I Miss My Bracelet

Once again I have managed to break my bracelet. Guess this is why you don't wear them 24/7. Actually I broke it over Christmas and I have someone fixing it... just haven't seen them since then. I miss not having it. It was the daily reminder of how far I have come. More importantly, it is the reminder to take one day at a time and not to go back to it... no matter how tempted.

A Great Big Thank You

As many of you are aware I lost my bracelet. So today I want to say a big thank you to my friend Derren. He knew just how much that bracelet meant to me and so he went out and made one for me. It even has a clasp making it much harder for me to lose. So thank you for that! :o)

Who Knew It Would Be This Hard

Here is a picture of the bracelet that I lost. Since it has been gone I have come to realize just how important it was to me. I am also realizing that recreating it is a real challenge. You would think that it would be easy.... It's just orange and white beads after all. Finding orange beads that are the right size has become a nightmare. I've discovered that the beads from the original bracelet were incredibly tiny. But the ones I seem to find now are either too big or too small.

I spent about 3 hours yesterday looking up bead sizes and by the end I think I was even more confused then ever and still had absolutely no idea what I should be looking for. There are plenty of auctions on eBay but it's a gamble. I have no idea if it would be the right size or the right colour. So I am a little reluctant to go that route.

There are 2 self-injury sites that carry bracelets and what not. Seems the supplier in the UK that was providing them with the orange beads has discontinued them so they are not an option. I really do have to make it myself.

Some suggested getting one of the silicone bracelets. I tried that once. it was too big and just slid off my wrist. Then Azrael turned it into a toy and I never saw it again.

Better Late then Never

Seems I missed Self-Injury Awareness Day (SIAD). My bad. Better late then never, right? I do want to bring attention to this topic as I feel it is important. So March 1 was actually the day designed to bring awareness to what is still a virtually unknown, or taboo subject. I never said I was going to make people comfortable or shy away from difficult topics. Just look at the right hand side. I have links already to all my posts on the subject.

On a related note I am very saddened at the moment. The other day I lost my orange and white bracelet. I ransacked the apartment but to no avail. Now we're talking like $2 in beads but that's not the point. I am so not the arts & crafts type and can see me getting really frustrated trying to tie the knot in it. Aside from when I broke the first one it has not left my wrist in 2 years. So I am pretty devestated over it.

It's not that I think I am going to go back to the self-injury because I don't have it. I just used it to remind myself each morning that it was one more day. It's like any addiction. You have to acknowledge each day the accomplishment that comes from making it through another day. And when things were tough I would look at the bracelet and remind myself that I was stronger then that and that recovery was a lifetime process. I already tried looking on eBay for a replacement and the place where I bought it from in the first place but they are sold out. It's a sad day... especially since it's supposed to be the month of awareness. What do I do... lose the bracelet. So much for that thought.

My Heart Breaks...

Every time I listen to the song "Cut" by Plumb and/or watch the video I posted on self-injury it tugs at the heart strings. I feel like my heart is breaking. I know all too well the isolation that comes from being a self-injurer. The video reminds me that we are not alone.

I recently made the comment to someone, "At least I haven't gone back to the self-injury. All other coping mechanisms are socially acceptable." It's sad to think about the truth behind that statement. I can starve myself and people just associate it with stress... or the media's portrayal of the perfect body image. I can have indiscriminate sex with strangers, subjecting myself to god knows what but that's okay. I have the freedom to choose who I am having sex with and what sexual practices I am engaging in. If I choose narcotics then people tend to have sympathy and blame it on the brain and the nature of addictions. I can even drink to alcohol poisoning (and have) but that is acceptable. "Cheers"

Self-injury is just another negative way of coping. I don't endorse it or condone it but, at least for me, it can be less destructive then some of those other ways of coping. Anything to excess is unhealthy. So why is there such a stigma to self-injury? I suspect that it is a lack of understanding. People don't understand how someone can take a razor blade and intentionally cut themselves so it must be abhorrent. Since it's not a suicide attempt it must be attention seeking? Wrong. It is simply a way to cope, pure and simple. It is used when faced with overwhelming emotions.. in some cases it is to prevent suicide.

