How do I deal with self harm?

[Akita]

My dBPDw self harms.  I would to be able to help her stop.  We have discussed it and she told me she does it to stop her pain.  She also likes how cutting feels and watching the blood.  It is like an addiction for her.  She doesn't just cut.  She pulls hair, eyebrows, and eyelashes.  She scratches, pinches, and bites herself.  She does this throughout the day to feel less anxious or angry.  I really want to the cutting to stop.  She cuts deep enough to need stitches sometimes.  She is embarrassed by her scars and feels ashamed after she has done it.  She is in counseling but so far he hasn't been able to help her stop this behavior.  Does anyone have any advice?

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PLEASE - NO RUN MESSAGES This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members may appear frustrated but they are here for constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[lbjnltx]

In DBT they teach alternatives to self harm.

Use a red washable marker to simulate blood

Snap the wrist with a rubber band

Hold ice cubes in the fist

these are only alternatives until coping skills take the place of the urge to self injure.  My daughter revealed in RTC that self injury was an addiction for her.

[Akita]

Thank you for the suggestion, but she has attempted all of these.  She says they don't work for her.  She isn't getting any emotional relief.  She says these are just weak methods to delay the inevitable. Is there anything else out there that has helped someone?  What can I do to keep her from getting to this point emotionally?

[lbjnltx]

She needs to develop coping skills, it is up to her to do it.

You can help her process her emotions through validation.  Here is some info on this skill:

Tools:  communication, validation, and reinforcement of good behavior

This info is amongst the Lessons on the right side of the page----->

lbj

[Akita]

Thank you.  I will look into this.  Please other posters add information if you have it.  The more I can gather the better chance I have at being successful.  This behavior is very distressing for me.

[Cloudy Days]

She needs to find a replacement that will have the same effect of getting rid of the emotions. To me I would see it like replacing any other destructive addiction, drug or alcohol abuse for example, they use for the exact same reasons your wife cuts. They use exercise a lot of the time to sort of distract from the pain and the uncomfortable feelings, negative energy is channeled into positive energy.

[Akita]

She has gone for walks.  Though one of these walks was her climbing out a bedroom window so she wouldn't have to see me.  I have offered to walk with her and we use to go on 2 miles walks a lot.  We probably need to start walking again.  I'm sure she would be willing and I have actually asked her to ask me to go for a walk if she feels like she needs one.  The big problem is she spirals down so fast and then can think of nothing but the knife.  It's just set.  Nothing can divert her from the path she is on.  I need to figure out how to keep her off this path.  Thank you for all the input.  I am starting to feel like I have options.

[Cloudy Days]

Can you have a sort of intervention and take anything she would cut with away from her. If she doesn't have the tools to do it then she will have a harder time running strait for that.

[Akita]

I have taken her knife.  She gets angry and hunts for it.  Says it's hers and I have no right to take it.  She will use kitchen knives.  She has also used regular objects around the house... .paperclips, staples, scissors, broken plastic, and utility knives.  It just feels impossible to remove all sharp objects from her.  I will consider it though... .thank you for the thought.  I appreciate all this help.

[Akita]

She was in DBT therapy but couldn't get past chapter 2 with her therapist.  She has since left that counselor.  Her new counselor doesn't believe in using a program but addressing each problem as its own thing.

[lbjnltx]

If she is determined to self harm she will find a way.  Even the kids in residential treatment who have no access to sharps find a way.

It isn't healthy for the non in the relationship to shift the responsibility onto themselves regarding things out of their control.  I realize you are trying to help her and there is a difference between helping her help herself and trying to stop something you don't have the power to stop.

You can be a source of support and encouragement for her, ongoing as well as in the moments when she has the urge to self injury.  As difficult as it is for us to comprehend, self injury is a coping mechanism, a maladaptive coping mechanism.

lbj

[Akita]

Thank you.  How do I support her in the moment?

[lbjnltx]

Listen to understand, validate the feelings she is having, encourage her to talk through those intense emotions, ask her validating questions to keep her talking.

These are urges she is having, when the intense feelings find relief and begin to dissipate the urge of the moment will too.

Many therapists teach the visualization processes to deal with intense emotionality moments.  You can encourage her to do this as well.  It is like self hypnosis.  It works well with PwBPD because they are very imaginative and creative.

