To say I am furious is an understatement. Last night my mother alter switched during the night and as she so often does she self-harmed by cutting with a razor blade. She inflicted two deep approximately twelve centimeter cuts down my left forearm. Something woke my husband up at about three o’clock and he knew something was wrong so checked on me to find me in a pool of blood and clots. I was sound asleep. He had to awaken me from a deep slumber. Again, in a dissociative state, I had cut, totally unaware of what I had done. I had obviously done it hours ago as the blood was dry and the bleeding had stopped.
We had been through this scenario so many times but it brings shock with it so many times. It’s so dangerous and discombobulating. It feels terrible to feel you have no control over what is happening to you let alone something so destructive. I suffer from Complex PTSD and Dissociative Associative Identity Disorder and have five alters, two of whom are very dangerous, a mother alter and a seventeen year old. They are hell bent on punishment. They believe I should be punished for the abuse I received from the men involved in a paedophile ring I was involved in while I was a child.
To go back to why I am furious. After a cutting incident the Mental Health Team from my local Hospital rings the next day to check up on me. It is a real “hit and miss” affair as to the quality of the psychologist you get. Some are great and really have an innate understanding of your situation whilst others are hopeless and do more harm than good. Today it was the latter.
I explained I was in a dissociated state and was awoken from a deep sleep. He questioned how I could have been asleep through such pain. Then he went on to say did I think “dissociation was an excuse for cutting myself!!!!”. I was horrified that a health professional would have such little understanding of DID and the power it had to block out the present and all feelings. Apart from from DID, PTSD and self-harm block out all pain and feelings of being in the present.
PTSD and self-injury (also called deliberate self-harm), such as cutting and burning, frequently co-occur. Deliberate self-harm has been defined as the deliberate and direct destruction or alteration of body tissue without conscious suicidal intent, but resulting in injury severe enough for tissue damage to occur. Basically, deliberate self-harm means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-harm behaviors may include:
- Banging your head
- Carving on your skin
- Severe scratching
- Punching yourself
- Biting yourself
Cutting, skin carving, severe scratching, head banging, and punching oneself have been found to be some of the most common methods of self-harm.
Deliberate Self-Harm, Trauma, and PTSD
The experience of a traumatic event has been linked to deliberate self-harm behavior. In particular, people who have a history of sexual abuse and/or physical abuse have been found to be more likely to engage in deliberate self-harm. Women who have been raped may also be more likely to begin engaging in deliberate self-harm behavior. People with PTSD have also been found to be more likely to engage in this behavior.
Why Do People Use This Behavior?
There is evidence that people engage in deliberate self-harm as a way of attempting to express and manage their emotions, such as anxiety, sadness, shame, and/or anger. Deliberate self-harm may also provide a temporary escape from or be a way of avoiding emotional pain.
People with PTSD in particular may use deliberate self-harm as a way of getting back in touch with the present moment (also called “grounding”). Some people with PTSD may experience dissociation or flashbacks. Hurting oneself such as through cutting or burning may “shock” the body back into the present moment, ending the flashback or dissociation, much like the way smelling salts work.
Deliberate self-harm is a serious behavior. Although some people report that it causes relief from painful emotions, this relief is temporary. Afterwards, people may feel more painful emotions, such as shame, guilt, sadness, and/or anger. The behavior may also leave scars which people may feel shame about and attempt to hide, and the behavior may become more severe over time.
This man left me with feelings of self loathing, hatred and intense low self esteem. He did a lot of damage with few words. He is ill equipped to do is job and is highly unprofessional with little understanding of psychiatric conditions. I pity the other clients he has to deal with. I am lucky I have a great psychotherapist I can debrief this with but not all others are so lucky.