As an example of the stigma attached to self-injury is evidenced in the way I was treated at work back in January, 2006. It was a bad time period in my life. I couldn't deal with anything and eventually was tempted to go back to the self-injury. I gave a friend of mine (who happened to be a co-worker) the knife to remove the temptation. Then the shit hit the fan. Someone else found out and thought I needed an intervention. There was a big scene at work (I happened to be off for days) and management got involved. When I came back to work (feeling much better I might add) I was told that they considered me a risk to myself or others. It was an x-acto knife.... an office supply. They sent me off work and I was blackmailed into being on anti-depressants. In the end I was off for seven weeks and had to be cleared by a psychiatrist to return to work. For more details I had a blog about it which can be found here. I was humiliated and isolated. What makes this story even more tragic is the fact I never even went back to the self-injury. The temptation had passed by the time I had returned to work. Even human resources, who are supposed to be the advocates of the employees, stigmatized me and made me feel like a social pariah. I learned a valuable lesson that day. Drink yourself to death. Starve yourself. Have sex without protection. But whatever you do.... don't intentionally cut yourself.

It has been over a year now. I still have days when I am tempted. I treat it more as an addiction now then I ever used to. I wear an orange and white bracelet to remind me that I am in recovery and that it is a process. So when I hear the stories of others my heart goes out to them. I understand their pain and isolation. Trying to make it through this life. There is one image in the video that stays with me and I want to leave you with what it said. "Only God can judge me."

Plumb
Cut

I'm not a stranger
No I am yours
With crippled anger
And tears that still drip sore

A fragile flame aged
Is misery
And when our hearts meet
I know you see

I do not want to be afraid
I do not want to die inside just to breathe in
I'm tired of feeling so numb
Relief exists I find it when
I am cut

I may seem crazy
Or painfully shy
And these scars wouldn't be so hidden
If you would just look me in the eye
I feel alone here and cold here
Though I don't want to die
But the only anesthetic that makes me feel anything kills inside

I do not want to be afraid
I do not want to die inside just to breathe in
I'm tired of feeling so numb
Relief exists I find it when
I am cut
Pain
I am not alone
I am not alone

I'm not a stranger
No I am yours
With crippled anger
And tears that still drip sore

But I do not want to be afraid
I do not want to die inside just to breathe in
I'm tired of feeling so numb
Relief exists I found it when
I was cut

This was taken from an interview with Plumb about the song "Cut."

RS: They also remixed the song off the album called Cut, which is about a really strong subject like Damaged. Tell us a little bit about the song Cut?
Plumb: It's more or less that a fan on the message board said she was a cutter and she was asking if there was anyone else out there that was a cutter and she had a huge response from some people. Self-cutting is unfortunately a growing form of abuse. She said in her message that her family doesn't understand, her friends don't understand and even sometimes she doesn't understand, but just sometimes she feels so numb inside, just to feel alive she wants to cut the skin. That was just so powerful and poetic to me that it was the inspiration behind Cut, and I certainly didn't write it because I understand it completely and I know how to fix that problem. It was more or less to create conversation so that when someone hears it, if nothing else they feel less alone knowing that there's someone else out there like them going through a similar thing and to give them a tool to start talking about it. Because that's one of the first steps of healing, is to be able to communicate and write it out and talk it out and have a conversation about it. So if nothing else, that would be a goal of the song. It's already doing that and I'm really excited about it.

You are Not Alone

Warning: Potentially triggering images. I came across this video on YouTube and wanted to share it with others. I thought it was a powerful video and also raises awareness on self-injury. Kudos to the author on a job well done. The song used is "Cut" by Plumb. Hope it makes you think and reduces the stigma faced by anyone that self-injures.

Who Needs a Thumb?

I had a shower the other day. No big deal right? I am still pretty congested and tired. Apparently I wasn't paying attention to what I was doing. I went to rinse off the razor blade and my thumb was in the way. I gashed it open pretty good. At least I know the razor was sharp. Maybe having a three blade razor isn't such a good thing. As I am watching the blood pour out of my thumb I start wondering how to stop the bleeding. I was also starting to wonder how serious it was. I got out the of the shower and got the bleeding stopped. Bandaged it up and tried to ignore it. I changed the bandage the next day and as I took a look at it I started to wonder if I should've gone and got a stitch put it. But it will heal and it meant not spending 4 hours at the ER. I am sure that I will be fine. I'm just thinking that I need to stay away from sharp objects *lol*

Changing Times

I have been single for a year and three months. It has given me a chance to be alone and not dependent on someone else. Sure there are times when I would like to be in a relationship but I no longer feel that my self-worth is determined by someone else. It shouldn't be. I am okay with who I am and I like me. Yes it does seem to be odd saying that but that's okay.