In a time of calm, you 2 can do it together.  Think of a place of calm, natural, beauty.  There is a place there to sit and rest (lounge chair or a patch of cool green grass as soft as lambswool), there are wild flowers blooming 3 feet tall of every color and aroma imaginable.  Visualize yourself lounging there, you can hear a stream trickling over the rocks and birds chirping in the distance.  On the other side of a large oak tree a doe and her fawn are feasting on the wild flowers, they see you and you see them and neither of you want to disturb the other.  The clouds are floating by on the gentle breeze that you feel on the bottoms of your feet.  This is your safe place and you can come here anytime.

It is up to her to decide what her safe place looks like, how she gets there, and what she finds there.

In times of intense emotionality remind her that she has a safe place and encourage her to go there in her mind.

Many people also journal or do art to ease their emotions.

Whatever works best is what she can do and you can participate with her as well as encourage her to do it alone.

lbj

[Akita]

That really sounds like something we could try.  If she will cooperate.  Thank you for the suggestions.

[Bpdsupporter]

Poor darling she must be hurting do bad. My heart goes out to her... and you must be so worried. Is she at all open to medication for her anxiety? My pwBPD and myself both take a natural supplement called Inositol also known as viatimin B8. He said he's been feeling more balanced since taking it. I struggle with anxiety too and its been really helpful. Of course check with your physician. And do your own research about it... .I discovered it because I was looking for natural supplements that are good for those struggling with BPD and it came up in my search that it's actually beneficial.  It's natural so there aren't any side effects you can get it at most health food stores. Because maybe if there is a way to reduce her anxiety and internal pain she might cut less. I'm not the biggest fan of pharmaceuticals  but there are tons of natural supplements and teas you can get at your health food store that promote an overall sense of well being.Like camomile tea, passionflower tea... st johns wort is really great for depression. Anything that will promote and calm nerves should just be in stock at your home. Again please make sure you check with your doctor on anythung you try... i m not a physician and wouldnt want you to take something off my word alone. But inositol has really been helping both of us. Peace to ya!

[Akita]

She was on Celexa for awhile but stopped taking it because she didn't like how it made her feel.  She attempted to get back on a medication but the PA-C who helped was no longer willing to help her.  She doesn't want to go to a new person so she is currently not interested in medication.  I will google the natural remedies you suggested and see how she feels about that.  Thank you for your thoughts.  She is in a lot of pain.  She can be doing fine and then something will set her off and I can't bring her back.  I never know what will start this spiral.  I've asked her and she doesn't understand either.

[Akita]

She has a new best friend she met on Facebook.  This friend also has BPD.  Yesterday they had an argument or something and her friend stopped messaging her.  It was for 9 hours that the friend didn't respond.  My dBPDw became very distressed.  She had also tried to make plans with her sister and her sister didn't respond immediately.  She has a difficult time waiting for information.  She ended up hurting herself.  It was fairly deep and could have used stitches.  She didn't discuss any of her feelings with me.  I would like her to be better able to wait, that may help reduce some of her self harm behavior.  I of course don't know that for sure but it's something I would like to try at least.  Plus it's probably a good life skill.  Anyone have thoughts on this?

[lbjnltx]

Behaving impulsively is a trait of BPD.  Learning to delay gratification is a skill that she can develop.

Does she ever seek help for herself online?

Here are some online resources for pwBPD:

www.bpdresources.net

If she uses online resources, talking openly about whether or not these resources are helping or making her feel worse is advisable.  My d found the members on the forums frustrating and invalidating because they weren't working on self at the level she does nor offering much support in return.

[Akita]

She is part of a DBT group on facebook.  That is how she met her new friend.  She has told me she likes the online forums.  Helps her to not feel alone.  The flip side is that if the other people are unresponsive or disagreeable she can become overwhelmed with negative feelings.  She easily falls into the everyone hates me mode.  She has a lot of difficulty viewing herself in any positive way.  I think this helps feed her self harming behaviors.  It's also hard on me as she gets into a very depressed mood and I can do nothing right.  I will have her check the resources you listed.  It's always advantageous to have more options.  She really likes this new friend, has called her her best friend.  I get that this other person has more insight into what BPD feels like but I also worry about how a relationship between two borderline people will work out.  It makes me pretty nervous.  This other BPD person doesn't self harm so I see that as a positive but I'm still anxious about how the communication between them will be... .I don't want her to lose her friend but I don't want the friend to just be a new source of emotional distress.  My wife doesn't have any friends in person.  She doesn't trust people and feels like people can see through her and can tell she is different.  I guess I just don't want any fuel added to the stress level so she won't have more reasons to hurt herself.  Any advice on this?

