This post may be a little triggering for those who self-harm, however, I have tried to write it sensitively and most certainly haven’t glorified it or written about it in a positive light, nor have I vilified or criticised it. Please take care if you choose to read it and seek support if necessary.
I’m guessing that the readers of this post will mostly fit into one of two categories, either you’re considering self-harm, or you’re wanting to know why someone would consider self-harm. Hopefully I can help both groups. Self-harm is the act of harming oneself, in any of a multitude of ways, which causes pain and either temporary or permanent injury. I’m not going to list all the ways in which this is done and I’d seriously advise against looking a list up too because it just tempts those of us considering it to think of ever more inventive ways of harming and researching this topic can make you more likely to think about self-harm and ultimately do it. If you’re seriously considering self-harm then please read the whole of this post before acting on your thoughts because this is what I, and others I know, wish I had known before I hurt myself for the first time.
It’s Addictive
The first thing you need to know which I wish I’d known before starting is that it’s addictive. Yes, you read that right, hurting yourself becomes addictive and while most of us start doing it in order to exert some control and express pain, it quickly becomes addictive and out of control and rapidly becomes part of the problem which doubles the number of issues you’re dealing with. It’s addictive because it releases adrenaline and along with adrenaline you can get a release of endorphins, just like when you do intense exercise or overcome a fearful situation, you get a high afterwards because of the hormones coursing through your system. The problem is, that these highs get shorter and shorter and you therefore have to harm yourself more often or more severely in order to get the same effect. I have a long history of cutting myself, never severely enough to need stitches or any sort of medical treatment but I went from doing it once a fortnight to 4 times a day and running out of “safe” spaces to cut myself quicker than I was getting relief from it. It rapidly stopped helping me and became a problem of its own and a huge part of this was because I became addicted to it and when I was actively harming myself I would obsessively think over how, where and when I next could. It was a really dark few years of my life and not something I wish to repeat.
People finding out
Once you start, you’re pretty much starting a timer until someone around you finds out. This is never easy. It never gets easier. I still remember so many of the incidents of people around me finding out I was cutting myself at 16 and 11 years on I try very hard to not remember them because it still causes me pain to relive those moments. Seeing the pain and hurt on other people’s faces is really tough, feeling guilt, fear, feeling like you’ve let them down is really hard and I can guarantee that you will feel that way. When you’re young it’s very difficult to cover up any injuries and people aren’t half as stupid as you might think, the excuses of a cat scratching you or falling into something will only work once or twice, they won’t work multiple times a week and people react very badly when they find out that you’ve lied to them. Many take it very personally and blame themselves. In many ways, people finding out is the best solution because then you don’t have to deal with the problem on your own anymore but this assumes that whoever finds out is understanding and sympathetic, that may well not be the case because most of the time they’ll find out by accident, when you’re caught off guard and the situation will shock you both and neither of you is likely to react well under those circumstances.
Education and Work Problems
Self-harm isn’t accepted in education or workplace settings. If you are found out to self-harm at school, college, uni or work then you could be asked to leave. You will have to disclose your history of self-harm on occupational health forms which then leads to a fun chat with someone from occupational health at each company you work for having to explain to you that it’s unacceptable to self-harm at work or school and that any injuries must be sufficiently covered up not to arouse suspicion and that if you’re found to be self-harming within the institution that your contract or course will be terminated. This isn’t fun for anybody involved, it’s not the end of the world but it’s another thing that I wasn’t aware of until after I’d started and it was too late. I’ve never self-harmed anywhere other than my own home and was rarely tempted to do so either but if your main coping strategy is self-harming and something triggers you while you’re at work or school then you’re going to need to have a very good plan in place for how you’re going to cope with that without breaking those rules and jeopardising your future.