The time has also given me a chance to become sober... not that I was an alcoholic or anything but there were definitely some bad benders. It's still kind of weird not drinking though. When I go out I almost feel like I should be getting a drink. I haven't completely given up alcohol but now it's only a drink with dinner, that kind of thing.

I also quit smoking. I have now made it to the 8 month mark and counting. It's pretty impressive since I was the adamant smoker that kept saying I was not going to quit. Somehow that has translated into me doing more work... Partially to keep myself busy... and partially because I just don't know what to do otherwise.

I'd like to say I've given up all my vices but that would not be entirely true. I still battle with the thought of self injury. I haven't gone back to it but the temptation is still there. The last time I did was just before I got my annual review back in July. So I guess that means I just made it to the 6 month mark :o) One day at a time... It's like the alcoholics creed. Maybe one day I will have found a healthy way to cope and won't even think about it. But until then I wear the bracelet and remind myself that it's one more day.

Celebrity Self-Injury

Recently newspapers reported that Lindsay Lohan had scratches on her arm and there were "concerns she is a victim of self harm." The headline was "Self harm fears over Lindsay's scars." Another article said that she was "accused of being a cutter." I realize that people want the latest celebrity gossip and that any news will sell. Maybe it's more of a witchhunt. One that wants to out Lindsay as a cutter.

But there is another issue with these statements. There is already a huge stigma surrounding self injury. Calling someone a "victim of self-harm" makes it sound like it's something that happened to them. And accusing someone of self-injury just reinforces the stigma and makes it sound like it's the worst thing you could do.

Plastering pictures of what may (or may not) be self-inflicted scars has no positive benefit. It just reinforces the shame a self-injurer feels. But for someone that is young and impressionable it can also lead someone to choose self-injury. After all celebrities are role models and people will mimic their behaviour. Plus the pictures are sensationable and can be triggering for people that do self-injure.

My question... who cares? Maybe she fell in the bushes as has been claimed or maybe she really does cut herself. It is none of our business. At the end of the day Lindsay Lohan is a person and whatever she needs to do to cope should be her decision. Plastering photos in numerous newspapers and across the internet does not help. *If* she is cutting herself then what she needs is support and help to find better ways of coping and to deal with what is the reason behind it.

Having said that... there are worse things that she could be doing. Now sometimes self injury is a symptom of a mental disorder and that definitely should be examined. Self-injury is typically a controlled response used to regain balance when things feel out of control. In some cases it is to prevent suicide from becoming an option... Society seems to have the idea that it's linked to suicide but it's almost the opposite. It's about regaining control. All I can say, as someone that is all too familiar with self injury (and can't even imagine having pictures of my cuts plastered all over) leave her be!

Career Options

My degree is in psychology and I work in a call center. To most people those two ideas don't really go together all that well. Personally, I think that call center employees don't get the respect they deserve. There's too much of an emphasis on temporary employees since the wages aren't going to attract people for the long term. But that was a bit of a tangent. I find that I do use the psychology degree every day. After all my job is to coach and develop the other agents. I also use it when communicating with customers. So it is a useful skill to have in my line of work.

The big issue I have... and the reason I am at a bit of a cross-roads is that there are very few opportunities for advancement at work. They have done away with the team leader position here and with the turnover rate no manager positions will be available on the horizon. And even if there was there is a LOT of competition among all the performance coaches. The most I can make as a performance coach is $15.65 an hour ($32,552/year) and that is after 5 years of being a performance coach. Not to mention the fact you have to meet your metrics to even get a raise, something I didn't do in February. If it wasn't for my student loan it wouldn't be a big deal but that is still hanging over my head.

Steve seems to like coming up with career options to make more money. Now none of his ideas involve me actually leaving to pursue other opportunities. He does know that I applied for a promotion in Niagara Falls so he already knows I am willing to leave. I don't think he was quite so happy about it. So what is his current thought? He seems to think I should start a counselling practice specializing in people who self-injure. He thinks I would do well since I understand the behaviour.

I have a few issues with that thought. As an unlicensed counsellor you are a lot more vulnerable. Self-injury is a behaviour and in order to treat it you have to treat the underlying causes. That's not exactly short-term therapy. You really do have to change thought process and behaviour. It's also extrememly frustrating. There is a reluctance to change. You need a mix... otherwise you risk facing burnout. You just can't deal with the same thing over and over and over... especially when it is a behaviour that is resistant to change. Then there is the whole self-harm behaviour. Generally speaking you have a duty to report any threats to self or to others. So it's a bit of a catch-22. The last thing I would want to do is force someone to sign a no-harm contract.

