Life in a Bind – BPD and me

My therapy journey, recovering from Borderline Personality Disorder and Generalized Anxiety Disorder. I write for welldoing.org , for Planet Mindful magazine, and for Muse Magazine Australia, under the name Clara Bridges. Listed in Top Ten Resources for BPD in 2016 by goodtherapy.org.


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The multiple meanings of self-injury: raising awareness and examining preconceptions

*TRIGGER WARNING: SELF-HARM*

Three years ago I was self-harming three or more times a week. It was such a big part of my life that it felt as though it had become my identity. My emotions were on a constant rollercoaster and my close relationships were under immense strain. I couldn’t make sense of the possibility of a future, or of having a place in the world. I felt helpless, life felt out of control, and depression was eating me up.

I started self-harming as an adult in my thirties. Although it is often perceived as a ‘young people’s issue’, self-harm affects all age groups and not all adults who self-harm will have started as teenagers. Self-harm is a coping strategy, and quite often the strategies we adopt are determined or influenced by the situations we find ourselves in. In my case, the coping strategies of my early twenties – mainly around intense relationships – were simply (and thankfully) not as readily accessible in my ‘married with kids’ situation. The first time I self-harmed, it was in response to perceived abandonment by a therapist; a couple of past coping strategies did come to the fore, but in desperation to find something that would alleviate the distress, helplessness and self-hatred that I felt, I turned to something more readily available, that I felt would be less destructive for those around me.

And it worked – for quite a while. I do not mean in any way to advocate self-harm; and I hope that ultimately I will be able to rely on ‘healthier’ ways of coping. But I think it’s important to acknowledge that those who self-injure do so because they find it helpful, or at least they did when they first started. For those who use it, it does alleviate distress, and many would say that it has afforded them the possibility of staying alive when their emotions felt almost too intolerable to be borne. As well as this fact, if there is one other thing that I have learned about self-injury that I am passionate about wanting to convey to others, it is that it is incredibly complex, and has multiple meanings. There are as many reasons why people self-injure, as there are people who do it. The reasons vary from person to person; but also, crucially, they can vary for the same person, at different times.

I have used it as a way of punishing myself when feeling worthless or guilty or ashamed. I have used it as a way of punishing others – even though they never knew about it – when I felt hurt by them but incapable of conveying it directly. I have self-harmed in order to try and cope with immense emotional pain by masking it with physical pain instead. Conversely, I have done it in order to feel something, anything, rather than bear with the truly horrific frustration of feeling emotionally numb and cut-off from myself. I have used it as a way of expressing acute distress, even if only to myself – a ‘silent scream’ as it is sometimes called. And I have used it as a way of self-validating my distress and keeping it and myself ‘real’. So often my ‘inner critical voice’ would accuse me of being a fraud and ‘making it all up’; seeing the cuts on my body was ‘evidence’ of the reality of what I was experiencing. As the days went by and the cuts started to heal a little, and as even more days went by and the marks started to fade, I used to become extremely anxious – as if the reality and legitimacy of my emotions depended completely on those marks.

But by far the strongest and most enduring factors behind my self-injury, have been a desire for comfort and control. When I first started self-harming my confidence and self-worth were at their lowest ebb, and it felt as though cutting myself was the only thing in my life that I had power over. And although I know how strange this will sound, the self-injury did not just represent something I could control, it represented the only thing I felt I could ‘get better at’. Having always been afraid of pain and the sight of blood, being able to overcome that actually felt like an achievement. As for comfort – I have never fully understood this aspect of my self-harm, and yet it is a powerful motivator for me. When I feel immense sadness, grief, or abandonment, pain itself seems like a great big, enveloping hug. I don’t understand why I have made a connection between pain and comfort, I just know that for some reason that connection has a great hold over me.

People talk about self-injury being addictive, and I do think that for a while, I was very emotionally dependent on it, if not physically dependent. At some of my worst times I have sat in meetings at work unable to get thoughts and images of self-harm out of my mind, and giving in to the desire to hurt myself only increased the need to do so again. At one point the desperation was so strong I went in search of ‘suitable tools’ in the stationery cupboards. When I first started self-harming I tried to ‘restrain myself’ and only use it when I felt ‘really bad’. I think I knew that if I started to give in to it regularly, it would become both more frequent and less effective. And that’s exactly what happened. It became my ‘go-to’ coping mechanism; my first port of call, rather than my last. It acquired a kind of habitual nature – and that too, can be a feature of self-harm for many people. It isn’t always carried out impulsively or in the height of emotion. For some people self-injury is ‘ritualistic’, involving particular times, places or tools. For me, the practical restrictions of having a partner and children in the house, meant that I was rarely able to self-harm impulsively and ‘in the moment’.

And perhaps the strangest thing of all – sometimes I self-harmed when I was happy. At the time in my life when self-injury felt like a core part of my identify and my main means of expression, it felt ‘natural’ for me to turn to it to express positive emotions as well. Moments of joy were incredibly rare at that time, and when they came my first thought was to respond by cutting. Perhaps it was connected with the part of myself that found it hard to accept and hold onto hope in any form, including accepting joy – but I have to be honest and say that I don’t really understand this aspect of my self-harming either. But it’s an example of how self-injury can confound people’s expectations and of how assumptions should never be made about what it means to any one individual.

My self-harming has gone from three to four times a week, to once a month or less. It has gone from involving numerous cuts on each occasion, to normally not more than one or two each time. The change has been very gradual, and thinking about how and why it has happened, leads me to believe that there are two key factors to reducing self-injury. The first is a close supportive relationship with someone who accepts and tries to understand both the person and the self-harm – in my case, this is my therapist, whose acceptance of my self-harm is just part of her unconditional acceptance of me as a person. The second is making the decision to ‘postpone’ self-harming. Putting a distance of time between the desire to self-injure and the act itself, has the effect of allowing the intensity of my feelings to reduce, as well as the desire to harm. In addition, postponement doesn’t feel as though I am trying to prohibit self-harm or replace it with something else. Postponing feels easier because I tell myself that I can still do it; but I will simply do it later. It doesn’t try and remove the option and I still feel I have some control. But 9 times out of 10 postponement does mean that I do not end up cutting.

The frequency of my self-harm started to change very soon after I started blogging. That is because my main method of postponement is writing; and I am using it now. Earlier, I felt a strong desire to ‘punish myself’ but I made a decision to write instead – and it is what has kept me from self-harm on countless occasions over the last two years. These days, the strength of the bond with my therapist (who I have been seeing for two and a half years) also means that I want to stop for her – and although I know that eventually the desire to stop has to come from within me, at the moment I will take any motivation I can find! Postponement works for me, most of the time; but fundamentally, it is the relationship with my therapist and the ongoing work that we have been doing in understanding and addressing my underlying difficulties and distress, that is the key to helping me reduce and eventually to stop self-harming. Self-harm is not the message, but the messenger; and we shouldn’t be looking to shoot the messenger – but to figure out who sent them, why, and what it is that they are trying to express. I believe that that is the most compassionate, patient, respectful and enduring way of making the messenger, finally, redundant.

[Self-injury awareness day takes place on 1 March each year. Please note that although I have used the words self-injury and self-harm interchangeably in this post, they are slightly different. Self-injury is behaviour that causes direct harm or damage to one’s body (such as cutting or burning). Self-harm is a broader concept that includes self-injury, but which covers other behaviours such as eating disorders, risk-taking behaviour, and substance misuse.]

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