Have you taken care of your physical wounds? if not, go do that now. we'll wait.
Yes
What had happened just before?
I'm really anxious about going back to work. I had a meeting with my boss who told me she would be watching me closely this year. She's set deadlines for me to do things that no one else has to do. I'm not only doing my work, I'm doing my co-workers' as well. I'm just plain lonely.
What were you thinking and feeling?
I HATE MYSELF! I can't do anything right. My therapist left her practice and I don't feel like I'm "clicking" with my new therapist. I'm incredibly exhausted and sleep deprived. I feel guilty about some things that have happened at work that invlove my co-workers. I could go on...
Why did you end up hurting yourself then instead of some other time? was there an event that was the final straw? What was it?
Like I've said before, the evening is the most difficult time of the day for me. I was always reflect and dwell on the happenings of the day. Final straw - self loathing, extreme stress, feelings on inadequacy, I'm tired of feeling sick all the time and not being able to see a doctor until September, and I'm still having PTSD flashbacks.
How did the situation get to the final straw stage? Trace it back through the events that led up to the last event. Look for some point at which you could have made a different decision and not arrived at the final straw.
Constant dwelling on things that have happened. I'm tired of being treated like crap. I should have tried calling someone. (I'm just feel that I'm constantly bothering people.)
Were there outside factors like drugs, alcohol, being off your meds, lack of sleep, etc? Can you address those in the future? How?
Definitely a lack of sleep. I'm only taking my meds once a day. I don't know what to do about the sleep - I take my sleep meds and go to bed early, but I end up staring at the ceiling for hours. I need to write myself a sticky note and leave it on the bathroom mirror to remind me to take my meds in the morning.
What other ways of coping did you try besides self-harm? How well did they work?
Reading
Online
Rocking and pacing
Looking through my coping packet I received during one of my IP stays - but nothing seemed to be working last night
*I've noticed that a lot of activities in my packet have abstract methods. This is hard for me since I cannot visualize things and forget they exist. I need something straight forward.
In retrospect, are there coping methods that you now realize might have helped? What were they?
Call someone? Take a break from my work? I tried lots of many things...maybe I just need to keep trying...???
Name at least two things you will do to help yourself remember those coping methods if you end up in this situation again.
1- Try to get in touch with someone I trust
2- Take my anxiety meds, though I hate to rely on meds
How do you feel about the situation that led to self-harm now? Is it resolved? If not, what are some steps you might take toward resolution?
Still VERY MUCH stressed - not resolved, so much to deal with and I
need to chill - this is almost impossible as I am OCD, but I can't dwell on these things. Realize that my boss will probably not like me and will continue to make me jump through hoops.
Are you likely to be in that emotional place again? How will you recognize it when you're in that situation?
YES - I'm pretty much 100% sure it will happen again tonight.
Reflecting--->leading to depression and anxiety.
Negative feelings toward myself.
What will you try before you resort to self-harm if you're in that situation again? List three specific things you will commit to trying.
!- Try reading or word search puzzles or internet to keep myself occupied.
2- Call and keep calling friends until I reach someone.
3- Take anxiety meds.
About Opportunities to SI
Opportunity to Self-Harm seems to be a common theme. Think about why opportunities are important to slips and learn why opportunity is important to you.
What made that opportunity more appealing than any other?
Nothing else worked - but I did resist the urge to burn (which is good for me). I had RAGE directed at myself - why can't I do anything right?
QUESTION I ACCIDENTILY DELETED
Yes - the opportunity was there for the taking.
What would you have done if there was no opportunity, how would you have handled your urge?
Try to have a "normal" evening. Enjoy a TV show or read...
If there had been no opportunity would your urge to self-harm have increased or decreased?
Probably stayed the same.
What consitutes opportunity for you? Being alone? Having new tools? Waiting for the right feeling?
Being alone for sure!
Not having IRL support
Having tools available for sure!
STRESS!!!!!
If your opportunties were taken away, how would you feel?
If it's that bad - I will find a way.
After You Beat an Urge
How do you beat your urges? Examine how you beat the last one so it can help you beat the next one.
Sometimes I can distract myself. It really depends on how strong the urge is.
Did I identify what feelings were leading me to want to SI?
Yes - in OCD thoughts and in retrospect. Also, loneliness, tired of being put down, and feelings of no self worth.
If Yes - What were they, and how did I figure them out?
Dwelling on negative thoughts.
What coping skills did I use to deal with these feelings?
See above...
Were these coping skills the most effective I could have used?
To be honest, I think they were. I'm constantly looking for new strategies. Whenever I hear of one, I will try it. I will try and try, but in most cases it won't work. Is there something wrong with me??
If No - What coping skills got me through?
I used to have my old therapist's phone #, but I have a new therapist. My old one would try to help me calm down.
Why do I think they worked?
I trusted her and she helped me calm down. She made me see that there was actually some good in me. (I miss her!
)How can I deal with these feelings more effectively next time, before the urge to SI sets in?
I'm just not sure yet.
7.12.08 Carmen 
SHACA