While I do understand the behaviour and have been there that is only so beneficial. And since I still struggle with it I am not sure I would be the best counsellor. You can treat it as long as you can empathize with the person... which should be true in any therapy relationship. If it's not there then you should be looking for another therapist.

Now I can see me more as an advocate and generating awareness about self-injury. I could handle that. I do think there is a need for that. But as a counsellor... I'm not so sure about that idea. Unlike Steve I try to take a practical approach and not just have the idea of the week.

Time for a Good Laugh

Maybe it's just me but I am quite entertained by this... and it's not like I just came across one page with this information.

Things Not to Do When You Have a Low Platelet Count

• Avoid activities that increase your risk of bleeding when you have low blood platlet count:
  • Contact sports
  • Amusement park rides that involve fast or quick motion.
  • Strenuous exercise.
  • Avoid or limit the use of sharp objects such as knives, razors.
  • Hold pressure on any cut or scrape for at least 5 minutes.

So now that I have a reason to be absolutely lazy. As for the contact sports overall no problems there. Back to being lazy. I could say something... but I am better off leaving that one alone. No Canada's Wonderland for me. But, the one that gets me, is avoiding or limiting the use of sharp objects. What do you want me to do, make sure I eat finger food? I guess people can rest easier knowing I won't be intentionally cutting myself. I realize that these guidelines (there were others... but they weren't as interesting) are for people with an extremely low platelet count. But I get a good laugh every time I read the part that says I should avoid knives.

Legacy of Abuse

I'm not sure why I am so melancholic at the moment. I think it's just from the pressure I placed myself over the last month. Well, that plus various sources of stress... quitting smoking... and then there was the weekend. I haven't exactly been able to relax at all.

I should be ecstatic about the fact we were able to meet the mandate last month. It was quite a feat. Plus the help we were able to give to another team. You'd think I'd feeling pretty good about it. But, instead I am wondering what more I could've done. I've hit the mandate every month since I came back. Christie keeps telling me I'm going to develop an ego, as a joke. Yet I just push myself harder and have trouble accepting any praise. I can point out my flaws much quicker.

For much of my life I was told I wasn't good enough... and that I never would be. That does wonders for your self esteem. So to me... everything I do has to be perfect and I have trouble accepting anything less. And I do have a tough time with compliments. I just shrug them off.

The effects of abuse are long lasting and stay with you. They also affect all aspects of life. For a long time I denied it... and had to keep the family secret. That things weren't perfect. Now I doubt myself all the time. And I isolate myself. I go to work and then I come home. I tend not to socialize and I have difficulty trusting anyone. This has been increasingly noticeble in the last year or so.

I think part of that relates to events in the past year. Plus my TL didn't help. Don't get me wrong... as a person I still think highly of Chris. I think her heart was in the right place. But it reminded me of when I was younger. Nothing I did was ever going to be good enough. That has a psyhological effect.

And if you look at the two posts on the effects it's easy to see that some of them are factors in my life. I tend to engage in risk-taking behaviours. There's also immune suppression, chronic pain, insomnia, headaches and attentional deficits. Even my need to be an overachiever is likely related to the history of abuse. I'm compensating for it... and trying not to be noticed. I try to be invisible... to blend in... so I don't stand out. But it seems to be a conflict... since I am also an overachiever to compensate making it harder to be a ghost. The self-injury is probably one of the most noticeable effects. Somewhere along the way I learned that cutting myself was a reinforcing behaviour and that it reduced stress levels. But I also knew it was maladaptive. And typically when people find out they try to control the behaviour instead of helping me find a better way to cope. Now I haven't purposely cut myself in over a year now... but I haven't really replaced it with anything else.

Abuse leaves a lifelong mark.... and shapes beliefs about the world. It shapes how we interact with others and how we perceive ourselves. I'd like to say that time heals the wounds I'm not so sure tht's true.

