Going to the ER when your suicidal

(trigger for suicidal thoughts and self injury descriptions)
SIV = self inflicted violence

Last month a suicidal man showed up the ER at one of the local hospitals. Only problem was he showed up with a gun, and was threatening the staff.

The police and security guards were able to keep everyone safe and defuse the situation.

Local social media was complementing the staff/police in one breath and then being angry with the man in the next breath.

Everyone was missing one perspective. The mans. What that tells me, is those commenting, thankfully, have never been so suicidal that they have been forced to go the ER to seek help.

Let me give you a look at what it's like to go to the ER when you are suicidal...from the prospective of the suicidal person.

I have lost track of the number of nights I spent sitting in the my car in the ER parking lot, bawling my eyes out, trying to summon up the courage to walk into the ER and ask for help.

The "I can't handle my head - I'm going to loose this battle - Suicidal as fuck - help me" plan was firmly in place before I left therapy.

I fought  like a motherfuckin' wildcat to stay alive in my 20's.

I wanted to be damn sure I continued to more forward after leaving therapy.

When Richard first suggested I go the ER for help, I blew him off. I mean 'common I couldn't even call him on the phone for help at that point.

There were the fears too. Images of being restrained and forcefully drugged...as well as the awful, awful knife to the gut fear that ....they wouldn't believe me, and turn me away.

Imagine, me, walking in to the ER. Calm. Collected, dissociated the fuck out to the point I am a smooth empty shell with no humanity in it.

"Hi." I'd say.

"What do you need to be seen for?" they would ask.

"I'm suicidal and want to kill my self." I'd say, then punctuate it with my high nervous laugh.

They would look at me eyeing me, judging me, trying to determine the truth to my words, and before they could ask my name I would loose my nerve and stammer an apology and beat a hasty exit.

"never mind, sorry for wasting your time, its nothing really, I'm fine."

When you go to the ER with a broken bone, or your guts hanging out, or writhing in pain YOU don't get judged. You are automatically treated with compassion and professionalism.

Because you can't see mental pain there is no way for them to triage you without having to ask you questions that make it sound like they think your faking.

The ONE time I got the nerve to go inside, I never made it a foot from my car. brain washing from my childhood stopped me and I got back in my car.

my mothers ghostly words "are you bleeding? no? then stop crying."

I bashed my face with a hammer until I was a bloody, snotty bawling mess.

"Now you can go in." I had told my self. Now I looked the part. Now the pain was visible...now I looked like I was in danger...........now....now I would be believed.

But it was too late. The self inflicted violence had dissipated the suicidal urges and calmed me, and put me in head space I could handle my self. The danger had passed. Totally defeating the purpose of coming to the ER in the first place...which was to deal with the suicidal state without using SIV as the coping skill.


There is a huge battle when you are suicidal and seek help.  Part of you wants to die, and another part of you is reaching for help. A wrestling match that is of epic proportions. Guess which one has the greater pull? If your head is thinking suicide, that is where the balance of the weight will rest. The internal built in preservation for life encoded into your DNA, is there to save you from dangerous situations, stuff like if you see a bear, it tells you to RUN!

No where to run when the danger is in your head.

This man who came with the gun to the ER told them he was suicidal. There was a war raging within him. GET HELP - DIE - GET HELP - DIE .....let someone take control and help me .... fuck let someone else kill me...

Perhaps he wanted the police to kill him. Perhaps he needed to make the mental pain visible so he felt justified in going to the ER for help.

either way its not as easy as the media makes it sound.

"If your suicidal, get help. Reach out. Go to the ER."

I eventually wrote what became known as my "Owners manual". A document with all the info the ER staff would need to know. So I could walk in and just hand it over, and not have to talk, or prove anything. 

My name is Paja, I am feeling very suicidal and I am not safe. I need help to keep my selves safe. I have a history of SIV and working with my therapists to stop that negative coping skill.

