when a friend is struggling with self harm

Hi everyone,

So my best friend Jess is in crisis. She’s been having trouble for I don’t know how long. She and I are so different. I’m very expressive even when I want to keep things to myself my face/ demeanor always give me away. A psychiatrist I had once said I was a terrible liar and shouldn’t even try LOL!

Anyway my p problem as far as self harm went wasn’t about needing to feel. It was that this was the only way I could snap myself out of feeling really emotional especially when people were saying I had no reason to be crying/ anxious angry ETC. No matter what I did I couldn’t get my brain to switch gears and calm down. But SI did this for me. For once I was able to act like everyone else wanted me to act.

Those who deal with this know that Self injury is as individual and diverse as any other aspect of mental illness in the aspects of how and what and why of it all.

For Jess I’m not sure why she does it. I know her internal state is a lot different than mine. In my head there’s constantly a dialogue going about how I’m feeling what I’m thinking what I’m feeling about how I’m feeling along with a lot of other complex stuff about how I relate to people situations interactions past, thinking about the future ETC. Someone once said I have a “firing on all cirits mind.” Which is pretty accurate. With Jess its different as I’m learning more and more about her. When I met her she was very aloof and closed off. Kept feelings close to her chest but put out an air of slight prickliness. She was friendly enough but a bit intimidating at the same time due to the sense that she wasn’t gonna let anyone too close and that you better move carefully so not to set off her anger. I was a bit afraid of her at first anxious. Some of these characteristic reminded me of my mom. As time has gone by the prickliness has gone away at least with me. And she’s more approachable to others than she was then though she’s by no means someone who will just walk up and start being friends with anyone. It’s hard to really get to know her.

Anyway she has a hard time even figuring out what’s going on in her head. Feelins come up and she has a hared time identifying what they are. Even if she can generally identify the feeling as anxiety or depression when someone asks why she doesn’t know. She feels like people even staff here that are well trained and compassionate and know that a huge reason why people that live here are having a hard time is due to emotional regulation issueswill say she’s stupid. Or she feels stupid not knowing. She’s one that feels she needs to be really precise with her words so careful in what she says and how shesays I’ll just go on and on for an hour.

Anyway I know her reason for SI are very different from mine as are the methods and how she does it. We’ve been living together for well over a year. We both had to do a lot of work to earn the right to have our own room. I was seeing Jonathan and doing intense therapy at the time. She was somewhat as well but it was harder for because if she can’t identify what’s going on it’s hard to talk about it. I really think art or jpournal therapy would be best for her. She does find more clarity in sitting and writing things down than anything else. But you’re very limited on Medicaid.

Anyway when I first met her I was very jealous. She seemed extremely stable, balanced. Seemed to know how to cope with her self injury depression ETC. I don’t know if it was just my perspective in that I was really in crisis at the time I first met her in the observation room. I had just figured out a ggood care plan for my SI. Was actively doin it but within safe boundaries that finally all staff agreed to. A harm reduction approach. She just seemed to have it all together. I continued to work with Jonathan. Up until a couple of months ago where he was having absolutely crazy scheduling issues and not bothering to be in contact about it. Plus I noticed him totally backing off emotionally due to I guess the fact I wasn’t “in crisis” anymore. This should have been thoroughly discussed but never was. Anyway. So I was doin well in therapy. The

The consequences of engaging in SI while not horrible as in if it’s within the care plan the Dr. isn’t even called aren’t fun. You have to have an incident report done which means you get vitals taken for three days even at night. You have to talk to a PRC which for me a huge reason I did scratch was to bypass my feelings and not have to talk about them. So that took that reason away. Some older staff, staff that just didn’t know better do judge the SI situation just not getting it . The majority don’t but I’m extremely sensitive to other’s perceptions and feelings. I know when I’m being judged even if they try to hide it. Though the majority get it the reactions of the ones that don’t put me in my place.

A new feeling emerged last week when Jess did have an SI incident. Because of her internal issues with identifying and expressing feelings no one often knows something is wrong until it’s “too late.” That is she’s already had a cutting issue. At least she now goes to staff right away. She used to wait hours which they hated for obvious reasons. Anyway she did go to staff. And she was closely observed. But I found myself instead of beingflooded with anxiety and wondering what I could have done to help her, extremely angry. Like wanting to shake her a few times angry. I know deep down it’s because I care about her so much. I want her, within the limits off the haywire chemistry in her brain, to be content. To have some stability and know it’s hard earned and that she has a lot of support. Somewhere along the line I had and have the intuitive feelin like her progress stopped or slowed down while I’ve continued to grow. This isn’t at all a competition it’s just a sense I have. Anyway I care so much about her. We basically saved each other’s lives. I know that’s dramatic but true. We both were in extremely terrible places when we met. And somehow formed a healthy sisterhood that no one would have expected because we’re such opposites. Anyway I just felt so frustrated because she works so hard to support me. Which though I’m extremely emotionally intense it’s in a way easier due to you can read me like a book. The feeling that with her even if she says she’s ok you never know at all what’s under the surface, and the worst thing that she doesn’t seem to know either, is so scary.

