(even if it's hard to see it in writing 
)I’m not about to SI immediately, but I know this brand of urge, it can build for days, weeks, waiting for opportunity.
- Why do I feel I need to hurt myself? What has brought me to this point?
Ever since I took the ‘access to higher education test’ (a bit like the SAT in the US) about 3 weeks ago, I have felt on edge, not sleeping well, many days almost nonstop anxiety (chest tightness, palpitations, stomach butterflies). It brought up old issues of academic failures, lack of future plans, how I have messed my life up in many ways. I even SI’d after the test after 2.5 months clean, though that was superficial and more of an impulsive act, not the kind of plans I’m having now.
But I haven’t quite felt like this since January, when I also became seriously suicidal and was put on maintenance ECT when meds didn’t work. I had treatments scheduled every two weeks until beginning of May, but I cancelled last week. Have suddenly developed panic at the thought of being put to sleep. I don’t know why. I have had 20+ ECT treatments in the past and even brain surgery without problem. It makes me feel weak and pathetic to have given in to my fear. If it had been an intellectual decision on my part I would have had no problem with it, I can allow myself to change my mind about a controversial treatment. But not this, not just chickening out. And I feel shame towards my pdoc and the psych ward staff, they have put up with me for years and tried so much stuff and now when something works, I refuse it for no real reason.
I understand logically that the re-emergence of heavy SI urges can to some extent be because the positive effects of the last ECT I did have is wearing off by now. Just chemicals playing around in my brain. But that doesn’t stop me from indulging in them. Sometimes my intellect and my emotions seem to live on different planets.
- Have I been here before? What did I do to deal with it? How did I feel then?
Yes. Both similar external circumstances: Did the same test 5 years ago and felt like crap then, too. Have messed around with meds several times in a not too different manner, knowing it could make me feel worse.
And similar thoughts and feelings: almost obsessed with how to hurt myself, where, how much, etc. Feeling split, one part of me very aware of how useless and outright stupid it would be to SI, another part not giving a damn about this and being convinced that hurting myself will somehow put things right, that standing the pain will make me stronger, that any bad consequences are just what I deserve.
Sometimes I just went ahead and SI’d. Sometimes I used distractions like music, computer, tv, books, jigsaw puzzles, walking and other exercise, talking to friends about random things, eating, hot showers, curling up in bed. Talked about issues with b/f, friends, T, on bus. Once or twice (if also leaning towards SU thoughts) even called pdoc. Several times I postponed things this way, but eventually got tired of caring and SI’d anyway.
How I felt afterwards – often very mixed I think, whether I had SI’d or not. Pleased that I resisted the urge but empty. Glad I could be rational but resentful that I adapted to what other people want me to do. Or relieved to be rid of the tension but scared of the lengths I go to. Usually embarrassed – embarrassed for having admitted to having these thoughts or embarrassed for acting them out, embarrassed for getting attention or for keeping secrets.
- What I have done to ease this discomfort so far? What else can I do that won't hurt me?
Distractions – from house work to food. Planned some social interaction for the next 6-7 days, people I will see or talk to on the phone (esp. when b/f is working) so I can’t let myself freak out too much. Have talked a little to b/f, T, a friend and in my place thread about recent worries, though not really about the SI urges bit.
Should allow myself to sleep better, but I find that hard…
Maybe I can simply keep going like this until next pdoc appointment (a month).
- How do I feel right now?
Angry with myself. Scared. Hopeless. Pleased at the thought of going through with my plans. Guilty for having these thoughts.
- How will I feel when I am hurting myself?
Detached. Determined. Like the rest of the world doesn’t matter.
- How will I feel after hurting myself? How will I feel tomorrow morning?
Relieved. Embarrassed. Shut off from people.
- Can I avoid this stressor, or deal with it better in the future?
I really don’t know.
- Do I need to hurt myself?
No, I know I don’t need to. I want to. In my head I know it brings a bunch of bad consequences (embarrassment, pain, scars, risk of infection, upsetting b/f, perpetuating self hate, at worst maybe an ER visit). In my heart I don’t get what’s wrong with it.
When I'm close enough to acting out thoughts that it could be called urgent, I'm often past the point where I want help. I know it's stupid when I'm in the position where I do have several people who would take me seriously and help out if I only asked, I don't need to SI/OD to get noticed. But when I'm in the place where I'm about to hurt myself, I don't want anyone to stop me. Looking back, it has mainly only been when I have had serious SU thoughts that I have allowed myself to ask for help beforehand.