Diversity of motivation among self-harming individuals

An estimated one in twelve teenagers has committed self-harm. Of those many will continue self-injuring into young adult hood. Yet older adults are not immune to committing this act. In 2003-2004 adults age 25-44 were responsible for nearly fifty percent of reported/discovered self-harm cases.  There are many reasons that people self-harm. These reasons may include self-harming as a survival mechanism, self-harm as an outer expression of inner emotional turmoil, and self-harm as a means to exercise control over one’s environment.
Contrary to popular thought, only one in ten people who make the decision to self-harm are suicidal. The majority of people who cause injury to themselves willfully have a wish to avoid killing themselves. The act of self-harm is developed as a “technique” to cope and survive the afflictions of life. How can we know that this is the reasoning or thought behind the action of self-harm? “Cutters” typically reason out the least amount of damage that will “remedy” the stress intensive situation that they find themselves in, and exercise an enormous amount of restraint in inflicting only a measured amount of damage. Cutters’ common logic is that through this expression of injury, further damage to their selves may be headed off. --------, a former cutter, attests to the reality of this when he says, “Every time that I touched a blade to my skin, I would resist making a larger cut, a deeper wound. Every time that I hurt myself, I did so only in response to what drove me over the edge; Each time the amount of physical damage that I did was the very least that I could muster. I fought to do the least damage I could, no matter how intense the pain that I felt became.” He sums it up rather nicely.
Secondly, self-harm is used as an outward expression of deeper, more complex emotional and psychological phenomena. It is not a diagnosis; it is a symptom. It is a symptom of a struggle that is inherited by victims of abuse, those who lose a loved one, or experience other traumatic events during their childhood. These groups are far more likely to indulge in self-harm. One study conducted by Boudewyn and Liem found that of those college students that reported a history of self-harm, fifty two percent had been sexually abused as a child. Those that self-harm do not simply cut to cut, burn to burn, or mutilate to mutilate. There is a deeper motivation. This motivation is commonly emotional. These motivational emotions are often the results of tragic or traumatic life experiences. It is seldom that a cutter’s motivation is a want for attention.  In fact, most cutters are chameleons.
Self- harm is used as a tool to exercise control in a chaotic environment over which one would not otherwise have any means to control. Among chaos and turmoil such as the loss of a parent or close friend, relational betrayal, divorce of one’s parents, or consistent, one time, or sporadic physical, emotional, or ****** abuse an individual is radically more likely to engage in self-harm. Outside reasoning on this is only speculative. For this reason it is valuable to look at the action from the perspective of those who commit it. Cody, the same individual mentioned earlier says something else that lines up with this common scholarly opinion. He says “I remember the very first time I cut myself intentionally. I was in the ninth grade, in the school bathroom. I had just experienced what I saw as betrayal by my best friend of about ten years. I felt like I lost him. I felt like things were spinning out of control, and I couldn’t control the way I felt about it all. The only way I could feel that control was with something sharp in my hand.” This is characteristic not only of ----- but also of many other cutters.
Cutters are not (necessarily) crazy. On the surface it may appear that cutting goes against the ingrained survival and self-preservation instincts in human beings. This is actually the opposite of the truth. Many who cut feel that if they don’t inflict smaller harm to themselves that they may indeed fall to suicide. They feel that by letting out their pain in increments, and escaping in fragments, that they can slay the thoughts of suicide and urges to escape that they carry. When at the edges of rational, some instincts may take different forms. What may seem counter intuitive – an act of self-harm – becomes the definition of an instinct that it seems to defy. The desire to survive becomes so strong that it is necessary to inflict pain. This is not uncommon to survival situations. For example, the movie 127 Hours reenacts the experience of a man trapped under a boulder in a beautiful and secluded gorge. He cut off his own arm with a dull multi-tool in order to escape death. That act is the epitome of self-harm as a survival instinct.
Cutting could lead to a series of events that tailspin out of control. Loss of control could take the form of the spiral of therapies and prescriptions that would follow if it were discovered that one were cutting , or it could be the accidental slip of a blade gone too far. It could end in hospitalization. It could even end in death. However, those individuals who choose to cut, as long as sober, take precautions to avoid discovery or more injury than is intended. They are meticulous, careful even. They reason out how, where, and when they can cut “safely”. They are very much in control over the act, when they feel they cannot be in control of anything else.
It may rationally appear that pain is pain. That it would make no difference whether out or inward, because whatever its state, the pain is still owned by the individual. However, emotions are often harder to process than physical events. A burning rage, hate or guilt may well be harder to cope with than a burn to one’s arm, leg, or hand. An emotional cut to the bone may be less painful than a physical one. It may be said that the act does not transform the pain, but multiplies it. This in essence may be true, but one form of pain allows a man to ignore another. A pinch may allow a man to ignore the emotional pain of a nightmare. A small cut may allow ignorance of the bigger cut on one’s spirit or psyche.
There are widely varying and increasingly complex variations of motivation and cause of self-harm. They may include, but are absolutely and in no way limited to: self-harm as a coping or survival mechanism, self-harm as a tool to exercise control over one’s increasingly chaotic environment, and self-harm as an outer expression of inner emotional turmoil. To believe that cutting is simple is to nearly deny it altogether. Its essence is complicated. Stereotyping self-harm or self-harmers may well lead to opinions that will ostracize or further encourage the occurrence of self-harm.  Since the motivation and causes of self-harm are undeniably complex, to attempt to brush this under a rock would be to diminish its importance, and to deny healing to those who need to understand it.

