Reflections on self-injury

Sigh... After an eight AM meeting, I opened this morning... And now, coming on briefly after I got off, Crystal closes tonight. So no baby all day. Makes me sad.

Feelings of instability have increased markedly lately. My feelings about eating (if not quite my habits themselves) have begun to improve, but the depression and anxiety hang around as they always have. It's been about four or five months since I last cut and the urges are strong again. They never really go away.

I don't talk about my cutting much. I guess that it's something which feels like it's always been with me and still feels more like a friend and companion than a bad coping mechanism or dangerous, destructive habit. It's one of those things which therapy has yet to talk me out of. So far most, if not all, of my previous therapists have wanted me to go to an inpatient facility to tackle the issue.

I've always argued around aggressive treatment/inpatient as primarily a matter of affordability (after all, right now I can't even afford therapy in and of itself) and secondarily as a Not Really Major Issue. Somehow the infrequency of my indulgence makes me think it's less of a problem. (Isn't it?) Things have never been so bad that I'd cut multiple times a day (well, not usually) and as a general course have been once every few weeks at most. Over the past year and a half or so, once every few months. That's not a big deal. Right?

Of course... There is the porning. Like I used to food-porn with anorexia, I cut-porn now. Most recently, the scenes in Harry Potter and the Order of the Phoenix with Professor Umbridge's wicked little quill have provided both a trigger and feelings of satisfaction, at least to some degree. The internet teems with triggers and 'porn'. The imagination fills in where my physical actions continue to refrain. While physically I may not have cut for months, I guess you could say I'm a total porn addict. A few times a day, maybe. Constant daydreaming, sometimes.

Here's the thing, though. Technically, I'm not harming anyone by this. Beyond that, I'm not sure how to stop it. Beyond that, I'm definitely not sure I WANT to stop.

I never 'gave up' cutting as a personal resolution or a decision to recover, heal, overcome. I never have wanted to stop. (This was another reason I argued against inpatient: most places, unless you're a serious medical harm to yourself/others, require that you sign a contract certifying you're entering the program of your own initiative and with a strong desire to recover.) I suppose it's a sign that my thoughts in this area are still ruefully unhealthy or something, but no one's ever managed to convince me either of how cutting hurts me or how I'd be better off without it.

The reasons I've physically stopped are simple: other people. Namely, Crystal, my little brother, and total strangers who see my body and look horrified. Were I completely alone and able to ignore others better, I'd probably continue to self-injure on a weekly or daily basis.

I don't know how to deal with the sense of loss. I don't know how to cope with the feelings of self-hatred, anxiety, loneliness, emptiness, self-loathing, inadequacy, helplessness, mania - even just boredom. These are all some of the things which drive me to self-injury, physical or imaginary. When I'm not self-injuring regularly I feel a loss of identity and a lack of completion. Something is MISSING. I grieve for it in a way usually reserved for close loved ones. In the same way that I get confused about who I am if not an anorectic, I don't know who I am if not a cutter. (God, how BDSM does that sound?)

There's a hotline that I've often been referred to and never called - 1-800-DONT-CUT. It's supposed to be really good; I've read much of the book written by the people who started the line and they actually run the only inpatient program I've so much as considered for self-injury. (The reason I've never called is that when I'm to the point that I want to actually self-harm, I don't want anyone to talk me out of it, deter me, or break my mood.) Lately I've been wanting to call them just to talk about this in lieu of a therapist: how do I face the sense of emptiness that comes without cutting?

I wonder a lot if this is a normal feeling. More and more the Powers That Be are looking down on calling self-injury an addiction, opting instead for a more learned behavior, benefits/rewards approach, but I still feel like 'addiction' may be the best term. After all, don't recovering alcoholics, smokers, drug addicts reference this feeling of confusion, lack of direction, etc? (Hell, isn't that part of what AA and its higher power teaching is about? Just redirect that passion!) I don't know. It's one of those areas that I'm left aware both of my personal lack of knowledge and the communal lack of understanding in this area.

Therapists have given me dozens of worksheets and thought pattern charts and you-name-its to fill in, to understand the thoughts and emotions that drive my urge to self-injure. These charts often backfire and, instead of helping me to break it down and understand my feelings, lead me to think that I'm either too damn crazy for a chart or just plain have a glitch in the system. I've got so many filled out charts with reasons ranging from the classic 'anger at' whomever to things the docs can't understand (or accept as truthful) like boredom, feeling 'too' happy, feeling distractible, and missing someone.

Several docs have been adamant that all my urges are simple: anger turned inward. ...even though anger is rarely a motivating feeling.

Several tell me it's frustrated sexual energy, or sexual fear, or sexual something. (Freud is aliiiive!)

Others still insist I just want attention. (After all, I gave up a long time ago on trying to hide all the damn scars where most cutters will still opt for long sleeves no matter the weather.)

In the end, I often have to wonder if anyone truly has a solid understanding of self-injury, its triggers and motivators. Maybe that's why it's so hard to want to give up: if no one can help me understand what it is and how it works in the first place, how can they convince me it's an altogether 'bad' thing?

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In other news, August 1st my new insurance kicks in. I stopped seeing Shelley about a month ago and have been (again) out of therapy since then. I've been unmedicated since February due to the whole insurance cut-off fiasco. All improvement, stagnation, or backsliding has been the result of lack of any sort of treatment whatsoever beyond the self-nurture I've learned to give myself.

I have the number for another therapist with whom I'm supposed to call and set up an intake... She has a lot of extensive, varied experience and works with an organization which seems to have really good policies toward medication... So I guess that once August rolls around we'll see what's what with that.