before

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Before You Self-Harm (n.B. there will be an A for cutting and a B for non-fatal Rx drug OD'ing for each question that's relevant.)

write down the shadow that's hiding behind the urge. look at it. ask yourself:
how will this situation or feeling change if i hurt myself?
situation will not change, but feeling will.
A)strong feeling of release & relief from emotional pain.
B)feeling of relaxation & overall well-being, relief from some emotional & particularly physical pain.

what will hurting myself bring to the situation? what will it take away from the situation?
adds relief and/or good feeling. takes away A)residence, if they find out, or B)?

how do i want to feel about this in the long run? is hurting myself likely to get me closer to or farther from feeling that way?
in the long run, i want to feel better about myself. A) and/or B) would take me farther from this in the long run.

if hurting myself seems like my best option right now, how long will the relief it brings last? what will i do then?
A)will last hours or overnight. then i'll see my t.
B)might repeat to continue good feeling. then i'll see my t in the morning.

what is something i could do now instead of hurting myself? how will it change the situation i'm in? how long will that change last, and what will i do then?
journal & bus--forums & possibly chat room. might improve my understanding of why i need/want to do thisl could be long-term. i'll talkl over anything i discover w/ my t.

how will i feel tomorrow if i hurt myself? how will i feel tomorrow if i do the other thing i came up with?
A)guilty, bad feelings about myself.
B)maybe guilty, maybe bad feelings, depending on t's reaction.

what do i really want to do right now? how can i best honor the self-protective instinct that has me wanting to self-injure right now?
i really want to both si & OD. i think this could best be done w/ a non-lethal Rx narcotic OD, which will ease the pain that makes me want to do both or possibly su, depending on how bad the night is.

urges aren't necessarily the enemy. they happen for reasons, and they're an expression of a desire to stay alive and stay sane and keep coping. remember that.

More Before Questions To Answer

Why do I feel I need to hurt myself? What has brought me to this point?
working on abuse issues in therapy is causing panic attacks, flashbacks, & other severe emotional pain. t says we went too fast & didn't take enough time processing. i need relief from the pain.

Have I been here before? What did I do to deal with it? How did I feel then?
similar feelings have been occuring since therapy session last Tues., i think it was. panic attacks & flashbacks have started just recently. so far i've been handling it by journaling, talking to Karl (t), listening to non-triggery music, calling Crisis & talking to my 2 favorite Crisis guys, trying (& failing) to distract, & repeating the whole thing till i make it through the nights (my hardest times). A)haven't cut. B)have taken extra methadone & morphine. that got me through the night alive, though i felt terrible--guilty, failure, fear of anger of therapist, fear of going ip, etc.

What I have done to ease this discomfort so far? What else can I do that won't hurt me?
see above, except ideally i wouldn't have taken the drugs.

How do I feel right now?
very urgy, want to take more drugs & si (cut).

How will I feel when I am hurting myself?
A)pain while cutting: relieved, release from emotional pain. much better.
B)calmed down, a little high. less emotional & physical pain. much better.

How will I feel after hurting myself? How will I feel tomorrow morning?
both--much better except very guilty.

Can I avoid this stressor, or deal with it better in the future?
take difficult subjects in therapy slower w/ more time to process.

Do I need to hurt myself?
i will give it as much time as i can--it's only 10pm--but i think i will probably end up needing to OD on morphine non-lethally.

Remember you don't have to answer all the questions if you don't feel up to it.

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[Spidey]

is there anyone that you can call or anywhere that you can go?

for the flashbacks and panic attacks, can you create some sort of 'safe zone' for yourself? ie, create a zone full of things that comfort you / make you feel better?

remember: si is a choice. in the end, what you do...the action lies on you. do what you can to keep yourself safe and si-free.

si is not worth losing your residence for.

