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Doc,

I am coming to you for advice because going to an actual therapist might have ramifications for my job. Generally it's frowned upon for a Special Forces operator to have mental issues. If I approached a therapist I could be putting a job I LOVE on the line.



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But I have recently realized that I may have a problem with Self Injury. The first time I cut myself I was completely drunk. My Girlfriend whom I love very much, and I were having issues. One of the issues was my unfaithfulness. I believe that there is a lot of guilt associated with that. Anyways, that was the first time I cut myself. I believe it was around August of 2006. I again was having issues with the same girlfriend, and I again was drinking, and cut myself several times. I believe that was around June of '07. Last night I was having issues, again with the same girlfriend, and she had my knife in her hand. I told her to close it and then grabbed it from her, cutting her hand in the process. She was drunk as well and freaked out, understandably so. I was mortified. I would never hurt her, ever. I freaked out and as she was being cleaned up by her friend, I left and cried and cut my arm. It wasn't enough. So I pushed the knife into my thigh about a half inch. It bled a lot and I sobered up very quickly, realizing that I was acting F-ing ridiculously. I felt stupid for doing it and immediately went back in to check on her, comfort her. Be the man I know I am.

Jane we'll call her, knows about every time I've cut myself. She's kissed the scars on my legs and has never judged me. I love her, and she loves me unconditionally. She is a rock for me.

Doc, I need to stop doing this. I've never cut myself sober, or had any desire to hurt myself at all while sober. Normally I can handle our issues and be just fine. I've never thought about cutting myself ahead of time. I just seem to impulsively do it in these situations, I don't think I feel a release. I believe some of it has to do with externalizing my pain. Last night it was just about making myself bleed because I made her bleed. I think somewhere I just wanted to make myself feel her pain, maybe.

I've just been reading a lot of articles on the internet. Some information is helpful--other information doesn't seem to pertain to my situation. I am not the victim of any sort of family issues, incest, or molestation. My parents are still happily married. I have friends that love me and respect me. I own a house, own my car, I have a job that I've wanted to do since I was 11. A very difficult job, that makes me so proud to be a part of. In all other aspects I believe I am a healthy individual. The scars are starting to show. . . the cuts a little deeper. and I think it's time I look for some help and advice somewhere. I am starting here. I am not totally adverse to the idea of going to a therapist. I will pay for it out of my own pocket and my employers will never know if I have to. But I have a serious alpha personality and this is a weakness. I don't fail. I don't let others have control of me. I am a strong individual, I never need anyone's help. But right now. I feel a little weak and I am asking for your frank and honest advice.

I love that girl. She is not the issue. I deal with our problems just fine sober. Maybe drinking is the problem. I am willing to entertain the idea of not drinking. Those two factors are obviously my catalysts, drinking and my GF, but Mostly I just think I don't cope well with things when I'm drunk. Do you have any advice for me?

I am 23 years old and I live in Virginia

Signed,

Philip B.





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Hello, Philip--

I have written about cutting and self-injury elsewhere. Perhaps you already have read that piece. I understand that you have been doing some research on the web, and apparently have gotten the idea that cutting is usually a response to family violence, incest, molestation, or some other violation of childhood boundaries, but that is not the case. Self-injury can be a way of coping with the aftermath of such violations, but cutting, as I wrote earlier, "may serve many purposes in the psychic economy--expressing anger which one is afraid to manifest openly; escaping from emptiness, depression, or feelings of numbness or unreality; preventing suicide; expressing or repressing sexuality; continuing abusive patterns from earlier childhood; attempting to remind oneself of physical reality as a way of dealing with feelings of depersonalization and dissociation; establishing a feeling of uniqueness or of being somehow special; [or may be] a way of being 'in control,' in other words, an attempt to deal with an internal sense of powerlessness, helplessness and anger."

Now you work in a high-stress occupation which demands great discipline, self-control, obedience to command, and the ability to see other people not as human beings like yourself, with lives of their own, girlfriends like yours, or families who depend upon them, but as enemies who must be neutralized, even if that means killing them. In other words, Philip, your work demands that you dehumanize yourself to some extent simply in order to be able to do the job. I understand that you love your job, and obviously it is a job which needs to be done, at least sometimes, but you must realize that such work extracts a great psychic toll on the people who do it. Not just the work itself, but even the training for it come at a great cost to the individual. I have never known a Special Forces operative, but I have worked with both SWAT team cops and prison guards, and I have seen firsthand how psychologically demanding these jobs can be. And one reason that such jobs are so demanding is that being able to kill on command requires building a solid wall, an impregnable membrane, between ones professional self, which must be ready to obey and to act without considering human values, and ones real self, which includes weakness, fear, sentimentality, tenderness, compassion, and all the other human feelings which might prevent a man from pulling the trigger when necessary, or at least slow him down, perhaps fatally.

Now you describe yourself as a type-A guy, a strong individual who never fails and never needs help. I understand what you mean, I think, but that self-evaluation is unrealistic. It only describes what is on one side of the membrane, not the other. We all fail from time to time. That's just human. And we all require help at times. That's just human too. Fortunately, you have been able to admit to feeling a bit weak and out of control, and have reached out to me for advice. This admission that you require help and advice is not a sign of weakness at all, in my opinion, but a sign of psychological strength--strength which might allow you to see things less according to some impossible macho ideal, and more as they really are. Since you seem to have that strength, I will address your situation head on, but please be aware that without knowing you personally, my advice can be based only on what you have written, and so is likely to be incomplete at best.

That said, I believe that you cut yourself whenever your real self--the one stuffed away behind the tough guy mask--threatens to emerge. In other words, I believe you cut yourself to prevent breaking down entirely and expressing through words and tears the shock, sadness, and depression that I imagine you must feel, at least unconsciously (behind the mask, that is) at having started out an innocent child and ended up a young man trained to kill on command. This is not to say that your work is wrong or unnecessary. That is a moral judgment I am not prepared to make. I mean to say only that your work requires, in order to be able to do it at all, that you isolate your awareness somehow from some of your gentler and more vulnerable feelings by stuffing them away behind a membrane of toughness, a membrane of macho pride in never failing but always completing the mission, a membrane perhaps of patriotism. But the membrane is not totally impregnable, not totally waterproof. It can leak, especially under certain circumstances, as you so rightly observed, such as the presence of catalysts like alcohol and the guilt you feel over betraying your girlfriend whom you love but do not totally honor.

If this rings true, and I expect it will since you already know it, my advice is that you get some specialized therapeutic help with this. If you have to pay for it yourself, that would be, in my view, money well spent. In the meantime, try to cut down on the alcohol and other women. Neither of those things, to which I imagine you turn whenever your fears, anxieties, and depression threaten to surface, can do you any good.

Be well.









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