SAFETY CONTRACTS AND SELF HARM

I’ve been with my therapist for about three years now. One of the first things she did was put me on saftey contract. I am proud to say, in that three years, I have only intentionally violated it once. I say intentionally, because the things she considers to be self harming behaviour are myriad. Not using my seatbelt in the car, driving too fast on the highway, not eating right, even not maintaining good sleep hygiene. All of which I’m guilty of at some point. I’m finally at a point where my med compliance is no longer an issue, just a struggle. When I’m feeling good, I don’t think I need them. When I’m not feeling good, I feel what’s the point. So it’s a constant struggle. But the main focus of my contract is the obvious, direct ways I harm myself: drinking and cutting. And after yesterdays session, the struggle is real. I even reached out to her about it last night. She didn’t respond, but as I was in no real danger, I wasn’t really expecting her to.

Self harm. Two little words. The act of hurting oneself. Doesn’t really sound too bad, does it? I even managed to inflict a bit on myself while in her office yesterday, squeezing my hand too hard and leaving deep imprints of my fingernails, took a bit of skin off. She commented on how easy it is to fall back into old ways of coping. It left marks which still are there, though faint, today. It’s so deeply imbedded in my pysche as the only way out of emotional distress, be it feeling too much or too little. And right now I’m feeling too much. Way too much. I can’t even define all that I’m feeling. I tried to in her office yesterday, and last night when I was dying for a sharp to drag across my skin. Lost. Alone. Sad. Melancholic. Overwhelmed. Not present. Broken. Hurt. And a multitude more floating through my brain and body. And that’s what’s so damn hard about this. The feelings are so strong, they’re painful. My body hurts from carrying them. The release of a little blood seems a fair price to pay for the relief. But one of the last things she said to me yesterday was, “Remember your contract. A promise.” A promise to her as well as myself to stay safe. And there are days I curse that contract. That promise. If it was only with myself, it wouldn’t be so bad. I could live with that. But the shame I would feel going into her office next week, and having to say, “I fucked up,” keeps me strong. That and the fact that there are no readily available sharps that I can access. I have a disposable razor in the bathroom, one I keep for emergencies like this. However, the fact of the matter is, I would have to dig it out, dismantle it, and then carry through with the very act I have sworn not to. Many opportunities to pause and think things through. Which she would not hesitate to point out. Something I really value in her is her refusal to accept bullshit answers and provide clarity when things are muddy to me. So rather than face that, I stayed in bed, my safe zone. Except when it isn’t. I try hard to keep my bed a safe place. Injuring myself in the bath, where it’s easy to clean up, or on the floor of my bedroom. My bed is sancrosanct. Not to say I haven’t used an x-acto knife that I forgot to put away while sitting there, focusing only on the imminent relief. That pressure valve which causes immediate and tactile release. But word is my bond. So I suffer. Like Tennyson wrote in Ulysses, “All times I have… suffer’d greatly, both with those/That loved me, and alone… One equal temper of heroic hearts,/Made weak by time and fate, but strong in will/To strive, to seek, to find, and not to yield.”

MED COMPLIANCE

It’s kind of cool, at the end of the week, to look at your weekly pill box and realize that you haven’t missed a day, and it’s been a few weeks since you missed a dose. For someone like me who struggles with med complaince, this is huge. And I’m still struggling. I’ve been feeling pretty stable the last little while, so the first thing I think of is, “I can go off my meds!” Of course, my therapist,the wonderful grounding presence that she is, immediately responds with, “Maybe it’s your meds making you feel this good.” So, of course, I bring it up to my GP, who handles my meds. “I want to see you stable for a longer period of time. And back to work. Maybe once you’ve been at work for a year we can look at tapering back a bit.” Talk about feeling deflated. Stupid brain. Can’t make it’s own feel good chemicals. And I know, I know all about the comparisons to heart medicine or diabetes. The brain is just like any other organ that can, and does, malfunction. And there is nothing wrong if your brains happiness needs a boost from the wonders of modern medicine. But I have to wonder, if treated today with our vast assortment of chemical bliss, would Van Gogh have painted Starry Starry Night? Would Byron and Poe have been so eloquent and prolific if their fits of melancholy were treated with modern medicine? Would Shelley have written oh so beautifully? Byron was well aware of the connection between madness and creativity. He wrote, “We of the craft are all crazy. Some are affected by gaiety, others by melancholy, but all are more or less touched.” Sure, there are many examples of people being medicated and having successful careers. A quick google search provided me with the names of ten poets currently living with mental illnesses. I wonder how/if they’re all medicated. My medication makes me dull, and creativity is hard. When I’m unmedicated, the words fly to the page easily, too easily I’ve been told. Those words are hard to follow, syntax becomes strange. Even given the free nature of verse, mine becomes difficult to embrace. Kay Redfield Jamison writes quite freely about her battles with bipolar disorder. She knows the dangers of not being med compliant. Yet she wrote a whole book, “Excuberance”, about the very thing lacking in my life with my meds. I tried lithium, but the amount I needed in my system to keep it at therapeutic levels was too high, and the side effects too great. So I’m on the mood stabilizer aripiprazole, to help boost the anti-depressant that I’m on. And I can’t tell which one makes feeling deeply and passionately difficult. So for the sake of my mental health, my creativity suffers. Some days I have to ask myself is it worth it. Then I look at my two boys and realize a subdued mom is better than no mom.