This post is going to be triggering for some people and will contain very graphic descriptions of self-harm. If this is an issue for you, I recommend caution.
One of the symptoms most indicative of Borderline Personality Disorder (or Emotion Dysregulation Disorder) is self-harm. It comes in many forms ranging from superficial to injuries requiring medical attention. Self harm isn’t a suicide attempt. It can be hard to understand the difference at first, but let me try to explain.
I was a cutter. I picked a spot on the inner part of my left arm, and I would slice it with razor blades or knives or anything sharp. I also scratched up my hands and fingers when I was a teenager. The first time I went inpatient I was so self-destructive that I stole staples and paperclips just to be able to scratch myself. I would even hide them in my mouth so the staff couldn’t find them. It worked: even after they searched my mouth they couldn’t find it. A fellow inmate had ratted on me so they knew to look there. Today I still have white lines running up all of my fingers and on my hands from where I scratched.
When I first started, my then best friend noticed and would grab my wrist and squeeze it so I would feel more pain, I think in attempt to dissuade me from doing it again. “Sixteen-toed cat scratches again?” she’d ask sarcastically while tightly gripping my arm. We were only 14.
The cutting got worse as I got older, and worse still once I moved out of my parents’ house. In college I could cut because I had no adult. I was very close to my adviser and eventually had to disclose my mental health issues when they interfered with my schoolwork, which they did a lot. She learned that I was a cutter. Unfortunately, one time I cut so deeply, I couldn’t get it to stop bleeding, and I had to call a friend to help me. I ended up in the ER and needed about ten stitches. The next day in class, I rolled up my sleeve to scratch an itch, my adviser saw my bandage and gave me a look. “What’s that.” It wasn’t a question. It was a knowing statement of fact. “Oh, nothing,” I said rolling down my sleeve, blushing, and shrinking in my seat. We didn’t talk about it, I don’t think. We didn’t have to. She knew my demons, she saw them manifest.
As an aside, part of my “borderline-ness” has always been developing too strong an attachment to people and then oversharing. I shouldn’t have told my adviser the details of my MI. There was no real need. I had a therapist. I had a psychiatrist. I had a boyfriend. I had friends who knew. But I idolized her, and I wanted to be close to her, so I divulged things that should have been kept behind more “professional” boundaries. Anyway.
I cut when I was stressed out. I cut when I was super depressed. I cut when I was so dissociated that I didn’t feel real any more. Sometimes the motivation was to convert psychic pain into physical pain, because at least it was something visceral that I could see, feel, touch, taste, experience with other parts of my brain. At other times I was so numb and empty that I would feel implosive and need an outlet to bring me back to earth. Pain was grounding.
When I was old enough, I got tattoos. I put a bipolar tattoo over my scars, and got little tattoos on the inside of both wrists to remind me of life and peace. Later on when I was in rehab, I decided that I needed to cover up that area once and for all so that I wouldn’t cut any more. If there was art there, I reasoned, then I wouldn’t want to screw it up. So I got a huge, half-sleeve tattoo. It worked. For a while. Then I had a breakdown and made one slice that was so bad I had to go to urgent care for stitches. That was not a fun experience.
One of the most difficult parts of self-harm for people who don’t suffer from it to understand is how it differs from suicidality. You can be suicidal and self-harm, but part of the diagnostic criteria of self-harm is that there is no suicidal intent in the action. None of my self-harming incidents were suicide attempts. But when you walk into urgent care, bleeding from the inside of your arm, it is hard to convince the staff that no, you don’t need to go to the ER because no, you’re not suicidal. The only way I could avoid being sent against my will to the ER was to have them call my therapist, talk to her, tell her what happened, and promise that I would go to my appointment the next day. Because she said it was fine, they agreed not to call the white coats on me.
In the hospital over the last few years I took up cutting again and, for the first time in my life, started punching walls. I became obsessed, shortly before I tried to kill myself, with trying to break my hand. It was the strangest desire, but I knew that’s what I wanted and that’s what I tried to do. It got so bad that my hand was bruised from knuckle to wrist, so badly that they brought a portable x-ray machine to the unit just to look at my hand. I punched because I was angry and frustrated and I wanted to feel pain. I deserved to hurt. I wanted others to know I hurt, on some level. I tried not to get caught but it was impossible. They almost always found the knives I stole, or caught me stealing them.
Now, I have mindfulness tattooed in the middle of my left arm. My scars are visible but no one really sees them because they’re not looking. I haven’t self-harmed since I was in the hospital over a year ago. I have wanted to. I have thought about it. But never in the obsessive way that I did when I had the same feelings before. It is just default thinking. It still happens. I get flashes, mild urges, but I’m so used to them that I can say to myself, “There I go again.” Then I try to occupy myself with something else. It works.
When I was having acute urges, some of the methods I used to avoid cutting were to stick my hand in ice water or snap a rubber band on my wrist. I would also hold ice cubes until my hand went numb. Less direct methods were to meditate, color, draw, exercise, talk to someone, or write. Whatever could take my mind off of the obsessive thoughts was useful.
I don’t have a clear summation of how I feel about this. I will say that I think I feel like I’m past that phase of my life, that I have enough tools under my belt to stay safe, and that if you feel like you need to hurt yourself, try one of the methods I mentioned above. Self-harm is hard to understand and hard to explain.
Meanwhile playing in my head right now: “Blue” by Joni Mitchell
You know I’ve been to sea before
Crown and anchor me
Or let me sail away
Hey Blue, there is a song for you
Ink on a pin
Underneath the skin
An empty space to fill in
Well there’s so many sinking now
You’ve got to keep thinking
You can make it through these waves
Acid, booze, and ass
Needles, guns, and grass
Lots of laughs, lots of laughs
Everybody’s saying that hell’s the hippest way to go
Well I don’t think so
But I’m gonna take a look around it though
Blue, I love youBlue, here is a shell for you
Inside you’ll hear a sigh
A foggy lullaby
There is your song from me