Motivation for self-harm, and alternatives

Trigger Warning: This post discusses self-harm, and references feeling suicidal.

This post’s focus is the often invisible self-harm that happens without people noticing it, normally. I explore the causes of myself having self-harmed in the past.

See here for help on minimising the harm you do to yourself. Some techniques I’ve found useful are snapping an elastic band against yourself, punching a pillow or sofa or running. Distracting yourself is a good option as it lets the emotions dissipate so you don’t end up harming yourself (see this post). I often count from 1-8 again and again when feeling anxious.

Should you ever want to kill yourself call someone you trust, a service like Samaritans 116 123, your local CRHT (if you have the number), or just 999. If you don’t live in the UK the numbers you have access to will be different.

Punishment

Self-punishment is a way of trying to cope with some “crime” you feel has been committed by you. It only emphasises the “crime”, and the goal is to make you feel worse as the punishment.

The crime could be an unwanted intrusive thought, or something like fogetting a chore. The action can be tiny, with no-one else aware of it, but to you it feels significant. A rational response would be to acknowledge that it happened, and move on, which is what you have to do in the end.

As the least extreme example (and not in the self-harm category) you could say not watch a series you like on Netflix, or make yourself go to bed early. This just emphasises that you were unhappy with the action, but, as I’ve found, isn’t any good at preventing it in future, as I just obsess over the mistake more.

At the other end of the spectrum you could feel you deserve to die for the action, and take some steps to do that.

Inbetween the two extremes are superficial cuts (where the cut draws blood, but doesn’t need treatment), serious cuts (which need treatment or leave very nasty scars), and burning. Any self-harm can leave a mark.

The main effect of the self-harm is it’s shock value as I find I am now well and truly distracted as I’ve done something worse that the original problem!

This gets out of control for me. As a tolerance develops to the mild self harm, so more extreme self harm is used to get the same shock again. This escalates quickly and is dangerous. I (back when it was a major issue) ended up taking it too far, and ending up in A&E, which persuaded me to stop it for a while, although not forever, the cycle repeated a few times.

It’s not an issue for me at the moment though. After seeing a psychologist I’ve found it easier to accept that I’m OK and that I mess up, but it isn’t such a big deal.

Venting emotion

When suffering a mental illness the distress felt can feel like it is inexpressible. So damaging yourself is viewed as an option.

The type of self-harm used and how extreme it is varies between people. I’ve found I tend to ramp up how severe it it is quickly, as I use it as a last resort to vent, and then next last resort is always worse than the previous one. I do know people self-harm regularly, every day a consistent amount without it getting worse over time.

Hitting something soft or smashing ice cubes is a safe way to vent aggressive emotions as it doesn’t cause any damage.

If you’re unbearably sad cozying up in a blanket is a good way to make yourself feel better.

Obsessing over self-harm

Sometimes I find my mind obsessing over self-harm, and I think about a specific way to hurt myself, again, and again, and again; which gets exhasting to just not hurt myself despite my mind thinking about it. For me, at least, this is part of suffering from OCD; what you obsess over can vary massively between different people with OCD, so some people may not even consider it.

Exhasting to just not hurt myself

Me

After several days of my mind obsessing over it it can feel easiest to just harm myself to get rid of the thoughts. That’s pretty much what happened today when I cut myself, the worst incident in a while.

Conclusion

The thoughts behind the self harm vary a lot, but the results appear the same, and none of it is ideal. Professionals refer to it as a maladaptive behaviour, as opposed to an adaptive, healthy response.

It can feel like you’re cheating by distracting yourself, or minimising the distress by not self-harming. You’re really not, you’re just coping differently in a way that will last and be usable forever.

Advertisements

Am I abandoned by you?

Yes? No? Are you sure?

Didn’t I feel like this last week? It wasn’t true then…

Sometimes the smallest items can trigger feeling abandoned by an individual. A late reply to a message. They forget to message you.

Sure, some of the time it’s real, but most of the time it isn’t a slight to me personally. So far I’ve always found there’s a good reason. Eventually messaging resumes, with no issues remaining.

The impulse is to disconnect from the individual so this never happens again. I abandon them first, so they can’t leave me. From experience this isn’t ever the right technique, and when the reason clears up, they message me, without prompting.

Coping with these events is normal. Other people have stuff going on. However sometimes it can escalate, when both sides feel abandoned due to experiencing mental health issues.

A not so great way to test whether you’ve been forgotten is to not message the person on the grounds that they will message you. This isn’t a good idea, don’t do this at home, I’ve been advised by a mental health professional that it is destructive to relationships. It usually works just fine, the other person messages me; all my friends have “passed” the test way more than once.

This testing falls to pieces when both sides try the same tactic. There aren’t any messages. This tends to happen when both sides are experiencing low mood.

There’s only one solution, not running this “test”. Easier said that done, as the moment my mood crashes I lose the motivation to resist running the test. It’s really hard. When my mood is stable, I rarely consider it, but when my mood is low, it is done all the time.

Not sure that I can ask someone else to avoid doing it though, as I know that even knowing it’s a bad idea I still do it anyway. So how can I ask someone else to do better than me?

There isn’t a neat solution. Just trying not to jump to the worst conclusion, and then do the same again, again, and again.

Waking up

I have to do this every single day. It’s usually the worst part of the day though, with the behaviours generated by having OCD.

Step 1: Leave my bed

Leave my bed. This is the easiest part, so long as I don’t touch anything.

My OCD splits all the environments in my flat into different contamination states. In the past being in bed didn’t count as having any contamination, although in the last year it’s evolved into being avoid a state all of its own.