Diagnosis of Borderline Personality Disorder

According to the DSM-IV (The Psychologists Bible) Borderline Personlity Disorder is diagnosed with the following criteria:

Diagnostic criteria for 301.83 Borderline Personality Disorder
(cautionary statement)

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) frantic efforts to avoid real or imagined abandonment.
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

(3) identity disturbance: markedly and persistently unstable self-image or sense of self

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7) chronic feelings of emptiness

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

Now this one is the most frequent diagnosis of anyone that self injures. In a study 48% either met the criteria or were diagnosed with BPD (I can't remember which) but if you removed self injury then only 28% met the criteria. Some people will diagnose it just for self injury, they don't have to meet 4 more of the symptoms. It also seems to be the catch all of psychological disorders. Borderline personality disorder is typically a label given to women while Antisocial Personality Disorder is typically label given to men. So if someone tells you that you might have Borderline Personality Disorder then it's not such a good thing. Doctors are also reluctant to treat patients with this diagnosis chalking them up to a lost cause and difficult to treat. Maybe they should either do away with this diagnosis or change it so it is more useful. After all at some points in our life almost all of us could probably get the diagnosis.

The Diagnosis of Depression

According to the APA and the DSM-IV-TSR (basically a psychologist's Bible):

Criteria for Major Depressive Episode
(cautionary statement)

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either
(1) depressed mood or
(2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
(4) Insomnia or Hypersomnia nearly every day
(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
(6) fatigue or loss of energy nearly every day
(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms do not meet criteria for a Mixed Episode (see p. 335).

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

So... what can I say about that? You have to meet 5 of the criteria to get the diagnosis. And it can't be caused by a medical condition... Hmm... they never tested for a medical condition. As far as the insomnia goes... I was diagnosed with insomnia and "Phase Delayed Sleep Disorder" back when I was in university. The weight loss has always been an issue. I can gain/lose 5 pounds in a day. The difficulty concentrating can be seen as a symptom of depression.... although I believe it was related to the fatigue.

I was under a great deal of stress at the time. Nothing I did for my boss was ever going to be good enough. I was beyond fatigued and could not concentrate. I was constantly feeling sick. And then there was the actual reason that I was tempted to go back to the self-injury... my stalker. It was really stressing me out because I felt alone and isolated. I couldn't go anywhere or do anything. I really felt trapped. So I was having a tough time. I was having issues at work but didn't want to be at home either. It was a losing battle. So with everything that was going on I was stressed out.... But I was not suicidal or depressed. I'm not even sure I would've met the criteria for a diagnosis.

Quacks... AKA Doctors

Okay I don't think my family doctor is a quack. I actually respect him. I am just thinking about how things were going before my LOA, the LOA and the aftermath. I also re-read my posts over at Time off Work. Aside from the fact it's been two months since I last posted there... I almost feel like I should update it with recent developments.

Before my LOA I was having a lot of trouble focusing and concentrating on anything. It was really affecting my performance and I would even zone out halfway through a sentence. Chris started telling me that it was just an excuse. It wasn't but I couldn't argue with the team leader. Then I brought a knife to work (well actually I was off work and had already been home and came back just to give it to someone) and that gave her an excuse to force me off work.

Then there was Dr. Caskey. He was the doctor that work contracted for me to see. Things went from bad to really bad quite quickly. First of all, he didn't believe that Firomyalgia existed. He felt it was just a symptom of a psychiatric disorder. I'm sure a number of rheumatologists, and other family physicians would disagree... but what can I say? He's the one with the medical degree, determining when I return to work. He believed I was suffering from depression as evidenced by the lack of focus, the fatigue, the insomnia and the self-injury. He had received a letter from work indicating my performance was suffering and I had numerous physical complaints. The fibromyalgia had been untreated for 4 years and I was exhausted all the time. As far as work goes... I still met the aces mandate. And was only failing the aces Chris did on me. There was only one month I was low in sales. So he wanted me to have an emergency psych evaluation at the hospital. I didn't have a choice if I wanted to return to work. Talk about leading questions. They didn't ask me if I was depressed... they asked how long I had been depressed for. I got the prescription that Caskey wanted and he still would not allow me to return to work. He wanted me to do a follow-up with the psychiatrist.

Dr. Caskey also told me I would be closely monitored when I went back to work. He also felt my performance would not improve without anti-depressants. That's what he used to justify not allowing me to return.

The psychiatrist put me on Zoloft and I really reacted to it... maybe because I am not depressed. I felt like I had the flu and couldn't get out of bed. I think it actually invoked feelings of depression. I called Telehealth since I was exhibiting a number of symptoms from the warning label on the medication and they said to contact a doctor immediately. Back to the ER where they said it was normal.

Eventually I was back at the ER to get a new medication. This time they put me on a Benzodizapine which is used to treat acute insomnia, not chronic insomnia. It is also a restricted medication and highly addictive as I learned first hand.

