"I'm cutting myself” The voice on the telephone was high-pitched
and quavering. "I'm cutting myself right now! Ow! There, I've started.”
The voice howled with pain and rage.
Twenty minutes later, the clinician had Josephine's address and her
promise that she would come in to the emergency room right away. Two hours
later, her left forearm swathed in bandages, Josephine Armitage was sitting in
an office in the mental health department. Criss-crossing scars furrowed her
right arm from wrist to elbow. She was 33, a bit overweight, and chewing gum.
“I feel a lot better,” she said with a smile. “I really think you
saved my life.”
The clinician glanced at her nonswathed arm. “This isn't the first
time, is it?”
”I should think that would be pretty obvious. Are you going to be
terminally dense, just like my last shrink?" She scowled and turned 90
degrees to look at the wall. "Sheesh!"
Her previous therapist had seen Josephine for a reduced fee, but had
been unable to give her more time when she requested it. She had responded by
letting the air out of all four tires of the therapist's new BMW.
Her current trouble was with her boyfriend. One of her girlfriends had
been "pretty sure" James had been out with another woman two nights
ago. Yesterday morning, Josephine had called in sick to work and staked out
James's workplace so she could confront him. He hadn't appeared, so last evening
she had banged on the door of his apartment until neighbors threatened to call
the police. Before leaving, she'd kicked a hole in the wall beside James's door.
Then she got drunk and drove up and down the main drag, trying to pick up a
date.
“Sounds dangerous,” observed the clinician.
“I was looking for Mr. Goodbar, but no one turned up. I decided I'd
have to cut myself again. It always seems to help.” Josephine's anger had once
again evaporated, and she had turned away from the wall. “Life's a bitch, and
then you die.”
“When you cut yourself, do you ever really intend to kill yourself?”
“Well, let's see.” She chewed her gum thoughtfully. “I get so angry and depressed, I just don't rare what happens. My last shrink said all my life I've felt like a shell of a person, and I guess that's right. It feels like there's no one living inside, so I might just as well pour out the blood and finish the job."
DSM-IV Made Easy: The Clinician's Guide to Diagnosis. James Morrison.