...after.

[lily_trying]

• have you taken care of your physical wounds? if not, go do that now. we'll wait. as much as i was able.
• what had happened just before? i was frustrated with myself for not being able to go to sleep, i got up & started reading things that triggered me.
• what were you thinking and feeling? feeling physical pain, thinking that i had made a "good" mistake when i hadn't taken my pills because i "deserved" the pain. feeling frustrated at my inability to cope with anything. thinking that i was a horrible, bad person (& worse). feeling like i was on autopilot.
• 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? i think because i didn't even try to challenge my thoughts at all--they just felt too automatic & quick. & without challenging those thoughts at all, it seemed easy to just punish myself more.
• 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. having taken my meds earlier on may have helped. trying other coping strategies to get to sleep (or cope with no sleep) may have helped. i could have maybe tried to challenge my thought patterns more. or noticed them more... sort of remembered more that those thoughts usually lead to self harm & to be more on guard about it...?
• were there outside factors like drugs, alsohol, being off your meds, lack of sleep, etc? can you address those in the future? how? some lack of sleep, and having skipped my meds. i can address these things, though it feels that at least the skipping meds is an ongoing temptation/struggle on it's own...
• what other ways of coping did you try besides self-harm? how well did they work? i think before going to what i read that had triggered, the original intent may have been to look for distracting or comforting things, though that didn't last for long...
• in retrospect, are there coping methods that you now realize might have helped? what were they? maybe some kind of distraction that wouldn't have involved going to the computer--putting on music or a dvd. trying some kind of relaxation or self-soothing, though that sometimes frustrates me more when i can't sleep... still worth a try i guess.
• name at least two things you will do to help yourself remember those coping methods if you end up in this situation again. try to write out a note as a reminder to take the meds, or to not look at certain websites. think of a small reward for doing those things maybe.
• 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? the issue from what i had read isn't resolved, i'm afraid that's an ongoing thing that probably has a lot of psychological work to do on... don't know where to start with it. the sleep issue, etc. is easier to work on, though i don't think that was the main trigger.
  
  
• are you likely to be in that emotional place again? how will you recognize it when you're in that situation? very likely... still need to find ways to spot the automatic self-hating thoughts quicker or to not accept them without thought... perhaps trying to slow down thoughts when in that emotional place, or trying to have an automatic positive response to try to challenge for each of the negatives?
  
  
• 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 some kind of visualization or other relaxing exercise... try challenging self-hatred thoughts... try slowing down the negative thoughts.

• What made that opportunity more appealing than any other? having the thoughts be so automatic.
• Did you make an opportunity or was it there for the taking? probably both...
• What would you have done if there was no opportunity, how would you have handled your urge? unsure... i have a feeling i would have just coped until i was alone & had an opportunity, though maybe i would have been able to move past it...
• If there had been no opportunity would your urge to self-harm have increased or decreased? stayed the same.

[Proximity]

The automatic thing can be so hard to get past

Taking medication regularly is really important. You said it's an ongoing struggle ... have you tried any particular strategies to make sure that you take your medication when you're supposed to?
Can you think of some motivations to take your medication?

(I know this can be a struggle, it's one that I have too. I am trying to make medication taking a non-negotiable absolute with myself ... to do it at the same time every day etc.)


What do you think you can do to distance yourself from reading things that trigger you?
Could you do something like unplugging the internet from your computer when you're feeling vulnerable? You could tie a ribbon or something around the plug to remind you not to go on the 'net for the wrong reasons.


Can you find some ways to work on your perception that you need to be punished?


prox.
[hang in there, cowboy]

[lily_trying]

have you tried any particular strategies to make sure that you take your medication when you're supposed to?
Can you think of some motivations to take your medication?

i remember a thread on the main board recently about taking meds, i was thinking of going back to it & making notes of any ideas that might work. the meds i was writing about are pain meds -- so when i do take them, i'm able to get a lot more done -- if i skip them i'm basically stuck on the bed or couch... ... i think if i can focus on that fact more it might help for motivation. (& of course, if i take them, then i can do more things which means more options for distraction & chances to be productive &... etc etc, so i guess not taking them blocks off a good deal of coping options.)

what you wrote about making it a non-negotiable absolute makes sense to me, too... i wonder if maybe i sort of used the automatic thought process with taking the meds, in a way maybe i could turn something that is usually a negative into a positive in that case? if i try to be on auto-pilot when taking them a bit, so the other thoughts don't get in the way & help to motivate to not take them...? (if that makes sense?)

What do you think you can do to distance yourself from reading things that trigger you?
Could you do something like unplugging the internet from your computer when you're feeling vulnerable? You could tie a ribbon or something around the plug to remind you not to go on the 'net for the wrong reasons.

i like those ideas & will definitely give them a try. in the past, i used to rely a lot on IMing someone if they were around & hearing the reassurance to not look at it -- but i'm afraid of doing that again, since it could get dependent & things...

maybe if i make my home page default to something really comforting/distracting that might also serve as a reminder, or putting a little e-mail to myself or something like that. if i just deleted a few connections i wouldn't be able to read a lot of it (someone on social networking sites) but i don't feel ready to do that yet...

Can you find some ways to work on your perception that you need to be punished?

that's the issue that seems to really be getting worse & causing more problems. i'm not in t currently, but i was thinking of going over my old notes from sessions to see if anything might apply. i was also thinking of maybe starting a thread over in workshop about things like that.

thank you so much for the response, i really appreciate it.