bus

After

• have you taken care of your physical wounds? if not, go do that now. we'll wait.
  
  Yes.
• what had happened just before?
  
  Had talked on the phone to my mother, my older son and my friend S. Nothing upsetting, just updates. Put some laundry away. Had a shower.
• what were you thinking and feeling?
  
  A little tired from talking to many people, I talked to a lot of people on the phone last night as well. Looked at my arms in the shower, it’s time to take the sutures out and the bruises are fading. Thinking that I don’t want them to heal, felt a vague sense of loss. But no strong emotion.
• 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?
  
  It seemed convenient, was home alone and in the shower. No particular final straw, just a yes/no decision.
• 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.
  
  It wasn’t totally impulsive, have had frequent SI thoughts the past month (some life stressors like b/f being ill, plus changes in my depression treatment). The night before I had the same thoughts about wounds healing but no energy to SI, so I thought I could do it the next morning instead.
  
  Don’t know what I could have done differently other than decide to fight the urge. Don’t know why I wouldn’t do that.
• were there outside factors like drugs, alcohol, being off your meds, lack of sleep, etc? can you address those in the future? how?
  
  Sleep has been an ongoing issue, it wasn’t extremely bad last night though. I know a couple of things I should do to improve it, don’t know how to convince myself to do those.
• what other ways of coping did you try besides self-harm? how well did they work?
  
  Nothing. I had no desire to avoid SI.
• in retrospect, are there coping methods that you now realize might have helped? what were they?
  
  I don’t really know – I wasn’t trying to deal with any particular emotion at the time, I just wanted visible cuts on my arm and I don’t quite know why. (I’m in the long sleeves gang so noone other than possibly b/f will see them, and I’m very sure this wasn’t aimed at him.)
  (Painting myself with a red marker or similar doesn’t work.)
• name at least two things you will do to help yourself remember those coping methods if you end up in this situation again.
• 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?
  
  As I said, I’m not sure why I did it.
  
  Re current stressors in life, I can’t do much about b/f’s illness other than try to support him. For myself, I have a pdoc appointment tomorrow which I really really don’t want to go to, but I will anyway.
• are you likely to be in that emotional place again? how will you recognize it when you're in that situation?
  
  The emotion is more lack of emotion, indifference. It’s over 12 hours since I SI’ed, and I still feel no regrets or anything else really, just a desire to “improve” on those cuts. Some rational part of me recognizes that not feeling when I would normally feel is not a good sign (which is why I’m at all writing this).
• 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.
  
  I could take a walk, call/email a friend, do the dishes. But I can’t really make an honest commitment in this state, I could easily do those things and then SI later anyway. This lack of motivation… it doesn’t feel bad. I just know in the back of my head that it’s not good.

Hi Stellaria

As I was reading your post, I was thinking, "What word was it she used in the title?", because I was thinking "apathy". Apathy, indifference...are they interchangable in your mind? Or do they mean different things? I'm just wondering if playing with another word that your post brought to the reader's mind might give more insight into what you were feeling when you self-injured?

Or maybe not, that's fine too.

Indifference/apathy brings to mind symptoms of depression for me. Is it extending to other areas of your life? It sounds like you're having trouble making yourself go to your pdoc...how long has that been going on?

I wouldn't underestimate the impact that your b/f's illness may be having on you...that's stressful stuff, and I know from when a close friend of mine was very ill last year that I felt very helpless and like things were beyond my control...I don't know about you, but those are major trigger emotions for me.

Hope some of that maybe helped. Take gentle care.

Hi LBC,

Thank you for your reply and thoughtful questions.

little_bear_cub wrote:Apathy, indifference...are they interchangable in your mind? Or do they mean different things?

To me they are of similar nature, but apathy is a stronger word... a deeper form of indifference. Associating to staying in bed and not caring about getting up to eat or shower or answer the phone. I'm not that low, I can manage the basics. Just a bit disconnected.

little_bear_cub wrote:Indifference/apathy brings to mind symptoms of depression for me. Is it extending to other areas of your life?

I guess so. I have been so much up and down lately I hardly know what I feel anymore. I can do things I need to do but in a sort of robotic way. Nothing really interests me, but I fake interest.

little_bear_cub wrote:It sounds like you're having trouble making yourself go to your pdoc...how long has that been going on?

