Words cannot express...

This blog is turning into a pain and trauma-fest, which was not my intention. At the moment, my life revolves around therapy, self harm, trying not to self-harm, emotional suffering and the struggle to survive it all. I wish I had something positive to say but the past week has been difficult with two major incidents of self harm, and I am feeling overwhelmed.

I am not sure if I can use words to convey exactly how I feel. They seem too detached, too controlled, too trite. I have tried using art; there is an art therapy group at the Day Unit once a week, and it's one of the most helpful groups for me. But although the painting I did in the group yesterday was full of emotion, it looked too "nice" and another patient said that she liked it and could see it being made into a textile design.

Maybe self harm is the only way to reflect how I feel. My outside looks like my inside feels. I am covered with open wounds and scars. I look like the freak that I am.

I'm still trying to think of something positive to say. There is one thing - I am trying to practice mindfulness. It has been suggested by my therapist that it may help me, and one of the groups at the Day Unit is focussing on learning mindfulness skills. I am aiming to do a mindfulness exercise every day, and then to gradually integrate the concept into my everyday life.

The Largactil shuffle

I've been meaning to post for the last few days, but my messy brain wouldn't let me. I had a case conference on Tuesday and although it was intimidating to sit in a room with all five therapists from the Day Unit plus Superstar psych, I felt that a few helpful suggestions were made. I now have to actually take action but at least I feel that there are things I can do that may help. And even if they don't, I will have tried.

One of my meds has been increased (Chlorpromazine, otherwise known as Largactil) which has reduced the feelings of anxiety and agitation. My head is a bit fuzzy and I feel slowed down but at least I feel more relaxed. And I sleep really well. This medication is a temporary measure - ultimately, it will be the therapy that will improve my state of mind. Although I am worried that it won't. And what then?

I have been at the Day Unit for three weeks, and it has been intense and hard work. It is difficult to explain the therapeutic process. Here is a site with some definitions and description of MBT: http://www.mentalising.com/index.html As a person who is experiencing it in a group and individual setting, the theory doesn't seem apparent and the the dialogue between therapists and patients feels natural and exploratory.

My head is not clear enough to descibe it more at the moment. I am struggling with the weekends and the emptiness of them. I have absolutely nothing to do today, just and empty day to fill and it stretches ahead of me. This is a dangerous time, when I am less strong to resist the urge to harm myself.

Please can someone help me to organise my messy brain?

What is wrong with me? My head is messy, I have thoughts that jump from one idea to another with no connection. It is an effort to perform simple tasks and to make sense of things.

I have thoughts and ideas that I don't want and they seem to come from nowhere. I am looking for signs that will help me to decide whether to self harm or not. So far, there have been about the same of each. I don't know what the signs are until I notice them. They may be words that stand out at me on an advert on a bus shelter or a newspaper someone is reading. Or events or situations that happen.

How will self harm help? It has to be something major, like another burn, as only extreme pain will snap me out of my confusion back into reality. I feel out of sync with my surroundings; the world seems faster, louder and brighter than it should be. When I'm outside, I am fearful and nervous. At home, I am more easily disturbed or irritated by small things.

Being at the Day Unit today helped. It is quiet there, but I'm not on my own. I am trying to use the therapy and be hopeful that it will help. It's all I have. If it doesn't work, then I don't know if I have any more options.

Start the year with self-destruction

Will this be the year I self-destruct? Will I still be here this time next year?

Spending the second day of 2011 in A+E after self-harming seems like an ominous sign. I want to say that this will be the last time I burn myself, but it feels inevitable that once the pain from this burn recedes, I will start planning where to do the next one.

Now I have bandages on both arms, from wrist to shoulder, making my arms look padded out, like a Michelin man. Yesterday's burn is mainly full thickness, but around the edges where it is superficial/partial thickness, it is very painful and stinging. My arm has swollen up to twice the usual size and the redness has spread beyond the place where I burnt, which is a bit worrying, as that doesn't usually happen. But I don't want to seem like a drama queen and rush back to the hospital as there may not be anything that they can do. Every time I go to hospital for self harm, I feel guilty and expect to be judged by the medical staff. But when they are kind and respectful, I feel even more guilty as I don't deserve it.

I have forgotten exactly why I ended up harming myself. It's important to remember - I was so lost in my emotional state that I lost the capacity to think rationally. Maybe in my therapy session this week, I can try to disentangle this messy brain of mine

Want to harm

I really want to burn myself. It feels inevitable that I will do it this weekend. There is a space on my arm that needs to be filled.

My head is hurting and I can't express what I feel or why.

Three days to fill

I survived Christmas. My mum came over for lunch, which she had prepared (as my cooking skills are seriously impaired at the moment, due to lack of focus and concentration). I struggled to fill the four hours we spent together, as she is not the most talkative person and we don't share many interests, so we run out of things to say.

She pretended not to notice the bandages on my arms, which were covered by the long sleeves that I always wear, but are bulky and make my arms look twice as fat as usual. If she had asked, I would have explained, but she would rather avoid difficult conversations.

I have three days to fill before starting the Day Unit. Three long, empty days alone. In the back of my mind, there is the urge to burn myself again. No, not an urge exactly, more the idea that I could if I wanted to. And if I am not careful, it could become an urge, and then a compulsion that would be difficult to resist.

