Sixteen years ago I was a forty-year-old employed white male who had just informed his doctor that he self-harmed by cutting his arm. My psychiatrist at the time spun in his chair to face me, shock showing on his face.
“Teenage girls normally do that,” he informed me. My embarrassment was immediate but I’d promised my primary physician that I’d tell this doctor the truth, about everything. “That’s a sign of borderline personality disorder!”
“I have scars if you don’t believe me,” I offered shamefully.
“No don’t show me,” he insisted. “But I do want you to see a therapist…”
That referral would start a sixteen-year professional relationship with an LCSW who’s unique approach with cognitive behavioral therapy would bring me from the verge of suicide to a healthier more comfortable life.
My history with depression, anxiety, and suicidal ideation had just begun and I’d suffered mental illness symptoms for over a year before meeting my therapist, who I’ll call Bonnie. At first, she didn’t believe I had a personality disorder as I didn’t meet the normal criteria, so I set out over the next decade, to prove her wrong.
The self-injuring behavior started innocently enough. I was simply cutting vegetables for a stew when the knife blade slipped, punctured my thumb, and as Amanda Palmer points out in her music, the angels began to sing. I had heard of cutting as a self-coping mechanism that was related mostly to teenage girls and considered to be a fad, but my interest was not invested in such a myth especially since I was a forty-year-old married cis white male holding down a job, which is the opposite description of a teenage girl.
This did not stop me from recognizing the immediate appeal, especially since before cutting I’d found I was able to cope by self harming in a variety of ways; specifically with drugs, booze, tobacco, and food. These ways of self harm could also be technically considered as fads since I was introduced to these behaviors by friends and coworkers. So I think mislabeling self harm as a fad adds to the stigma of these behaviors and allows the population at large an excuse to ignore the behavior as something that will eventually pass.
I prefer to view copy cat behaviors as clustering. That’s the professional term when a localized area suffers a significant number of suicides after one person succeeds at taking their life. Suicide is not a fad the same as self harm is not a fad. When a person who is prone to such behavior hears of an incident and it sounds attractive to them then a cluster of such activity begins. Add the internet to that and a cluster can become something more than a localized incident.
The universally accepted theory behind self-harm is that it helps with anxiety by releasing tension, which it does. But Bonnie never assumed this, she asked what I derived from self-harm and cutting specifically. The truth, for me, was that my depression was so bad that self-harm allowed me to feel something other than numbness. When I’m anxious everything else just adds more anxiety, including cutting. Besides, anxiety was something I was used to since I’d suffered it’s symptoms since childhood. But deep, dark, and numb depression was new to me. Self-harm gave me something to feel, if only for a little while.
I learned from Bonnie to focus on recovering from the depression in order to combat the self-harm, which makes sense as depression was the root cause for harming myself. I probably don’t need to explain how exhausting and self-deprecating depression becomes. And I fear that when a teenager is brought to a professional that the self-harming behavior is addressed foremost, leaving the root cause as secondary. Depression leaves its victims in the wake of a tirad of hateful storms that puts the person in a position of being not very fond of themselves. Self-harm treatment can often manifest shame as the person who dislikes themselves already fails repeatedly to string together a couple of days without self-harm.
I don’t know how long it’s been since I last cut. It’s not marked on a calendar anywhere or listed in my therapist’s notes. It’s been a while, years I suppose, yet the manifestations of dislike for myself will still take the form of overeating, which is just another self-harm coping mechanism that isn’t cutting.
Bonnie utilized CBT in my therapy, and I know that isn’t the answer for everyone. When I became a certified counselor myself I found where dialectical behavior therapy worked wonders for people suffering the effects of out of control behavior disorders as well as emergency treatment for suicidal ideation. I think what the victim of mental illness is comfortable with is very important in finding a path to wholeness. My therapist is one of the best kept secrets in my state and that is her choice. She is a glass ceiling breaker in her field who started successful outpatient therapeutic centers at local hospitals before beginning her own lucrative therapy business with a number of therapists studied in various fields. Weekly her office receives requests for consultation from her for television, newspapers, and periodicals that she routinely turns down. Where she could be in a position to disseminate anti-stigma and false information, her priority is her patients. I appreciate this since it means I’m one of her priorities. I need someone to put me first as I rarely do so myself.
I don’t know for sure if I was my wife’s inspiration, but while I was battling my mental health issues, she went back to school to get a masters in counseling that later translated into her own LCPC license. Part of her success is not being therapeutic after hours, which I thank the gods for. She leaves my recovery to my therapist and concentrates on her own clients, though we do bounce ideas back and forth about self-harm behavior and suicidology.
Where I’ve retained Bonnie throughout my battle with mental illness I’ve managed to go through a good many doctors, usually firing them over medication disagreements. I’m safe now with a doctor who I knew from my own days as a mental health recovery specialist. He refuses to label me with BPD as it can be hurtful to me in the future with treatment plans, which is fine with me. I’m no diagnosis purist. Under his care and Bonnie’s treatment, I’ve managed to go back to school for my bachelor’s degree in English while having my debut novel published last summer. This is a long way to go in sixteen years and was measured by small achievements along the way. One of which being that I don’t remember the last time I cut my arm.