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Geek

Cognitive Dissonance

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I am intensely ashamed of my self-harm. I don't want to talk about it or show my scars or wounds to anyone - strangers, my care team, friends, acquaintances.

I am also wanting to do significant damage in very visible places on my body. I do not know to what end. It just feels like need and deserving.

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self harm is such a push-pull kind of thing. you'd think the shame would stop us, but it kind of just makes it worse, in my experience. for me it's like, "i deserve this shame."

i realize this might not be possible considering how you feel, but talking about why you're so ashamed of your SH might be good therapy material. if you understand it more, you might be able to cope with the urges better. shame is a powerful prison to be in.

i see you posted this last night. how are you doing right now?

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4 hours ago, echolocation said:

self harm is such a push-pull kind of thing. you'd think the shame would stop us, but it kind of just makes it worse, in my experience. for me it's like, "i deserve this shame."

Definitely.

4 hours ago, echolocation said:

i realize this might not be possible considering how you feel, but talking about why you're so ashamed of your SH might be good therapy material. if you understand it more, you might be able to cope with the urges better. shame is a powerful prison to be in.

I have not talked much about it in therapy, though my Tdoc is aware that I do it sometimes. She has historically asked me to call her beforehand, or pushed alternative coping mechanisms pretty hard... and mostly that just results in my not talking about it again for a long time. Maybe I feel judged?

I saw her yesterday and it came up that it is something I've been doing again recently. She didn't respond just trying to quash it, but asked questions and I ended up talking about it in more depth than she's invited before. Not that it was a lot... but it was something, and it really freaked me out. I found that since then I have been quite anxious about having discussed it with her and some of what I disclosed.

4 hours ago, echolocation said:

i see you posted this last night. how are you doing right now?

Not good. I am not engaging in publicly visible or extreme self-harm, but I'm struggling to keep it off the table altogether. I am not doing very well at identifying feelings, beyond ongoing and overwhelming emotional pain.

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6 hours ago, echolocation said:

self harm is such a push-pull kind of thing. you'd think the shame would stop us, but it kind of just makes it worse, in my experience. for me it's like, "i deserve this shame."

That's a good way to describe it. I didn't have quite the same thoughts about deserving it, but the emotional weight of the shame certainly adds to the urge to SH. I think the effort of hiding it does, too

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16 hours ago, Geek said:

I saw her yesterday and it came up that it is something I've been doing again recently. She didn't respond just trying to quash it, but asked questions and I ended up talking about it in more depth than she's invited before. Not that it was a lot... but it was something, and it really freaked me out. I found that since then I have been quite anxious about having discussed it with her and some of what I disclosed.

good for you for opening up, i know how awful it can feel. anything you can give her that allows her to better understand what's going on for you is ultimately going to be helpful therapeutically. i'm sorry it's bothering you now, though. where is your anxiety based? is it fear of being visible to her, fear of acknowledging something shameful? you don't have to respond to that, but it's worth thinking about. for me (and not saying this will/should work for you), trying to get to the root of my amorphous anxiety feelings sometimes helps me cope better with them.

16 hours ago, Geek said:

Not good. I am not engaging in publicly visible or extreme self-harm, but I'm struggling to keep it off the table altogether. I am not doing very well at identifying feelings, beyond ongoing and overwhelming emotional pain.

i'm wondering if you're being too hard on yourself by expecting that you should be able to keep self-harm off the table entirely right now. i'm not telling you that it shouldn't be a goal at all, but maybe one to focus on when you're more stable. i'm suggesting you focus on harm reduction instead, in whatever form that takes for you. for me, slapping my thighs so they sting for a while helped avoid harm that would break skin. i also have allowed myself to make just one superficial injury, and then made myself sit with it for several minutes while being very present with the feeling of endorphins flooding. often, when i do that, i'm able to stop after one injury, but of course, that's just me -- might not work for other people. my point is, anything you can do to keep your self-harm as small, superficial, and clean is helpful right now.

your worthiness of help and love is not associated with your self-harm. it's a coping mechanism that we sometimes go to when we're unwell, not an indicator of your goodness or badness as a person. please try to be kind to yourself right now, you're doing the best you can with the tools that you have.

how are you doing today? i meant to reply yesterday, but i didn't have time to write out a proper reply.

