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Need Ideas to Justify Freedom from Self-Injury

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Sorry to waste your time with a problem that is completely my fault, but I have been free of self-injury for over 1000 days now, but it is still a fight sometimes. All the information on the internet seems to say find someone to talk to, but that is a lot easier said than done for me. My best friend is 9 years older than me, and is married with a baby and a full-time job, and doesn’t necessarily think of me as a friend, so she isn’t really available to help me very often. I don’t really have many other friends. I do have a counselor at school but she made it clear before break that she will email when she is ready to start back up and until then does not want contact with students so at least at the moment she is not an option at all. Also, she doesn’t seem to see my SI as an issue because whenever I bring it up she pretty much ignores it then goes back to whatever she must have planned to say. (Maybe because I never did anything that left permanent physical damage)

I need ideas to keep me from hurting myself because legalism is what is keeping me from doing it, but I don’t know if that will continue to work long-term, because right now I know hurting would make things seem more manageable, so it is hard to justify keeping myself from that. Any ideas you could give would be very much appreciated. Thank you!

An unequivocal statement of fact is that cutting, and self-injury, is never a wise idea. It is always a mistake. Self-injury is a sign that someone is suffering and that they lack the necessary skills to deal with emotional pain. Specific reasons why you should resist the urge to cut are provided below.

  • Cutting is dangerous. You could accidentally cut yourself in a manner that causes serious or permanent damage. Many people do not realize how deep they are cutting. You might think that cutting is a secret thing that you do but you might cut too deep, requiring a trip to the emergency room. Then your secret will no longer be a secret.
  • Cutting is ineffective. Cutting is often used as a strategy to reduce emotional pain. It might make you temporarily feel better but the negative feelings that led to the cutting will inevitably return. It is an act of self-destruction and it doesn’t address the underlying reasons that are motivating you to cut. Eventually, the underlying reasons for self-injurious behavior need to be addressed. That is where your focus should be.

You have not cut yourself in a very long time and it is important that you resist the urge to do so. One thousand days free of cutting is a major success. Try to remain committed to your ongoing success.

I would recommend that you find additional support systems that you can count on when the others are unavailable. You stated that you have a counselor at school. Perhaps you should also have an outpatient therapist. I would also recommend attending a support group. Your local community mental health center, outpatient therapy center or your school counselor could assist you in locating a support group.

You also might want to consider journaling. The content of the journal could include the following: What has kept you from cutting for the past 1,000 days? What other types of behavior have replaced the cutting? How has your life changed since you stopped cutting? What positive gains have you made over the past 1,000 days? How would you instruct others to have their own “1,000 days free of cutting?” Answering those questions might assist you in resisting the urge to cut and it may serve as a reminder for why you stopped. I hope that you can remain free from self-injurious behavior. Please take care.

Dr. Kristina Randle

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Intentional Forgetfulness

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

The question I have today has bothered me for a long time. While I was normal for most of my life, the past few years have been evolving many problems for me.

For example, I have had numerous problems with skills such as driving. Once it had been an easy, low-attention activity but now I notice things are changing. Now, instead of driving being second nature, I am starting to overly concentrate on things such as whether I am correctly positioned in a lane. Furthermore, even with all the concentration on a very small skill, I fail to perform this skill effectively (for example, staying in the lane). The worst thing, however, is that I have not found a way to stop concentrating on one thing for my own safety. I feel like I am a deadly risk on the road because of this and I am often very scared to continue driving.

Furthermore, the situation in other areas of my life is not very good. For example, I’m studying to become a chemist, and I consider chemistry and studying skills to be the bulk of what I know. However, as I try to think about these subjects, I often feel the irresistible urge to forget these subjects. It sounds stupid, but my mind will sometimes say to me, “forget chemistry” or “forget how to study”. I always have to harshly resist the urge to do so. However, when I think I have the problems solved, my mind often finds other ways to incite the same urge. Or my mind will cajole me to “try to forget something”. I feel like if this goes on for much longer, my knowledge of topics like these (and others) may start to be lost. I don’t know what may happen and I am in the dark about this topic. As I write, my day is completely occupied by trying to resist the urge.

