Tag: therapy

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My Experience of Cutting as a Form of Self-Harm

The act of cutting oneself, on purpose (or a more comfortable label for it, self-harm) can be a very scary thing to those who do not know about it.

I started cutting myself, small cuts, during my sophomore year in college, which wouldn’t necessarily hurt when I did it, but I just needed to see the bit of blood. I had never heard of anyone doing this to him/herself, but it came to me and what began at the age of 19 has continued, on and off since then. I am currently 47 years old.

In the beginning, I honestly don’t remember much of what brought me to do it. It wasn’t for attention because I made sure it was covered during the colder weather and would cut my thighs in the warmer weather when I’d wear shorts. It was for me, and, perhaps, my therapist at the time. My first year in therapy was my sophomore year in college following a summer as a camp counselor where I experienced a lot of anxiety and had suicidal thoughts. I had no idea why it was all happening. After camp, I returned to school in NYC, and my school’s health services referred me to my therapist, who was wonderful.

I don’t remember talking a lot during that first year, but she began the work of teaching me about my feelings. You see, there are more feelings than happy, mad and sad, and that was all I knew. I began cutting myself, I believe, because my entire life prior, was missing a big piece of being human. It’s all about feelings, many feelings, good and bad, and I had no idea. Those 7 years of therapy became the base of the next step in my therapeutic work as I moved to Boston and took a little break from therapy but then started up again. I saw this therapist on and off for about 20 years. I continued to cut myself, at times, mostly when I was angry or felt misunderstood by someone, including my therapist.

I have learned, through a lot of hard work with my current therapist in CT (moved here in 2011), more about feelings but that my cutting was an “easier” way to cope with my anger about, well, anything. I never want to feel angry at someone as it makes me feel like a bad person. My therapist always reminds me that if I never felt anger, that would be a problem. When she says, ” welcome to the human race,” that can help me feel a bit more at ease about any of my feelings.

It’s only been a few weeks, but I am now able to feel good while also feeling anxious or disappointed or angry. My life prior to this was feeling one at a time and if more showed up at one time, I’d become completely overwhelmed, sometimes have panic attacks and sometimes cut myself for relief.

For me, cutting is more than a habit at this point. It is an addiction. It is not something I want to do, in terms of hurting myself on purpose and then dealing with the emotional consequences as well as the scars that are on my body. It is up to me, though, to stop. No one can make me stop or stop it for me and my therapist reminds me of that often. Even though I am sometimes able to use my healthy coping skills to ward off the thoughts of doing it, I am not always successful. It’s hard to break away from it after so many years. Yet, as the years have gone by, my awareness of the cause of the action has increased. Awareness is key to stopping but it is a long process. I do want to stop but I can get caught up in it.

Having bipolar disorder and obsessive-compulsive disorder doesn’t help much. I have cut myself when depressed and when hypomanic. The OCD can play a role if I feel the obsession with it start, then the compulsion to do it to feel relief. But, at this point, I often don’t feel relief, as I have in the past, which is a sign of good work in therapy, but there’s a lot more to go.

I do not want cutting or self-harm to be a secret, just as I do not want someone with any mental illness to stay quiet. Reaching out, voicing your truth can be freeing and help to educate those who do not understand what those of us with mental illness combat daily. Secrets never lead to anything positive. Let people in, those you trust the most. Just having one person who supports you and cares about you, no matter what, can make all the difference in the world as you navigate your daily life with all symptoms of your mental illness. For me, I wrote this today to free myself of this secret. While some know about it, most of the people in my life don’t or believe I stopped years ago. I needed to write about my cutting now because it’s current and has been an off and on behavior for the past several years. It’s part of me, and while unfortunate, it’s my challenge to face head on.

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People Struggling with Mental Illness Pre-Coronavirus and Today

The current talk about the effects of social isolation on everyone due to the coronavirus is extremely important. This is a crucial topic as it is affecting millions of people all over the world. People are not meant to be isolated, not only those who live alone but also a family of 6 under one roof. In either scenario, a person can feel alone, set apart from his/her “outside” life which can include school, work, friends, going to the library, stores, etc.

But what about those who were already struggling with mental illness before the coronavirus hit? This is another group of people who are not only struggling with depression, anxiety, schizophrenia, etc. but must now also cope with the state of our world. Being one of these people, I can tell you it is a major complication for my recovery. As I have written before, moving from in-person therapy and group sessions to online has been difficult.

The main purpose of my attendance in an Intensive Outpatient Program (IOP) was to help stabilize and provide me with more support after reacting to medication for a nerve problem which caused hypomania followed by depression. I am still not stable even though medication changes are in the works and I am, for the most part, an active group member and try to be present in my individual sessions. My outpatient and IOP Psychiatrists describe what’s happening as a “rebound effect” where my brain (neurotransmitters) is trying to “figure things out” after what they’ve been through as a result of the medication that initially caused the first bout of hypomania/depression in December.