I can't say I have ever felt comfortable seeing pdocs, I feel vulnerable in that situation. My current pdoc is a nice guy, so that is not the problem. But it's harder than usual this time. I feel a bit guilty about quitting the ECT that was working. I don't know if my antidepressant is working at all or not, things are not great but maybe I would be worse off without it? And I'm not eager for more med experiments. So I don't know what I'm seeing him for, what can he do? I don't even know how to answer the questions about how I'm doing.

little_bear_cub wrote:I wouldn't underestimate the impact that your b/f's illness may be having on you...that's stressful stuff, and I know from when a close friend of mine was very ill last year that I felt very helpless and like things were beyond my control...I don't know about you, but those are major trigger emotions for me.

Yes, it has been stressful, and he is in hospital right now being evaluated so I don't know exactly what will happen. And there has been other more in-my-own-head stuff too, I can't really attribute my reactions to one or the other, it's a tangle.

I guess I don't really want to find out why I do things like SI right now, because I'm too tired to deal with it. I just want everything to go away...

Stellaria wrote:I guess I don't really want to find out why I do things like SI right now, because I'm too tired to deal with it.

It seems to me that this is an important realization in itself. Maybe, whether you can identify the reason behind it or now, right now this coping strategy is just something you need. That's nothing to be ashamed of; but perhaps something important to acknowledge (as gently and with the least amount of judgement of yourself as possible, because you don't need self-judgement or harshness piled on top of what might already be there, emotionally).

I don't know you very well, but I've read some of your posts over my time here, and I believe from what I know of you that when you're ready to be without this coping mechanism...you'll do just that.

Have you read some of Deb's posts on mindfulness?

little_bear_cub wrote:Maybe, whether you can identify the reason behind it or now, right now this coping strategy is just something you need. That's nothing to be ashamed of; but perhaps something important to acknowledge (as gently and with the least amount of judgement of yourself as possible, because you don't need self-judgement or harshness piled on top of what might already be there, emotionally).

Thanks. I guess I can't quite identify it as a need though, I know logically that I don't need it. I lived for so many years and went through enough shit without it (I started late). I just don't care enough to not do it.

Even though I know it will hurt my b/f when he sees this... and he's the one person I really don't want to hurt. I was with him in the hospital in the afternoon and he asked me several times to please stay safe, and I wouldn't answer. Well, I guess I still have that, I try not to promise things I won't keep.

little_bear_cub wrote:I don't know you very well, but I've read some of your posts over my time here, and I believe from what I know of you that when you're ready to be without this coping mechanism...you'll do just that.

I don't know what to say. It's nice that you believe in me.

little_bear_cub wrote:Have you read some of Deb's posts on mindfulness?

I believe I have, though when I went looking I couldn't find more than the odd one. Was there anything in particular you were thinking of?

I didn't have a particular post in mind. I think I asked about mindfulness because...well, maybe I have it on the brain because it's something my t and use to help me deal with some of my ED-type stuff, and it seemed to me that you're in a kind of "mindful" place regarding your self-injury right now...aware of what place you're at emotionally and kind of "sitting" there with the feelings for a bit, and then making a conscious decision about whether self-injury is something you want/need (or a bit of both?) at that point.

I think it's a good place to be when you're struggling with these things, relatively speaking, because it's easier to figure out what you really need when you're in that place of awareness.

I'd talk more, but I'm afraid that I may be reading too much of my own stuff into this...feel free to tell me if I'm way off-base, it wouldn't be the first time I've heard it.

little_bear_cub wrote:I didn't have a particular post in mind. I think I asked about mindfulness because...well, maybe I have it on the brain because it's something my t and use to help me deal with some of my ED-type stuff, and it seemed to me that you're in a kind of "mindful" place regarding your self-injury right now...aware of what place you're at emotionally and kind of "sitting" there with the feelings for a bit, and then making a conscious decision about whether self-injury is something you want/need (or a bit of both?) at that point.

I see. I haven't encountered the concept of mindfulness in a therapy setting, and I don't know a lot about it, but I'm not a total stranger to it, have read a bit about DBT (have friends who have done it, one saw a therapist who co-authored the Swedish text book on DBT), and I have also tried some meditation and yoga techniques in my shady past.

I guess I don't understand very well though the 'conscious decision' bit - I can take the position of an observer and describe a lot of what is going on, but I'm not so sure about the deciding part. In many SI situations I just go along with an emotional decision already made on some other level, I can list pros and cons for myself as if I was debating what to do, but I already know how it will end up as if I was following a directive, it's just an intellectual exercise really.

What I'm getting at is that often when people talk about 'conscious decisions', I get the impression that they are referring to some rational, logical process. As if you are weighing various factors and reaching a conclusion, aware of what you're doing. But to be honest, practically all major decisions I have made in my past (including the good ones) have been on a hunch basis, I woke up one day and knew what I was going to do.