My bipolar fantasy is that one day,
I’m going to come home and leave my bipolar at the door,
Scatter it along with muddy boots and raincoats and winter mittens
I have no use for currently,
That I’m going to take it off and enter my house unencumbered.
My bipolar dream is that I’m going to go to bed tonight
Without measuring my sleep,
Wondering if it’s an indication of mania or depression,
If it’s stress or I need medication to push me into a nocturnal daze,
The haze of which will bleed over into daytime.
My bipolar wish is that this illness
That I lug around like a suitcase made of brick
Might lighten in load or unpack itself once in a while,
That it will not brand me as a traveler on a road
Pockmarked with landmines and loneliness.
I wish that this suitcase did not bear the mark of mental illness.
My bipolar life is a story,
One laid out in the lines of swinging,
Of flying and then falling
Before realizing they are often too closely related to tell the difference.
My story is written in the narrow margins between creativity and hospitalization.
Sometimes the two occur together.
My life’s manuscript is forever alternating
Between the way the night sky speaks to me
Or the way the bathroom smells like my blood.
It is being abuzz with electricity and then short circuiting your battery
And not being able to move.
My bipolar song is a tune alternating between grandiosity,
All hail my intelligence and beauty (psych!)
Before falling into apathy and self-loathing.
Sometimes it’s not knowing what version of me I’m going to wake up to in the morning.
My bipolar hope is that the dizzying combo of diet, exercise, and daily medication
Will keep me out of that 1 in 5 number I’ve danced with so perilously,
Keep me off of those bridge ledges and out from empty pill bottles,
Keep me alive in my skin even in this painful reality.
My bipolar fear is that when mania and depression have a love child
And mixed mania runs amuck in its terrible two’s,
The anger will taint the feelings of loved ones.
I fear callous words uttered insouciantly in my own misery,
Slithering from my mouth agonizingly slowly yet too quickly to stop
Might wound those I care for when I do not mean it.
My distress and agitation sometimes equal cranky.
My bipolar prayer is that when energy plus impulsiveness plus danger is no longer
A concept I understand collaborate,
Those around me know this is not who I am.
My mood is a high-flyer, a free-faller, and an everywhere in between,
But that is not my personality.
I am an optimist, a free thinker, creator, compassion giver.
My story is broader than the confines of bipolar.
I am sometimes aflame and others underwater,
But I weather it all with a twisted sense of humor.
I am a person before I am bipolar.

Everyday I show up
After the privilege of sleeping at home
To partial hospitalization
A step down from residential
Now they feed my six meals a day
And my whole body resists
As I choke down my meal plan
And cry an internal song
Of repetitive stories
Terrified of my changing shape
Doubtful of their expertise
A frustration beyond myself
A secret plan to return
To my comfortable place
Where I starve into emotional regulation
A safe place to rest a weary, threatened head
How will I ever get better?

I've been in and out of therapy and partial hospitalization programs for about 20 years. you'd think by now I would be better or at least discover a new flavor of ice cream I enjoy but nope, I only like green mint.

there's a lot that's wrong with what I've been dealing with so I'm going to short list it:

start therapy
see new psychiatrist
psychiatrist prescribes me meds before my first therapy session even begins
I hate my psychiatrist
I hate my therapist
therapy does nothing
talking does nothing
I start fantasizing about murdering animals
it scares the ******* **** out of me
I tell my psychiatrist
she said it's the meds
she prescribes me something else
the fantasies stop
my therapist thinks I have daddy issues
my therapist won't stop talking about my father
it's annoying
I hate her
I ask to see a new therapist in the same facility
she asks why
she asks about my fetishes
she takes off her flats and crosses her legs
I'm not sure if she does it intentionally
I feel weird
I see a new therapist
I love my new therapist the first visit
my psychiatrist is replaced
my new therapist only sees me once
I tell her everything she needs to know
I feel amazing
I feel like this is good
she was a temp
I am lost in the system
I have no therapist for 4 months and no one sees to care
my new psychiatrist seems great
she likes plants
she's funny
I feel good about this
she cancels an appointment
I try to make a new one
no one calls me back for a month
I get a new appointment
she cancels
I get a new appointment
she doesn't show up
I'm calling and calling and leaving voicemails
no one calls me back
I still have refills until July 28th
I call everyday the last week of July to make an appointment because I need her authorization for my refills now
I call my pharmacy to ask for help because I'm running out of meds and no one is helping me
every time I go off my meds it's very bad for everyone and I start doing drugs
I don't wanna be off my meds anymore
my pharmacy calls her the day of my refill
she denies the refill
I can't even get a few pills until I get a new appointment because she's denied it and they can't do anything if she denies it
I call my general Doctor
she prescribes me for two weeks
I leave a crazy voicemail on my psych's machine
she never calls me back
I can't get a new appointment
I called all day everywhere
no one is taking new patients
I don't know what to do

did you get all that?

my issue with this situation isn't even really about me directly. it ***** for me but if I end up off my medication I know I can always buy it online illegally or just do dissociatives to keep me from being violent or hurt myself or anything remotely alarming.

my issue with this is I know a woman who sees my ex-psychiatrist. she is not well. she goes into these catatonic episodes and can't do anything. she hides out for months. she's in an abusive relationship. she doesn't eat. she can't talk sometimes. she needs someone to do more for her than just have her show up. she needs people to be actively involving themselves. she needs intense help and I know her appointments were canceled as well.

I can't stand the thought of how many people are in this field who are not doing their job. how unprofessional to literally cancel my refills the day I need a refill because I need to "make an appointment" like ***** I haven't been trying?

what kind of ****** up spiteful **** is that?

that's not right. I don't even know HOW to deal with this. I feel like what she did is illegal or at least negligent. but also that this is something that must happen all the time because these people know they are treating people who are unwell and maybe don't know how to help themselves.

I don't know. I wanted to share this in hopes someone has dealt with something similar and knows the next step or if there's something I can do to have my psychiatrist dealt with. do I call the facility? do I talk to someone about it? who? she knows I don't know the first thing about how to do this and I know I'm not the only one.