Don't let my quiet nature fool you. I am in danger. I wouldn't be here if I could take care of this my self.

(a list of my therapists/doctor's phone numbers)

(list of my diagnosis, and medications I was taking)

Coping skills that are useful:

1. Have me visualize snow
2. argue, with me, if you can get me to cry the rage/anger will dissipate and I can handle my self from there.
3. ect etc

That document was my voice.

It brought me great comfort. It was like an invitation to the ball. I no longer needed to crash the party with blood and violence, I could simply go in and hand it over.

I kept a copy in my car and in my trailer.

I have never had to use it, but you'd think otherwise if you saw how tattered the copies are.

I am brave enough now to go in without it.

Others are not so lucky. Be compassionate and thankful they make it to the ER at all.

same song different day

(trigger for pathetic whining)

First off apologies for all the blog spam. I am trying to get my mind back on line and focused on writing. I desperately want to finish Skinned.  Its very frustrating not to be able to. Even more frustrating to leave a character in limbo like that.

My physical health is just overwhelming everything right now. Second only to the chaos of my mental health.

I asked the FNP last week to put me back on Zoloft.

Which is a HUGE thing considering the last time I was on it things got ugly. So ugly its listed on my chart as an allergy.

Any way we are back tracking through mountains of paper work looking for the data on the episode. I on my end looked though my journal entries.

Its always devastating to me to look through my therapy books/journals. For the primary reason....all I have to do is change the dates and those entries could have been written today.

If that isn't enough to make one feel crazy I don't know what is.

My paper chart from that time lists the symptoms I asked to be seen for.

Exactly the same ones I was seen for last week. I'm still trying to get help for pain issues that date back 20 + years.

Why can't I be helped?

garrrr, I shouldn't go in those books without a chaperone. They're pretty intense.  I also was in there looking for my old "owner's manual." A document I wrote in case I had to go to the ER. It was all the info the ER staff would need if I showed up on there doorstep in a suicidal state. I need if for the next blog I am working on. I can't find it. That's frustrating. I am going to have to write without it, because I can't go back in that pile of papers. Too triggering.

Just a quick jaunt through it has left me bawling.

Xanax on board, going to get a hug from hubby and then go to the store for a shit load of hostess crap to drown my sorrows in sugar.

What if I can never write again? what if who I level out to be after all the dust settles is no longer me?
Why is it ....only the pain survives each time I molt, evolve, and change?

Faded

I was recently featured in a magazine that our local paper puts out.

http://www.mailtribune.com/special/20170430/healing-journey?start=2

(there is an error in the article -   It incorrectly states I advise against "support groups" for self injuries. I advise against group therapy.)

A year ago I was in the paper and on the noon news. The residents at my work commented on seeing me in the paper, and on the news. But they didn't comment on the topic of self injury.

THIS time was different. BOY did they have questions!

I figured they wouldn't see it and gave it no thought. HA! boy was I wrong. They grilled me with all kinds of questions and most wanted to see my scars.

Which brought up an interesting observation.

my scars are faded.

I don't have any red scars. They are all ghostly white...and I am okay with that. In the past I wouldn't have been okay with that.

Healed white scars have been a trigger for me in the past. Some of my injures are reflective of trauma's that I don't want to forget, if my 'bookmark' is faded then I worry about forgetting why they're there, I've been known to re-injure to keep the scars bright red for the year it takes them to fade again.

I wonder if I'm okay with this because I'm more healed? Or is it because I've got my hands full right now with my health issues.

Being on prednisone rolls around in my head. It makes healing wounds more difficult. A burn would also artificially elevate my CK level and we need to keep tabs on that to see how bad the polymyositis  is flared.

I still have SIV urges.

BOY DO I.

I came awfully close last month to going on a SIV spree when I was so suicidal. I actually gave my self permission to do it.

Yet, I never even picked up my tools.

Some days I wish the urges were as faded as my scars.