The scariest feeling is that, as each day passes, these problems seem to be getting worse. Two Around 2 and a half years ago, when these problems started, they barely got my attention. Now, however, they are so much worse. I feel in the dark and don’t know what to do. I’m scared to tell people because I’m afraid there may be repercussions on relationships and my life. Any advice would be greatly appreciated. Also, may I remain anonymous? Thank you in advance for you advice.

It’s possible that you are not forgetting intentionally. It may be that something is physically wrong. It would be wise to have a medical evaluation to determine what might be wrong. Discuss all of your concerns with the physician and be certain to mention that this problem is increasingly interfering with your life.

If medical problems are ruled out, then a psychological origin can be explored. A mental health evaluation will determine what may be wrong. Being evaluated by both medical and mental health professionals can assist you uncovering what may be wrong.

Have you recently experienced a life change? Trauma? Are you experiencing a great deal of stress? Recent life changes, trauma or stress might be contributing to the problem. It may also be related to obsessive-compulsive disorder or generalized anxiety disorder.

In the meantime, you may want to read about the concept of hyper-intention. The basic premise of hyper-intention is that a person’s fears or problems are made worse by their intense focus on them. Frankl says that the solution to hyper-intention is paradoxical intention. Paradoxical intention means that you do the opposite of what you would normally do in response to something that you fear. You can read more about these concepts in a book called Man’s Search for Meaning by Viktor Frankl.

Medical and mental health evaluations might uncover the source of your problems. Subsequently, consider psychotherapy if it has been indicated. I hope that you are able to find the help that you desire. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Shaking of Hands and Pretending To Be Someone Else

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I am a 23 male veterinary student. I grew up with great parents in a wealthy neighborhood and was given and continue to be given everything I need in life. I am very social, have tons of friends and am able to fully function in everyday life. I have been trying to figure out what is wrong with me for a few weeks now, mainly because my problem is interfering with my life more and more. I have never discussed this issue with anyone, not even my doctor. Since I have been in second grade, in private, I have the urge to shake my hands in the air. While shaking my hands i am going through day to day life situations of another person. I have a house, furniture, kids etc all pretending to be this other person. I can only pretend while shaking my hands. I used to only be able to do this in private, but now, if I shake a pencil in my hand, I can pretend as well, which I do in class, while in public etc. I have no idea why I do this, I dont even think I want to be the person I am pretending/daydreaming about while doing this. Any ideas?

Two possibilities come to mind: you may be experiencing a state of disassociation or there may be a neurological explanation. Disassociation is characterized by a loss of the connection of an individual’s thoughts, memories or their sense of identity. People can experience disassociation on a continuum. For example, a minor to mild case of disassociation may be experienced when a person becomes “lost” in a book or a movie. This is a common experience that many people can relate to. A more severe and concerning level of disassociation may occur when an individual begins to believe that they are someone else and has difficulty “coming back to” who they are. It’s also concerning if an individual has difficulty deciphering reality and finds themselves increasingly living in a fantasy world.

I also mentioned above the possibility of a neurological disorder. It is important that you rule out a possible medical cause. My advice is to make an appointment with your primary care doctor, speak to him or her about your symptoms and ask to be referred to a neurologist. Neurologists are essentially brain doctors. Brains are their specialty. I would highly recommend that you be examined by a neurologist to be certain that nothing medical is causing the shaking of your hands and the accompanying disassociation. Seeing a neurologist to rule out a medical cause is the best place to start.

It would also be advisable that you speak to a professional therapist about this issue. You can do this while you’re undergoing medical testing or after a medical cause has been ruled out. I suggest professional counseling because as I mentioned above, this problem may be an issue of disassociation. If you choose to see a therapist, then you’ll want to choose one who specializes in dissociative disorders. I’m not suggesting nor could I know if you have a dissociative disorder, but if you are experiencing disassociation then it’s helpful to have someone who’s specifically trained to treat those types of issues.

It is important that you take action and be evaluated by both a neurologist and a mental health professional. The obvious concern is that you may have a medical condition that needs to be treated. As you noted in your letter, it does seem that this problem is increasing. I hope you will take my advice and be evaluated. Thank you for your question. Good luck.