If my rational and emotional sides disagree on something, and they are of about equal strength, the emotional trumphs.

little_bear_cub wrote:I'd talk more, but I'm afraid that I may be reading too much of my own stuff into this...feel free to tell me if I'm way off-base, it wouldn't be the first time I've heard it.

*grins* Actually, I tend to find other people's experiences, whether they agree with mine or not, a good starting point for looking into my own position, so it's secondary to me whether your stuff exactly parallells my own, it's still useful.

Thanks for talking to me.

Hello Stellaria. I hope you don't mind me adding in here a bit late.

I just wanted to say that I recognise a lot of what you say about indifference and not really caring, and for me the feelings of emptiness which I accossiate with indifference are some of the most difficult to deal with. If I'm depressed or distressed then that's awful, but at least I have something to fight, if that makes sense. When I don't feel anything apart from indifference and weariness it's much harder to know whaat to do, and I am more likely to end up SIing because I don't care, and also because I miss the warning signs.

I suppose I think of there being two different reasons that I might be in that place- one of them is that there is a strong emotion which I am cut-off from and not dealing with, and that somehow that "comes out" as SI, and the other is where I actually don't have anything to feel- a sort of neutral mode which I get after bouts of hypomania. I don't know if that makes sense.

If it does make sense, then I wondered which of these might be going on for you now? Do you think you are cut-off maybe from difficult feelings to do with your situation or your boyfriend? Or could it be that this emptiness is just the natural staate you are in right now? To me, each of these would suggest diffierent courses of action.

The stuff that you say about your Pdoc and not feeling like he can do very much for you right now- I just wondered if that might be a bit a part of the feelings that you are describing. Do you think you would still be thinking like this if you were feeling different? I don't mean that to be a leading question- I just wondered, that's all.

I hope you find a way to deal with this, Stellaria. To me, it sounds like what you are dealing with is very tough at the moment.

Take care.

tatty

Tatty,

I certainly appreciate your input. I'm afraid this is very much an ongoing situation still, so I'm not done looking at it. But I will have to come back to it later, right now I'm going to brave the pouring rain and walk over to the hospital to visit b/f.

Thanks.

tattybluetrees wrote:Do you think you are cut-off maybe from difficult feelings to do with your situation or your boyfriend? Or could it be that this emptiness is just the natural staate you are in right now?

I'm not completely numb, I can start to cry or laugh or panic, but it sort of breaks off after 30 seconds, as if I have no energy to be truly emotional. Maybe that has to do with having been through so much emotion the past two months, a week ago I was literally curled up on the floor screaming. I think I started out trying to push strong feelings aside because I needed to be able to stay on top of things when b/f got sick, take care of practical matters and keep a check on him in case he was getting worse and try to comfort him. Then I would flip out a bit now and then when things got overwhelming. Now I'm too tired for the flipping out part.

tattybluetrees wrote:The stuff that you say about your Pdoc and not feeling like he can do very much for you right now- I just wondered if that might be a bit a part of the feelings that you are describing. Do you think you would still be thinking like this if you were feeling different?

I don't know. Some of it is factual, there's obviously nothing he can do about my b/f being ill. And as for depression treatment, what has been temporarily effective is ECT which I won't do, I absolutely can't stand the thought of being put to sleep again, it's very illogical, but I can't take it. So pdoc can't use that. I have been through tons of meds already.

Some is probably more mood-related. I'm thinking that I really am a hopeless case, I don't believe that anything will help much. I don't expect much anymore from the therapy I'm in, but there is absolutely no way in hell I can muster the amount of energy and motivation needed to try to change to some other form of therapy (I can't afford going private so I have to use the public system, similar to the NHS, but even if they would let me change therapists, which isn't a given, I don't feel up to it). My apathy seems to run deeper than before. Even in my worst moments, before I have usually had some flicker of hope that somehow I would get better. I have done some stupid risky things but never a full-on suicide attempt. Not that I am actively suicidal right now, I'm thinking that since I have relationships to people I don't want to hurt, I have to accept that I'm trapped here.

And now that I have seen pdoc, it seems even more final. The appointment went exactly as expected, he thought I'm doing ok, kept me on the same medication and said he'll see me next year.

I almost feel as if I have a license to SI, that it doesn't matter anyway.

But I have also had unlimited opportunity the past few days when I have been home alone, that will change today, younger son who has been away for a month is coming back home. And I don't expect b/f will stay in the hospital for very much longer. So I will have to contain myself.

Well, I'm not being very constructive but thanks for talking to me.