Scars, Stigma and Sadness

Today was sad. I had a beautician appointment with a new clinician. I hate those sorts of appointments, they bring up their own triggers and vulnerabilities every time. But this beautician in particular made things even trickier to manage.

I have scars over various areas of my body, and they were exposed. She made a handful of inappropriate (and highly unprofessional) comments. I will give a few examples of the things she said:

“Why do you do this to yourself? You are so beautiful and young”

“Aren’t you upset with yourself? Look at what you’ve done”

“You should really consider getting them covered with tattoos, then people won’t ask questions”

“But what will your boyfriends/ future husband think!?”  [This assumption is honestly the worst, I can’t stand such heteronormativity – UGH!]

“If you do it again, I’ll tell your Mum and she can sort you out”

“Oh babe, you’re crazy”

She kept on making comments, and we kept on going around in circles. I envisioned having a conversation with my therapist and her coaching me through the interaction. But even though I knew the interpersonal skills I needed to use, I was far from being able to implement them.

I left the appointment feeling a ton of mixed messy feelings. Her comments and attitude made me feel even more uncomfortable (quite literally) in my own skin than I already was. Everything she said highlighted and reiterated to me all the fears and self-judgments I have about myself. There I was, being told in so many words, just how unacceptable I am. It hurt.

The worst thing is, the woman was trying to be nice. She genuinely thought that she was being considerate and helping me with her oh so fucking fabulous words of wisdom. She had no idea about the impact of what she was saying. She had no idea how unaware and insensitive she was being. And I remained stuck, frozen, unable to stand up for myself. As always.

Nevertheless, ironically, all those feelings turned in on myself. Self-disgust. Self-hatred. “YOU ARE SO WEAK – why didn’t you DO something?”. Self-blame. Familiar feelings of inaction and paralysis. A spiral of shame. A desire to hide, to hurt myself, to destroy the unacceptable.

I am trying to remind myself that this is just the opinion of one woman. One woman who doesn’t know the first thing about mental illness, who lives in a world very different to my own, who is irrelevant to my life except for one hour every 6 weeks.

But I guess the truth in all of this is that I am sad. I am sad because my scars are a result of the things I have been through. It doesn’t matter what schtick I get for them, they do not exist for no reason. I am also sad because as much as they are a part of me, and as much as they interfere with my life, the only reason they do interfere is because of people like her. Inherently, I don’t hate my scars. I don’t see them as bad. They are mine and they are a part of my experience as a human being. I have come to accept them as a part of me – just one of many parts. But when others fail to see beyond that – when they judge my past, my present and my future on the physical marks etched onto my skin and fail to see beyond that – it is hard to not slip into judging myself in much the same way.

Medical Tattooing for Self Harm Scars

I had a consultation over the weekend at a medical make-up clinic. I now have the opportunity to invest in a scar camouflage treatment that will allegedly minimise the appearance of the scars I have from cutting myself. The treatment is a mix of micro-needling to try and improve the skin texture itself, with the addition of a pigmentation to match the colour of the scars to my natural skin. 

I thought I wanted to get rid of the scars I have on my arms, but being faced with the decision now that it is a potential reality, I am no longer so sure that I do. 

The treatment is expensive, although not outrageously so and it is safe and reliable. The results do look remarkable from what I have been shown. The make up artist is top of her field so I will be in trusted hands. If it helps the appearance of the scars, I may be more able to do things my scars stop me from doing, such as wearing no sleeves whilst nannying.

However, it could amount to a lot of money depending on if I require top-ups (apparently “permanent” does not actually mean permanent, you see). It is slightly invasive and will irritate the skin for a while after. I will not be able to continue with laser hair removal on the area if I get it done! Also, I feel a sense of guilt to my self, for wanting to get rid of a part of who I am. I wonder if I am doing it for other people, more than for myself. Now that my scars are mostly healed, they don’t impact my life as much as they did when they were purple. If I get the treatment, will I be sending myself the message that my scars are something to be ashamed of, and something I need to hide?

