CW: extreme self-harm

This is very hard for me to write, so I hope you will pay attention. I’m only going to talk about it once, and never again. I am not doing this for sympathy—in fact, it’s the last thing I want to post on twitter, but I’m posting it because it’s important. https://twitter.com/exavierpope/status/1386657130036580352
This used to be me. There are maybe 5 people in the whole world who knew this about me, until now.

I am only reposting the video because it is a mirror-image of me, and I’ve never seen others do it, but I know from therapy that I am not the only one.
I have type 1 bipolar disorder. Some have said this behavior is also common to people with autism as well. I don’t know anything about it, so that speculation is better left to autistic people.
The man, in case you aren’t 100% sure on it, is not “smacking” himself in the head, he is *punching* himself in the head. Then he slams his head against the hardest thing in front of him. After that, he hides and sobs. I bet if the video kept going, you would hear him scream.
I used to do this about once a month. That turned into once a week. Eventually, it became once per day. But I didn’t tell anyone.
It hurts afterward, it hurts a lot. I have caused not only welts and lumps on my temples, but also open cuts—just from the sheer force of the hits. If someone you love does this to themselves, it will scare you. It will shake you to the core.
It can cause brain damage in the person doing it.

So, the obvious questions are: where does it come from? How does it happen? Why would anyone do this to themselves?
It has its roots in deep feelings of shame, anger, guilt, and an unshakable darkness that plagues our minds. There might be a traceable precipitating incident, or there might not be anything at all that an outside observer can point to.
The bipolar cycle often looks something like this: mania -> rage -> guilt -> powerlessness -> depression -> ideation. That has some accuracy, but it doesn’t tell you much. What do these things look like for us?
Here’s an example: someone tells me I’ve done something wrong. Maybe it’s an issue I care about deeply and already feel incompetent or guilty about, maybe it’s been told to me by someone I love, maybe I had an imaginary conversation in my head with someone else and it escalated.
More times than not, I was catastrophizing a small and honest criticism, but occasionally I was actually guilty of emotional harm to someone I cared about. 95% of the time it happened because of past trauma visited upon me as a child.
So. Now you’ve got the outline, but how does this lead to literally punching yourself in the head? Remember: this can cause *brain damage.*
Here is a concrete example from my own life, and it was the main cause of my daily self-harm: I am always alone in the house on weekday mornings, as my wife works a day job and I do not. It would start with a conversation in my head.
This could be any conversation; something “minor,” like an argument from recently—or perhaps long ago. It could be that a noise or an image triggered an emotional response that reminded me of trauma I suffered as a child. It could be my dog barking too much on a bad morning.
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