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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: BPD BEHAVIORS: Self injury and self harm  (Read 33327 times)
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« Reply #70 on: March 04, 2010, 08:18:25 AM »

Cutting normally begins to occur in the teenage years and peeks in the early 20's, with most people stopping in their 30's. The estimates are that about 2 million people have engaged in some form of self harm to cope with their emotions at least once in their life.

When we find out that our loved one has self harmed or self injured themselves, we often experience shock, anger, frustration, and guilt.  

* Our shock may lead us to judge them as doing something "wrong" or "bad".

* Our anger may erupt because we feel "manipulated" and that it is "unnecessary".

* You may feel guilty for not "being there for them",  for not "helping them enough", or for not being a "good enough parent".

You will find yourself filled with questions - "how could you?" - "Why did you do this to yourself?" - "what's wrong with you?" - "you're doing this to manipulate me" - "you're not who I thought you were" - and the biggest question of all "what should I do or say?

* "Do" discuss this with them. Self injury flourishes in secrecy, since it is typically performed when the person is alone and feeling overwhelmed by their emotions. Trying to ignore it or control it (which you can't anyway) only sends the signal that you don't care about their emotions or feelings. It diminishes them even more and adds to their shame and poor self esteem. This will be tough to do, but don't judge them. Stay neutral and calm and away from negative comments. Maybe ask some nonjudgmental questions, such as:

   * "How long have you been hurting yourself?"

   * "Why do you hurt yourself?"

   * "How do you hurt yourself?"

   * "When and where do you usually hurt yourself?"

   * "How often do you injure yourself?"

   * "How did you learn to hurt yourself?"

   * "What is it like for you to talk with me about hurting yourself?"

   * "Does it hurt when you injure yourself?"

   * "How open are you about your self-injurious behaviors?"

   * "Do you want to change your SI behaviors?"

   * "How can I help you with your SI?"

* Be available. This means that you offer to discuss their need to self injury at any time, within reason (ex: not in the middle of the night or during your work day or if you feel threatened and manipulated). You are offering to be their support person so that they don't have to engage in self injury to cope with their emotional pain.

* Help them find other sources. Make suggestions for them to talk with a therapist or to join an online support group. Offer to help them surf the internet for available resources, since the more support and understanding they receive, the less shame they will feel and the better the odds that they will learn to control and stop it before it starts.

* Don't discourage self injury. The emotional pain that someone feels that drives them to hurt themselves is so overwhelming, that to offer the advice "just don't do it" trivializes and mocks the pain they are in. It will damage your relationship with them and reduce their desire to seek your support and create further shame inside of them. For some, engaging in self injury is the only alternative they see besides ending their painful life.

* Don't push. Now if they don't appear to want to discuss this with you - don't push them to. Insisting that they do only further damages the relationship and trust between you.


The fact that they are hurting themselves isn't a reflection on you - it is a signal that your loved one is in extreme emotional pain and that they need to find a release for it. They aren't deliberately trying to manipulate you. This isn't a game they play to control you. It is a severe and unhealthy coping mechanism for them.

Accepting them isn't the same as condoning what they have done. Try to connect with the fact that they are hurting, and offer them empathy and sympathy based on that. Judgments and negative criticism will only make it worse...

Our job is to offer nonjudgmental support and acceptance of them - as hard as that seems, it is nothing compared to the shame they feel inside themselves.

Threats to self harm and how to care for ourselves

If they are making threats to self harm to stop you (for example: to stop you from going somewhere) or in an attempt to control you - this "can be" an attempt at manipulation. We can't allow ourselves to be manipulated in this fashion. Your response should be to offer them healthier options while also not being controlled by their threats. Don't give in to this and think that by staying and talking to them more, that you are helping them. You are giving them the green light to threaten you every time they want to get their way. In this form of crisis, we can't allow them to emotionally blackmail us, since that only guarantees that they will do it again (threaten us) as a way to control us. It doesn't mean that they won't hurt themselves, since they probably will "to show what you made them do to themselves",. It means that while our loved one is a lot of emotional pain, we still can't allow them to control us in this unhealthy fashion.

