Tag Archives: dermatillomania

Therapy 2020: Session 16

Date of session: 16/12/2020

Please be aware that some of the content may be triggering. Please take care 💚

Today was my last session of 2020. It was also meant to be the last session of this course of therapy but that has changed and will be now continuing in the new year.

Yet again the anticipation of the session was overwhelming. In all honesty I’ve just felt incredibly tired since last week and no idea what else I have felt. I’ve not really had the time to investigate what I’ve been feeling either.

Today we looked again at the stopping of self harm. To do this we looked again at the motives behind it and how I feel when I try to stop. The huge anxiety it gives me. This made her more sure this was now an OCD behaviour. We looked at intrusive and obsessional thoughts and how they relate to my thought patterns. I did get a little frustrated that I wasn’t being understood.

Because of looking at this as an OCD behaviour it has meant we are going to look at a certain way of combating this. I think it was called habituation and changing the way I see it from a need to a want. We looked at what is classed as a need and what is classed as a want. It did leave me feeling guilty about my self harm. There will also involve a behaviour experiment about what might happen if I don’t act on the thoughts.

Part of the habituation means giving up the self harm and riding out the urge and the anxiety it causes. This feels scary and my anxiety started to creep up just talking about this. It was edging on panic. The thought of losing the self harm is scary. I’m terrified. I have to log everything about how I feel, what I think, what I do to distract/help myself and how long the anxiety lasts. Apparently anxiety shouldn’t last more than 40 minutes. This is not my experience but we shall see.

This time of year is hards for me. Part of me wants to say this isn’t the right time to stop but is it just another excuse? I’m dreading later on when I don’t do it. Will I just be a failure either way?

I have two weeks to see how I go. Two weeks until another session. I hope not to be a burden to others. I’m hoping I don’t compensate with other behaviours I use to ease anxiety. We shall see.

Lost In Lockdown

So it seems like the world has been shut down for forever. Everyone is finding it tough. People are losing loved ones or being kept away from them at least. Life is restricted. Unfortunately my mental illness has decided to take advantage of this situation to cause ultimate unpleasantness.

I know this lockdown is not fun for anyone. I’m not pretending that I’m the only one negatively effected. Everyone seems to be in the same boat. But unfortunately that doesn’t help make it easier. In fact it’s making it harder. I feel guilty that I need support. I feel like a burden when I know so many are struggling to deal with this. I hate myself for being able to access support yet still feel on the edge.

The thing is I know I would tell any of my friends who are mentally ill and struggling that it’s OK and mental illness doesn’t make it easier but harder. That it will impact you more as you have to work harder than everyone else to stay well. I’ve even said these words to others. But I can’t apply it to me.

I think also that as things that help keep me more stable have been removed temporarily due to the lockdown this is going to make it harder. I’ve been lucky that my mental health team have given me permission to exercise more than once a day. This is allowed for medical reasons. (For more information click here.) But there are other things I’m missing that I’d not even realised I needed.

Social contact for me has always been exhausting and something I need a break after. I thought I’d be OK without it as I still can contact friends and others through social media or WhatsApp. But it turns out I need to physically see people. I need hugs. I need to be closer to them. I miss them. Yes I may need quiet time after but I still need the contact.

While we can all say lockdown is not our ideal situation I have found some things that are helping keep me a little bit saner (never completely sane, that ship sailed long ago). I’ve rediscovered things I liked doing. I’ve discovered I’m more skilled in them than I thought and that they can help others feel better. Drawing has been a major one for me, with me drawing animals and characters for others and children.

I’ve also found it useful to set myself projects. I’ve put together things I’ve been meaning to do for ages, I’ve built Lego I’d been meaning to make or made friendship bracelets for others. Focusing on this one thing has helped me keep moving and not dropping into deep despair.

The thing is it’s not always helpful. I seem to have a regular Friday night meltdown at the moment. I just disintegrate. My anxiety at times is so high it gives me chronic chest pain. I’ve got an almost constant headache. These are things that I’m struggling to manage. I’ve had a lot of anxiety that I’m going to infect my family. Hair pulling and skin picking have increased along with self harm. Things are not ideal.

Unfortunately there is nothing we can do to make this go quicker but we can help each other. Just checking in is helpful. And we need to ask for support when we need it. Fingers crossed we’ll be able to have some normality soon.

To keep in contact please feel free to use the comments or Twitter, Facebook, or Instagram.

Learning To Live With It

Please be aware that some of the content below may be triggering. There is discussion of suicide and self harm. I’m safe. This piece was originally written several days before publication. The content has not been edited.