Between work and Dr. Caskey they were not allowing me to return to work until after the follow-up with the psychiatrist. I still remember Chris calling. She asked how I was doing. I said something about the Fibromyalgia and she basically accused me of lying. You could tell she thought it really was depression. Right about now I really want to say "I told you so."

Keep in mind that the doctor had not run any tests to rule anything out. He just felt it was depression and that was the end of the discussion. Then with my three trips to the ER. The 2 psychiatrists I saw just long enough to write a prescription. And the ER doctor just felt the reaction to Zoloft was normal. Is that why there are lawsuits against the manufacturer?

After the first month off work I finally got a family doctor. I was sick of getting the run around. The first thing he did is change the medication to one that wasn't addictive and helps the Fibromyalgia and the sleep. Then he referred me to a rheumatologist.

When I saw the rheumatologist he did some chest x-rays (since I was sick at the time), back x-rays and some blood work. Then I was recalled for the blood work. That concerned me a little but they didn't tell me why it was done.

After 2 months I finally had the appointment with the psychiatrist. It lasted about 15 minutes. He didn't feel I was in crisis any more and thought I was fine to return to work. He did think I should go to see the EAP counsellor and/or take part in an eating disorder support group at the Women's Health Center. Now that is just a judgment call on the part of the psychiatrist. I have a really hard time gaining weight. But I'm not withholding food. Maybe this was a sign they should be looking at metabolism and thyroid disorders. I never saw the EAP counsellor either. I am pretty sure my file at work indicates that I have clinical depression. That might be good for job security but it is completely false.

I've been back at work for 3 months now. My performance has not been an issue. Well okay my sales this month are low... but it's the first time for that. I'm meeting all my mandates... and passing all my aces. Of course I still have a while to go before I can apply for anything due to the disciplinary action prior to my LOA which they didn't remove after the doctor decided that it was all because of depression.

Now here is the part that makes me angry. Things might have been very different if the first doctor had not just passed the buck but had actually done tests to rule out other issues. Now I realize that he could not look past the self-injury and treated me with no respect as a result. The self-injury is about coping, nothing more. And as a side note I have not cut myself (intentionally any ways) in over a year now. When the rheumatologist did the blood work they discovered my white blood cell count was low and so was the platelet count. The second blood test came back the same. So when I went in to see my family doctor he redid the tests since it had been 2 months and said if they came back the same then he would refer me to a hematologist and more then likely I would need a bone marrow biopsy done. The low platelet count would account for the fatigue and the low white blood cell count accounts for being sick quite often. I can't fight anything off. This time around the red blood cell count might also be low. When the tests were done the first time I was taking iron supplements 3x a day (5x the recommended dose of iron in one day so it's no wonder the red blood cell was normal). The reason he wants to do the bone marrow biopsy is to make sure the bone marrow is still producing blood cells. That's usually a serious thing. For now it's still a waiting game. The test results haven't come back yet. So we'll see.... but I finally feel validated... They're no longer telling me it's all in my head. Imagine that... there actually is a physical reason for this.

Needless to say I am not too fond of the doctors I saw regarding my LOA, aside from my family doctor. After all there were 3 doctors and 3 psychiatrists and not one of them did any tests. It would've been nice to catch this 4.5 months ago. At least then I would've had the answers by now... and if it's something that is easily treated would already be feeling better. But no... they just wanted to give me the label of depression and believed that anti-depressants would be the answer.

Self Injury Awareness Day (SIAD)

Now for a little more honest glimpse into my life. The title says a lot. For years I have struggled with self injury. You learn to hide the scars, and the pain and remain silent. I learned to cut where the scars could be concealed. I lied to people and I hurt the people that were close to me. But since the temptation to return to the cutting after 9 months is part of the reason I am on the leave of absence from work I am breaking that silence and opening up about it.

We all cope in different ways... and if we wanted to be honest with ourselves there is always at least one negative coping mechanism. Maybe it's that bowl of ice cream that we get when under stress... or maybe it's the bottom of a bottle. Whatever it is... we have all these tendencies. But we wouldn't do them if they weren't reinforcing. There's a pay off somewhere.

The subject of sef-injury tends to have shock value and almost seems to be taboo. It also tends to conjure up images of a mental illness because no one in their right mind would willingly cut themselves would they? When I had to see the doctor he said it was "A cry for help" and associated it with suicide. I had given away the knife so I would not be tempted to use it, not because I wanted to spend time with a shrink and be put on anti-depressants. At the time I was under a great deal of stress with my roommate and with work. I was also exhausted and never felt rested... I was basically a walking zombie. Add stress to that and I was a pressure cooker.