I am thinking of getting the treatment on one arm to start with – the one I find uglier and less “attached” to the scars of. I can then see how it goes, playing things by ear, and I will still have my other arm full of scars (and other body parts) untouched if that is how I want them to stay.

I thought this would be a simple decision, but for some reason it is not. My mum is encouraging me to go ahead and book the appointment ASAP, and I’m not entirely sure why, but I keep on putting it off…

1 Year Self Harm Free

I do not think I, nor any of my family members nor treatment providers, ever thought I would get to this day.

Today marks an entire year since the last time I a) cut myself and b) was admitted to hospital for related reasons. 

That is all!

Urge Surfing

Sometimes you just have to stop whatever you’re doing, put it all down, get away from people, and lay on the floor. 

Sometimes you just have to switch off from the world because it is all too painful, nobody gets it, nothing they say even touches the sides of what you are going through.

Sometimes you just have to lie on that floor with nothing around you; just lie and lie there and wait. Wait for the urges to pass, wait for the urges to wash over you, wait for the impossible to become possible again.

Sometimes you just have to stay lying on the floor for minutes or hours at a time doing nothing because you know that if you move, if you get up, you will Do Something You Will Regret.

Sometimes you just have to lie there and wait until it is safe enough to stop lying still; safe enough to be a part of the world again.  

An Almost Relapse

Tonight I made the *decision* to self harm. I thought I had decided without doubt that I was going to do it because the urges were so high and fighting them so effortful.

Then something noteworthy happened.

As soon as I let myself stop fighting the urges and allowed myself the potential of giving in to them, they lost their full power. It was like not being “allowed” to do it was making me want to do it more. Then when I gave myself the option of doing it, the intensity of the urges faded and something within me was liberated.

I had been dead set on it after the point I was triggered. I didn’t care that it would be a total relapse or how it would affect myself and potentially those around me because I was hurting so much. I had given in 99% of the way; and didn’t think I would be able to resist this time.

However, I did.

When I let go of the white-knuckling and desperate attempts to not give in to the urges, and let go of the fight I was in, the tension and impulse dissipated slightly. Yes it was only slight but it was enough to put some space between the urge and the action.

I don’t know exactly what that means as I haven’t had such high urges in a while but it kept me from giving in to them. It was like the skill of Mindfuless of Current Thoughts but with a twist. When I really noticed the urges as thoughts instead of as the visceral impulse they initially felt like, something in me shifted – and my *decision* to self harm was eventually reversed.

He Saw My Scars and Asked if I Owned a Cat

On my way back from Florida, after battling with myself all week about whether I needed to cover my scars or not, this is what happened –

My family and I were in the airport going through security. I was wearing short-sleeves, as I had done (albeit with difficulty) all week, and my scars were visible enough (despite my attempts to cover them up with medical make-up.) I was at the back of our family, lagging 2 suitcases, so the officer at the desk had to wait a little while longer for me to catch up and move forward in the line.

I thanked him and shot him my best smile, as a gesture of appreciation, expecting a “No problem!” or something of similar meaning. However, his response was so unexpected that I had to ask him to repeat himself:

“So do you have pet cats then?”

He asked, nodding towards my arms.

“Pardon?” 

I said. I wasn’t sure if I had heard him correctly…

“I asked if you have pet cats or something?”

He said, rolling his eyes, gesturing again towards my arms. 

I stood there, somewhat in shock. My heart started racing, my cheeks flushed a rosy red, and I felt my body go numb. 

If anyone has seen the film about Walter Mitty, you will remember his vivid imagination and impressive fantasising skills. This is exactly what happened to me right then:

An imaginary scene played out in my head in which I attacked this man, shouting abuse at him for his ignorance, lashing out at him physically, crying and losing all self-control, turning into the hulk, causing a scene in the airport….. and being dragged away by airport security personnel – to a room with white walls and booty-juice – to top it all off.