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Extreme Anxiety

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

For as long as I can remember I have had extreme anxiety issues. I have social anxiety, but the main source of my anxiety is my health. I can’t do anything, and I mean anything without worrying that I am going to die. For example, me and my family went to Disneyland the other day, I was having panic attacks and worrying that I would either just drop dead for no reason or since I had a little bit of a headache that day I was scared was going to have a brain aneurysm. Its always something everyday with my health, it’s exhuasting. All I want to do is sleep all day or just zone out in front of the TV so I dont have to think.

I also have other symptoms, but am not sure if they are part of the anxiety or not they are: feeling like I am in a dream or like a spaced out feeling, weird “what if” thoughts (ex: What if I killed myself or someone else?) and by no means do I want to do this or even have the urge, but since I thought it I get anxiety about it, thinking I am crazy for thinking such things or I am afraid I might sleep walk or something and do it out of my control.

I dont have a job right now and no health insurance, I am just trying to figure out whats going on with me. I am sick of feeling like this. I just want to feel “normal”.

I should mention that I have been on Effexor XR since my daughter was born in 2006, I had Postpartum Depression. I am still taking the Effexor XR, which doesn’t seem to help much anymore, and I am taking 1mg Ativan as needed. I hope you can give me some insight and direction from where to go from here.

Thank you

Thank you for writing. The first thing to do is to go back to the doctor who prescribed the Effexor. The period of time that a postpartum depression generally lasts is long over. If you haven’t been back for a discussion about your symptoms and how you are doing on the medication, you should immediately make an appointment. One of the potential side effects of Effexor is anxiety. What you are taking for depression may possibly be contributing to your anxiety. If your PCP or OB-GYN has been prescribing your medication, I do suggest you see a psychiatrist to get a specialist’s take on whether you still need the medication or if you are taking the right one.

Meanwhile — you really should consider finding some therapy for yourself. Some cognitive-behavioral therapy could help you get your anxiety under more control so that you can enjoy life. I know you have no health insurance. Before you give up on the idea of getting any help, I do suggest that you talk with your doctor or spiritual leader about any free or low-cost resources that may be available in your area. Many private therapists also offer a sliding fee scale or low-income slots.

Please be more concerned about finding treatment and less concerned about finding a label for yourself. As you said, the important thing is to get back to feeling “normal.” You deserve it. Your daughter deserves to have a mom who feels stable and able to cope.

I wish you well.
Dr. Marie

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Visual Hallucinations & Urges to Do Strange Things

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hello, for the past few months I have started to have strange visual hallucinations. Usually when I see things I become scared; I turn on the sink and blood comes out or a man will be standing by the top of the stairs when I’m walking up to my room. The hallucinations last seconds. I know that what I am seeing is not real but at the same time when it happens I am afraid for my life, when I see a person in my house I believe they’re really there(from another universe or something) until after the fact when I am calm and the hallucinations are gone. I remember as a young child I would hear a voice telling me to “do it” and I would get so angry that I would hurt myself but I’m not sure at what age that went away. I have also been having urges to do strange things… for example I woke up last week and had this urge to go dig a hole in my yard thinking there was something in the ground. I got up and did it because I believed it but looking back I know it was foolish for me to think something/someone was trapped in the ground.

I have talked to my therapist about this and he recommended I see a psychiatrist but my parents won’t allow it. He is a LCSW and can not diagnose me. I have not spoken to him about it in awhile because it is embarrassing and part of me feels like he doesn’t believe me. He said visual hallucinations are very rare. Could this be schizophrenia?(my sister was diagnosed with schizophrenia then re-diagnosed by a different psychiatrist with BPD she is currently medicated and it helps but I am unsure of what her symptoms were, I do not think she hallucinated) or could the hallucinations be caused by my depression, which has gotten pretty severe recently? Is there any advice you could give me to help control my strange urges/decrease the occurrence of my hallucinations.

It is difficult to know what may be wrong. Visual hallucinations are experienced by individuals who have schizophrenia, schizoaffective disorder and on less frequent occasions, major depression and bipolar disorder, if there are psychotic features present. Approximately 16 to 72 percent of individuals with schizophrenic disorders have reported experiencing visual hallucinations. In that way, they can be relatively common among individuals who have those disorders.

Individuals can experience visual hallucinations in the absence of a psychotic disorder. In these cases, there may be an organic brain syndrome present. Some physical problems that may cause visual hallucinations include (but are not limited to): dementia, delirium, drug and alcohol withdrawal, severe sleep disturbances, migraine headaches, seizures or tumors. Generally it is recommended that an individual who is experiencing visual hallucinations be evaluated by both a psychiatrist and neurologist.

