Hiding the knives

[DriftlessRider]

My 21yo daughter w/ BPD (DD21xBPD, is that the acronym I should use?) cuts herself. Her mental illness first came to light when she was in 7th grade when she bravely told us she was cutting herself. I think that behavior is largely under control, but this winter she asked us to pick her up at the ER, she had cut both of her legs and had needed stitches. What was scary about that incident is that we were in such a great period where everything was going so well. It kind of shocked me that it came out of the blue like that.

Well, we were invited to a meeting with her therapist and I learned that the therapist had suggested to daughter that she remove knives from her apartment. I asked daughter about that afterwards, and she just rolled her eyes and told me not to worry about it.

She did throw out her razor blades, she put them out in the trash. (I hope she hasn't renewed her stock since then). She can't do without a knife, I mean steak is one of the few foods she eats.

What is the solution I should suggest here? I am thinking about suggesting she get a lock box, like the one you might store cash in, and she keep her knives in there. The idea being, I believe she dissociates before she cuts herself. She is not in her own mind, kind of. The act of retrieving the key and unlocked the box may slow down the process? Disrupt it?

I expect she would not get in the habit of keeping her knives there, but maybe if she felt a wave coming on she might store them temporarily?

Just looking for any practical advice along these lines, or is this just not a reasonable approach?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[wendydarling]

Hi Driftlessrider  

What a shock for you, your DD was doing well managing self harm. I had a similar experience last October, first self harm since 2015/16 and yes it was during a dissociative amnesia episode when she overdosed on her meds, woke up in hospital,  it really scared and disturbed her that she did that without intent... and after all her determination to get well she felt she'd let herself down.  We talked and she agreed to hand her meds to me, which she did for a couple of months, now she is back in full control of managing her meds. She uses a weekly dispenser and locks the rest away.

How do you think your DD might receive your suggestion, have you talked about similar things, safety plans together before?  

WDx

[DriftlessRider]

How do you think your DD might receive your suggestion, have you talked about similar things, safety plans together before?

I think she would humor me at least, and appreciate the intention. Not sure it would actually get used though. I may do it anyways and include a rubber knife in there, and a picture of her dogs.

As for the safety plan, she can get herself to the hospital. She knows the phone and online suicide prevention sources, and I think she's used them. She knows she can come home anytime, and she's asked to come home when feeling depressed (which I thought was an excellent sign). She knows we'll get her anywhere anytime. Any additional suggestions welcome

[wendydarling]

I think she would humor me at least, and appreciate the intention. Not sure it would actually get used though. I may do it anyways and include a rubber knife in there, and a picture of her dogs.

My DD's humour about her BPD gets her through, her saving grace, go for it  

[FaithHopeLove]

hello Reckless. I join Wendy Darling in welcoming you to the group. It sounds like you are really going through a tough time. The good news is you have come to the right place to get help. I see you already know the acronyms. That makes you automatically family. You asked about locking up your knives. As a former police officer I recommend you do that. Using a lock box is fine. It just removes one more temptation

[No-One]

DriftlessRider:
I'm thinking that removing all knives from her own apartment isn't practical ( if she does any food prep)  Perhaps you could remove most sharp knives from her apartment, and only leave one knife that doesn't cut very well (i.e. perhaps one with a serrated blade).  That one semi-sharp knife could be locked up, when she feels like she is slipping. 

New Habits:
To change a habit, you need to replace the bad habit with a healthy one. She needs to develop some personal distress tolerance tools and ways to improve the moment.  What healthy alternatives can she try when she has the urge to cut?

If she doesn't have a personal list of things to do for distress tolerance, then she should make one.  If she already has one, perhaps she could fine tune it.  It might help to have a list of things to do when she is sad and then other things to do when she is angry.  It might, also, help to list actions in levels.  i.e.

First level: For things she can do on her own (deep breathing, soothing music, funny movie, journal writing, exercising, using ice or rubber band, etc,).

Second level: perhaps calling a friend, calling family and if necessary a help line.

Third level would be to go stay at your house for awhile or go to the hospital.

