TRIGGER WARNING: In this post, I will be talking about self-harm and self-injury.
I think that one of the reasons why it was so difficult for me to receive an accurate diagnosis of borderline personality disorder is because I did not have any overt self-harm behaviors. It’s probably also one of the reasons why I doubted that I had BPD. I had read books by other women who had the condition and some who had even overcome it, (see the Resourcespage for recommended titles), but until I was in an intensive outpatient (IOP) treatment program and looked at the criteria for the diagnosis (and realized that self-harm was one of many variables that didn’t necessarily have to be present), that I realized I did have BPD.
I didn’t realize until later that I did, in fact, engage in some passive self-harm behaviors that I later shared with my therapist. This included not taking care of myself by responding to hazards, such as slippers that were really worn. I would get depressed and not care about myself, and even though I knew that my worn slippers often cause me to slip and fall and get cuts and bruises, I opted to allow that to happen and to be injured rather than to take care of myself and get a new pair of slippers. I know this may sound really confusing or bizarre for someone who does not have this disorder or who has never experienced anything like this type of behavior. The bottom line was, with things like this, and, for example, not taking safety precautions to prevent myself from getting burned while cooking, all came back to the same underlying problem: I believed I deserved to be punished, and I created opportunities for that to happen, albeit in a passive way.
So, while I wasn’t actively cutting or burning myself, which are the more typical, well known, deliberate self-harm behaviors, I was still technically engaging forms of self-harm. I also learned that slapping yourself on the head when frustrated and angry at yourself also counts. I imagine I can draw the connection to having been abused as a child to believing that it was okay and warranted to abuse myself. It took a lot of intentional generation of self-love, talk therapy, a willingness to discover a feeling of connection to something greater than myself, and intensive DBT (dialectical behavior therapy) to overcome this type of behavior.
Perhaps even more troublesome than the passive physical self-harm for me was the more overt self-sabotaging. Because it often felt uncomfortable or even awkward to experience success or “things going right,” I often found myself having crisis after crisis, whether it be in relationships, school, or work. There was always some type of drama, and I was always at the center of it.
The crisis almost always left me feeling desperate and afraid, wanting someone to come and rescue me, take care of me, reassure me, and make me feel whole. I attempted to have all of these needs met by repeatedly showing up in the emergency room and ultimately being referred to psychiatric services. As you can imagine, these things did not fill the void.
Going to the hospital did make me feel safe. I did felt taken care of. I did feel rescued. But I didn’t feel reassured and whole. Those were things that I could only give myself. And, they took time. Lots of it. And, it didn’t come easy. I really had to work hard for it. My life looks very different now than it did three years ago. I am in recovery and actually teaching these skills once a week online to students all over the world at DBT Path with licensed therapist Amanda Smith, LMSW.
I consider it a great privilege that the universe now allows me to connect with men and women all over the globe who are dealing with the issues that come up when you are emotionally sensitive, have difficulty regulating your emotions, and are ready to make real changes. I no longer engage in the passive self-harm nor the self-sabotaging behaviors. Believe me when I tell you that if *I* can do it, I have hope that YOU can do it, too.
It took hitting my own personal rock bottom to really take seriously that I needed to change my life. What will it take for you? What will it take for you to realize how precious and valuable and amazing you are? What will it take for you to realize that you are worth the time and effort to heal the wounds of your past so that you can build a life worth living? What can you do to support your healing recovery goals?
Thank you for reading.
More soon.
In kindness,
Debbie
Check out this article and free downloadable PDF on Understanding Non-Suicidal Self-Injury (NSSI). Share it with those you love it they need help understanding.
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Learn DBT Skills Online at EmotionallySensitive.com These are the skills that helped this blog’s author overcome BPD!

I only engaged in self-harm a couple of times as a teenager, years before I was diagnosed. Other than that, all of my self-harm has been passive, the same as yours. Have shared this important post on my blog. Thanks for such a great article, Debbie!
Debbie, as always, your post hit home. Except for the visits to the ER, this is me to a T. Even now, in my 50's, I am still struggling with this. Your kind words, gentle attitude and positive example give me hope. Thank you! All my best to you <3
I believe it's my 11 (or 12, I don't know) history of aggressive self-harm that really catapulted me into the BPD label (well, technically traits). But as you have mentioned the more passive forms of self-harm often go unnoticed but the intention to harm is still there. I guess the passive methods actually require others (maybe even ourselves) to ask us if we are trying to hurt ourselves.This can be uncomfortable. I'm really bad at using psychiatric drugs as a passive method of self-harm (especially since these drugs are viewed positively by most). I know my reaction to those drugs can be very severe but sometimes I want to be on them because of that reason.
Thank you for writing this post! See you in class!
-Kristen