Back to the pay-off for self-injury. For me, any ways, it has a calming effect. In many ways it's a way to escape. It allows me to avoid feeling the emotional side of things because suddenly you have to focus on the physical. But it is also a trap. Because there is such a stigma with it as soon as you self-injure there is a tremendous amount of guilt and shame. Quickly you feel those emotions again and return to the cutting.

The first time I quit it was for 3 years. But it always stays with you... always in the back of your mind. And any time you get stressed you think about it. When Adam and I split up I didn't handle it so well. I wasn't sleeping, was still living with him and was trying to just get by... but wasn't really coping very well. So I ended up back where I started. I told someone about it and they freaked, tried to control the behaviour. Made me feel like a rat in a cage. So I cut deeper and more times. Just before I moved out I stopped again and haven't cut since then. But the temptation remains. One day at a time. It's all I can do. And here I thought removing the temptations was a good thing... instead it gets me 2 months off work.

Before I start the next paragraph I am going to add a disclaimer. I am not pro self-injury and am not going out and buying a black and blue bracelet to show my support for the behaviour. Nor will I ever post pictures of the scars. However, I do believe that I should be allowed to cope in whatever way I need to. The reality is that I am more likely to accidentally kill myself with alcohol then I am with a knife. I've had alcohol poisoning a couple of times now and not once did I ever go to the hospital. Yet people are okay with me having a drink to escape. It's more socially acceptable. In fact, I have had people tell me to get drunk every night since I am on an LOA and there's nothing work can do. If I am a genuine threat to myself (or to someone else) then you have a right to force me into treatment... but until then I believe I should have that choice and the right to refuse treatment. Not have psychiatric treatment be a condition on me returning to work. That's blackmail. And my ability to work is not related to the cutting. It may be related to the stress but it is mainly because of the fatigue. As it turns out the fatigue is not related to a psychiatric disorder... but untreated anemia. I can thank the chiropractor for that one. I felt 1000x better after increasing my daily dosage of iron. I went from barely being able to move off the couch and having no energy at all... to being able to function again.

Any ways... March 1 is Self Injury Awareness Day. While it is not recognized if you know someone that self-injures, or injure yourself show your support that day and wear an orange ribbon or bracelet. The colours typically associated with self-injury are:
Orange: Still self injuring
Orange & White: In recovery
White: Friends and family who understand

And for those that think self-injury is way out there... millions of people self-injure. The estimates may be as high as 1 in 4. Chances are you know someone who injures themselves. If you want more information feel free to contact me... or do a search on Google. There are a number of web sites out there and a number of books on the subject.

The assumption is that the alternative to self-injury is "acting normally," but on the contrary . . . the alternative to self-injury is total loss of control and possibly suicide. It becomes a forced choice from among limited options.
Solomon and Farrand (1996)

A Bill of Rights for Those Who Self-Harm

1. The right to caring, humane medical treatment.
   Self-injurers should receive the same level and quality of care that a person presenting with an identical but accidental injury would receive. Procedures should be done as gently as they would be for others. If stitches are required, local anesthesia should be used. Treatment of accidental injury and self-inflicted injury should be identical.

2. The right to participate fully in decisions about emergency psychiatric treatment (so long as no one's life is in immediate danger).
   When a person presents at the emergency room with a self-inflicted injury, his or her opinion about the need for a psychological assessment should be considered. If the person is not in obvious distress and is not suicidal, he or she should not be subjected to an arduous psych evaluation. Doctors should be trained to assess suicidality/homicidality and should realize that although referral for outpatient follow-up may be advisable, hospitalization for self-injurious behavior alone is rarely warranted.

3. The right to body privacy.
   Visual examinations to determine the extent and frequency of self-inflicted injury should be performed only when absolutely necessary and done in a way that maintains the patient's dignity. Many who SI have been abused; the humiliation of a strip-search is likely to increase the amount and intensity of future self-injury while making the person subject to the searches look for better ways to hide the marks.

4. The right to have the feelings behind the SI validated.
   Self-injury doesn't occur in a vacuum. The person who self-injures usually does so in response to distressing feelings, and those feelings should be recognized and validated. Although the care provider might not understand why a particular situation is extremely upsetting, she or he can at least understand that it *is* distressing and respect the self-injurer's right to be upset about it.