[swanfaerie]

if you see karl tomorrow, can you simply tell yourself that both option A and option B are postponed till after you discuss this at your appt? you can always give yourself the option to do either or both afterwards, but if appt is tomorrow, can you just hold on till then?

at what point is the mis-use of your meds going to cause the same possible residence loss as the si?

if you need to sleep is there another med alternative besides doubling your morphine?

have you ever tried the ice cube in the hand method? (i hated it but tried it for my T and it helped for a bit).

even if you don't sleep well or even sleep at all tonight, sooner or later fatigue will catch up with you and you'll sleep. but if the extra meds is all about escape, what does your education tell you? if you can't deal with the emotions right now, can you simply turn this in to an intellectual excercise and battle it out?

hang in there. i'm glad you posted.

[microsue]

mercy snow said:

is there anyone that you can call or anywhere that you can go?

for the flashbacks and panic attacks, can you create some sort of 'safe zone' for yourself? ie, create a zone full of things that comfort you / make you feel better?

remember: si is a choice. in the end, what you do...the action lies on you. do what you can to keep yourself safe and si-free.

si is not worth losing your residence for.

no, there's no one i can call except for Crisis, nowhere i can go.
i haven't had any luck making a "safe zone". i'm in a tiny room with not many of my own things. this room in general does not feel "safe" for me.
i know si isn't worth losing my residence to. that's why i'm fighting so hard not to si. that's why i'm grasping at straws. thát's why Rx drug OD looks so good==it replaces it.
in 35 years of si, i've never gone more than 2 years si-free. i don't think it's at all fair of them to expect perfection from me, with such disastrous consequences if i slip.
i'm trying.

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[swanfaerie]

in 35 years of si, i've never gone more than 2 years si-free. i don't think it's at all fair of them to expect perfection from me, with such disastrous consequences if i slip.
i'm trying.

i'm glad you're trying. if you can, don't think of not si-ing as a forever thing. just think of it as, 'i can't si until my appt with karl.'

just for tonight, don't si. you don't have to think about anything other than getting thru tonight.

while it may not be fair of them, fact of the matter is, this is what they expect and they've made the consequence clear. so while you can fret about the unfairness, that still doesn't change that you have to figure out a way to get thru tonight.

do you have to stay in your room? can you walk the halls? are you allowed to go outside this late at night? perhaps sitting in the fresh air will help?

[microsue]

hiya,
swannie said,

if you see karl tomorrow, can you simply tell yourself that both option A and option B are postponed till after you discuss this at your appt? you can always give yourself the option to do either or both afterwards, but if appt is tomorrow, can you just hold on till then?

at what point is the mis-use of your meds going to cause the same possible residence loss as the si?

if you need to sleep is there another med alternative besides doubling your morphine?

have you ever tried the ice cube in the hand method? (i hated it but tried it for my T and it helped for a bit).

even if you don't sleep well or even sleep at all tonight, sooner or later fatigue will catch up with you and you'll sleep. but if the extra meds is all about escape, what does your education tell you? if you can't deal with the emotions right now, can you simply turn this in to an intellectual excercise and battle it out?

hang in there. i'm glad you posted.

i did make myself hang in there till after the appt. but now i'm going through the same stuff, and i don't see Karl until Friday. that's an awfully long ime to hang by your fingernails.
if i can keep Karl from reporting my med abuse, it won't cause me any problems, as far as residence goes & otherwise.
i'm using Rozerum and Gabitril for sleep. right now they're doing nothing. nonetheless, i'm not using the drugs for sleep anymore.
yes, i've done the ice cube in the hand method. it helps for such a short period that it's not much more than worthless.
as far as dealing with the emotions right now--Karl says i have to feel them in order to work on them. this scares me to death. and no, i can't intellectualize abuse. many other things, yes, but not abuse.\

thanks for postingl
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[microsue]

hiya,
swannie said,

i'm glad you're trying. if you can, don't think of not si-ing as a forever thing. just think of it as, 'i can't si until my appt with karl.'

just for tonight, don't si. you don't have to think about anything other than getting thru tonight.

while it may not be fair of them, fact of the matter is, this is what they expect and they've made the consequence clear. so while you can fret about the unfairness, that still doesn't change that you have to figure out a way to get thru tonight.

do you have to stay in your room? can you walk the halls? are you allowed to go outside this late at night? perhaps sitting in the fresh air will help?

