I'm not too sure what triggers it. It seems random but there might be some underlying pattern that neither I nor the therapists I have seen have figured out. I can be perfectly fine and then four hours later I'm in crisis and either self harming or having bad urges. It's weird how that happens. Sometimes when things are going too well that seems to be a trigger too. What is that like self-sabotage? IDK. It's tricky. I think right now the urges are related to my thoughts being unstable. What I mean by that is more paranoia, hearing things that aren't there etc. So I think the urges have popped up due to these other things going on. So maybe that's a trigger?! IDK.