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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: BPD BEHAVIORS: Self injury and self harm  (Read 32607 times)
Cosmo
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« on: November 14, 2006, 07:11:19 AM »

People can cut to feel something because they are so psychologically NUMB.  *OR* they can cut because there is such a bottleneck of so much psychological pain that it RELEASES some of that pain.  And maybe that goes back and forth from day to day in an individual.

When our daughter was doing this, I was told it's a coping mechanism.  Much like her eating disorder.  It's a hard thing to see, but I had to come to look at it as a way for her to SURVIVE.  She was so suicidal at times, I was almost, sickeningly, "grateful" for the release/coping even though it sucked to see her clothes and sheets bloodied and these horrible scars on her now.

Once the total downhill mental slalom began, she was covered with cuts.

There are "better" things to do - like rub ice on your wrists, or pop a rubber band on them.  My daughter tried these and none of those seemed to compensate like the actual bloodletting.

All I can recommend, as a teenaged girl's mom, is that the LESS you refer to the cutting, the better.  That sounds so creepy and enabling,maybe, but really, it only stresses the cutter more.  When my daughter would see me even LOOKING at her arms (how can you NOT? you know?) she'd freak.  I'd have to tell her, "You can't blame a mom for being scared, hon."  When I mentioned my feelings to her about what she was doing, she could handle it.  If I in any way acted grossed out or the "right or wrong" of it, that would be when I could see her stress level zooming up.

Your other kids won't copy this, I don't think, unless they get a crisis mode going themselves. 

TIME mag ran a great article about the "trendy" CLUBS at American high schools doing this! I guess that is what I can't get at all - doing this as a trend.  Smoking, yes, that will hurt you in the long run, but actually cutting?
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Aloha Lady
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« Reply #1 on: November 14, 2006, 07:18:40 PM »

My daughter cuts, which is really when we started to get very alarmed about her.  Firstly, understand that there is a EPIDEMIC of this behaviour out there - not just confined to BPD people but many, many of our young people.  Secondly, understand that it is a LEARNED behavior - my daughter found out about it from a friend, then saw a made for TV movie about it which just validated what she was doing.  Thirdly, understand that it is an ADDICTIVE behavior - not easy to give up.  It is crucial that other coping skills are learned through professional therapy.  All this was taught to me by professionals in the mental health field.  It is scary, but it is also a way to release tension and anxiety build up - the trick for the person who does it is to find healthier behaviors.

Just some info I've learned along the way.  If it is any consolation at all at least you know the person is trying to help themselves - albeit in a very unhealthy way

Take care and regards.

Aloha
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lasagna
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« Reply #2 on: November 14, 2006, 07:29:57 PM »

Self-mutilating does release endorphins, so the person does feel better-for a while. Seeing your own blood does make a borderline feel '"real" when they are depersonalizing. It's all part of the illness. Such a sad, sad disorder.

I don't agree that it is always learned behavior. there are a lot of kids getting off on it these days but some are purely driven by their amygdala disorder.

My niece finally stopped cutting herself when she started taking Seroquel (a new anti-psychotic) and Wellbutrin XL( dopamine agonist that helps her not over-react to perceived slights). Her parents tried everything else. It's a very low dose, so it does not impair her functioning. But it has opened up a whole new world for her. she is no longer consumed with thoughts of hurting herself. Alleluia!
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Cosmo
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« Reply #3 on: November 15, 2006, 04:49:10 AM »

Lasagna you bring up such a good point about the endorphins.  I remember reading it's like a runner's high, the *anticipated* cut.  Yet an unexpected paper cut will hurt like hell - no high.

I don't think it can be "learned" either.  But did read of, somehow, "clubs" at schools consisting of nothing else but cutters.  Chicken or the egg?

My daughter is on Zoloft and Wellbutrin combo and marked improvements in last two months.
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RTTCB
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« Reply #4 on: November 15, 2006, 07:18:19 AM »

My friend self harms - cuts with anything sharp she can get her hands on. Its usually as a result of an "episode". Something has happened to upset her. Actually happens more frequently when she has got drunk, but has happened on occaision when she's sober - it really depends on the trigger.

Her's is definitely a release - its a physical release, as whats going on in her head is uncontrollable - the  transfer to a physical pain actually diverts her attention for awhile. She is also markedly calmer after shes harmed herself.

