Self mutilation, as a symptom of BPD, is generally a common occurrence. Doctors meet many BPD patients for the first time during a crisis, which might include some form of cutting, burning, or other self imposed physical abuse as a means to either manipulate those around them, or to ease the pain they are feeling inside. Suffice to say, in all but the most serious of BPD cases, self mutilation recedes with treatment. It would be impossible for a BPD sufferer to cut themselves every day and still expect to walk around without restraints. Therefore, if you’ve witnessed someone with BPD in the midst of a self abusive act, take some solace in the fact that it is an uncommon event,that is, if the BPD gets some sort of treatment.
Left untreated, BPD self mutilation will continue, and might even approach suicide attempts. For the purposes of this blog, however, we’re going to assume that a BPD sufferer is “caught” in time and does not further escalate their self harming acts. Instead, it is important to discuss low-grade self mutilation.
During the initial years of my diagnosis, I was prone to cutting or searing my body with a small flame. This was mostly a private act meant to assuage the pain I was feeling, and the worst of it occurred before I was in formal treatment. After receiving medication and general psychotherapy, my urge to outwardly self mutilate fell away. I realized that hurting myself was extremely detrimental to my recovery and appearance. What’s more, I didn’t want to go to the next extreme, which from time to time crossed my mind. I have a couple faint scars on my arm left from when I was cutting, which are ironically hidden by diabetic glucose lancet pricks that leave my arm with plenty of small dots to distract the eyes from getting a closer look.
To say that I have completely stopped self mutilating would be a lie. Now, I practice low-grade self mutilation, characterized by spontaneous, random moments where I feel the need to touch my body in a potentially harmful way. In some cases, these acts take on the form of stress relief, allowing me to vent anger or frustration. Other times, I poke at myself because I feel very depressed and helpless. For some reason, being able to release the pressure behind the “pain valve” takes the form of agitating my body, no matter what state of mind I’m in.
Here are a few examples of my low grade self mutilation:
- Mutilating Acne Lesions – This is relatively common among people without mental illness, but it takes on different proportions when the sufferer has BPD. If I am feeling upset, I will often focus all my energy on an acne lesion, squeezing it, poking it with sharp objects, or even trying to suffocate the lumpy appearance on my skin by inserting a diabetic syringe and sucking the pus out. I know, this is absolutely disgusting. For some reason, however, during the brief moments where I succeed in removing the lesion, I feel like I’m in control, that I was able to feel the pain and express it. Unfortunately, this quick fix for mental anguish comes at the expense of my skin. The result has produced scars where lesions used to be, and in most cases aggravating the acne only results in more breakouts. It’s a vicious cycle that continues even though I’m well beyond my adolescent years when acne is particularly severe.
- Head Picking – I started this habit during early adolescence. Initially, I had a neurotic obsession with making sure wood ticks where not on my body. Sometimes, after playing outside or walking through the woods, I would spend several minutes running my fingers through my hair at all angles, hoping to catch a tick and remove it. One time, I actually did find a tick, and when I pulled it out, I felt a rush of relief come over me. Although it makes sense to be happy about not having ticks, the act ultimately gave me a horrible habit of picking at my head whenever I felt stressed or anxious. During particularly frustrating moments, I used to dig my nails deep into my scalp and yank out as much skin and hair as possible. It comes as no surprise to say that I developed a noticeable callous and scar. I was only able to drop this habit about a year ago. Now, instead of picking my head, I simply rub it profusely, which has allowed my small wound to heal.
- Poking at My Ears – It seems the moment I dropped head picking, I picked up ear poking. This is a potentially dangerous substitute, because I risk losing my hearing. Still, in stressful moments, I will have the urge to insert unraveled paper clips into my ear, especially if I feel an itch that can’t be soothed from the outside. Sometimes I will play around with my inner ear by moving the paper clip in all directions, which for some reason just makes me feel better. Last year, however, I was doing this so much that I gave myself 2 outer ear canal infections that required a trip to the doctor, antibiotics, and ear drops. As recently as two months ago I felt another infection coming on, and was somehow able to reel in this awful habit long enough for my ear to heal. Don’t ask me how I got the idea for this. I can only tell you that it soothes me AND that I know it a bad thing to do. I’m slowly trying to get rid of this habit.
- Prodding at Tonsils – By now you must be thinking, “This guy is a maniac! Who plays with their tonsils?”. The answer: I do. About 3 years ago I realized that I would develop tonsil stones from time to time. For the uninitiated, tonsil stones are small clumps of mucus, dead skin, debris, and bacteria that lodge themselves into the tonsillar crypts. If allowed to fester, they engorge themselves and eventually become the most foul smelling things you have ever experienced. After I realized I had this problem, I obviously became super self conscious about my breath, since these pungent balls of waste were lining the back of my mouth. To mitigate their effect, I slowly worked my way into a routine of poking, pushing, pulling, and even prodding my tonsils with metal objects in order to remove the stones. In fact, it is part of my nightly oral hygiene regimen: after floss, I grab a flashlight and begin playing with my tonsils to get rid of any semblance of tonsil stones. The only benefit to this habit is that I’ve managed to delay my gag reflex long enough to get rid of them. Other than that, in stressful moments when I think there are stones in my mouth, I’ve actually made my tonsils bleed after poking them with small pointed objects like toothpicks. This has only left me with a sore throat and minor infections. It’s a strange habit that I justify to myself by seeking fresher breath. In reality, that’s really just a cover story.
So, even though I’m no longer cutting my arm or searing my stomach with a lighter, I still practice small acts of self mutilation. The bottom line is this: If I can’t get the pain out of me, I MAKE it come out. I will poke and prod at my body, even to the point that blood comes up, until I have gotten rid of whatever I am chasing and get the mental relief I am seeking.
The real question to consider is how one can stop such habits, particularly when they are interwoven with BPD symptoms. I don’t have an answer for that right now, but I can tell you that the only thing that has worked for me is “downgrading” my poking to rubbing or pushing. Instead of making the acne bleed, I push it and then clean up with a tissue. Instead of picking at my head incessantly, I rub it round and round until my stress is alleviated. Instead of jamming things in my ear, I try tugging on my ear lobes if I feel an inner ear itch (much like a toddler might do).
I still have no answer for the tonsils, but I’m working on it. 🙂 Until then, don’t try to go cold turkey on your low grade self mutilation, because it is high mountain to pass in one leap. Try bringing your habits down notch by notch, and eventually you will not pose a threat to your own body anymore.