SelfHarm

Self-Harm

There are many different names for self-harm, these include "self-injury," "self-immolation," "self-mutilation," "self-cutting" and "self-inflicted violence." It is often referred to as SI (self-injury). I will stick to self-harm, as many of the other terms such as self-mutilation add to the stigma already surrounding the 'ghastly' practice of self-harm.

So What is Self-Harm?

Self-harm is the practice of deliberately damaging ones body as a way of coping with inner feelings. It is often misinterpreted as a suicidal act, however nothing could be further from the truth - most often, people harm themselves as a way of staying alive and coping with their feelings. Self-harm is however a symptom of great distress, so there is more chance of a person who is harming themselves going on to attempt or commit suicide. It is important to remember though that an episode of self harm is very different from a suicide attempt. There are totally different feelings and thoughts involved.

How do People Harm Themselves?

People use many different methods to hurt themselves, here is a list of some of them:

     Cutting or scratching the skin with knives, glass, razors, or any other sharp object.
     Burning the skin, either through the use of hot objects or chemicals.
     Picking or biting at skin or wounds.
     Pulling hair out.
     Hitting or banging head/wrist and other body parts.
     Laxative, alcohol or drug abuse.
    Taking deliberate drug overdoses frequently (No matter how small the quantity).
     Self-asphyxiation (Suffocation).

In rare cases there will only be one extreme act of self-injury, such as removal of the tongue, self- blinding or castration. These usually occur in people with severe paranoid or delusional psychosis, such as those with schizophrenia.

Although some of these methods may seem more extreme than others, and some take, say cutting for example, further than others do, it does not mean that there is any less pain there. Anyone who self harms is hurting emotionally and just because someone 'only pulls their hair out' does not mean they are in any less pain than someone who cuts or burns.

How Can I Help Someone Who Self-Harms?

Helping someone who self-harms is a very stressful thing to do and not everyone can manage it. Do not feel guilt about this, you can only give what you have got, that is very important. If you feel you can or want to help here are some suggestions -

* A person who self-harms is very distressed already, so don't ignore the person as this will not help. Try to respect them, and be the same person as they knew beforehand.
* Make it clear that you are a safe person and that they can talk to you about their problems.
* Try and help the person find other sources of support, for example and support group or therapist.
* Try to show that you are interested in helping. Ask occasional questions, to show your interest, rather than just letting him/her talk.
* Help encourage the person to recognise their urges to self-harm, what has caused it and ways to cope. Suggest distractions such as exercising, talking or watching TV.
* Acknowledge that stopping self-harm instantly could be very hard and may not be the best way to go about it. Also remember that some people simply are not ready to stop harming themselves, as it has become a survival mechanism. The best results come when a person is ready to stop within themselves, no matter how long it takes to get to that point, it is worth it, so don't lose hope.

Why Do People Deliberately Harm Themselves?

This is the aspect of self-harm which those who don't do it find almost impossible to understand. Although it doesn't seem like it, there are many reasons why a person would want or feel the need to harm themselves. Here are some reasons why self-harmers feel the need to hurt themselves:

     To escape from feelings of emptiness, depression and unreality.
     In order to ease tension.
     To feel relief - When intense feelings build up and a person feels unable to cope, causing
     pain to themselves reduces the level of emotional and psychological arousal to a bearable one.
     To express some sort of emotional pain.
     To escape feelings of numbness - some people harm themselves in order to feel something, to
     know that they are still alive.
     To continue an abusive pattern - A lot of people who self-harm were abused as children and
     sometimes self-harm is a way of punishing oneself for being 'bad'.
     To relieve anger - Many self-harmers are full of rage and it is easier to vent these feelings by
     injuring themselves rather than letting it show outwardly.
     To obtain or maintain influence over the behaviour of others.
     To exert a sense of control over one's body.
     To ground themselves from feelings of depersonalization or dissociation.
     To express or repress sexuality and feelings of alienation.

Many people who self-harm feel extreme guilt or shame over their behaviour afterwards. Generally though the feelings of relief and calmness outweigh these bad feelings, which is why it is very difficult to stop.

What Kind Of People Harm Themselves?

People from all walks of life harm themselves, people you would never even suspect. The 'typical' self-harmer is female, and between 15-30 years of age. Most people who harm themselves have been doing it since their teens and they are often intelligent people, who have had a good education.

Often there is a history of sexual and/or physical abuse in those who self-harm, but this is certainly not the case with everyone who self-harms. There are many other reasons why someone would harm themselves. For example - losing someone very close to them, not being loved, listened to and cared for enough, having too much expected of them, being seriously ill or disabled or being bullied, harassed, hated or discriminated against in some way.

Other more practical circumstances such as being homeless or unemployed, having no money, being pregnant or on your own with a baby, going into prison and being very isolated can also cause you pain and make it more difficult to cope.

There seem to be some common psychological characteristics in those who self-harm. The overall picture self-harmers seems to be people who:

* Strongly dislike/invalidate themselves. * Are hypersensitive to rejection.
* Are chronically angry, usually at themselves. * Tend to suppress their anger.
* Have high levels of aggressive feelings, which they disapprove of strongly and often suppress inward.
* Are more impulsive and more lacking in impulse control. * Tend not to plan for the future.
* Tend to act in accordance with their mood of the moment. * Suffer chronic anxiety.
* Are depressed and suicidal/self-destructive. * Tend towards irritability. * Tend to be avoidant.
* Do not see themselves as skilled at coping. * Do not have a flexible repertoire of coping skills.
* Do not think they have much control over how/whether they cope with life.

*If you have recently harmed yourself and you are unsure as to whether your wound needs medical treatment or not then please take a look at my 'Treatment of Self-Inflicted Injuries' page for important information.*

To Mental Health

How Can I Help Myself?

If you self-harm one of the most important things you can do is get professional help. You self-harm for a reason and you need to sort this reason out in order to stop hurting yourself. It is crucial that you learn new coping skills, appropriate anger release, better interpersonal and social skills and better self-esteem, as well as having a way of expressing emotion openly. Seeing a therapist can give you this. It is however not always this simple, but there are still things that you can do in the meantime.

* Use the internet, and you can find online support in groups and chatrooms. Sharing your feelings with others who understand can be a great release.
* The human mind can hold between 4 to 9 thoughts at the same time. If you can find distractions, games and things to keep you occupied, no matter how silly, you can replace the triggering thoughts with other, more productive thoughts.
* Try and set yourself small, achievable goals. Put off harming yourself when you get the urge to do it, for 15 minutes, keep putting it off for 15 minutes, and sometimes you can overcome the urge. Set yourself goals such as "I will not harm myself for the next week, or even the next day."
* Find other less harmful ways of hurting yourself. For example having a rubber band around your wrist and snapping it, whenever you feel the urge to harm yourself, still causes pain, just none of the damage. Similarly squeezing an ice cube for as long as you can in your hand has the same effect.