My therapist is a godsend.
Specifically: I have been admitted to the psychiatric hospital so many times I can’t even remember all of them anymore (I have borderline personality disorder, which accounts for something like a quarter of psych hospitalizations, according to this study). There’s a strict procedure for discharging patients, which in my experience is about the same no matter where you go: among other things, you have to spend 45 minutes writing up another damn suicidal crisis safety plan.
A plan which through all of my suicidal bouts over the years, I have never used.
Some people may find the crisis safety plans that hospitals use very helpful; I can’t deny the research that has gone into finding effective strategies for keeping suicidal people out of harm’s way. They just don’t work for me.
But the staff at mental hospitals force everyone to make them. They have a preconceived idea of what your plan is supposed to look like, which gives you incentive to just spew out the raw ideas they want to see, whether you intend to use them or not. The worksheet isn’t personalized to you at all, which is a huge issue – what if, like me, you’re the kind of person who can’t even move when you’re suicidal, let alone practice self-care techniques? What if you don’t have the energy or strength to call someone? In the hospital, they tell you to write down coping strategies and phone numbers anyway, so oftentimes you end up making a plan that’s totally impractical.
“So let’s think practically,” my therapist told me last week, because she is, as I mentioned, a godsend. “What will actually keep you safe when you want to self-harm?”
I couldn’t come up with anything that felt truly helpful.
“Then you could just lie down,” she suggested, and I swear it was like turning on the lights in a room I didn’t even know was dark to begin with.
“I… what?” Just lie down? That wouldn’t be taking action! The idea that I could just do nothing, and my PhD psychotherapist actually endorsed that, was a complete shock to me. But I fell in love with it immediately. It was the first crisis safety suggestion I’d ever heard that felt intuitively like it could actually work.
So why hadn’t I tried it before? The answer, I realized with my therapist’s help, was self-judgement. I’d simply never given myself permission to to just lie down.
“I’m a loser if I don’t get something done today.” “Sleeping another hour would be a waste of time.” “Only lazy people lie in bed all afternoon.” I would never say any of these things to a sick person. But I believe they’re true about myself. I repeat them in my head every time I need to lie down, which is quite frequently – but when I really stop and think about it, I realize I’m the only one saying these awful things about me. The problem is that I don’t often stop and think about it.
This week I’ve been making an effort to notice little self-judgements like these that keep my self-respect low and my psyche exhausted. As it turns out, there are a lot of them flitting through my brain on an average day – small beliefs I harbor about my worth as a person that are negative, pessimistic, and damaging. Sometimes I even judge myself for judging myself so much! My negative self-beliefs usually circle around the things I’m not getting done, like writing or studying. But you know a really, really great way to make sure those things stay undone? Judge yourself for not doing them.
I don’t have a magic bullet solution for finishing your to-do list or losing weight or doing a better job at work. But I know that for many of you, disliking yourself is a huge barrier standing between you and your goals. I don’t recommend you drop everything and start loving all of yourself right now; that, as my therapist says, would be impractical, and a great way to end up crashing and burning by starting out way too ambitiously. However, noticing your self-judgements is the first step toward dismantling them.
Noticing is a simple but difficult process. It means being fully honest with yourself, and stating in plain terms what the reality of the moment is. Noticing judgement is more like looking at it than actually feeling it. Psychologists describe this process as taking a figurative step outside of your brain and just observing what’s happening there without getting caught up in it (this is a basic technique called mindfulness that’s involved in many therapies, especially dialectical behavior therapy).
Noticing your thoughts isn’t the same as telling yourself what you should be doing. “Shoulds” are nasty little creatures designed to make you feel badly about yourself. They’re ugly and they breed in shame. Noticing, on the other hand, allows you to take control of your thoughts, feelings, and actions without guilting or shaming yourself. Which version of this sentence makes you feel more accepting of yourself: “I’m noticing that I’m judging myself for procrastinating” or the more commonly heard “I shouldn’t be procrastinating”? Hear the difference?
So when you can, practice taking a moment to breathe, figure out the difference between how things are and how you want them to be, and then finish the sentence that starts with these words:
“I’m noticing that I’m judging myself for ___.”
If eventually you feel you’ve gotten good at honestly and automatically distilling your self-judgements down to an unabashed truth and admitting them to yourself, then that’s when the real change can begin. Try adding improvement-promoting phrases slowly and one at a time like “I’m noticing that I’m judging myself for (sleeping in, etc.) and I would prefer to be (getting out of bed now, etc.)”. After some practice with that, you can begin to repeat action-oriented mantras, like “I would prefer to be (practicing my instrument, etc.) and I’m going to start (practicing my instrument, etc.) right now.”
With less self-judgement in your way, taking action becomes much, much easier. But like every type of therapy, it’s a process, and it takes time to achieve – so don’t be too down on yourself if change doesn’t come right away. Just be honest with yourself about what’s practical, even if it means finally understanding that the suicidal crisis safety plan the rest of the world uses doesn’t work for you.