What actually happened was that my stepmum gestured to me to go over to her for comfort, 19 Year Old Sis gave me her jacket to cover my arms with, and 12 Year Old Sis gave me a cuddle and continued to check up on me for a while. (I am so glad that she knows the truth now, and that she is as accepting and compassionate as she is.)

I looked away from them all, desperately blinking back tears, feeling as though it was the end of the world. I felt like the most shameful piece of shit in existence. I was sure all the hard work I had put into showing my (albeit medical make-up concealed) scars over the holiday was for nothing. I was convinced I was being punished for allowing myself to expose this part of myself. I just wanted to disappear into the face of the Earth. 

Now that it’s in the past, I am calmer and able to mentalise: maybe he genuinely had no clue being from an older generation; maybe he was trying to be nice; maybe he thought I would find it funny; maybe he is socially impaired himself, etc. 

Although, having said that, my anger, sadness and shame at the time was totally legitimate; it was not a pleasant situation to be in at all.

At least I have a plan of revenge generated: One day I’m going to be proud to show the world who I am – imperfections, scars, and all. 

Drowning in Jealousy 

I am so incredibly jealous of somebody right now and it’s making my insides hurt. It’s been going on for a few weeks but every now and then something new involving the person happens – triggering an intense burst of emotion which quickly becomes overwhelming. It’s making me want to cut myself, or act out in some self-destructive way. 

I feel so on edge and dysregulated each time I am exposed to or reminded of them. But the fucked up thing is that I am actually making the situation so much worse for myself by putting myself in a position of awareness, hence triggered to feel the subsequent hurt. I could so easily withdraw and put some healthy personal “bottom-lines” in place so that I am sheltered from the person, but for some reason I just can’t.

Some sick part of me would rather expose myself to these triggers and feel the intense jealousy and emotion that I do; instead of choosing to not know anything at all and risk the ignorance and lack of control which that alternative brings with it.

My insides hurt with jealousy and anxiety, and I can’t even talk to my therapist about it because of what it entails. I don’t even think there is a solution – the “threat” feels so strong that I’m not capable or willing enough to use skills to deal with this situation alone – and so I don’t know what to do. 

I Will Hurt Me to Punish You

Something minor happened today which left me feeling like I wanted to cut myself. The event itself doesn’t feel important now; what I am more interested in is how quickly and automatically I jumped to self harming as a possible solution. 

(I feel like I am at a stage where I can manage the low/moderate urges pretty effectively, so it’s not like I wasn’t safe or anything. I was actually pretty effective in how I went about the next few hours, despite wanting to physically attack (either her or myself!) for a while.)

So, I was very mindful of the thoughts and urges I was experiencing, and was even able to start thinking about what was going on for me with curiosity and distance as opposed to impulsivity and willfulness. 

My thinking amounted to a realisation I have had before: that if someone hurts me, upsets me, shames me or angers me, I end up wanting to hurt myself in order to punish them for their wrongdoings. 

I think that generally I really struggle with anger and it’s much easier for me to turn it in on myself as opposed to onto other people – even the person who has provoked it. So one way of getting back at them is by attacking myself. Make total sense, right? ­čśë

These instances are absolutely not the number one trigger for me to want to harm myself, but when I do feel this way, it is a clear indirect mode of communication – to both myself and the other person. I think during these times, what I’m really meaning to say is something like this:

“Fuck you for hurting me. How dare you shame/ anger/ upset me. How dare you have that power over my world. If you think you can get to me, look how much worse I can get to myself. I can hurt myself (physically) far worse than you will ever be able to hurt me (emotionally). I will show you how much you hurt me and then you will suffer. Then you will see what you have done and why you should listen to my needs – so that I don’t have to show you so tangibly. I am the one in control here. And now it is your turn to feel the helplessness and powerlessness you inflicted upon me. And I on the other hand will feel liberated.”

Edit: ironically, this applies when the person has absolutely no idea that I have engaged in any behaviour, let alone that I am hurt or struggling because of them. The only people I ever told (and very indirectly at that, or they found out via other more dramatic means) were my therapists/ people on my treatment team. Then it really did apply. I will give an example later. 

