To mark Self Injury Awareness Day 2024, I’ve teamed up with Pinterest to utilise their incredibly massive host of images in tackling the topic of developing and maintaining a good, positive level of self-esteem after having utilised self-harm as a coping mechanism…

This piece of advice might seem a bit surprising to be coming from me after my post a few days ago on their huge failings and my subsequent, resulting complaints against the Crisis Team (if you missed it, you can read it here). In keeping with typical I’m NOT Disordered’s fashion though, I’m going to keep this bit honest, open, and real and start this bit by saying that I 100% recognise that psychiatric services and the various professionals who can be involved in a mental health crisis, aren’t always beneficial with self-harm…

After a year or so in the specialist psychiatric hospital, a girl was admitted and the first thing I noticed about her was that she had her sleeves rolled up and had no scars or wounds on her arms. Firstly, I think it’s actually quite sad that seeing someone who hadn’t self-harmed in that way was a rarity for me. Secondly, after speaking to her, I finally learnt that self-harm could take many different forms because her admission was a result of her continuously misusing her Diabetes medication as methods of both self-harm and suicide attempts.

Unfortunately, I think it’s quite a common understanding that psychiatric hospitals aren’t necessarily always the best place for someone, and I felt that – by the time I was being discharged (another year or so later) – this girl was a prime example of this fact, and I say this for two reasons… The first is that when my discharge began being talked about and planned, she asked me what had been the thing that I felt had really changed things around for me. Without thinking, I replied honestly and told her that it was after having gone AWOL on some unescorted leave from the hospital and making a suicide attempt that left me on life support for the second (but longest) time in my life. When I finally woke up, I was transferred to the Psychiatric Intensive Care Unit (PICU) on the floor above the ward I’d been on for over a year.

Now, this PICU… Well, it was a ward that I’d heard terrible rumours and stories about and being directly below it on our ward meant we often could hear screams, bangs, and alarms going off up there. And what’s massively more horrific than that; one patient actually suffocated and killed another patient (it’s still on BBC News here) on that ward a month before I left the hospital! So, to be put on it whilst also feeling really physically poorly from being under sedation for so long, felt like – not to sound too dramatic – hell on earth! I was being sick almost constantly and when I wasn’t being sick, I was asleep and for the entire time, I was on ‘eyesight observations,’ which meant that when I finally felt physically able to take a shower, I had to be watched the entire time. And I just remember this one, massively powerful thought coming into my head; ‘I don’t want this to be my life.’  And that mindset really proved to be the kick up the bum I needed to really start cooperating with the hospital staff, taking my medication, attending the therapeutic groups and engaging in Therapy. I mean, it wasn’t as though I had wanted everything that had happened until that point to have happened, it was just that I had felt… apathetic, towards the whole thing. I literally didn’t have a single care about what happened in/to my life.

So, after being honest and telling this girl how that entire experience had shaped my mindset into finally working towards recovery, the next thing I knew, she was basically doing all that she could to be sent to the PICU too. I remember hearing the staff shout at her; “we know you just want to copy off Aimee and be sent there, but you’re not going when you’re not genuinely poorly like she was!” That shouting-match led to a huge fall-out between the girl and I with me feeling so very guilty and seriously responsible for everything she was doing. And then pretty much the entire ward chipped in with their opinions on the matter and I was encouraged by everyone saying that the girl really was a grown adult and could make up her own mind as to what to do and how to interpret what I had said.

A while after our argument, I was passing her room and heard a funny noise and something just made me wonder and at first, I moved to continue down the hallway, but then I thought that if something happened, I wouldn’t be able to forgive myself for not helping just because we’d argued. So, I looked through the observation window in her door and saw her with a ligature around her neck and her face was turning blue and swollen. I immediately tried to open the door, but she’d locked it and so I just – almost instinctively – started kicking it to try and break it in whilst screaming for staff to come and help.