5. The right to disclose to whom they choose only what they choose.
   No care provider should disclose to others that injuries are self-inflicted without obtaining the permission of the person involved. Exceptions can be made in the case of team-based hospital treatment or other medical care providers when the information that the injuries were self-inflicted is essential knowledge for proper medical care. Patients should be notified when others are told about their SI and as always, gossiping about any patient is unprofessional.

6. The right to choose what coping mechanisms they will use.
   No person should be forced to choose between self-injury and treatment. Outpatient therapists should never demand that clients sign a no-harm contract; instead, client and provider should develop a plan for dealing with self-injurious impulses and acts during the treatment. No client should feel they must lie about SI or be kicked out of outpatient therapy. Exceptions to this may be made in hospital or ER treatment, when a contract may be required by hospital legal policies.

7. The right to have care providers who do not allow their feelings about SI to distort the therapy.
   Those who work with clients who self-injure should keep their own fear, revulsion, anger, and anxiety out of the therapeutic setting. This is crucial for basic medical care of self-inflicted wounds but holds for therapists as well. A person who is struggling with self-injury has enough baggage without taking on the prejudices and biases of their care providers.

8. The right to have the role SI has played as a coping mechanism validated.
   No one should be shamed, admonished, or chastised for having self-injured. Self-injury works as a coping mechanism, sometimes for people who have no other way to cope. They may use SI as a last-ditch effort to avoid suicide. The self-injurer should be taught to honor the positive things that self-injury has done for him/her as well as to recognize that the negatives of SI far outweigh those positives and that it is possible to learn methods of coping that aren't as destructive and life-interfering.

9. The right not to be automatically considered a dangerous person simply because of self-inflicted injury.
   No one should be put in restraints or locked in a treatment room in an emergency room solely because his or her injuries are self-inflicted. No one should ever be involuntarily committed simply because of SI; physicians should make the decision to commit based on the presence of psychosis, suicidality, or homicidality.

10. The right to have self-injury regarded as an attempt to communicate, not manipulate.
    Most people who hurt themselves are trying to express things they can say in no other way. Although sometimes these attempts to communicate seem manipulative, treating them as manipulation only makes the situation worse. Providers should respect the communicative function of SI and assume it is not manipulative behavior until there is clear evidence to the contrary.

© 1998-2001 Deb Martinson.

Labels

"Who knows where thoughts come from, they just appear" (Empire Records)

I am really starting to think there is a lot of truth to that statement. I was having a shower and suddenly, randomly started to think about the labels we give people which then shapes how we see them. Have I mentioned my mind is a little quirky? If we label someone then we start seeing other behaviours as a pattern. In turn, this reinforces our view of them.

Take ADHD for example. Before I go on I am going to say that I do believe ADHD is real... However, I do think it is overdiagnosed. Is the child hyperactive because they are seeking attention? Maybe it's the only way for them to get attention. Are they hyperactive because they are not challenged? It's possible they act this way because the task at hand does not stimulate them enough. Or are they hyperactive because of a real disorder? As soon as a child is labelled with ADHD then they are put into a box and that label goes with them. It affects how other people interact with them. It also affects how they see themselves. And once they are diagnosed with ADHD then other behaviours are attributed to the ADHD and it becomes a reinforcing circle. They have all these behaviours so the diagnosis must be right.

Now I don't have ADHD. Some days I may have ADD from a head injury but I work hard to minimize that. But some people could give the label of "Borderline Personality Disorder" because I was a cutter. I engaged in self-injury. It's a great resource on the subject. But as soon as you label me with BPD then you are going to say that the impulsiveness and reckless behaviour are also part of the disorder. How about we just call it what it is. It was a maladaptive coping mechanism. We all have them. For some it is binge eating, for others alcohol or drugs, or it could also be reckless sexual encounters. Deep down we all have ways of coping that are not healthy. There is just a greater stigma associated with cutting. I couldn't handle emotions so I turned it into a phsyical pain. I'm also not trying to justify it but I can say it was not about seeking attention. I will also be the first to admit that it is not a good thing. But don't put a label on it so that you can treat it with some medication. Or so you can say that I did it because of a disorder. It was a way to cope... end of story. If you're not familiar with self-injury I encourage you to check out "Secret Shame"

So the next time you want to label someone think about the long term effects it will have. No idea why I was even thinking about it but whatever. You never know what I am going to think of.

Heather