Body-Focused Repetitive Behaviours: Dermatillomania/ Skin-Picking And Nail-Biting

Body-focused repetitive behaviour (BFRB) is the umbrella-term label given to any obsessive, compulsive, repetitive self-grooming behaviour which causes damage to an individual’s body and/or appearance. BFRBs come under the category of impulse-control behaviours, and can become so preoccupying and debilitating that they may interfere with an individual’s quality of life to a large – and rather misunderstood – degree.

The main BFRBs are dermatillomania (skin-picking) and trichotillomania (hair-pulling). Other common behaviours in the category range from nail-biting and lip-chewing, to cuticle-peeling and blemish-squeezing.

I have struggled with some of these body-focused repetitive behaviours (BFRBs) for as long as I can remember. As a child and teenager, I always had my fingernails in my mouth; my cuticles became chewed and picked to the point of bleeding and infection. As a young teenager, I became obsessed with plucking my eyebrows to the extent I barely had any left for significant periods of time. As an adult, I continue to struggle; my biggest difficulty being with picking the skin around my fingernails, and attacking the keratosis pilaris (a pretty common skin condition) on both my upper arms and legs.

Recently I have be struggling with the picking to no end, and to be honest it’s really been getting me down these last few weeks. I have constantly new or healing sores from all the picking, and a growing collection of small circular scars as a result, too. I can end up losing hours of each day as a slave to the picking, and feel trapped within a battle between my brain and body: Even though I am so desperate to STOP the behaviours, I am finding it simply impossible. Worst of all the consequences is the shame, helplessness and frustration I feel as a result, as well as the inevitable perpetuation of my low self-esteem, self-consciousness, self-hatred and self-disgust.

I have been researching on the topic a fair amount in order to try and understand exactly what I am experiencing, and why. I have been relieved to find that I relate to multiple people and sources on the Internet and in the world. To know that I am not alone in the BFRB struggles certainly reduces the shame and stigma I have felt in the past. I genuinely hadn’t realised that others have such similar struggles, obsessions and nuances as I do in this way.

Here are a few things that have struck me in my recent reading around BFRBs:

  • It is common for family members and friends to grossly misunderstand that BFRBs are not just habits that can be broken. I, like many others, have been judged and shamed by those around me who fail to comprehend the intensity of the compulsion to engage in behaviours which seem so unacceptable and off-putting to others. My mother often tells me that she feels she is “sitting next to a monkey” because I am always picking at myself. Similarly, my sister tells me that I am disgusting and shouts at me to remove myself from the room. In response to judgments such as these, my shame, anger (self-directed) and urge to hide away are reinforced.
  • People are under the false impression that we can just stop, man up, or that we simply┬áneed more willpower. This is not the case; if it were so simple, if it were a choice, we would stop in the click of a switch. BFRBs become diagnosable as a disorder when the sufferer finds that no matter how hard they try to stop, no matter how many times they have attempted to do so, they just cannot seem to get a grasp on a prolonged and liberating remission.
  • I, like many others, tend to engage in the BFRBs during one of two states of mind. The first is during periods of heightened emotion; for me specifically with anxiety and fear. During these moments, the BFRBs act as self-regulating and soothing mechanisms, and can lessen the intensity of whatever it is I am experiencing dramatically. The second state is within a more dissociative, robotic frame of mind. Oftentimes, whilst feeling on auto-pilot, the BFRBs come into play without any conscious or intentional awareness.
  • My BFRBs, like many other people’s, are an attempt to “fix” or “perfect” an irregularity or imperfection on my body, such as a loose nail or uneven patch of skin. Ironically, engaging in the behaviour – which involves attacking myself in some form – inevitably worsens the appearance of the area I am attempting to rectify. In trying to physically correct myself, I end up creating even more damage. This then leads to an increased desire to “fix” the worsening problem, which followed by the corrective action, leads to consequent further self-destruction. It is an endless and self-perpetuating cycle, and in my opinion one which is accompanied by distorted and even body-dysmorphic thinking.
  • As I have experienced, BFRBs sound pretty darn hard to treat and fully recover from. Although there are a few specific therapies targeted to help combat these difficulties, BFRB disorders remain largely stigmatised, misunderstood and dismissed within society.