Some things that could help for the long run:

Substitutes for the Cutting Sensation

• Rub an ice cube on your skin instead of cutting it.
• Wear a rubber band around your wrist and snap it gently against your skin.
• Draw on the skin with a soft-tipped red pen in the place you might usually cut

I don't know if you are familiar with TENS units.  They are readily available these days.  Their purpose is for physical therapy and pain management.  Ironically, if you dial into a high enough level, you can get an unpleasant sensation.  I've read where some cutters have used a TENS unit, while getting off of cutting.  Not the ideal goal for the long run, but doesn't cause damage. 

I'm not a cutter, but I do have a TENS unit and have used it on my knees for physical therapy.  I've tried various levels and patterns.  So, I've found some levels/patterns that I find uncomfortable or painful. I'm not into pain, so I don't use those levels/patterns. Guess I can see why some cutters used it to help step down the scale from cutting. 

I'm not promoting the use of a TENS units for cutters.  It's not likely that a therapist would recommend one (likely controversial).  Just sharing a thought to park in your brain, should you find that she just can't seem to stop cutting and has tried ice, rubber bands and other measures.

[sandgrounder]

This post brings back memories for me of the first time my daughter's mental health caused concern. At the time, it was diagnosed as PTSD from sexual abuse. She coped by self-harm and I was told by her therapy team to lock all the knives and pencil sharpeners in the boot of my car. It made meal preparation interesting to say the least.

I can't see how you could do this for an adult.

My daughter was also told to use distraction - in her case to put her face into a bowl of very cold water.

[mggt]

Hi. Isn’t it sad we all have to hide knives. Lock our bedroom door. Check on them in morning. Hoping they are still alive. Hoping they haven’t sneaked out. Hoping if they did they are safe. Not with thoose people that supposed hurt them hoping if they are there in morning. They are in a better mood from the night before. That night you never slept. Wondering. Who the hell they are.  Knowing you did nothing accept love them beyond belief   God help us All

[powerup123]

I find the self harming very difficult to cope with. My DS22 self harms but hides it from us. If I ask him about it, he denies it and gets defensive, he feels a lot of shame about it. There would be little point in us hiding knives as he always has razor blades or lighters.
I know that he doesn’t hide it from his mental health team and he has attended hospital on at least one occasion in the last month for self harm injuries.
I’m trying to accept that I can’t stop him self harming, he is an adult and it is his choice. In other ways he is improving so I hope eventually the self harming will improve too.

[Mirsa]

Hi DriftlessRider,

Both my daughters have had episodes of cutting, and it is indeed just awful.  The BPD will only use razor blades, and the younger one has used scissors, a tack, a compass, and even broken a plastic utensil in half.  She does more superficial scratches than anything else.

When they were in crisis, I locked away all knives, blades, sharp tools, and scissors.  It didn't really matter.  When they wanted to cut, they found something, once even taking down a picture and pulling a nail out of the wall.   As BPD got better, she stopped cutting, but I think razor blades still trigger that impulse in her, which upsets her now.  Younger DD will scratch herself when in distress...she has OCD and anxiety.  We are getting better as using coping mechanisms to intervene when these urges are strong for her, so thankfully, the cutting is getting increasingly less (every few months now, versus weekly). 

Sounds to me as though your DD is older, living on her own, and this is her battle to fight.  If knives are not her weapon of choice, don't lose sleep over it.  (easier said than done, I know!)

Hugs to you during this difficult time.  Don't forget, these episodes are traumatizing for the other people in her life (you).  It's like second-hand smoke; what someone else does to their body/life can have a huge secondary impact on us.  Hope you can practice some self-care and self-compassion during this difficult time.

[Kiss]

Hi Driftless and Group at large.  I'm new to this so take my feedback as such. I observed my son cutting himself on his arm with a razor blade (against the veins) right in front of me on our back deck one morning.  I was stunned but knew that it wasn't suicidal and also i didn't want to reinforce this behavior as a way of controlling or manipulating.  I simply stated "Peter, cutting yourself like this makes me scared for you and I'm not going to sit here and become a party to this behavior.  With that I walked into the house.  He's continued to self-harm at times but I think this has been mostly drug seeking or some type of escape mechanism.

