Struggles With Homicidal Urges

Published: May 01, 2014
Dear TeenHealthFX,

I used to struggle with very bad homicidal urges that eventually led to me attacking a classmate. After the initial assault (for which she didn't press charges), the urges got even stronger and I was tormented for many months. I never felt guilt about hurting her, though I did have initial panic at possibly being arrested. The urges eventually subsided, but then I started becoming suicidal and began cutting. Although I never tried to commit suicide, I did come very close once and had to be talked out of it by a close friend. My mother took me to a therapist where I accidentally revealed that I was cutting. Although I have been in therapy for a while now, I doubt I will make any progress. *The suicidal feelings aren't very important, because I can easily be talked out of it if someone catches me before I go through with it. *I'm too afraid to talk about what happened with my classmate. I twisted a lot of the details about what happened when I talked to my mom and officials about it, and I also managed to get to my classmate before she gave her report on what happened, so I convinced her that I was very sorry and didn't mean to hurt her. I'm afraid of what will happen if I tell my therapist the full truth. I don't want to get in trouble. I also fear that he will doubt my story, or that if he does believe me, he will become frightened of me and think differently. *I don't actually want to stop cutting. I know it's bad for me and that I'm hurting my friends and family, but I like cutting. It's like smoking. It's a bad habit but it makes me feel a lot better. I'm only in therapy for cutting to placate my mother and Hannah. In general, can you tell me what might be wrong? Why did I have homicidal urges followed by self-harm and suicidal thoughts? I know you can't diagnose online, but even a foggy idea would be better than nothing at this point. Should I not bother with therapy since it's not working for me? If it helps, I was abused sexually by my first boyfriend when I was 10.

Dear Struggles With Homicidal Urges,

You really can’t say therapy is not working for you because you never made any real investment in it. The appearance of doing something is not the same as doing something. You readily admit that you are going to placate your mom and that you have not been honest with your therapist. Your fear of getting into trouble if you tell your therapist the truth is unnecessary. The circumstances for breaking confidentiality focus on self-harm or harm to others that could occur in the near future, not on past events. The reason you cannot be honest with the therapist concerning the assault, is that your actions and impulses are very frightening, so you avoid dealing with them. Your actions were not good but it does not necessarily mean you are a bad person. Homicidal and suicidal urges are very often the signs of an underlying psychological condition. For example, suicidal ideation is a primary symptom of depression and homicidal ideation is often associated with repressed rage. In both cases the person can have relentless compulsive and intrusive thoughts that he/she could eventually act out on. 

You will do yourself a great service by staying in therapy and being honest with your therapist. There is an old saying that you can’t save face and your butt at the same time. It is very hard to admit things that you are not proud of but it is the only way to free yourself of them. Your therapist is there to help you make sense of what is going on, not to make judgments. Keeping everything inside will only make you sicker.  If you want conformation of this you only have to look at your own words; “the urges got even stronger and I was tormented for many months.” 

If you follow TeenHealthFX you know that we support the theory that cutting used as an unhealthy coping mechanism. You can compare cutting to smoking, but these are compulsive habits that have significant health consequences. Leaving dishes in your room is a bad habit. Cutting may make your feel better right after you do it but it does nothing to address the problem. Since the source is still there, the stress will build up again, which results in the need to reduce anxiety which leads to cutting. Eventually it becomes a rapid and vicious cycle that person becomes a slave to. 

What’s wrong is that you are not giving yourself a fair chance to have less pain in your life. Therapy will work but only if you are honest. That also means being honest with yourself and not being afraid to share your fears. In your last line you slipped in; “If it helps, I was abused sexually by my first boyfriend when I was 10.” TeenHealthFX suspects that you have never really talked about this traumatic event in therapy since you don’t seem to place much significance on it or recognize the role it might be playing in your current situation. 

Therapy is an investment in you. Make that investment for you, because you are worth it.

Signed: TeenHealthFX