I am going to start trying to combat my own skin- and nail-picking BFRBs in two ways I have discussed with my therapist. Firstly, by applying hand lotion every time I notice the urge to pick at my hands, I will attempt to replace one (more self-destructive, ineffective) behaviour with another (more loving, intentional) behaviour. Secondly, perhaps practicing Mindfulness i.e. the intentional, momentary and non-judgemental awareness of the urges will help me feel more able to make a choice about whether to engage in the behaviours, or not – instead of mindlessly picking away at myself, unaware.

Fear And Loathing In 36°C (97°F) London 

I am actually shi**ing myself in preparation for this afternoon. All I’ve done so far today is hide away from the heat in my bedroom with a fan to accompany me. But in just a few hours I have to brave the outdoors and go pick up the girls I nanny from school. It will be 35┬░C (95┬░F) and I will be wearing a cardigan. 

Here’s to me trying not to die of hyperthermia… Pray for me people!

(Seriously though, I am struggling so much to accept the consequences of my self-harm scars and what it means for me today and in my future. I’m really sad and bloody anxious. That is all.)

Living With Self-Harm Scars

This week in London has marked the beginning of true summer, with temperatures increasing up to around 24┬░C (75┬░F). Next week the weather warnings indicate a mini heatwave with temperatures soaring as high as 32┬░C (90┬░F) and lasting up to a week. Now, whilst for most people in London, this is news of celebration and excitement as the bikinis, sunscreen and paddling pools come out, for someone with self-harm scars all over their body, it is a totally different story.

An extensive portion of my arms and part of my legs are covered in self-harm scars. They vary in colour, size, shape and severity, with some being a lot more noticeable than others. In the past, I have gotten away with wearing sports bandages and using the excuse of a sprain or injury (with most of the damage being on my left arm). However, during the more recent and severe stages of my BPD and self-harming history, more and more areas of my body became subjected to this self-destruction.

I can no longer hide under bandages unless I am prepared to look like an Egyptian mummy.┬áWhilst part of me would love to feel confident and able enough to expose my scars for what they are, right now I am at a stage where I do not believe this to be the most effective choice. Working as a receptionist means constantly interacting with people, and ┬ádue to the extent of my injuries and the slow healing process, I don’t feel it would be appropriate to have them on show in this role at this time. Also working as a nanny with two young children, the same applies to an even greater extent: it simply would not be appropriate for the girls or their parents to see my scars if I want to continue with my *role* in their family over the next few months. Sadly, public opinion on mental health is limited, and I am unsure as to what my employers’ attitudes towards my history and such physical evidence of it would be. Especially when young children are involved, there are many more cons than there are pros for exposing my scars (and hence a huge part of my life story) within the context. With the risk of honesty and exposure leading me to being misunderstood, judged as a bad influence or dangerous, and potentially even “fired”, I would rather not take the chance!

One day, ultimately, I would like to be able to show my scars for what they are without feeling suffocated by feelings of shame and self-judgement, worrying what those around me are thinking. For the time being however, I have been researching alternative and short-term options.

After considering surgery and ruling it out as an option at least for now, my GP referred me to a charity which specialises in medical make-up. The results of the cover-up can be seen below in these before-and-after photos of one arm:
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In certain┬ásituations, the medical make-up has felt life-saving. I used it in Copenhagen and felt confident and able to expose my skin – it was the most liberated I had felt in months. I use it when I am with friends so that I feel less socially anxious and self-conscious in public places (my friends themselves don’t mind at all and are 100% supportive). I use it so that I feel able to go on the stuffy London underground without worrying that people are staring at me as much when I take off my cardigan. When I go back to university in October I plan to show my arms/ legs in this made-up state too.