[lbjnltx]

It seems like you are trying to manage her life to minimize any negative affects she might suffer.

It really isn't possible nor advisable to do this akita.  She will make her own choices about where, what, who, when, and how.  Your job is to be her husband and support her in the positive choices she makes and validate her feelings.  It is important that you have healthy boundaries and that she does as well.

She could become resentful of your attempts to protect her.

I know you mean well

[Akita]

I'm not sure where to draw the line.  She says she cant do it alone.  She wants my help.  She tells me that all the time... .I just don't know how what when or where.  She can't help me with that.  When she has spiraled she has a hard time discussing anything and usually just more angry.  How can I spot situations I can help with and how do I know when to stand back?

[waverider]

self harm is only one side of the bigger picture of a disordered mind. Focusing too much on the self harm will distract from caring for her in the wider picture. It is just one highly visible aspect and you wont be able to solve it in isolation.

If you word on building self esteem, reducing anxiety and delay immediate gratification of impulses they need to self harm will dissipate.

You will not be able to physically stop it or blocks access to means. My wife did this on and off for most of her life ad reached a peak following diagnosis of BPD. She need plastic surgery on her lips after she had continuous bitten her lips and inside of her mouth. She was hiding this and blaming it on a rare ulcerating disease. We had close to 30 trips to ER in ambulances due to ODs, Endless amounts of cutting. Forcing herself into sleep depravation, starving. Lots of other destructive behaviors.

Most was driven by a need to make unseen emotional hurt into an identifiable physical one. The doctors can fix a physical injury, but they can fix an emotional one.

Me getting into a flap over it only stressed her even more and increased the need to do it. Do not attempt to wrap her in cotton wool. Do not allow her to project the drama in her head onto you via using self harm as a link in the soothing chain. If you both gets stressed it normalizes stress. Stress shared is stress halved.

The direct self harm has gone now, mainly do to feeling more secure and being able to more openly discuss the distorted stuff that is going in her head without me just dismissing it as being "silly' (thanks to bpdfamily).

It is an evolution though.

[Akita]

How do I build her self esteem.  She tells me I'm lying if I attempt to compliment her.  I tried to reduce anxiety by setting up routines for her.  She says I'm controlling her or that I am treating her like a child.  I'm not sure on the impulsiveness.  I know she is impulsive, I just don't know how to help with it.  Any thoughts?

[waverider]

  She tells me I'm lying if I attempt to compliment her.

pwBPD often believe others are superficial and are only trying to appease, words have little weight. This can often be a projection of themselves. The best complements are usually to listen and ask questions. This is showing genuine interest and validates their opinions even if they can be way out at times

 

I tried to reduce anxiety by setting up routines for her.  She says I'm controlling her or that I am treating her like a child.

 

Trying to fix is seen as controlling and brings about a push reaction. It also highlights their inabilities and is therefore invalidating. best way of achieving this is asking her how she might be able to organize things better, then reinforcing the good ideas. This way it is instigated by herself and brings more reward and self satisfaction.

I'm not sure on the impulsiveness.  I know she is impulsive, I just don't know how to help with it.  Any thoughts?

This is a hard one, inserting questions like "what do you think the consequences of doing that will look like?" . Its a way of linking cause and effect. You are unlikely to stop it but by inserting a "pause" between thought and action you get the chance to redirect harmful actions. Talking about the consequences of what they are doing rather than focusing on the "emergency' of stopping it.

Getting worked up about what they are doing is taking the focus away from their feelings which is invalidating. eg They are trying to cause physical pain, you are trying to stop this is in conflict with that, and invalidating. It is their choice to inflict pain. What they need is for you to focus on the feeling that is driving this (Support and Empathy), and also adding a dose of reality about the ongoing consequences, such as leaving visible scars, causing an infection etc (Truth).

They are focused on the act, it is almost a dysfunctional action akin to Mindfulness, a point of focus, you want to take the focus away from the action and back to the bigger picture

[Akita]

Thank you for the advice.  I will work on it.  Her cutting seems to be an urge that takes hold.  Sometimes I can tell by how she is behaving that she is likely to cut.  Other times she appears to be fine and then I find out later she cut minutes after I left.  Sometimes I'm home sometimes I'm not.  I'm just suppose to ask her what the consequences of cutting are when she appears to want to cut?  What if I'm wrong and she was going to do it?  What if I put it in her mind?  What if she does it out of spite for me thinking she might cut?