Today I was told I need to learn to live with my suicidal thoughts for the rest of my life. It’s made me question a lot. It’s caused a number of emotions. I can’t lie that it hasn’t left me in a bad place.

I understand that living with an illness is something a lot of people have to do, physical or mental. I’ve always been fairly sure that mental illness will be part of my life continuously as well. So why has this hit me so hard? Why? I feel I should be OK. I’m not.

I think at the moment my mental health is particularly poor. Suicidal thoughts are there an awful lot of the time. Sometimes it’s continuous. Dealing with them seems near on impossible in a healthy way. Self harm is my go to. It’s far from ideal, though currently I’m not trying to stop the self harm (there are many reasons behind this). The idea of living with the thoughts forever just makes the feeling of wanting to die stronger. Why would I want to live like this?

But that wasn’t exactly what was said. It was that I need to learn to live with them and I guess I should think about what that means. Is it reducing their frequency? Or their intensity? Or the hold they have over me? Or does it mean I push them down and try to ignore them until I explode? (This last option seems like my current approach). I don’t know.

As some may know I’ve done DBT (Dialectical Behavioural Therapy) skills training. Not the full DBT programme as is suggested but the basics of the skills. I also go to a DBT peer support group which helps me apply the skills to my situation. It’s been helpful in some areas. But dealing with suicidal thoughts has not been one of them. The distress tolerance skills seem great, when I’m not in a crisis. I’ve tried them in crisis mode and it has not helped me de-escalate the situation. I know many people find them helpful to stop impulsive behaviours but I think that’s the problem for me: my attempts are very rarely impulsive and the desperate need to do something can linger at its height for a very long time with nothing seeming to bring it down. Believe me I have tried.

So I don’t know where to go from here. I’ve recently heard I’ve been put on a waiting list for individual therapy which I’m truly grateful for. Maybe it will help. But the thought it may not is there. I feel so guilty that it’s there. I know I am lucky I will get these 16 weeks at some point. But I’m terrified of failing and being in the same situation. A hopeless case.

That’s exactly how I feel. A hopeless case. Someone who will never improve and will be fighting forever more. Someone who, if they live, will be old and mad. The worst thing to be in this world when you need help. I can cope with the idea of being on medication for life, if I feel it will help me have a life. But the thought I’ll be suicidal forever is something I’m not sure I can live with. Why live when you want to die all the time?

I realise I’m probably overreacting (notice the probably, I’m not 100% about this at all). But in some ways it feels like a kick to just get it over with. To be gone. To stop being a constant burden to everyone. Because if I’m going to be suicidal forever isn’t that what I’ll be? (If you’re suicidal you are not a burden, it’s how I see myself).

At the moment I’m still processing this. It was said to me eleven hours ago. I don’t know how or what to feel. Apologies.

To keep in contact please feel free to use the comments or follow on Twitter, Facebook or Instagram.

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Self Harm: A Decision?

Please be aware this post will be discussing self harm so some content may be triggering.

There is a lot of thought about whether self harm is a decision or not. I know it’s a highly controversial topic and it’s something I’ve been thinking about for a while. As someone who self harms it can be a difficult thing to consider.

The definition of self harm is deliberately hurting yourself. This suggests that self harm is a choice but how much is that true? When we consider self harm as a symptom of a mental illness is it really a choice?

If you had an illness like cancer would you consider your symptoms your choice? Quite obviously the answer would be no. So is self harm any different? If you ask anyone with self harm about what happens when they need to harm most will say its an uncontrollable urge. It is something they feel forced to do. This is especially common as you go deeper down the self harm hole.

The urge to self harm, for many, is intense. It takes over. It’s hard to think clearly. The urge is made stronger by the fact that many who self harm have low self esteem and don’t feel deserving of care. Whatever has been a trigger will bring up all sorts of feelings that are hard to deal with. Everything can feel overwhelming. Sometimes we are not totally there, maybe dissociated. Then it’s not really a choice is it?

But in some ways it can be a choice. We decide to inflict the harm, don’t we? I honestly don’t know. This is where I’m hugely torn. And why I’m torn is based on how I see others and how I see myself. For others, and this is probably the most important part, I don’t think it is a true choice. There is a lot leading or pushing you in that direction. It is a symptom of an illness so is never a true choice. Then I look at myself and berate myself for choosing to hurt myself in the first place.

I don’t give myself a break on the decision making idea. I blame myself for self harming every time. I blame myself for making that “choice”. I see myself as truly being the reason I’m hurting myself. Even the name makes it seem like that. Especially when medical staff call it deliberate self harm.