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7 hours ago, echolocation said:

good for you for opening up, i know how awful it can feel. anything you can give her that allows her to better understand what's going on for you is ultimately going to be helpful therapeutically. i'm sorry it's bothering you now, though. where is your anxiety based? is it fear of being visible to her, fear of acknowledging something shameful? you don't have to respond to that, but it's worth thinking about. for me (and not saying this will/should work for you), trying to get to the root of my amorphous anxiety feelings sometimes helps me cope better with them.

Oh, it's entirely about being visible. Historically the people who have acted like sharing thoughts/feelings along the lines of those I did... have acted like it was okay (to have shared) in the moment, but it's really not.

7 hours ago, echolocation said:

i'm wondering if you're being too hard on yourself by expecting that you should be able to keep self-harm off the table entirely right now. i'm not telling you that it shouldn't be a goal at all, but maybe one to focus on when you're more stable. i'm suggesting you focus on harm reduction instead, in whatever form that takes for you. for me, slapping my thighs so they sting for a while helped avoid harm that would break skin. i also have allowed myself to make just one superficial injury, and then made myself sit with it for several minutes while being very present with the feeling of endorphins flooding. often, when i do that, i'm able to stop after one injury, but of course, that's just me -- might not work for other people. my point is, anything you can do to keep your self-harm as small, superficial, and clean is helpful right now.

This is a good thought. I have been trying to think of any action as harm reduction, given where my mind is focusing at the moment. I haven't tried your second suggestion, but I might.

8 hours ago, echolocation said:

your worthiness of help and love is not associated with your self-harm. it's a coping mechanism that we sometimes go to when we're unwell, not an indicator of your goodness or badness as a person. please try to be kind to yourself right now, you're doing the best you can with the tools that you have.

how are you doing today? i meant to reply yesterday, but i didn't have time to write out a proper reply.

You're so kind echo. I really appreciate it.

Honestly, I feel like I'm hanging from a cliff and my fingers are slipping. I've been asking for help/support from my care team and they can't. I'm starting to feel like it doesn't matter. 

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it's scary to feel that your care team can't help. that might be a sign that it's time to consider going IP. it's probably worth asking what your standard is for when is it absolutely time to go to the hospital. remember that an emergency doesn't have to be acute to be an emergency. to make an analogy, plenty of folks with physical conditions live their life as normal as they can while working around their pain and symptoms, until something happens to physically prevent them from functioning, at which point they usually end up hospitalized. lots of people get scolded by their docs for not coming in earlier. just because you're able to maintain some function doesn't mean you're not at emergency levels.

can you hold out until you see your pdoc? i'm worried about you, geek. i like seeing you around here.

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I saw my pdoc on Friday. She gave me samples of Fetzima to try. I tried to tell her that things are not going well, but I don't know if she understood. I spoke to my tdoc on the phone on Friday afternoon. She wants me to be kind to myself.

Maybe I would feel better if someone was even just talking about doing something other than maintaining the status quo.

Much of this afternoon I have been toying with harming myself bad enough to go to the ER - not the extreme and very visible damage that is often on my mind. Just... my usual thing but a little bit more.

Maybe it's some kind of validation. A "reason" to hurt? A way to show others how much I hurt? I don't know.

God I'm fucked up. 

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i'm glad she gave you something new to try, but the trial for any new drug is so long. i agree that she doesn't seem to realize how bad things are.

i think self harm is definitely a way for a lot of people to turn internal pain into external pain so others can see it too. when i'm depressed i feel wrong if i don't have any injuries on my body -- it feels incongruent to how i feel inside.

would it maybe be easier to write out something explaining how bad you feel and give it to pdoc/tdoc next time you see them? i know it's hard to properly express how bad things are when you're talking to someone. or email maybe?

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