YOU WILL NOT FALL IN LOVE IN A HOSPITAL, YOUR SKIN WILL SMELL LIKE THE DYING AND YOUR LIPS WILL CRACK AND YOU WILL NOT FIND BEAUTY

I USED TO THINK I WOULD FIND SOLACE IN THOSE SANITIZED WHITE HALLS BUT ALL I EVER FOUND WAS MY OWN EMPTY EYES STARING BACK AT ME FROM THE UNBREAKABLE SUICIDE-PROOF MIRROR AND THERE WAS NO COMFORT IN MY BRUISED TENDER FACE

HOSPITALS ARE NO PLACE FOR YOUNG GIRLS WHO HAVE NOT YET TURNED AWAY FROM LIFE AND THEY ARE NO PLACE FOR KISSING YET YOU READ ABOUT MOUTHS FINDING EACHOTHER IN THE DARKEST HOUR AND YOU THINK OF CEMENT HOSPITAL WALLS; THERE IS NO DARKNESS IN HOSPITALS, JUST PURPLE FLUORESCENT LIGHTS THAT MAKE YOU LOOK SO PALE YOU MIGHT JUST REALIZE THE IMMINENCE OF YOUR OWN DEATH.

YOU WILL NOT FALL IN LOVE IN A HOSPITAL.

It hits you, in the middle of a late night re-run.
And all of the sudden..
You listen to the scheduled bickering in pure optimism.

Your eyes grow heavy,
                   stories grow ridiculous and lengthly.

The scrubbed lady appears less frequent,
                         the mechanized beeps become dulled.

The scheduled hit of temporary relief
                            your head falls back into medicated sleep.

Lymphoma
There was a  fundraising run for lymphoma and other cancers
A little notice for it on top of the garbage can
at a home grown Jamba Juice right off the BART in Berkeley

It hit home: what I was up against
People don't run through the streets casually
and my cat had lymphoma

I couldn't find him last night for the first time
He had his weekly appointment and I brought in
something that didn't look at all like he was the week before

They paged the vet and she came in
saying thing like he needed an IV and tests and
wasn't there nothing else to do
didn't she say that
he needs hospitalization--his liver
we can't tell you what to do
but it would all go in a circle and come back
to a suffering being who had
come to the end of what science could do for him
what she was trying to tell me in her barrage of words
came through loud and clear

They brought him in
with a blanket and a catheter
and he struggled until he got warm and then rested
I wanted him to see me, as the last thing he saw in this world

She took the three syringes out of her white coat
Don't hurt him, just don't hurt him
my only request
There was no pain
Only relaxation, sleep and then at last no heartbeat
Her ability, her smoothness of execution was perfect
and he went limp in my arms
not suffering

The nurse took his body away
"It's the last gift we can give them" she said
and I imagined a man, a stereotypical
image of a man pacing back and forth in a white coat in front
of a lecture hall full of vet students saying that
exact thing and there was a serious air in the classroom and some wrote this down,
it was so true, sound, capable and final
but this woman said it
this veterinarian from Michigan
and through my tears and grief
there was some kind of undercurrent
of relief, that there is no more pain for him
He no longer suffers
and I did all I could do

1937

bushido invasion
memory still vivid in the Chinese
of a slaughter
prisoners
chopped and lobbed into the river
display their heads
let the next line kiss the remains
but the time is ticking
and the water is only pink
prisoners
mowed down
with bullets
and laughter
they can turn and swim
Japanese aim is good
not one makes it to the other side
the pink
is a deep red flood
becoming a dam
with the bodies of
children
ladies
gentlemen

why did those murdered forget
the purple mountain legend
when it burns
the city falls
why did they not flee faster

the policy issued
plunder
burn
******
do not let that little boy
take revenge
5 years old
they severed him

Japanese leaders saw a chance
to remove any pity
in the solider
they ripped out
humanity
inserted
brutality

training exercise
hoist your bayonet
plunge forward
twist
extract
plunge
twist
extract
men with bound wrists
considered subhuman
butchered
plunge
twist
spit

routine puts soldiers at a disadvantage
fire is added
fields are swamped with oil
and laced with people
patrolled edges
keep the cries alive
the only release
death

movement is needed
tanks must pass
chatting soldiers hang out the sides
wheels roll over the bodies
filling the ditches
carcasses
and
wounded
if there is not enough
they found the closest Chinese
and added it to the pile

competition
2 leaders
in a fight to show superiority
uptake a challenge
to win is 100
swords are withdrawn
ignore its' eyes
the race
a beheading
lost count
up the stakes
150

only the beginning
for the women

a hunt commences
females do not leave the house
there is not one in the streets
rounded up
army trucks
bringing in loads
******* like animals
chained to racks
*****
commonly gang-*****
bleeding to death
aged under 8
over 80
a pregnant women
***** to death
her fetus cut out
and destroyed
encouragement
from higher ups

and the advice given
pikankan is acceptable
every warrior should
do not let them talk
**** the pigs
when they are done being women

more than 20,000
maybe less than 80,000
defiled
in the carnage

journalist support
with authentic recounts

but with time
confused hospitalization
of the soldiers
who puked every meal
and gagged from inside out
as the horrors ate them

the only relief
an international safety zone
perhaps 20 Westerners
to help a mere 300,000
only half
at intervals
Japanese crossed the fence
for the women hunt
for Chinese soldiers
recognized by calloused hands

irony
******* on a Westerner arm
a symbol
as he aided
survivors of the massacre
and the Nazis in Nanking
aghast
leaked information
on the horrors
and
****** ordered silence

a single surgeon
a lucky boy with only one bayonet puncture
another
missing eyes
missing ears
half a nose from
100 tied together
set on fire

Japanese photography
of bonding moments
as they watched
a house packed tight
panicked people on roofs
to escape flames
jumping

6-8 weeks later

more refined brutality
enforced prostitution
and intake of *****
****** cigarettes for children

the West
in ignorance
watched the German rise
forgot responsibility
to humanity
in the Asian wars

no apology
denial
unfair hatred
of later innocent Japanese generations
mention of Hiroshima
amuses some Chinese
doesn't bother others
it's not everyone
that's still too many

lacking sympathy
the road to brutality
lingers

Can I just write a poem that says "**** the police"
for every single line
for every single stanza
and leave it at that?