And this is where the issue becomes more apparent. We are treated by medical staff, including in mental health teams, who see it as a choice rather than a symptom. Yes I may pick up the blade etc but there is something pushing me to that. I am unwell. My choices are not truly my own always. It’s not an excuse but an explanation. I’ve been told I’ve made the choice to hurt myself. This in a time when I was so distressed I couldn’t see any other choice. So surely it isn’t a true choice?

There is hope with this though and this is where it gets more into the dodgy area of being a choice. Learning through therapy of other ways to cope instead of self harming means we do start to have a choice between self harm or using our new coping methods. I start to see why they say its a choice. They’ve given us other options and we’ve gone for self harm. What they don’t seem to realise is we probably chose their new methods first but it takes time for them to be an effective choice for us. It’s all about time.

So these are just my views on self harm as a choice, I’d love to hear yours. Feel free to connect in the comments or on Twitter, Facebook or Instagram.

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Sunday Night

Please be aware this a personal piece and therefore some of the content may be triggering.

It’s Sunday night. Many people dread it as its the symbol that the working week is ahead. To me that’s not currently an issue but tonight my mood is extremely low. The suicidal thoughts are strong in my mind (I am safe). The voice is loud and I feel isolated. So I’m writing. If you’re reading this good luck as I’ve no idea where this may go. Also sorry as it may get self pitying.

The last few weeks have been hard. Many difficult things have happened and are ongoing. The future is uncertain. As it is for everyone I know. But this makes things hard with my desperate need for control. This makes my mental illness go wild. It sees it as an opportunity to take over even more of my life. It makes me isolate myself. It makes me hurt myself more. It makes me want to no longer exist. The symptoms of depression such as loss of appetite and concentration and difficulty sleeping are back. In my head it is an obvious depressive episode.

I’m also though pushing my way backwards in some ways. I’m trying hard to hide my emotions again which means turning them forever inwards. I’m pushing away the question of how I am and getting others to answer it and forget I never answered. I’m punishing myself in these ways. I’m going back into relationships that are unhealthy. I have no self respect. I have no self worth.

The voice is helping me along with all this. Its a constant torrent of how I should be dead and how much people hate me. It puts doubts in my mind and increases my paranoia. I know people are out to get me or pretending to like me. I understand. I’m unlikeable but they don’t want my death on them and that’s fair. They are lovely people who deserve better than that. They deserve better than me. I’m a burden to them but they are too polite to say it. I’m needy. I’m a pain. I’m selfish.

I’m currently convinced I’m going to be arrested. I’m scared about going outside. I’m forcing myself to do it but I’m terrified. I think Lorazepam is going to be my friend. The anxiety is high. I’m sure I’ve done something wrong and it will soon be discovered. I’m watching out on the local police force’s Facebook page for my picture to appear – without liking the page so they cant find me. Every siren makes my heart beat faster. I’m resorting to pulling out my eyebrows to help me cope with the anxiety.

Also I feel I’m not allowed to feel how I do. That people are trying to take the feelings away and rubbish them. To rubbish me for feeling them. I know they seem irrational. I’m not stupid. But I need to work through them myself to see it. I need to be allowed to feel if I can. I don’t want people to ask if it’s logical or question it. I do that myself. Twitter is my place that I allow myself to currently express myself and I really don’t want people pointing out it’s not logical. I just need to express it.

Physically my body feels like its giving up on me. I feel very unwell all the time. I’m waiting on hospital appointments for different things. I think the current count is five different hospital teams aside from the mental health team. I’m pushing my body all the time. I’m walking about 4k a day. I’m doing things around the house. All on little sleep and feeling pretty awful. I want to give up and stay in bed. It’s just not an option. Other forms of self care are falling by the wayside as well.

I’m also finding the thought of asking for help from my mental health team hard as well. I know I’m a drain on services. I’ve been made very aware of this lately with my care coordinator complaining about her high workload and not wanting me as part of that anymore. It doesn’t matter that a month ago I tried to end my life. Or that in September/October I was with the crisis team. Nope. I’m just a burden and what I feel doesn’t matter. And they’ve lied to me as well.

So there are my current thoughts and feelings. My rant. My Sunday night. Hope yours is better.

To stay in contact you can follow me on Twitter, Facebook or Instagram.

Control

This is a personal piece. Please be aware some of the content may be triggering.

Control is the thing I crave most in my life. I’ve known it for a while but it’s taken a while to admit it. A lot of what I do is about trying to retain some control in a life that constantly feels out of control. It’s also about managing the feelings of being out of control. The problem is I’ve gone down what people would call negative routes to deal with this.

The reason I think I need the control is that so many people have taken away any control I should have had. People have taken away control of my body and my life. Little decisions don’t feel like mine to make. My life doesn’t feel like mine.