Your parents are unwilling to allow you to see a psychiatrist. I would encourage you to inform your parents that visual hallucinations are possibly a sign of a neurological problem. It is very important that you are medically evaluated to rule out the possibility of neurological problems. It would also be helpful to share this information with your therapist. He may be able to help convince your parents that you need to see a neurologist and or a psychiatrist. Please take care.

Dr. Kristina Randle

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Do I Have Trichotillomania?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

I was reading one of my client’s profiles when I came across the term “trichotillomania” so i googled it. Now I am bothered by it. I remember when I was young my parents would always scold me to stop pulling my hair. Now that I am 30 I still find myself doing it subconsciously. I am generally a happy person and laid back kind of girl. I have a 3 year old son and am married for 5 and a half years now. I do not have any bare patch on my scalp but i can tell one area is thinner compared to the side where I dont pull hair. I do remember when I was young I did have lesser hair on one part in my scalp.

I only pull one strand at a time. I usually like to play with a single strand of hair first before I pull it to make sure i like how it feels tugging on my scalp. There is a sense of tension before pulling hair or when trying to resist the urge to pull hair. Once I find the one that feels right I hold on to it and will not let it go. I can control the urge but I feel sad if I let go and that is only for a minute or two then I am fine. There is a feeling of relief, satisfaction, and/or pleasure after acting on the impulse to pull hair. I usually do this when I am relaxed like watching TV or browsing the internet or sometimes even when I am driving.
There is also a presence of other associated behaviors such as inspecting the hair root, twirling the hair around my fingers and sometimes falling asleep at night and wake up in the middle of the night or the next morning with the strand still twirled around my fingers. Then when I get tired with it and i shred it into pieces. I feel like i have to shred it into pieces when I am done playing with it. I feel like it should not go to waste. Every now and then when my husband catches me playing with my hair he tries to steal the strand from my fingers and it annoys me but not to the point where I am just furious. I just find it annoying and wish he would just leave me alone with my hair.
I never wanted or ever desired to eat it.

I also suffered from Enuresis when I was young. I wet my bed until I was 12-13 but I dont do it when I am awake only at night time bed time. (This is just my self diagnosis base on my experience and what google says put together)

I’m sorry that a diagnostic label bothers you. I can’t, of course, provide a diagnosis on the basis of a letter. All I can tell you is that what you describe is consistent with what is called trichotillomania. But a name of a group of symptoms is intended to help professionals communicate with each other in order to decide what treatment, if any, might be helpful. No value judgment is attached.

Here’s the thing: Kids who are at all anxious tend to find something that soothes them. Some get attached to a blanket or a pacifier. Some bite their nails. Some twirl their hair. Some suck their thumbs. No one knows why a particular habit develops. The common denominator for all such habits, though, is anxiety. As children grow and develop internal coping skills, they are often persuaded to give up the lovey or habit that helped them stay calm. It’s a little harder when the “lovey” is a renewable resource like hair or nails. A mom can’t exactly wean a kid away from nail biting by gradually eliminating nails from the kid’s view. (Blankets can be gradually made smaller and smaller until they disappear.)

You’ve reduced your habit to something that is managable. You aren’t balding. You aren’t behaving in a way that hurts yourself or anyone else or that is socially unacceptable. As you said, you do it when you are relaxing it. I suspect there is something about doing it that helps you relax. It works for you. If you were seeing me, I’d ask you to think about whether the benefit of dropping the habit is worth the stress of trying. If you do think so, then we’d work on helping you find other satisfying ways to relax and perhaps to occupy your hands.