~ We can't lose our own sense of self trying to save them. We can't allow their pain to dictate whether we go out bowling or to see family members or to work. We can't stop living our lives because of their pain.

references: www.self-injury.net/
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« Reply #71 on: March 04, 2010, 12:40:35 PM »

this is a hard subject for me... my boyfriend cuts himself...he is willing to talk about it, so we do...he wont stop it, cause he told me that...he told me that it was something for him, and noone could take that away from him... i dont know what to do to help him...i do ask questions, and he answeres if he is up for it...other than that i just make sure that it isnt infected or that he has seriously hurt himself... hes never gone really deep... and if he did, i would call the ambulance... but should i do that anyways, when there isnt any threat to his life... im not sure...

he has tried to blame it on me...i cut my self because of u, and i drink because u dont love me..., but i do shoot that down right away now...i tell him that u cut ur self, because u feel like it, u drink because u feel like it, it has nothing to do with me...

dont know what to do... we are going to a t on tuesday, so we see what happens there...

hugzamillion
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« Reply #72 on: March 05, 2010, 11:34:29 AM »

My son learned to use SI from his then gf. He sliced up his arms with so many scratches that his scars will be permanent. To make matters worse, he then added tattoos on his wrist to supposedly remind him not to cut anymore. The left wrist reads "final" and the right wrist reads "cut". They didn't help, since he admitted to me last month that he cut himself again  cry

Honestly, I didn't know how to respond at the time.

I challenged him and questioned why he needed to do that.

If there is a next time, i will know better how to respond...

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« Reply #73 on: March 05, 2010, 01:21:44 PM »

My BPDs now 23 used to self harm.  He would use razor blades from any source.  It's a miracle that he didn't end up with endless infections.

He would cut his forearms, upper thighs, even his back although I am not sure how he managed that.  He has deep, angry scars that will never go away.  Rarely wears shorts or short sleeved shirts, even in summer.  

I walked in on him cutting himself one night and it was so deep that it needed medical attention.  I did not try to dicsuss the cutting with him, just told him to put on some pants and we went to hospital.  He was treated and at my insistance was kept in the phsyc ward overnight.  That was 8 years ago and was the beginning of our dance with BPD.

Most of the time after that we did not see any cutting, just the evidence of it.  DH and I didn't really know how to deal with it so it didn't get discussed much.  The last time that my S cut was on a night that he and I were staying with some friends.  We were sharing a room that had it's own bath.  We had gone to bed and at some point he got up and cut himself.  Then, he decided to smear his blood all over the walls of our friends bathroom.  He woke me up and asked me to take him to hospital.  I looked at the cuts and since they were superficial and I had taken meds to sleep, I declined making that trip. I took him into the bathroom to dress the wounds myself and found the blood on the walls but did not react.  After caring for the wounds I very calmly told him that he would have to clean up the mess he had made.  I handed him a cloth and some cleanser that was under the sink and went back to bed.  The bathroom was clean the next morning.

It wasn't long after that incident that he "graduated" (my words) to suicide.  Thankfully he never quite figured out how to get the timing right for success, but he got very close twice.

We eventually found DBT therapy for him and that helped him stop the cycle of SI behaviour.

I hope that I never have to endure life with another cutter.  It is so hard to watch someone I love hurt themselves and not be able to help. Its frustrating, sad and guilt making all at the same time. Despite our efforts, our S did not get help until well into a pattern of SI as a form of coping for any crisis.  The good news is that he did get help and this pattern has changed.  I still wish I could have done more sooner so that he wouldn't have to wear these scars as a constant reminder of his very sad, very troubled teen years.

pennifree
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« Reply #74 on: March 05, 2010, 01:40:08 PM »

my BPD13 started cutting in sept. of 08.  only superficial but the scars are still visible.  she also burned and scraped herself as well as pulled her hair out right in front of me once.  

she  learned about cutting from her bi polar cousin.  last summer, in the midst of a calm rage (if you know what i mean), she tried to burn herself in my presence.  she had also been having suicidal thoughts (what it would be like to die, how it would happen).  i made the decision to put her into an acute care facility as i was afraid she would attempt to hurt herself permanently!  she was there 2 weeks and was put on Prozac and Abilify for depression and mood stability.  she is still on those meds 7 months later and has had NO s i incidents and is no longer depressed.  i'm still paying the hospital bill but am thankful for the improvements that she has made..

gotta love those meds ...  now she has a more even playing field for her therapy (DBT now!) to be affective.