The things I use to feel in control include self harm and hair pulling. They are not the only things I have used or do use. These are just the most regular. Food has been something I’ve used to feel in control (I do not have an eating disorder nor been diagnosed with one, this was just a period of restriction). Alcohol was another thing until it took control of me. I also feel some of my suicide attempts have been an attempt to be in control of when my life ends among other reasons.

I also can see my need to be in control in other situations. When I sit in a room with others I try to be first in to choose a seat that I feel safe in. I’m constantly early. I plan things meticulously. If I’m creating things I find others input hard to deal with. Relinquishing control on things and allowing others in is hard. I’d much rather do things myself. It’s things I’m trying to work on.

So what are your tips to deal with the need for control? Feel free to share in the comments or on Twitter, Facebook or Instagram.

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Shut Up

This is my response to some comments I’ve had and seen other people have. It is my personal opinion. Please be aware some content may be triggering.

“Shut up!” are the words I wanted to say. Someone tried to tell me what I could do even when I expressed how difficult it would be. They totally invalidated my feelings. They totally disregarded my illness. It was like they thought I had a choice over how I felt.

The thing is this is common for people with mental illnesses (and I’m aware it’s the same for those with chronic physical illnesses, especially if they’re invisible, but I don’t really have much experience of this so would not like to comment further on this). People seem to think you are just being difficult. They seem to think it’s a choice. They can’t see how much of a battle these so called “simple” things are to do.

Mental illness can create barriers to doing certain tasks. Getting through these barriers takes a lot of work. Just because you put it in simple terms does not make it any easier. It does not take away the mental, and sometimes physical, blocks. It does not change my feelings. It does not take away my anxiety (or depression, BPD, bipolar, schizophrenia, etc). All it does is frustrate me as I feel misunderstood.

What can be worse is when it is someone who has experienced their own mental illness. You kind of expect some understanding (and most are) but instead you are met with their own standards of what you “should” be able to do with a mental illness. This is so wrong. Everyone with a mental illness is different. It effects people in different ways. What might be an easy task for me, might be the hardest thing for someone else and vice versa. Please don’t hold us all to the same standards.

In short before you voice that someone can do something (and not in a “you’ve got this” way but in a “you will do this as you are capable” forceful way) think. Why are they saying they can’t do it? What can you do that is a practical way to help? Are they ready to tackle this right now? Maybe ask them these questions. Please don’t invalidate what they are feeling.

If you’ve got any thoughts on this feel free to share in the comments or on Twitter, Facebook or Instagram.

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Unconscious Self Harm *Trigger Warning* 

This is a personal piece. Please be trigger aware when reading.

Just lately things have been really tough for me. I have found living extremely difficult and getting through each day is a challenge. Part of my coping strategies has been self harm. Now I have always been open about the fact that I self harm on this blog and with mental health professionals, but I have noticed I am not just harming consciously. There has been a lot of unconscious self harm going on. I therefore thought I would explore this topic about ways I unconsciously self harm to raise awareness. These methods I do not condone and I would never want to tip share so will not go into a lot of detail. Please be careful when reading the following post.

A major way I have been unconsciously self harming is to make myself physically unwell. I have physical health conditions that can be exacerbated. Unconsciously this is what I have been doing by not taking proper care of myself. When depression strikes this is an easy thing to do as you can neglect your physical health in a number of ways unintentionally. This is part of what has happened to me but I have also pushed myself to limits I know I can’t deal with.

Another part of not looking after myself physically has been not taking pain medication so I feel the pain of an injury I have at the moment. This is self harm as I am causing myself pain even though I am unconsciously doing this. I’m also possibly exacerbating the injury by not taking the doctor’s advice.

Another unconscious method of self harm for me is hair pulling (or trichotillomania). I know a lot of people do this consciously but for me it is an unconscious action and I suddenly find myself with a bald patch or missing eyelashes. It is self harm as it causes pain and also, for me, embarrassment which makes me feel worse. I will try to do a fuller blog post on this topic in the future.

The final way I unconsciously self harm is to skin pick (or dermatillomania). I do this without thinking and pull away skin from my arms, chest and face. Quite often I make it bleed and am left feeling sore and even scarring myself. I know some people do this as conscious self harm but for me it is mostly unconscious and I have no idea to what extent I am doing it.

So those are some of the ways I unconsciously self harm. They are things I do without consciously thinking about the damage I may cause myself. They are things I slip into when things are particularly bad. If you find yourself unconsciously (or consciously) self harming there are things you can do to help. Being aware of it is the first step. Then there are alternatives you can try. They may not work straight away. For more information on self harm check out the Mind website.

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