*************** TRIGGER - GRAFFIC SIV IMAGES OF SCARS below ***************

I hope that one day the mental pathways that bring to reaching for SIV as a coping method will fade too. Be so dusty that I don't slide easily into them. There are days I am miles away from self injury...and days I wanna just do it for no reason.

I will always carry those reminders of the SIV on my skin. I'm at peace with that. My scars and me? We good. We good.

Mirror... self injury ...rorriM

* * TRIGGER for self injury* *  

The pain was crushing.

I had reached the end of my coping rope and had reached for the matches.

I sat on my bed in my little trailer and ran through all the things I should be doing instead of burning. All these healthy skills I could have reached for. I could reach out to my therapists. I could go to the ER, I could do any number of healthy things.

But in that moment all I wanted was to be comforted by the sweet pain of the flame licking my skin.

I was still in in the trenches of switching from the mentality of pain = comfort. Trying to learn and implement other things to bring relief. Trying to befriend my body and get reconnected with it.

The thick mental stew of depression, anxiety and resurfacing memories was making thinking clearly impossible. The constant state of dissociation was adding another suffocating blanket of weight.

I need to injure to breath.

cut a hole in my skin to let air in....

...or the demons out.

Any hope of stopping the injury went out the window with a flick of my wrist as the tiny match head igniting.

I lite the candle and moved into position to put my arm over it.

I stared into the flame. I could feel its heat on my forearm. My insides welled up in anticipation of the physical pain, which would drive out the mental pain.

Deep inside  a small part of me tried one more time to derail the burn.

you don't have to do this. go call for help, go ride the horse, go sit with the dogs, go to the store for pepsi, go for a hard run, call Richard, call Iona and Nola...

"I can't." I say with much effort to be heard from under the heavy weights

try

"I can't."

can't or won't?

My internal mercury switch tripped and I came up swinging.

"LEAVE ME THE HELL ALONE. I AM GOING TO BURN. I DON'T WANT TO STOP INJURING MY SELF. I DESERVE TO BE INJURED I DESEVER THIS PAIN I AM A MONSTER. I KNOW WHAT YOUR TRYING TO DO! YOUR TRYING TO GET ME TO CRY TO DISIPATE THIS MOOD. IT'S NOT GOING TO FUCKING WORK I NEED THIS BURN!  I NEED THIS BURN!  I NEED THIS BURN!"

Angry now, the injury motivation moved from "burn for pain relief" to "rage burn for the sheer hell of damaging my self." I moved to the table at the other end of the trailer, in hopes that those two seconds of transit time would calm the rage.

I set  the candle on the table and got ready to burn. My eyes focused on the flame. As I raised my arm to apply it to the flame, my eyes defocused on the foreground and became aware of the background.

What I saw stopped me.

It was my reflection in a small  mirror.

I was face to face with my abuser.

That didn't look like the face of someone 'trying to help' me by injuring me. It didn't look like someone who wanted to be helped. It looked a lot like a angry animal trying to look fierce so everyone would leave it alone. She looked to be in a lot of mental pain/torment. She didn't look reachable.

I tried to get my brain back to burning my self by returning my eyes to the flame.

but my focus again returned to my eyes in the mirror. The rage and hate were gone, there was just a wounded me in there now.

My guts churned. what was this? What is going on?

I blew out the candle and ended up having a good sobby cry with my reflection.

******************************

The mirror became a tool in my arsenal to help me heal. It forced me to SEE. See not only who was harming me, but who I was hurting as well. Firmly connecting that "hello...you are both the abuser and the abused here."

It also was helpful in derailing injuries because it added an "audience" and took out the secretive/solitary aspect of the SIV.

For a long time there was a note on my box of matches. "look at who you are going to burn." A reminder to use the mirror.

I found quickly that I have zero tolerance for watching my self be abused/injured.

I can even to this day derail injury urges by sitting with a mirror and connecting with my self.