I wish you well.
Dr. Marie

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Unjustified Anger?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

My problem is I have extreme anger attacks especially toward my boyfriend. Generally I get annoyed easily. When I think deeper I understand it’s mostly due due to ego, attitude my perfectionist nature which expect people to behave considerate and conscious. Though I get easily annoyed by the slightest things such as looks, facial expressions, use of words, and certain behaviour and do fail to put on a completely pleasing face I do not lose control as such. Though I get extremely irritated at unfair and unjust behaviours of others I do not lose control in a bad way. This happens especially with my boyfriend and sometimes with family members only because I don’t keep my guards up with them. I’m very close to my boyfriend like he’s my soul mate I get the urge to share everything with him but his behaviour triggers extreme anger in ways that scares myself. This happens on the phone but I still do not believe without sufficient cause. My boyfriend is irresponsible and inconsiderate in many ways sometimes though when I’m around physically he’s extremely loving and caring. Because of this I don’t get extreme anger triggers when I’m with him generally. I’ll give an example. He went abroad last week and while leaving sent a text saying he’ll inform me as soon as he landed. Since there was no sms I tried calling him and I found the phone off several hours after landing. Without any means of getting any info about him and analysing the situ I thought he couldn’t have been MIA for 36 straight hours hadn’t it been something crucial and I was panicking and sent a FB message to his sis only to learn he had been sleeping since he landed. Later he sent a text citing coverage issues. I was extremely mad at his ignorance and lack of care for how I would be feeling back home. I was of the view he could have called from some other line, sent a message through his sis’s phone or at least sent an online message somehow. I didn’t talk to his for two days only to find he’s MIA again the next day I texted. His phone was off throughout until he sent me a message from a local sim on the next morning. I tried texting that number and calling the whole day and none of the called were picked up or messages replied. Later that night he sent a message and I could call and I screamed from the top of my voice, yelled, blastered, cursed and I was slanderous, called him names and said everything I possible could and said I wish he was dead and then the whole thing would be over and I’d feel better off. This anger scares me. I was in so much anger I wanted to kill him brutally. I’m scared of this. It makes me feel bad about myself and he’s not the kind who would behave any different the next time. What do I do?

You have a right to be angry at your boyfriend for not having contacted you but clearly you have overreacted. You became overly emotional and verbally abused him. Eventually, he’s likely going to grow tired of your behavior and end the relationship.

In this situation, your expectations were not unreasonable but your reaction was.

When your boyfriend did not call you for three days, you had a right to be angry. Technologically, it was difficult for him to make contact with you but it was still possible. He waited too long. However, you should not have reacted in such an extreme manner. You should have expressed your concern for his well-being and strategized about the best times for him to make future contact.

Your extreme anger is either justified or not justified. If it is justified, then the obvious question is “why would you want to be with someone who is so terribly bad?” After all, he must treat you very badly indeed to deserve that level of your anger. The conclusion: you should break up with this very abusive man.

If the anger you display for him is unjustified, then it is you who is abusive and has the psychological problem. Undeserved anger is always abuse. You must determine which of the two situations exists; justified or unjustified anger.

It’s encouraging that you recognize that a problem exists and have a desire to fix it. You can teach yourself anger management techniques by reading self-help books. You should consider attending an anger management workshop or a therapy group. Individual psychotherapy is also an effective strategy for learning to deal with your anger. If you’re willing to seek help and are open to changing your ways, then you can expect a positive outcome. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Urge For Suicide And Suicidal Images And Thoughts

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I I am from Korea, Seoul and I have been on medication for my psychological reasons. I tried to suicide less than twice and I have been always the one who has a lot of suicidal tendencies. However, my only brother did it last year. Sometimes when I think about past with him, I can’t help myself from the urge to kill myself. Even now, the only reason I am alive is because of rest of my family. my sister and mom saw him and I saw only pictures from detective office. It looked painful and I can’t forget his purple fists.

I gotta live only for my family because I don’t want to give the pain as we got from my brother. I got diagnosed to have Bipolar I, depression, ADHD, anxiety disorder. and recently I think I might have border line of schizophrenia due to my thought, images, and also the way how I understand whatever other people say.

I really need your help so that I can be alive for my rest of family. is there any way for you to give me any advice?

I am sorry for the loss of your brother. I can imagine how difficult this time in your life has been for you. The fact that you have attempted suicide, are currently considering it and have a family history of suicide, is concerning. Those variables put you at risk for suicide.

You stated that you are taking medication for psychological reasons but you did not mention counseling. Medication alone is often not enough to treat psychological problems. Counseling is an important aspect of treatment. Counseling could also greatly assist you in appropriately grieving the loss of your brother.

