Published on 12, July, 2020
So this is a bit of a delicate one, obviously, but I just wondered whether anyone else here was a self-harmer, and how it related to their autism, emotional dysregulation and meltdowns. I've been a self-harmer since I was 14, which is now 20 years - mostly by cutting, but occasionally other things as well such as overdoses or burning. During a meltdown, I will also head-bang, wrist-bang, scratch and hit myself and pull my hair out.
I guess I'm just wondering how other people manage their self-harm and whether people had found things which were actually decent alternatives which work for them, or ways to avoid getting to that point. I've heard and tried a lot over the years (e.g. drawing on yourself with pen, holding ice cubes, flicking elastic bands, hitting something else like a pillow), but none of them work. I feel like perhaps those are geared towards people who aren't in an exceedingly uncontrolled emotional state/meltdown and once it gets to that point nothing else helps. I'm also in therapy and have been in and out of it for most of my life now - she's great but I always seem to fall into the same patterns because they're so ingrained at this point.
I suppose I also just want to feel less alone with it. I've known a lot of self-harmers over the years, but none of it has quite been in the same context when it comes to the autistic meltdowns. I'm not sure what I really need from this, I guess, but hopefully some replies might be helpful or at least supportive!
I've only experienced this in head banging meltdown due to medical stressors, but feeling for you.
Our emotions do get raw and difficult to communicate.
I'm wondering, do you feel heard by those around you? I know it's hard when our voices are inaudible and only our actions scream and then even that is not understood. In so far as that goes the key might be with others, not you.
For what it's worth I do think that self harm in autism is different than for NTs. What therapy do they offer you? Any? Whatever it is this needs to hold Aitism at its core to work.
I find Luke Beardon's equation helpful: Autism + Enviroment = Outcome. With that is there any chance that rather than replace the behaviour; wrist band twanging, a strategy of identifying triggers and reducing or eliminating them might work?
I haven't got magic answers, just musings ...if they help.
Thanks for the sympathy Dawn, it does really suck. Our emotions definitely get raw and yes you're right about commuinication.
TW: SuicideI actually ended up standing on a bridge sobbing on Tuesday, wanting to jump, and that was mostly triggered because of communication issues and feeling like nobody will ever understand me properly. My tone of voice and way I say things is often misunderstood, even by other autistic people, and I just find it really hard ending up in interpersonal difficulties or not being heard fully as a result.
Autism does seem to make self-harm different. Not always, for me, but sometimes. If I'm self-harming in a meltdown then it looks different to when I'm not in a meltdown and I imagine outside of the meltdown is probably more similar to the way NTs self-harm, but how would I know I suppose!
Therapy is integrative. My (private) therapist isn't an autism specialist, but she is amazing. I've been seeing her since 2019 and we have a great working relationship and a hell of a lot of trust. She's very willing to adapt things and learn and grow, and goes away and looks into things and makes suggestions which might be autistic-friendly, she's really reflective too and keen on me having autonomy in the therapy. I only got diagnosed as autistic in 2020, and then the pandemic screwed things up for me massively with my mental health, and then I've spent most of this year in the worst suicidal crisis I've had in 20 years of poor mental health... So we've not actually had loads of time to work all of this out and put things in place, but we have worked out a more tailored meltdown plan (but that only works if it's possible to intervene early enough in the process) as well as some other adaptions which help.
There are probably loads of triggers, but I'm not sure whether much of it can be changed. I can't do much about work stress because I need to work full-time regardless and I can't stop all of the changes which happen there - they're pretty supportive overall but things have changed so much that it's almost unrecognisable to me. I can't really change stress from studying if I want to get my degree (but have a disability profile and whatnot, and postponed my last assignment this year when I was really unwell). I did move house and so my environment is better now, but even that is changing outside of my control because my flatmate is leaving in September so I'm going to have to find someone else which is really scary in a 2-person flat. Then there are interpersonal difficulties which just crop up as part of being a human, so there's not a huge amount I can do there either.
Thanks for taking the time to reply, I really appreciate it. I just feel a bit stuck and I'm not sure where to go or who to ask for. The CMHT won't help me unless I stop seeing my private therapist, and I refuse to do that, and unless they're going to offer me DBT therapy then I'm not interested anyway. I wonder whether an OT would be someone who might be able to help, but I'm not sure enough about what they do to know whether that's a thing I could legitimately ask about (despite potentially wanting to go into it myself one day!!).