[waverider]

Thank you for the advice.  I will work on it.  Her cutting seems to be an urge that takes hold.  Sometimes I can tell by how she is behaving that she is likely to cut.  Other times she appears to be fine and then I find out later she cut minutes after I left.  Sometimes I'm home sometimes I'm not.  I'm just suppose to ask her what the consequences of cutting are when she appears to want to cut?  What if I'm wrong and she was going to do it?  What if I put it in her mind?  What if she does it out of spite for me thinking she might cut?

Dont bring it up unless you see it happening, or has happened, or she is talking about it. Dont attempt to preempt it. With most repetitive behavior the effects of how you react are more reflected on future episodes than the current one. You are planting thought seeds for the future.

Everything is long term, rather reacting to the moment.

[Akita]

Is there a way to encourage her to talk about it.  She generally doesn't come right out and say I'm going to cut.  A few times I have asked her if she wants to hurt herself and she has nodded but becomes more upset i.e. she starts crying.  She has a difficult time talking about what she is feeling.  She is more of an acting in type of borderline.  She will yell and display anger and has screamed in the face of our 16 month old son using profanities.  I would say she mostly goes quiet.  She stops talking or responding or just gives short answers.  Many times I feel like she just tells me what I want to hear so I'll stop talking to her.  One acting out behavior she has is leaving without letting me know she is going anywhere, she also drives recklessly at times.  Overall I would say she uses her body to deal with how she is feeling, and cant or wont share to let me into her world of hurt.  She has told me when she does try to share I make her feel worse.

[waverider]

  She has told me when she does try to share I make her feel worse.

Vocalizing her feelings is obviously hard for, probably self harm is an easier form expression for her. When you talk to her she probably feels pressure to vocalize what she can't.

I told my wife that if she ever feels that way she can come and sit on the sofa next to me and tell me she is in a bad place and we can have a hug and i wont question her but she is free to tell me anything she wants to. It gives acknowledgement and support without pressure.

Has she ever written her thoughts down?

[Akita]

She is currently trying to journal.  She  wrote about one incident she was angry about and hasn't written in it since.  She has said she's not sure what to write.  She had a couple of hard sessions with her therapist recently and cancelled half her appointments.  Instead of going twice a week she is only going once a week.  She has done a lot of cutting since this happened, can't identify what's wrong.  Just feels anxious, sad, fearful and angry.  Can you give more specifics with the journal?

[waverider]

Can you give more specifics with the journal?

Make a time of the day to do it. start  off with one word description of how she feels, without going into details. Start each day answering one word questions to kick start the ordering of thoughts. If that is all that is entered for the day it is the start of structuring. There is no need to write an entire essay everyday.

eg:

Emotion now: sad

Emotion when I woke up this morning: excited

Best thing that happened today: Met mum

Worst thing that happened to day: Fought with H



Things on my mind today (expand here on anything): XYZ

[Akita]

Thank you.  I will try this.  She is back to twice a week therapy and accepted a referral to start medication again.  The office that houses her therapist refuses to monitor medication for her.  They did once but now say she is out of their comfort zone.  She is very angry and hurt by this.  She believes the PA-C just hates her.  Has anyone had success with medication reducing self harming behaviors?

[PLEASE - NO RUN MESSAGES]

PLEASE - NO RUN MESSAGES This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members may appear frustrated but they are here for constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[waverider]

Medication per say doesn't control BPD,  though it can temper some of the masking behaviors such as anxiety, depression and sometimes mood stabilizers. The real danger with meds is that pwBPd are prone to the desire for quick fixes and can very easily become dependent on, and abuse, medications. Then getting frustrated because they dont fix everything and so either stop, or go through cycles of overuse and withdrawal creating a whole bunch of side effects.

Psych meds need to be overseen by a psychiatrist rather than just even a GP, otherwise its like constantly trying to add color pigments, eventually you end up with poo brown and adding further to this makes things more confusing.

Stopping self harm behavior is just part of the whole rebuilding self esteem and better communication paths process. i doubt meds will directly stop this

[Akita]

Her self harm seems to be getting worse.  Deeper and more frequent.  She is frustrated by her therapist because he has become ill twice and cancelled her appointments.  She used their message system to vent and cancelled all her preset appointments.  Now he will only see her for one appointment at an unusual time, she's afraid he is firing her.  The therapist was trying to get her to use ice instead of cutting.  It never took.  She feels like he is quitting on her.  I don't know what to do.

