I have a history of DSH in response to feeling emotionally overwhelmed; when I cut/burn/overdose, I effectively shut myself down. A year ago, my (now) ex-CPN was the first to address this, and she introduced me to two techniques: 1) wearing a rubber band around my wrist to ping myself with if I felt the need to self harm, and 2) delaying: if I want to self harm, I have to wait five minutes and see if I still want to do it (and repeat until the urge goes away).
These are good ideas in theory, and I found they worked for a while, but eventually they weren’t enough. My CPN couldn’t understand why my DSH persisted, and apparently decided that since she ‘wasn’t helping’ (her interpretation, not mine) she might as well discharge me.
Since then I’ve been relatively un-supported regarding my DSH, until today at my weekly ‘Reasons Not to Kill Yourself’ session at the psych hospital. First off, Nurse L identified that my DSH methods are intense and short term, (as compared to alternatives like denying food/drink etc), so she wanted to give me alternatives that would have the same kind of immediate impact but without any lasting damage. She came up with the following, adapted from techniques used with adolescents:
1) Ice bowl: Fill a bowl with water and ice, and then dunk your face in it for 15 seconds. Come up to breathe, and then repeat until you’ve done this 5 times.
2) Cold shower: As it sounds, turn the shower to the coldest setting, and jump in WITH your clothes on. Stay there until you’ve counted to 60.
Nurse L explained the theory behind these suggestions; primarily that they are painful, and will cause an adrenaline rush, but they won’t actually harm you (in fact, the ice bowl is apparently really good for your skin). After the temperature shock from both of these, you’ll be freezing, and all those overwhelming emotions will be dampened for the time being – all you’ll want to do is wrap up warm and sleep. This is what they used to do before tranquillising patients in psychiatric hospitals: put them under a cold shower, and a minute later they’ll calmly go to bed.
I like that Nurse L explained to me how and why these techniques work. I like that they’re private, and relatively easy to do. The trick is turning to these methods before your brain goes for the old (and more damaging) ones; that’s why you have to get in the shower with your clothes on – in the time it would take to undress, you might change your mind and do something harmful to yourself.
People aren’t born with tendencies to self-harm; it’s a learned behaviour. I don’t remember where I learnt it, so I would guess I must have seen it on TV, or read it in a book. There’s something really sad in that, but there’s a positive to take away too – if self harm is a learned behaviour, it can be unlearned, or altered.
That’s what I need to remember now. It may be a long time before I lose the urges altogether, but I can learn better ways of acting on them.