After oxygen and a trip to the local A&E, the girl survived, but by the time I was leaving the hospital, her beautiful, empty arms were bandaged, and she was awaiting surgery for a self-inflicted injury. And the entire thing probably looked kind of ironic from the outside; the fact that I’d come in with scars across my entire body and the service and professionals had been really beneficial for my mental health, yet the girl without those, became more poorly from being in there. And taking into account the fact that we both had the same diagnosis, both met the same criteria to be in that same hospital (which was also a specialist service for people with a Personality Disorder!); I think it’s the perfect illustration of the fact that what helps one person might not help others (no matter how many important details people seem to have in common) – one size definitely does not fit all!

For me, there have been several ways in which the services and professionals have helped me in terms of self-harm… I think that the first, largest, and most temporary way, was by being sectioned to the specialist hospital for two and a half years. Before I was admitted in 2012, I had spent the previous three years constantly in and out of both medical and psychiatric hospitals with numerous acts of self-harm that escalated to almost three times a week and my records documented over 60 admissions during that three-year period. I honestly think that if I hadn’t been sectioned to that hospital, I wouldn’t still be here. I mean, there were no specialist services in my locality for my diagnosis of Borderline Personality Disorder (BPD) and professionals were becoming dismissive, rude, and offensive towards me in response to the regularity and frequency of the really dangerous, potentially life-threatening instances I kept creating/finding myself in. So, I could easily imagine that had I been left to my own devices for much longer, deprived of this specialist help and support, then things would have only continued to escalate.

The second largest, more long-term helpful act from services and professionals to tackle my self-harm was being given Dialectical Behaviour Therapy (DBT)…

So that leads me nicely onto this second way of developing and maintaining self-esteem after self-harm; utilising one of the skills I learnt in DBT – self-soothe.

In DBT, you’re taught four modules; Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness, and Mindfulness, and it is in the Distress Tolerance module that you begin talking and thinking about utilising self-soothing activities as a means to help you to cope with and get through difficult feelings and situations. Similarly to many of the coping strategies DBT teaches you and talks about, self-soothing was definitely one which made me feel incredibly stupid. I say this because being taught that you could try taking a bath, getting cosy on the settee, read a book, do your make-up to cope instead of self-harming, truly made me think ‘how the hell did I not think to try this instead of what I was doing?!’ And my frustration really came forward with the recognition that had I thought to do so, I seriously could have avoided so many horrible situations (including hospital admissions).

Also, similarly to other coping skills DBT teaches you, in learning about the helpful components self-soothing can bring to your mental health and general safety levels, you have to make the skills applicable and able to work for you and your very unique and individual mental health needs. I mean, it’s like I said earlier; one size doesn’t fit all – especially not in the mental health world – so it’s essential that you put in the time and effort to take the skills you’re taught and figure out ways in which you can make them helpful for you. I mean, for me, ‘taking a bath’ will currently never work because my home has a wet-room so there is no bath – I once joked that if I tell professionals I’m taking a bath they should be worried that it likely means I’m now hallucinating bathtubs!

So, to adjust ‘self-soothe’ to be relevant and beneficial for me, I take it to mean the really, genuinely, pampering moments and activities that make me feel soothed and better about myself. I like to take a shower, do my make-up, put fresh pjs on and get into a clean bed, do my nails, faff around with my hair when I have new extensions in, get snuggled up in a blanket with my kitten…

In a way, I think it’s a good thing that you sometimes have to put in extra time and energy to make DBT skills applicable for you because it really highlights a few things:

1.       It teaches everyone who takes DBT that each person is different and has individual needs that mean they find different things helpful and enjoyable, and this can help to minimise any chance of judging others and belittling their favourite things to do.

2.       It can be really testing on just how eager and passionate you are to feel better and to stop self-harming because for those things to happen, you have to put in the time and effort to apply and test out what you are being taught because simply learning about it isn’t enough.

3.       It ensures that you put your own stamp on your experience of DBT and have more control and influence over how you benefit from it and the impact it has on your mental health and your self-harming in particular.