Scars
Scars don’t fade half as much as you think. I convinced myself that the scars would go really quickly each time and that I wouldn’t be left with any permanent reminders. This isn’t the case. Some do fade really quickly and keeping your injuries clean, allowing them to heal as quickly as possible and moisturising your skin certainly helps but most scars don’t disappear quickly at all. I had chickenpox scars as a child, all of which have gone, I don’t have a mark on me from the various times I must have scraped my knees or ended up with accidental injuries that every child accrues. But self-harm does cause scars and you need to be aware that while you might be fine with that now when you’re feeling desperate and looking for anything that might offer temporary relief, you may well not be fine with it later. Personally, I’ve made peace with my scars, I know that those actions kept me alive and if they don’t fade any more than they have then I’m ok with that but some of them I do wish weren’t there. I’ve got scars on my right leg that are very obviously from self-harm and that can make me quite self-conscious in any sort of swimsuit. I also have them on my left forearm and these are faded but noticeable and people, especially inquisitive children, do sometimes ask and it’s a bit tricky to think up excuses on the spot or decide whether you’re going to tell the truth. Scars are a very permanent reminder of how bad you felt, sometimes they can help remind you of what you’ve overcome and in that way they can almost be positive, but they’re also a constant reminder of how bad things got and a reminder of that coping strategy having been an option even years after you’ve managed to stop. People aren’t always very understanding about self-injury scars and can be pretty judgemental and you need to also be aware that if you have them in very prominent places that are tricky to cover up, these may possibly cause you problems with employment and possibly other opportunities.
Excuses and lying
Unfortunately, self-harm turns the most truthful of us into liars. I’ve always prided myself on telling the truth and always being honest but I absolutely wasn’t when I was self-harming. I couldn’t be. It’s not nice having to keep secrets from people or outright lie to them and then come up with excuses for why you’re wearing long sleeves in summer or flinching when someone hugs you too tight. When you’re suffering from mental illness you can feel really lonely and isolated, self-harm just makes this worse, you feel detached from people, you don’t want them getting too close to you physically or mentally and the lying drives a wedge in ever further. When it eventually comes out that you’ve been lying it can take ages to rebuild trust because most of the people around you won’t understand that you were only lying to cover up the self-harm, they’ll think that you can’t be trusted about anything and that’s beyond infuriating and upsetting. You’ll spend countless hours trying to think up excuses, work out outfits that won’t arouse suspicion and engineer situations so that you don’t have to change clothes in front of people or stick to a uniform code. It’s endless and it just exacerbates the stress and underlying conditions that you were originally trying to cope with.
It’s often mistaken for a suicide attempt
This is a difficult section to write because there are kind of two distinct types of self-harm, there is the type that is used for relief, to express pain and to help cope and then there is the more suicidal type which is either a suicide attempt or a very serious cry for help which requires immediate intervention. Many people think that all self-harm is a cry for help and this isn’t true but equally it should never be dismissed or viewed as attention seeking. Some people do harm themselves and then get deliberately “caught” because they don’t know how else to express the pain they’re experiencing. This isn’t done for dramatic effect, it’s done as a last-ditch attempt to get help and to have their feelings noticed, validated, and hopefully treated! Be warned that if you do decide to self-harm it’s a slippery slope and it’s often mis-interpreted by those around you who don’t understand the thought processes behind it. To someone who’s never self-harmed or even considered it, this world is very alien and it’s something they’ll never fully understand, they simply can’t, but once they know you’ve been covering it up, lying and making excuses and that in their mind you “can’t be trusted” they’ll make all sorts of assumptions and jump to all sorts of conclusions and this can mean that the situation gets escalated way beyond your control, really quickly. It’s really scary suddenly being unable to control what’s happening to you and you may get forced to go to the doctors or hospital and if you’re deemed enough of a risk to yourself you may be asked to go into hospital either as a voluntary/informal patient or under Section if you refuse and your risk is deemed high. While this is often necessary, it’s not nice to be on the receiving end of. I’ve worked with countless numbers of patients who this has happened to and it’s really hard for them to come to terms with and can cause a temporary deterioration because they feel so let down or betrayed or misunderstood. Learning more positive coping strategies rather than resorting to self-harm is the absolute best option and while it may not be such a “quick fix”, it will be infinitely more useful in the long run.
