Advice please

[purposeful]

I am a 37 year old woman, and believe or not, I am in a great relationship and have been the happiest of any time in in my life. My concern and fear right now are my compulsive scab picking, binge eating - although improved - and my addictive tendencies towards gambling, smoking and computer games.

I have over 30 scars on my forearms, lower legs and shoulders and now I have started in on my face. It's hideous and sickening to look at, but for me, it's even more disturbing and hideous that I continue to do this even though I know it's a problem.

I am ashamed and I experience severe anxiety when I think about explaining the picking compulsion and self injury to anyone, even a therapist. I am at a point where I feel completely beaten down.

I know that trauma is a major part of this. I was probably molested as a child. I say "probably" because I don't know but I have enough insight to recognise this. My mother died when I was 10 and I left home at the age of 15 after dealing with an alcoholic father who was verbally abusive and neglectful. I lived in foster care for nearly two years before a wonderful cousin took me in. Shortlly there after, I was raped after passing out in a car following my drinking episode. I have not allowed myself to even think about the sex as rape until recently. I attempted suicide two times following the rape but I never connected that action to the rape and/or grief to my suicide or depression, nor did I find the 10 day hospital stay helpful.

A short while later, I was verbally and physically abused by my ex-husband to the point of strangulation. I was stabbed with my latest ex who, sadly but true, I found through sobriety nearly five years ago. Just last month, this same person was on the news for burning down a house. Crazy and unbelievable stuff and crazy and unbelievable me for being in these circumstances.

Now that I am in a caring and loving relationship that couldn't be any better, all of these traumatic events in my life constantly creep into my thinking. I've told my partner the easiest things - like my mother dying and the stabbing and how I feel responsible and guilty that I left my brother and sisters in the home - but I haven't had the courage or the self esteem to reveal the rape, self injury and suicide attempts. My dark, dark secrets, I guess.

I have had therapy for years and never dicussed these situations at length. I have received the diagnosis of major depressive disorder, and in earlier years, an adjustment disorder. I currently take cymbalta and adderral for energy, in addition to regular pychiatric appointments where I struggle to be honest. I am so ashamed that my psychiatrist doesn't even know about my self injury. Why can't I trust anyone and why can't I let go of my shame and guilt of my own and other's actions?

Please help me to find a recovery facility or outpatient program in the San Diego area that can deal with a whole multitude of emotional problems. Obviously I need it.

[Mark]

You're doing some really good things for yourself, first of all. That therapy you're in is a right direction. You've gotten yourself sober (which helps you with your judgement). You've learned to recognize abuse in a relationship and now you have found yourself a relationship you are enjoying which doesn't harm you. Despite this positive momentum, there are still many difficulties (the low-level self-injury scab picking, and more than anything the shame. You don't say it but I'm reading between the lines and seeing someone who probably feels not very good about herself and feels deserving of punishment. Please correct me if I've got it right, because I'm only guessing here. You seem focused on what is still bad right now, and that is very natural, but let me just point out that youv'e come a long hard way to be where you are today, and that shows your strength and desire to heal. Life has gotten better, and that accomplishment of yours (you did it) is something to celebrate.

Two issues today are how to deal with the shame and the anxiety (which is really the shame kicking into gear I'll bet), and how to work on the self-injury. Hard to work on the self-injury without first understanding what that behavior accomplishes for you. Do you experience it as a self-punishment? Is it a compulsive thing you do without realizing it? Is it deliberate? Please talk about what your experience is as someone who is picking at yourself and that might help us. If we can start to understand how the behavior functions for you (what it accomplishes) we can have a better chance of understanding how to alter it.

The shame is paralyzing. It is keeping you from moving forward with things you'd like to accomplish it seems. You'd like to be able to talk about the rape and other traumas but the prospect is too frightening. Do you have a sense of what is frightening about sharing this information with a therapist? Are you afraid of being rejected, for instance, or being taken advantage of again? If you can get a handle on what it is you are fearful about sometimes you can get some leverage on the fear. Often the things we fear are not really all that fearsome when you examine them up close.

[nightfalls]

Hi purposeful,

I just wanted to let you know that you are not alone in the stuggle to be honest with Dr's I have finally made an appointment to talk at the end of the month and all I can think about this is what do I say? and what mabe should I not say? I guess for me I am afraid of what they will think of me if I say it all. I always wonder what people are thinking around me. My husband does know all of it though and sometimes I wish I had not said it, but how can you hide it forever I think it is imposible. Probibly better to tell him on a good day then have it all come out on a bad day. take care.

[janet]

I am one who also found strength first in a therapy, and with my wonderful husband now. He helped me by sharing that he cut at one point in his life. WOW that was the first time in my life that I actually believed that someone new what was going on inside me. Most people have no clue how to handle this self injury thing. That just makes the mind worse.

I found that when I would just state to anyone the truth about myself and what I have done that is "bad" and not worry about how it would make them look at me or how they reacted to what I said- I did not cringe at myself. Why you might ask? It is the simple task of being truthful for my own sake, to save myself. In the 4 years that I have gone without hurting ME have been the greatest gift I have been given- and I gave this gift to myself. I no longer have skeletons in my closet or a door on that closet. I am an open book to those who chose to be in my life. This is a whole lot easier to live with than living with secrets and shame for things in the past that we can never change. All we have is the present day and we have to live in the body and mind that we are in so be truthful and honest and the pain inside does become small worth handling.