A Safe Place for Cutters Blog


Do You Hate Yourself After Cutting?
July 18, 2009, 22:46
Filed under: Borderline Personality Disorder, Coping Skills, self-harm, Tools | Tags: ,

Do You Hate Yourself After Cutting?

Hate YourselfI hear from many cutters* that they loathe themselves after they succumbed to cutting after struggling to fight off the urge. This is true of my patients at the state hospital as well. They complain of feeling like a failure and figure they might as well go all the way and make it big.

Rather than beat yourself up for this setback look at it something to learn from. So much of the time you don’t really know where your urges came from or why you are feeling the way you do. This makes it easier to cut once you get the urge. Instead, take a close look at the steps that led up to your cutting. This is called a Chain Analysis or Backward Chaining. By practicing this method you will come to better understand yourself and help you to better manage your urges and put controls in place.

A Chain Analysis can help you identify why you are engaging in certain problem behaviors. It will help you figure out all the things that can contribute to cutting, and in doing so, a chain analysis can give you insight into how to stop cutting.

  • The first step is to describe the cutting incident that you just engaged in. Rather than berate yourself over having cut again, stand back from the situation and examine the behavior as if you were an indifferent bystander. Describe it in enough detail that an actor in a play or movie could recreate the behavior closely. Describe exactly what you did, said, thought and felt and the intensity surrounding the problem behavior.
  • Next, think about what happened prior to your cutting. What were you doing? What was going on around you? Were you in an argument? Did you have a memory of a traumatic event triggered? Basically, you want to identify the event or situation that served as the starting point for the cutting.
  • Now, identify what kinds of thoughts were brought up by the situation or event you came up with in Step 2. How did you evaluate the situation or yourself in that situation?  It might also be helpful to identify what things might have made you more susceptible to responding to the situation as you did. What was making you feel particularly vulnerable? On another day, those things that were going on in your environment would not have triggered you. Why this time? For example, when people do not eat well or do not get enough sleep, they may be more susceptible to experiencing negative moods or having more reactive emotional experiences.
  • Think about what emotions you were having as a result of that situation. Try your best to list as many emotions as you possibly can, such as worry, fear, sadness, anger, shame, guilt, embarrassment, and feeling isolated.
  • Pay attention to what you felt in your body. Try to recognize and label all the sensations that came up. For example, did you experience shortness of breath? Muscle tension? An increased heart rate? Think about how your body reacted to the situation you identified in Step 2.
  • Next, list off what your thoughts, emotions, and bodily sensations made you want to do. That is, did they make you want to escape the situation or do something to make those feelings stop? Did you feel a need to engage in your problem behavior?
  • Finally, think about consequences of engaging in your cutting. Did you feel better afterwards? Did you feel disappointed in yourself? Ashamed? What was the impact on others? Was there any property damage? Did someone have to take time out of their schedule to drive you somewhere? Was a relationship damaged? Try to list off as many consequences (both positive and negative) as you can.
  • What can you do to repair the situation or make amends? This can include fixing something that broke, doing something for someone else to make up for the situation and even apologizing.
  • This final step is the most important of all; what did you learn about yourself after completing the Chain Analysis? What can you do differently next time?  Did yuo have any deep thoughts or insights?

Tips:

  • It can be helpful to go through a chain analysis soon after you engage in a cutting. This way, your experience is fresh in your mind and you will likely be able to remember more information about the factors that led up to your cutting.
  • Behaviors can serve multiple functions. Therefore, go through a chain analysis for a number of different situations that led to a problem behavior and try to identify all the functions a problem behavior serves for you.
  • After you go through the chain analysis, come up with different coping strategies that you could use at each stage. In addition to identifying the function a problem behavior serves, it is also incredibly important to figure out how to “break the chain” with healthier coping strategies.
  • Click this link for a Chain Analysis form that you can download to help guide you through the process as well as an MP3 of a recent teleconference I did on the subject.

Next: A real life example at the state hospital.

To A Life Worth Living,

Foresteen Forbes, Psy. D.

*If you would like to be a member of my Facebook group “The Safe Place for Cutters,” please find me on Facebook and invite me to be your friend. Click here!

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