I’ve Been Considering Cutting Myself

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Reader’s Question

I’m wondering whether I have a disorder. Firstly, I am 22 which just makes this seem even sillier.

I’ve been considering cutting myself. I used to do this when I was a teenager, but I stopped. I’ve been thinking of buying a Swiss army knife because it’s portable and I can use it whenever I feel the urge.

I’m not sleeping well, and I feel a little more depressed each day.

It’s like I don’t actually live in the real world anymore. I feel like I’m living in a fantasy world that I create in my head.

I have very low self-esteem and have no friends where I live. I can’t be honest with the people I do know, so I just pretend I’m fine and they believe me.

I know you’ll probably recommend going to see my GP but they’ll put me on anti-depressants again. I hated them last time because they made me feel completely emotionless. I also tried to see a therapist but I couldn’t really open up for fear of being judged. I don’t know what to do any more and I’m wondering if there are any other options.

Psychologist’s Reply

“Having a disorder” sounds pretty terrible, doesn’t it? It takes all of the fear and stigma of mental illness, wraps it up in a bow and leaves it at your doorstep. It’s as if there is a “disordered” threshold to cross and once crossed, can’t be crossed back. Maybe we should start by rephrasing the question.

There is a distinction between being disturbed by one’s emotions and having a mental illness. We tend to think of mental illness as one that is chronic, severe, and manageable but not curable. In the physical health world, this description would apply to something like diabetes. The disease is manageable, but usually not curable. If properly managed, however, diabetes need not be disabling.

The other category, being disturbed by our emotions, is one in which we all belong from time to time. In your question, you reject antidepressant medication because it makes you feel flat. You prefer to be disturbed by your emotions rather than have no emotions at all. That seems to be a healthy choice, since your feelings are now available for the work ahead of you. Now, it is a matter of finding a way to manage your feelings so you can work with them without being overwhelmed by them.

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The cutting is not the problem. It is the symptom. I encourage you to reject this maladaptive solution to the real problem just as you’ve rejected the antidepressants.

The work for you seems to be in dealing with that harsh, critical agent that lives within you that judges you. So harshly in fact, that you can’t even talk about your problems. Because you’ve been silenced by this critical internal agent (CIA), you become anxious and start to suffer derealization and withdrawal from real life. These are things you must be able to talk about in therapy. If medication would help you relax to talk about it, fine. Meds may be a short term help. But if you reject medication, then you will still be able to do the work.

Once you have a therapist chosen, consider seeing her 2-3 times per week. Stay focused on the real problem. Don’t let yourself get distracted or the issues diluted by cutting. And you seem to be able to express yourself well in writing. You can always take your writing into therapy if you find yourself tongue-tied when you arrive.

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