My BPD son is 25 now, his behavior began manifesting (outwardly to us anyway) when he was a senior in high school. First diagnosed as hyper-active, then drug abuse skyrocketed and he was in and out of rehabs for several years.  His continued using was met with being kicked out of the house and several years of legal problems including prison for several years. He's now out on probation and living in a family owned home about 2 hours from where my wife and I live.  One day at a time...

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[DriftlessRider]

Thanks for all the replies, and especially the insights into distractions. And potentially less unhealthy methods of self-harm, the TENS unit thing is interesting. (Reminds me of safe-sex vs teaching-abstinence debates.)

I just asked DD21xBPD about the idea of the lock box, and distractions. She got really uncomfortable and said she didn't want to talk about it. But in an embarrassed way more than hostile. I said that's fine, I'll bring it up later maybe, I'd like to be able to talk about it. She was happy with that, and was actually quite lovey afterwards. She knows we care.

The second time she hospitalized herself I happened to be in the room during discharge. The nurse started taking about suicide, which is not a word we had discussed within the family at all. Daughter was clearly uncomfortable that I was in the room, and I pointed that out to the nurse and asked daughter if I could stay, I thought it would be healthy. And she said yes and it was.

Since then I make a point of using the "suicide" word periodically. Not in a big way, not often, but enough to normalize it a bit. I want to be able to say "are you feeling suicidal" in crisis moments, and not have that be the first time the word was uttered between us. And I think that has worked.

So, I'll gently bring up the self-harming thing again later. And I think I will get her the box. Maybe not the rubber knife at this point. Not so much because I'm sure she'll use it, but because it's a physical sign that there is a problem and we all know about it. So we might as well work together on it and not pretend it doesn't exist.

[FaithHopeLove]

I think you are handling this beautifully, Driftless.

[No-One]

I just asked DD21xBPD about the idea of the lock box, and distractions. She got really uncomfortable and said she didn't want to talk about it. But in an embarrassed way more than hostile. I said that's fine, I'll bring it up later maybe, I'd like to be able to talk about it. She was happy with that, and was actually quite lovey afterwards. She knows we care. . .

So, I'll gently bring up the self-harming thing again later. And I think I will get her the box. Maybe not the rubber knife at this point. Not so much because I'm sure she'll use it, but because it's a physical sign that there is a problem and we all know about it. So we might as well work together on it and not pretend it doesn't exist.

Perhaps you might find it helpful to go on your own exploration regarding ways to improve distressful moments/thoughts.  If you Google these words, "improve the moment distress tolerance", you will find several Youtube videos, articles, websites, etc.

Check some things out, experience them for yourself.  There is a very useful app for apple devices and android, called "Insight Timer".  The free option gives you a lot to work with.  There are lots of different styles of meditations, classes and relaxation techniques. You might want to download it and try it out for yourself.  Sample some of the guided meditations, check out the courses, etc.

Perhaps you end up giving her the box, but put in some things that could be personal for her - ways to improve her moment.  Perhaps she could go to the box, exchange the knife for something in the box, lock up the knife in the box and proceed to enjoy the alternative.

The alternatives would have to be something she likes. Maybe there is a gift certificate to her favorite ice cream/frozen yogurt store, online music purchase, audio book, kindle book, etc.

I just purchased a little novelty item recently at Amazon.  It's a red panic button.  It has a USB cable so you can record a message for someone.  Once you make the recording, if someone pushes the panic button, the message plays.  Just an idea of something to put in the box.  She could go push the panic button and get a message to help coach her on how to improve the moment, or some message of encouragement to help remind her that cutting has never really made it better and that other actions can.

Just sharing some thoughts.  Perhaps the box can be something that evolves and changes.  Maybe it can be a fun thing for you and your daughter and something that reminds her of new possibilities. 

It sounds like you and you daughter have a good relationship.  It's good that she has your help and interest in her well being.