You said it yourself, it is hard to get better. It is very hard work.
I did a lot of self-sabotaging myself. Honestly, I liked the feelings that resulted from it. The adrenaline rush, panic, self-loathing, self-condemnation, and it helped me to isolate in this world cause I was so different from everyone else. I was 'naughty'. I was confirming it...making it so.
This is what is so tricky for me to understand. Why on earth would I do such a thing? For me, I think it came from watching my mother behave in this manner and from her telling me I was naughty all the time. So personally, over time, this was embedded behavior/thoughts, and I knew no other life or behaviors. When you have been doing it for 4 decades (personally), it certainly is hard to break. And, as I made those efforts to change, I would become exhausted from all the hard work and would often regress back to my previous behaviors/patterns. I still do it occassionally, but I am starting to see some more productive thinking and behaviors.

I think it is so important for me to SLOW my life down. I have created a living situation (over time...that was a long process as well and a whole other story) where I can rest/sleep whenever I want to, cook what I want when I want it, I shut the phone off and use it when I want it, I don't answer the door just because someone is knocking, etc. I also have two serious addictions that I had to work on. I only focused on one at a time. I have to limit myself and personal daily expectations. And, I had to stop worrying about what society thinks about how I should live. I eat dinners for breakfast. I bought a scooter (very nice 350lb one!) and learned how to ride it instead of taking walks with other people (like other women my age) etc. This is my life and I chose to do things that work for me...not others.
Key: slowing down and figuring out what I like and want and want to do. (made many lists over the years!!)