My concentration is erratic, but my energy levels are up, so the anti-depressant increase has worked. But I feel edgy and itchy (physically, I mean, due to the burns healing process, but it affects me mentally as I become restless and irritable). I feel like I need to go out today, but not sure where. Definitely not anywhere that will be busy. It's still icy so a walk in the park would not be wise as I am clumsy at the moment and I'm sure I will fall over.

I have a few activities at home that will hopefully keep me occupied:

Crochet project - I'm making little toy animals.

Sewing project - finishing off another toy animal.

Jigsaw

Piano practice - something I haven't done for months, but Superstar psych thinks it will help my brain to focus.

Mindfulness exercise - another suggestion from psych - need to do 10 minutes a day


I am scared that this is not enough, that by Tuesday I will be so fed up with this distracting, and the stress level will build up and up. And being alone and having minimal human contact is not good for me and leads to me losing touch with reality and going a bit weird and borderline psychotic.

Back to the Day Unit

I met with my psychiatrist (who I shall now refer to as Superstar psych, due to his reputation and status in the field of PD) and he has arranged for me to start at the Day Unit next week. Initially, I was relieved as at last, something was being done and I needed something intensive and immediate. But I am also disappointed in myself and see it as a kind of failure, as I have not been a day patient for seven years and hoped that I would never need to return. Yes, it is better than being an inpatient, which would be pointless and would have limited therapeutic value. And if I continue self-harming in this way, the consequences could be serious.

The Day Unit is a specialist PD service, based on group therapy following the Mentalisation Based Therapy model. It runs from 9 to 2.30 on weekdays, with 2 groups a day and one individual therapy session a week. It has changed since I was last there - there are much less patients now, probably only about 6 rather than 12. I know two of the staff quite well, and my therapist is someone I have had groups with in the past.

There is an art room that I can use outside of group times, and although my creativity has waned during this depressive period, maybe I can start to do some art again.

The therapy can be intense and difficult at times, and there is often conflict and tension in the groups, as we are encouraged to explore the impact we have on other group members, and the impact they have on us. Most of the patients are in their 20s and 30s and have the diagnosis of BPD. I hope I am not the oldest, at the grand old age of 36.

I start on Wednesday, after the Bank Holidays. Unil then, I have to manage by myself as the service is closed from Friday, and Superstar psych is on leave for a couple of weeks.

Drifting into dangerous waters

I'm trying to keep posting regularly even though I'm not sure I've got anything worth saying.
I am slightly zonked out on Chlorpromazine; also, I didn't sleep well and dreamt that I was at the dressings clinic at the Burns Unit. A doctor was asking me lots of strange, personal questions and implied that I was a liar. Then I woke up. Any kind of implication or accusation that I am a liar upsets me. Ok, I lie, sometimes. Doesn't everyone? Mainly it's to protect people, or to avoid revealing something that I am ashamed of. But about the Big Stuff - I do not lie.

I know where this comes from. The 'allegations' of abuse that were apparantly a lie, according to family members and social services. I allowed them to bully me into retracting them and thus branding myself as a liar and a fantasist. Now, I often worry that people don't believe things I am telling them. Sometimes I don't even believe myself. I even think that my whole life history could have been a lie, a story that I made up.

This post is not going where I thought it would. I feel like I'm drifting into subjects that I am not sure I can deal with at the moment. I am struggling with the desire to go and buy some more acid to burn myself with. I don't think I'll use it straight away but I feel like I need to have it just in case.

The damage I do *trigger for self harm*

Why do I not take the harm I do to myself seriously enough? I remember a therapist telling me to imagine that the these injuries were inflicted by someone else, to someone I care about. How would I feel? Not only would it be a crime but it would make me angry, distressed and wanting to do anything I could to help.

When it's me doing it to myself, I find it hard to feel anything other than annoyance at myself, and sometimes regret. Sometimes I'm even strangely satisfied with the injuries, if I feel they are "bad" enough. But if they are too bad, it scares me and I do worry about what will happen if one day I go too far and do damage that is permanently disabling. It's too late to worry about scars, about 20 years too late. But if I were to lose the use of any part of my body, especially my hands/arms, I would be devastated.

My latest bout of self harm has scared me as I haven't burnt myself for ten years. I have cut myself, but managed to stay away from A+E for self harm. But the burns are too serious to treat myself - I hoped I could, but as there are now 3 quite large 3rd degree burns on my arms, I am facing months of dressings at the Burns Unit. I didn't want skin grafts, and the Burns Team were concerned that I may not be mentally well enough to cope with surgery. So it's goodbye arms, hello bandages.

I don't actually like the blood and gore aspect of self harm so every time I see my arms, I feel disgusted and freakish. Part of me wants to wake up tomorrow and to be completely healed. But another part of me wants the pain, the punishment, the hospitals and the care I receive.

I hope this is just a blip. My psychiatrist has upped my meds, and I am considering becoming a day patient if things don't improve, just for a couple of months to get me back on track.

I am not sure if I'm mentally "unwell" or not. I don't know how to describe how I'm feeling exactly, and this frustrates me. I have days when I'm lethargic and feel disconnected from the world. I have days when I am agitated and fearful and anxious. I seem to flip from one state to the other, maybe a couple of weeks of the lethargy and then few days of the agitation.

Today I'm lethargic. This is safer - I'm more likely to harm when I'm agitated. Today, I haven't got the energy.