[waverider]

She used their message system to vent and cancelled all her preset appointments.  Now he will only see her for one appointment at an unusual time,

This is common, what the therapist is doing is protecting his time, allowing her appointments only at a time that minimizes disruption to his day if she starts to not turn up. Typically they are allocated last appointment of the day.

[Akita]

He had been seeing her twice a week.  She needs the last appointment due to her job being 25 min from his office.  This is the second time she has cancelled all her appointments.  She is also misusing their website message system.  She became distraught when the therapist cancelled an appointment due to illness... .this was the second time he has done this in 4 months.  So she cancelled all the appoints via the website messenger then sent another message explaining why.  The therapist said this belonged in therapy as the website is only for cancelling or confirming appointments.  This is not the first time she has misused the message system.  She is very impatient and impulsive.  I'm not sure him only seeing her once a week is good or not.  She does get wound up after sessions so maybe only seeing him once a week would help that.  All I know is her cutting has increased since seeing this therapist and the therapist isn't even working on stopping the self harm!

[waverider]

Cutting and meltdowns after therapy means the the therapy is hitting a nerve. If the sessions are purely soothing them. often they are being ineffective and maybe indicative of therapists who are simply lending a  shoulder to cry on and avoiding the hard issues.

I attend most of my wifes appoints with her, left to her own she will misinterpret most things the T worked on. This is more as an aid rather than a joint session. It also reduces her tendency to go of on a delusional tangent. It is only the distressing appointment that seem to get anywhere.

[Akita]

This therapist won't let me attend.  He says she isn't ready for me to be there.  He is still working on the trust and rapport.  We work different shifts so I would never be able to attend all of them.  Does that give you much insight into helping her?

[waverider]

.  Does that give you much insight into helping her?

It does, and what I have learned here along with my own observations of my wife gives a huge step forward to the Ts.

It helps that we are at a stage where my wife is not toxic on me so it doesn't become one of those blame shifting sessions that MCs often descend into.

[Akita]

What exactly do u mean by toxic ON u?  

[waverider]

What exactly do u mean by toxic ON u?  

Not being blamed or accused of anything by my wife. Neither does she deny any of my observations

[Akita]

How did you get to that point or was she always that way?

[waverider]

How did you get to that point or was she always that way?

By practicing the tools and techniques advise on here.

No i have been the brunt of horrors and most of the issues members talk about on here, including the extremes of alcoholism

[Akita]

Did she self harm?  Has anyone helped their pwBPD stop self harming?

[waverider]

Did she self harm?  Has anyone helped their pwBPD stop self harming?

Yep, cutting, chewed the insides of her mouth/lips to the point she is now permanently disfigured and has had reconstruction surgery. Following diagnosis she regularly overdosed. Had between 20-30 ambulance call outs over about 18 months, plus other admissions. Not suicide attempts just self harm. Forced sleep deprivation was common.

Hasn't done anything for a long while. As a result of me being involved in her therapy when she is feeling self destructive she talks it over with me so apart from the usual BPD self sabotage there has been nothing seriously physical.

[Akita]

Mine doesn't self harm to that extreme.  She does the lip and cheek biting but doesn't break the skin often.  She cuts but few are deep.  She scratches her arms, hair pulls, and will press against edges until she bruises.  She hasn't even used pills to overdose she just misuses them.  She has never been hospitalized.  Ever since she started therapy her behaviors have gotten worse.  She cuts more frequently and struggles emotionally after seeing the therapist.  She has not incorporated anything he has discussed with her.  She still in my mind just does what she WANTS to do.  I'm not sure what to do to help.  She doesn't know either.  Her therapist cut her back to one session a week.  He told her she is unsettled and they need to reorient the treatment.  Not sure what that means.  He had given up helping her with SI because she wasn't able to accomplish hardly any tasks according to him.  I just want this to be easier for her.

[Akita]

Last night she severely cut her wrist.  Deep with gushing blood.  She has been struggling with her therapist.  He says she is unsettled and they need to refocus the therapy.  He dropped her appointments from twice a week to once a week.  She didn't like this.  She is having a hard time so he sees her less?  Makes no sense to her.  She did send him a very angry letter after he cancelled an appointment due to illness.  She drove there to be certain he wasn't there.  She feels that he may claim illness to avoid her.  Now he has cancelled appointments so obviously he is avoiding her.  She also had what she considered a best friend threaten to kill herself and then she unfriended my wife.  They are both borderline and the relationship has been confusing for her.  We had just purchases a game console.  She enjoys video games.  She couldn't get logged in and I wasn't being helpful.  She shut it down and went in the bathroom after she was answering my questions with colorful language.  Everything just piled up on her so she used her knife.  I don't know how to derail this.  Neither does the therapist. 