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« Reply #75 on: March 05, 2010, 02:07:29 PM »

My dd used to cut a lot.  Her wrists, calves, and palms of her hands still have scars, but they've faded quite a bit.  She used razor blades, knives and anything else that could draw blood. I tried talking with her, and reminding her of alternatives (coloring on her arm with red marker, using ice to numb the spot she wanted to cut), it never lasted long and she would go back to cutting.

She is still attempting to SI, but she doesn't get away with much at the Residential Treatment Center.
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« Reply #76 on: March 05, 2010, 02:15:31 PM »

I have to agree with the plan here that UFN posted. My daughter had a chart that her therapy team made for her, a safety plan of what to do when she felt like cutting, distractions she could use. She refused to talk to me ever about it, and I didn't pressure her, I did tell her I was worried about her. Honestly I did feel like a failure as a mother especially since I myself had gone through some cutting at 17 for about a year. I felt like I knew what she was going through and tried to talk with her the way I wish anyone would have spoke to me, but she was in different place than me. She was numb to feelings and for me it was a way to let the pain out and not hold it in. I just kept trying to be supportive of her and kept telling her how much I loved her and tried not to focus on her just cutting, but I did take away any thing she could use to cut with, but she found things, little broken pieces of hard plastic, broke off pieces of the hospital's formica and used it too, disasembled part of a pocket pencil sharpener and took the blade out.  Mine finally stopped at the RTC, she would be supervised during bathroom, shower, etc, 24/7, and wear an orange jumpsuite, she worked on DBT skills, etc.  She has no desire now and is still using her plan it's on her wall today.
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« Reply #77 on: March 06, 2010, 11:36:56 AM »

I can't bear to read the first post in this thread. The pain from my DD's period of cutting this past fall is still too hard for me. She will have permanent scars on her forearms. We locked up all the razors, but she managed to cut anyway.

I can share that, with enough hospitalizations, proper medication, and a smattering of DBT therapy before she quit, she isn't cutting now. She is not dealing with her BPD, but at least she is not self-injuring or suicidal and hasn't been that way since shortly after Christmas.

There is hope.
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« Reply #78 on: April 11, 2010, 08:44:04 AM »

Children show scars like medals. Lovers use them as secrets to reveal. A scar is what happens when the word is made flesh.

—Leonard Cohen


From this interesting blog from "shadowlight".

After I finally stopped allowing myself to use cutting as a coping technique, I seriously toyed with the idea of getting the following 2 latin phrases tattooed on my wrists: Vincit omnia veritas (truth conquers all) and Sub specie aeternitatis (under the aspect of eternity). They would be reminders not to cut, to honor a promise I made to myself NOT to kill myself, and as a commitment to heal.

Here's a really good website form I used in the past when I was still struggling with wanting to cut:

Assessing your immediate need to self-injure.

It "talked me down from the ledge" many times. I self-injured because it acted like a light-switch, turning off the too-painful feelings of emotional pain. Physical pain is manageable and controllable: I'm in charge. Recently I've been struggling with the urge again after years of not cutting. But I'm working with my T on that. I find I think about it more when I'm not using my healthy coping mechanisms (proper sleep, nutrition, exercise, healthy relationships).

 to all the people who are struggling when their loved one SI's. It was really hard for my mom, I know.

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« Reply #79 on: May 25, 2011, 12:52:12 PM »

The BPD in my world suffers from Dermatillomania. I was just wondering how common this was here. I see that BPD is mentioned along with OCD in many write ups about the disorder. They liken it to cutting and self harm. Anyone else dealing with this? Is it something that the kids might mimic later?

Here is a link about it if you are unfamiliar:

www.psychology.wikia.com/wiki/Dermatillomania
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