So, what can you do instead? There are heaps of things you can do that might help and different things work for different people so just because one thing doesn’t help doesn’t mean that the rest won’t. Some people need to feel pain and so pinching themselves or snapping a rubber band on their wrist can help. Others need the adrenaline and therefore doing high intensity exercise is a great, healthy alternative, especially high impact activities like running or boxing where you’re physically exerting energy, stress, and any bad feelings you’re currently experiencing. Often, self-harm is used as a way to express pain that you don’t know how else to express, learning to talk about these feelings or write them down or draw them can be really beneficial. Distraction is also a great tool and especially activities that use your hands so that you’re not tempted to start hurting yourself, things like adult colouring, knitting, crochet, sewing, baking, anything that uses your hands in a repetitive way is a great thing to keep you distracted and keep your hands busy and safe. Steer clear of activities that involve using risky objects for you, the less temptation you have around you, the better. Don’t make implements easy to get hold of, if you use something specific to hurt yourself then make it inaccessible, don’t get rid of it unless you want to because sometimes just knowing you could hurt yourself is enough to make you delay doing it or even not do it at all so removing all implements is not necessarily the best option but make it difficult to access them so that you can’t do it without thinking. Wrap them up, put them in a box, put them at the back of your wardrobe or under your bed with stuff dumped on top so that you have to go to some effort to reach it and in the process be thinking about whether you actually want to do it at all. If you’re going to hurt yourself, do it safely, make sure what you’re using is clean and that you keep any injuries clean too and if you think you’ve gone too far then please seek medical help. We’ve all heard horror stories of people seeking medical help and being treated very badly but times are changing and most medical staff are better trained now to deal with self-injury and help rather than judge. Please seek help if you need it. Some of the best ways of coping are simply to try to delay hurting yourself. Saying you’re never doing it again is really difficult and most of us who’ve managed to stop haven’t actually made that choice. While I’ve not harmed myself in at least 3 years, I haven’t written off the possibility of doing so again in the future and actually, by knowing it’s an option, it makes it much less likely that I’ll actually act on it. In many ways it’s like dieting, if I told you that you could never eat a cake again then all you’d think about or crave is cake, whereas if I told you that you could have cake whenever you liked and there was always a cupcake waiting in your freezer to be defrosted then you might find it much easier to have it in an hour, or three, or tomorrow, or next week, knowing it’s an option makes it much easier for most people to not have to act on it right away.
Finally, if you want to talk about how you’re feeling but don’t feel able to do this with anyone you know then please do contact a helpline or charity, there are heaps of them out there and they deal with issues like this all day, every day and have lots of training to be able to listen and help. It’s amazing the difference that can be made just by knowing that a stranger has volunteered to spend their time talking to people like you in the hopes that it might brighten your day just a little, it’s at least worth giving a try. This doesn’t just have to be done by phone, many charities now offer a huge range of talking services including face-to-face talking, phonecalls, texting, email, live online chat and more. If none of this has manged to put you off self-harming then fair enough, it wasn’t specifically aimed at doing that, I just wanted to write the post that I wish I’d have been able to read before starting, I’m not sure that knowing all of this would have stopped me but I’m sure I’d have started later and I’d have been better prepared and less scared about what came next so I hope that this has helped in that way.
If you know someone who you suspect or know is self-harming then try not to panic and please talk to them. Find out their motivations and find out how serious they are, accidents can happen when self-harming and those in deep despair don’t always make the greatest choices about hurting themselves in safer ways, try to find out the extent of the problem and advise them if you can. If you’re worried then seek professional help but try to be as honest as possible with the person because going behind their back will only cause more problems. The absolute best thing you can do is talk about it so that the person is no longer struggling alone. Show them you care and don’t berate or criticise their self-harm; they’re not doing it to you, they’re not ‘acting up’ and they’re very unlikely to be doing it for attention. Self-harm is almost always an expression of feelings that are overwhelming, unbearable, and intense and we need help to discover healthy and safe ways of expressing and dealing with this pain, not judgement for the way we’re currently handling it which is the only way we know how. You can make such a difference just by talking, listening, and showing that you care.
In The Midst Of Madness 