4.       It can end up providing you with a better understanding of yourself and why you enjoy the things you enjoy, and, in turn, this can, fill you with confidence and determination to promote those things and to not be deterred or undermined by anyone who tries to degrade them.

Aside from making self-soothing relevant to me, the other difficulty I had with putting it into practice and using it as an alternative coping strategy, was developing the recognition that I was actually even worthy of doing these lovely, enjoyable activities. I mean, I had spent the previous six or seven years (from the abuse starting in 2006 until the start of DBT in 2012/2013) being told constantly and consistently – both by myself and others – that I was unworthy of anything pleasant. That I would never achieve anything in life. And that I was undeserving of not just my own, but also anyone else’s help, support, or attention.

To get around this debilitating mindset, I decided to take things one step at a time and that rather than force my entire head to believe I was downright worthy of engaging in self-soothing activities, I would just concentrate on actually doing them and just see if they even helped first. Baby steps. I mean, I think it would be totally unreasonable and impractical to expect me to just reverse something that had been a permanent fixture in my head for so many years! Like, how could I suddenly change that just because this DBT Therapist in the specialist hospital was telling me that it wasn’t true? How could I trust and believe in something so big and important from someone I had known a mere number of months?

So, I just found the courage and strength to firstly just allow myself to test the theory out instead of full-on tackling my belief in it. I tried to look at it as ‘what’s the point in fighting too hard if it doesn’t even help?’ I realised that if I had tried self-soothing activities and found them beneficial then it would really help and motivate me to put in the extra time and effort that might be needed to fight the ultimate fight that would help me feel deserving and worthy of continuing to use these skills.

Now, don’t get me wrong; just because this happened – both self-soothing helping me and me finally finding myself to be worthy of help and support and generally pleasant experiences – it doesn’t mean that’s it; I’ve reached that point and I’m staying there. For a long time, I was still having to fight to believe this on a daily basis, but then gradually, that grew further and further apart and moved to maybe weekly, and then the odd week, then a couple of times a month… And even all these years later, I’m struggling to keep it in my head, but by this point, using self-soothing activities as an alternative to self-harm or to maintain a good level of self-esteem, has become a bit of a habit more than a choice or it being an actual decision-making process. This is something the Therapist said would happen – when you had to fill in Diary sheets documenting which skills you’d used on which days, why you’d used them, and how they’d helped – she had explained that eventually, you get to the point where you can’t record that information because it’s all just coming so naturally to you that it’s stopping you from being able to pinpoint particular skills/moments.

My Top Five Feel-Good Songs:

1.       Praying – Ke$ha

2.       This Is Me – from The Greatest Showman

3.       I Lived – OneRepublic

4.       Warrior – Demi Lovato

5.       One Last Time – Ariana Grande  

My Top Five Feel-Good Movies:

1.       The Greatest Showman

2.       Date Night

3.       Frozen

4.       Alice in Wonderland

5.       Legally Blonde

So, when it comes to developing and maintaining my self-esteem, I rely heavily on the positive things in my life and this massively includes I’m NOT Disordered, the achievements it has accomplished (did you notice we’re almost on 1.3 million readers?!), the opportunities it has afforded me, the feedback I get from readers about the content I create, and my enjoyment of creating that content.

If you told someone who knew me when I was younger that I had become a blogger, I don’t think many people would be that surprised because I always loved writing – one of my teachers in Middle School once told my Mum that she could see me becoming a Journalist when I was older – and enjoyed doing anything creative (which is why I took Textiles as an optional subject to study at High School). Unfortunately, my Textiles teacher was incredibly negative and in my years of study with her, she didn’t give me a single bit of constructive criticism; it was always so derogatory and almost shaming. She took away any confidence I had in my creative abilities and looking back and thinking about how she made me feel, I’m actually genuinely proud of myself for overcoming all of that negativity and unproductive feedback and continuing with my creativity and re-developing my confidence in it, to the point it is now at.

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