Step 2: Breakfast

At this point I have two choices.

  • I can wash my hands twice so that I can touch my cupboards (estimated time 30 minutes)
  • I can use disposable gloves as a barrier between me and the things I touch (estimated time 30 seconds)

Now onto making and eating breakfast. Put my granola with milk in a bowl and eat it.

Because of the contamination level from the contact between my mouth, which hasn’t been cleaned yet and (in)directly on other items, the bowl, spoon and surface now require cleaning before I can use them later in the day.

I usually don’t clean them until later.

Step 3: Netflix

I know have to change gloves to ensure I don’t contaminate my phone from the breakfast items. I’ll break my phone from cleaning it later, it has happened to more than one phone.

This step is just while I work up the motivation to have a shower. Depending on what I’m doing later and how anxious I am this state could last between 5 minutes and 5 hours.

Step 5: Shower

Including disinfecting the bathroom floor,washing my hands, cleaning myself and brushing my teeth this part usually lasts about 2 hours.

After this the bathroom floor and any sinks I’ve used are now contaminated from whatever I’ve washed off. Exactly what that is and why it’s a big deal doesn’t matter. It just is.

Step 6: Flat cleaning

This bit just eliminates any contamination created on any surfaces or sinks by the previous steps. It means that for the rest of the day I don’t need to worry about contamination as touching the items will no longer feel contaminating.

Done

I’m ready to start the day now.

If that seems tedious and and excessive, that’s because it is. With OCD I’m aware of the irrationality of what I’m doing, but I have no real means to control it.

This is my start of the day, every day. On the plus side, for today, I don’t want to hurt myself.

The real value of distraction

Trigger Warning: Post discusses self-harm and avoidance strategies.

Distraction

When interacting with mental health professionals they often advise you to distract yourself to avoid doing something dangerous.

It can feel like they’re being dismissive “just distract yourself”.

Sometimes distraction really doesn’t work, but most of the time it just buys time. Buying time is valuable though, often the impulse to do something dangerous isn’t strong enough to last a significant amount of time. By distracting myself Igive time for the impulse to fade, and when it does, I’ve “won” – I haven’t hurt myself.

For example, today, I wanted to burn myself. I don’t keep a kettle on hand, which means heating up water to burn myself in a saucepan is going to take a significant amount of time. Today, by the time I’d put water in a saucepan, and started heating it, the impulse faded giving rise to the thought “what on earth am I doing”, at which point I poured the water down the sink and went out.

Usually 20-40 minutes is the estimated time for a normal impulse to last. The problem is when I disassociate, as that can last for hours, or even days. Disassociation is a when I feel disconnected from reality, and it’s as if my mind is still operating, but I’ve lost control. The best analogy I have found is it’s like being in a car, with the brakes broken, accelerator locked down and doors jammed, hurtling towards the edge of a cliff. You can steer to adjust how you fall, but you can’t avoid falling off the cliff.

It’s like being in a car, with the brakes broken, accelerator locked down and doors jammed, hurtling towards the edge of a cliff. You can steer to adjust how you fall, but you can’t avoid falling off the cliff.

Me

There’s very little that can be done to prevent me from hurting myself in that scenario, unless another person realises what is happening and gets in the way. As I’ve discovered that is incredibly unlikely, see below about seeking help.

Similar strategies can work. In this scenario I find myself tricking myself into doing a quite long sequence of steps is needed to be completed before I can do that final action of self-harm.

The steps can include procuring the items I need, decontamination related to my OCD, or tidying up my room/flat under the reasoning that whatever happens I’m left with nothing to clean up, or whoever has to deal with what I’ve left behind isn’t left with much to do if I’m suicidal.

Seeking help, personally

Trying to indicate to someone that I need help when distracting myself is something I find incredibly difficult. When in crisis I can’t justify threating to do something dangerous or preventing myself from doing whatever it is. Hence the most I can justify is giving a minimal indication that something isn’t right. Generally people will have no idea that it indicates a crisis, but if they know me well enough they might or might not realise what it means. So technically I’ve left it up to an unlikely chance whether someone stops me, which as far as I’m concerned at the time isn’t the same as getting someone to stop me.

Part of the difficulty in seeking help is wanting to avoid being viewed as threatening to do a dangerous act. Not really seeking help is, as far as I am concerned at the time, very much not threatening to do something. From my point of view as I’m not actually saying anything about doing something dangerous.

Included in that is that I don’t want to bother anyone if I’m not actually going to hurt myself. Unfortunately by the time I know whether or not I’m going to it’s too late to seek help, as I’ve already done or not done it.

There’s also the fear that I’m not worth the help and support. As far as I can tell that is entirely irrational. At the time though, it’s hard to believe that.

A lot of the time when professionals realise something is very badly wrong, it’s way too late and I’m already need A&E for treatment.

I have requested help before a crisis, but it’s usually a long time before when there isn’t any immediate threat.

That can make helping me difficult, as I’m aware, and make me seem unpredictable. I’m not sure how to break the thought patterns so that seeking help is viewed as a valid option.

If you can seek help, do!

Transition and recovery

This blog will cover my experiences recovering from OCD and its complications.

In the last week I have been told that I am no longer ill enough to have the local CMHT follow me.

The CMHT is the community mental health team. They work with people whose physical health is at serious risk as the result of a mental health problem. That no longer applies to me as it’s been nearly 4 months since the last incident where I was at risk.

While it’s good to have a sign of progress, I’m going to miss the members of the CMHT who keep track of me. I will lose having someone reliable to talk as they will no longer be available.

The road ahead is unlikely to be smooth, but, fingers crossed, I’ll do more than just survive.