Because I'm imagining his next victim, because there will be a next one,
and how she will feel when she finds out that he had my former report
on his private police record, accessible only by certain police.

I want to scream, but the metal chain he put around my throat to choke me because
"ha ha you like that, right?" after I had already said no
is still there, so nothing can come out of my mouth,
except I've been screaming as loud as I can for so long;

One year and I'm still not free.

His body weight is still crushing me, still heavy; the bruises on my body still felt every day, my body a museum of decaying loss and my mind a perfect video recording that plays on repeat whenever I just
want
some
sleep;

Nightmares I wake from and can't wake from.

I think one of the hardest days of my life was when I got my **** kit.
I mean- you know- other than the actual ****.
I developed a stutter that day.
I blame myself.
I blame. I -I- I blame myself.
But I can't!

All of the "no's" that I said to him didn't matter, the police said;
everything non consensual didn't count;
it was only the one coerced "yes" that counted;

Scared for my life but, **** the police, right?

And all the times that I said to the police "yes" that I was *****,
collapse and boom like a bomb on deaf ears of police that tell me that,
"maybe you just regretted having *** with him."

Or how about when they rolled their eyes when they learned that I met him on tinder?
I gave them a smile and answered that yes, that's true, because what else was I supposed to do but tell the truth?

Or the first thing they said to me was "so then you had a few drinks..."
Well no, sir, that's not what happned, at all.

See, there have been multiple levels of injustice here and I thought I was doing the right thing to heal.

In my partial hospitalization program that I went to for PTSD,
that I got from my ******,
I learned that the "right" thing to do was to seek help right away after a traumatic incident so that it doesn't lead to lifelong suffering;
Quick help leads to a faster recovery,
and I've always wanted to do the right thing:

Like getting him arrested for ****** me.

But the police don't listen even when your body has been confiscated, graffiti marked by your ******,
and the police tell you coldly to just seek counseling because, after all,
you "consented,"
and that your ****** isn't a ****** in the eyes of the law.
A ****** isn't a ****** but is a ****** and he's going free.
I did the right thing but I'm still stuck night after night, waking up crying;
I wonder who will be next, and that person's weight is added on top of me;
The gallery of bruises he inflicts will just continue, and I wonder where on snapchat will they be next?

Impregnated with uncertainty
Long overdue

Waiting on opportunity
My patience is subdued

Attempted abortions
With 4th trimester distortions
Stillbirth ensues

Screams inside the sirens
Struck with hospitalization
Bedridden doormen
Realization…

The time arrives
With labor pains
And liberation pangs

I cut the umbilical chains
Only a piece of me remains

I feel the guarantee
The time is now
I feel parturiency…

i feel your absence like a cancer multiplying and multiplying within me
and i feel sadness sicking my whole anatomy so i physically hurt from the mental trauma of missing you

not even your love can cure me from this sickness
tell me you love me, tell me you miss me, it doesn't matter
as every day more i die physically from the physical absence of you in my life

so here i am hospitalized
every beep of the heart monitor,
ever drip of the IV fluid,
every throb of the blood pressure pump,
every hair follicle ripped from my skin with the band aid,
every second reminding me that im living and dying at the same time without you

and i'm aware of every atom splitting inside me
as the doctors carefully preform the surgery on each one to separate the bond of you and me

⚠️Trigger Warning: The following poem contains subject matter pertaining to self-harm, suicide, and involuntary psychiatric hospitalization⚠️

Over the duration of high school,
there is one fear that eclipses
the daily rumination of my thoughts.

Behind sepulchred eyelids,
burn the imaginings

of wasp-needled syringes

straitjackets curling around bodies
with noose-like exactness

a padded room
absorbing brain-curdling screams
into its pink insulation.

At the time,
I was petrified that my newly-discovered
flirtation with self-harm
would land me a permanent stay in an asylum.

The rational part of me knew
that they don't call them
asylums anymore.

The rational part of me knew
there would be no syringes
or straitjackets
or pink, padded rooms.

It was the principle

If it was decided that I was
"an immediate risk to myself"--
a decision that would
incorporate the voices
of the people who barely knew me
but deny me my own voice--
I would be admitted
to a psychiatric ward,
and it would be against my will.

It wouldn't matter
if it was at the Children's Hospital or not--
It wouldn't matter if the walls
were coated with those
sickeningly bright colours
or if there was an Xbox
in the common area.

You can dress up a prison cell
as vibrant as you'd like.
But, by principle,
it's still a prison cell.

When they strip you
of your clothes,
and force you into
their bleak hospital gowns,
they also strip you
of your independence.

(You aren't even allowed
to wear your school cardigan,
the one whose soft, green fabric
you nestle against your fingertips
when you need comforting.

What makes you think
you can leave when you want to?)

See,
doc keeps ya locked up
until he's snuffed the
crazy outta you.

They don't like using
the word
crazy
anymore, either.

So,
like the prison cell,
they play dress up
with your "crazy",
draping it in euphemisms like

unstable.

erratic.

incapacitated.

suicidal--

Once this word is used to label you,
you are never quite able to
abandon its connotation of
madness--
a reputation of inferiority.

And everyone believes
that they are only doing what's best for you,
that hospitalization is the only thing
that will save you from yourself,
when, in fact, it's the ultimatums
and the countless visits to the ER
and the way you are treated--
like a poor ***** lying in wait
to be put down--
that destroys you.

The memories still
bleed fresh most nights.

I seethe at
the mistreatment and
the betrayal and
the destruction
like an army of bees
whose hive has been kicked in,
a snow-globe convulsing
between careless hands.

I was kinder
before they stole away
the last moon-slivers of hope
I held between heart and ribs,
between lips and flower petals.

The nectar has been
exorcised from my soul,
leaving only infestation behind.