Anyway that night I just lost it. I don’t remember being this angry in a long time. Anger was a big feeling I surpressed due to the emotional abuse anger being my mom’s right only. So I screamed at her that she was “ruening her life!” Well I could have put it nicer. I was just fed up with a lot of stuff. Mainly her saying she was gonna do thins and then not doing them. In the aftermath we did calmly discuss things, somew of it by e-mail.

I agreed I wouldn’t push her on issues because she needs to do them in her own time no matter how slow that is. I also agreed to try to be calmer and not freak out on things so she can actually feel comfortable telling me. An anxiety issue I have for example is her being hospitalized. She’s my only friend in this facility. She helps me a lot with different things like meals laundry ETC and we share a room. It’s extremely hard not only that my best friend is in the hospital but my only 24/7 companion is gone and I’m kinda lost. People can say make more friends. It’s so hard in this facility where so many residents are so low functioning on the psychotic/ aressive side, or on the withdrawn side that it’s hard to make friends.

Anyway about the anger explosion. It felt freeing to let all that out. And to know staff weren’t ruffled one bit. And I didn’t get yelled at. I was actually told I did a good job expressing myself. It felt better than scratching which was a whole new feeling. I think we both had breakthrouhs that day especially in communicating. Her in being able to be as honest as possible me in trying to be able to calmly receive it.

Fast forward to yesterday. She had another incident of a really bad day not knowing really what was going that built up to an SI incident. This time did go better because we were more open with each other. Still it’s so hard that she doesn’t know what’s going on in her own head. She’s going through the typical protocols of the facility, observation not being allowed in our room ETC. Not sure if she’ll be hospitalized or not and am preparing myself for the possibility.

It’s hard on me right now because Edith is on vacation til Wednesday. Kari is my coverage PRC. She didn’t give me a good first impression as she was running the show last night in terms of crisis intervention for Jess. One of the requirements is a room search looking for anything that someone could use to harm themselves. She did admit that anything could be used. There have been room searches before many of them, but this one was particularly intense and I felt she was rough with some of my things. She pulled so hard on part of a clay bowl Jess made at her treatment program that it broke off. No one ever broke anything in a room search before. I just hated her touching my things. She took away a seashell that had a sharp part on it even though it’s mine not hers. An object that a few months back had been taken in another room search of an SI incident of mine but I got back. To have it gone again and to go through the trouble of getting it back just sucks.

Then she started talking about how many power cords were in the room. I got really anxious that she was gonna take cords to go with my technology stuff and started screaming about accomidations. Most experienced professionals here can juggle two things at once especially two clients. She is about a month in and has never done work quite like this. She clearly couldn’t handle Jess and the room search and me progressively getingg more emotional. She was very short with me and basically I think if she had been able to would have said shut up.

In the end she didn’t take my tech cords. Some night liht cord of Jess’s. And to her credit she did come back and say I bet I felt frustrated with her and angry which was about right. And that she couldn’t handle everything once which I guessed. She said she’d glue the bowl. Still I don’t trust her. I just don’t. To my credit in the past I would have gone off at her and called her a bitch instead of just thinking it and being able to keep my mouth shut.

So anyway. Jess was in observation last night. Her doctor ordered she be out of our room which is too private, be around staff ETC. I think the big reason she wasn’t hospitalized was due to no empty beds on the unit though she had to go to the ER if needed.

Everyone’s just playing it by ear. She says if she feels even close to cutting again she’ll ask to be sent out to the hospital no matter if she has to sit in the ER which is smart. And scary/ anxious for me due to what I said above. Granted I got through two other hospitalizations of hers with flying colors. Staff were supportive I held it together and things were ok. Preparing myself for this possibility. Hoping if she does go she makes the most of it.

The unit she goes to, and that I would if needed go to is very good. Good staff lots of groups ETC. How a unit should be. When I was in a unit like this my first time I took advantage of everything, like it or not I was kinda forced to for my benefit. She didn’t seem to at least the last hospitalization. I had asked her if others had had similar experiences with SI. I personally love meeting people my age experiencing this stuff because only we know what it’s really like. She said she really didn’t talk to anyone about her issues. Some might say she just didn’t want to tell me but we don’t keep secrets especially something like that she’d tell me. She sort of sees it as a place to get meds adjusted which it can be. But you have to take advantage of the other stuff offered I think as much as possible.

So there’s the anxiety that even if she does go to the hospital she won’t really get the full benefit. But I can’t do anything about that. I think some of my anger release last week was to do with my feelings growing up with a mentally ill mom. I’d suggest therapy, or that she divorce my dad once and for all since she spent years screaming about it, or whatever and she’d agree only to not do anything. I think that reminded me of what I’d do with Jess trying so hard to help her get in the right direction again. Like with my mom I finally learned you can’t make anyone do anything. She, Jess, as hard as it is has to choose to do the hard work of step by step getting more supports in place. Of learning how to keep thins from building up and things like that. No one can do it for her.

All I can do is be her friend and give lots of hugs and try to make her laugh with my playfull antics. And just see what happens.

Has anyone else gone through this? Helping a friend through a problem that either you both share, or that they’re just going through on their own and feeling helpless. Have others experienced room searches for SI issues and staff that don’t get it? Would love to discuss.

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