i can't help thinking of it as a "forever thing" because the folks at my residence keep rubbing my nose in it. they keep "reminding" me that it's a fovever thing. but i'm trying to focus on getting through the night.
you're right about fretting about the unfairness. but i didn't mention that we have a weekly meeting to decide whether i can stay another week. that makes it hard not to stew about it.
yes, i have to stay in my room,so your other suggestions are out.

thanks for posting.
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[sine nomine]

i hear your pain, and i remember how it felt to be in that place. even if you don't realize it now, you do have choices. and i agree with mercy and swannie, especially the bit about making the goals short-term. there were nights when the only reason i got through safely was the 15-minute game: i will wait 15 minutes and see how i feel then. then i'd set a new goal for another 15 minutes.

when i was staying in the homeless shelter, i had just started dbt and was actively trying to stop hurting myself. i knew that if i gave in, i stood a good chance of being back on the street. one night i did it anyway and sure enough, they said do it again and you're out.

i'm saying this because i can relate to the anger and resentment; it's like they were taking away my choice or replacing it with a harder, worse choice. it sucked, but i like living indoors and it had been hard finding the place. sometimes it helped to think about how hard it had been. i can understand how it might seems as though they're rubbing your nose in it, and i'd talk to them about that and how you feel when it happens.

to me, the big worry about the meds is that your regular dose doing nothing could mean you're developing a tolerance -- not a good sign.

i can relate to wanting to numb out, too. trading self-harm for drugs isn't a great idea, but it could be a step away from self-injury. if it's something you think you need to do, i'd say use something safer and nonaddictive. i've used benadryl before (and when i was inpatient, i was given a different antihistamine). it's actually really effective at putting you to sleep. you could also talk to your doctor about getting trazodone for sleep. it's incredibly effective in most people, and it's not addictive. it can also have slight antidepressant effects.

i'm wondering about your using the word "overdose" here. when i think of overdoses, i tend to think of active suicide attempts. i'm wondering if it might be useful to find another way to describe what you're doing, to get away from the idea that it's a prelude to an attempt. does that make sense?

i know this is getting long and i'm covering a lot of stuff here, but i hope you're still reading. one other thing that's really important is to catch yourself when you start yes-butting. to me, yes-but means that i need to look at the ambivalence, invite it in for a chat and figure out what i'm afraid of. it can be really frustrating for people who are trying to help if you've got a reason why nothing will work. it helps if you can come up with some alternative that might help and give it a try. there's only so much other people can do -- then the ball's in your court.

deb

[microsue]

hiya,
i'm sorry about the yes-but-ing. i hadn't realized i was doing that. i don't want to frustrate people who are trying ro help. i apologize to all.
i know the 15-minute game and have been using it and hating myself for it. i feel i should be strong enough to accept the restrictions and just stop. that's what everyone says i should be doing (except Karl).
as far as OD-ing--i'm a pharmacologist and that's the correct terminology. however, i understand the impications and will start referring to it as something else--excess drugs, perhaps?
as far as trazadone goes--gives me Grand Mal seizures, so it's out. i'm on Rozerum and Gabitril . usually they do they job--but not when i'm in crisis.
i have talked to them about how i feel about their "rubbing my nose in it". when i first moved here 5 months ago, i had been kicked out of the nursing home i was living in for one instance (though serious) of si. they made sure that no other nursing home in the state would take me. i was about to go to the homeless shelter. but i appealed to FlexCare and they decided to give me a chance at assisted living==which is what i had wanted in the first place. they started out with this same contract and i told them how i felt. they changed the contract to allow "minor" si, with allowed dimensions. i si'd but stayed within this, but after 3 ER visits in 2 days (from Crisis calling 911), they changed to the current contract. I protested that i hadn't broken the old one. they agreed, said if i had i would have been out (homelelss shelter), but they hadn't realized i could go deep in addition to the length and width dimensions, and they were upset b/c i cut in the same place & thus couldn't get stitches (one of the restrictions). anyway, now nothing i say matters.
dawn has broken, and i'm OK for now. thanks for writing, Deb.

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thanks for reading, Seradjernie. just knowing i matter to someone helps.
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