I have realized, I do not.
When feeling bad, most of us want to feel better. Because... feeling bad feels BAD.
Things that is confused with self sabotage:
Inability to see things through. This can be because many reasons, like not enough tools, too much fatigue, too much fear, too little support, a brain that cant think clearly because of illness, inability to delay gratification....
Fears can be: Change is scary, what if I start feeling even worse? Will dealing with one issue reveal a bigger, scarier one? What if I lose my identity? What can I replace the badness with? Can I fathom a world with less mental pain or do I just paint it as a big scary nothing? Will I have the power to keep going, or will I feel like now just be deprived the expression of how I feel (Hard to fathom what good feels like)?
Inability/obstacles can be: Trying to do too big steps. Blaming self for shortcomings instead of understand to work around weaknesses (everyone has them!). Internalizing criticism. Illness too strong at the moment (as said, fatigue, anxiety, brain fog). Comparing to others and getting down. Slipups with bad behavior (those have a reason, they are not you wanting to stay sick for the sake of it).
Losing gained ground: Many people believe this is the ultimate proof one doesn't want to get better. Like going back to bad/harmful behavior. I think it is just a bumpy ride. Being told one doesn't want to get better will tell someone to internalize that they don't want to get better. What kind of therapy IS that? Everyone has bumps in the road, even those trying to stop very minor habits! It IS hard. Finding what caused it might be better and I bet it wasn't "I really want to feel bad".
Self punishment: Internalizing everything bad that happened to you that you could not control, making you feel that the "world" was somehow right in treating you bad and you should continue it.
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There are those people who thrives on drama. They are FEW. But they exist. They actually do not want to change because there is nothing wrong with them more than they need negative attention. If they get into a good situation, nothing to talk about. Also they drag other people in so they feel bad too. Being toxic is "fun" for them. Here there is not much to fix. I only know a very few like this, and most dramatic people are not drama thrivers, most are plain desperate and scared. The drama thrivers have antisocial traits. They pretend they want help at times.
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What also can be confused with self sabotage: Wanting to feel the depth of life. Feeling a little non depressed blue can make us feel alive. Listening to a sad song can speak to our souls. Connecting with emotion is quite human. Lets not toss that out with the bath water.
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If you feel I am all wrong here, you are fine saying so. I know I'm sticking my nose out here some, and I am not hurt by another opinion on this.