(and there is no escaping this swarm)

I. You are an angel,
a beautiful crystal-clear wet tongued straight-spined haloed human,
bringing that peace,
bring that piece of you that everybody needs. You hand it out like sin at a confessional, like blue jeans in Texas. They all need you. They all want to be saved.
You have something that everybody wants. They want that silver aura, that mist that hangs off your hips, a cloud that only God could have sent down with you. It is a stench.

II. You did not shiver when he touched you. You did not bark, did not swing your fists, did not pray, did not scalp him. You only asked to go in a different room, so your sister wouldn't have to witness
your ******* and the hollow of your collarbones not holding tears you held in. This one is not a lie. When he poked you in the morning, toe hanging out of his sock, you stared at him, weak smile. Smile keep smiling keep smiling walk out the door. Never feel shame, never wash your hands seventy-three times, never wake up four years later that same month and unconsciously decide to have *** with one person who looks like him and another who shares his name.

III. You wanted help. You
wanted attention, wanted somebody to pick up the phone, the line dead, you screaming you blaring you walking mindfully stepping over cracks you spitting out condolences and quotes like a book on grief. You want help.

IV. When you called the girl's father to tell him she had five new razor blades baptizing her back pocket, you did not lie to her when she asked if it was you.

V. If she had died, you would have lost more.

VI. You have an addiction to being ****** up. Not on anything, not on the pills you stole from your father, not on the mushrooms you gave to your mother, not on the bottles that sit in your kitchen like gravestones, scattered, weeping. No, this is on being
****** up.
Ask me how long I've been in therapy. Ask me if I can get enough.

VII. I can't. There will never be enough time for me to fill up "process group" with a voice that tells everyone that I am more damaged than them, that I've got more past, that I binge and starve and take pills that make me suicidal, that I've cut and have blurred the lines between ***, love, and intimacy, that my father was absent. That my father could hold a place in my life and still be
absent. That my father is a functioning alcoholic, that at least he didn't beat me, as far as I remember. That my mother carries her sorrow in boxes, carries her untold stories in the back of her throat, in the pit of her stomach, in her sweat. She compartmentalizes, you were a room she filled up with ****. That I am borderline, that I am bipolar, that I am **** spun into a web and called a patient, called smart and shy but I've got a need that will never run dry and it's for ears, it's for noses that can't smell out the lies, though I don't know if I have any.

VIII. I just have a need. My mother says that you can get addicted to therapy. My mother has never been a ******, doesn't know addiction. Doesn't know anorexia, only knows dinner with her daughter. Doesn't know depression, only knows a daughter who gets sad. Doesn't know borderline, says it's too severe. Says I could never be crazy enough for that.

IX. The woman I had *** with that shared his name called me crazy. I'm sure she went to sleep soft and angelic that night. I'm sure she has no baggage. She asked if she can visit me at the hospital. I asked her if she planned on bringing her suitcase too.

X. They want me and I let them. I want friend, I want family, I want a dinner that isn't me eating slivers and then shaking it off, I want -

XI. I wonder if it's an act. I feel myself talking. I am digging myself a hole. I am digging myself whole but at the risk of raw soul and flashing teeth and bleeding makeup, tissues in the middle of the circle I have too much pride to walk up to. This is my confessional. I pick a problem and never let it go, turn it into hospitalization, turn it into inhumanity, turn it into I Could Have Been More Than What's Happened To Me. Never take responsibility, never ask yourself why you are so happy to be on meds when the meds make you want to die. Never learn faith. Never learn patience. Learn mental tantrums. Learn how to take it like a woman. Learn how it feels when your therapist calls you seductive, calls you intentional. Learn how it feels to have your psychiatrist call you hot.

XII. Never trust yourself, not ever. Not your opinions, not your ink blots, not your journal entries. Question everything, all the time, in therapy. See a personality disorder online and decide you have it. See an addiction, have it verified. See your vulnerability on display, call it therapy. You beg for this. They call you strong and you question that too. You think you haven't been through that much, but you sure act like you have.

dude I bet I can
stick this entire melon
up my left nostril

After my first hospitalization I began writing. I signed my name, about five times, proving to the staff and myself that I was ready to be discharged. The envelope held against my chest contained reading material, a diagnosis, and copious sheets of paper with lightly drawn animal sketches. Two weeks in a hospital, sitting at a desk by a caddy-cornered television, holding a styrofoam cup of decaf coffee, I'd sit listening to news stories while skimming through piles of xeroxed copies of coloring books. This became the precursor to many more manic months that would eventually and periodically follow.

Adolescent behavior is uncertain, but a child that runs off into a wooded enclosure to scream until collapse is significantly more uncertain. More often than not, when a child screams, an adult comes running. But when the source of the scream is just as misplaced as the child, it will only become an echo lost to the wind. When feeling lost becomes a constant what else is there to do but draw a map, or in this case, animal sketches.

Have you ever cried hysterically while laughing? Not producing tears from a belly ache caused by momentary elation, but two conflicting emotions? Imagine dowsing yourself in gasoline and running into a burning home to get a drink of water. Picture yourself flying through the air, wind caressing your face, but you can't fly, and right before you hit the ground you only just realized that you jumped. No child can prepare for this, as much as an ignorant parent can help their child clean wounds that will not scab over. Medication will become a bandage, and if the wound can never heal, the bandage will eventually be ripped off.

Art therapy before therapy was introduced was sitting on the bedroom floor, fashioning little cut-out rectangles, hole at the top, and string pulled through and wrapped around my big toe. A blanket pulled over my face, just to know what it was like to rest in peace. But you know, kids will be kids, or so they say.

