Sympathy is a knife
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The speaker feels threatened and insecure around another woman, even though she is unsure whether the threat is real. She suspects people may be laughing at her, while someone close to her says she is being paranoid. This disagreement leaves her ashamed of her jealousy but also wanting comfort. As the song continues, her feelings become more intense and harder to control.
The phrase โsympathy is just a knifeโ suggests that comfort does not soothe her; instead, it seems to sharpen her pain. She may feel that other peopleโs kindness is false, or that accepting sympathy makes her feel weak and exposed. Saying she โcouldnโt even be herโ expresses a painful comparison: she sees the other woman as someone she cannot become, and feels she belongs on the opposite side.
The lyrics present the speakerโs thoughts as a struggle between suspicion and self-doubt. She recognizes that she may be โspiralingโ or paranoid, but this awareness does not make the feelings disappear. Her wish that the couple would break up reveals an unkind, jealous impulse that she admits rather than hides. The violent lines convey extreme distress; they may be literal thoughts or dramatic language for feeling overwhelmed, and the lyrics do not settle that ambiguity.