[Meadowslark]

Last night she severely cut her wrist.  Deep with gushing blood.  She has been struggling with her therapist.  He says she is unsettled and they need to refocus the therapy.  He dropped her appointments from twice a week to once a week.  She didn't like this.  She is having a hard time so he sees her less?  Makes no sense to her.  She did send him a very angry letter after he cancelled an appointment due to illness.  She drove there to be certain he wasn't there.  She feels that he may claim illness to avoid her.  Now he has cancelled appointments so obviously he is avoiding her.  She also had what she considered a best friend threaten to kill herself and then she unfriended my wife.  They are both borderline and the relationship has been confusing for her.  We had just purchases a game console.  She enjoys video games.  She couldn't get logged in and I wasn't being helpful.  She shut it down and went in the bathroom after she was answering my questions with colorful language.  Everything just piled up on her so she used her knife.  I don't know how to derail this.  Neither does the therapist. 

To be fair, she did go and cancel her appointments with him, send him and angry letter and misuse the website messaging system a couple times. This could be the therapist instituting some boundaries? If she does not comply with what the therapist is trying to do, there is no point in therapy - it's wasting her time and his time.

I highly doubt that the therapist is trying to actively avoid her - if he's sick, he's sick. Telling her that reorienting the therapy would be in her best interest might be him trying to have her focus on the work that needs to be done to get better. It could be a, "If you're not going to do the work, then I can't help you." sort of deal.

This is just guesswork though, and I'm sorry both of you are going through this difficult time. I can't imagine how scared and frustrated and confused you are, Akita.

[Akita]

The messaging system really aggravates her.  She hates the lack of communication.  She has brought up that point several times.  He just says that is not how he does things and leaves it at that.  She is attempting to journal to avoid the overwhelming desire to use the message system inappropriately.  I guess it could be boundaries... .expectations?  She has a hard time waiting.  If she wants to go somewhere, say something, or find out about something she has a difficult time if it isn't immediate.  She gets a lot of negative thoughts rolling around in her head in order to stop them whatever it is needs to happen now so she won't need to think about it anymore.  She is also quite worried that no one actually cares about her.  She is an insurance claim.  They don't want her to get well.  Her cancelling appointments was out of anger at him cancelling and trying to see if she is still welcome there.  The letter was out of hurt.  She hurt a lot about many things and had to let it out before it consumed her.  I can see why borderline patients are not sought after.  Therapy is difficult to say the least.  Thank you for your kind words, Meadowslark.

[waverider]

The messaging system really aggravates her.  She hates the lack of communication.  She has brought up that point several times.  He just says that is not how he does things and leaves it at that.  She is attempting to journal to avoid the overwhelming desire to use the message system inappropriately.  I guess it could be boundaries... .expectations?  She has a hard time waiting.  If she wants to go somewhere, say something, or find out about something she has a difficult time if it isn't immediate.  She gets a lot of negative thoughts rolling around in her head in order to stop them whatever it is needs to happen now so she won't need to think about it anymore.  She is also quite worried that no one actually cares about her.  She is an insurance claim.  They don't want her to get well.  Her cancelling appointments was out of anger at him cancelling and trying to see if she is still welcome there.  The letter was out of hurt.  She hurt a lot about many things and had to let it out before it consumed her.  I can see why borderline patients are not sought after.  Therapy is difficult to say the least.  Thank you for your kind words, Meadowslark.

Been through all of this. Therapists have too, which is why they are strict. I doubt there is a therapist around who hasn't been left abusive messages by patients. My wife leaves the longest abusive messages for everyone on message banks. Luckily she is incapable of texting, otherwise that would get her in even worse trouble. At least with voice messageing the receiver can tell that the person was obviously not stable when they left it. with text you can only guess.

My wife's doctor went on leave and my wife was convinced the her doctor had left the practice because my wife was a 'bad person". Ditto when she has a sick day.

If a line of therapy is overly triggering it is common for therapists to drop it and change tact. Even if they have hit a nerve nothing gets achieved while a patient is loosing the plot and combatitive