Aspirations to be an artist should have been the first clue that mental illness had come and was here to stay, but the dreamers of the world ruined that. You start painting happy little trees, and two months later you're medicated in a hospital room with the faintest idea of what a tree even looks like, let alone the fact that because of these unimaginable trees you are able to breath. But you are breathing, and slowly you are able to grasp a pencil, and soon after you are able to draw these trees, these happy little trees that you not so long ago had forgotten about. And you lean your face down, nose touching the sheet of paper, and you inhale. You feel reborn. Not exactly home, because, well, you're not home, but you're comfortable in your new skin. This new skin leads the doctors to explain to you that you are manic. You nod your head, obligatory nodding, seeing as how your mind is elsewhere, many places in fact, thinking of all of the ideas you'd like to put on paper. And soon enough you're signing your name, multiple times, being discharged with your diagnosis. This is your enlightenment you're told. This is the first day of your new life.
But it's not. The cycling wasn't explained. And you failed to read the paperwork given to you that was sealed in the envelope. Instead you tore it open to procure your drawings and discarded the rest of the contents.

Those drawings lead you to college. To be the artist you know you are.
You bleed for your work. Figuratively, at first. Until you decide to find a new medium. You put yourself into your work. Red smeared all over a canvas. Curled up in a ball on the floor, losing blood quickly, eyes slowly closing. And when you wake, with tubes in your arm, and hands secured to a bed, you wonder what season it is. And what the trees look like, whether they are barren or blossoming.
Then you smile.
You smile because you remember what trees are.

If only you could find a pencil.

Something good
a night of terror-less sleep
a friend who's there
a pain pill
a memory without the inevitable crash
tears wetting the clay
a *** that doesn't crack
art that's honest
losing one of many addictions
peace pipe
a starry-flourescentless night
lose my mind
for something good
1,500 pills
2 manic episodes
1 hospitalization
loads of shame
prison of Blah
depression
more depression
all I'm looking for-
the one thing I need tonight
something good.

I am thirteen
    when the mean girls call
me weird—
I do not shave
I do not wear makeup.
I do wear basketball shorts
and messy ponytails.
I am pressured to be her—
Aria.
I shave relentlessly
    for the next two years.

I am fifteen
    full of discomfort
    and anger
breaking my bones like they
    are glass
reckless rage—
all reckless no brave
    depraved of a home
    inside my own skin.

I am fifteen when I
learn what gender dysphoria is.

I am fifteen when I
    realize I am a boy
that I always have and will be
    a boy.

I am fifteen—
putting holes in wall and
    overdosing on advil
like it is a sport
championing my own self demise.

I am fifteen afraid and closeted—
I write my name as
ALEX
on my school assignments
I always change it back
before I turn them in.  

I am fifteen
    convinced everyone loves the girl
I am not
    and will never love me as the boy
I actually am.

I am sixteen crying on the floor
    of a psych ward
    this is my fifth hospitalization
in fourteen months.
Pretending to be her is
killing me.
I choke back tears as I tell
my mom that I am
transgender.
She tells me she loves me,
    and she saw me writing
    ALEX on my papers.

It will take five years
for her to let her daughter go.

I am seventeen when I am shoved
    to the floor in a men's bathroom
    slammed and slurred across the tile—
It will not be until six months into
    Hormone Replacement Therapy
that I use the men's public restroom.
I am eighteen when my moms boyfriend of the
time pulls me aside
and tells me I am making a mistake.
He would wear his mothers dresses and heels,
    hiding in her closet
    all of this is to say
    this is a phase.
When people say that this is a phase—
    I am sixteen
    sobbing on linoleum floors
    covered in cuts
    wanting nothing more than death
    if I have to pretend to be her
    for more than one second longer.

I am nineteen hopeful
    and naive.
Voice cracking and hair sprouting
    I am coming into my own body.
    I have learned that there
    are things much worse than needles.

I am twenty out of the
    ashes of abuse and trauma
    I am finally becoming
    the man I have always been
    meant to be.

I find things ending, bending, breaking
And not the way they're suppose to be
My love that was transcending
Hit the brick wall that was reality

In my inebriation
I found myself separate from reality
My love hospitalization
Came to a point where there no resuscitating

~
⚠️Trigger Warning: the following poem contains subject matter pertaining to self-harm and involuntary psychiatric hospitalization
⚠️
~
An emulation of the song Drunken Sailor by The Irish Rovers
~
what will they do with a maddened writer?
what will they do with a maddened writer?
what will they do with a maddened writer?

early in the morning

way hay and up she rises
way hay and up she rises
way hay and up she rises

early in the morning

cuts her wrists with a rusty razor
cuts her wrists with a rusty razor
cuts her wrists with a rusty razor

early in the morning

way hay and up she rises
way hay and up she rises
way hay and up she rises

early in the morning

put her in the 'sylum till she's sober
put her in the 'sylum till she's sober
put her in the 'sylum till she's sober

early in the morning

way hay and up she rises
way hay and up she rises
way hay and up she rises

early in the morning

stick her in the room with the padded walls
stick her in the room with the padded walls
stick her in the room with the padded walls

early in the morning

way hay and up she rises
way hay and up she rises
way hay and up she rises

early in the morning

put her in a bed with her limbs strapped down
put her  in a bed with her limbs strapped down
put her in a bed with her limbs strapped down

early in the morning

way hay and up she rises
way hay and up she rises
way hay and up she rises

early in the morning

that's what they do with  the maddened writer
that's what they do with the maddened writer
that's what they do with the maddened writer

early in the morning!

I promise you I am safe every night.

I don't need a bodyguard.
I don't need a guardian angel.

I know you're out there somewhere away from me.

And that's okay.

I should tell you I still imagine myself in the hospital.

I sometimes wish I was in critical condition just so you would have a reason to talk to me without feeling weird, awkward or forced into it.

Although hospitalization is a weird way of forcing you to see me out of guilt.

Mostly because if I was dying...

You would show up only if you really did care.

It is not enough for me to just let you go.
I may have stopped talking, or stopped crying.
But I never stopped hurting.

And I reach out, I hope for you with all I can. I'm still on your side.

So if you end up at my hospital bedside...

I want to hear you say it.

That you care.
That you never stopped caring.
That you actually want me around.
That you want me to live.

Or just that you don't want me to die thinking that you didn't give a ****.

