precious_poppy: The more I self-injure, the more I want to do it. What do you do then when you have no one to turn to?

Emily J: I think you have to be honest with yourself. Is injuring really working for you? Have you lost anyone or anything because of it? Do you want to spend the rest of your life mutilating yourself? I agree it's harder when you have no one to turn to, but that's why it's important to build a support system. Some examples would be attending a church with a large population of people your age, or something like that.

David: Here are a couple of audience comments regarding "paying for treatment":

Montana: From my experiences, the insurance would not pay the emergency room visits because it was obvious that it was involved with self harm. I have to pay out of pocket.

rig: OH MY GOD! I can't even get any one to insure me right now!!!!! If any one knows of any insurance company that will insure post traumatic stress disorder (PTSD), let me know!

Nanook34: What about aftercare?

Emily J: They have an aftercare group for people who live in the Chicago area, but I live nowhere close to Chicago so I had to build my own support here, after I got back.

David: Are you still in therapy?

Emily J: No. That was a big step for me, because I was very attached to my therapist in a very unhealthy way. She set boundaries with me but I was almost obsessed with her. Saying goodbye was so freeing. The S.A.F.E. Alternatives program recommends that you do continue therapy after the program, but I thought I was at a place where I did not need it, and I have not been in therapy for a year now.

David: Just to clarify, you went into the S.A.F.E. Alternatives program last summer and spent five weeks there as an inpatient, correct?

Emily J: Actually, I spent two weeks inpatient and the last three outpatient. S.A.F.E. owns some apartments right next to the hospital and we stayed there at night when we reached outpatient status.

David: Do you still have urges or feelings of wanting to self-injure?

Emily J: I have not had an urge in quite some time now, but when I first came home, I had them quite often. When I have an urge to self-injure, I fill out an impulse control log, so I can identify what I'm feeling and why I want to injure. After I fill out a log, the urge has usually diminished.

David: The SAFE program is in Chicago, right Emily?

Emily J: Berwyn, Illinois, a suburb of Chicago.

David: Can you describe the impulse control log for us. Can you give us an idea of what it contains?

Emily J: There are several boxes to fill out.

1. time and location
2. what I'm feeling
3. what the situation is
4. what would be the results if I did injure
5. what would I be trying to communicate through my self-injury
6. the action I took
7. the outcome.

David: Here are some more questions, Emily:

twinkletoes: Have you found that other friends from the program you went with, are still injury-free as you are? Or have they relapsed?

Emily J: I met two people in the city I live in, that attended S.A.F.E. Of course, I have many friends nationwide that I still keep in touch with. Most are doing very well and are still injury-free.

jonzbonz: I was wondering how one goes about starting a program of recovery from self-injury without a therapist. I cannot afford one.

Emily J: Most communities have mental health resources where counseling is offered for free or at a reduced rate. Look in your yellow pages under mental health resources. Also, I mentioned the book "Bodily Harm." The book outlines everything the program does and it offers advice and help for people who cannot attend the program.

David: I'll add here, you might try your county mental health agency, a local university medical school psychiatric residency program, even the local women's shelter. You do not have to be battered to take advantage of their low-cost counseling services.

lisa fuller: Is there any medication that is helpful?

Emily J: I didn't find any that helped for my self-injury behaviors.

David: Why did it take an inpatient/ intensive outpatient program like S.A.F.E. to help you stop self-injuring? What did the program offer that your therapist couldn't or didn't?

Emily J: Mainly, time and an intensity that cannot be offered in a fifty minute therapy session. Also, I was surrounded by a group of peers who were struggling with the same thing I was. Unlike most psychiatric hospitals who lump all psychiatric patients together, S.A.F.E. was just for self-injury.