Studies of suicide survivors have shown that the decision to end their lives was not well-planned. Those decisions were often made impulsively. If you feel that you might harm yourself, it is imperative that you go to a hospital. The hospital can protect you from making an impulsive decision.

Suicide survivor research also has shown that the majority of individuals who had survived their suicide attempt, never truly wanted to die. They were thankful to have survived. Those individuals were suffering and they often lacked the necessary coping skills to deal with difficult life situations. I believe, at least in part, this is the case with you.

It is important that you talk to your parents about getting into counseling. You should also consider joining a suicide survivors support group. Go by yourself, attend group meetings with your family or do both. Survivor groups can be tremendously helpful. Here is a link to a website where you can find a list of support groups in your community. Here is an additional link to a resource page where you can find related websites.

It is imperative that you speak to your parents or to your prescribing physician about your suicidal thoughts. If you feel that you can’t protect yourself, then you must go to the hospital or call 911. The phone number to the suicide helpline is 800-273-8255. Do not hesitate to call if you are feeling overwhelmed.

Help is available. Please be willing to accept it. If not for yourself, do it in honor of your brother and for the sake of your family who would be immensely devastated by the loss of another beloved family member. Please take care.

Dr. Kristina Randle

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Am I Clinically Depressed?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m always depressed when I’m not around my ex. because he’s the only one who really gets me and knows me and really listens when I talk. When he isn’t around I have no one to talk to so I start thinking that everyone(my ex, my son, everyone) is better off without me. I never leave my bed or my house very much(online schooling). I wake up all night and I never wanna get up in the mornings. I hate the thought of people not wanting me around. I cry all the time! I hate myself a lot/most of the time. The only time I leave my house is family events or my ex convinces me to go somewhere with him. I’m always in pain unless I’m venting to my ex. I mean emotional and physical. I just ache all over. I want to get better and need to for my son and ex(we might get back together later on and he’s my rock and I’m his and if I’m sick I can’t be there for him like I’d like). My ex is the only one that I know who knows about me thinking I’m sick because I don’t want to go to the doctors and have them put me on meds or something. Am I clinically depressed? Should I ask my mom to take me to the doctor to get help or am I fine? I need to know!!

An in-person interview, with a trained diagnostician, would provide the most accurate diagnosis but depression may be a realistic possibility. According to your letter, your symptoms include: a desire to isolate, physical and emotional pain, low self-esteem, and the consistent urge to cry. Those are common signs of depression.

Your symptoms are interfering with your life and they should be treated. To answer your question directly, yes, you should ask your mother to take you to a doctor. Being evaluated by a doctor does not mean that you will have to take medication. Many people who are receiving treatment for depression don’t take medication. Instead, they undergo counseling. With the right therapist, counseling is an effective treatment modality.

What are your next steps? Speak to your mother. Tell her about your symptoms. Ask her if she will schedule an appointment for you with either a primary care physician (PCP) or a local therapist. Consider seeing your PCP first to rule out possible medical problems. The PCP can then refer you to a therapist. If you choose not to see a PCP, the “find help” tab, at the top of this page, can help you to locate a therapist in your community.

The best way to find the right therapist is to call at least four or five and ask them various questions, including:

  • Can they help you?
  • How exactly would they help you?
  • What would they suggest that you do?
  • Would they be willing to see you and if so, how soon and how often?
  • How long have they been in practice?
  • Have they helped other individuals with similar problems?
  • What were the outcomes of those situations?

Choose the therapist who you feel most comfortable with and schedule an appointment. I wish you the best. Please take care.

Dr. Kristina Randle

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At War With Myself

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Thank you for taking the time to read this. Lately I have had this constant nagging feeling when I get home. Like I’m worthless, maybe broken or damaged beyond repair. I am not suicidal as most I have found here but rather I have this horrible fear that I will die before I can fix my problems. before I finally get up and do something about it. At work I excel and am constantly receiving praise. Currently my mother lives with me and her and I have always had a horrible relationship. Though her complaints may sometimes be true, she is the child of an abuser and she says things so aggressively. She tells me I’m a 500lb loser that nobody cares about (I am overweight but certainly not 500lbs). Sometimes as soon as I come home she picks a fight and it like my whole day gets ruined. In my head I know just who I want to be and what I want to do but its as though I’m paralyzed. I want to lose weight but I lack will power and self control. All of my relationships end in angry emotional words filled with hate. What steps should I take to turn my life around and develop some sort of structure?

