I guess I do this sometimes when we watch movies or go to events or cook together or talk about what makes soup soup (it was a hilarious discussion).

It’s also a problem for me because I stress about my friends not doing well, and I worry about whether I’m acting wrong and what I can do better.

And, this could also be a problem for my friends if I’m making them feel worse.

So… something to think more about later 🙂