a compromise adaptation to the problem of suicidal ideation

I struggle constantly with suicidal ideation. (Perhaps these thoughts are instead best described as thoughts of self-harm; I’m not sure where the dividing line is between self-harm and suicidal ideation).

I do not ever plan suicide attempts, nor do I want to die. I never make arrangements for suicide. I don’t have any thoughts that life is not worth living.

So what gives?

What I do get I refer to as “impinging” thoughts of harming myself in a fatal way. For example, the most prominent images are of slashing my left wrist with a knife or blowing my brain out with a pistol.

Cause? These thoughts are often my first response to an emotional frustration, usually related to heartbreak or an argument with someone I love. I developed this pattern from living with an abusive partner for many years—I believe it is a PTSD symptom. It is a very short neurological circuit. Fires extremely rapidly.

Frequency? When I’m mentally stable (I have bipolar disorder), I get about one of these thoughts a week. At this frequency I don’t worry about them much. When I’m extremely mentally ill, these thoughts imping on me several times a minute. And the methods I imagine for harming myself get more creative. At these times I fear loss of control over myself—fear that such thoughts will become an impulse and I’ll follow through with the impulse. In my day-to-day life the frequency lies somewhere in between these extremes.

Now I manage this somewhat well most of the time: I don’t own any guns, I keep my razor blades locked under my trailer in the toolbox (so I can’t reach them on impulse), I take medication, and work with appropriate professionals.

However, I still carry the burden of the impinging thoughts, and they drain a lot of energy out of me as I consistently “talk back” to them.

I’ve made effort to rewire the neurological circuit that leads me down this path, with no success so far (I’m going to keep working hard at it).

But the following compromises have been successful:

1. For the image of slashing my wrist with a knife, I now imagine missing my wrist entirely while handling the blade. In other words I visualize pushing the blade into thin air.

2. For the image of blowing out my brain with a handgun, I now envision the process in reverse: The bullet flies back into the gun, my gray matter flies back into my head, and the bullet entry and exit wounds heal.

These simple visualizations have greatly enhanced my power over these impinging thoughts; reducing the energy I expend dealing with them.

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