You feel as if you are “worthless, maybe broken or damaged beyond repair.” It is a nagging feeling. Each individual must find his unique way in life. Jung would call this individuation. Maslow would term this self-actualization. Existentialists would refer to this process as living authentically.

If I may speak generally and of course I have no choice since I am unaware of all of the details of your life, persons in your situation have stopped the process of growth that I have referred to above. The unpleasant feeling that you have described seems to be the same one that I have heard described by hundreds of clients. It is an urging to move forward. Where does that urge come from? Well that depends on what theory you ascribe to and thus what language you would use that would be true to that specific theory.

Though the theories use differing language, the message is very similar. To be happy, to live a life of meaning, you must follow that path of self-growth. That path may take you to another continent, to a completely new career, to a new life philosophy or to the realization that you must separate from your mother. The path of growth will not be easy in any case.

One can think of a thousand reasons why moving to a new continent is impossible, why a career change is ridiculous, why it is preposterous to think of accepting a new life philosophy and how it is unthinkable to separate from one’s mother. The required changes, whatever they might be, are all hard, maybe extremely so but they are absolutely necessary to your life.

If you were to ask Jung or Maslow or Nietzsche, they would tell you that all people, including your mother, must face this growth process.

Jung considered murder the only unforgivable sin. You must not take another life but you cannot let another take your life from you. They are both sins.

I have already stated clearly that I could be wrong in your specific case because I cannot be specific with knowing specifics. However, in general, when applied to “being” en masse, it is so very true.

A good counselor/therapist would get the specifics that this Internet format denies me. I would highly recommend you begin the solution to this problem by finding a therapist who could provide you the additional insight that will help you along the path to self-actualization, individuation, authenticity etc.

The “find help” tab, at the top of this page, can help you locate psychotherapists in your community. Goup therapy may also be very beneficial. I wish you the best. Please take care.

Dr. Kristina Randle

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Family issues

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

As I’ve been becoming older, I’ve been getting into arguments with my parents. But recently they’ve been happening more and more frequently and I’ve been getting more and more angry each time. Each argument has been about the same major topics: my behavior towards my siblings or how I “disrespect” my parents. But sometimes I can’t help what I say to my parents. If they’re in my face yelling about what I just said or how I forgot to do something, how can I not yell back? My parents say its disrespect, but I feel that they have no respect for me when they’re yelling in my face. But the topic we argue most about is my little brother. He’s 7 and if I do the slightest thing to him he goes and tells and I get the whole “you’re older and need to grow up speech”. I’m sick of it. I feel that they can’t see that my little brother does things that really bother me, and I’m not being dramatic. Like today, my little brother does this thing where he just touches me. I HATE when he does this because it’s COMPLETELY unnecessary. So I hit him back, not that hard just a slap in the arm. Just so happens my dad was walking by at the same exact time. When he saw this he immediately got in my face, hit my arm (and I had to fight back the urge to hit my dad right back), and started giving me a speech (which during I was completely being a smart aleck because I felt this whole thing was not my fault). When my mother got home I got the same speech from her, but she just didn’t understand how I felt! Then while I was in the room right next to the kitchen they started to discuss what they should do to that “devil”. But my defense is that my little brother is just very dumb and a wimp and that my parents baby him too much. But to avoid these confrontations I feel the only way to do this is to COMPLETELY IGNORE my whole family. I’ve been doing this by sleeping all day and my schoolwork is suffering, I also barely eat because of sleeping all day. But these arguments always seem to find their way into my life. Is there any way to get my parents to understand me? How do I deal with 7-year-old brother? Can I just keep ignoring them? Please do not treat his as a teenager being dramatic, this is a serious cry for help. After some of these arguments I’ve hurt myself. I scratched my arm with tweezers and today I dug my own nails into my arm. Some of these arguments have resulted in me almost getting smacked in the face by my dad. I’ve also cried for hours before. So please I’m begging for help.

Thank you for your letter. I hope I can offer something useful.

Fifteen is a rough age because you are in-between everything, and are just starting to see weak spots in your family and the world. It is very normal for teenagers and their parents to go at it during this time, and for the siblings to throw in with the mix as well. But I understand the fact that it is common doesn’t offer much comfort.