Additionally though there is an element of attention seeking going on, as she likes you to "clean her up". This relaxes her - but also puts me in mind of a child - its a kind of nurturing thing in my opinion, and certainly although I call her my friend it is not really an accurate description. A friendship is a two way relationship - with "give and take". Mine has been very clearly a "caretaking role".

I think also the concept of some sort of chemical release when they self harm is not to be discounted.

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Cosmo
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« Reply #5 on: November 15, 2006, 07:49:29 AM »

RT, you mention how she allows you to help her "clean up."  My daughter has such a deep shame about it, I've tried to convince her all I can that NOTHING she does disgusts me or makes me think worse of her.  I know this is her projection about how SHE feels about it.  And I've heard of other people helping care for the cuts.  I'm lucky if I can get her to tend them with salve and band-aid.  My deepest fear about all this, on a health level, are these super strains of staph that are out there, in the community now where you used to have to be hospitalized to get them.  She uses her fingernails.  One old bat at church told me to "cut her nails off."  right.

Only one really bad one got infected early on. 

Isn't life so sad?
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RTTCB
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« Reply #6 on: November 15, 2006, 10:04:46 AM »

Well in the case of my friend - usually she is drunk by the time I get to her - which of course takes away alot of her usual inhibitions. She is not happy about just anyone doing this for her - not sure whether I'd go so far as saying its because she trusts me - thats not a common trait for a BPD. It could be a controlling thing as she has me giving her all my attention etc.

Once sober she is very ashamed like your daughter - hides the cuts from anyone. But strangely not so with me.

Of course I agree whole heartedly with your worries re infection - my friend uses anything sharp she can get her hands on - and that means that its almost certainly not sterile! So I guess thats where the cleaning her up thing came from in the first place - my instincts to prevent infection kicked in. Finding that she in fact calmed down etc if you did this was really quite by chance.

It is indeed all very sad - it breaks my heart really. sad
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lasagna
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« Reply #7 on: November 15, 2006, 04:40:20 PM »

Let me share how we handle self-mutilation in a psych hospital. Of course, your it's your decision.

Unless an artery is burst, the patient (under nursing supervision) cleans, disinfects and bandages her own wound in a very matter-of-fact fashion. This is not done in a punitive way and the patient can certainly choose the nurse she is most comfortable with. The emphasis is strictly on wound care to prevent septicemia (a life-threatening blood infection). The patient is never made to feel shamed about the self-mutilation. Her motivation to cut is discussed at another time, in another place.

I would hesitate to physically nurture a family member after they've cut. It might be contributing to a cycle of feeling abandonment/ get reassuring nurturance.

Just my thoughts. I am not in the situation so I cannot say what I would do at home.
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eternaloptimist
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« Reply #8 on: November 16, 2006, 08:05:47 AM »

If I am an observer or I know about the injury, I remind him that he needs to take care of it to prevent infection (we're talking about an adult here now) but I do not offer to clean or help him take care of it in any way.  I might point him to the Aloe plant if it is a burn but that's as far as I go.  I have lately told him that I don't want to be any part of self harm - Sometimes he gets angry and wants to harm himself in front of me - I will walk out.  It seems harsh but when he is in the "mood" there is no way to get through to him.  I'm so sorry you have to deal with this in your daughter - I can't imagine - it must be just that much more difficult.  - EO
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Cosmo
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« Reply #9 on: November 16, 2006, 08:21:29 AM »

At one point she was ripping away the BandAids I was getting her to keep germs out, hopefully, at school, and she was injuring WITH the strips, if you see what I mean.  They'd leave these 2nd-degree-burn-lookiing nightmare places.  I told her, "No more BandAids.  I won't help you do this."  So then I'm screaming inside thinking of dirty desktops and stuff at school!  But she does wear LONG sleeves to cover the cuts, so at least some protection, maybe there.  She cut for so long in secret places we couldn't see, then when it started on her arms, and we were dumbstruck, she said that was when she wanted help about it.

Such a push-pull dynamic.  She loathes it, she needs it, we hate it, we see it's a coping mechanism that might defer or stop "worse" actions, AAGH!

She's here, she's functioning, her grades are so good, her artwork taking off, and the cuts are MINIMAL.  Every great once in a while a tiny dot on her underclothing as it goes in the wash.  I offer it up to the great Misery in the Sky.  'Please, help it stop.'

Same for all of you witnessing it.  STINKS!  But what are we gonna do?  Just need time.  Passage of time, maybe.
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