Because that's what this still feels like.

That's what walking away does to a person.

I'm safe here. I will not go anywhere.

But I still hold out optimism for you.
For us.

But I was told, "Things will not go back to the way they were."

So I guess that optimism is just ******* right?
It doesn't mean anything.

I know you wish I would just simply tell you this face to face.
But in all honesty...

I'm not brave.
I'm not as strong as you thought I was.

So I write instead.
You told me I could write to you anytime.
And you would be here.

But now you're gone.
And I can't do anything about it.

So I will continue to pray for your safety for as long as I can.

Because I don't know when I'll see you again.
And I've told you I fear the day when I don't.
You told me I would.
But that was before...

Things are different now.
And despite all the pain...

I'm still safe.
And I'm still...

Holding on.

The photograph frames a proud father,
Holding a dark haired, wide eyed boy of two,
A handsome, smiling child, appearing                    
Normal and happy.
Back in the still good old days.

The little boy in the photo never grew up,                  
Stayed locked up in a grown man’s body.
A Misshapen, painful body racked with
Years of recurring illnesses and frequent
Urgent trips to the Hospital.
The doctors said he would not live into his teens.

The little man within never complained,
His attentive loving family never gave up.
It was love and hope that sustained them.
The Child/Man suffered a hard fought, 40 year life.
And yet he endured. While all that time being
Imprisoned in his diminished child’s mind and his
Tortured adult man’s twisted ever failing body.
Causing some to say; “How much suffering is enough?”

On his last day on Earth, in his limited fashion,
He enjoyed the sunshine,
Smiled a little and even spoke a few rare words,
To his Care Givers.  
Perhaps he was actually celebrating,
It is reported that he even laughed a little.

No doubt painfully exhausted from being
Imprisoned within himself.
Recently back from yet another difficult Hospitalization.
Last night, deep in his own heaven of peaceful slumber
His soul took wings.

At last that little boy that was there, but not there,
Trapped within himself for a life time,
Is finely released and free to soar.

Fly on Child of God, soar now, fly free Little Big Man!

my most prominent childhood memory
is when i stood barefoot in the snow
screaming for my mommy.
it was hard to see her go.

i understand now why my father
drinks beer day in and out
because i know the feeling to want something nearer
or close to your mouth.

i was ***** by the same person
who molested me when i was four
i was just sixteen, wasnt even over the first one
same year mommy died, i turned into a *****.

i was in love with a hurricane
and it ate me alive
no use for Novocaine,
i could hardly survive.

last hospitalization
the sixth time i spent a week
with intravenous medication
for my soul to keep.

the first song i wrote was
about my step father
as he tried to push mommy down the stairs because
she was drunk, and such a bother

i spent a week at my now passed grandparents' home
with barbies, cookies, not one school day
as young as i was, as little that i had known
my life was not okay

i have been used about 36 times
in different ways, but on different days
and it makes me feel guilty sometimes
i could have coped in better ways

i reach for you like nothing before
no where near the bottle, the blade
i dont want you like the smoke, the noose i almost wore
it came apart, like we did, and so i hoped and prayed

this prose is ugly to the core
my angel would hear me sing
until she started to snore

I was in a shop recently
And a voice said, "Phil!"
I turned to see a stranger smiling at me
I said, "That's me, mate but
You've got the better of me.
The face is familiar," I lied
He said his name was ****
Which limited it to the hundreds
Of Micks that I've met

Then he mentioned his surname
And the dusty rusty cogs of memory
Started to slowly grind into life
By the time I was leaving the shop
I knew exactly who he was
From when we met
About fifty years earlier

We both started our working careers
At the same textile mill
About four or five of us kids
Were the butts of all jokes and tricks
Mostly we would pull our faces a bit
Swear a helluva lot
And laugh it off with everyone else
A lot of how we would be treated
Would depend on our reactions to this
It was normal
Traditional even
Never too malicious and no-one got hurt
He brought his ****** mother down!
I think he left not long after

A couple of years or so later
We happened to use the same pub
He had his friends and I had mine
And we didn't mix, might say "Hi" at the bar
Then....
He got the landlord's thirteen year old daughter pregnant
Then dumped her and said that
He wanted nothing to do with the child
He was at least eighteen then

Now, whether through arrogance or stupidity
Or, more likely, cruelty
He carried on using the pub!
Unsurprisingly
He was beaten up outside
It wasn't serious
No hospitalization or broken bones
Just a softener
Then I was asked to be a go-between
Because I "knew" **** and they trusted me

So I went to his home and spoke to his family
A meeting was arranged I believe
And I don't recall any more
So yeah
I remember you
Ya little ****

                                   By Phil Roberts

Contemplation & Procrastination cause Starvation of Salvation,
Intimidation of Reconciliation cause Deprivation of Sanctification
Hospitalization due to Laceration leaving imperfection, never to see Immaculation
Revitalization of Harmonization based on the Perseveration of Consideration through Consolation.

Devastation & Humiliation cause Trepidation & Depreciation fading Animation,
Disassociation from Civilization & the Population results in Saturation,
Ramifications of a Situation pertaining to Infatuation & Obsession won't bring Rejuvenation,
Desolation & Isolation with out a friend
Desperation & Depression
foreshadow a means to an end

-Ajm

⚠️Trigger Warning: The following poem contains subject matter pertaining to self-harm, suicide, and involuntary psychiatric hospitalization⚠️

I don't recall a whole lot
about my first hospital visit.

I know only the
fleeting
keynotes of the experience.

And I'm not just referring to my first...
psychiatric (?) visit.

(I'm not sure if psychiatric is
the right word,
but I find that I often struggle
to find the right words
when I attempt to describe hospitals
and the time I've spent in them.


I'll do my best.)


See,
I had never been to the
Emergency Room for anything before.

(Well,
except for that one time
I tumbled off the changing table as a baby.
But I'm not sure that really counts,
my only knowledge of the event
having come from second-hand stories.)