Probably the best-known book about teenage girls is Reviving Ophelia: Saving the Selves of Adolescent Girls written by Mary Pipher. I’d recommend reading it—see if you agree with the author, then ask your parents to read it. Sometimes an outside source can help make the change.

But my guess is that you are going to need a few sessions of family therapy. The fact that you are hurting yourself because of all this demands something is done sooner rather than later. I would ask your parents directly to have you talk to a therapist, and then explains to the therapist what is happening. More than likely the therapist will engage at least one of your parents, if not the whole family.

Don’t suffer in silence with this. If your parents are not willing to take you to a therapist, talk to the school counselor or a trusted teacher. He or she will be able to help get the ball rolling.

This may be a tough time for you, but there are many good things waiting for you as you move through high school. As you are seeking some peace within the family, keep developing interests outside of the home: Clubs, sports, classes, etc. Work on developing yourself, not focused any on the family feud.

Wishing you patience and peace,
Dr. Dan

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Worried About Getting Worse

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have been diagnosed with major depression, but I think I may have something else. I am worried i could be a danger to others.

I often have fantasies of poisoning and hurting other people. I feel an incredible urge to poison and when I did I felt a rush of adrenaline. I actually liked it. I have already poisoned one woman I roomed with. I was kicked out of that lodge for that and sent to the hospital. They put me on wellbutrin XL for my depression and abilify for my psychosis. I don’t think they are working. Aside from my violent fantasy’s I am a cutter. I have intentionally overdosed to hurt myself. I am often suicidal. Everyone in my family is dead and I have not really dealt with that yet. I am a binge eater and sometimes I throw up my food to get rid of it. I have an imaginary world I escape into even at my age. I often feel like crying. I want a relationship but always break them off after around 2 weeks. I don’t have many friends because I am very self conscious. I sometimes steal small things from other people’s houses and cars. I feel no remorse for this but I know it is wrong. At this point I have been able to fight my urge to hurt someone else, but It is a struggle and I feel I will eventually lose. I often feel the best way to make sure other’s are safe is to kill myself.

I am at a loss as to what I should do. Somebody please help me! I am miserable and I hate myself.

If you believe that you are a danger to yourself or someone else then go to a hospital immediately. The hospital can keep you safe. When you go to the hospital tell them what you wrote in this letter which is that you have a strong urge to poison someone. You should also inform them that you have harmed someone in the past and that you’re worried that you may do it again. They will likely hospitalize you and you can get the help you need immediately.

My main concern is that you seem unable to stop yourself from harming people. You have succumbed to your impulses in the past and that is concerning. You may need to be hospitalized at this time but you also should consider entering an intensive treatment program. Perhaps it is the psychosis that is driving you to want to hurt yourself or someone else.

Perhaps there are other explanations for why you want to harm yourself or another individual. As you mentioned you feel a sense of pleasure when you think of hurting someone. That sense of pleasure needs to be addressed and extinguished. That may be accomplished with a partial hospitalization program, a competent therapist or a team of therapists. The desire you feel to harm others or yourself is not something that should be ignored. It is not normal or healthy and it may be dangerous.

As I mentioned above, if you believe that you may harm others or yourself then go to the hospital. If there is no immediate danger then the hospital may not be helpful but treatment for these issues is strongly recommended. You should contact a therapist or an intensive treatment program as soon as possible and enter treatment. A therapy program could help you address your issues. Perhaps you could learn to redirect your unhealthy impulses toward a healthier outlet.

I am encouraged that you recognize that there is something wrong. I hope this recognition means that you are willing to attend treatment. You have already harmed someone and were punished, albeit not very harshly. At this point in time you recognize that those destructive thoughts have returned and you feel the urge to repeat your actions. Now is the time to do what is necessary to prevent a tragedy. At this juncture, your thoughts are only thoughts. Thoughts cannot harm another person but they may eventually lead you to engage in a serious or deadly crime. It is your responsibility to seek help for this problem. If left unchecked there is a chance you could seriously harm or kill another person and may be imprisoned for the rest of your life. You may even be given the death penalty. For the sake of yourself and the lives of innocent individuals please seek help immediately. Here is a website that may assist you in finding a therapist in your community. I thank you for your question and hope you will get the help that you need.

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