The above has the outline for a crisis plan if you have Borderline Personality Disorder...
I badly need a better plan than grabbing for something with which to hurt myself...
***
"A safety plan is a critical part of treatment for borderline personality disorder (BPD).
People with BPD are among the most at risk of attempting suicide, or engaging in other high risk activities.
Without a safety plan, you may be in danger of harming yourself or someone else." (I'd NEVER harm someone else...no matter how far i was pushed...i only ever harm myself!!
"A safety plan can reduce your risk and make it less likely that you will make a decision in the heat of the moment that will have serious consequences."
"Ask Your Therapist About A Safety Plan" -eh, ok if she ever gets back to me...
"If you have BPD, you should be working with a mental health
professional on a safety plan." (then why on earth am i finding this out online!! The NHS has a lot to answer for!!!)
"If you and your therapist have not
yet developed a safety plan, ask them whether this is something you
should do together. If you do not have someone to work with on this,
find a therapist" (Nah, you're ok, i'll give it a bash myself...it's better than the harmful coping mechanisms i turn to at the moment...)
***
"Target Your
Safety Plan: Evaluate Your Risk Behaviors[sic]
Once you have enlisted your therapist, you can have them help you to evaluate your risk.
Once you have enlisted your therapist, you can have them help you to evaluate your risk.
For example, do you have thoughts of suicide?
Urges to harm yourself?
Thoughts of harming other people?
Problems
with violent behavior?[sic]
What symptoms or behaviors[sic] do you have that
put you most at risk of harming yourself or others?
These will be
the targets of your safety plan, so it is important that you think
carefully about what behaviors[sic] you may need to plan for.
Along with
evaluating your risk, you should evaluate whether there are factors
that may be increasing your risk of completing a suicide or harming
others.
For example, are there firearms in your home?
Are there
medications in your house that could be used in a suicide attempt?
Are there other items that might make it easier for you to harm
yourself or others?
If you
answered yes, you need to work with your therapist on a plan to get
rid of these items or to reduce the likelihood that you will use
them.
For example, can you get your medications prescribed in
smaller quantities?
Can you leave firearms at the police station?"
(*Doesn't everyone have thoughts of suicide?
...Well, okay, i have them every day at the moment...and almost complete my plans when something comes along to knock me further down than i already am...
*URGES to hurt myself?...varies from moment to moment but it is a daily occurrence just now as i try to get through the day. I have come to the conclusion that making it through the day with cuts or burns is better than not making it through the day at all...although, this thought is very often turned on it's head inside my head.
*Harming others?...i have dreams of harming -very badly- people who have hurt me...like the ones described in flashbacks in other parts of this blog...i dream with the flashbacks of the actual events but then the ending twists to me hurting them and 'winning' ...and i wake up feeling horrible and like a bad person, even though it was only a dream...
*Violent behaviours? ...i am very violent towards myself and only myself...(though i may throw a phone/ipod etc in anger) ...i mostly only punch/cut/burn etc myself.
*I am pretty impulsive and that is a bit of a worry for me...i worry that if too many overwhelming things come along at once then i will reach for that rope...
**My flat has no firearms...not very many of them in the UK really i guess...
**I have a great many medications but will not be getting them in smaller amounts as this means more trips out of the flat which means more cutting and burning as it's the only way i can get out of the door these days...besides i don't think i'd ever take them all as i have -sadly- researched the statistics for overdosing in this country and the chances are high that i'd be found and kept alive and probably than a worse-off state than i am already...)
***
"Identify
Triggers for High-Risk Behaviors
Once you have a list of the behaviors or symptoms that put you at risk of harm, identify the events, situations, people, thoughts, or feelings that trigger those behaviors or symptoms.
Once you have a list of the behaviors or symptoms that put you at risk of harm, identify the events, situations, people, thoughts, or feelings that trigger those behaviors or symptoms.
For example,
many people with BPD have abandonment sensitivity, which makes
experiences of real or perceived abandonment very painful. For those
individuals who suffer from this symptom, abandonment experiences
may trigger suicidal thoughts or thoughts of harming others. Think
about the events or thoughts that tend to trigger urges to engage in
harmful behaviors [sic] for you, and create a list of triggers."
***
"Make a
Safety Plan for Coping Resources
Now, identify how you can respond to your triggers in ways that will keep you safe. These will be coping resources that you will use before your symptoms become so intense that you are having a mental health crisis.
Now, identify how you can respond to your triggers in ways that will keep you safe. These will be coping resources that you will use before your symptoms become so intense that you are having a mental health crisis.
Make a list of
coping skills that you are familiar with and that work for you, as
well as sources of social support, and people/places that can help
you if you need it. For example, do you use mindfulness skills when
you are starting to have negative thoughts about yourself, and do
these skills help you to let go of negative thoughts before urges to
harm yourself begin to happen? Do you have a friend you can call who
is a good source of support when you are down?
Next, write
down things you will do if your coping resources do not work and you
experience a mental health emergency or crisis (e.g., your urges to
harm get to the point that you are at immediate risk of committing
suicide or to harming or killing someone else). Is there a hospital
nearby that you can drive to? Do you have an emergency phone number
on hand (e.g., in the U.S., the National Suicide Hotline:
1-800-273-8255)? If you are not sure what you could do in an
emergency, read this article:
Write Out Your Safety Plan
Now it is time to put it all together. You have a list of your risk behaviors [sic], your triggers, ways you can cope before symptoms become too intense, and ways you will respond in the case of an emergency. Put these all together to give yourself a step-by-step plan of action.
For each risk
behavior [sic], write out the triggers for that behavior [sic], the coping
responses you could engage in if you experience a trigger, and what
you will do if the coping responses do not work and you begin to
experience an emergency situation. Continue until you have a safety
plan for all of the risk behaviors [sic] you identified."
Behaviour Trigger Coping response
Self Harm Too many emotions at once Sort through things in small parts
Self Harm Feeling numb Talk to another human being
Not eating Feeling worthless Think of positive things about self (!)
Self Harm Too many emotions at once Sort through things in small parts
Self Harm Feeling numb Talk to another human being
Not eating Feeling worthless Think of positive things about self (!)
"Make a
Safety Plan Commitment
The last step is to make a commitment to your safety plan. This means committing to yourself that you will follow this plan when the need arises, and then committing out loud to someone else (e.g., your therapist) that you will follow this plan. This is also called “contracting for safety.” In fact, sometimes your therapist will have you actually sign a statement saying you will follow the plan."
The last step is to make a commitment to your safety plan. This means committing to yourself that you will follow this plan when the need arises, and then committing out loud to someone else (e.g., your therapist) that you will follow this plan. This is also called “contracting for safety.” In fact, sometimes your therapist will have you actually sign a statement saying you will follow the plan."
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