Surprisingly enough,
being the clumsy child I was,
I had never sustained
any significant injuries
while growing up,
especially in comparison to my sister
who had a daunting repertoire.

When she was a toddler,
she executed a daredevil jump
from the top of the staircase,
breaking her arm as she crash-landed
onto the basement carpet.

While we were waiting
for her to be fitted with a cast,
I remember her doctor told me
to stop misbehaving.

While I can't remember
exactly how I was misbehaving,
I'm sure it had something to do
with the chaos of my temperament,
a chaos that has churned inside me
for as long as I have known.

Over the course
of my high school years,
when I would make several
appearances at the hospital
due to my own brokenness--
the very brokenness that persuaded
the lacerations on my wrists
and my lust for death--
the doctors would,
in their clinical, roundabout ways,
tell me the same thing:

to stop misbehaving.

In the ninth grade--
this here. this is the first visit--
my guidance counsellor and English teacher
had driven me to the Children's Hospital,
which was only up the road from my high school.

Oddly enough,
I had been relatively compliant.

I had gone quietly,
devoid of the defiant uproar
that seethed under my skin.

Perhaps I acted as I did to prove that,
despite, my darkness,
isolating me from the world I knew
would be a grand disservice to me.

Or perhaps I feared
what would happen
if I was to purposely disobey,
that, upon arriving at the hospital,
I would be treated like the rebel I was,
promptly disrobed of my independence.

The remaining details of the visit
have been resolved to vagueness
as time has passed.

I only know my father  
came straight from work to pick me up.
Before we left,
the doctor gave us pamphlets--
crisis hotlines,
accessing resources
within my quadrant of the city,
alternatives to self-harm.

The doctor dwelled on this last subject;

if I felt like cutting myself,
I could still satisfy the urge
without actually drawing blood.

I could press ice to my skin
or write on myself with markers--
markers not pens--
or snap a rubber band against my wrist,
which was the method
he had particularly fixated on.

He explained he wasn't too keen
on me snapping myself
all the time, either,
but that it was a preferable
alternative until I improved.

"Doc,"
I wish I'd said,
"If only you knew
how lovely it is to bleed."

I am the girl who wakes up extra early to put on a face.
I put it on so good, No one would ever know the brokenness that I have to face.
Family never ask and friends can never tell
Only my pillow knows and is there to catch all of my tears.
Thank you to my pillow who knows my brokenness all to well.
I was sexually abused many of times to the point of hospitalization.
My family knew this family member who admitted to have harmed me, but gave me the
condemnation.
They gave me the evil looks, the you should have said something sooner speeches. The get over its
The it would be best if you would find somewhere else to live, oh and the oh your off our insurance too.
We dont care where you go... As long as we don't have to deal with you!
At church it began with the whispers, and then where I sat in a pew all alone as if I was the disease.
No knows how much I tried to hold my life together.
Only the Heavenly Father and my sore sore knees.
The family members who knew, never asked me
if I was okay, but they didn't know that I was contemplating taking my life every day.
From trying to  black out on alcohol and sleeping pills. Hoping I would wake up and this would all be a dream
To being successful with making that nuise out of my favorite blue bathrobe rope
My dad walked in EVERYTIME and gave me one more day to add to  my life which seemed like a treacherous timeline.
Was this God maybe, was he trying to save me and open up my eyes?
Some of them who knows that all this actually happened said it was for attention and I needed to just drop it, move on, let it go.
Well "you have become negative...maybe it is best if you go"
If I didn't feel like a slave in that house, I sure did now.
I feel like I literally did everything and there was still something my mom would bicker about.
I started noticing she would come up with basically anything to get my dad to kick me out.
I would drive to the park somedays and just sit in my car and cry.
I would drive down old back roads , and think would this world miss me when I die.
Family gatherings  where I once was welcome, I was no longer invited to
I spent thanksgiving all alone, just me and a box of tissues.
Friends invited me to their family events, but I was embarrassed.
I didn't want to intrude.
The friends who did know, I would call crying and they would not know what to say
For they have never felt this broken or had to feel this type of way.
I would sleep with a couch in front of my door and have an alarm set for 4 am
I could finally close my eyes and rest my tired head
4 am is when I felt like it was safe enough to close my eyes and be safe from my predator who crept in the night to finally go to bed
My friends said I was strong, but I really felt so weak.
I felt so gross, so worthless, so ashamed, and no one knew
After trying to recovery from my childhood, I will now have to recovery from this too.
I really would not be here today if it was not for the baby in my belly
And someone saying they would carry me the rest of the way.
these two are my world and the reason I get up every day.
So I am the girl who wakes up extra early to put on a face.
I put it on so well no one would know the brokenness that I have to face.

I wish I could **** myself,
I just don't have the guts.
I'm afraid of pain so I avoid any form of self mutilation,
I just wish I had it in me to get over the pain and do it because the pain in my chest is so much worse than the pain I'd feel.
I don't hate,
I love everyone,
I love everything,
I just hate my life.
It's been 5 years since my first hospitalization,
they put me on medications,
told me I'd feel better.
It's been five years.
Nothing has changed.
I'm still living the same life,
with the same feelings,
with the same self hatred,
the same indescribable pain in my chest.
I'm just waiting for something,
anything,
a sign,
a glimmer of hope,
a reason to believe,
a reason to finally do it.
This isn't really a cry for help,
just another poem.

What is a sin?
Something foul and loathsome
Something done in ignorance
Not knowing the action
Is considered unsavory
To those who sit on church pews
And listen to the hate spewed
From self-righteous mouths
Of self-proclaimed holy men
Bigots I say
According to them no gay should be gay
No happiness for the queer
They’re not born that way, they’re sick
And they require a cure
A cure that entails “hospitalization”
And endless prescriptions
Of “holy” medication
They preach God hates ****
But their words fall flat
Because it is not God who hates
No
God loves
That’s the whole point of God
But they forget this in their “holy war”
On pure and natural love.