What I do not understand is why it has continued this long. Almost 4 months and lately I have been in what is called a “mixed state.” This basically means I experience major agitation and irritability, sometimes racing thoughts while also feeling sadness, low energy and a loss of interest in activities. There are times when I am tearful or even crying while also smiling, feeling grandiose. I may feel extremely happy and energetic for an hour and then feel tremendous sadness. It can be emotionally exhausting and it feels uncomfortable. I don’t like it and no one can give me a concrete answer as to why this has continued. That’s frustrating but I realize there’s no crystal ball for my professionals to tell what is happening, why and when or if it will stop.

Bring on the coronavirus and the levels of sadness I feel are so severe I can barely breathe. I miss my friends and I miss being with my group therapy members. I miss my therapist in such a way that I often cry during our online sessions thinking about how much I wish we were in her office. I limit my news check-ins as the tears I cry hearing of the utter mayhem of our healthcare system and the patients who are ill and those who died is too much and only mixes into my “mixed state” in a complex way.

This is where I am like you. We are stuck in our homes, making home-made masks for protection and trying to create structure for our kids this week of school vacation. I wear a mask when I go food shopping and keep a distance but inside, I am terrified, just like you. How do we handle this while being a steady guide for our children? I guess, for me, it’s simply been one step and then the next. I have been furloughed from my job and while I feel confident I will be re-hired once stores re-open, it remains a stress even though I had not been working for a few weeks leading up to the shut-down due to my mental health needs. So, we share quite a bit, we really do. There’s the personal: our families and friends, there’s the economy: will I have a job once things become safer? We don’t know.

All we can do is take one step and then the next. There is no crystal ball. One possible difference between you and me: when I take one step I may feel grandiose and have a sinister view of what’s in front of me and when I take the very next step, I am in tears, feeling the most intense sadness. I do hope there will be 2 crystal balls: one that will solve, cure and vaccinate against the Coronavirus and one that will provide answers and the best treatment to my almost 4 months of hypomania and depression as well as to all who have suffered with mental illness, pre-Coronavirus and currently.

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Online Therapy is NOT the Same as In-Person Therapy and I Miss My Providers

This image is washed in fog, difficult to see and difficult to grasp.

We all have the same questions and so many more. We are living in an unprecedented and terrifying time, something we haven’t dealt with before. What I’m left with is anger. My hypomania had just decreased to a point where I had insight, thanks to starting the medication, Lithium. A minute later life shut down: moving from in-person sessions to phone sessions with my therapist, then from in-person group therapy at my Intensive Outpatient Program (IOP) to online, to online sessions with my therapist.

I continue to have difficulty focusing as I recover from my hypomania/depression. This can make it difficult to write, as you can imagine, but I am trying. You see, I am sad, scared and tired. I have good times of the day but I also have not so great times. This is normal for the way our world is right now, but, currently, my thoughts center around all of my providers and supports. It’s great to connect online with my IOP people and it’s great to see my therapist via technology, but you know what? – it’s not the same. The novelty has worn off and I feel so sad as if I’m just flying out here alone. I miss these people so much. I count on them when meeting in person, but now, it’s not that I don’t count on them, it’s that it feels too separate. There’s a void between us that I am feeling, in a strong way. This is what has made me cry the past few days. I’m hanging on, holding on to my recovery, but it’s abstract, in some ways. I want my supports, my professional allies and I want to feel it, not remember it or imagine it as it will be in the future. I want to feel it NOW.

I heavily rely on my psychological team and right now, it feels surreal, as if no one is actually there. Intellectually I know they are, but the feeling of them, it’s as if it’s being chipped away and I’m scared by that. I am more vulnerable right now, still in IOP, still getting used to the Lithium, while also living this unbelievable existence in order to be safe and keep my family safe.

I just don’t want to feel alone, flying alone, because, in reality, I am not, not even close. My therapist, psychiatrist, my IOP therapist and psychiatrist are there for me and in touch with each other. I am simply not coping well with the lack of in-person meetings. When I feel alone in treatment, which can come about for many different reasons, I become very scared and sad. I talked to them during my zoom appointments today about this. That’s the only way to help myself, to make sure everyone is on the same page. My therapist told me today to not be afraid of my sadness or tears, that it’s all okay. She said I have to not only cope with the current state of our world but I also have to focus on my recovery from 3 months of extreme difficulty, psychologically. I felt validated and I have to keep reminding myself that this treatment team is there for me. I just hope I can get that feeling back soon and, of course, to meet again in person, once it’s safe enough. I just can’t wait to really feel it again.