However, whilst the difference is substantial and I am very grateful to the service, I still feel unable to be bare-skinned around the children. Sadly this decision extends to my own younger half-sisters aged 9 and 12 who are unaware of the struggles I have faced over the years (due their age, vulnerability and environmental factors.) This means I do not wear short sleeves with this side of the family, and I cannot go on holiday with them either over the summer months.

Due to the behavioural manifestations of my mental ill health, the truth is that I face a number of consequences and probably will continue to for years to come. It saddens me to have to miss out on so much because of what I have done to myself. I am in a continual state of hyper-vigilance and anxiety in recovery around my scars because of the impulsive acts which occurred during periods of being so unwell. Although part of me loves my scars because they are a part of me and my journey, representative of so much, I cannot avoid the impact they have on me every single day in trying to build a life for myself.

The truth is I am fucking terrified of the next few weeks to come. I don’t do too well with heat anyway as I find it perpetuates my anxiety through the body sensations it induces. And so having to deal with this without being able to take off my sleeves and cool down poses another challenge in itself. I have genuinely been thinking about calling in sick next week because I am so scared I won’t be able to get through the stifling heat whilst nannying, especially if we are outdoors. I have a selection of very light long-sleeved/legged clothing and am trying incredibly hard to practice Radical Acceptance around the situation…

At the same time, I can’t help feel a deep sense of loss and sadness around the potential future ‘normality’ I have been stripped of through the consequences of my illness. Whilst trying to be self-compassionate and kind towards myself, there is no denying the truckload of regret and anger I am experiencing too.

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One Month Self-Harm Free

I have tried writing this post about 5 times and cannot think of how to formulate what it is I am meaning to say…

I know that this is because I feel shameful admitting the fact it has been ‘only’ one month since the last time I cut myself; because I am scared that you will think of me as a fraud for not mentioning this earlier; and because then maybe you will see my blog and my recovery process in a different and tainted light hereafter.

The truth is, however, that this incident was truly (and miraculously) a one-off. Besides this episode on May 1st, I have not self-harmed in almost 6 months. What happened a month ago from today was an unfortunately ineffective and unhealthy response to some excruciating feelings I was going through. What I have to remember, however, is the contrastingly high number of times I have been able to get through this pain without resorting to my old coping mechanisms, in recent months.

I am trying not to see the ‘slip-up’ as a failure, but instead to step back and widen my perspective, and to acknowledge – and applaud – the fact that I have self-harmed just once in the whole of 2015, as opposed to once a day like I had been doing previously.

Instead of seeing the relapse as an opportunity to beat myself up and dig myself further into a pit of shame, I have been attempting an alternative approach – seeing it as an opportunity for learning and growth.

The fact that I self-harmed on that day does not take away from, by any means, the vast amount of progress I have achieved over the last 6 months. The fact that I self-harmed on that day does not dictate my overall worth nor strength nor applied efforts. The fact that I self-harmed on that day does not mean that I have ‘no right’ to be publishing posts on a blog in which I express my strides and strengths (as well as pitfalls) in my recovery. The fact that I self-harmed on that day does not mean that I have ‘failed’ or that I am a ‘fake’ or ‘weak’, or that I have taken steps backwards in any way.

The fact that I self-harmed on that day does mean, however, that I can take away from the experience a number of things to boost my chances of effectiveness in similar situations in the future. I have completed a Chain Analysis exploring what was going on for me emotionally, what my vulnerability factors were within the circumstances, what I didn’t manage to do so effectively, and how I could cope with the feelings and situation better next time.

Also, the fact that I am actually one whole month self-harm free again is a miracle in and of itself. It really was not long ago that I was unable to even anticipate surviving just a few days without it. And so a whole month free from it, following a period of a number of further months before that, is an achievement I cannot overlook.

Cheesy as it may sound, tonight my efforts go towards looking at what I have achieved, instead of dwelling on what I have not.